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HomeNewsNHS pays out MILLIONS to treat patients abroad, figures reveal

NHS pays out MILLIONS to treat patients abroad, figures reveal

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Naga Munchetty grills Therese Coffey on NHS funding

Knee and hip replacements, weight loss surgery, infertility treatment, dental extractions and kidney stone removal are among those carried out in clinics across Europe. NHS data shows 5,330 individuals have gone to Poland, France, Lithuania, Germany, Spain, Italy, Bulgaria, Belgium, Latvia and Slovakia for procedures since 2020. In some cases, they have been sent to America for cancer therapy. These arrangements have cost taxpayers £4.5million in less than three years.

John O’Connell, chief executive of the TaxPayers’ Alliance said: “Taxpayers will rightly be asking why on earth these treatments couldn’t be done at home.

“With NHS resources already stretched, health bosses will be expected to provide justification for sending patients overseas.

“The health service must ensure it’s open and transparent with taxpayers on how it funds treatments.”

Official data, obtained by this newspaper, will raise fresh questions about the ability of the NHS to adequately treat patients as it enters the most difficult winter of its 74-year history.

The rush to get seen abroad comes as the waiting list in England now tops a record seven million people.

The figure – those waiting to start planned NHS treatment in August – was up from 6.8 million in July, the highest number since records began in August 2007. One in 18 had been waiting more than a year.

The Daily Express used Freedom of information laws to ask health bosses how many patients had travelled abroad for treatment on the NHS, where, for what, and how much it cost.

NHS England [NHSE] confirmed 3,400 patients left the UK in 2020, and 1,130 in 2001. The figure for this year, correct as of October 10, was 800.

This newspaper made clear it wanted information on arrangements where patients had left the UK for treatment, as opposed to receiving it while overseas, on holiday, for example.

Health Secretary Steve Barclay at the Ralph Lauren Centre for Breast Cancer Research

Health Secretary Steve Barclay at the Ralph Lauren Centre for Breast Cancer Research (Image: Getty)

NHS England – whose boss is £255,000-a-year chief executive Amanda Pritchard – is responsible for commissioning primary care services like GP and dental surgeries, as well as some specialised secondary care services.

Data shows some of the most common operations for which taxpayers are believed to have picked up the tab were knee, hip and osteoarthritis procedures; gynaecology including for endometriosis, fibroids and polyps; ear, nose and throat complaints, including tonsillitis and infections, and neurosurgery, including back and spine surgery.

Other ops included treatment for infections, UTIs, cystitis, cataract correction, varicose veins, deep vein thrombosis and haemorrhoids.

Some £1.8 million was spent sending UK patients abroad in 2020, a further £2.4 million in 2021 and £220,000 so far this year, bringing the total to almost £4.5 million, data showed.

Health chiefs set up the overseas commissioning scheme in 2002 in an attempt to help struggling NHS trusts reduce long waiting lists, allowing hospitals to send patients abroad for surgery.

The costs of sending patients abroad in this instance relate to the EU Directive where healthcare in Europe – but not Switzerland – is paid for by the NHS.

When asked it was unable to explain why so many had left the UK to receive treatment abroad, or what was reimbursable under the arrangements, like flights, hotels and subsistence.

It was also unable to say whether the numbers were connected to record waiting lists for planned treatment or explain the risks of having surgery abroad.

Meanwhile, separate figures reveal 44 patients were sent for pioneering proton beam therapy – 37 to Germany and seven to America. They were sent by the NHS England Specialised Commissioning team which approves treatment on behalf of devolved nations.

The state-of-the-art cancer treatment delivers a dose of high-energy protons precisely targeted to the tumour, significantly reducing damage to surrounding healthy tissue and organs compared to traditional methods.

The scandal comes as world-respected oncologist Professor Karol Sikora, 74, the former director of the World Health Organization’s Cancer Programme, fights to reopen his suite of centres across Britain which have been shut for more than six months “gathering dust”, despite record waits lists for life-saving treatment as the killer fallout from Covid continues.

Last year he offered the NHS a not-for-profit deal that would have seen around 30,000 of the most seriously sick public patients treated privately and within weeks, but it was snubbed.

He said: “For whatever reason, the NHS has been reluctant to fully embrace it and access in the UK is pitiful compared to countries of similar wealth.

“In my professional view, this is a significant error which will leave British cancer services even further behind. To send patients overseas shows the powers that be understand the benefits, so why not support capable facilities here in the UK?”

The figures are separate to those treated using the UK Global Health Insurance Card, which replaced the European Health Insurance Card, and enables individuals to access medically necessary state-provided healthcare when visiting an EU country or Switzerland. In most cases, this only covers emergencies where treatment cannot wait until a patient returns to the UK.

NHS Confederation and NHS Providers declined to comment.

NHSE claimed the FOI data did not discern between being sent abroad and a patient happening to be abroad.

A spokesman added: “This represents a tiny fraction of the elective work the NHS carries out for patients in England and these figures will likely include patients who happened to be abroad while treated, rather than those who were sent for planned treatment.”

Last year around 5,000 UK health tourists travelled to Latvia for treatment

Last year around 5,000 UK health tourists travelled to Latvia for treatment (Image: Getty)

5,000 Brits travelled to Latvia as treatment in UK would ‘take years’

Lengthy NHS waiting lists prompted Stacie Mai Flanigan to pack her bags and fly to Latvia for weight loss surgery.

Repeated failed attempts to shed pounds through diet and exercise saw her contact a GP about state-funded bariatric surgery, but she was told it could take years.

Stacie, of Barry, Wales, signed up with Weight Loss Riga and paid £6,000 for travel, a hotel and gastric bypass surgery. She was one of 100 Welsh patients who have visited them for surgery in the past two years.

Stacie said: “I tried nearly everything that’s out there and every time I asked for help, people just said eat less and move more and lose weight. I had enough of doctors going ‘it’s her own fault she’s got this, send her home’.”

Last year around 5,000 UK health tourists travelled to the Baltic state for treatment because waits for operations here can be more than two years.

Stacie went under the knife last month and during the two-hour operation, medics created a smaller stomach which was attached to her bowel. She has since lost two stones.

She said: “The worst-case scenario was that I’d come home in a coffin. But I feel that could happen anyway, being overweight. I’m either going to die sooner, or I’m going to live a very miserable life.”

Bariatric surgery is available as a last resort and is available on the NHS to those aged over 18 and who have a body mass index of 40 or more.

Celebrities who have had the procedure include Fern Britton, Sharon Osborne and Mariah Carey.

The crisis engulfing the NHS comes as it prepares to face a brutal winter with record numbers waiting for treatment and staff under intense pressure.

And next month, in the run-up to Christmas, tens of thousands of nurses are set to strike over pay and conditions.

On Thursday the family of a pensioner left sitting on a chair in a hospital corridor for 11 hours criticised the “appalling” lack of care which they claimed led to his death.

Grandfather-of-four Bryan Fulstow, 83, died at Hull Royal Infirmary on November 15 after being taken to A&E six days earlier with suspected sepsis.

He was moved to a frailty assessment ward, then onto a chair while waiting for a bed. His death has left Barbara, his wife of 59 years, “heartbroken”.

His son Steve said: “The whole caring for people aspect of the NHS seems to have left. We are just numbers to them. I can see how upset the nurses are.”

Hull University Teaching Hospitals NHS Trust said: “Although we are unable to comment on individual cases, we would like to express our deepest sympathy to the family of Mr Fulstow.”

The costs

The costs uncovered by the Daily Express relate to treatment abroad, as opposed to being treated while abroad.

Reciprocal arrangements mean that UK nationals abroad are entitled to the same medical treatment as a local at state-run hospitals and GPs in any European Union country and Switzerland.

It means free treatment if the country in question offers it, or a charge if they do not.

Post-Brexit arrangements mean the free European Health Insurance Card (EHIC) for free or discounted medical care in all EU countries and Switzerland is being phased out.

Previously all medical arrangements for UK nationals were covered by the EHIC – which is valid for five years from issue.

After our official exit from the European Union in January 2020, the cards are being replaced with the UK Global Health Insurance Card and can be used to access medically necessary state-provided healthcare when visiting an EU country or Switzerland. In most cases, this only covers emergencies where treatment cannot wait until a patient returns to the UK.

EU, Swiss, Norwegian, Icelandic or Liechtenstein nationals living in the UK before January 1, 2021, are still able to apply for a new EHIC which remains valid in the EU, as well as Switzerland, Norway, Iceland and Liechtenstein. Those who moved to the UK from that date do not qualify.

Neither card qualifies the holder for planned medical treatment, only that which cannot wait before a national returns to Britain, usually emergencies.

”Strikes won’t affect operations”

Patients will not have operations cancelled at the last minute due to nurses’ strikes, NHS England’s chief has said, writes Hanna Geissler, Daily Express Health Editor.

Amanda Pritchard said some care would have to be delayed due to walk-outs and conversations were ongoing between unions and trusts about what services will be affected.

She told MPs on the Public Accounts Committee decisions would be made on a patient-by-patient basis. But asked whether some may be left to find out “on the day”, Ms Pritchard replied: “No, things will be planned in advance.”

Meanwhile, Steve Barclay said the Department of Health had not formally requested military support to assist the NHS during walkouts. The Health Secretary said all options were being considered and insisted his door remained open to talks with the Royal College of Nursing.

Speaking during a visit to the Royal Marsden Hospital in London, he said:

“They have raised a range of issues, not just pay, but also about working conditions, patient safety. And so I’m very happy to continue that dialogue with the RCN.

Operations won't be cancelled due to the strike

Operations won’t be cancelled due to the strike (Image: Getty)

“But alongside that, it’s right that, with NHS England colleagues, with hospital leaders, that we look at our contingency plans and ensure we’re as best prepared as we can be, recognising that there will be impacts on patients if the strikes go ahead.”

Mr Barclay also suggested during a speech at The Spectator Health Summit that the NHS should take more risks to embrace new technology.

He gave the example of using machine learning algorithms to interpret scans as a new innovation that could speed up treatment and save money.

He said: “I believe the NHS scores the risk of innovation too high when compared to the risk of the status quo and I think that needs to be recalibrated.

“This is because innovation tends to be judged in isolation in a silo. Take for example the risks around introducing machine learning on its own – it may carry some risk but this should be judged against the basis of the status quo where there may be long delays due to staff shortages.

“And so the speed of treatments and the ability to better target valuable resources needs to be weighed as part of the risk assessment of that innovation.”

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Comment by Karol Sikora – Former Director of the World Health Organisation’s Cancer Programme

Instead of spending vast amounts on sending patients abroad, there should be a concerted effort to get facilities running seven days a week – even 24 hours a day if necessary.

Why is money being sent overseas when there must be the possibility to treat these people near their homes? A can-do attitude is required, not relentless defeatism.

That would provide better value for money in the short-term, twinned with a long-term strategy to deliver a bigger trained workforce, improved facilities and a better health service for all.

Proton Beam Therapy is a state-of-the-art cancer treatment technology which delivers a dose of high-energy protons precisely targeted to the tumour – this significantly reduces damage to surrounding healthy tissue and organs in comparison to more traditional methods.

For whatever reason, the NHS has been reluctant to fully embrace it and access in the UK is pitiful compared to countries of similar wealth.

In my professional view, this is a significant error which will leave British cancer services even further behind. To send patients overseas shows that the powers that be understand the benefits, so why not support capable facilities here in the UK?

The Rutherford network had three proton operational centres in Newport, Northumberland and Reading – my question is, why were vulnerable cancer patients sent for treatment as far away as the US when there was the possibility to treat them in their home country? Especially during a global pandemic, with the potential of catching the virus whilst travelling coupled with the stress of moving away for several weeks at a time.

That makes no sense to me whatsoever, particularly considering we offered a not-for-profit deal in 2022 to use our services which was rejected.

Tragically, the Rutherford centres are now sat empty, gathering dust following financial difficulties – these fantastic life-saving machines are being wasted. I’m desperate to get them reopened and we’ve worked hard to raise sufficient funds which are now in place.

The problem? The decision maker, a fund manager named Equitix, refuses to act. I’m confident that if we were given the green light from them, the centres could be back open and treating patients within a matter of weeks.

Recent figures show cancer waiting times are at catastrophically poor levels, sadly this is now translating into cancer deaths which are considerably above what would normally be expected. Hundreds and hundreds of people are unnecessarily dying of cancer and there is a world-class network of cancer centres lying virtually abandoned.

Quite frankly it’s scandalous. Equitix refuses to properly engage and I find that a great shame. Getting these centres open should be an urgent priority – let’s make it happen.



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