£1 million to help British NHS reclaim debts from overseas visitors

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Health and Social Care Secretary Matt Hancock has announced plans to expand the NHS’s existing team of cost-recovery experts, backed by £1 million.

Since 2018, a dedicated team of cost-recovery experts has been established to work with trusts. The expansion of this team will help the NHS to reclaim outstanding debts from overseas visitors who are required to pay for their care. These experts will work with existing cost-recovery managers in NHS trusts to:

  • provide additional time and human resource to help identify patients who should be charged, easing the administrative burden and speeding up the process
  • ensure the rules and exemptions are universally understood and consistently implemented in hospitals across the country, including making clear that urgent treatment should never be withheld
  • help improve the reporting of income and debt collection, ensuring chargeable tourists pay debts in full


The team will also help the NHS understand and implement the charging rules and processes for EEA visitors and migrants as part of preparations for leaving the EU. After Brexit, EEA nationals living lawfully in the UK can continue to use the NHS as they do now.

The NHS has already made progress in ensuring patients not ordinarily resident in the UK are identified and charged appropriately for access to NHS services, recovering more than £1.3 billion since 2015. However, there is still a significant amount of unpaid debt.

Only people who are ordinarily resident in the UK are eligible for free care, with non-EEA visitors required to pay a health surcharge when they apply for a visa to live temporarily in the UK.

The government remains committed to protecting the most vulnerable people in our society, including refugees, asylum seekers, victims of modern slavery and children cared for by local authorities.

NHS rules state that trusts must never withhold treatment from patients who require urgent healthcare while they are in the UK, even if they cannot afford to pay. This means any care clinicians say should not wait until a visitor’s departure from the UK, and recovery of charges can take place after the care has been provided. Where treatment is non-urgent and it can wait until they leave the UK, it must not be provided unless fully paid for in advance.

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