Concerns over foreign transplants

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A London hospital has been referred to health watchdogs after concerns that too many liver transplants are being given to foreign patients.

The Healthcare Commission was alerted after 72 non-British EU nationals were given new livers in four years at King's College Hospital.

Of those, 37 were given to Greek and Cypriot nationals in what were classed as "private" operations.

But the hospital said non-UK patients could not "buy" a transplant.

It said the figures were an anomaly caused because the Greek and Cypriot governments operate a different funding arrangement with the Department of Health than other states.

Most countries pay the Government a block fee to cover their citizens' treatment in the UK. However, Greece and Cyprus pay hospitals directly on a patient-by-patient basis and so the procedures are classed as "private".

NHS guidance

The proportion of Greeks and Cypriots was so high because unlike most European countries, they do not operate their own transplant system, the hospital added.

In a statement, King's College Hospital, Europe's leading liver transplant centre, said it carried out 210 liver transplants in the year to this April, including 24 on patients from other EU countries. Eighteen of them were from Greece and Cyprus.

Decisions over... allocating an available liver rests with the individual transplant centre Department of Health spokesman

It said: "King's carries out liver transplant surgery on non-UK EU patients, as it is required to do so in accordance with NHS guidance and European Law.

"In accordance with current NHS guidelines for transplantation and European law, all EU patients awaiting liver transplant surgery at King's are assessed and prioritised according to clinical need only.

"There is absolutely no truth in the assertion that patients from outside the UK can 'buy' a transplant at King's."

European law dictates that EU citizens are equally entitled to NHS services, including transplants, as Britons. However, some hospitals choose to prioritise UK patients.

Board members of NHS Blood and Transplant (NHSBT) made the decision to refer the situation to watchdogs.

In a statement it said: "The Board was presented with information about the unusually high number of non-UK EU residents who received liver transplants at King's College Hospital NHS Foundation Trust between 2003-2007.

'Equal access'

"While there is no evidence that the organ allocation system is being breached, NHSBT has an overarching statutory responsibility to ensure the integrity of organ donation."

There are currently 285 patients awaiting a new liver in the UK. Organs are allocated depending on their size, blood group and severity of their condition. However, emergency cases always receive priority.

A Department of Health spokesperson said: "The transplantation of donated livers into non UK EU residents who qualify for NHS treatment is lawful. This is guided by European law which effectively regards such patients as having equal access to the NHS.

"Decisions over accepting a patient onto the transplant waiting list and allocating an available liver rests with the individual transplant centre."