Millions lost in NHS private fees

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NHS trusts are writing off millions of pounds in unpaid debts from private and overseas patients, a report suggests.

An investigation into the finances of four trusts found by the end of the last financial year, they had written off more than £4.8m of private bills.

Private work by trusts is increasing, and the money is designed to be ploughed back into patient services.

But the Health Services Journal said its research suggested private practice may not ultimately be that profitable.

The magazine looked at four trusts: North Bristol, Great Ormond Street Hospital for Children, Moorfields foundation and Chelsea and Westminster Hospital foundation.

Of these, North Bristol had the largest proportion of outstanding debt.

As of March 2007, nearly 60% of its total private income of £1.8m was owing, and private debt write-offs that year were £855,000, a figure which did not include those made insurance companies.

A spokesperson from the trust said 90% of its debt was from overseas patients to whom it had provided emergency treatment, and less than 10% to private customers who had booked their treatment in advance.

Public v private

Great Ormond Street Hospital trust, meanwhile, had written off £3m as bad debt by the end of last year, but said this did not mean its private work was unprofitable.

It is disgraceful that hospitals and taxpayers are propping up the private health sector at the expense of NHS patients Karen JenningsUnison

"Historically the issue has been slowness in recovering sums due, rather than failure to pay. Most of this income comes from sovereign governments or large insurers who wish to continue to use us," a spokesman said.

The Kuwait health office, Greek insurer IKA Elefsina and Bupa were all among those with debts outstanding.

Chelsea and Westminster, which is about to expand its private maternity service, last year wrote off £1m - or 17% of its would-be profits - as bad debt, but stressed this had actually been accumulating over several years.

A spokesman denied there was any risk that NHS funds were subsidising private treatments.

Unison's head of health, Karen Jennings, said taxpayers were doing just that.

"These bad debts are another example of the growing instability created in the NHS by forging links with the private sector," she said.

"We will be raising this issue with ministers at the earliest opportunity."

But Sue Slipman, the director of the Foundation Trust Network, said debt write-off was likely to occur all organisations - whether commercial or public, and that generalisations could in any event not be drawn from such a small sample.

She added that members had not reported this as a significant issue, and that when it has been raised, the majority report their bad debt comes from overseas patients arriving at A&E needing treatment.