14. What steps he is taking to tackle health tourism and ensure a fair system of contribution to the costs of the NHS. (165211)

On 3 July, my Department and the Home Office launched co-ordinated consultations on a range of proposals on a new charging system for visitors and migrants in which everyone makes a fair contribution to health care. Those include making temporary migrants from outside the European economic area contribute to the cost of their health care, and introducing easier and more practical ways for the NHS to identify and charge those not entitled to free health care.

I very much welcome the statement by my right hon. Friend and support the new visa fee proposal for non-EU foreign nationals who come here and receive NHS treatment. May we also have an assurance that the treatment of EU nationals will be properly audited in the NHS, so that those costs can be recovered through the European health insurance card scheme?

My hon. Friend is right to point to the fact that we estimate that we collect less than half the money for which we invoice for “overseas operations” and we identify fewer than half the people who should be invoiced in the first place—that applies in respect of those from inside the EU as well as from outside the EU. We can get refunded for the care we give EU nationals if we are sensible about collecting this money and we put those systems in place. Given the pressures in the NHS, we are absolutely determined to make sure we do so.

I thank the Secretary of State for his statement. Last year health tourism cost the NHS £24 million—that was in one year alone. He has outlined the new system coming in, but will he say how it will be administered? Many of us feel that it might not be as easy to do in practice as it is on paper.

The hon. Gentleman is absolutely right. If this is to work, we need a slick system that is easy for hospitals to operate. We have done this in another area, as the NHS successfully and seamlessly invoices insurance companies for the costs of coping with road traffic accidents. At the moment, however, if hospitals declare that someone is chargeable for their NHS care, they do not get paid by the NHS for that care, meaning that they have to collect the money themselves from overseas, so the incentives for hospitals are wrong and we need to sort them out.

20. I welcome the Government’s initiatives to tackle health tourism, but what is being done to help hospitals on the front line, such as Bournemouth hospital, better to identify chargeable visitors? (165218)

We are considering whether something can be done with the NHS number. At the moment, people can visit any GP and, completely legally—whether or not they are entitled to NHS care—get an NHS number. That number can then become a passport that can be used throughout the system, so we are examining whether there is a way of giving people either a temporary NHS number, or a different NHS number, that can be tracked through the system so that if they undergo complex medical care that is chargeable, we are able to trace that and collect the money from them.

If we are to make this work, do not we need a clearer idea about the real cost? Is it the £200 million that the Secretary of State has been quoted as using, the £10 million suggested by the Prime Minister, or the £33 million that the Under-Secretary of State for Health, the hon. Member for Broxtowe (Anna Soubry), has cited in a parliamentary written answer?

The truth is that we do not know the cost, which is why we are carrying out an independent audit this summer. The £12 million figure is the amount written off by the NHS each year because of unpaid overseas invoices, but many people think that the costs are much greater. We want an answer for the hon. Gentleman and everyone in the House, so we are carrying out that independent audit and we will publish the results later in the autumn.