Places on GP lists are being sold on the black market to NHS ‘health tourists’ for up to £800 a time, an undercover investigation has found.
Surgery practice managers and ‘fixers’ have been secretly filmed selling access to doctors, enabling foreign nationals who have no legal right to free hospital treatment to be seen without paying.
The practice manager told the journalist, who was wearing a hidden camera: “Just with the scan you’ve made your money.”
Programme makers also found ‘fixers’ working outside the NHS who were selling places on GP lists across the country.
One fixer was filmed selling an undercover reporter, posing as a Nigerian health tourist, a registration at a GPs’ surgery for £300. The reporter went on to receive free blood tests in hospital.
Everybody in Britain - regardless of immigration or residency status - is entitled to free care in accident and emergency, as well as treatment for sexually transmitted infections.
However, hospitals are meant to check if patients receiving further treatment are entitled to it for free, or should pay.
The rules are complex but the single most important criterion is whether a foreign national has lived here for at least a year.
However, Panorama found a third of England’s hospitals were failing to ask patients that question.
It means patients who have fraudulently obtained places on GP lists are routinely able to access costly hospital services at the taxpayers’ expense.
Jim Gee, the former head of NHS Protect, tasked with combating fraud within the health service, told the programme that the system in hospitals was “unworkable”.
Anna Soubry, the Health Minister, said she was “surprised” that only a third of hospitals were failing to check if patients were entitled to free NHS care.
“If I’m being honest I’m surprised it’s not more than that,” she said.
She also told Panorama: “There are many people… myself amongst them, who would be offended frankly if every time I went to hospital I was effectively being asked to prove that I was entitled to free NHS treatment. I don’t think anybody wants that system.”
Some GPs are also concerned at new guidance from the Primary Care Commission, a quango, on GP patient registration.
These state: “Nationality is not relevant in giving people entitlement to register as NHS patients for primary care services.”
They also emphasise that anyone in the UK can register at a GP practice, no matter how long they have been in the country.
Neither should registration be withheld “because a patient does not have the necessary proof of residence or personal identification”.
Dr Chris Clayton-Payne, a GP from Saffron Walden, said: “It seems very strange when we’re shaving off the pennies here and there, to actually open the door wide open to the citizens of the world to walk in and have free medical care at primary care level in the UK.”
Given the lax nature of hospital checks on eligibility, the guidelines could also make it easier for foreign nationals who should be paying, to get expensive specialist NHS care for free.
Last year a Department of Health report conceded that the NHS was at risk of “health tourism” because it was a high-quality service that was “free at the point of access”.
Some £40 million is recovered from visitors every year but at least £10 million in charges is written off. The true scale of the problem is not known.
Matthew Sinclair, chief executive of the TaxPayers’ Alliance, said “insufficient checks” meant the system was being abused.
He said: “Of course no one should be denied emergency treatment, but the NHS is already stretched and we cannot afford to run an international health service.
“It is now clear that insufficient checks are in place to stop the system from being abused by those from overseas and not eligible for free health care in the UK.
“The authorities have a responsibility to the British taxpayer to ensure that foreign patients are not taking advantage and getting treatments worth thousands of pounds to which they are not entitled.”
A Department of Health spokesman said the recent guidance on GP patient registration, published in July, merely “clarifies long-standing recommendations” that everybody was entitled to free primary health care.
On the selling of GP list places, she said: "There are very serious allegations and it is right they are investigated fully."