The UK recovered only £50 million from European countries in 2014/15 put paid out £675
In a damning report they said not enough was being done to recover hundreds of millions of pounds – £289million billed in 2015-16 – which is spent each year by the cash-strapped NHS treating foreign visitors.
Claims about foreigners specifically flying into the UK for NHS maternity and serious illness treatment, then leaving without paying, have seen them branded "health tourists".
Patients' entitlement to free care depends on whether they ordinarily live here and the type of treatment.
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Some care including GP appointments and emergency care are free to all but other kinds should be billed.
A report from the Common's Public Accounts Committee, which follows criticism last year from the National Audit Office, warned: "If the NHS does not recover the cost of treating patients who are not entitled to free care, then there is less money available to treat other people and even more pressure on NHS finances."
The Department of Health responded that it would announce further steps "very shortly" to reach its target of recovering up to £500million a year by 2017-18, which the committee said it was "still a long way" from meeting.
The MPs warned the NHS was both charging and collecting too little.
This is a problem for the health service as a whole
Meg Hillier, Labour and Co-operative MP and chairwoman of PAC
Committee chairman Meg Hillier underlined: "The Government's failure to get a grip on recovering the costs of treating overseas visitors is depriving the NHS of vital funds.
"Our committee has reported extensively on the financial pressures facing the health service and it is simply unacceptable that so much money owed should continue to go uncollected.
"This is a problem for the health service as a whole and work to put it right must be driven by central government.
"We are concerned that financial progress to date does not reflect meaningful progress with implementing the rules and the Department for Health and NHS have much to do if they are to meet their target for cost recovery.
"The public rightly expects the Government to enforce the rules and more can and should be done to recover money where it is due."
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The report said the NHS was not identifying all patients who should be charged and trusts collect only about half of what they bill patients for – even though increasing the amount could help cut trusts' deficits which hit a total £2.45billion in 2015-16.
In 2014-15 the UK got back only £50million from other European Economic Area – the EU plus Iceland, Liechtenstein and Norway – and Switzerland for treating their citizens on the NHS, but paid out £675million to those nations for treating Britons.
Some of the difference was because of the relatively much larger number of British state pensioners living in Europe but that did not explain the whole difference and a £90million shortfall persisted once OAPs were removed from the statistics.
In recent years hospitals have been given financial incentives to do more and that has seen the amount charged for treating foreign visitors is up from £97million in 2013-14 to £289milion in 2015-16.
The Government has a target to recover up to £500 million a year by 2017/18
But the MPs said the increase was mostly due to different charging rules rather than trusts getting better at billing.
GPs and other parts of the NHS should do more to identify patients who should be charged – but other ways should be found than requiring all to show passports or other ID which the MPs said could penalise those who qualified for free care but did not have the documents.
Meg Hillier said the problem is central to the health service and must be driven by governmet
The committee stated: "The systems for cost recovery appear chaotic.
"The Department told us it was planning further changes relating to policy and regulation, good practice and IT, but we are not convinced that enough is being done to identify and charge overseas patients."
A Department of Health spokesman said the Government had put measures in place to recoup costs and some hospitals were doing "great work. However, there is more to be done".
British Medical Association chairman Dr Mark Porter said recovering costs was important but warned: "Any charging systems should not prevent sick and vulnerable patients receiving necessary care, otherwise there may be serious consequences for their health and that of the public in general."
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