UKH

I wouldn't normally post something like this, but this is pretty heartbreaking stuff:

Dying man given bill for tens of thousands of pounds for NHS treatment https://www.theguardian.com/politics/2019/jan/22/dying-man-bill-thousands-p...

"Nasar Ullah Khan is lying in a hospital bed in Birmingham. He is 38 and has weeks, if not days, left to live. Khan, a Pakistani national who came to the UK nine years ago and overstayed his visa, was refused a lifesaving heart transplant just before Christmas because of his ineligibility for free healthcare. Now he’s been told that he will be charged before he can receive end-of-life care. He was handed his first invoice for £16,000 on New Year’s Eve, days after he was told he would probably die within a month. The payment for hospital treatment already received is due at the end of January."

There you go. We're the country that charges dying people for palliative care. Because dying alone in a hospital ward far away from their family isn't an emergency, and because they're "foreign".

Multiple people participate in decisions like this: from politicians like Theresa May to the person who typed-up the bill to the person who gave it to him. I wonder if any of them refused, and how many? I think I understand a bit more about "the banality of evil" now.

Having to leave dependents behind is going to be heart wrenching at the best of times, leaving them with over £30k of debts and an uncertain future must be horrific. Poor guy.

A very emotive subject, certainly.

However, how many heart transplants, plus a lifetime of aftercare and drugs, should the NHS provide for people who aren't eligible for them?

The NHS costs around £2 billion a week to fund a service that's now failing in many areas. How much further do we expand treatment to cover foreign nationals?

The NHS has to make funding decisions every day that means people will die and others have a much more limited life, or don't get mental health services, or get effective palliative or geriatric care.

To brand everyone involved as uncaring monsters because we can't treat everyone in the world isn't helpful.

I don't think anyone is suggesting that the NHS should "treat everyone in the world" - I'm certainly not. And our inability to do that doesn't relieve us of all responsibility. To assert otherwise is just saying "I can't do everything so I don't have to do anything." A cop-out.

What I was commenting on was the abject moral failure involved in this way that this person, just another human being like us, is being treated at a time when he is undoubtedly vulnerable, and probably very frightened and lonely. And I was also condemning the apparent willingness of some of my fellow citizens to participate in a system that does this to people.

He's been here for 9 years, how long ago did his visa expire? He says he has not seen his wife or kids in 9 years but is now desperate to see them, seems like a long time to stay away?

There seem to be bits missing from the story that could be filled in, perhaps there is more?

This is about NHS policy, not the hostile environment policy which was a Home Office thing. I'd be surprised if Theresa May has had any input into this decision whatsoever.

I think you'd find most if not almost all other countries would also charge people for medical care who weren't entitled to it and most would enforce it more vigorously than we do.

Any money spent on the healthcare of people not entitled to it is money that can't be spent on people who are, unless you'd like to divert resources away from other things and put in a special pot for "people who aren't entitled to it".

Perhaps you could set up a just giving page or even a charity especially for that purpose and then all the bleeding hearts could pay voluntary taxation to demonstrate how worthy they are.

On a human level I'm sorry for the man in question, but I'm equally sorry for the millions around the world in similar circumstances but I see no more reason why we should pay for him just because he's here illegally than we should for all the others who aren't.

I wouldn't expect major surgery or other expensive healthcare at the expense of taxpayers in a foreign country whether I was there legally or illegally.

To quote one of the GPs in the article: “Seven years ago, I’d do a referral and they [migrant patients] would get seen and sorted out,” says Beale’s colleague, Dr Natalie Miller. “Somebody might be billed in retrospect, but if they couldn’t pay nothing would happen”.

That sounds, as far as the GP is concerned, anyone from anywhere in the world could turn up at her surgery and expect free NHS care, no questions asked.

That's not necessarily a bad thing and it obviously depends on numbers and cost of treatment as to the impact it has on services. There'll be a level where it's morally right, and cost effective, not to even bother attempting to verify eligibility. At the other end of the spectrum you have a level of abuse that impacts the ability of the NHS to deliver even basic levels of care to those who contribute to the system. Given the state of care in some areas of the NHS it looks like every penny counts at present. Yes there's an argument, which I agree with, that we should be paying a lot more to fund the NHS. However with the cost of treatment for complex cases if there was no control on spending the NHS could burn through whatever we put into it.

I actually agree that presenting a dying man with a huge bill is pretty callous. However the NHS sends frail pensioners home to die when hospice beds aren't available and with bugger all care in place, so he's not in a unique situation. Although he does have advocacy services and media interest, something most patients, particularly those in geriatric care, don't have.

It's a very complex situation that can't be simply broken down into good guys and bad guys. TBH using the phrase 'banality of evil', which seems to imply anyone working for the NHS who doesn't walk out over this is no better than a Concentration Camp guard, doesn't do you any favours.