This article was updated on 1 August. The Department of Health published its data following our internal review.
"Chaotic and often out of control" - that was how Health Secretary Jeremy Hunt described the current system of monitoring free NHS care for foreign nationals in March. Answering an urgent question from Frank Field MP on what steps the Government were taking to prevent an 'International Health Service', the Secretary added:
"the Government are determined to ensure that anyone not entitled to receive free NHS services should be properly identified and charged for the use of those services. Currently, we identify less than half of those who should be paying and collect payment from less than half those we identify."
For the Government to be identifying and collecting from a minority of those liable to pay for NHS care is a costly deficit. In fact, these 'undetected' cases could have a large bearing on the accuracy of various estimates that 'health tourism' costs the UK £20 million, £200 million or even "billions", as Full Fact noted recently.
Neither Mr Hunt nor the Department of Health (DH) provided any further information about the claim. So we sent a Freedom of Information (FoI) request to the DH to find out where it comes from.
But today, we were refused the information.
The DH told us the source of the figures was their own 'Internal Review of the Overseas Visitor Charging System'. However, they considered the information was exempt from disclosure under Section 35 of the Freedom of Information Act (2000):
"The Department recognises the general public interest in making this information available for the sake of greater transparency and openness. However, the Department believes that the public interest lies in protecting the policy-making process and preserving the ability of officials in the Department to engage in free and candid discussion of policy options without apprehension that suggested courses of action may be held up to scrutiny before they have been fully developed or evaluated."
For anyone who wants to take an informed interest in the debate, this isn't good enough.
If any Government Minister discloses information in Parliament that informs public debate about an issue, they should be expected to explain where it comes from. The FoI Act itself places the requirement on holders of information that:
"regard shall be had to the particular public interest in the disclosure of factual information which has been used, or is intended to be used, to provide an informed background to decision-taking."
As things stand, the Health Secretary is left free to introduce claims into the debate over NHS treatment while providing no means for anyone to check where they come from. As such we'll be requesting a review from the DH under the terms of the 2000 Act so that the information can be disclosed.
Update (1 August 2013)
We heard back from the Department of Health yesterday. They've shown us the data after our internal review.