health tourism uk nhs

Health tourists: How much do they cost and who pays?

• 'Deliberate' use of the NHS—use by those who come here specifically to receive free treatment or who come for other reasons but take advantage of the system when they're here—is hard to quantify. It's thought to be very roughly between £110 million and £280 million a year.
• 'Normal' use of the NHS—by foreign visitors who've ended up being treated while in England—is estimated to cost about £1.8 billion a year.
• The majority of these costs aren't currently charged for. Only about £500 million is thought to be recoverable or chargeable at the moment.

Who do you think of when you hear the term 'health tourist'? A Spaniard who breaks a leg while on holiday in the UK? An American travelling here deliberately to use the NHS for free? What about a British expat who comes home every now and then to see their old, trusted GP?

All of them can be seen as 'health tourists' in that they've come from somewhere else and may have received healthcare in the UK for free. But for some the cost of their treatment is recoverable and for others it isn't. Keeping track of these cases is exceptionally difficult and so is working out the cost to the country.

We can split the estimated costs into two categories:

Normal use: The estimated cost of normal use of the NHS—by foreign visitors who've ended up being treated while in England—is £1.8 billion a year ( including a small number of European visitors treated in the rest of the UK). This includes the cost of treating them in A&E, though visitors aren't currently charged for this, and the cost of treating some foreigners resident in England who currently don't incur charges.

Only around £500 million per year is estimated to be recoverable or chargeable according to the Department for Health . In reality only £100 million was recovered in 2013/14.

Deliberate use: This is the estimated cost of treating those travelling to England  deliberately for free treatment, or those who take advantage of the health system while here (which means using it more intensively than they might have done otherwise). This group is particularly difficult to quantify as we don't really know who most of them are. It's thought they could cost the NHS somewhere between £110 million and £280 million a year, on top of the £1.8 billion a year.

Only hospitals are required to charge overseas visitors

The NHS was founded on the principle that it's a service "free at the point of use" for those ordinarily resident in the UK. But foreign or migrant patients usually need to pay a fee for their treatment.

Only services provided in or linked to a hospital in England are required to  charge for overseas visitors . This excludes services like A&E and walk-in centres.

GPs in England  have the discretion to register overseas patients in theory, and once registered they can be treated just like any other resident. But in reality they can only refuse a patient from their list if, say, it was closed to new patients, rather than because they don't have leave to remain. The situation is similar in the rest of the UK .

Currently, foreigners who are 'ordinarily resident' in the UK—those who are seen as settled in the UK—are exempt from charges. Full time students and some others are too. The definition of 'ordinarily resident' was tightened in last year's Immigration Act  to include only those who have Indefinite Leave to Remain (ILR), but this hasn't come into force yet.

Most Europeans don't have to pay for treatment themselves. Charges for patients from countries in the European Economic Area are claimed back by the NHS from their country of residence. The NHS also has reciprocal agreements with some other countries  such as Australia, where visitors can receive free urgent treatment if they find they need it when visiting the UK. These agreements are currently being reviewed .

Deliberate health tourism—a very rough estimate

Research commissioned by the Department for Health has  estimated the gross cost of 'deliberate' health tourism for urgent treatment in England to anywhere between £110 million and £280 million. Which barely compares to the £1.8 billion gross cost for 'normal' use of the NHS. But these figures are rough, as the report makes clear : "[it's] impossible to estimate with confidence".

The research splits the 'deliberate' health tourists into  two sub-groups :

• Deliberate intent: Those travelling to the UK for urgent, acute expensive surgery where they'll go straight to A&E:   £60-80 million
• Taking advantage: Those accessing more routine treatments, having been able to register with a GP and visiting on a regular basis. This includes British expats who may be chargeable but who have an active GP registration: £50-200 million

To get a number for those coming with 'deliberate intent' to receive treatment the researchers calculated the risk of people coming from different countries. This 'abuse rate' is based on how close their country of origin is to the UK and the quality of publicly-funded healthcare there. It guessed an abuse rate of about 1 in 100 visitors from high risk countries being health tourists, and about 1 in 1,000 visitors from medium risk countries.

To work out the cost, the research assumes all health tourists will be receiving more expensive treatment—they're unlikely to travel to the UK for a flu jab—settling on about £7,000 per case using (incomplete) data on previous unpaid bills owed to the NHS.

So combining the abuse rate and the cost data, the report estimates the cost of providing care for this first group of deliberate health tourists could be anywhere between £20 million and £100 million.

For the second group of health tourists 'taking advantage' of the NHS, the researchers say:

"... we feel it would be potentially misleading to come up with an estimate".

Nevertheless it has a rough stab at it, suggesting a range of between £50 million and £200 million a year for these routine NHS users.

'Normal' use of the NHS by visitors

Gross costs to the NHS for the wider group (excluding the 'deliberate' health tourists) have been estimated  by the same report as:

• £260 million per year for visitors and non-permanent residents from the European Economic Area (EEA) to England
• £1,400 million per year for visitors and temporary migrants from outside the EEA to England, and irregular migrants
• £95 million per year for English expats living abroad

A further £100 million a year could be added to this if you include UK-wide figures for use of the NHS by Europeans, according to the Department of Health.

The vast majority of the costs for non-EEA visitors and migrants are not recoverable, because they're related to GP, A&E or other services that don't charge or are exempt for some other reason. About £300 million also relates to irregular migrants who the report says are likely to have no means to pay.

About £500 million 'recoverable' currently

About £150 million can be invoiced to individuals living outside the EEA. Of this, it's thought  that health Trusts get back about 15%. That's based on about 40% of people being identified, 85% of those being invoiced, and 40% of those invoiced actually paying.

About £340 million is recoverable from European (EEA) visitors (including those using the NHS in the rest of the UK ), mostly under the European Health Insurance Card scheme .

The report is again at pains to point out  that these are 'uncertain estimates' because of the full complexity of the eligibility rules.

Is it even worth the trouble to recover the money?

The Department of Health has  previously estimated  that the costs of recovering what's owed could be more than £18 million. That was compared to the costs being recovered at the time of about £15-25 million per year.

The money has to be recovered by the NHS bodies that provided the treatment and NHS Trusts don't have any incentive to identify overseas visitors. That's because, by flagging concerns about a patient's entitlement to free treatment, it'd be rejecting money that it would otherwise receive from the government. Once an overseas visitor is identified, the Trust instead has to recover its own debt, which will also run up administration costs.

To tackle this recovery problem the Government announced in July 2014 that it was introducing measures which would recoup an estimated £500 million a year by 2017/18. This is based on:

• £200 million  from better identification of EEA patients and recharging to their home countries
• £200 million  via a 'health surcharge' for non-EEA migrants with a visa to stay for over six months
• £100 million  from better identification and recovery directly from non-EEA migrants

NHS Trusts will be paid 75% of the cost of non-EEA patients by health service commissioners, and will then be able to charge double that to the patient in fees.

So if treating a patient has cost £100, the provider will get £75 from the commissioning group and then will try to recoup £150 from the patient or their insurer. If successful, they'll pay the £75 back to the commissioning group. We've got more information on this here .

Medical tourism 

None of these measures consider the money the NHS actually brings in from medical tourists, that is overseas visitors coming here to pay for treatment. According to an independent review on overseas use of the NHS for the Department for Health, it's a "growing market".

• By Amy Sippitt
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DESTINATION

United kingdom.

Brief Introduction to the Country and its Reputation in Medical Tourism

The United Kingdom (UK), comprising England, Scotland, Wales, and Northern Ireland, is known worldwide for its high standards in healthcare. With a long history of medical research, innovation, and a robust National Health Service (NHS), the UK has become a leading destination for medical tourism. While the NHS primarily serves UK residents, the private healthcare sector has garnered significant attention for its premium services, cutting-edge technology, and highly skilled medical professionals. Medical tourists often seek the UK for specialized treatments and procedures that are either unavailable or have long waiting lists in their home countries.

Historical and Cultural Significance in Medicine

The UK has been a pioneering force in the field of medicine for centuries. It is the birthplace of many significant medical discoveries, such as the structure of DNA and the development of various vaccines. Furthermore, British universities are known for their medical research programs, contributing significantly to global advancements in healthcare. This rich history imbues the medical tourism sector with an aura of trust and expertise that few other countries can match.

Medical Research and Innovation

The UK's commitment to medical research and innovation ensures that it remains at the forefront of new treatments and technologies. Investment in research is significant, with world-class universities and private institutions continuously working on breakthrough medical advancements. These factors make the UK an attractive destination for medical tourists who are looking for the latest, most effective treatments.

Global Influence and Reputation

The country's reputation extends beyond its borders, attracting patients from Europe, North America, the Middle East, and other parts of the world. Many come for specialized treatments, the high standard of care, or second opinions from renowned experts in their field. Moreover, the UK has several international collaborations, showcasing its commitment to improving global health standards.

Popular Medical Procedures

List and brief descriptions of procedures.

Medical tourists primarily visit the UK for specialized and complex procedures, including but not limited to:

• Oncology Treatments
• Cardiovascular Surgeries
• Orthopedic Procedures
• Cosmetic and Reconstructive Surgery
• Infertility Treatments

Specializations and Pioneering Treatments

The UK is particularly noted for its advancements in oncology and cardiovascular care. The country offers some of the most modern cancer treatments, including immunotherapy and targeted therapies. Moreover, in the field of cardiovascular health, it provides specialized surgeries that use cutting-edge technology, often less invasively, thus reducing recovery time.

Top Hospitals & Clinics

A list of renowned hospitals and clinics.

Some of the top healthcare institutions for medical tourists include:

• The Harley Street Clinic, London
• The Wellington Hospital, London
• Spire Healthcare Hospitals
• Nuffield Health Hospitals

Accreditation and Affiliation Details

These facilities are usually accredited by the Care Quality Commission (CQC) in England and their respective regulatory bodies in Scotland, Wales, and Northern Ireland. They often have affiliations with world-class universities and medical research institutions.

Special Features, Awards, or Recognitions

Many hospitals have been recipients of various national and international awards for their exceptional service and innovations in healthcare. Features like state-of-the-art medical equipment, patient-centered care, and specialized units for various treatments make them attractive options for medical tourists.

Cost Comparison

Comparative data.

While the cost of medical procedures in the UK may be higher compared to countries like India, Thailand, or some Eastern European nations, many patients find the higher cost justified by the quality of care and expertise available. For instance, a knee replacement surgery that might cost around $40,000 in the United States could be 20-30% less expensive in the UK.

Price Ranges

The prices for medical procedures can vary widely depending on the hospital, location, and the specific needs of the patient. However, the UK’s private healthcare sector is generally transparent about costs, and you can expect detailed billing that accounts for the procedure, anesthesia, hospital stay, and any additional tests or treatments required.

Quality & Safety

Medical standards and practices.

The United Kingdom maintains rigorous medical standards, governed by various regulatory bodies including the General Medical Council (GMC) and the Nursing and Midwifery Council (NMC). These institutions ensure that medical professionals are highly qualified and adhere to the latest best practices in medical care.

Patient Safety and Rights

UK hospitals are committed to patient safety, with clearly defined protocols for various treatments and procedures. Moreover, the UK has strict patient confidentiality laws, assuring visitors that their medical information will be securely managed.

Medical Visa Information

Guidelines and requirements.

Non-EU/EEA nationals typically need to apply for a visa to enter the UK for medical treatment. The primary requirements usually include a detailed medical diagnosis from a healthcare professional in your home country, a letter from the UK medical facility confirming your treatment plans, and proof of sufficient funds to cover your medical and other expenses.

Duration and Documentation

The duration of a medical visa can vary but is usually granted for the length of the treatment plus recovery time. The documentation needed can include medical records, treatment plans, and financial statements, among other things.

Cultural Considerations

Local customs and etiquette.

The UK has a diverse cultural tapestry, but manners and politeness are generally highly valued. When in medical settings, it is standard to address healthcare professionals by their titles, such as “Doctor” or “Nurse.”

English is the primary language spoken in medical institutions, and many healthcare professionals are fluent in multiple languages, making communication easier for tourists.

Travel & Accommodation

Popular areas to stay.

London, Manchester, and Edinburgh offer a range of accommodation options close to major hospitals and clinics. Prices can range from budget hotels to luxurious suites.

Transportation Facilities

The UK boasts an extensive public transportation network, including buses, trams, and an efficient train system, making it easier for tourists to navigate between their accommodation and medical facilities.

Legal & Ethical Considerations

Legal rights of patients.

Patients in the UK have the right to confidential and high-quality care, as well as the right to complain if the service does not meet their expectations.

Medical Malpractice Laws

The UK has a well-defined medical malpractice law framework. Patients who believe they have been subjected to negligent care have the right to legal recourse.

Benefits & Risks

One of the major advantages of choosing the UK for medical treatment is the high standard of care and the availability of specialized treatments. Hospitals are well-equipped and staff are highly trained.

While the risks are generally minimal due to high medical standards, they can include high costs and longer wait times for some procedures compared to other medical tourism destinations.

Post-procedure Care

Post-operative care.

UK medical institutions offer exceptional post-operative care, including specialized rehabilitation services when necessary.

Frequently Asked Questions (FAQs)

Typical questions.

• Is healthcare in the UK free for tourists? No, the National Health Service (NHS) is for UK residents. Tourists will generally use the private healthcare sector.
• Do I need insurance? It is highly recommended to have a comprehensive medical and travel insurance policy when coming to the UK for medical treatment.
• How long will it take to get a medical visa? The process can take several weeks, so it’s advisable to apply well in advance of your planned trip.

Global Provider Members

British Pound

The United Kingdom has a temperate climate, with plentiful rainfall all year round. The temperature varies with the seasons, seldom dropping below −11 °C (12 °F) or rising above 35 °C (95 °F). The prevailing wind is from the southwest and bears frequent spells of mild and wet weather from the Atlantic Ocean, although the eastern parts are mostly sheltered from this wind, since the majority of the rain falls over the western regions.  

Facilitators

London, United Kingdom

Lancashire, United Kingdom

Cambridgeshire, United Kingdom

Featured Treatments

MedicalTourism.com

MedicalTourism.com is a free, confidential, independent resource for patients and industry providers. Our mission is to provide a central portal where patients, medical tourism providers, hospitals, clinics, employers, and insurance companies can all find the information they need. Our site focuses on patients looking for specific knowledge in the fields of medical tourism, dental tourism, and health tourism.

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Health Tourism

Health tourism has been a hotly debated issue in the UK in recent years. Here’s a guide to the facts, myths and debates around it.

• Find out what health tourism is
• Understand the debates and myths around it
• Learn the arguments against new legislation

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Health tourism is a much-debated hot topic that could come up in your Medical School interview .

What Is Health Tourism?

Health tourism refers to non-UK residents travelling to the UK with the specific intention of using NHS services.

It is estimated that the government spends between £100 and £300 million per year on ‘deliberate’ health tourism. When the cost of treating non-UK residents who didn’t come to the UK specifically to seek treatment (such as holidaymakers and temporary workers) is added, the total spend amounts to around £1.8 billion .

There is a great deal of misunderstanding around health tourism, and the topic often ignites a wider debate about immigration. As the debate gained momentum in the time surrounding Brexit, the government reacted by amending health tourism legislation. 

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Changes To Legislation

In April 2015, the government introduced new regulations requiring non-EEA nationals without personal health insurance to pay 150% of the NHS national tariff for any treatment they receive. A&E and emergency services remain free to all patients. 

As of 2017, foreign patients can be refused non-emergency operations unless they pay for the treatment upfront . In July 2019, the Department of Health reported that these charges had raised a total of £1.3 billion since their introduction.

Opposition To The Changes

The British Medical Association (BMA) has heavily criticised the ‘pay upfront’ rule, likening doctors who must charge foreign nationals at their workplace to border guards . At the BMA’s annual conference in 2019, delegates voted overwhelmingly in favour of scrapping the rule, so the BMA will lobby the Department of Health to overhaul it. 

Deliberate health tourism only accounts for around 0.3% of NHS spending , so there is an argument that government and media focus on health tourism is disproportionate to the impact it actually has, and does not help with the public perception of migrants in the UK. People who are determined enough to travel to the UK in order to seek treatment they cannot afford or access at home are more likely to be acting out of need than greed. 

It can also be argued that charging for NHS services could actually increase health tourism in the long term among people who can afford it. Potential buyers may feel reassured that what they are purchasing is legitimate and that the process they are buying into is legal, which could lead to an influx of health tourists looking for cheaper healthcare than what is available in their domestic, privatised systems. 

In one case since the new ‘pay upfront’ system was introduced, a couple whose baby died following an emergency Caesarean in the UK were not given the body to take with them, because they couldn’t present a valid EHIC (European Health Insurance Card) so were required to pay £10,000 medical fees which they couldn’t afford. In addition to the BMA calling for the system to be abandoned completely, the Royal Colleges of Physicians, Paediatrics and Child Health, Obstetricians and Gynaecologists, and the Faculty of Public Health have written to ministers urging them to suspend the system. The Royal College of Midwives has also expressed that maternity care should be exempt from charges.

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Health Tourism Questions

You could bring up health tourism as a topic if you’re asked depth of interest questions such as ‘What recent changes to healthcare have you read about?’.

Other related questions could be:

• Do you agree that foreign patients in the UK should have to pay for non-emergency treatment upfront? For this kind of ethics question , you need to discuss the ethical issues and outline both sides of the argument. 
• Imagine you are a Medical Student on a hospital ward placement. How would you explain to a foreign patient that they need to pay for their non-emergency treatment upfront? Take a look at our empathy questions for similar questions and answers.

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Health Tourism – Key Points

• Health tourism drains the NHS of at least £300-400 million each year because hospitals fail to identify overseas patients or never send them bills. 
• The government has estimated that £388 million is spent each year on EEA and non-EEA patients who should be paying for their care but are not identified or charged. This does not include the cost of what the government calls ‘abnormal’ health tourism, nor the costs of illegal migrants.
• Health tourists are non-UK nationals who target the NHS because they will often get better treatment than at home — and for free, either by ‘flying in and flying out’ or through existing registration. By their very nature they are difficult to identify and quantify because they are likely to make efforts to conceal their true eligibility status or are not flagged up in the system.
• Britain is among the worst countries in Europe at extracting payments from foreign patients and four in five hospitals do not expect to start recouping more money (see House of Commons Public Accounts Committee  report ).
• £340m for EEA visitors and non-permanent residents to the UK (excluding expats). While the UK was a member of the EU, the government estimated that approximately £180m of this was recoverable through the European Health Insurance Card (EHIC), with the remainder potentially recoverable through S1 (£60m) and other arrangements. It was estimated that the NHS recovered around £50m in one year, less than 20% of the total potentially recoverable amount.
• £1,070m for non-EEA visitors and temporary migrants to England. Of this approximately 14% (around £156m) was thought to be potentially, currently chargeable because the total gross expenditure includes both the costs of non-chargeable services A&E and primary care and those individuals who are currently not chargeable due to being ordinarily resident or otherwise exempt.
• Total = £1.74 billion
• In contrast, the cost of those who had traveled to England purely to receive urgent treatment and regular visitors who were described as “taking advantage” of the system by registering for GP services and other NHS services to which they were not entitled was estimated at up to £300 million per year . See Department of Health assessment
• Figures for 2015/16 show hospitals only managed to invoice patients for £289 million and much of this was never repaid (Public Accounts Committee  report , 2017). Government studies also suggest that the NHS is also simply failing to charge when it is supposed to—recouping only a fraction of what should be around £340m from other countries .
• GPs were also found to be doing too little to flag up those who should be charged. Britain is among the worst countries in Europe at extracting payments from foreign patients and four in five hospitals do not expect to start recouping more money.
• Surgeon Dr J Meirion Thomas has  described  health tourism as a ‘gaping wound’ in the NHS. He says abuse is particularly bad in maternity and cancer wards.
• A relevant question is:  Do those saying that this is not a problem believe that it should be the UK’s responsibility to extend free health care to the whole world?  

Contextual points:

• Unsurprisingly, ‘health’ is currently the public’s top concern (YouGov issue tracking poll), with immigration behind the economy in third place (on par with the environment).
• A UK-wide poll of just over 1,000 adults by  Ipsos Mori  for the BBC showed that  74%  of respondents supported increasing charges for overseas visitors
• From April 2017, NHS hospitals in England were made subject to a legal duty to charge overseas patients upfront for non-urgent care if they are not eligible for free treatment (see  report ).
• From December 2018, the immigration health surcharge was increased from £200 to £400 per year for non-EU nationals, with students and those on the Youth Mobility Scheme on the discounted rate of £300 per year (see  announcement ).
• In mid-2019 the delegates at the British Medical Association voted overwhelmingly to stop charging overseas patients for their treatment at NHS hospitals.
• Those illegally crossing the Channel in order to claim asylum, as well as 40,000 failed asylum seekers, are able to get immediate and full access to the NHS. Illegal immigrants are able to access GP services (see written Parliamentary Answer , September 2021) despite the huge pressure and crisis which GP practices are facing due to skyrocketing demand. This is surely unfair to the millions of people who pay into the system and expect to get good NHS care when they need it.
• Between 2010 and 2020, there were just under seven million new GP registrations by migrants in England, Northern Ireland and Wales ( ONS local area migration indicators ). That is more than one every minute.
• The total additional cost of net migration for the NHS in 2014 was £360 million (£160 million for EU immigration and £200 million for non-EU immigration) – (See source : NHS Five Year Forward View, Nuffield Trust calculations, May 2016).
• Total NHS expenditure for the migrant population in 2014/15 was £18.6 billion (see Table 2 of our fiscal analysis ).
• Research suggests that immigration has been a huge overall annual fiscal cost (between £4.3 billion and £13 billion per year for 2014/15 and 2016/17 depending upon assumptions – see e.g. our fiscal analysis ).

21st October 2021 - Health , Migration Trends , Policy , Population

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• David Oliver: Health...

David Oliver: Health tourism, immigration, and the NHS

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• Peer review
• David Oliver , consultant in geriatrics and acute general medicine
• davidoliver372{at}googlemail.com

Results from a pilot scheme designed to clamp down on “health tourism” were reported by the London Evening Standard last month. 1 As part of the scheme, which ran in 18 hospitals (11 in Greater London) over two months in autumn 2017, patients were required to show two forms of ID to prove that they were eligible for free NHS treatment. Checks carried out on 8894 patients found only 50 who were not eligible for free NHS treatment.

Overseas visitors are already eligible for free emergency care, and we have reciprocal arrangements with other EU countries for reimbursing healthcare costs, although the Public Accounts Committee did criticise the NHS in 2017 for a “chaotic approach” to chasing reimbursement from EU countries. 2

One quoted example in the Standard , from Barts Hospital, illustrates the relatively small scale of the problem. Of 2752 renal outpatients only two were ineligible, and they were charged a total of £2500. St George’s Hospital checked 1660 maternity unit patients and found only 18 ineligible, with a total chargeable amount of £45 000. Equally small proportions of ineligible maternity patients were found at Newham General and Redbridge Hospitals.

Checks carried out on 8894 patients found only 50 who were not eligible for free NHS treatment

Sadly, our national conversation is often led by emotive and distorted reporting. How did the Daily Mail report St George’s maternity unit issues? “Crackdown on health tourist women who fly to the UK to give birth ‘on the NHS’ is WORKING despite fury of doctors’ union [the BMA].” 3

The Daily Telegraph stated in 2017 that health tourism was costing the NHS £2bn a year 4 and said in 2016 that “NHS hit squads” would collect the cash. 5

The independent Full Fact site estimates that the cost of deliberate health tourism to the NHS is only around £300m a year. 6 Such use—by people ineligible for free treatment who visit the UK to receive it—accounts for around 0.3% of the total NHS budget.

The government set out in 2016 an “ambition” to reclaim £500m a year from health tourism by the 2017-18 financial year, 7 but it predicts that this will be more like £350m. 6 Not negligible, but it’s hardly going to save the NHS (total budget around £122bn) despite the rhetoric and headlines.

In primary care an agreement was signed in 2017 between the Department of Health, the Home Office, and NHS Digital to hand over information on patients registered with GPs, to help identify illegal immigrants. GPs understandably rejected the move, 8 wanting to practise medicine rather than be immigration agents, as the “Docs Not Cops” movement has made clear. 9 The arrangements were subsequently scrapped. 10

Most immigrants to the UK are in their 20s or 30s, either working or paying to study, thus contributing to the funding of public services such as the NHS. 11 12 Rising healthcare costs are driven principally by people in mid- or late life with long term medical conditions.

Around one in five of the NHS’s clinical workforce trained overseas. 13 Until recently, we’ve happily recruited EU and non-EU staff at scale to supplement our homegrown workforce, especially in shortage specialties and deprived or remote regions. 14 Home Office visa restrictions currently exclude many from coming here to fill pressing workforce gaps, and Brexit has made EU trained staff less keen on working here. 15 16

The Brexit “leave” vote was driven largely by voters’ concerns about immigration, and the politicians and newspapers are playing to the gallery. But immigrants give far more to the NHS than they take from it.

Competing interests: See www.bmj.com/about-bmj/freelance-contributors/david-oliver .

Provenance and peer review: Commissioned; not externally peer reviewed.

• ↵ Lydall R. 8900 checks on NHS ‘health tourists’ find just 50 liable to pay. Evening Standard 29 May 2018. https://www.standard.co.uk/news/health/8900-checks-on-nhs-health-tourists-find-just-50-liable-to-pay-a3850121.html .
• ↵ Donnelly L. NHS should charge health tourists “upfront” instead of chaotic debt chase. Telegraph 1 Feb 2017. https://www.telegraph.co.uk/news/2017/02/01/nhs-should-charge-health-tourists-upfront-instead-chaotic-debt/ .
• ↵ Adams S. Crackdown on health tourist women who fly to the UK to give birth “on the NHS” is WORKING despite fury of doctors’ union. Mail Online 17 Dec 2017. www.dailymail.co.uk/news/article-5187057/Crackdown-pregnant-health-tourists-WORKING.html .
• ↵ Donnelly L. “Health tourists” to be charged upfront for NHS care. Telegraph 20 Oct 2017. https://www.telegraph.co.uk/news/2017/10/20/nhs-ask-patients-bank-statements-check-qualify-free-health-care/ .
• ↵ Donnelly L, Bodkin H. NHS hit squads to collect payment from health tourists. Telegraph 28 Oct 2016. https://www.telegraph.co.uk/news/2016/10/27/hit-squads-to-tackle-hospitals-not-charging-payment-from-foreign/ .
• ↵ O’Leary J. Health tourism savings won’t plug the hole in NHS funding. Full Fact 3 Feb 2017. https://fullfact.org/health/health-tourism-savings-wont-plug-hole-nhs-funding/ .
• ↵ National Audit Office. Recovering the cost of NHS treatment for overseas visitors. 28 Oct 2016. https://www.nao.org.uk/wp-content/uploads/2016/10/Recovering-the-cost-of-NHS-treatment-for-overseas-visitors.pdf .
• ↵ Hill R. Activists launch legal challenge against NHS patient data-sharing deal. Register 9 Nov 2017. https://www.theregister.co.uk/2017/11/09/ukgov_patient_data_sharing_deal_challenged_by_campaign_groups/ .
• Docs Not Cops
• ↵ Campbell D. NHS will no longer have to share immigrants’ data with Home Office. Guardian 9 May 2018. https://www.theguardian.com/society/2018/may/09/government-to-stop-forcing-nhs-to-share-patients-data-with-home-office .
• ↵ Darvas Z. What is the age profile of UK immigrants? Bruegel 8 June 2016. http://bruegel.org/2016/06/what-is-the-age-profile-of-uk-immigrants/ .
• ↵ Rienzo C. Characteristics and outcomes of migrants in the UK labour market. 15 June 2018. http://www.migrationobservatory.ox.ac.uk/resources/briefings/characteristics-and-outcomes-of-migrants-in-the-uk-labour-market/ .
• ↵ Health Education England. Facing the facts, shaping the future: a draft workforce strategy for England 2027. 2017. https://bit.ly/2kKUuCL .
• Iacobucci G

What is health tourism and why is it growing?

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Health tourism is a growing trend around the world. But what is health tourism and why is it so popular? Read on to find out…

What is health tourism?

The growth of health tourism, why is health tourism important, health tourism activities, health tourism- further reading.

Health tourism is a tricky one to define. It is more of an umbrella term, encompassing both wellness tourism and medical tourism. These two types of tourism may seem quite different, but they both fundamentally have health at their core. So, health tourism can be defined as follows:

Health tourism covers those types of tourism which have as a primary motivation, the contribution to physical, mental and/or spiritual health through medical and wellness-based activities which increase the capacity of individuals to satisfy their own needs and function better as individuals in their environment and society.

This definition comes from an executive summary published by the World Tourism Organization and the European Travel Commission in 2018. As you can see, the exploration of health tourism in itself is a relatively new idea. The two organisations also provided the following definitions of wellness and medical tourism respectively:

Wellness tourism is a type of tourism activity which aims to improve and balance all of the main domains of human life including physical, mental, emotional, occupational, intellectual and spiritual. The primary motivation for the wellness tourist is to engage in preventive, proactive, lifestyle enhancing activities such as fitness, healthy eating, relaxation, pampering and healing treatments.       

Medical tourism is a type of tourism activity which involves the use of evidence-based medical healing resources and services (both invasive and non-invasive). This may include diagnosis, treatment, cure, prevention and rehabilitation.   

There are many reasons as to why health tourism as an industry is growing. People are keener than ever to put their health and wellbeing first – especially now we are 2 years into a global pandemic. As a population , we are more aware now than ever before how our health can hang in the balance. And just knowing this, coupled with all of the other changes brought about by the pandemic as well as the general ease of accessing information, mean that life is generally more stressful. So it is no wonder that we are looking for wellness trips to calm and soothe ourselves – and to affordable and accessible medical procedures that may be unavailable at home…

The UK sees health tourism as a distinct and negative phenomenon. The media uses the term to refer to people who travel to the UK deliberately in order to access free medical treatment from the National Health Service. This is seen as leeching off the state, and as you can imagine is particularly frowned upon by many in the country. However, reports show that the government estimates ‘health tourism’ costs the NHS only £300m annually – or 0.3% of their budget! But due to this, new laws are in place to charge people who do not ‘ordinarily reside’ in the UK if they use the NHS.

Health tourism is important for many reasons. Looking at it from an economical point of view, it provides a boost to local economies when people travel to a destination for any reason. So heading to a summer yoga retreat in Santorini or getting some dental work done in Turkey is contributing to the local economy. And it’s not just the cost of your treatment or stay – you will also purchase food and drink, maybe even souvenirs. You might extend your trip and do some sightseeing with local tour companies too. All of these things mean a cash injection for the area and its inhabitants.

Linked to this is that health tourism often provides a cheaper opportunity to do something you were going to do at home. Travelling for optional surgery or going to a small spa in a remote village might be much cheaper than doing so in your home country. In this way, health tourism actually provides people with a way to save money.

Health tourism is also important as it is a reflection of my earlier point – people are taking more of an interest in their health. Regardless of whether it’s wellness tourism or medical tourism, health tourists are travelling with the primary focus of improving their mind, body or life in some way. This is obviously a positive factor for society.

As health tourism combines wellness and medical tourism, the activities it involves are anything which falls under these categories. Essentially, anything you do as a tourist which is aimed at improving your health is classed as health tourism. See a list of activities below:

• Dental/dentistry
• Orthopedics
• Cosmetic/plastic surgery
• Bariatric surgery 
• Fertility treatment
• Eye surgery
• Ears, nose and throat
• Organ transplants
• Rehabilitation
• Alternative medication access
• Yoga retreats
• Writing retreats
• Meditation centres
• Weight loss or healthy eating retreats
• Sensory deprivation

Popular health tourism destinations

There are many destinations you can visit as a health tourist. Your home country may also be a health tourism location for people from other countries. It is all contextual and subjective, depending on what exactly you are looking to get out of your trip…

This is a popular place for health tourism – particularly when it comes to wellness. With its geothermal pools, breathtaking scenery, infinity pools and mountain hiking areas the options are endless! A very popular part of Iceland for wellness activities is Myvatn Nature Baths, where the alkaline in the water has a lot of minerals and is incredibly beneficial for the treatment of skin conditions. Because of this, it can also be seen as a destination which works for medical purposes – making it a dead cert for health tourism.

Ever heard of the saying ‘Turkey teeth’? It doesn’t come from nowhere! The reason this term exists is because many people (particularly younger people, celebrities, and influencers) flock to Turkey to have dental treatment done for cosmetic purposes. They want straighter, whiter and brighter teeth. Something like this might cost double or triple in the UK, for example, than what it would in Turkey. Plus, visitors get to combine their trip with sun, sea and sand!

India is a big one for health tourism as it has a big wellness tourism industry combined with many options for medical tourists to have cheaper procedures done. Being such a spiritual country, it is no wonder that people come here for wellness purposes. The Indian government readily promotes the country as a hub for yoga, Sidha, naturopathy and Ayurveda – citing the ‘spiritual philosophy that has been integral to the Indian way of life’. There are retreats right across the country, particularly in countryside areas but also in the bustling cities which mean it works for both primary AND secondary wellness tourism.

Primary wellness tourism is when someone’s whole trip is focused on wellness; it is their sole reason for travel, and the major component of their trip. Every aspect of their holiday is tailored to wellness. Secondary wellness tourism is when general tourists incorporate some aspect of wellness (a massage on the beach during an all-inclusive Mexican vacation) into their holiday.

India is also a huge destination when it comes to medical tourism. Locations such as Chennai, Maharashtra and Kerala are really popular for medical procedures, with costs being about one tenth of those in either the UK or the USA. Medical tourists travel to India for alternative medicine, cardiac procedures, bone-marrow transplants, eye surgery and hip replacements in particular.

Beautiful Hawaii is like one big spa in itself. Primary wellness tourists visit here in droves to experience the therapeutic salt water, the laid back atmosphere, the glorious sunshine and the traditional practices of omilomi massage and pohaku (hot stone treatment). With scenery that will leave you lost for words, it is one of the most relaxing places in the world which is why wellness tourism is so big here – and so, by extension, is health tourism.

This stunning country has cutting edge technology and beautiful spaces to relax – making it ideal for health tourism encompassing both wellness and medical tourism. People tend to head here for small elective surgeries, choosing to get the procedure done for a lower price and recover somewhere beautiful! And there are so many options for wellness tourists, too. From Thai massage parlours to serene meditation retreats on beaches where the sunsets are bright pink and shiny gold, you couldn’t ask for somewhere more suited to a relaxing wellness trip.

If you enjoyed this article on health tourism, I am sure that you will like these too-

• What is birth tourism and is it legal?
• What is special interest tourism and why is it so popular?
• What is alternative tourism and why is it growing so fast?
• What is dental tourism and why does it exist?

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Health Tourism: Fact vs Fiction

14 November 2019 Keep Our NHS Public Fight racism and defend migrants , General Election 2019 , News 2

FICTION: “Health Tourism” is a problem for the NHS

In September this year Matt Hancock announced an additional £1m funding to expand the team of experts responsible for recovering millions of pounds in costs for treating overseas visitors in the NHS.

Since the law changed in 2015 many people are no longer deemed ‘ordinarily resident’ in the UK and are charged for all NHS care at 150% of cost price except for emergency care. Since 2017 the law has ben tightened further, putting pressure on Trusts to collect money from those deemed as ‘non-resident’.

Matt Hancock said: “Our beloved NHS is renowned around the world for providing high quality health care and it is able to do so thanks to the valuable contributions made by hardworking taxpayers - so it is only fair we ask overseas visitors to pay their way as well.

“This new drive will help recoup millions in unclaimed funds for our NHS which can go back into frontline patient care, so the NHS can be there for all of us when we need it most.”

FACT: Government policy on this has developed as part of their “hostile environment”

Government policy on charging upfront for treatment has rendered 600,000 people, including 120,000 children, ineligible for free NHS care . This has put many lives at risk and caused great hardship.

The policy has been opposed by almost all professional bodies representing doctors and midwives, by the health unions and now by the Labour Party which is committed to scrap the charges.

Pregnant women have been particularly targeted: a Freedom of Information request from Save Lewisham Hospital Campaign showed over 500 women in Lewisham and Greenwich NHS Trust in 2018 alone, were asked to pay up to £9,000 for having a baby.

A new report from Maternity Action backed by the Royal College of Midwives (RCM) in September 2019 showed these charges risked making women unable to access appropriate perinatal care.

The 2015 regulations placed a statutory requirement on NHS Trusts to identify and charge people not eligible for free NHS care; it also increased the amount people could be charged to 150% of the national tariff and introduced the Immigration Health Surcharge.

Lewisham Hospital Campaign showed over 500 women in Lewisham and Greenwich NHS Trust in 2018 alone, were asked to pay up to £9,000 for having a baby.

Duty to charge upfront

In 2017 additional regulations placed a statutory duty on NHS Trusts to charge people upfront for treatment if they were found to be ineligible for free NHS care; increased the range of services that were chargeable to include some community and mental health services; and mandated that NHS Trusts record people’s chargeable status on their patient record.

Never before have Trusts been required to charge people upfront for routine NHS care.

The DHSC had originally planned to extend charges to A&E and GP services by 2016 but have delayed this process following outcry from the healthcare community and civil society.

The intention to extend charging still remains and the 2017 regulations should be understood as a first step in any Government plans to extend charging to all NHS services.

So-called ‘health tourism’ is a political concept that is almost ubiquitous in the media and is often pointed to as a major drain on NHS resources. In reality however there is very little evidence to substantiate its existence.

‘Health tourism’ refers to the idea that people travel deliberately to the UK to seek free treatment for a pre-existing condition.

The Government’s own estimate puts the cost of deliberate misuse of the NHS by overseas visitors at £300m at most – equating to roughly 0.3% of the NHS budget. But the majority of this is attributed to British migrants that live overseas and return to the UK to use the NHS.

The £300m figure includes the use of primary care and A&E services and does not take into account an assessment of the likelihood of the people charged being able to pay the bill.

A number of Trusts that have resorted to using bailiffs to chase down unpaid debt, suggesting Trusts are failing to use their discretion to write off debts owed by people that have no means to pay.

The Government itself admits that even if it did extend charging to all services it would still be unable to recoup the total costs.

The Government’s often used refrain “the NHS is a national, not an international, health service” mobilises the myth of ‘health tourism’ to justify a policy that is based on unreliable evidence, causes harm and leads to discrimination.

Nor is it clear how people are selected for checks on their identity and status. The large majority of the thousands now subject to delays and stress as a result of checks have proved to have a legitimate right to NHS treatment.

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Help our campaign

Health tourism is rife. I lived and worked in the Middle East and ISC for years where people routinely visited the U.K. to avail themselves of free health care, especially maternity care. This article is hopelessly naive and ignorant of what is going on in the world.

It is rife. Free treatment of NHS is being widely abused and the woke NHS is allowing it. Foreigners are flying in just to have babies on the NHS and not being regulated. NHS should really clamp down on this abuse.

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Travel vaccination advice

If you're planning to travel outside the UK, you may need to be vaccinated against some of the serious diseases found in other parts of the world.

Vaccinations are available to protect you against infections such as yellow fever , typhoid and hepatitis A .

In the UK, the  NHS routine immunisation (vaccination) schedule protects you against a number of diseases, but does not cover all of the infectious diseases found overseas.

When should I start thinking about the vaccines I need?

If possible, see the GP or a private travel clinic at least 6 to 8 weeks before you're due to travel.

Some vaccines need to be given well in advance to allow your body to develop immunity.

And some vaccines involve a number of doses spread over several weeks or months.

You may be more at risk of some diseases, for example, if you're:

• travelling in rural areas
• backpacking
• staying in hostels or camping
• on a long trip rather than a package holiday

If you have a pre-existing health problem, this may make you more at risk of infection or complications from a travel-related illness.

Which travel vaccines do I need?

You can find out which vaccinations are necessary or recommended for the areas you'll be visiting on these websites:

• Travel Health Pro
• NHS Fit for Travel

Some countries require proof of vaccination (for example, for polio or yellow fever vaccination), which must be documented on an International Certificate of Vaccination or Prophylaxis (ICVP) before you enter or when you leave a country.

Saudi Arabia requires proof of vaccination against certain types of meningitis for visitors arriving for the Hajj and Umrah pilgrimages.

Even if an ICVP is not required, it's still a good idea to take a record of the vaccinations you have had with you.

Find out more about the vaccines available for travellers abroad

Where do I get my travel vaccines?

First, phone or visit the GP practice or practice nurse to find out whether your existing UK vaccinations are up-to-date.

If you have any records of your vaccinations, let the GP know what you have had previously.

The GP or practice nurse may be able to give you general advice about travel vaccinations and travel health, such as protecting yourself from malaria.

They can give you any missing doses of your UK vaccines if you need them.

Not all travel vaccinations are available free on the NHS, even if they're recommended for travel to a certain area.

If the GP practice can give you the travel vaccines you need but they are not available on the NHS, ask for:

• written information on what vaccines are needed
• the cost of each dose or course
• any other charges you may have to pay, such as for some certificates of vaccination

You can also get travel vaccines from:

• private travel vaccination clinics
• pharmacies offering travel healthcare services

Which travel vaccines are free?

The following travel vaccines are available free on the NHS from your GP surgery:

• polio (given as a combined diphtheria/tetanus/polio jab )
• hepatitis A

These vaccines are free because they protect against diseases thought to represent the greatest risk to public health if they were brought into the country.

Which travel vaccines will I have to pay for?

You'll have to pay for travel vaccinations against:

• hepatitis B
• Japanese encephalitis
• tick-borne encephalitis
• tuberculosis (TB)
• yellow fever

Yellow fever vaccines are only available from designated centres .

The cost of travel vaccines that are not available on the NHS will vary, depending on the vaccine and number of doses you need.

It's worth considering this when budgeting for your trip.

Other things to consider

There are other things to consider when planning your travel vaccinations, including:

• your age and health – you may be more vulnerable to infection than others; some vaccines cannot be given to people with certain medical conditions
• working as an aid worker – you may come into contact with more diseases in a refugee camp or helping after a natural disaster
• working in a medical setting – a doctor, nurse or another healthcare worker may require additional vaccinations
• contact with animals – you may be more at risk of getting diseases spread by animals, such as rabies

If you're only travelling to countries in northern and central Europe, North America or Australia, you're unlikely to need any vaccinations.

But it's important to check that you're up-to-date with routine vaccinations available on the NHS.

Pregnancy and breastfeeding

Speak to a GP before having any vaccinations if:

• you're pregnant
• you think you might be pregnant
• you're breastfeeding

In many cases, it's unlikely a vaccine given while you're pregnant or breastfeeding will cause problems for the baby.

But the GP will be able to give you further advice about this.

People with immune deficiencies

For some people travelling overseas, vaccination against certain diseases may not be advised.

This may be the case if:

• you have a condition that affects your body's immune system, such as HIV or AIDS
• you're receiving treatment that affects your immune system, such as chemotherapy
• you have recently had a bone marrow or organ transplant

A GP can give you further advice about this.

Non-travel vaccines

As well as getting any travel vaccinations you need, it's also a good opportunity to make sure your other vaccinations are up-to-date and have booster vaccines if necessary.

Although many routine NHS vaccinations are given during childhood, you can have some of them (such as the MMR vaccine ) as an adult if you missed getting vaccinated as a child.

There are also some extra NHS vaccinations for people at higher risk of certain illnesses, such as the flu vaccine , the hepatitis B vaccine and the BCG vaccine for tuberculosis (TB) .

Your GP can advise you about any NHS vaccinations you might need.

Find out about NHS vaccinations and when to have them

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Private health insurance market grows by £385m in a year amid NHS crisis

Demand for private treatment booms as NHS waiting lists remain long, while more people also sign up for dental cover

Britain’s health cover market has grown by £385m in a year as the NHS crisis prompted more people to seek out private medical treatment and demand for dental insurance increased, according to a report.

The total health cover market, including medical and dental insurance and cash plans, grew 6.1% to £6.7bn in 2022, the latest year for which figures are available, according to the health data provider LaingBuisson.

About 4.2 million people were subscribed to medical cover schemes. Including dependants on the policies, 7.3 million people were covered – the highest number since 2008.

Since the market’s Covid-driven drop in 2020, when it declined by 2.2%, it has grown considerably faster than historical norms. Average annual growth was 6.1% between 2020 and 2022, compared with 1.7% between 2008 and 2019.

The NHS waiting list in England continued to lengthen , to a peak of nearly 7.8m last September. In February, it was still 7.5m and half of the patients had been waiting for 18 weeks or longer.

Private medical insurance, the largest part of the health cover market, grew by 6% year on year in 2022 to £5.3bn, more than triple the average annual growth rate of 1.8% between 2008 and 2019. After a decade of decline until 2018, more people signed up, particularly in the aftermath of the Covid-19 pandemic which led to a backlog of major procedures such as hip and knee replacements .

Tim Read, author of the report, said: “Demand began to increase in 2018, as the NHS waiting list began to rise out of control. A new Labour government is likely to aim to tackle it but will have limited fiscal headroom to make substantial progress.

“With people still struggling to access NHS services and the waiting list remaining stubbornly high, there is little likelihood that demand for health insurance is going to fall any time soon.”

Read added: “Growth is led by company-backed schemes, which may suggest an increased awareness of the impact of employee ill-health on a business – and possibly frustration at the impact that an inaccessible NHS is having on productivity.”

Growing numbers of people are also paying out of their own pockets for medical treatment, despite the high cost of some procedures, such as knee operations which typically cost between £12,000 and £15,000.

Dental insurance and capitation plans (fixed monthly payments) have shown the highest growth of the market, up 9.7% year on year in 2022. However, most people who see a dentist privately pay for treatment without any cover.

The emergence of “dental deserts ” – swathes of the UK where NHS dentists are not taking on new patients – means hundreds of thousands of people have turned up in hospitals or at GPs with severe tooth decay .

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The average health insurance premium went up to £1,225 in 2022 from £1,203 in 2021, according to LaingBuisson. Premiums on work policies went up to £975, while individual premiums rose to £2,252.

Insurers have flagged premium rises of more than 10%, with one placing them as high as 40% this year and possibly beyond. This reflects a rise in claims and higher medical costs. Some people who could not get what would have been a cheaper treatment option during the pandemic are now suffering from more expensive conditions to treat, Read said.

The UK health insurance market is dominated by Bupa, France’s Axa Health , Aviva and Vitality Health, which is owned by South Africa’s Discovery.

In dental insurance, the main players are Bupa, Simply Health and Unum, after Cigna left the UK market.

Read said: “I don’t think that the NHS is going to fall apart overnight or that the private sector is going to run rampant overnight. But I do think as people as customers, rather than people as taxpayers, are beginning to reconceptualise the value of paying additionally for healthcare entitlements, which technically they should get on the NHS.”

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'The only cure is a Labour government': Tory MP and doctor Dan Poulter defects over NHS 'chaos'

Former health minister Dan Poulter said "chaos" in the NHS has led him to defect to Labour from the Conservative Party. The part-time GP said the Conservatives had become "a nationalist party of the right".

Sunday 28 April 2024 03:41, UK

Conservative MP and former health minister Dan Poulter has defected to Labour in frustration at the worsening NHS crisis.

The MP for Suffolk Central and Ipswich North, with a majority of 23,391 at the last election, has indicated he is not planning to stand at the next general election .

The defection was revealed in an article on The Observer website, in which he said working as a mental health doctor in a busy hospital A&E over the past year had shown him how desperate the NHS situation had become.

"Working on the frontline of a health service under great strain left me at times, as an MP, struggling to look my NHS colleagues, my patients and my constituents in the eye," he said.

He recalled seriously ill patients suffering long waits for treatment often hundreds of miles from their homes, adding that the "chaos of today's fragmented patchwork of community addiction services" had put more pressure on already-stretched A&Es.

"The mental toll of a service stretched close to breaking point is not confined to patients and their families. It also weighs heavily on my NHS colleagues who are unable to deliver the right care in a system that simply no longer works for our patients."

He said he had resigned from the Conservative Party to focus on his work as a doctor and to support Keir Starmer.

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What does victory and defeat look like in the local elections for Conservatives and Labour?

MPs share experiences during assisted dying debate

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• Conservatives

"I can well remember when I first qualified as a doctor and began working in the NHS in 2006. At the time, patient care had been radically improved and transformed by Tony Blair and Gordon Brown's Labour governments, following many years of Conservative neglect and under-investment.

"...I have come to the conclusion that, once again, the only cure is a Labour government."

Dr Poulter criticised the Tories for "putting the politics of public sector pay ahead of ending strikes with healthcare workers", adding: "Political ideology has been put before pragmatism and meeting the needs of patients, who are the real losers from the strikes".

He also told The Observer the Conservatives had become "a nationalist party of the right" in the last eight years.

"It is not to say all [Tory] MPs are like that," he said.

"There are good MPs, but it feels that the party is ever moving rightwards, ever presenting a more nationalist position."

The Labour leader Sir Keir Starmer celebrated the defection on social media, tweeting: "It's time to end the Conservative chaos, turn the page, and get Britain's future back. I'm really pleased that Dan has decided to join us on this journey."

Sky's Jon Craig called the defection a "disastrous blow for the Conservatives and a massive propaganda coup for Labour".

However, two councillors in Dr Poulter's constituency seemed glad to see him go.

Councillor Samantha Murray said in a post on X that the local Conservative Party "have had to carry him for years".

Councillor Ian Fisher posted: "Was campaigning this morning and he didn't even have the decency to tell his hard-working activists in advance. A very self-centered man."

Stop the boats? Sunak needs to stop the rot in the Tory party

Chief political correspondent

Dr Poulter isn't just any backbencher, which is what makes his defection to Labour all the more damaging for the prime minister and the Tory high command.

He's an NHS doctor who's worked in mental health services and was a junior health minister from 2012-15 when David Cameron was prime minister.

Alongside the formidable Mr Streeting, the dashing doctor will be a powerful advocate for Labour on the NHS.

Stop the boats? After the "honeytrap" MP scandal and the fiasco of the "bad people" MP, this calamitous defection from a high-profile and highly-respected MP, Mr Sunak needs to stop the rot in the Conservative Party.

Read more: Stop the boats? Rishi Sunak needs to stop the rot in the Conservative party

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A Conservative Party spokesperson responded to the resignation by saying the news would be "disappointing" for Dr Poulter's constituents.

"Under the Conservatives we are raising NHS funding to a record £165bn a year, helping it recover from the effects of the pandemic and driving forward its first-ever long-term workforce plan so that we train the doctors and nurses we need for the future in our country.

"Thanks to our plan, we have already virtually eliminated the longest waits and overall waiting lists have fallen by 200,000 in the last five months - and we will go further to make sure everyone gets the world-class care they need."

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