COMMERCIAL: A report to Epsom and St Helier University Hospitals Trust’s Finance and Service Improvement Committee said maternity and dialysis services were those that attracted the most overseas visitors.

Minutes of the Finance and Service Improvement Committee said: “[chair] Laurence Newman noted that there had been recent press coverage of foreign debts outstanding to the NHS and asked what the Trust’s position is.

Chrisha Alagaratnam [director of finance] reported that the trust makes a provision against overseas visitors’ debts until the cash is received and therefore there is no risk to the trust’s reported position.

“Ms Alagaratnam reported that as reported at the audit committee £290k of bad debts had been written off.

“Mr Newman asked what systems the trust has in place to deal with this and which specialties attract the most overseas visitors.

Ms Alagaratnam reported that the trust has robust procedures in place to identify overseas visitors and that renal dialysis and maternity services attract the most overseas visitors. Martin Stockwell [medical director] stated that there are difficult ethical concerns in withholding renal dialysis from overseas patients who have not paid.

[Chief operating officer] Karen Breen stated that all patients are entitled to emergency medical treatment, however renal dialysis is a grey area as potentially at the point of presentation at hospital the patient will not be an emergency, but the will be in a few days if dialysis is not given.

The committee would ask the renal directorate to get a network-based solution which would be reported at the Patient Safety and Quality Committee.”