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A foreign heart patient has obtained more than $50,000 of taxpayer-funded treatment in Auckland by using a dead person's passport.

The woman, who used a Chinese name, appears to have fled when about to be confronted.

Health officials said the 66-year-old was not eligible for the free care she received. Auckland District Health Board chairman Wayne Brown said the case highlighted the difficulties in detecting ineligible patients.

"It's a good example of the lengths people will go to. These people really understand our system," he said.

Auckland's three health boards, serving the country's biggest immigration area, bear the brunt of foreigners' bad debts, which are only partially offset by extra Crown cash.

People entitled to free hospital care include New Zealand citizens, permanent residents and visitors with long-term work permits or from countries with reciprocal health deals.

The patient with a deceased's passport received care at Auckland heart, blood and outpatients services from August 2004 at a cost of $51,189.

The Immigration Service told the board the woman was ineligible and had been using another person's passport to claim eligibility.

"The facts suggest that this may well be a case of someone fraudulently using the identity of another passport holder to obtain treatment from ADHB," a staff memo to the board's audit committee says.

Chief financial officer Roger Jarrold said last night that officials had intended to ask the patient and her daughter for payment at an arranged meeting - the two women having not been told of the purpose of the meeting.

"We are no longer in contact with them. We've advised Immigration what's going on ... We will go to the police with it.

"We have been informed by the Immigration Service that the individual believed to be using the passport is no longer in New Zealand."

Despite this case, the board's clampdown on ineligible foreign patients last year is paying dividends.

Mr Jarrold said bad debts owed by non-residents amounted to $939,000 in the six months to September, compared with $2.01 million for the corresponding period last year. "There's been a significant improvement. It's working better for us, we are receiving more money. It's still a large issue, because we treat acute patients automatically and deal with it [eligibility] after."

Since last October, all new patients, including New Zealanders, have been required to prove their eligibility by showing their passport, birth certificate or similar document to Auckland City Hospital officials - or face being billed for treatment.

Those already known to the health system have a number, accessible by hospitals, listing them on the National Health Index, which records their residency status.

The Counties Manukau board had non-resident bad debts of $2.3 million last year.