Health board to demand patients' ID

Little Shihab Fahim's parents face a $37,500 medical bill.

New Zealanders will have to show a passport, birth certificate or other identification from next week to qualify for free care at the country's largest health board.

The Auckland District Health Board is clamping down on treatment for ineligible foreigners which left it with $2.9 million in bad debts to June 30.

Now it is demanding that all eligible patients - New Zealand citizens, permanent residents, people with work permits or from countries with reciprocal agreements - produce identification, or they will get a bill for their treatment.

The move marks a new stage in the board's clampdown on free treatment for ineligible foreigners.

Overseas patients left the board with the $2.9 million bill, which was paid by the Health Ministry.

In a recent case, the family of Bangladeshi boy Shihab Fahim, 3, faced a bill of $37,500 for emergency treatment he received at Auckland's Starship hospital.

Nationally, the ministry is putting $2.77 million into bad debts this year, down from $9.45 million last year.

The board's new chief financial officer, Roger Jarrold, said yesterday that the taxpayers of New Zealand were paying for that non-resident care.

Bad debts were increasing, but the Government was reducing its funding to cover them, he said.

The main focus was on elective services. No patient needing acute care would be turned away.

Board staff will post the new rules next week at hospital and clinic reception areas. Prices for treatment will also be available to patients.

Mr Jarrold said even people who were born in New Zealand would have to prove their eligibility, for example by presenting their passport or birth certificate. But once the board held proof of a patient's eligibility, he or she would not have to show the documents at later visits.

The Counties Manukau District Health Board chief executive, Stephen McKernan, said his board, which runs Middlemore Hospital, had already implemented a policy like Auckland's.

Auckland and Counties Manukau, in New Zealand's biggest immigrant region, have been among boards worst affected by foreigners' bad debts.

"In the last few years we have made good headway in reducing that level of debt," Mr McKernan said. "Two to three years ago it was about $3 million per annum; now it's less than half that.

"We support the Auckland position and the fact that the New Zealand public health system should be provided primarily for New Zealanders."

In 2003, the Auckland board wrote to hundreds of National Women's Hospital patients who had declared on forms that they were born overseas, but for whom the hospital had no record of their proof of New Zealand residency or citizenship.

Also in 2003, the Government resumed charging non-resident women for birthcare after learning that some came to New Zealand just to cash in on the scheme.

Health Minister Annette King would not comment on the Auckland move yesterday, because of the Government's caretaker status.

* Donors have contributed more than $18,000 towards the $37,500 bill faced by Shihab Fahim's family.

The boy was treated at the Starship after a stroke. His father, Ashraf Uddin Khokon, who is in New Zealand on a student visa, had sought time to pay the bill, but the board gave him 12 months to settle the account before it would refer the matter to a debt collector and the Immigration Service.

But yesterday, in another blow to the family, an Immigration spokeswoman said Mr Khokon's student permit had been revoked following information that he was working full-time as a taxi driver.

Shihab is now paralysed down his right side.

Burden of proof

* Auckland District Health Board requires new patients to prove they are eligible for state-paid care.
* Citizens or permanent residents will have to show their passport or similar proof of eligibility.
* People with a work permit that is continuous for at least two years also qualify.
* Australian and British visitors are entitled to free acute care.
* Australians resident in New Zealand have the same entitlements as New Zealanders.