A person in the country illegally racked up a medical bill of more than $165,000 that was later written off by a DHB.
Northland DHB recently wrote off about $335,000 as bad debt, the majority of which was owed by the one elderly patient.
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According to the DHB, it did so after unsuccessful approaches to Immigration NZ and the relevant embassy for help, and deportation was ruled out on humanitarian grounds.
The DHB declined to release information about the case, including what country the patient was from, exactly how much they owed, and what medical services they needed.
"Anyone in New Zealand requiring acute health services can receive the services they require from a district health board. If they are not eligible to receive publicly funded health services, they can expect to be invoiced," Northland DHB chief executive Dr Nick Chamberlain said in a statement about the case.
"If a person is too unwell to make an informed decision about whether they want further treatment, and a clinician determines that treatment is necessary to prevent loss of life or significant disability, treatment should be provided."
Chamberlain said the person in question was a vulnerable elderly patient who still lives in Northland. They had complex health conditions and there was a high likelihood they'd need hospital care in the future.
Summary information obtained by the Weekend Herald under the Official Information Act, including from emails between staff about the case, show the patient had been in the country illegally since a visa expired in 2012, and was fearful of deportation.
"NDHB service manager has explained to patient that it would be in patient's best interest to contact Immigration NZ and return to home country but patient is adamant that they do not want to return," one summary of an email from the DHB to the person's home consulate states.
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"The patient's circumstances have been explained to Immigration on a number of occasions who say they are unable to act due to a new policy with the DHBs that prohibits Immigration NZ acting on information supplied by DHBs."
In May a debt collection agency met with the patient, and was told all their income went on living expenses and they had no other income or savings to pay any debt. Two months later the board agreed to write off up to $335,531 as bad debts, the majority of which was owed by the patient.
Dave Campbell, Immigration NZ's national manager for compliance, said he wasn't able to comment on the case, without a name being provided. There was no new policy in relation to information-sharing with DHBs, he said.
"DHBs are able to make inquiries with Immigration New Zealand about the status of a visa holder to determine health subsidy eligibility. INZ and the Ministry of Health/DHBs continue to work on how health information relating to visa applicants can be shared in a lawful manner."
Health boards often take on bad debt related to ineligible overseas patients. Auckland, Waitematā and Counties Manukau DHBs write off about $10 million of such debt between them each year.