Visitors should pay up, say locals

The enforcement of rules requiring foreigners to pay for hospital treatment gets the approval of people polled informally outside Auckland City Hospital, and many of them say that New Zealanders' health has to come first.

"We take priority," said Dianne Adams, sitting outside the Grafton complex. No one who supported good public health, she added, should be offended to be asked for proof of eligibility - a New Zealand passport or relevant residency visas.

The hospital's parent, the Auckland District Health Board, was saddled with $2.6 million of bad debts in the year to June 30. It has long had a policy that new patients, or those whose status is uncertain, provide proof of New Zealand citizenship or residency to avoid bills.

But a spokeswoman said the policy had not been well enforced. From this week, to reduce the bed debt load, staff would start clamping down.

Glendowie man George Statham said that he had paid taxes all his life in return for free healthcare, and New Zealanders should not have to "give way to people from overseas who have been here a few minutes". He accepted that he would pay for treatment while overseas if it was required.

A woman born in China whose son was delivered at the hospital said she was not bothered to be asked, as she was being discharged, to prove her New Zealand residency.

"People from overseas do abuse the system," she said. She handed over her passport, which was photocopied.

A New Zealand-born patient with terminal cancer was angry that ineligible foreigners had sucked up money and resources. As she sat on a waiting list, she said, her cancer had become inoperable.

She wondered if earlier intervention would have prevented a death sentence.

The middle-aged woman referred to 3-year-old Bangladeshi stroke patient Shihab Fahim, whose family has received donations of $18,619 towards a $37,500 bill: "That child has had more treatment than I have."

Overseas nationals treated at Auckland City Hospital's emergency department can expect to pay, for example, from $42 for a splint or dressings, up to $200 for a blood transfusion. Payment is sought after treatment.

A staff member reported little difficulty broaching payment with most overseas patients - many were used to paying upfront for medical care at home. The Auckland board is focusing most closely on recouping the costs of elective, or non-urgent, surgery, suggesting that this is its area of greatest bad debt. A knee or hip replacement costs, for example, upwards of $16,000, and a gall bladder removal about $8500. Inside the Grafton hospital yesterday there was little sign that things were changing. Some, but not all, departments bore the standard-issue notice on payment by overseas patients. New posters are due this week.

What it costs

Non-resident treatment prices at emergency department, Auckland City Hospital

Clinical assessment and examination: $133
Dressings and splints: $42
Prescription: $48
Social worker, per hour: $68
Resuscitation per 15 min: $68
Ambulance transfer: $88
Interpreter, per hour, daytime: $85
Interpreter, per hour, after hours: $102
X-rays, each: $118
Ultrasound: $156
Blood transfusion, per unit: $200
CT (computerised tomography) scan: $761
Source: Auckland City Hospital