It has emerged that there is an unpaid bill of almost £70 million owed to the NHS racked up by visitors to the country who then leave without paying.

Almost two thirds of this (£25 million) says the Express has been built up in the last two years alone.

The true extent of this problem has yet to be fully uncovered and it is thought that the unpaid bills may in fact be far higher than this initial amount.

Although many people will throw their hands up in horror at this abuse of our system we have to admit to ourselves that we are the ones that let it happen.

We have put in place a National Health Service that is designed to welcome all comers to its doors and treat them equally putting healthcare above cost. We proudly declare that our system is superior and will never turn anyone away that requires medical treatment. Unlike the US system, we shout from the rooftops, where no insurance could mean no healthcare. And if we can afford to fly in one girl from Pakistan and treat her here for a gunshot wound to the head and advertise it to the world then some may surmise that we are a very rich nation and can afford to help them too. No wonder people come here for treatment.

But we are now on the verge of doing the exact same thing ourselves, starting with foreigners. No National Insurance Contributions or other insurance or non-insurance based payment = no healthcare (note the word 'insurance' in there).

And after we've applied that to foreigners for non emergency treatment, who's next and where do we go next? Cut off emergency treatment?

But there are problems here:

To be effective this sort of policy would need to have teeth – we would need to see people who are in need of treatment being turned away until their condition becomes an emergency (which could be too late and is also I imagine not good medical practice), so putting off other would be health tourists – but that would never be acceptable in the UK. So any such policy is a non-starter.

There would need to be more NHS administrators to monitor and chase the money and managers to manage them. Would the added cost justify the take?

Will medical staff and administrators be shielded by the law from the results of any resulting deaths and injuries (including psychological) suffered by those they turn away? If not then they won't be turned away and the bill passed on to the tax payer.

NHS LogoWe could try billing the embassies of the countries concerned who could then chase the non-payers, but it would not take long for visitors to learn to refuse to say where they have come from (there's probably a human right in there somewhere).

We also have to accept that we have actively trawled the world for the best doctors and nurses to fill the NHS to our benefit and other countries' detriment. There maybe should be a cost to us associated with that above and beyond the wages of those we hire.

But, at the end of the day, it is the money that talks; and that coupled with the public's sense of fair play may well mean we see the NHS asking for proof of payment prior to non-emergency treatment (to start with).

And if you want to see a privatised healthcare system in the UK that is probably the steepest slippery slope to getting there.

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