Migrant family’s toddler cancer treatment ordeal

The parents of an East London toddler suffering from a rare cancer were hounded by debt collectors at the request of their local NHS trust.

In 2022, Barking, Havering and Redbridge University Hospitals (BHRUT) sent parents Reeja and Basu Shrestha a £76,000 bill for treating their three-year-old daughter Omisha for a rare form of liver cancer.

Reeja and Basu are both from Nepal and, despite living in the UK for over a decade, have limited access to public services like the NHS due to their visa status.

Campaign group Migrants Organise, who assisted the Shrestha family, said it took months and “mountains of evidence” for the trust to recognise the family’s financial situation and call off the enforcement.

Thankfully Omisha, a “brave and happy child”, has since been granted British citizenship, which means her NHS treatment is now free.

Reeja told the Local Democracy Reporting Service (LDRS) that, during a “very stressful” period, BHRUT’s overseas team repeatedly asked her to pay £76,000 for Omisha’s care before passing the case onto collection agency CCI Credit Management.

She said: “We do not feel like they are treating us with dignity, respect or compassion.

“We have heard of similar cases of people who have been chased for their NHS debt, so we know that we are not alone and that there are lots of other people who are struggling. 

“We think that it is unjust that Omisha has to pay for her NHS cancer treatment and that we have been treated in this way because of the hostile environment, and we don’t want any other family to go through this stress ever again.”

When contacted for comment, BHRUT said it has carried out an “investigation” and plans to write off the debt in May.

A spokesperson for the trust apologised “for the time taken” over accepting that Reeja and Basu should not pay the £76,000 bill.

They added: “We know this will have been a worrying time for the Shrestha family. As the law stands, overseas visitors who aren’t entitled to free NHS care must pay for their treatment.”

The trust said it charged 700 “overseas patients” for treatment in the current financial year. Its most recent accounts also show that, in 2021/22, it charged “overseas patients” £2.6million, although only £492,000 was paid.

While BHRUT denies debt collectors were “sent to the family”, an email from a member of staff at the trust, shown to the LDRS, said the bill was “passed to a debt collection agency” in early 2022.

Aliya Yule from Migrants Organise also told the LDRS she also discussed Reeja’s debt directly with CCI Credit Management.

Aliya said: “Omisha’s story is not an accident, nor is it an isolated incident.

“It is the result of a decade of increasingly hostile immigration policies being brought into the NHS by successive governments in order to scapegoat migrants for the crisis in the NHS.

“This stops hospitals treating their patients with compassion or dignity.”

She added that the charging policy turns NHS trusts into “border guards” and erodes trust between patients and health workers.

Reeja is now campaigning against “unjust” NHS charging policies. The family has started a Change.org petition calling on BHRUT to put in safeguards against billing “destitute” families and not to refer patients’ debts to collection agencies.

Following the publication of this article, a spokesperson for the Department of Health and Social Care (DHSC) spokesperson said: “Overseas visitors, including people living in the UK without permission, are generally chargeable for NHS care.

“However, we’ve always been clear that urgent care should never be delayed or withheld, even if a person cannot pay.

“Guidance is clear that it is for NHS Trusts to work with patients to discuss reasonable repayment plans, and in cases where charges cannot be recovered because the person liable is without funds, the Trust should consider writing the debt off in their accounts and pause measures to pursue collecting repayments.”

Guidance issued by the DHSC recommends that NHS bodies employ debt collection agencies to recover “overseas debt”.

Although the guidance instructs NHS bodies to write off debt if patients are unable to pay, it must remain on their record and may still be recovered if financial circumstances change.

Josh Mellor

Local Democracy Reporter