The Department of Health said those not entitled to free care should pay. But a third of overseas visitor managers polled by their association admitted patients were not routinely asked about their entitlement. Guidance published in 2004 stipulates hospitals should check whether foreign nationals are entitled to free care.

One of the many excuses given to justify the lack of procedure is that staff are scared of possible abuse, not only by overseas visitors, but also from people who feel it is unjust to be asked.

A confidential report for the Department of Health, released under the Freedom of Information Act last year, estimated that £30m was lost in un-recovered debts from foreign visitors in 2004. Some overseas visitor managers in hospitals told the BBC that they found the guidelines confusing and described how some staff are uncomfortable checking patients’ immigration status. Four years on, the Donal MacIntyre programme on Radio 5 Live has learned the rules are widely ignored.

And we wonder why the NHS is always in debt.