Overseas patients needing non-urgent treatment at hospital will be made to pay first under a major crackdown on health tourism. 

From April hospitals will be legally obliged to charge patients upfront for procedures which are not deemed immediately necessary. 

This includes hip or knee surgery, cataract removals and operations to remove hernias as well as certain scans and medications. 

If patients are unable to pay, doctors will be told to make a decision, based on their clinical need, as to whether the treatment should go ahead anyway. 

One in 14 people in England are on an NHS hospital waiting list. Some 3.7million are waiting to be admitted for routine treatment the highest figure for nearly a decade. 

Nearly one in ten of those 350,000 people have been waiting for longer than the official maximum waiting time. 

Many may be instructed to return to their home countries and have the procedure there. 

The rules will not apply to maternity care or any treatment considered potentially life-saving or immediately necessary. 

This includes scans or treatment for cancer or heart conditions as well as operations to remove the appendix.

Hospitals are also being told to ask all new patients for passports and utility bills when they first arrive to check they are entitled to NHS care. 

Those which fail to show they are collecting enough money from patients at the end of the year may be fined. 

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