PLP helps family overturn £153,000 hospital bill 

In 2025, Public Law Project (PLP) supported a family in successfully challenging NHS charges of over £153,000 for care provided to their baby, B, who was born extremely prematurely. The case raises serious concerns about the way NHS Trusts are applying the NHS Charging Regulations to families protected under the EU Settlement Scheme (EUSS). 

PLP is also acting for another family challenging the lawfulness of the Regulations themselves, as applied to EUSS status holders who got their status after applying late, where the Home Office recognised there were good reasons for them applying late. 

Background 

B was born in April 2023 at just 25 weeks’ gestation and spent the first months of his life in hospital, where he received intensive neonatal care. He remained in hospital until September 2023 and continued to need significant follow-up treatment, including a later readmission. 

While still caring for their medically vulnerable child and living on a low income, B’s parents were shocked to receive an NHS bill in 2024 for more than £153,000. The scale of the charge caused significant financial and emotional distress at an already extremely difficult time. 

B’s father, a Swedish–Somali dual national, moved to the UK for work in 2019 and was granted pre-settled status under the EUSS in 2020, later progressing to settled status in 2025. B’s mother joined him in the UK in 2022 and was also granted pre-settled status. Under the terms of the EU-UK Withdrawal Agreement and the EUSS, children born to parents who are protected by the Withdrawal Agreement are entitled to EUSS status as well.  

When B was born, he was extremely premature and admitted straight into intensive care. His parents mistakenly believed he would automatically be treated as British. They also then experienced delays in obtaining documents that they had been advised were needed to make an EUSS application. As a result of these events, an application for his EUSS status was unfortunately not made within three months of B’s birth, the current deadline for newborn children. When the family applied to the EUSS on his behalf in May 2024, the Home Office accepted that the application was late for a good reason and granted him status. The guidance recognises that children will usually have reasonable grounds where their parents did not apply in time, and B was granted pre-settled status on that basis. 

Why the NHS charges were wrong 

Our two main arguments for this case were: 

1. The NHS Trust misapplied the NHS Charging Regulations 

B was entitled to free NHS treatment during the first three months of his life, as the child of an EU citizen protected by the Withdrawal Agreement. However, PLP argued that, under the NHS Charging Regulations, he was also entitled to further free treatment after he was 3 months old, where this treatment was part of a continuous course of treatment. His exemption from charges should have lasted until that course of treatment ended, or if he left the UK (which he had not).  

B’s hospital care flowed entirely from the complications of his premature birth. Because that treatment began under the three-month exemption, the exemption should have applied to the whole period of related care. The Trust failed to apply this rule. 

There was a second error. Under the NHS Charging Regulations, a person with a pending EUSS application cannot be charged. The Trust incorrectly assumed that B’s entitlement began only when the Home Office issued his certificate of application, validating his application, in August 2024. But the certificate confirmed that his application had been made months earlier, in May 2024. This meant he should not have been charged for treatment received during that time. 

2. The Charging Regulations and Guidance themselves may be unlawful 

Beyond the NHS Trust’s errors, PLP has also acted for families who are challenging the legality of the Regulations and Guidance themselves. We have argued that under the Withdrawal Agreement, once a late EUSS application is accepted, the status granted should take retroactive effect. In other words, the person should be treated as though they had applied for their EUSS status in time and were always protected by the Withdrawal Agreement.   

People with EUSS status are not chargeable for NHS care. PLP argued on the family’s behalf that the NHS was not entitled to charge B’s family for any NHS treatment he may have received in the past, once he obtained EUSS status: his late application was accepted with good reason, and so he should be treated as having been protected by the Withdrawal Agreement, continuously, from birth. 

Outcome 

The NHS Trust ultimately accepted that it had applied the regulations incorrectly and agreed to cancel the entire debt. 

The financial and emotional toll of this case on the family was enormous. For more than a year, they lived under the weight of a bill larger than most UK mortgages, issued just months after the birth of their child, who required serious medical treatment. 

“I was so low and devastated because my child was born very premature. After he received treatment I was invoiced. I was so surprised… we were not able to pay that level of debt. We have been affected in so many ways.” 

The family urged others who receive incorrect NHS invoices to seek help, saying they would refer anyone in their situation to Public Law Project. 

Why this matters 

NHS charging rules are complex, and mistakes can have enormous consequences. Families who are lawfully entitled to free NHS care can be incorrectly presented with life-changing bills, at exactly the moment they are coping with medical crises. 

This case shows why robust legal oversight and advocacy is essential when public bodies are making decisions with such serious consequences for individuals. It also shows why public bodies must understand and apply the rights guaranteed by the Withdrawal Agreement. 

PLP continues to challenge incorrect charging decisions and to pursue another legal challenge to the Regulations and Guidance themselves, which will be heard on 17 and 18 December 2025 in the Royal Courts of Justice.  

No family should face financial ruin because of errors in the application of the law.