UK ex pat and NHS

[darbyman]

I had a visit from a Thai lady named Nid last Friday.  Never met her before but she had found me through a friend of a friend of my wife.  She was in a bit of a state and was looking for some advice relating to visas.  Unfortunately, as a retired family solicitor my legal knowledge is restricted to family matters, but my wife does have the habit of blowing my trumpet to excess. Anyway, I said I would try to help if I could so this is her story.

Nid married an Englishman some 10 years ago and they settled in Thailand to run a business between them.  He is in his mid-50’s and as far as I can tell has never bothered with health insurance or had regular check-ups whilst in Thailand.  Then the pains started.  A visit to the hospital showed that he had several serious internal problems which needed immediate surgery. The problem was that it was going to be very expensive.  They decided to close the business down temporarily, Nid to get a 6-month visitor visa, and they come to England to use the NHS.

They stayed with friends in the UK and he went to the hospital where he was told either receive immediate surgery or die, so he is in hospital now.  It’s three months since they came to the UK. Her main concern is that here visa will runout before he is well enough to travel. My question to this forum is- would the UK authorities extend her 6 months visitor visa on compassionate grounds or would she need to return to Thailand and renew the visa?

There is another problem which I raised with her.  Both she and her husband are convinced that this treatment with NHS is free.  I indicated that this may not be so.  I believe the hospital is aware of his circumstances but the question of financing has never been raised. I wonder if this forum can clarify the situation.

All help would be gratefully received

 

[theoldgit]

There isn't an option to extend her visa because of her husbands condition, she could try and extended it on compassionate grounds, but I'm not aware of any mechanism for doing so and I've never heard of it happening, that doesn't mean that it never has.

 

Her option would be to return to Thailand and reapply, but there's no guarantee that the visa would be approved, maybe try to extend in the UK, and take it from there.

 

You're of course correct in your concerns about NHS cover, access to the NHS is residence based, and as he's not resident in the UK he's liable to be charged 150% of the cost of any NHS treatment. Emergency treatment is free, as it would be for anyone visiting the UK, but ongoing treatment is chargeable.

 

NHS Trusts are obliged by law to check if patients can receive free treatment or whether treatment should be charged, I suspect some Trusts are more robost than others in their procedures.

 

If he intends to settle in the UK then he would be covered as soon as he sets foot in the UK, but he would need to provide evidence of his intentions, his wife wouldn't be covered and neither could she apply for Settlement in the UK.

[BritManToo]

1 hour ago, darbyman said:

All help would be gratefully received

She'll need to ask UK immigration.

I thought caring for a sick/disabled spouse was a reason for extension in the UK.

[steve187]

emergency treatment would be free

[theoldgit]

emergency treatment would be free

Yes, as I said earlier, it is, ongoing treatment isn’t.

[globalThailand]

10 hours ago, theoldgit said:

If he intends to settle in the UK then he would be covered as soon as he sets foot in the UK

On my return to the UK after 13 years in Thailand I had to wait 6 months before registering to a GP - despite starting a job within the first week of arrival. 

[magicroundabout]

Until very recently I worked for NHS and its very confusing. As said different trusts and boards have their own processes but if you are moving back to be a uk resident again it's free from the point you return.  The difficulty your friend may have is proving this.

The only thing I can say is the nhs isn't geared up particularly well to  charge patients so he might be lucky. 

 

In terms of a doctor when I returned to the UK from Thailand I registered with a doctor and dentist within a week and had no problems. 

 

 

 

 

[theoldgit]

On 1/29/2019 at 5:04 AM, globalThailand said:

On my return to the UK after 13 years in Thailand I had to wait 6 months before registering to a GP - despite starting a job within the first week of arrival. 

The rules are very clear, a British Citizen who returns to the UK after living overseas is entitled to the full range of NHS benefits as soon as they arrive in the UK providing that they can demonstrate that on returning to the UK, intend to become ordinarily resident.

 

However, as magicroundabout points out, it's very confusing for NHS staff who, rightly, see themselves as caring for the sick rather than revenue collectors.

 

Guidance on implementing the Overseas Visitor charging regulations

 

Nationality policy assessing ordinary residence

 

Ordinary residence tool

[chickenslegs]

The Citizens Advice website has a lot of information about UK visas, and can be contacted by phone or online.

 

Might be worth a try.

 

https://www.citizensadvice.org.uk/resources-and-tools/search-navigation-tools/Search/?c=HOME&q=extending+a+uk+visa

[OJAS]

20 hours ago, darbyman said:

It’s three months since they came to the UK. Her main concern is that here visa will runout before he is well enough to travel.

First and foremost Nid and her husband should IMHO seek an opinion from the doctors who are currently treating him as to how much longer he will need to continue receiving emergency treatment (at zero cost) before the green light can be given to him flying back to Thailand (with fingers firmly crossed that this will be possible within the remaining lifetime of her visa).

 

However, he would, of course, then be liable for the cost of any residual treatment he might need after his return to Thailand, but my gut feeling is that this would probably amount to rather less than the corresponding NHS cost + 50%. In this connection he would almost certainly find it impossible to obtain health insurance cover in Thailand for what would now in all probability be deemed a pre-existing condition.

Edited January 29, 2019 by OJAS

[gamini]

I really wonder if they did the right thing. I have found that most of the government hospitals here are very good and very cheap.  

[Pdavies99]

On 1/29/2019 at 12:21 AM, magicroundabout said:

Until very recently I worked for NHS and its very confusing. As said different trusts and boards have their own processes but if you are moving back to be a uk resident again it's free from the point you return.  The difficulty your friend may have is proving this.

The only thing I can say is the nhs isn't geared up particularly well to  charge patients so he might be lucky. 

 

In terms of a doctor when I returned to the UK from Thailand I registered with a doctor and dentist within a week and had no problems. 

 

 

 

 

She can fairly easily apply for extension of compassionate grounds, I have experience of this last year.

 

Your friend does not have to prove anything, the fact that he is back in the UK and states he is a UK resident is sufficient.   Of course it makes it easier if he can quote a NI Number, a UK address whatever that is, and has registered with a Doctor (Although that is not an issue).

 

You need to remember these rules re access to the NHS were originally set up to stop non UK residents from obtaining free care and the fact is, you are never actually classed a a THAI resident unless you have obtained this status, most if not all normally have a one year only visa of some type.

 

Regardless I am sure some will argue these points, but I have never heard of someone being refused NHS treatment as long as he can do what I suggested above. (Unless you state you live in Thailand and are only back for treatment...Duh!)

 

Good.luck.

[NanLaew]

5 hours ago, gamini said:

I really wonder if they did the right thing. I have found that most of the government hospitals here are very good and very cheap.  

Good and very cheap is less efficacious and 100% more expensive than excellent and free.

[Jaggg88]

As previously stated all UK citizens have unfettered access to the NHS unless they reside abroad. No matter where you choose to live you will never cease to be a UK citizen unless you renounce citizenship. You can return to the UK whenever you wish and just give the hospital your name, DOB and NI or NHS number - a UK address and GP would be beneficial but not compulsory. You do not have to explain your presence there or where you have been although not giving a UK address will prompt further questions.

[nontabury]

On 1/28/2019 at 10:04 PM, globalThailand said:

On my return to the UK after 13 years in Thailand I had to wait 6 months before registering to a GP - despite starting a job within the first week of arrival. 

It would seem,you were wrongly advised. I returned to the U.K last year after 20yrs in Thailand. Within a few days, I and my two children were registered with the local doctor. I also attended an appointment with him to discuss, medical treatment I had received abroad, he then sent me for blood test, no problem.

 Furthermore my Thai wife, who had paid for a NHS insurance policy, as part of her Visa application, was also allowed to register, immediately with the same G.P.

  The only requirement, is that you should state that it’s your intention to re- locate back to the U.K. even if it’s not true. I gave my address as the Holiday cottage, where we were staying.