NHS Treatment

saintdomingo · June 23

There has been mention and some discussion over UK Citizens (possibly only applying to pensioners) who have been away from the UK over 3 years no longer qualifying for free treatment.

Is it a rule but a rarely enforced one.?

Anyone with knowledge or experience on this matter care to comment.

I am not saying treatment would be refused but would be chargeable, I have seen comments a few years ago, some naysayers and some saying that there have been a few crackdowns.

Sheryl · June 23

To my understanding, the policy is that people who have been living abroad are not eligible unless they have permanently returned to the UK i,e, returned with "intent to permanently remain. " Obviously intent can not be objectively proven, it comes down to what the person states.

Some people just maintain their registration with a UK GP and a UK address so have no problem.

There have been board members who returned to UK for urgent treatment apparently without problem, but I have also heard io people running into refusal. Mainly these were people who advertised the fact that they lived in Thailand.

If you can maintain a UK address (family, friend etc) and registration with a GP that would be advisable, If you cannot, remember that the rule is "intent to resttle permanently in UK",

And if planning to rely on returning for NHS care in case of need for medical care, make sure you have at least travel insurance. In an emergency you may not be stable enough to fly.

proton · June 23

If these lying illegal immigrant boat people arriving in the UK with no passports are eligible then i'm certainly going to make sure I am, after paying national insurance for 40 years!

soi3eddie · June 23

"Never burn your bridges". Just one piece of advice my dear mother drilled into me from an early age.

it is what it is · June 23

simply being born in the uk is winning the lottery, why would you throw all the advantages away? keep a uk address, keep a uk bank account, keep registered with a gp. only an idiot would completely cut ties for, with all due respect, thai banking and medical care.

josephbloggs · June 23

4 hours ago, proton said:

If these lying illegal immigrant boat people arriving in the UK with no passports are eligible then i'm certainly going to make sure I am, after paying national insurance for 40 years!

No need for right wing nonsense in a factual thread, thank you.

josephbloggs · June 23

4 hours ago, Sheryl said:

To my understanding, the policy is that people who have been living abroad are not eligible unless they have permanently returned to the UK i,e, returned with "intent to permanently remain. " Obviously intent can not be objectively proven, it comes down to what the person states.

Some people just maintain their registration with a UK GP and a UK address so have no problem.

There have been board members who returned to UK for urgent treatment apparently without problem, but I have also heard io people running into refusal. Mainly these were people who advertised the fact that they lived in Thailand.

If you can maintain a UK address (family, friend etc) and registration with a GP that would be advisable, If you cannot, remember that the rule is "intent to resttle permanently in UK",

And if planning to rely on returning for NHS care in case of need for medical care, make sure you have at least travel insurance. In an emergency you may not be stable enough to fly.

I have been in Thailand for 28 years and haven't paid NI in that time. I am currently on a two week visit to the UK. I needed to visit A&E a few days ago which I wasn't happy about as I don't like to burden services, but I needed to. I went to the registration desk and was honest and told them upfront that I am a UK citizen but not a resident, and I have lived abroad for 28 years with no UK address (other than family). They asked if I had a GP, I said no. I had my passport with me but wasn't asked for it. They were happy to accept my brother's address as that is where I was staying at the time.

Long story short, no further questions asked. I spent several hours there (mostly waiting), had an ECG, blood tests, an examination, and finally was dispatched with some medicine with advice to come back the next day if not improved. (I didn't go back).

All free, all service was great if a lot slower than Thailand. I was honest upfront as I expected I might have to pay - and rightfully so as I have not contributed NI since I lived here 28+ years ago - but no problem, all looked after, all free. And I didn't try to game the system, I was honest upfront without being asked.

scubascuba3 · June 23

1 hour ago, josephbloggs said:

No need for right wing nonsense in a factual thread, thank you.

What he posted was factual, maybe you were offended, tough

scubascuba3 · June 23

1 hour ago, josephbloggs said:

I went to the registration desk and was honest and told them upfront that I am a UK citizen but not a resident,

You got lucky, that was a mistake, why even risk it, a different person at the desk might have processed differently

saintdomingo · June 23

Many thanks for all responses, very helpful.

hunkidori · June 24

I think if you can give them an address that you have an association with like a bank account and are still registered at a doctor's surgery then I can't see too many questions being asked. No need to volunteer information that is not asked for

The Fugitive · June 24

5 hours ago, josephbloggs said:

I have been in Thailand for 28 years and haven't paid NI in that time. I am currently on a two week visit to the UK. I needed to visit A&E a few days ago which I wasn't happy about as I don't like to burden services, but I needed to. I went to the registration desk and was honest and told them upfront that I am a UK citizen but not a resident, and I have lived abroad for 28 years with no UK address (other than family). They asked if I had a GP, I said no. I had my passport with me but wasn't asked for it. They were happy to accept my brother's address as that is where I was staying at the time.

Long story short, no further questions asked. I spent several hours there (mostly waiting), had an ECG, blood tests, an examination, and finally was dispatched with some medicine with advice to come back the next day if not improved. (I didn't go back).

All free, all service was great if a lot slower than Thailand. I was honest upfront as I expected I might have to pay - and rightfully so as I have not contributed NI since I lived here 28+ years ago - but no problem, all looked after, all free. And I didn't try to game the system, I was honest upfront without being asked.

Interesting and thanks for your information. I'm pleased you were tested, examined and received medication that was obviously effective. I'm guessing they accepted your case was an 'emergency'. Therefore, everyone regardless of residential status is entitled to free treatment. If they hadn't, they might have moved heaven and earth to get you out of the door without spending any money, telling you to go to your GP. The fact you'd told them you weren't registered with one may (or may not) have made any difference. We shall never know that.

The Fugitive · June 24

10 hours ago, Sheryl said:

To my understanding, the policy is that people who have been living abroad are not eligible unless they have permanently returned to the UK i,e, returned with "intent to permanently remain. " Obviously intent can not be objectively proven, it comes down to what the person states.

Some people just maintain their registration with a UK GP and a UK address so have no problem.

There have been board members who returned to UK for urgent treatment apparently without problem, but I have also heard io people running into refusal. Mainly these were people who advertised the fact that they lived in Thailand.

If you can maintain a UK address (family, friend etc) and registration with a GP that would be advisable, If you cannot, remember that the rule is "intent to resttle permanently in UK",

And if planning to rely on returning for NHS care in case of need for medical care, make sure you have at least travel insurance. In an emergency you may not be stable enough to fly.

Very good information (as always), thanks Sheryl. I can advise that when checking-in for an outpatient appointment at my UK NHS hospital the check-in machine asks; 'Have you been resident in the UK for at least the previous six months?'. The answer options are limited to yes or no.

hotandsticky · June 24

10 hours ago, Sheryl said:

To my understanding, the policy is that people who have been living abroad are not eligible unless they have permanently returned to the UK i,e, returned with "intent to permanently remain. " Obviously intent can not be objectively proven, it comes down to what the person states.

Some people just maintain their registration with a UK GP and a UK address so have no problem.

There have been board members who returned to UK for urgent treatment apparently without problem, but I have also heard io people running into refusal. Mainly these were people who advertised the fact that they lived in Thailand.

If you can maintain a UK address (family, friend etc) and registration with a GP that would be advisable, If you cannot, remember that the rule is "intent to resttle permanently in UK",

And if planning to rely on returning for NHS care in case of need for medical care, make sure you have at least travel insurance. In an emergency you may not be stable enough to fly.

I returned for a hernia op and had no issues.

The key for me was still being registered with my doctor. He examined the hernia and made the referral.

proton · June 24

5 hours ago, josephbloggs said:

No need for right wing nonsense in a factual thread, thank you.

Right wing? calm down, or are you one of those that think the countryside and now milk are racist and colonialist?

mokwit · June 24

It seems a lot of people, but not all get treated - I believe the law was changed in response to a certain type of abuser.

https://www.gov.uk/government/publications/help-for-nhs-to-recover-costs-of-care-from-visitors-and-migrants/settled-purpose-tool

The Fugitive · June 24

1 hour ago, hotandsticky said:

I returned for a hernia op and had no issues.

The key for me was still being registered with my doctor. He examined the hernia and made the referral.

I had a left inguinal hernia repair (with mesh inserted) by UK NHS in 2000. Despite reading some stories I've had no problems since. Did you obtain a quote for this operation in Thailand? However, I suppose if you were returning to UK anyway........

Sheryl · June 24

3 hours ago, The Fugitive said:

Very good information (as always), thanks Sheryl. I can advise that when checking-in for an outpatient appointment at my UK NHS hospital the check-in machine asks; 'Have you been resident in the UK for at least the previous six months?'. The answer options are limited to yes or no.

I leave it to you to decide what to do in that case.

A "No" answer will lead to problems/visit not being covered under NHS for hospital care.

I recently spent 2 months in the UK as a visitor along with a family member who has no regular insurance so researched carefully NHS policy on non-residents/tourist.

For non-residents (including former UK residents living abroad, as well as tourists etc) A&E visits are free as are GP visits, but hospital care is not. See https://www.gov.uk/government/publications/how-the-nhs-charges-overseas-visitors-for-nhs-hospital-care/how-the-nhs-charges-overseas-visitors-for-nhs-hospital-care

I can verify from first hand experience that this is true, and also that visit to "urgent care" centers are also free, I guess classed as GP care. At least was in the Urgent Care I used.

Of course the free GP care presumes you are registered with a GP or can become so, and it is up to GPs whether to accept new registration of non-residents/temporary visitors. In the case of the family member who accompanied me and was staying a full 6 months, one GP rejected her registration but another accepted her.

To my understanding the free GP care does not extend to care from a specialist if GP has to refer you to one.

Basically, to be covered for specialist care/ hospital care you need to be able to either:

- present yourself as a UK resident and not mention having been out of the country. If coming back to UK on a regular basis and maintaining a UK address and GP registration, this is frankly what I would do.

- present yourself as having lived abroad and now returned with intention of permanently remaning

-have travel insurance that covers you for hospital care while in UK

hotandsticky · June 24

3 hours ago, The Fugitive said:

I had a left inguinal hernia repair (with mesh inserted) by UK NHS in 2000. Despite reading some stories I've had no problems since. Did you obtain a quote for this operation in Thailand? However, I suppose if you were returning to UK anyway........

No, I wasn't returning.

I had the hernia op in Korat (an excellent recommendation from Sheryl), first class treatment - unfortunately it didn't work and I wasn't going to pay another 205,000 Baht.

I timed a holiday visit to enable me to see the local GP in the knowledge that the op date should fall into my Christmas visit. I had to make one extra visit for the hospital consultation but managed to do the pre-op stuff remotely.

The Fugitive · June 24

6 minutes ago, hotandsticky said:

No, I wasn't returning.

I had the hernia op in Korat (an excellent recommendation from Sheryl), first class treatment - unfortunately it didn't work and I wasn't going to pay another 205,000 Baht.

I timed a holiday visit to enable me to see the local GP in the knowledge that the op date should fall into my Christmas visit. I had to make one extra visit for the hospital consultation but managed to do the pre-op stuff remotely.

Thanks for replying. I'm surprised and sorry your operation in Thailand wasn't a success. I would have done the same as you and gone for the operation here too. From what I've been told hernia repair is very common and doesn't present any challenges for surgeons.

hotandsticky · June 24

19 minutes ago, The Fugitive said:

Thanks for replying. I'm surprised and sorry your operation in Thailand wasn't a success. I would have done the same as you and gone for the operation here too. From what I've been told hernia repair is very common and doesn't present any challenges for surgeons.

I was disappointed too because the whole process had been so smooth....whether mesh was not used? I don't know.

I had quotations from Surin hospital around 80,000 Baht (2016) but I chose Bangkok Hospital Korat partly on the advice of Sheryl who recommended a larger facility in the event of any complications arising.

NanLaew · June 24

On 6/24/2024 at 3:26 AM, josephbloggs said:

I have been in Thailand for 28 years and haven't paid NI in that time. I am currently on a two week visit to the UK. I needed to visit A&E a few days ago which I wasn't happy about as I don't like to burden services, but I needed to. I went to the registration desk and was honest and told them upfront that I am a UK citizen but not a resident, and I have lived abroad for 28 years with no UK address (other than family). They asked if I had a GP, I said no. I had my passport with me but wasn't asked for it. They were happy to accept my brother's address as that is where I was staying at the time.

Long story short, no further questions asked. I spent several hours there (mostly waiting), had an ECG, blood tests, an examination, and finally was dispatched with some medicine with advice to come back the next day if not improved. (I didn't go back).

All free, all service was great if a lot slower than Thailand. I was honest upfront as I expected I might have to pay - and rightfully so as I have not contributed NI since I lived here 28+ years ago - but no problem, all looked after, all free. And I didn't try to game the system, I was honest upfront without being asked.

Much more importantly, why have you stopped your NI contributions?

stratocaster · July 4

If you are interested in the current state of returning expats to use the NHS I suggest you view a British Thai based utuber called Steady Eddy. Ed Sweeny was diagnosed in Thailand with a brain tumor. He was medivaced to the UK by his insurance company and put in to an NHS hospital. Today he complained that he has been in the hospital for one week and no treatment has been carried out. But he does say he understands there are waiting lists and he can not jump the queue. He demanded an MRI scan to see if the tumor has grown. The scan confirmed it had.

saintdomingo · July 4

Cancer treatment is quick to start in Thailand even in a government hospital, though not cheap. But then I didn't go shopping around I just wanted to get started.

Thanks for your post.

DaLa · July 4

27 minutes ago, saintdomingo said:

Cancer treatment is quick to start in Thailand even in a government hospital, though not cheap. But then I didn't go shopping around I just wanted to get started.

Thanks for your post.

I was diagnosed with cancer here in los and started treatment immediately. I'm a UK citizen and could have returned there for treatment. So £3k on flights+6 months rent (£4.8k)+ car rental £2.4k against the £10k treatment here. Bored and lonely in freezing UK with 4 walls to talk to, excessive parking fees at the hospital and chaos compared to my experience here.

Hopefully I won't have to repeat the experience but in my case treatment here with the most modern ( Siriraj teaching hospital with specialists trained in the US and the most up to date LINAC) was far more acceptable than the alternative. Just get yourself a 'in case' fund.

Sheryl · July 4

25 minutes ago, DaLa said:

I was diagnosed with cancer here in los and started treatment immediately. I'm a UK citizen and could have returned there for treatment. So £3k on flights+6 months rent (£4.8k)+ car rental £2.4k against the £10k treatment here. Bored and lonely in freezing UK with 4 walls to talk to, excessive parking fees at the hospital and chaos compared to my experience here.

Hopefully I won't have to repeat the experience but in my case treatment here with the most modern ( Siriraj teaching hospital with specialists trained in the US and the most up to date LINAC) was far more acceptable than the alternative. Just get yourself a 'in case' fund.

Glad your situation worked out.

But funds can and do get depleted.

I would strongly advise every UK expat to retain a UK address and GP registration just in case.

Tropicalevo · July 4

My case was not that recent and did not require surgery, but may be useful.

I left the UK more than 30 years ago.

I was no longer a tax resident, but through my employer, I still paid NI contributions.

When I retired at 65 I received the full pension - frozen, as I had told the pension people that I lived in Thailand.

I still have a UK bank account (for the pension) and a UK address (MIL).

I was in the UK and I needed a prescription for some medication that I had run out of plus some minor ailment.

I tried to sign on with MIL's doctor using her address and my NI number - not interested. I could not even get an appointment to talk to anyone. They only make appointments for registered patients :wacko: ???

I went to the local A&E department and they checked their records. I was still registered with the same doctor that I had 30 years ago. Unfortunately, he was 200 miles away!

As I was not an emergency, they could not help me.

They suggested trying a 'Walk In' surgery. Which I did.

Told them that I lived in Thailand etc etc. No problem.

Got the prescription and treatment.

I tried to pay something and they said no. No charge.

The Fugitive · July 4

6 minutes ago, Tropicalevo said:

My case was not that recent and did not require surgery, but may be useful.

I left the UK more than 30 years ago.

I was no longer a tax resident, but through my employer, I still paid NI contributions.

When I retired at 65 I received the full pension - frozen, as I had told the pension people that I lived in Thailand.

I still have a UK bank account (for the pension) and a UK address (MIL).

I was in the UK and I needed a prescription for some medication that I had run out of plus some minor ailment.

I tried to sign on with MIL's doctor using her address and my NI number - not interested. I could not even get an appointment to talk to anyone. They only make appointments for registered patients ???

I went to the local A&E department and they checked their records. I was still registered with the same doctor that I had 30 years ago. Unfortunately, he was 200 miles away!

As I was not an emergency, they could not help me.

They suggested trying a 'Walk In' surgery. Which I did.

Told them that I lived in Thailand etc etc. No problem.

Got the prescription and treatment.

I tried to pay something and they said no. No charge.

Good that you got sorted eventually, and at zero cost! I paid National Insurance contributions for 50 years (16 to 66). I've kept my UK address where I return from time to time. Last time there I experienced a nose bleed. Took 45 minutes to stop it. As I was flying back to Thailand in a few days I wanted to avoid a possible repetition on the aeroplane. Unpleasant for me, crew and other passengers. I went to a walk-in clinic (attached to my local NHS hospital A/E dept). The doctor refused to cauterise my nose, making the excuse that it had stopped bleeding now and he wouldn't be able to see where it had come from. Told me to go home. Very strange, I had my nose cauterised in 1971 and the doctor back then had no such difficulty!

Tropicalevo · July 4

2 minutes ago, The Fugitive said:

Very strange, I had my nose cauterised in 1971

That sounds painful. :ohmy:

The Fugitive · July 4

1 minute ago, Tropicalevo said:

That sounds painful.

Amazingly, no pain at all. Anaesthetic spray up nostril, tiny crystals on a probe inserted. Less than a two minute job. I never expected to be turned away when all I wanted/needed was that. Not impressed with UK NHS anymore I'm afraid.

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