NHS Treatment

[saintdomingo]

4 hours 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.

I did not realise how complicated it could get. If you are not a Thai speaker or have one with you almost every step of the way it must be very, very difficult for a lengthy treatment.

[scubascuba3]

8 hours ago, saintdomingo said:

I did not realise how complicated it could get. If you are not a Thai speaker or have one with you almost every step of the way it must be very, very difficult for a lengthy treatment.

Yep stressful too which won't help

[BigStar]

15 hours ago, saintdomingo said:

I did not realise how complicated it could get. If you are not a Thai speaker or have one with you almost every step of the way it must be very, very difficult for a lengthy treatment.

 

Not as much as you might think. Google Translate, with text-to-speech, has made a vast difference nowadays. Moreover, the hospitals, esp private hsps, can find a translator to help in critical instances.

 

A lot of instructions are pretty basic and Thais will try to be patient. I've been treated well on every occasion I've been to a Thai hsp. 

 

[scubascuba3]

9 minutes ago, BigStar said:

 

Not as much as you might think. Google Translate, with text-to-speech, has made a vast difference nowadays. Moreover, the hospitals, esp private hsps, can find a translator to help in critical instances.

 

A lot of instructions are pretty basic and Thais will try to be patient. I've been treated well on every occasion I've been to a Thai hsp. 

 

Queen Sirikit their English was poor, even the designated English speaker counter person had to admit he couldn't speak English, Google translate worked well though

[thaibeachlovers]

On 6/24/2024 at 8:26 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.

Sounds like you got a clerk that was sympathetic. Others may not be. Feel lucky?

 

IMO the restrictions were brought in to stop immigrants with residence bring over their relatives for free treatment- they must have had a crooked GP.

 

While it was some years ago and may have changed ( hopefully ) I assisted at many operations for elderly foreigners that IMO had no right to NHS treatment, but we were not allowed to query their eligibility ( Labour government )

[BigStar]

47 minutes ago, scubascuba3 said:

Queen Sirikit their English was poor,

 

Yup, typical of staff in gov't hsps. The docs' English is adequate, however.

 

47 minutes ago, scubascuba3 said:

even the designated English speaker counter person had to admit he couldn't speak English

 

That's an information counter--for Thais, ha ha. But it doesn't matter, they don't know anything anyway. OK, a few elementary things. 

 

47 minutes ago, scubascuba3 said:

Google translate worked well though

 

Thar ya go.

 

Go to a gov't hsp long enough, and IF you're friendly, very polite, and a bit humble, not arrogant, difficult, impatient, and perversely stupid, the staff get to know you and kinda look after you. I've found Thai patients in the waiting rooms helpful, too.

 

The more Thai you speak (correctly), even if just a little, goes far.

 

[scubascuba3]

1 hour ago, BigStar said:

 

Yup, typical of staff in gov't hsps. The docs' English is adequate, however.

 

 

That's an information counter--for Thais, ha ha. But it doesn't matter, they don't know anything anyway. OK, a few elementary things. 

 

 

Thar ya go.

 

Go to a gov't hsp long enough, and IF you're friendly, very polite, and a bit humble, not arrogant, difficult, impatient, and perversely stupid, the staff get to know you and kinda look after you. I've found Thai patients in the waiting rooms helpful, too.

 

The more Thai you speak (correctly), even if just a little, goes far.

 

I subsequently went back there recently and glided through like a dream

[DaLa]

I'd like to address the issue of language here. Firstly I'm useless at languages and learning Thai was never going to be on my list of 'must do's'.  So I'm lucky to have a wife that speaks reasonable English, and my first contact with the hospital was with her accompanying me. Both specialist (cancer and radiologist) spoke very proficient  English to the point where we could joke together. The majority of the staff had less to no English skills but the whole system works with numbers. You get a number when you arrive and wait to be called by that number (screens to help). Once you have been examined you have to pay the fees by awaiting  your number to come up. Same again for collecting any medication. Any time there was a problem, one of the staff would come out of their office and accompany me to the correct place. 

 

Also Google translate has the facility to translate any text or document you show it ( take a picture and dump it into the app). Obviously my experience is location specific, but I managed even without my wife for 90% of the treatment and visits. I don't know if the hospital had interpreters but that would have been another option, even to pay for. I'm a year older and 12 pension payments richer so grateful for the help I received. 

[OnTheLash]

On 6/23/2024 at 11:26 PM, 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.

You can back pay some of the missing NI. It would be a good idea to do so. Its well worth looking into. You will probably only be liable for class 2 contributions. Deadline is sometime next year.

[Bday Prang]

              To me it seems very unfair, to put it mildly , that a pensioner who has paid into the system all their lives, can be denied treatment purely because they might have spend time overseas, Lets not forget that nobody is liable to pay National Insurance once they reach retirement age. I see no reason why somebody who has paid 35+ years of contributions ( the minimum required for the state pension) might be denied treatment, especially when "new arrivals" seem able to bypass any such requirement. As indeed do the unemployed.

              Its also not that certain that one automatically remains registered with a GP either. During covid I tried arrange my vaccination via my family  GP  with whom I had been registered since birth, only to be told that i had been taken off the list and was no longer registered there, as I hadn't seen a Dr there for years. 

               They would not tell me how much time needs to pass between appointments for this to happen but other people have suggested it could be as little as just 5 years, I had no reason to visit a DR for over 20 years so I had probably been taken off the register a long time ago without being told.

               Throughout that time I did have reason to visit A&E hospital departments on several occasions, the only question I was ever asked was the name and address of my GP. naturally I gave the name of my original GP.  with whom  I was probably , unbeknown to myself at the time,  no longer registered, but  I never had a problem. They obviously don't check there and then.

               Admittedly turning Up at A&E with a minor injury is somewhat different than seeking treatment for a chronic disease,for which I think a Gp's referral is required except in an emergency,   but at least in the above instances it would appear that no further checks were made

                It will soon be 5 years since I registered with the new GP so I'm guessing I will be de registered again soon, I'm wondering if they will have the courtesy to tell me this time? 

                

[Bday Prang]

1 hour ago, OnTheLash said:

And I didn't try to game the system

You were not "gaming the system"   Any suggestion of such, is a strong indication that the system is just plain wrong.  In my opinion  NO Uk citizens should ever be denied NHS treatment when there are non UK citizens and illegal immigrants who are receiving it.

[Sheryl]

3 hours ago, Bday Prang said:

                It will soon be 5 years since I registered with the new GP so I'm guessing I will be de registered again soon, I'm wondering if they will have the courtesy to tell me this time? 

                

 

Many GPs these days have websites, see if yours does so you can message and ask.

[josephbloggs]

7 hours ago, OnTheLash said:

You can back pay some of the missing NI. It would be a good idea to do so. Its well worth looking into. You will probably only be liable for class 2 contributions. Deadline is sometime next year.

Yes, I have been looking in to this, thank you, good advice.

[Sheryl]

Off topic post removed.

 

Please stay on topic and avoid political debates, health forum is not the place for that.. 

[HauptmannUK]

I can clarify on a few of these issues.....

 

1. Over the last 10 years I have helped two seriously ill expats return to the UK and get treatment.

2. My daughter is a doctor in the UK. She currently works in Urology but has done spells in GP and A&E - I've had discussions with her about treatment for returning expats..

 

First of all, access to urgent treatment is free for anyone in the UK - that even covers e.g. tourists visiting for a two week vacation.  Urgent treatment means ambulance service/paramedic, A&E, Urgent Treatment Centres and 'walk in' clinics.  Theoretically it also includes GP surgeries, but in practice they will most likely just call an ambulance.  You will likely be asked for a contact address, phone number etc but unlikely to ask for a passport.

Non-urgent treatment is free to all RESIDENTS of the UK & Northern Ireland.  The only test is residence - having paid National Insurance doesn't come into it.  If you are not UK resident then you can be billed for treatment.  I think there exceptions to this, such as diseases, e.g. TB, which pose a risk to public health if not treated.

 

In most hospitals there is not much checking of eligibility, so if you can pass for 'British' and don't raise any red flags then you may well get away with free treatment if you can quote the name and address of your GP - even if you've not seen him for years.  Most medical staff, such as my daughter, are rushed off their feet and have zero interest in policing eligibility.

 

In larger hospitals there is likely to be an 'Overseas Patients Team' - basically a few administrators who chase up billing of non-residents.  In my experience if the patient is newly-resident in the UK (e.g. has returned from Thailand with the intention of relocating in the UK) then provided you can verify that intention with some documentation (e.g. accommodation rental contract, utility bill) then you will be left alone and not billed.

 

GPs don't normally remove patients from their list unless there is some kind of breakdown in the relationship with the patient.  GP's get paid per patient on their list, rather then per consultation, so most GPs are only too happy to have a 'silent' patient on their list, and indeed to sign up new patients.  There is an issue with GPs being paid for 'ghost patients' - basically receiving income for patients that have moved out of the area, left the UK etc - and I recall my daughter telling me that there are more patients on GP lists than there are people in the UK (probably a lot of foreign citizens who were UK residents for a time and then returned home without telling their GP).  Some years ago the NHS proposed 'list cleansing' so that patients would have to re-enrol with a GP every five years to reduce the number of ghost patients and cut costs, but I don't think that got off the ground.  Certainly GPs are under pressure from the NHS to remove ghost patients so it pays to make contact with your GP occasionally (even just ask a question via the NHS App). Normally when one is registered with a GP and moves out of the area you would sign up with a GP at your new location - your new GP would request your medical records from your old GP and that is what triggers the deregistration from your old GP.  Events such as GP surgeries shutting down would also trigger a letter to your registered address telling you that you need to find a new GP.

 

My daughter has encountered some interesting scenarios - she worked in an A&E department in Birmingham and they would routinely get foreign visitors arriving directly from Birmingham airport for urgent treatment. Often quite seriously ill and obviously having travelled with the intention of getting NHS treatment.  Most commonly Nigerians apparently.   The other common trick was e.g. a visitor from overseas passing themselves off as a UK-resident relative.  She was treating a very sick boy of about 5 years old when she realised the DoB shown on his medical record would have made him about 14 years old.  Turns out he was from the Middle East and his parents had used the identity of his older UK-resident cousin to get free treatment.

 

 

 

[Sheryl]

Off topic, baiting post removed