Health Care In The Uk

[ThaiPauly]

Unfortunatley I have been forced to spend a great deal of money here on health care recently.

Can anyone tell me if I can get NHS care in the UK when I vist.

My NI is fully paid up and I still own property there which I pay income tax for as I rent it out.

I am aware that I can only spend 90 days a year there because of my ex-pat status, but how does that affect health care? I am not of official retirement age at home and won't be for some time.

I am not looking for "freebies" I have served my time in the system there and made a great deal of dosh for the taxman in the 35 years I worked and never claimed a penny on any allowances, I never had a single day without a job. ..so does anybody know the exact position.

Thank you in advance

TP

[apetley]

I do not know a definitive answer but if I were in your situation then I would not let on regards my expat status. I would use one of the properties as my place of residence and seek treatment asap.

I would be surprised if there was any check on your residence staus if you can supply a UK address.

Hope everything works out for you.

[Penkoprod]

The exact position doesn't depend so much on whether you are an expat or not, how long you can spend inside the country, or, indeed how much of a "fully paid up member" of anything you are, and how entitled you may be.

You just join the back of an ever lengthening queue, along with everybody else and have to keep checking your lottery ticket that you were given when you joined.

Because thats all the NHS is these days, in spite of anything a politician might say, or how much cash is pumped in. Simply, its a lottery, but without a clear understanding of how the numbers are drawn.

Yes, you may get all six numbers on your line, and go racing to near the front of queue, but you are more likely than not to get no numbers up, and have to to spend countless months waiting to be referred from one doctor/specialist to another, as they swerve having to treat people in a timely enough manner.

And, again, yes, it's a lot better than it was 10-15 years ago, but thats not much to be proud of, tbh.

In answer to your question of whether you will get treated, then the answer will probably be "yes".

But realise that some of the more "enlightened" trusts are saying that they will charge for treatment.

Also realise that it might not be to a standard of service that you might expect it to be.

[partington]

I can't give any direct references, (although a search on almost any UK newspaper website will probably bring up relevant information), but I know that to be eligible you must be resident in the UK.

I read recently that in the UK now that the government were considering that even three months absence is enough to remove your automatic right to NHS care.

I've no experience at all, but if they really are tightening up, and with all the increased immigration into the UK from eastern Europe I would be surprised if they are not doing more checks to confirm residency before automatic access to treatment (eg electoral roll checks, checks on whether you are currently signed up with a GP etc).

I don't know this for sure though, so I too would be very interested to hear if anyone has tried to use the NHS after an absence, or while absent, and what happened when you did!

[Kwasaki]

If you keep a home address contact in the UK unless somebody told them you have been out of the country for a long time no-one will know at the NHS when and if you return and want treatment.

Your only problem I see would be your commucation with anything in the UK unless you have an arrangment with the people you rent your property to.

Edited June 25, 2011 by Kwasaki

[citizen33]

The test is whether or not you are ordinarily resident in the UK.

http://www.dh.gov.uk/en/Healthcare/Entitlementsandcharges/OverseasVisitors/Browsable/DH_074374

If you have lived abroad but state that you now intend to reside in the UK and can support this by providing details of an address, the hospital is likely to take your word for it. As has been stated, if you have a UK address already, and particularly if you are still registered with a GP (who will be making the referral to hospital), the issue may not even come up.

Contrary to what a poster says above, waiting times have fallen a lot in recent years. In England the target is 18 weeks from referral to treatment, and this is achieved with the vast majority of patients. With the disruption caused to the NHS by the present round of reform, many commentators think the waiting times may increase a little, but it should still be much shorter than a few years ago.

[Trembly]

1. Register with the GP nearest to your address.

2. Wait for your NHS number to arrive by post.

3. See your GP.

4. Your GP will make the appropriate referrals. If you live in proximity to a few hospitals you may have a pick of several specialists.

Eligibility for free hospital treatment under the NHS

You could just say that you've been living in that address since you bought it.

Edit : Considering the cluster-fuc_k that is NHS management, I didn't think the waiting times have been too bad in the past decade.(a few weeks max to see a specialist). I was able to book GP visits online and I usually got to see them within the week. After that I could change my choice of specialist online if I wanted to, within certain reasonable parameters.

Edited June 25, 2011 by Trembly

[CRUNCHER]

A few years ago I tried to get an answer to this question when I was in UK. After a dozen phone calls I got a dozen different answers; no one seemed to really know. In the end,however, it seems that once you have been non-resident for tax purposes, you need to be back in UK for 6 months before your regain your eligibility for NH treatment. You can get emergency treatment at casualty departments.

Of course, as has been pointed out, you have some practical options as you have an address in UK. You need to think what the consequences are if you get caught. A bill for medical treatment; you become resident for tax purposes and you get a tax bill? It is up to you.

You could try claiming refugee status next time you go back. These people seem to be eligible for everything from day one. The fact that you have paid your dues all your life counts for nothing as what you have paid has gone to support refugees. Small wonder some people prefer Thailand. At least you know where you stand.

[Penkoprod]

The test is whether or not you are ordinarily resident in the UK.

http://www.dh.gov.uk...sable/DH_074374

If you have lived abroad but state that you now intend to reside in the UK and can support this by providing details of an address, the hospital is likely to take your word for it. As has been stated, if you have a UK address already, and particularly if you are still registered with a GP (who will be making the referral to hospital), the issue may not even come up.

Contrary to what a poster says above, waiting times have fallen a lot in recent years. In England the target is 18 weeks from referral to treatment, and this is achieved with the vast majority of patients. With the disruption caused to the NHS by the present round of reform, many commentators think the waiting times may increase a little, but it should still be much shorter than a few years ago.

If this is in reference to the 18 week patient pathway, then this is easy to achieve (emboldened relevant text):

How about this? "Heres a pill, see you in 18 weeks"

Or how about "Sorry we cant do what we need to do to make you well, but, because you have this other ailment too, we have to clear that up before we can proceed with the main reason you were sent here. See you in 18 weeks"

Those 2 above examples are all "treatments" and ones i have personally heard myself, and similar to what others have said in the same part of the system as me.

And so it goes on and on.Job done, targets achieved, and a spin doctors dream come true.

I personally know of some people that have waited 36 months to get treatment for things like hip and knee ops, and yet, also know people who have had the same ops performed on them within 8 weeks... Both "from referral to treatment" as you put it

Like i say, the NHS is a lottery....nothing more, nothing less. Ya pays yer money and ya takes yer chances

No need to either run it down, or big it up, it is what it is.

Whether the OP is willing to take HIS chances is up to him.

Penkoprod

[pnustedt]

A friend of mine has just returned from a short spell in the UK where he was diagnosed with terminal cancer. Because he was not resident in the UK he was told that he would be invoiced for the treatment he received, despite being fully paid up on his NI and he had spent his life serving Queen and country in the British army. He is now back in Thailand and there is no chance that the invoice will be paid.

However, he did say that he could not fault the expert treatment and that there was no waiting list nonsense whatsoever.

[F1fanatic]

If you keep a home address contact in the UK unless somebody told them you have been out of the country for a long time no-one will know at the NHS when and if you return and want treatment.

Your only problem I see would be your commucation with anything in the UK unless you have an arrangment with the people you rent your property to.

Precisely. Basically ex-pats are not entitled to NHS treatment even if they're paying UK taxes on pension etc.

HOWEVER, as long as you're obviously British and able to give them a UK address, there will be no problem.

Edit - LOCAL UK address!

Edited June 25, 2011 by F1fanatic

[Richb2004v2]

My father had extensive dental work on the NHS last year. He was seen and treated within a couple of months. I couldn't believe how quickly he was treated. He also has knee surgery in a similar time scale. He was unaffected by waiting lists. My mother had cancer a couple of years ago and suffered no delays at all, and received the latest treatment available. I thought I was getting something good with relatively cheap medical care here until I realized it was all free in the Uk.

[F1fanatic]

My father had extensive dental work on the NHS last year. He was seen and treated within a couple of months. I couldn't believe how quickly he was treated. He also has knee surgery in a similar time scale. He was unaffected by waiting lists. My mother had cancer a couple of years ago and suffered no delays at all, and received the latest treatment available. I thought I was getting something good with relatively cheap medical care here until I realized it was all free in the Uk.

Dental work is no longer anything close to free, unless (I assume) you are receiving Social Security.

Other than that - sometimes medical treatment is good, sometimes its bad.... But its always free (apart from prescriptions).

Different discussion really. My father was diagnosed with cancer and was given a follow-up appt a couple of months later.... Needless to say he died before his appt.

My ex-husband spent weeks in a Phuket hospital with a constantly changing diagnosis. He went back to the UK and was told everything looks fine, come back in 2 months time....

He came back to Phuket only to need hospital care again. Went back to the UK where (finally) they diagnosed his real problem - something the Phuket hospitals had been unable to achieve.

[Beetlejuice]

I believe that once you have lived outside of the EEC for some time, then you have to return to the UK and stay for a minimum of 6 months in order to become resident again and entitled to medical treatment under the NHS. I`m not 100% sure of this, so if anyone knows better?

But: If you have a residentual address in the UK and still registered with your previous Doctor, then, as the wise man says; keep stum and just visit your Doctor.

Of course unless you have truckloads of cash availible and can afford private medical care, then be prepared for a long stay back in UK while waiting for any treatment under the National Health Service.

[F1fanatic]

I believe that once you have lived outside of the EEC for some time, then you have to return to the UK and stay for a minimum of 6 months in order to become resident again and entitled to medical treatment under the NHS. I`m not 100% sure of this, so if anyone knows better?

But: If you have a residentual address in the UK and still registered with your previous Doctor, then, as the wise man says; keep stum and just visit your Doctor.

Of course unless you have truckloads of cash availible and can afford private medical care, then be prepared for a long stay back in UK while waiting for any treatment under the National Health Service.

Yes, that was what I was trying to say (obviously ineffectually) in my previous post.

Any ex-pat who is sick enough to need to go back to the UK for treatment is no longer ENTITLED to treatment, even if they pay UK tax.

BUT, if you turn up at a doctor or hospital (with a friend's UK address) - nobody will query it as long as you are obviously British.

Undoubtedly this will change in the future as computerisation turns the UK into the 'Orwellian' society...

Again, as I posted before, its down to 'luck' - sometimes the NHS is wonderful, sometimes its woeful.

[citizen33]

If this is in reference to the 18 week patient pathway, then this is easy to achieve (emboldened relevant text):

How about this? "Heres a pill, see you in 18 weeks"

Or how about "Sorry we cant do what we need to do to make you well, but, because you have this other ailment too, we have to clear that up before we can proceed with the main reason you were sent here. See you in 18 weeks"

Those 2 above examples are all "treatments" and ones i have personally heard myself, and similar to what others have said in the same part of the system as me.

And so it goes on and on.Job done, targets achieved, and a spin doctors dream come true.

I personally know of some people that have waited 36 months to get treatment for things like hip and knee ops, and yet, also know people who have had the same ops performed on them within 8 weeks... Both "from referral to treatment" as you put it

Like i say, the NHS is a lottery....nothing more, nothing less. Ya pays yer money and ya takes yer chances

No need to either run it down, or big it up, it is what it is.

Whether the OP is willing to take HIS chances is up to him.

Penkoprod

'18 weeks RTT' is not my term: it is part of the jargon of the NHS. This target is used to monitor waiting times for hospital treatment.

http://www.rsm.ac.uk/media/downloads/j06-01nhswaitinglist.pdf

Or just google '18 weeks referral to treatment'.

I haven't heard of any 36 month waits in years. I don't suppose you have heard of NHS Choices either.

http://www.nhs.uk/Pages/HomePage.aspx

P.S. There is no requirement as a returning expat to have lived in the UK for six months before being eligible for NHS hospital treatment, as stated above. You may however be required to produce evidence that you have an intention to remain ordinarily resident in the UK (proof of house ownership would probably suffice).

Edited June 25, 2011 by citizen33

[Expatwannabee]

From the little I know on this subject the link that states that treatment is free if you are resident in the UK is correct. I feel very strongly about this because it does mean that someone who has worked paying Tax & NI all his life can be charged for treatment (once living outside the EEC) but a newly arrived immigrant is entitled to free treatment despite having paid nothing (and quite possibbly never contributing anything). Feelings are starting to run high over this issue but all major political parties ignore it fearing being branded racist or non PC. The blatant abuse of the asylum system (allowing criminal gangs to profit handsomely) is so great that really we should close it down and say sorry no more asylum. The relatively few (could still be in the thousands) of genuine asylum seekers denied sanctuary would then be paying the price for the 100s of thousands of bogus asylum seekers.

As far as being Non Domiciled for tax purposes goes, I thought that was only for the rich with off-shore accounts.If you get Non-Dom tax status and all your income is generated in the UK you will still be taxed.(with the exception of countries with a double taxation agreement with the UK.) However one condition of double taxation agreements is that to avoid UK tax you must be paying tax on the income in your new country.)

[Penkoprod]

Yes, that was what I was trying to say (obviously ineffectually) in my previous post.

Any ex-pat who is sick enough to need to go back to the UK for treatment is no longer ENTITLED to treatment, even if they pay UK tax.

BUT, if you turn up at a doctor or hospital (with a friend's UK address) - nobody will query it as long as you are obviously British.

Undoubtedly this will change in the future as computerisation turns the UK into the 'Orwellian' society...

Again, as I posted before, its down to 'luck' - sometimes the NHS is wonderful, sometimes its woeful.

Or a lottery, as i keep saying

But a key word is missing from the entitlment equation. That word is "FREE"

Only emergency treatment is free in certain cases, as previously mentioned.

However thats as easily overcome by the patient as the 18 week Patient Pathway is just as easily overcome by the NHS trusts. Again, as previously mentioned

One thing i cant work out is where the OP says he is "aware that I can only spend 90 days a year there because of my ex-pat status"

But, at the same time isnt a tax exile, as he pays UK taxes on his rental income.

Maybe, when he comes back to read the thread, he can clarify.

He may be putting a ticking clock under himself that doesnt need to be there, perhaps

Penkoprod

[Penkoprod]

'18 weeks RTT' is not my term: it is part of the jargon of the NHS. This target is used to monitor waiting times for hospital treatment.

http://www.rsm.ac.uk...waitinglist.pdf

Or just google '18 weeks referral to treatment'.

I haven't heard of any 36 month waits in years. I don't suppose you have heard of NHS Choices either.

http://www.nhs.uk/Pages/HomePage.aspx

Oh, believe you me, i have indeed heard all about the NHS Choices....more rhetoric and spin

I have also refer you to the term "treatment"

It can either be good, or bad, depending on a criteria no one can put a finger on, and i've stated as much...good and bad.

And those examples of people waiting for 36 weeks are NOT lies or figments of my imagination, either. And, neither are the examples of people getting the same ops in less than 8.

In fact, now i recall, i was in a hospital bed and the patient in the next bed to me had a visit from his consultant, who told him he needed the same op as i had waited 9 months for. He was told he can "stay in tonight and we will do the op tomorrow"

Like i said earlier, the NHS is what it is. Neither great or truely awful. No amount of bigging it up, or running it down will alter that. In other words...a lottery

What is it they say about statistics?

"There are three kinds of lies: lies, damned lies, and statistics"

Penkoprod

Edited June 25, 2011 by Penkoprod

[F1fanatic]

Yes, that was what I was trying to say (obviously ineffectually) in my previous post.

Any ex-pat who is sick enough to need to go back to the UK for treatment is no longer ENTITLED to treatment, even if they pay UK tax.

BUT, if you turn up at a doctor or hospital (with a friend's UK address) - nobody will query it as long as you are obviously British.

Undoubtedly this will change in the future as computerisation turns the UK into the 'Orwellian' society...

Again, as I posted before, its down to 'luck' - sometimes the NHS is wonderful, sometimes its woeful.

Or a lottery, as i keep saying

But a key word is missing from the entitlment equation. That word is "FREE"

Only emergency treatment is free in certain cases, as previously mentioned.

However thats as easily overcome by the patient as the 18 week Patient Pathway is just as easily overcome by the NHS trusts. Again, as previously mentioned

One thing i cant work out is where the OP says he is "aware that I can only spend 90 days a year there because of my ex-pat status"

But, at the same time isnt a tax exile, as he pays UK taxes on his rental income.

Maybe, when he comes back to read the thread, he can clarify.

He may be putting a ticking clock under himself that doesnt need to be there, perhaps

Penkoprod

I'm sure you're right - except that my husband (an ex-pat) gave a friend's UK address and received (free) cancer treatment for weeks in a UK hospital. He was obviously British though, so the NHS had no reason to question his status.

Mind you, I have to agree with a previous poster - we have paid UK tax throughout our lives and were still paying UK tax on our pension (even though we had retired abroad). Why the hell should we not be ENTITLED to NHS treatment just 'cos we've moved abroad??

AND, we were not enjoying any 'loopholes' - we had just decided to retire abroad, and accepted that our pension was taxed by the UK.

Edit - its not only emergency treatment that is free. All treatment on the NHS is free other than prescriptions and dental - and even then its free if you have a 'life threatening' condition or are on Social Security.

Edited June 25, 2011 by F1fanatic

[Penkoprod]

I'm sure you're right - except that my husband (an ex-pat) gave a friend's UK address and received (free) cancer treatment for weeks in a UK hospital. He was obviously British though, so the NHS had no reason to question his status.

Mind you, I have to agree with a previous poster - we have paid UK tax throughout our lives and were still paying UK tax on our pension (even though we had retired abroad). Why the hell should we not be ENTITLED to NHS treatment just 'cos we've moved abroad??

AND, we were not enjoying any 'loopholes' - we had just decided to retire abroad, and accepted that our pension was taxed by the UK.

Edit - its not only emergency treatment that is free. All treatment on the NHS is free other than prescriptions and dental - and even then its free if you have a 'life threatening' condition or are on Social Security.

Don't get bogged down in this "expat" mire. Its easily overcome, as i keep saying.

Or, for that matter is this "i've paid in all my life, therefore i'm entitled". Quite simply, the owners of the country dont "give a flying one" what you, i or anyone has put into the system in the past. Their only concern is taking as much out as they can, while they can.

Whether the OP is an expat or not isnt *really* the issue, its whether or not he wishes to spend more time than he might allow himself chasing some treatment that might, or might not take months and months to obtain to a satisfactory level

*edited to post a link to NHS Dental Charges

http://www.nhs.uk/nhsengland/Healthcosts/pages/Dentalcosts.aspx

Penkoprod

Edited June 25, 2011 by Penkoprod

[F1fanatic]

I'm sure you're right - except that my husband (an ex-pat) gave a friend's UK address and received (free) cancer treatment for weeks in a UK hospital. He was obviously British though, so the NHS had no reason to question his status.

Mind you, I have to agree with a previous poster - we have paid UK tax throughout our lives and were still paying UK tax on our pension (even though we had retired abroad). Why the hell should we not be ENTITLED to NHS treatment just 'cos we've moved abroad??

AND, we were not enjoying any 'loopholes' - we had just decided to retire abroad, and accepted that our pension was taxed by the UK.

Edit - its not only emergency treatment that is free. All treatment on the NHS is free other than prescriptions and dental - and even then its free if you have a 'life threatening' condition or are on Social Security.

Don't get bogged down in this "expat" mire. Its easily overcome, as i keep saying.

Or, for that matter is this "i've paid in all my life, therefore i'm entitled". Quite simply, the owners of the country dont "give a flying one" what you, i or anyone has put into the system in the past. Their only concern is taking as much out as they can, while they can.

Whether the OP is an expat or not isnt *really* the issue, its whether or not he wishes to spend more time than he might allow himself chasing some treatment that might, or might not take months and months to obtain to a satisfactory level

*edited to post a link to NHS Dental Charges

http://www.nhs.uk/nh...entalcosts.aspx

Penkoprod

I think I said in a previous post that the Phuket (paying) hospitals failed to diagnose his problem, even though he spent WEEKS there.... The NHS wasn't much better first time round, but at least found out the problem when he presented (second time round) at the hospital in trouble.

Not good - but better than the treatment he'd PAID FOR in Phuket hospitals....

Edit - What can I say? Been there, seen it, and have learned the lessons....

Edited June 25, 2011 by F1fanatic

[nocturn]

My, this certainly seems to be Thai related

[CRUNCHER]

My, this certainly seems to be Thai related

It seriously affects (some) Brits living in Thailand and relates, as per OP, to alternatives to paying for health care in Thailand.

[F1fanatic]

My, this certainly seems to be Thai related

This thread is "Thai related" . Surely not....

[F1fanatic]

My, this certainly seems to be Thai related

It seriously affects (some) Brits living in Thailand and relates, as per OP, to alternatives to paying for health care in Thailand.

At the end of the day we all need to pay for private health insurance. Anyone who doesn't buy a good policy is, sooner or later, going to end up in trouble.

[StreetCowboy]

We had cause to take one of our children to the local NHS hospital while visiting the UK for a routine examination of a recovering broken bone.

We went to Outpatients, suffered some trivial administrative bungling, no bureaucracy whatsoever, saw a charming and interested young doctor who seemed very professional, and never a question asked. I should have mentioned that the private hospital that we sought out in the first instance, since our insurance would have covered the cost, declined to handle paediatric cases... I am fairly confident that the effort in raising an invoice would have cost the NHS more than it earned, and it would certainly have added to our hassles and inconveniences.. and those of our insurance company.

One can still be a tax exile and pay UK taxes. If one exceeds one's quota of days in the UK, one can inadvertently become resident, and all one's earnings from one's career in the Phuket porn industry, (laundered and published through California for legal reasons, since porn filming would be illegal in Phuket) could suddenly become liable to the attentions of Her Majesty's Reveners. But all the while, one might be paying tax on the squalid and pitiful income from one's Rachmanist empire of slums.

SC

[F1fanatic]

We had cause to take one of our children to the local NHS hospital while visiting the UK for a routine examination of a recovering broken bone.

We went to Outpatients, suffered some trivial administrative bungling, no bureaucracy whatsoever, saw a charming and interested young doctor who seemed very professional, and never a question asked. I should have mentioned that the private hospital that we sought out in the first instance, since our insurance would have covered the cost, declined to handle paediatric cases... I am fairly confident that the effort in raising an invoice would have cost the NHS more than it earned, and it would certainly have added to our hassles and inconveniences.. and those of our insurance company.

One can still be a tax exile and pay UK taxes. If one exceeds one's quota of days in the UK, one can inadvertently become resident, and all one's earnings from one's career in the Phuket porn industry, (laundered and published through California for legal reasons, since porn filming would be illegal in Phuket) could suddenly become liable to the attentions of Her Majesty's Reveners. But all the while, one might be paying tax on the squalid and pitiful income from one's Rachmanist empire of slums.

SC

V funny, but I can't find the ROFL emoticon.

You might be right about the landlord though....

[4.real]

A friend of mine has just returned from a short spell in the UK where he was diagnosed with terminal cancer. Because he was not resident in the UK he was told that he would be invoiced for the treatment he received, despite being fully paid up on his NI and he had spent his life serving Queen and country in the British army. He is now back in Thailand and there is no chance that the invoice will be paid.

However, he did say that he could not fault the expert treatment and that there was no waiting list nonsense whatsoever.

Surely the government can take payments from his pension?

Or when he is drawing his state pension if not already doing so.

[Mossfinn]

Unfortunatley I have been forced to spend a great deal of money here on health care recently.

I am sorry to hear that TP

Can anyone tell me if I can get NHS care in the UK when I vist.

Not if you are visiting

You have to prove that you are 'ordinarily resident', it is not based on nationality, property ownership or paid up taxes or NI.

Have a look at nhs regulations, for overseas visitors 1989.

Hospitals should make enquiries in regard to your status, in reality, I don't know.

If you are outside the UK for three months and you have no other qualifiers and I don't think you do, then unfortunately you do not comply.

However, a returning expat who resumes residency is exempt from charges immediately, so just return and claim returning residency, get yourself some bank statements to your address and you will be fine.