Possible changes to expat Brits' access to the NHS

[uptheos]

I am an Expat living in Thailand with a UK passport. I'm also a pensioner who has paid NI contributions for 40 years and still has to pay Income Tax to HMG with no benefits except for a 'frozen' monthly pension. If I was an expat in a 'qualifying'/EU country my benefits would be the same as a UK resident. If healthcare costs here in Thailand are less expensive than in the UK would it not make sense to have some form of 'arrangement' to be made between the UK and Thai Healthcare systems so that a return trip back to the UK is unnecessary?? Wishful thinking, I know!!

To you and me it would, but the government of the UK probably know just how scalpel happy the surgeons here can be, without exploring other options. In that regard I can't blame them I suppose, because when there's money around the scalpel come out pretty darned fast!

[technologybytes]

In your first post you conveniently forgot to mention the intention to reside.

That has never been in doubt and, as you say, you don't have to prove it - in fact you cannot prove a future event.

Forget phrases like "True Brit" - if you are British you have these rights. Residency elsewhere is irrelevant.

No, in my first post I did say that the problem with the article was that it was an over simplification of brits rights after being abroad.

I use the word "true brit" because you are treated different in law if you were born and spent at least 10 years of your life living in the UK, it means the difference between potentially loosing some rights or unconditionally retaining them forever.

Also, the intention to reside is not always necessary if you are in receipt of a state pension or any other UK benefits. (but it's a good catch-all to ensure you get treated)

For the Non-brits, it's interesting to note that if you are detained at all (even for 30 mins) by immigration as you enter the country, then you qualify for free healthcare for the duration of your legal stay... should be easy enough the engineer if you have an imagination.

Edited April 26, 2014 by technologybytes

[uptheos]

This article is very misleading. It tries to oversimplify the situation for British citizens who stay outside the UK, most of which have never immigrated to Thailand (hence NON-Immigrant status) and as such have never emigrated from the UK.

I have lived in Thailand (on NON-immigrant visas) for 13 years, last year I took a short trip to the UK and needed some treatment whilst I was there.. I had to fight for my rights, but in the end the hospital treated me, as was my right.

True Brits staying in Thailand who are not truly resident in Thailand (99% of us) NEVER lose their right to NHS treatment the moment they set foot on british soil, it's just that there is a lot of bad advice offered to them, and they shoot themselves in the foot of they think they reside here, when they do not.

Whilst I agree with your sentiments, the reality, at least in my experience, is different. For one thing as a 'non-resident' by HMC&R definition (who's rules prevail) I am simply not entitled to free health cover if I return to UK, even for a couple of weeks.

Furthermore, the practice manager of my GP's practice in UK confirmed in writing that I was no longer entitled and would have to pay for treatment.

Doubtless, if push came to shove, and I turned up at a hospital in urgent need of treatment, I would receive it regardless of 'rules'.

Unfortunately, it is HMC&R who implement and enforce 'residency' rather than your or my interpretation.

This reform to the rules is long overdue.

Well my experience was in a hospital and not at a GP surgery.

The bottom line is that if you state it's your "intention" to resettle in the UK then you have the same rights as if you never left. This "intention" may be a temporary state of mind and no proof may be requested.

However, I have no idea how this relates to registering at a GP, only getting treatment in a hospital.

If you are in receipt of a state pension then you don't even need to state an intention to stay.

Just pick a surgery, give them your address and NH number plus where your records are currently (who your last Dr was). If you don't have a NH number they will get one for you and send it to you.....whola you have proof of address for other agencies. Remember less is best when it comes to giving information.

[PETERTHEEATER]

About time. pensioners especially will have 30 years plus of NH payments

If a person receives a British Government Pension then regardless of abode that person is entitled to free NHS treatment. That is clearly stated on the NHS website.

This proposal, if it goes through will provide free treatment (except for prescriptions) to any British subject even if they have never paid National Insurance contributions and British subjects who have paid NI contributions but are not old enough to draw a Government Pension.

First, it has to happen.

[technologybytes]

About time. pensioners especially will have 30 years plus of NH payments

If a person receives a British Government Pension then regardless of abode that person is entitled to free NHS treatment. That is clearly stated on the NHS website.

This proposal, if it goes through will provide free treatment (except for prescriptions) to any British subject even if they have never paid National Insurance contributions and British subjects who have paid NI contributions but are not old enough to draw a Government Pension.

First, it has to happen.

Healthcare for british citizens by birth has never been subject to paying national insurance..

[dunque]

Then go on a 6 months waiting list, just for a gp, then god knows how long for a hospital visit.I am sure that i dont have a gp, not seen him for 15 years

------------------------------------------------

Don't be so sure - I did not see a GP in my home town Southampton for over 25 years then when I wanted to sign up to a local one in London I had to be transferred from my old one! had obviously been claiming dosh for me for all those years.

[watso63]

Good to hear. What's really needed is annual state pension increases. Equality for all pension qualifying citizens...please.

[Essex Grampa]

Well, I went to get a further month's supply of medication in early April, just before coming here for a month. That was about a week after getting my March supply. However I was told that the "rules" now said that if I was going to be out of the country for more than a "normal" holiday length of 2, possibly 3 weeks I had to make arrangements to obtain where I was; the NHS wouldn't supply.

Now, fortunately I know how the system works so was able to point out that I'd had my medication in March, so all I wanted was April's a couple of weeks early and I'd be back to normal in May. Grudgingly I was given what I wanted.

I should say that this was a practice staff member; the GP, with whom I'd discussed the situation earlier, was quite happy.

My friendly pharmacist, when I went to have the prescription dispensed told me that other patients were being caught by this and that a diabetic lady, going to the US for a relatives wedding, had been sent away with instructions to buy her insulin there!

[trevoromgh]

Thanks very much to the OP for flagging this.

At last something positive on this travesty about NHS cover for ex-pats and many of us have been campaigning for this to change for some time now and I even got a chance to level a question at David Cameron, before he was elected, in a webinar held by SAGA and I asked why British citizens lose their NHS cover and pension upratings when they leave the UK. You can watch his answer here http://youtu.be/MrX39wBYBZM

Hopefully the Immigration Bill 2013-2014 (in which this NHS ex-pat reform is encapsulated) will be finally approved in the House of Lords shortly and sent for royal assent and thence become law soon.

[penwithcris]

I think it sensible not to 'burn one's boats' when one moves to Thailand. Retain as much as you can in the UK - bank accounts, a UK address, GP etc.

I've always considered myself as someone who stays in Thailand for long periods rather than an ex-Pat. I try to keep my options open. Things can change at any time

I would be very surprised if my entitlement to NHS care was ever brought into question should I return to UK at any time

[Estrada]

_{I do not believe this article. Looks like they copied some old news when the Government said that they were considering basing NHS eligibility on at least 7 years of NI contributions. That was superseded by a Government about face and the latest was that you have to prove you are returning to the UK permanently to get free medical care. If you look at the original article the editor was unable to find the news item that his story was based on and the link does not work. Try searching the internet there seems to be no news items from the NHS or the Government confirming this.}

_{Last year the NHS refused to cover my £20,000 hospital fees in Australia even though there is a reciprocal agreement. This despite the fact that I have paid a lot more NI contributions than the average UK citizen. Same problem with expat frozen pensions. Now they no longer want to give us our tax free allowance on our pensions and we will be taxed at the full rate on the whole sum they pay.}

Edited April 26, 2014 by Estrada

[sambum]

Will the proposal include those on a Retirement Visa, (renewed/extended annually) as opposed to those actual on a Permanent Residency basis?

[biggles45]

"Couldn't agree more! The frozen state pension is indefensible."

If you think that is bad what about all the british OAP who went to Australia to live. Australia has the British Queen as their head of state and yet the british pensions are still frozen, just the same as those in Thailand. Work that one out. !!

[uptheos]

Will the proposal include those on a Retirement Visa, (renewed/extended annually) as opposed to those actual on a Permanent Residency basis?

As many will tell you it's not a retirement visa. The Thai government haven't accepted you as a legal retiree, but rather have simply extended your guest status on an annual basis. If I'm just a guest somewhere, basically England is still my home and I can return and be habitually resident from day one because I have been habitually resident before, i.e. born there.

[taiping]

I agree. It is not easy to travel if you are in a coma and health insurance in Thailand remains a 'must'.

However, it is nice to know that the option will now exist to travel back to the UK. I, for one, will certainly take that option should the need arise - as long as I am fit to travel.

[oldsailor35]

About bloody time! They have realised (at last) that their stupid rules are totally unenforceable and a vote loser too, so now they want to appear to give something, big frigging deal. I see my GP and the miserable old bat on reception every year, even show him scans, blood tests etc. He knows I'm not milking the NHS and has never said anything apart from "that's cheap".

I have threatened expose him as a Peterborough United supporter, so maybe that helps.

With patients like you, he is lucky he is not a WHU supporter.

[taiping]

I agree. It is not easy to travel if you are in a coma and health insurance in Thailand remains a 'must'.

-------------------

As you get older the premiums get more expensive compared to the benefits. Those with the funds can afford the premiums but probably don't need insurance because they can pay out of pocket, and those who can't afford the premiums need the insurance. Catch 22.

I decided to cancel my BUPA Thailand health insurance for this reason, after being with them for 20+ years. Instead, after a degree of hassle, I obtained the government Nopparat Hospital health card which entitles me to the same free treatment as Thais. It helped that I have a Yellow Tabian Bahn which has my Thai ID number. I have not used Nopparat Hospital yet, so cannot vouch for the standard of service. It took my Thai speaking daughter to phone the government health hot line 1330 in the presence of the Nopparat Hospital staff to get them to issue a card to me since they originally claimed it only applies to neighboring countries like Cambodia and Myanmar. The hospital is a fair distance from where I live, so may be no use in an emergency.

[crazydrummerpauly]

About time. pensioners especially will have 30 years plus of NH payments

And the rest - my old man had 50, and it's common to have 45 (ages 20 to 65 in work). It was only during the Blair administration when the minimum number of years to qualify automatically for a full OAPension was brought down from 44 yrs to 30. Incidentally, it was Byers in the Blair mob who brought in the no-free-NHS for ex-pats in the first place, and when it was first drafted it was only THREE months out of the country to be disqualified from free treatment !

[crazydrummerpauly]

Absolutely immoral that it was ever debated to not allow access

Yep, and it was Stephen BYERS in the BLAIR administration who brought it in; and originally it was only THREE months out of the country to get barred from free NHS.

[Malthus101]

We have allowed government too much power; if they spend this money, it is our money there are spending. They do not have their own money.

We look at them as if they are our masters and thank them when they decide to give us/buy us something - it is our money through multiple taxes that pay (or do not pay) for these things.

They need to have their power stripped from them.

They are our servants, not our masters.

[SunsetT]

I will believe this when I see it. Most probably incorrect like the Thai Insurance for Farangs report.

Thai insurance for Thai resident farangs is available in Udon Thani. Go to counter 6 or 7 on the 1st floor of the Government hospital.

[crazydrummerpauly]

This article is very misleading. It tries to oversimplify the situation for British citizens who stay outside the UK, most of which have never immigrated to Thailand (hence NON-Immigrant status) and as such have never emigrated from the UK.

I have lived in Thailand (on NON-immigrant visas) for 13 years, last year I took a short trip to the UK and needed some treatment whilst I was there.. I had to fight for my rights, but in the end the hospital treated me, as was my right.

True Brits staying in Thailand who are not truly resident in Thailand (99% of us) NEVER lose their right to NHS treatment the moment they set foot on british soil, it's just that there is a lot of bad advice offered to them, and they shoot themselves in the foot of they think they reside here, when they do not.

IMO O think you are wrong.

As an expat spending more than 6 months out of the country (the article talks of 3 but I thought it was 6) you do not have an 'entitlement' and the NHS would be within their rights to charge for their services.

However, as uptheos (and others) have pointed out, you will not be denied treatment it.

There is nothing misleading about the article at all it sets out clearly what the requirements are i.e. 7 years NICs.

Forget NHS rules, they mean nothing. Look up the legislation instead, I had to print a copy and take it to the hospital, after 4 hours and a lot of crap from the receptionist they admitted I was correct and I got an apology.

No matter how long you are away, if you are a true brit (not a recent import) and you have not taken up legal residency in another country (as 99% of brits here have not) then 100% of your rights are reinstated the moment you set foot on british soil (you have to state that it's your intention to stay, no evidence of this intent may be requested).

Yes, but saying you were home for good as under the existing rules could only be (strictly speaking) used ONCE. If you have to show your passport when turning up for a hospital appt - which i was for a heart-scan at Papworth - then signs that you left the UK again for a period AFTER you'd said you were home for good would cause problems. That's why the word VISITING (the UK) is at the heart of this proposed change.

[oldsailor35]

This article is very misleading. It tries to oversimplify the situation for British citizens who stay outside the UK, most of which have never immigrated to Thailand (hence NON-Immigrant status) and as such have never emigrated from the UK.

I have lived in Thailand (on NON-immigrant visas) for 13 years, last year I took a short trip to the UK and needed some treatment whilst I was there.. I had to fight for my rights, but in the end the hospital treated me, as was my right.

True Brits staying in Thailand who are not truly resident in Thailand (99% of us) NEVER lose their right to NHS treatment the moment they set foot on british soil, it's just that there is a lot of bad advice offered to them, and they shoot themselves in the foot of they think they reside here, when they do not.

IMO O think you are wrong.

As an expat spending more than 6 months out of the country (the article talks of 3 but I thought it was 6) you do not have an 'entitlement' and the NHS would be within their rights to charge for their services.

However, as uptheos (and others) have pointed out, you will not be denied treatment it.

There is nothing misleading about the article at all it sets out clearly what the requirements are i.e. 7 years NICs.

As an Australian citizen, i find it very difficult to understand this. If one has a Brit passport and has spent most of his/her life in the UK why should they have to pay for treatment. At the same time i read and hear of Europeans just walking into the UK and having all kinds of treatment and hospitalisation completely free. Is this true ?

I cannot believe that any country would treat its nationals so disgustingly.

[crazydrummerpauly]

The 'GO HERE' in the article is dead ?

[sustento]

This article is very misleading. It tries to oversimplify the situation for British citizens who stay outside the UK, most of which have never immigrated to Thailand (hence NON-Immigrant status) and as such have never emigrated from the UK.

I have lived in Thailand (on NON-immigrant visas) for 13 years, last year I took a short trip to the UK and needed some treatment whilst I was there.. I had to fight for my rights, but in the end the hospital treated me, as was my right.

True Brits staying in Thailand who are not truly resident in Thailand (99% of us) NEVER lose their right to NHS treatment the moment they set foot on british soil, it's just that there is a lot of bad advice offered to them, and they shoot themselves in the foot of they think they reside here, when they do not.

Whilst I agree with your sentiments, the reality, at least in my experience, is different. For one thing as a 'non-resident' by HMC&R definition (who's rules prevail) I am simply not entitled to free health cover if I return to UK, even for a couple of weeks.

Furthermore, the practice manager of my GP's practice in UK confirmed in writing that I was no longer entitled and would have to pay for treatment.

Doubtless, if push came to shove, and I turned up at a hospital in urgent need of treatment, I would receive it regardless of 'rules'.

Everyone, whether British or not, is entitled to emergency treatment at A&E without cost. That's part of the 'rules'.

[trevoromgh]

_{I do not believe this article. Looks like they copied some old news when the Government said that they were considering basing NHS eligibility on at least 7 years of NI contributions. That was superseded by a Government about face and the latest was that you have to prove you are returning to the UK permanently to get free medical care. If you look at the original article the editor was unable to find the news item that his story was based on and the link does not work. Try searching the internet there seems to be no news items from the NHS or the Government confirming this.}

_{Last year the NHS refused to cover my £20,000 hospital fees in Australia even though there is a reciprocal agreement. This despite the fact that I have paid a lot more NI contributions than the average UK citizen. Same problem with expat frozen pensions. Now they no longer want to give us our tax free allowance on our pensions and we will be taxed at the full rate on the whole sum they pay.}

I do believe it and if you are prepared to read though the various documents in this link https://www.gov.uk/government/consultations/migrants-and-overseas-visitors-use-of-the-nhs you will find it seems to be restoring NHS cover to those ex-pats who have paid a certain number of years NI contributions although the number of years has still to be agreed.

As for your experience in Australia that seems rough treatment but I've not checked what reciprocal cover is provided there. Why not appeal if you think they have not stuck to the letter of the law ?

[gbswales]

People who have paid contributions should always be entitled to care from the NHS when they are in the UK whether as a resident or a visitor. I even think that the NHS should have some responsibility for your health care while you are abroad. I would have loved to retire to Thailand (having contributed to the NHS all my working life) but I have haemophilia which means keeping a stock of expensive blood products for self administration, when every I get a bleed. There should in my view be a way for me to obtain those supplies even whilst out of the country. Health insurance is not an option for anything other than short holidays because they are allowed to exclude pre-existing health conditions and even if they were to accept the risk the premiums would be unaffordable.

[oldsailor35]

_{I do not believe this article. Looks like they copied some old news when the Government said that they were considering basing NHS eligibility on at least 7 years of NI contributions. That was superseded by a Government about face and the latest was that you have to prove you are returning to the UK permanently to get free medical care. If you look at the original article the editor was unable to find the news item that his story was based on and the link does not work. Try searching the internet there seems to be no news items from the NHS or the Government confirming this.}

_{Last year the NHS refused to cover my £20,000 hospital fees in Australia even though there is a reciprocal agreement. This despite the fact that I have paid a lot more NI contributions than the average UK citizen. Same problem with expat frozen pensions. Now they no longer want to give us our tax free allowance on our pensions and we will be taxed at the full rate on the whole sum they pay.}

I do believe it and if you are prepared to read though the various documents in this link https://www.gov.uk/government/consultations/migrants-and-overseas-visitors-use-of-the-nhs you will find it seems to be restoring NHS cover to those ex-pats who have paid a certain number of years NI contributions although the number of years has still to be agreed.

As for your experience in Australia that seems rough treatment but I've not checked what reciprocal cover is provided there. Why not appeal if you think they have not stuck to the letter of the law ?

Having had reciprocal medical treatment whilst in the UK from Australia, i was led to believe that there is a fully reciprocal arrangement between the two governments.

[Norvabc]

I stayed in Thailand for 18 months, all the time retaining my house in the UK paying Tax on my pension my Rates, Elec, Gas Tv license etc as I had a house sitter while away. On the advice of my Doctor to "get away for a year or so” I was suffering with Chronic Fatigue.

When I returned and went to see the same Doctor not only was the waiting room devoid of English speaking patients but my Doctor told me that I have to now pay private as i have been out of the country for more that an year.

I was shocked, told him b*ll*cks. He said on this occasion, as he knew I had a house here and lived here before all my life he would see me this time without charge.

It seems the rights of the indigenous English man are diminishing.

[Jip99]

I stayed in Thailand for 18 months, all the time retaining my house in the UK paying Tax on my pension my Rates, Elec, Gas Tv license etc as I had a house sitter while away. On the advice of my Doctor to "get away for a year or so” I was suffering with Chronic Fatigue.

When I returned and went to see the same Doctor not only was the waiting room devoid of English speaking patients but my Doctor told me that I have to now pay private as i have been out of the country for more that an year.

I was shocked, told him b*ll*cks. He said on this occasion, as he knew I had a house here and lived here before all my life he would see me this time without charge.

It seems the rights of the indigenous English man are diminishing.

Then you are one who can welcome these changes with open arms.

You are unlucky in your choice of doctor. Many don''t care and will not make such a judgement on your lifestyle.

I am sure that they receive funding from the NHS based on the number of payments so you are hardly making them work for their money.