Registering spouse at UK Doctors - Problem

[magicroundabout]

Hi All,

Despite recently paying £500 for the NHS surcharge I'm having problems registering my wife at the Doctors - They are telling me my wife needs to complete an overseas patient form....On the form there is nothing about a Spouse Visa (Only Work and Study Visas). They also said we need to supply proof my wife is studying or working here with 6 months evidence. Surely this cant be right - Anyone had similar problems?

Many Thanks

[prestburypark]

I had the opposite, Mrs on a visit visa but registered and accepted as a resident, not trying to buck the system but they were not listening. Mind you had to go private for to get stuff done quickly.

For the moaners we only had one visit about migraine so no drain on the NHS

[Richard W]

Do you have a number for the form so that we may look at it. The problem is that your wife is not 'ordinarily resident', as she would have been before the hostile environment was instituted, and is highly likely to be covered by a form for those on work or study visas. I'm not having much luck in finding a web site to explain things to the receptionists.

[magicroundabout]

Do you have a number for the form so that we may look at it. The problem is that your wife is not 'ordinarily resident', as she would have been before the hostile environment was instituted, and is highly likely to be covered by a form for those on work or study visas. I'm not having much luck in finding a web site to explain things to the receptionists.

Hi Richard,

There is no number on the form (which seems strange from the NHS). Its called an "overseas patients form" the form along the bottom states its issued Practitioner Services - Medical Registration Department, Edinburgh. Its got a list of VISA's which are -

Possession of Study Visa

Possession of Student Dependant Visa

Possession of Valid Work Visa

Application for Asylum

Possession of valid visit Visa

There is also a list of evidence that needs to supplied against each category.

[Richard W]

Do you have a number for the form so that we may look at it. The problem is that your wife is not 'ordinarily resident', as she would have been before the hostile environment was instituted, and is highly likely to be covered by a form for those on work or study visas. I'm not having much luck in finding a web site to explain things to the receptionists.

The best I've been able to dig up so far is the Implementation Plan for the new cost recovery system by the NHS, at http://www.healthcarecostrecovery.co.uk/wp-content/uploads/2015/12/2014-16-NHS_Implentatation_Plan_Phase_3.pdf . In its jargon, your wife is a 'temporary resident' - see p. 69 (ink). Page 10 (ink), i.e. the 14th page in the document, then explains that your wife will be able to use the service because the NHS surcharge has been paid. I suggest you gather together her passport, her BRP, your marriage certificate, your passport, evidence that you have paid the surcharge - the reference number might be good, and front page and pp 10, 52, 57, 58, 69 (ink numbers) of the referenced PDF, and take them with you if you truly don't have the right form. By this stage, the proof of status you need should be just the BRP.

The initial BMA response to the proposed NHS surcharge just referred to certain categories of workers and students, which might be causing confusion.

[magicroundabout]

Do you have a number for the form so that we may look at it. The problem is that your wife is not 'ordinarily resident', as she would have been before the hostile environment was instituted, and is highly likely to be covered by a form for those on work or study visas. I'm not having much luck in finding a web site to explain things to the receptionists.

The best I've been able to dig up so far is the Implementation Plan for the new cost recovery system by the NHS, at http://www.healthcarecostrecovery.co.uk/wp-content/uploads/2015/12/2014-16-NHS_Implentatation_Plan_Phase_3.pdf . In its jargon, your wife is a 'temporary resident' - see p. 69 (ink). Page 10 (ink), i.e. the 14th page in the document, then explains that your wife will be able to use the service because the NHS surcharge has been paid. I suggest you gather together her passport, her BRP, your marriage certificate, your passport, evidence that you have paid the surcharge - the reference number might be good, and front page and pp 10, 52, 57, 58, 69 (ink numbers) of the referenced PDF, and take them with you if you truly don't have the right form. By this stage, the proof of status you need should be just the BRP.

The initial BMA response to the proposed NHS surcharge just referred to certain categories of workers and students, which might be causing confusion.

Thanks Richard very useful........We are going back on Friday to try and register hopefully it will be OK

[Richard W]

There is no number on the form (which seems strange from the NHS). Its called an "overseas patients form" the form along the bottom states its issued Practitioner Services - Medical Registration Department, Edinburgh. Its got a list of VISA's which are -<snip>

You should have said you were in Scotland! The UK doesn't exist for health - it's a devolved matter. (It's not clear what has happened to your NHS surcharge payment.)

There are several things wrong here. Firstly, I think the surgery was attempting to record your wife as a 'temporary resident' whereas in terms of registration, she is a 'permanent resident'. That's right - she's a temporary resident (English NHS term at least) who should be registered as a permanent resident for registration purposes, like you or me. Explain to the receptionist how long she'll be living at your current home. She's authorised to live in Scotland for at least 30 months - see BRP! The most up to date guide I can find for thrusting under the receptionist's nose is Overseas Visitors' Liability to Pay Charges for NHS Care and Services. It's several years out of date. I would hope that your wife would qualify under that document as 'ordinarily resident' (it's old enough that when it was written she was 'ordinarily resident' in English terms.) If that failed, she should have qualified as a 'family member of a person exempt from NHS charges'.

I couldn't find the form you mentioned - I strongly suspect it's been withdrawn.

The form your wife should have been asked to fill in is GMSGPR001 or just possible a later version. The link I got to it was at Practitioner Services: Guidance & Forms. The BRP may be better than a passport as evidence of identification - it is linked to the NHS surcharge payment in England.

[magicroundabout]

There is no number on the form (which seems strange from the NHS). Its called an "overseas patients form" the form along the bottom states its issued Practitioner Services - Medical Registration Department, Edinburgh. Its got a list of VISA's which are -<snip>

You should have said you were in Scotland! The UK doesn't exist for health - it's a devolved matter. (It's not clear what has happened to your NHS surcharge payment.)

There are several things wrong here. Firstly, I think the surgery was attempting to record your wife as a 'temporary resident' whereas in terms of registration, she is a 'permanent resident'. That's right - she's a temporary resident (English NHS term at least) who should be registered as a permanent resident for registration purposes, like you or me. Explain to the receptionist how long she'll be living at your current home. She's authorised to live in Scotland for at least 30 months - see BRP! The most up to date guide I can find for thrusting under the receptionist's nose is Overseas Visitors' Liability to Pay Charges for NHS Care and Services. It's several years out of date. I would hope that your wife would qualify under that document as 'ordinarily resident' (it's old enough that when it was written she was 'ordinarily resident' in English terms.) If that failed, she should have qualified as a 'family member of a person exempt from NHS charges'.

I couldn't find the form you mentioned - I strongly suspect it's been withdrawn.

The form your wife should have been asked to fill in is GMSGPR001 or just possible a later version. The link I got to it was at Practitioner Services: Guidance & Forms. The BRP may be better than a passport as evidence of identification - it is linked to the NHS surcharge payment in England.

They gave me the GMSGR001 form as well......I was clear that my wife was a UK resident and had lived in the UK for 3 years and had paid the surcharge but they were adamant she had to complete the overseas application. I've tried to find the form as well on net but cant. I'll take a photo of it tomorrow and post it up - it really doesn't look an official NHS form certainly not a controlled document (It doesn't even have a logo on it or issue date). I could get a letter from her work and supply payslips but to be honest I don't see why I should.

[Richard W]

Thinking about it, her settlement visa could probably be counted as a 'work visa'. (Its price includes a tax element whose stated justification is that it enables the recipient to work.) It's a shame you haven't kept her pay slips. I think the overseas patient form will simply be ignored in the end - the receptionist seems to have asked for both forms because she isn't sure what to do. I take it you've moved house and now need to change GP. I think the forms will go to a competent person who sees an adequate GMSGPR001 with completed references to the previous GP, and the other form will simply be ignored.

[Trevor1809]

Isn't this how MPs are supposed to earn their money sorting this sort of problem out? That would have been my first port of call.

[POMCHOB]

Isn't this how MPs are supposed to earn their money sorting this sort of problem out? That would have been my first port of call.

Hi Trevor 1809

I tried to to get some help for a Visa Refusal for my Thai wife some years ago She ( Local MP) was too busy looking after her children in our meeting so i

was palmed off with the rest of the meeting with her secretary advising i should write to Immigration Damien Greene at the time

and mention how much i love my wife to get the Visa Refusal Overturned....Priceless Advice!!!!

POMCHOB

Edited January 28, 2016 by POMCHOB

[KunMatt]

Every medical centre is different and it's at their own discretion whether they will register your wife.

We moved to the UK using a fiance visa last year and registered myself, my partner and our two children straight away at the local doctors. They called me to ask a couple of questions and then she was registered and used the doctors (quite frequently) until now.

She also went to the hospital and out of hours doctors one time each and it cost me about 1200 quid cuz she didn't have the IHS yet, but the doctors never charged her for any visits. Any prescriptions cost the same as for me at £8.20.

[Trevor1809]

Isn't this how MPs are supposed to earn their money sorting this sort of problem out? That would have been my first port of call.

Hi Trevor 1809

I tried to to get some help for a Visa Refusal for my Thai wife some years ago She ( Local MP) was too busy looking after her children in our meeting so i

was palmed off with the rest of the meeting with her secretary advising i should write to Immigration Damien Greene at the time

and mention how much i love my wife to get the Visa Refusal Overturned....Priceless Advice!!!!

POMCHOB

I suppose visa refusal is one thing but getting a constituent the services that they are legally entitled to but not getting is another. Its called discrimination.

[POMCHOB]

Isn't this how MPs are supposed to earn their money sorting this sort of problem out? That would have been my first port of call.

Hi Trevor 1809

I tried to to get some help for a Visa Refusal for my Thai wife some years ago She ( Local MP) was too busy looking after her children in our meeting so i

was palmed off with the rest of the meeting with her secretary advising i should write to Immigration Damien Greene at the time

and mention how much i love my wife to get the Visa Refusal Overturned....Priceless Advice!!!!

POMCHOB

I suppose visa refusal is one thing but getting a constituent the services that they are legally entitled to but not getting is another. Its called discrimination.

Hi Trevor 1809

I totally agree with your sentiment, it is discrimination i just happen to be of the opinion MP's aren't as useful as you hope them to be from

most of my dealings anyway. At My Original GP Surgery my wife was refused her registration because the utility bills were not in her name and wouldn't accept her Bank Account Details.So i moved to another GP's and they accepted her at that surgery that was in England with two forms of ID Passport and Bank Account Statement.This may of been under older rules for Settlement Visa 2012 things may of changed a lot by now.

POMCHOB

Edited January 28, 2016 by POMCHOB

[Trevor1809]

Isn't this how MPs are supposed to earn their money sorting this sort of problem out? That would have been my first port of call.

Hi Trevor 1809

I tried to to get some help for a Visa Refusal for my Thai wife some years ago She ( Local MP) was too busy looking after her children in our meeting so i

was palmed off with the rest of the meeting with her secretary advising i should write to Immigration Damien Greene at the time

and mention how much i love my wife to get the Visa Refusal Overturned....Priceless Advice!!!!

POMCHOB

I suppose visa refusal is one thing but getting a constituent the services that they are legally entitled to but not getting is another. Its called discrimination.

Hi Trevor 1809

I totally agree with your sentiment, it is discrimination i just happen to be of the opinion MP's aren't as useful as you hope them to be from

most of my dealings anyway. At My Original GP Surgery my wife was refused her registration because the utility bills were not in her name and wouldn't accept her Bank Account Details.So i moved to another GP's and they accepted her at that surgery that was in England with two forms of ID Passport and Bank Account Statement.This may of been under older rules for Settlement Visa 2012 things may of changed a lot by now.

POMCHOB

Well I have to agree that MPs are pretty crap at doing anything but we after all supposed to live in a democracy so denying somebody who is in the country legally the right to services that they entitled to is discrimination. Imagine the flak if a Syrian refugee was denied access to an NHS doctor. I have to say that it was pretty straight forward with my GP. I can't remember what they asked to see now whether it was just the passport or her NI number confirmation.

[POMCHOB]

Hi magicroundabout,

Although 2010 for Scotland this PDF may be worth a look it's the only thing i could find it has some emails and phone contacts too.

Annex B is interesting on examples of evidence

http://www.sehd.scot.nhs.uk/mels/CEL2010_09.pdf

Good Luck

POMCHOB

[Richard W]

The legal situation is not quite as clear as I would like. Legally, someone who does not have settled status or the appropriate EEA connection is a visitor rather than ordinarily resident.

For England, the exemption from NHS charges for visitors comes from The National Health Service (Charges to Overseas Visitors) Regulations 2011 Regulation 8 (Part 8(2)(e) in particular), which says there are no charges for those lawfully present for the purpose of taking up permanent residence. The obvious example is those present for the purpose of settlement.

I can't find anything so useful for Scotland. The best I can find is The National Health Service (Charges to Overseas Visitors) (Scotland) Regulations 1989 Regulation 4, which under the heading 'Overseas visitors exempt from charges' says

No charge shall be made in respect of any services forming part of the health service provided for an overseas visitor, being a person or the spouse or child of a person—

(a)who is shown to the satisfaction of the Health Board to be present in the United Kingdom or in a designated area of the Continental Shelf or, if his employer has his principal place of business in the United Kingdom, in or over any area of the Continental Shelf, or on a stationary structure within the territorial waters of the United Kingdom, for the purpose of—

(i)engaging in employment as an employed or self-employed person; or
<snip>
(b)who has resided in the United Kingdom for a period of not less than one year immediately preceding the time when the services are provided, whether or not immediately prior to the completion of one years' residence as aforesaid, charges under these Regulations may have been made in respect of services provided as part of the same course of treatment
<snip>

Many incoming spouses will be immediately covered by 4.a.(i), and Magicroundabout's wife is now covered by Regulation 4.b. I'm wondering if I simply haven't found the new Scottish statutory instrument corresponding to the English one, though perhaps the Scottish government simply hasn't caught up with the Immigration Act 2014 Section 39, which redefined 'ordinarily resident' for the purposes of NHS charging. Otherwise, some type of form relating to "overseas visitors" is indeed relevant! I thought Scotland was supposed to be immigrant-friendly.

I can find policy statements that say that full services should be available. For England, there is the parliamentary research briefing http://researchbriefings.parliament.uk/ResearchBriefing/Summary/CBP-7274, which says of the immigration health charge, "Once they have paid the charge, they are entitled to free NHS treatment on the same basis as permanent residents, for the duration of their visa."

For Scotland, the statement in http://www.gov.scot/Topics/Health/Services/Overseas-visitors is helpful - "If a person is found to be "exempt from NHS charges", they are entitled to healthcare and services on the same basis as a person who is ordinarily resident in Scotland". Mrs Magicroundabout is clearly exempt from NHS charges.

There are hints that the rules may change further, and that 'temporary migrants' (a foul term) may have to pay according to the cost of the services used in the first six months of their presence in the UK.

[POMCHOB]

magicroundabout

We also had problems with receptionists not understanding Settlement Visa in our case.

I would suggest contacting the Surgery Managers of GP's Practice rather than trying to deal with the receptionist's.

Try different GP Surgeries in the area.

Because our GP practice posting a letter to the wrong address and we obviously did not acknowledge having not received it my wife was

removed from that surgery and we had to go back and re-register(they did admit their mistake) and then soon after my wife made the decision to move to another GP.

POMCHOB

Edited January 29, 2016 by POMCHOB

[Richard W]

magicroundabout

We also had problems with receptionists not understanding Settlement Visa in our case.

I would suggest contacting the Surgery Managers of GP's Practice rather than trying to deal with the receptionist's.

The possible problem seems rather deeper - either the Scottish government doesn't understand that people on settlement visas are no longer ordinarily resident, or they hate them much more than the English government does.

As evidence of the latter, note the following from CEL 09 (2010)

53.

Ordinarily resident is a common law concept interpreted by the House of Lords in 1982 as someone who is living lawfully in the United Kingdom voluntarily and for settled purposes as part of the regular order of their life for the time being, with an identifiable purpose for their residence here which has a sufficient degree of continuity to be properly described as settled. A period of 6 months is seen as a reasonable period of time for a person to remain, lawfully, in Scotland before they can be classed as ordinarily resident.

By that argument, the first six months of a pure homemaker's residence in the UK is without full NFS cover!

Note that the Immigration Act 2014 restricted the meaning of the term 'ordinarily resident'.

[Richard W]

The possible problem seems rather deeper - either the Scottish government doesn't understand that people on settlement visas are no longer ordinarily resident, or they hate them much more than the English government does.

<snip>

Note that the Immigration Act 2014 restricted the meaning of the term 'ordinarily resident'.

I may have been unfair. The meaning was restricted only for charging purposes; for other purposes, Mrs Magicroundabout would be ordinarily resident, and there appear to be such other purposes in the law about the Scottish NHS.

As for entitlement to NHS services in Scotland, I still haven't nailed down how resident Sassenachs become entitled, as opposed to not being charged.

[magicroundabout]

Hopefully all sorted....just back from the Doctors. I was trying to explain to the receptionists the different types of visa's (and getting blank stares). Luckily, the Practice Manager came over (who seemed very knowledgeable) and said as my wife is on a Spouse visa its not a problem and the overseas form should be ignored - We just need to show her BRP card. We couldn't register today as its Friday but they will register my wife on Monday. Thanks everyone for the advice especially Richard....Although, I think it highlights some of the NHS processes lag behind UK immigration policy.

[Richard W]

For England, the exemption from NHS charges for visitors comes from The National Health Service (Charges to Overseas Visitors) Regulations 2011 Regulation 8 (Part 8(2)(e) in particular), which says there are no charges for those lawfully present for the purpose of taking up permanent residence. The obvious example is those present for the purpose of settlement.

We moved to the UK using a fiance visa last year and registered myself, my partner and our two children straight away at the local doctors. They called me to ask a couple of questions and then she was registered and used the doctors (quite frequently) until now.

She also went to the hospital and out of hours doctors one time each and it cost me about 1200 quid cuz she didn't have the IHS yet, but the doctors never charged her for any visits. Any prescriptions cost the same as for me at £8.20.

Whoops! I overlooked the National Health Service (Charges to Overseas Visitors) Amendment Regulations 2012, which withdrew that exemption if the patient was in England while being treated.

The message here is that health insurance is required for those who come over on fiancée visas. They would once arguably have been ordinarily resident from arrival, but no more for charging purposes.

[KunMatt]

For England, the exemption from NHS charges for visitors comes from The National Health Service (Charges to Overseas Visitors) Regulations 2011 Regulation 8 (Part 8(2)(e) in particular), which says there are no charges for those lawfully present for the purpose of taking up permanent residence. The obvious example is those present for the purpose of settlement.

We moved to the UK using a fiance visa last year and registered myself, my partner and our two children straight away at the local doctors. They called me to ask a couple of questions and then she was registered and used the doctors (quite frequently) until now.

She also went to the hospital and out of hours doctors one time each and it cost me about 1200 quid cuz she didn't have the IHS yet, but the doctors never charged her for any visits. Any prescriptions cost the same as for me at £8.20.

Whoops! I overlooked the National Health Service (Charges to Overseas Visitors) Amendment Regulations 2012, which withdrew that exemption if the patient was in England while being treated.

The message here is that health insurance is required for those who come over on fiancée visas. They would once arguably have been ordinarily resident from arrival, but no more for charging purposes.

Honestly I've not looked into it but what I know is that any NHS service like a hospital will treat a foreigner at A&E for free but if you book an appointment at a hospital then you pay for it, which is what I think you are talking about above . We had to pay for an appointment with a doctor at the hospital, an out of hours doctor and an MRI which is why it cost us £1200. A local GP doesn't necessarily charge for a visit which is why my (now) wife sees the doctor regularly for free, its up to them if they want to charge, it's not like a hospital visit where they will always charge you. Edited January 29, 2016 by KunMatt

[Richard W]

Honestly I've not looked into it but what I know is that any NHS service like a hospital will treat a foreigner at A&E for free but if you book an appointment at a hospital then you pay for it, which is what I think you are talking about above . We had to pay for an appointment with a doctor at the hospital, an out of hours doctor and an MRI which is why it cost us £1200. A local GP doesn't necessarily charge for a visit which is why my (now) wife sees the doctor regularly for free, its up to them if they want to charge, it's not like a hospital visit where they will always charge you.

Primary care (most GP work. dentistry and ophthalmic work) and A&E and emergencies in general are free (except where they are only free as a social benefit): secondary care (most scheduled care) is in general chargeable. The basic rule was that those ordinarily resident didn't pay, those in a similar situation (workers, students, those with long temporary residences) didn't pay, and the rest did, except that government-to-government deals meant that sometimes they didn't.

This was then complicated by the ordinary residence charging exemption being restricted to those settled here (as an immigration law term), and the introduction of the immigration health surcharge. Looking at rules used by the English NHS, I find that if your family gave up on the UK and went to reside in Thailand, then after say 8 months, you as a Briton could not go to England for free NHS treatment, but the non-British members of your family could, so long as their settlement leave to remain had not expired! I don't think their continuing entitlement to free NHS treatment is unfair, as in this hypothetical case you would have been writing off a considerable investment in visas and surcharges.

[POMCHOB]

Hopefully all sorted....just back from the Doctors. I was trying to explain to the receptionists the different types of visa's (and getting blank stares). Luckily, the Practice Manager came over (who seemed very knowledgeable) and said as my wife is on a Spouse visa its not a problem and the overseas form should be ignored - We just need to show her BRP card. We couldn't register today as its Friday but they will register my wife on Monday. Thanks everyone for the advice especially Richard....Although, I think it highlights some of the NHS processes lag behind UK immigration policy.

Sometimes its worth going over the heads of GP Receptionist's in my wife experience going straight to the GP Practice Manager

( even if you have to phone them) always gets results we found

Receptionist tend to be on a power trip and know very little in regard to Visa rules as we ,and you have experienced.!

Glad it has all worked out for your wife .

Good Luck.

POMCHOB

.