AIBU to expect NHS staff to ask me for proof that I’m eligible? And to charge me if I’m not?

[workwoes123]

DH, me and two children. We’re all British but have lived in France since 2006. We are fully integrated in the health service here. We have EHIC cards (and the post brexit equivalent) and we always take travel insurance when we come back to the U.K.

The last time we were in the U.K. DS1 had an accident and burnt his hand. We went to the local medical centre (in Scotland). When they asked our address, we gave them my mums address (where we were staying), told them we lived in France and tried to give our EHIC cards etc. They didn’t seem to know to do with them: they just said they’d use my mums address and the last GP we had when we lived here. We weren’t charged anything (didn’t seem like there was any way to do this). We would have been happy to pay: we are totally used to the pay up front / get reimbursed model.

So what do NHS staff think? Are you being encouraged or pushed to confirm eligibility to use the NHS? Would you know how to? Would you question someone who’s obviously British, locally born, has temporary local address?

YABU - the nhs is free at the point of service for all users / I wouldn’t push for confirmation
YANBU - the NHS is for U.K. residents, and non-residents should be charged as appropriate

Bit of a simplistic choice tbh. If NHS staff police this there will be less time for clinical care. It's a cost benefit analysis.

Emergency care is free for all regardless of citizenship status.

Emergency care is available to anyone, you wouldn’t be asked to provide any kind of proof or payment in that settling.

But yes hospitals have systems and processes in place for elective (non-emergency) procedures and treatment.

I know quite a few people that live abroad and come back here for treatment. I don't think they ever ask if you live abroad. They just use a local relatives address.

I mean they may have pushed harder if you weren’t native British/white

There's not enough funding for the admin needed to support these checks. It's as simple as that.

Apart from that, it would be a minefield. Unless you check absolutely everybody, people will end up wrongly singled out because they sound or look a bit foreign, or have a foreign name. A few years ago there was an outcry in my part of the world because a British woman married to a Polish national, living in the UK, was quite aggressively pursued for proof that she was eligible for treatment. It isn't a road we want to go down. Unless you're Priti Patel.

You wouldn’t have been charged for emergency care like that anyway. And clinical staff don’t have the time (or inclination) to police stuff like that.

No NHS staff are not border force. Emergency care is feee for all, thank goodness.
Hospitals do recoup costs from overseas residents.
Expats chest the system.

So what happens if you turn up at A&E and can’t produce evidence of your residence in this country? You go untreated? That would be disgraceful. Basic healthcare is a human right. It doesn’t matter where someone is from or what their residential status in this country is. If they need medical help then you help them.

What happened to your humanity, OP?

@Rillington

I know quite a few people that live abroad and come back here for treatment. I don't think they ever ask if you live abroad. They just use a local relatives address.

Well no wonder it’s in the mess it’s in. Where else in the world would you be able to take the piss like that?

You could offer to pay OP. If it would make you feel better.

Or is this not really about you not getting questioned?

It's a nightmare trying to get people to believe you arent entitled to NHS care.
We used to get DS new glasses when we came back in the summer - it was MUCH cheeper than buying them locally. Just outside London they knew exactly what to do, but I really had to argue with the staff up near my parents, because I refused to sign the paperwork to get free kids eye test.

Its not something that front line staff are involved in...there literally isn't the time and we have no process for billing/charging in wards the same way hospitals do abroad. There is a follow up though when a temporary CHI number is issued, I once had a patient from Wales and they came round to get some more details and I can't remember what they were asking for exactly but I think they wanted a passport. If you are an expat it would be pretty easy to come back for treatment though, i had friends when we lived in UAE who came back to give birth.

Emergency care is not charged - regardless off nationality, as an A&E nurse if a patient tried to give me their insurance details I would also have no idea what to do with them!

When I was a ward nurse there was a admin dept that appeared to deal with health inurance and eligibility etc. I would have had no idea what I was suppose to do with a EHIC card 🤷‍♀️.

when we had a visitor from forrin the fees office was by his bedside as soon as he was wheeled to the ward from a&e after an accident.

I use to work on the maternity ward and there was a poster on the wall saying if we suspected that a woman was not a UK citizen then we had to call a certain number so someone could come and charge them.
We never called that number.

I dont think it is the care staff who should do this - they have enough to do. In Spain or the US you have to go through a special clerk/department before you see care staff, and prove to them you can pay. Not if you are in crisis obvs, but for walk in cases or people with less serious injuries.

It’s a minuscule amount of money in the scale of the NHS budget

www.bbc.com/news/health-38065810

I've just today had a letter regarding an up coming hospital appointment and I have to take with me proof of residency here in the UK, something to do with chasing up those who cannot prove they live in UK.

I thought it is quite routinely checked... I had two episodes of being treated in an NHS hospital in more than a decade of living here (one emergency, one maternity related) and in both cases a lengthy documents exchange with the overseas department followed. Who are very badly informed about the immigration law, by the way - for example, they wanted to see some evidence of the NHS surcharge paid from the years before it was introduced. What I found also bizarre is that as Non EU citizen you are then charged not the actual cost of treatment, but 150% (I think) of the cost.

Basic healthcare is a human right

Not for everyone

It’s a minuscule amount of money in the scale of the NHS budget

How do you know? They’ve never seriously tested this by questioning people.

If people live abroad, and come back here for treatment- it's impossible to police if they have a UK address and GP, surely?

Local medical clinic is probably free for everybody, anyway.

I had similar. My DC has dual nationality and we were living in the other country. Came back to visit family, banged head, needed stitches, could have claimed all costs via our health insurance and the hospital didn’t want to know. The lady on reception at A and E just said she’d put him down as British and laughed, as if I was a bit crazy for mentioning it. I thought the NHS needed to save money where it could. Seemed a bit daft not to recharge my amazing overseas health insurance to me but there you go.

M’y question came out of a discussion with a group of mostly British friends, talking about whether we need travel insurance etc when visiting the U.K. post brexit. Lots of them had stories about taking their children to A&E, or walk in medical centres etc and getting free care despite telling the staff that they weren’t resident etc. The staff (admin or médical) weren’t interested and there didn’t seem to be anyway to pay anyway.

I think my post was more along the lines of: I don’t mind paying for medical care in the U.K. I’m not resident, I have an EHIC card, I have travel insurance. I’m totally expecting to pay up front and get reimbursed. But as one of the pps said, I wasn’t taken seriously!