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?

Oh and emergency treatment is not withheld in countries like France. But the system will absolutely chase up other governments to reimburse costs if emergency care. And providing ID, eligibility, insurance papers, EHIC card etc is part of the process. Sans papiers, refugees, asylum seekers, people on low incomes - there are schemes to cover all of these.

If someone has an NHS number and is registered with a GP they are entitled to NHS care. Proving that entitlement is quite tricky as most ex pats don't offer the info going as far as finding fake addresses to use etc. How can a GP remove them without detective work?

So hospitals are led by the registration on the spine which is fed by GP records. Frankly not enough hours in the day to waste on a bureaucratic process

Expats cheat the system

There are many expats in who have worked and paid NI contributions in UK for 40+ years. Most still pay (higher rate) tax in UK. They are not entitled to access non- emergency NHS treatment and have to re- insure in their country of residence -often at a very high cost.

Meanwhile, people who have just arrived in UK and have not - and in some cases never will - contribute to the system are automatically covered for free because of the antiquated NHS residence rules.

It's free so why would they check. That's emergency care

The whole premise of your post is flawed

The clinical staff are too busy to check, and the admin staff aren't paid enough to care, that is probably the crux of it

@workwoes123

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!

But that's because emergency care is free for all including non-doms. As has been stated several times. Theres no mechanism for taking money to pay for something which is free.

@Hallyup6

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.

Did it say citizen? Or resident?

I ask as a legal resident, who paid an NHS fee with my visa application, as well as my taxes while living here. While I've never been questioned, I witnessed someone else being really questioned by the GP receptionist pre covid, and it made me wonder what the procedure actually is. I've never had to show my BRP at the doctor but if they wanted to see it they would be welcome to.

My ex pat family member used my address to register at my gp. A bit embarrassing when Mrs Lego was called for her vaccination and it wasnt me. After being chased by the gp multiple times I told them they dont live in the UK.

I just presumed, as my family member tells me they are entitled to NHS care until they die regardless of where they live as they paid tax and NI?

I assume if my relative ever returns she will just re register at my gp? She has private health insurance but has said if she ever needs treatment for something like cancer she isnt covered and will need to return for it here.

Bil also has visited the UK just to get a vaccine. Not 100% sure why and hadn't had a gp for about 20 years. He had no issue registering for one to get vaccinated

If I don't think someone is eligible for NHS care there's a number I should ring. 10 years nursing I've rung it once.

I don't think it'd my job nor will I make it an active part of it. I'm there to care, someone else runs the chip and pin machine.

Emergency care is free and

the *government need to employ people specifically for this problem if they want to reduce foreign health tourism! So write to your MP and alert them to the problem

Free titchy???? Do doctors not receive a pay packet in your neck of the woods??

@pollylocketpickedapocket

Free titchy???? Do doctors not receive a pay packet in your neck of the woods??

Obviously she meant free at the point of care, not literally free.

I’m not British, had lived and worked here for over 5 years before using maternity services. I got a letter asking to prove I’m eligible. I forgot all about it and had a massive bill sent to me that I then had to dispute by sending proof of address/ payslips/ bank statements etc. So they do check if you are not British.

Yabu to start this thread without bothering to do even the most cursory research on which aspects of NHS care are chargeable to those not ordinarily resident and which aren't.

@Hallyup6

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.

Brilliant. Thanks for that. Heaven forbid we should get people to actually pay for services they use but never contribute to.

You’re bothered staff didn’t check your entitlement for treatment you were entitled to? Sounds strange.

I came back to the UK to have my third DC. Because of the sector we worked in we were eligible for NHS care but I was asked at every appointment about it and I took to taking a copy of the eligibility requirements with me to all appointments.
The slight grey area that I'm sure people exploit is that there is no minimum time here in the UK to resume eligibility, only the requirement that you intend to remain permanently. So what's to stop you deciding to stay and then a few months down the line changing your mind and moving abroad again.

@BluebellsGreenbells

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.

The point of a human right is that it is for everyone.

They do charge for non emergency care. The policy is that emergency care is free so it's not a mistake that you weren't charged. It's different in France as they will charge for it afterwards even if not at the time.
A pregnant friend who is a(white) British citizen went abroad for about 2 months over Christmas (her return was delayed due to covid but she lives and works in the UK normally). They made her prove she was eligible for NHS maternity care when she returned.

I used to work in NHS psychiatry inpatient unit. Twice we had foreign patients who we actually paid for their repatriation. One to China after a 6 month in-patient stay and another to Russia after a 4 month inpatient stay. We were expected to sort out their flights etc. No mention of them paying at all.

My mum used to charge people on her ward frequently.

The charging of overseas patients in Scotland is covered by various pieces of legislation. Not sure when you visited A&E but here is the CEL issued in 2008

<a class="break-all" href="https://www.google.com/url?sa=t&source=web&rct=j&url=www.sehd.scot.nhs.uk/mels/CEL2008_09.pdf&ved=2ahUKEwiIrLDTtYHxAhVZgP0HHfpVBIcQFjABegQIBRAC&usg=AOvVaw1eB1LsqtSv7aw-pc-936nF&cshid=1622927986229" rel="nofollow" target="_blank">www.google.com/url?sa=t&source=web&rct=j&url=www.sehd.scot.nhs.uk/mels/CEL2008_09.pdf&ved=2ahUKEwiIrLDTtYHxAhVZgP0HHfpVBIcQFjABegQIBRAC&usg=AOvVaw1eB1LsqtSv7aw-pc-936nF&cshid=1622927986229

I don't know exactly how Brexit has affected the charges but the principals of the 'free to absolutely everyone' parts (emergency care, ambulance journeys, sexual health, infectious diseases etc) are likely to be the same as they are in the public interest.

@pollylocketpickedapocket

Free titchy???? Do doctors not receive a pay packet in your neck of the woods??

I said the CARE is free. I didn't comment on the COST.

• NHS treatment is free and available to anyone who needs it. This includes:

treatment in a hospital Accident and Emergency department
seeing a GP - as an NHS or temporary patient
family planning services
treatment for some infectious diseases
compulsory psychiatric treatment*

The treatment we received didn’t fall into any of these. We called the medical centre, the nurse was around, she said we should just come in. Similarly à friends child was seen by a GP (which is free) but was then in hospital for a few days of treatment and eventually discharged with a bag of free medication.

It’s great to know that emergencytreatment in an a&e is free though - thanks for pointing that out.