NHS Treatment For Non Residents

[johnerebus]

What is it about non resident UK citizens claiming NHS treatment that upsets so many?

I'm now 76 and have paid UK income tax for more than 60 years and still do. Paid NI for more than 50 years. Does it really matter where a person lives who is a fully paid up member?

I recently had a cataract done in the UK and then paid for my other eye to be done here in The TRNC as NHS guidelines say I have to be almost blind, as I was in one eye, to have a cataract operation there.

I have no qualms about returning to the UK for any future medical treatment.

[erol]

What is it about non resident UK citizens claiming NHS treatment that upsets so many?

I'm now 76 and have paid UK income tax for more than 60 years and still do. Paid NI for more than 50 years. Does it really matter where a person lives who is a fully paid up member?

I recently had a cataract done in the UK and then paid for my other eye to be done here in The TRNC as NHS guidelines say I have to be almost blind, as I was in one eye, to have a cataract operation there.

I have no qualms about returning to the UK for any future medical treatment.

If you return to the UK to become resident there, then you are entitled to NHS treatment and there is no problem. If you return and pretend you are resident when you are in fact not resident just to get free NHS care then you are breaking the 'rules'.

As I understand it your position is you 'paid in' thus you should be able to use the NHS for free regardless of where you now chose to live. ? If I have understood you correct then the questions that immediately spring to my mind are, how long or much do you think you have to have 'paid in' for to be entitled to ongoing NHS treatment regardless of where you now chose to live ? If you had paid UK tax and NI as a UK resident for say 30 year or 20 or 10 or 5 or 1 and then left the UK, should that still entitle you to free NHS health treatment, 5 years, 10, 30 years after you left the UK and stopped paying such things ? Where is the 'line'. If you were a Nigerian national who had worked legally in the UK for say 30 years until the age of 55, paid in via UK tax and NI for all that period and then at the age of 60 or 65 or 90 and no longer resident in the UK you need medical treatment, do you think you should be entitled to fly to the UK, get your treatment for free on the NHS and then fly away again after your treatment ?

[tomsteel]

It matters not what personal opinions/length of NI contributions you may have/or paid. The UK law is quite clear in that you must be a resident of the UK to receive NHS treatment, unless it is an emergency situation.

[sophie]

I am totally 100% with tom steel. Like the first poster we paid for donkies years into NI and still do in the form of tax on our respective pensions. Having said that we were refused NHS treatment as we could not prove that we owned property in the UK and unlike many people here in the TRNC, we were not prepared to ask our four children with their 5 properties to lie on our behalf. One of my daughters is a practice Nurse but the Doctors in the practice refuse to involve themselves in politics and go strictly my the present restrictions. I have to bite my tongue very hard indeed when friends and acquaintances here openly boast how they "bend or even break" the rules in order to obtain free NHS treatment. The rules are perfectly clear for all to see and I will not ask my children to cheat and lie on our behalf. i wonder why the poster used a Father Christmas emoji, or need we ask?

[Ragged Robin]

As I understand it if you return to live in the uk permanently you have to prove that, which includes living there for (I forget whether it is three or six months) before you can register with a Doctor. (or presumably dentist, optician etc.) for NHS, OK but what it you have an urgent need or medical assistance or have a pre-existing condition and need a prescription and expensive medication and cannot afford to pay privately

[erol]

As I understand it if you return to live in the uk permanently you have to prove that, which includes living there for (I forget whether it is three or six months) before you can register with a Doctor. (or presumably dentist, optician etc.) for NHS, OK but what it you have an urgent need or medical assistance or have a pre-existing condition and need a prescription and expensive medication and cannot afford to pay privately

Registering with a GP is not the same thing as being entitled to free NHS care as someone who is 'ordinarily resident' in the UK. Your entitlement to free NHS care begins from day one of your status of 'ordinarily resident'.

You do not have to prove you are resident in the UK to register with a GP. You may have to prove you live in the area that GP surgery covers, to a level that satisfies the GP surgery but that is down to the individual GP practice and GP themselves. There is no legal obligation that requires GP's to establish your residency before allowing you to sign on to their practice.

https://www.healthwatch.co.uk/advice-an ... our-rights

As far as I understood johnerebus' post he was suggesting that entitlement should be related to how much you have paid in historically (instead of or as well as residency being a requirement). To which my question was, in such a hypothetical suggested system, how much do you think someone should have to pay in first before they get entitlement to free NHS treatment even if they are no longer resident in the UK and for how long after they leave the UK should they get this entitlement for ?

[Dalartokat]

As I understand it if you return to live in the uk permanently you have to prove that, which includes living there for (I forget whether it is three or six months) before you can register with a Doctor. (or presumably dentist, optician etc.) for NHS, OK but what it you have an urgent need or medical assistance or have a pre-existing condition and need a prescription and expensive medication and cannot afford to pay privately

You can register for a Doctor as soon as you move to UK permanently. If you become entitled to free Healthcare, for example if you are over 60 or claiming Pension Credit then you may be able to get a contribution to Spectacles, Dentist etc.

There is a criteria before anything can be claimed under NHS and it depends upon individual circumstances.
It is residency based.

The Pharmacies now are checking entitlement to free prescriptions and there have been people fined for stating they have been exempt from prescription charges. You may be asked to prove your exemption by showing a relevant benefit award notice or a pre payment exemption certificate. If you cannot show evidence you will still get your prescription


free but the NHS will still check and you may get a bill later on,or a Penalty Notice.

https://www.nhs.uk/using-the-nhs/health ... ealthcare/

https://www.nhsbsa.nhs.uk/exemption-certificates


https://kentandmedway.nhs.uk/download/4943/ This is what is happening in my area and consultations have been taking place and the final decisions on the plan for East Kent is due in October. There are a lot of changes taking place with the NHS, a huge amount of money is needed and will not be achieved until people pay extra taxes. Nobody likes to hear that but it is the only way now for the NHS to survive.

Prime minister Boris Johnson has said he will give extra money to the NHS but it will not be enough due to the lack of funding over the past 15 years. We have a serious problem with Adult and Children’s Services and to get a nurse to come to your home is like pulling teeth. (Kent & SEast)

My mother has just had a cataract operation on June 17. She is 90 years. She waited for 2 years as she was having injections in her eye to stop the blood clot at the back of her eye moving over and finally the Doctor decided she could have the op and it has been successful. Not all cataracts can be treated straightaway on demand. Or treated locally. My mother had to travel to the nearest hospital that could treat her cataract as the Consultant was the only one who could do the operation. Her travel costs to this hospital were £105 from Margate to Ashford and a further £45 for an after consultation at the Dover hospital. Patient transport(free but run by Group4S) is unreliable.

Everyone has a tale to tell and everyone at sometime needs help but the resources are at a seriously low level.

[Art]

So if I’m not entitled to NHS treatment and I live in Cyprus why am I paying UK tax on my income.?

[Dalartokat]

As you well know it’s nothing to do with you paying tax for not receiving NHS treatment for free. You keep bringing up the same old chestnut each time NHS topics come up. Right back as far as Cyprus44.

[Art]

You haven’t answered my question (why I’m paying tax) and I think you are confusing me with someone else.

[tomsteel]

Any UK-based State pension, unearned income from investments etc are subject to tax at source, whatever your age until you croak. NI contributions, which pay for the NHS, cease at age 65. Whatever, non-resident = non-entitled. Suck it and live with it!

[Dalartokat]

I have no idea why you pay tax. Everyone is different.

Clearly you have a problem with paying tax on your income and clearly you resent not being able to receive free NHS treatment. You must have known your status before you left the UK and you must have known that if you decided to remain permanently in the TRNC you would not be entitled to free NHS treatment assuming
you had done your homework before you left.

Maybe time for you to re evaluate your circumstances.


I understood that you were “Magicart” on cyprus44 and that you had changed your forum name to Art when you came to Kibkom.
If you are not then I apologise to you.

[erol]

Any UK-based State pension, unearned income from investments etc are subject to tax at source, whatever your age until you croak. NI contributions, which pay for the NHS, cease at age 65. Whatever, non-resident = non-entitled. Suck it and live with it!

As far as I know, which is not much, capital gains tax on a property bought in the UK and then sold at a profit, was until 2016, related to your UK tax residency status. If you were not UK tax resident then no capital gains tax was due on such sales, if you were then it was. This did get changed I think in 2016 so that any capital gains , from that point on wards (2016 change), is due even if you are not UK tax resident when you sell.

But yes NHS treatment entitlement is currently related to residency in the UK or not. I am just trying to get those who say such a system is 'wrong' or 'unfair' to explain what sort of alternative they would like to see ? So yeah you can just 'suck it and live with it', or you can just ignore the law, flout it and then boast publicly about having done so on a forum, or you could discuss what a better , fairer, system might look like. I personally am taking the third option here, or trying to.

[WotNoDeeds]

If a person in the UK pays NI contributions all of their working life, then surely they should be entitled to NHS treatment for the remainder of their life, no matter where they reside. Health tourism costs the NHS £millions every year. If this money was recouped then patients wouldn't have to wait years for relatively simple procedures such as cataracts.

[erol]

If a person in the UK pays NI contributions all of their working life, then surely they should be entitled to NHS treatment for the remainder of their life, no matter where they reside. Health tourism costs the NHS £millions every year. If this money was recouped then patients wouldn't have to wait years for relatively simple procedures such as cataracts.

You could make that the 'rule' but I do not see how doing so will make waiting lists on the NHS any shorter. The question then becomes what about someone who has paid in NI contributions in UK for 80% of their working life and 20% elsewhere ? Should they also get entitlement to free NHS care for the rest of their life as well, regardless of if they reside in the UK or not ? Or maybe 80% of cost of treatment paid by UK government and they make up the other 20% ? This is not a 'fictional' scenario. My partner is a New Zealand national. She lived and worked (and if anyone who knows her will know, worked hard) entirely legally for around 20 years, paying UK NI and income tax for that entire time. What is her 'fair entitlement' in to the future in your view for the contributions she has made historically ?

[jofra]

If a person in the UK pays NI contributions all of their working life, then surely they should be entitled to NHS treatment for the remainder of their life, no matter where they reside....

From Wiki - "National Insurance (NI) is a tax system in the United Kingdom paid by workers and employers for funding state benefits. Initially, it was a contributory form of insurance against illness and unemployment, and eventually provided retirement pensions and other benefits. Citizens pay National Insurance contributions to become eligible for State Pension and other benefits....
....NI was first introduced by the National Insurance Act 1911 and expanded by the Labour government in 1948. The system was subjected to numerous amendments in succeeding years."
Apparently National Insurance contributions are not funding the NHS - funding must be coming from other forms of taxation (also not limited to income tax?)

[Dalartokat]

Yes Health tourism does cost millions, but when the subject comes up in UK to discuss, it gets clamped down and you have GPs saying they are there to treat people and not to ask questions about their patients status in the UK.. As has been mentioned earlier, GP’s and the like have voted not to go down that route. You cannot win. It has to be one or other.

[jimm]

If you pay tax in the UK but live here all year get an accountant you could be classified as a non resident and get your tax back, the only thing to watch out for is any reciprocal agreement on taxes between countries

[erol]

Yes Health tourism does cost millions, but when the subject comes up in UK to discuss, it gets clamped down and you have GPs saying they are there to treat people and not to ask questions about their patients status in the UK.. As has been mentioned earlier, GP’s and the like have voted not to go down that route. You cannot win. It has to be one or other.

I personally do not think 'doctors' in the UK are saying the state should not restrict access to free NHS healthcare to anyone who is psychically there in the UK. I think the point they are making is that they and health care professionals in general should not be the ones who implement and police such restrictions as this is not their job. It's not so much 'should we do this at all' as it is 'who should do/implement this'.
It seems to me it is possible to have a system that robustly establishes an individuals entitlement to such care that does not require doctors to do so themselves. It seems to me we already have such a system, though it's robustness is questionable, which is the NI number system. I do not think doctors would complain if it was a legal requirement on them to require anyone signing up to their surgeries to provide a NI number. The 'getting' of a NI number is manged by the DWP, people who's job it is to determine a persons 'status' in the UK. So make this a requirement to get NHS care and sign up to GP surgery. No NI number, no free health care. Of course this will not directly stop the kind of health tourism abuse that the OP talks about, as they would have already had a NI number, but even in these cases it seems to me it is perfectly possible to have a system, managed by DWP, that looks for 'discrepancies' and then investigates further and if necessary takes action. So in the example of someone with a NI number, where by all 'records' relating to that number 'stop' at a certain date (when the person leaves the UK to live elsewhere) and then they suddenly start up again years later in regards to NHS treatment, this could be looked at in more detail by the DWP (not doctors).

[Art]

Clearly you have a problem with paying tax on your income and clearly you resent not being able to receive free NHS treatment. You must have known your status before you left the UK and you must have known that if you decided to remain permanently in the TRNC you would not be entitled to free NHS treatment assuming
you had done your homework before you left.

Maybe time for you to re evaluate your circumstances.


Dalartokat,

You wrongly assume I resent not legally being able to receive free NHS and I did do my homework.

I can easily have treatment through the UK NHS but by choice I prefer to pay for all of my medical services in the UK and in Cyprus.I have absolutely no issue with anyone using the NHS as long as they have contributed.

My tax question was aimed to understand why I’m still paying tax -if legally I do not qualify for the NHS ..I do not believe that the NHS is solely funded by N.I contributions .It is propped up by the tax payer.

On the subject on the NHS....if the UK government were to make private health care more affordable it would take a lot of people out of the NHS and the waiting times would drastically improve.

As an example.

CT scan in the Uk £850....TRNC circa £100

And yes I am the same poster.

[erol]

I have absolutely no issue with anyone using the NHS as long as they have contributed.

Contributed when ? How much ? Would you have a problem with my NZ partner, who contributed for 20 years, returning to the UK 17 years after she left, getting free NHS treatment ? As I see it, she paid for 20 years and she GOT free NHS entitlement for those 20 years (even though entitlement is not linked to contribution anyway). Why should she continue to get such after she left the UK ?

My tax question was aimed to understand why I’m still paying tax -if legally I do not qualify for the NHS ..I do not believe that the NHS is solely funded by N.I contributions .It is propped up by the tax payer.

The problem here as I see it is this 'linkage' between entitlement and contribution. This linkage only exits in peoples heads , for understandable reasons but it is not how the system works or ever has worked. To me it seems like a core principal of the original concept of a NHS was to NOT have such linkage. The purest form of such linkage is to privatise healthcare entirely. No contribution, no healthcare. Limited contribution, limited healthcare.

Yes the NHS is funded from general taxation as well as from NI contributions. So for example you can argue any time someone who is not entitled to NHS health care (because they are not resident in the UK) visits the UK and buys something (that is not zero VAT rated) they have 'contributed' in part to the NHS, yet they get no entitlement for that taxation. Just because you have paid or continue to pay something in UK taxation this does not mean you have paid for your entitlement for free NHS health care as I see it. I see perfectly reasonable scenarios where people are liable for UK taxation and yet that should not then automatically qualify them for NHS entitlement.

[Art]

Hi Erol,


Your first question is a difficult one to answer but given your partner contributed for 20 years I would be happy for her to use the NHS but at the moment assuming she doesn’t live in the UK now she is not legally entitled.

Question two is also difficult and I think you make some valid points and would agree it is a very complex subject which the politicians should address......god help us all!

[Mowgli597]

How many times does it have to be said that NI contributions do not go into an account for the contributor to draw down in future years (other than in the case of contributory pension payments which ARE related to the amount contributed - in terms of the number of payments made, not the monetary value of those contributions).

The NI payments you were making paid for the benefits being drawn down by those needing them at the time they were being made.

Just as your state pension payment is being funded by those currently making NI contributions. And no doubt in twenty or thirty years time some of them will be making the same complaint as some on here. In fact they’re already complaining because “our” pensions mean that we are “better off” than we “should” be - and they won’t be able to qualify for a pension until they’re well past their three score years and ten!

[EnjoyingTheSun]

National Insurance contributions pay for less than 20% of the NHS.

If you were running a restaurant and were only allowed to call the police to arrest one person a day;

Would you first choose the patron who is a regular customer but helps himself to an extra couple of bread rolls from another table?
or
Choose the person who you have never seen before who hops off his motor bike walks into your restaurant and helps himself to a couple of bread rolls?

Obviously when choosing please take into account that the regular customer might have white privilege which means he has the honour of being blamed for everything though out history.

[trooper]

Interestingly, if an ex-pat Brit living in the south applies for the Form S1 this will entitled him/her to 'free' treatment in the ROC, paid for by the UK government. More interestingly since about two years ago NHS England rules mean that the S1 holder is absolutely entitled to return to the UK for elective medical/hospital treatment as if they were ordinarily resident in the UK.

So once again we are reminded that being in the TRNC has its downsides.......moving south seems a high price for NHS treatment.

[erol]

If you were running a restaurant and were only allowed to call the police to arrest one person a day;

Would you first choose the patron who is a regular customer but helps himself to an extra couple of bread rolls from another table?
or
Choose the person who you have never seen before who hops off his motor bike walks into your restaurant and helps himself to a couple of bread rolls?

Obviously when choosing please take into account that the regular customer might have white privilege which means he has the honour of being blamed for everything though out history.

If you were running a restaurant and were losing 20 bread rolls a day to theft , 16 to someone who used to be a customer years ago but stopped being so and now only steals bread rolls from you and 4 to someone who has never been a customer before, which of the two would be best to stop first ? No need to consider a racial element at all.

[EnjoyingTheSun]

If you were running a restaurant and were losing 20 bread rolls a day to theft , 16 to someone who used to be a customer years ago but stopped being so and now only steals bread rolls from you and 4 to someone who has never been a customer before, which of the two would be best to stop first ? No need to consider a racial element at all.

Still paying some tax so still a customer and you have no way of knowing who is taking the bread rolls do you?
TBH I think I'm being conservative making it 50-50.
I know it doesn't equate with your poor little down trodden person who speaks very little English theory which would bring a tear to a glass eye. I generally found when in England that people who had a lot of trouble understanding no really seemed to pick up the language when they were confident they thought the answer should be yes.

[Brazen]

How much does an extended family of immigrants have to pay into the system before they are entitled to free healthcare ?

[tomsteel]

How much does an extended family of immigrants have to pay into the system before they are entitled to free healthcare ?

If the family are designated as, 'resident within the UK', nothing! That is the UK Government ruling.

[erol]

How much does an extended family of immigrants have to pay into the system before they are entitled to free healthcare ?

Depends on what kind of 'immigrant family' you are talking about really.

If it is an immigrant family that is in the UK illegally then the questions is meaningless because they have no such entitlement. (full stop)

If it is an immigrant in the UK under a student visa for a study period of less than 6 months then again the question is meaningless because they have no such entitlement. If they are an immigrant studying under a tier 4 student visa and coming to the UK for more than 6 months then it will start from day one of you arrival in the UK as long as you have paid the £300 per year 'health surcharge' for that visa.

If it is an immigrant that has sought and been granted 'indefinite leave to remain' in the UK then it will from the point such status was granted start immediately and regardless of if they have paid in or not, just as it does for UK nationals resident in the UK (not many 0-16 year olds have 'paid in' but they have such entitlement anyway).

There are other classes of 'immigrant' but the ones I give above give a sample of the point I am trying to make and I can not be arsed to go round and dig out the detail of all the different classes and what their entitlement is.

The devil is in the detail, though I have a degree of cynicism that you are not actually interested in the detail so much as the 'impression' ? If that is unfair then I apologise in advance.

[tomsteel]

Erol, I fear whatever your explanation/definition, there will be continual, "ah, but what about x group/ my situation?" Why, oh why, will posters not just accept the UK Government's ruling on this issue? Resident = yes, tax payer, citizen, but non-resident = no! Incidentally, I am a non-resident, living here, and being aged over 70, cannot get medical insurance cover.

[erol]

Erol, I fear whatever your explanation/definition, there will be continual, "ah, but what about x group/ my situation?"

Hear what you are saying Tom and agree with it. However somehow I doubt that Brazen was asking about the status of an "extended family of immigrants" because that is the group they are themselves in I could be wrong of course.

[sophie]

I get so tired of this subject. Some of us obey the rules and regs because thems the UK rules and regs. However, those who choose to lie (make no mistake, call it what you like "bending or breaking! because that's what it is) and ask their families to do so on their behalf must live with it, but I could really do without someone saying "well his Op and follow up treatment must have cost the NHS well over 46,000 pounds a couple of years back) My reply being, I'm grateful our taxes helped save your life. Sorry to sound cynical but there you go.