Lose NHS rights after 3 months

[Anonymous]

I thought folks would like to know that if they have been out of the UK for more than 3 months they lose their UK residency in the eyes of the NHS and are not entitled to treatment. I cannot find the actual rules/regulations/law that relates and can only find one of those infernal FAQs at http://www.nnuh.nhs.uk/dept.asp?id=365 which says...

Q. I have had a gap year travelling and have now returned to the UK – I am British with a British passport – I was born in the UK – do these rules apply to me?


A. Anyone who has been out of the UK for a period longer than 3 months is regarded as an overseas visitor on resuming residency and requiring healthcare.

Can anyone tell us the actual legislation or regulation concerned and explain how it is a British citizen and UK taxpayer can lose his or her right to treatment simply because they have been away from the UK for longer than 3 months?

 

[adrianm]

Surely that can't be right? You still have to pay tax etc in the UK for that period. Six months I could just about understand but three?

 

[guernseyman]

Some clarification is required.

The quoted FAQ refers to someone who has left the UK to live permanently abroad. That suggests that the thorny question of domicile arises. In other words, if you are going to live in Belgium for the rest of your life, paying your taxes there, why should the NHS treat you?

 

[tcm]

I'm not expert either but agreed that can't be right. Never mind three months, I think you'd be ok to leave the uk for three generations and lose the ability to speak English. Free, innit?

 

[Guest]

It's not very clear, but my reading of it is, it depends on where you're "ordinarily resident" which is the phrase they use. On another page on the site they talk about you getting residence if you've lived in the UK for 12 months. So reading those two together, that means if you leave for over 3 months and then return, it takes you 12 months to regain your resident status in their eyes.

However, I suspect that their site might be wrong. The phrase "ordinarily resident" is a legal concept (and not the same thing as tax residency either), and it means basically the country that you regard yourself as living in. If you return to the UK with the intention of living there more or less permanently, then you are immediately "ordinarily resident" in the UK. If they MEAN to use the phrase ordinarily resident, then their backpacker example is a bad one because such a person would not loses his UK residence just because he'd been away a few months, unless he'd settled to live in another country.

I suspect that their 3 month thing is may just be their own rule of thumb, that if someone's been away for 3 months then they should start to look into whether he's ordinarily resident in the UK. It's possible that they don't understand their own rules...

 

[Anonymous]

I agree with all you say. My interest in this followed a visit by my wife to a UK hospital after she had broken her ankle in Spain, and had a cast fitted in Spain. The hospital said that if we had been out of the country for longer than three months (which, thankfully, we hadn't) then she would not be entitled to NHS services. We really need to get to the bottom of this as we are UK residents and have a home in the UK and pay UK taxes but we are cruising long-term in the Med, on holiday.

What I need to know is the what the rules actually say, chapter and verse, so that we can plan accordingly and can argue our case backed up by facts, should we ever need to.

 

[jeremyshaw]

I don't think you need to worry about this too much in your case.

First I've come back after more than a year abroad and had no problems getting treatment.

Second the site you refer to itself says:
=============
Q: I am a EU national wishing to visit the UK for a holiday – am I entitled to free NHS healthcare?

A:The UK has a healthcare agreement with nationals of EU countries to cover healthcare “treatment the need for which arises during the temporary visit to the UK”.

=============
So even if you were deemed a resident of Spain you'd get reciprocal rights. After a couple of years outside Europe then it might get more complicated...

 

[Davy_S]

I have been told, I cannot Quote my source unfortunately, that if you say it is your intention to return to the uk one day, the 3 month rule does not apply.
This is how people return to India and Packistan for 5 months every year and do not lose their rights. I agree however the rules need to be a little more transparent.

 

[Guest]

Yes, I did a quick google search under "ordinarily resident nhs" and lots of sources confirm that it's the legal definition that applies. The 3 month/12 month rules quoted on your link are in fact nonsense. Here for example are the Scottish Office's guidelines on the subject (English rules are similar).

To quote the paper:

"This circular contains guidance on the identification of the ordinary residence of people who require social work services. ..

...

Meaning of "Ordinarily Resident"

5. There is no definition of "ordinarily resident" in the Acts and the term should be given its ordinary and natural meaning subject to any interpretation by the Courts. The concept of ordinary residence involves questions of fact and degree, and factors such as time, intention and continuity, each of which may be given different weight according to the context, have to be taken into account.

Case Law

6. The meaning of "ordinarily resident" or "ordinary residence" has been considered by the Courts, and regard must be had to such cases as:-

i. Shah v London Borough of Barnet (1983) Lord Scarman stated that "unless ..... it can be shown that the statutory framework or the legal context in which the words are used requires a different meaning I unhesitatingly subscribe to the view that ‘ordinarily resident’ refers to a man’s abode in a particular place or country which he has adopted voluntarily and for settled purposes as part of the regular order of his life for the time being, whether of short or long duration".

ii Levene v IRC (1928) Viscount Cave said that "ordinary residence" connotes residence in a place with some degree of continuity and apart from accidental or temporary absences. "

In other words, if you're living in the UK as your main place of residence, then you're entitled to the NHS services no matter how long you've been away.

 

[syfuga]

From the Department of Health website, I quote:

Anyone who is deemed to be ordinarily resident in the UK is entitled to free NHS hospital treatment in England. "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.

Which is about as clear as their Lordships could achieve with their heads deep in the Thames mud. No mention of three months?

More of this can be found here

How does it apply to long term liveaboards and cruising folk who may or may not maintain a home in the UK, but who regard the UK as their 'country'. A UK registered boat is arguably British territory.

As someone who experienced excellent emergency treatment courtesy of an E111 in Spanish hospitals, and who went on to have great treatment from the NHS during the past year, I am fortunate. I would be either bankrupt or dead if this had not been the case.

It is not generally realised that an E111 is only available for 3 months absence from the UK, and to obtain one you have to be resident.

You could try for insurance, but at 60 plus with a medical history, what chance do you have.
Yes, it is in need of clarification, but take care not to stir up a hornets nest.

With so many people opting for alternative lifestyles, it could become a major issue.

 

[Anonymous]

I'm not sure where this is leading us because from the Department of Health website (the link on your post) we have the following:-

[ QUOTE ]
How do I know if I have to pay?

The Regulations state that the hospital providing treatment is responsible for establishing who is entitled to free NHS hospital treatment. They will make their decision in accordance with the Regulations. The hospital can ask you to provide evidence to support any claim to free treatment and it is your responsibility to do so if asked. If the hospital decides you are eligible for free NHS treatment you will still have to pay statutory NHS charges such as prescription charges unless you are otherwise exempt. If the hospital decides you are not entitled to free NHS treatment charges will apply and cannot be waived.

[/ QUOTE ]

So one has to make one's case to a 'hospital'. What does that mean, in the context of this? Which 'Regulations' are they referring to, and where can one inspect them? Does one have the right of appeal? To whom? What is the precedent?

This is all very unsatisfactory and I find it unsettling. I am hoping that we will get some more input on this before the thread drops off the list.

 

[Guest]

http://www.dh.gov.uk/PolicyAndGuidance/I...;amp;chk=Kgqt9s

 

[syfuga]

So where does this leave the long term cruiser on a British registered yacht? He is not taking up or resuming permanent residence, he has been away for more than three months, and he may not have a 'home' in the UK as such. He may continue to be a 'resident' for tax purposes, or not as the case demands. He probably pays income tax on UK derived income, e.g. pensions, rent, etc. He has probably been paying taxes and NI all his working life.

But no rights to free NHS treatment?

 

[rallyveteran]

I spent 5 years circumnavigating when I was not Ordinarily Resident and needed to consult GPs for non-emergency treatment when on visits to the UK. Despite my pointing out the rules to them, more than one surgery refused to accept my money!
I also had a medical expenses policy arranged via Pantaenius which referred to covering the costs of repatriation to home country (and subsequent treatment). It took some exchange of correspondence before they admitted that they had not considered what would happen if, after repatriation, the cost of my treatment was not covered by the NHS. I took the view that I wanted the policy only to cover the costs of a catastrophic claim (e.g.major surgery) so if that was required I would apply to be oridnarily resident from the moment I was repatriated. As this would have carried a (considerable) tax penalty I would only have done this for a catatrophe.
As things turned out we had no claims in more than 5 years!

 

[Tisme]

We had an Aussie working with us last year. He had an English passport, by virtue of his parents nationality, but had never set foot in this country in his life. He registered for tax, national insurance etc etc and had no difficulty in signing on, and getting treatment, with a doctor.

 

[sailorgirl]

Our GP had no problem with us being out of the country for an extended period (no period was specified only that we would be back!).

However there are actually some rules and I found them out the hard way... when we returned to the UK my husband & son were still registered with the GP but as I hadn't responded to a routine request to attend a clinic (girlie stuff) they de-registered me. Didn't take long to sort out with the GP on my return but one to be aware of if your are female (why is it blokes don't get any of these routine requests to attend their local surgery for a poke and a prod?).

 

[Anonymous]

I have now stored on the PC for printing out a copy of the link given by SimonCr in message #939514. I think that it, combined with UK Driving Licence and UK issued credit cards, ought to prove my case. However, I do not feel entirely happy; the decision for eligibility should not to be discretionary, and in particular, not at the discretion of some local hospital!

Incidentally, in your first message you mention the 'E111'. The E111 no longer exists and if anyone still possesses the document they will find, if they inspect it, that it expired on 31st December 2005. You now require a plastic EU Health Card, which is obtainable online. It was said that the plastic cards would be sent automatically; this did not happen in our case, or some friends of ours (who also happen to be staying in Almerimar at the present time /forums/images/graemlins/smile.gif)

 

[lille_bee]

If you have been issued with an NHS number (on your NHS card) once in your life, then it is my understanding that you keep this number until your death, and presenting this number to any part of the NHS machine will certainly open many doors...
The new plastic E111 cards were only sent automatically to people who had requested a "paper" E111 since mid-2004 AND who had ticked the relevant box...

 

[abraxus]

A question:

If you're ordinarily resident in the UK and have a UK address but have been abroad for more than three months and then turn up sick at a UK hospital, how would they know you've abroad for more than 3 months unless you tell them?

 

[charles_reed]

(why is it blokes don't get any of these routine requests to attend their local surgery for a poke and a prod?).

They do in my practice, when they're over 65.

Still my GPs are aware of my 4 months away and 2 months in UK regime and even give me up to 3 months of medication to take away with me.