Lose NHS rights after 3 months

[syfuga]

Patience please, ladies and gentlemen!

Due to said financial pressures GP's are increasingly jumpy about patients registered with them. You may find in the future there is further change from this quarter.

I was questioned when I simply said I was driving over from Dunstable to see the GP in Berkhamsted.. (10 miles), and on another occasion my daughter in law whose address I am using was questioned when the surgery tried to contact me there.

I'd hazard a guess that my treatment this summer cost UK plc in excess of £50K, so where does the £10K limit get me?

I arrived from Spain (where I had been treated on the E111), and saw a consultant (initially privately) in Herts, when I was last registered with a GP in Gosport.

Fortunately I had attended A & E a long time ago, so I had a hospital number and was recorded as belonging to a local doctor that I had been registered with in the past.

I am now back on the boat in Spain, and trying to maintain the impression that I am living with my son and daughter in law in the UK.

I was lucky, and had a daughter working in the hospital who set up the consultant appointment for me. But I am not sure that everyone should be so complacent. /forums/images/graemlins/ooo.gif

 

[Guest]

There's been a lot of useful discussion and anecdote on this thread, but it seems to me that it's in danger of losing sight of what your rights are. Apologies for repeating them, but I think the basic point is in danger of being lost.

We are, it seems, entitled to treatment if we are 'ordinarily resident' in the UK. That's a legal concept, and the NHS are bound to follow its legal meaning. If you want to know the legal meaning, look back at what their lordships said. It's a pretty flexible legal concept in fact, you can get a long way to answer it by asking yourself 'where do I REALLY live at the moment?' Forget 3 month rules, 12 month rules etc., there is nothing in the legal definition about these periods, this is just the NHS getting its knickers in a twist. There's even a certain amount of scope for you deciding yourself where you want to be ordinarily resident, but you can't change it every five minutes. You can't be ordinarily resident in more than one place.

If the answer is the UK, then you have the right to free treatment.

The next issue is of course that hospitals may not really understand your rights, and what do you do if they get it wrong. Of course it's theoretically possible to get a court order putting them back on the right track, but you don't want the hassle in practise. But if you know what your rights are in the first place and make it clear to the hospital that you do, and present your case for residence to them clearly showing that you understand your rights and that you ARE ordinarily resident, then they won't give you the wrong answer in the first place.

 

[Guest]

p.s. knowing ones rights reminds me of the time I tried to apply for a passport at the FCO in Victoria. They lost my first application, asked me to make a second application. But then the clerk who examined my second application refused it because they couldn't take two applications simultaneously! The clerk knew the situation, that they'd lost the first one, but flatly refused anyway even to consider the second application anyway, and no other suggestions.

I threatened to obtain a court order against them, citing their obligations under various sections of the Nationality Act and informing them that the application to the court was to be made next morning. I had a new passport by the morning!

(a couple of days later they found my first application, and tried to give me a second passport)

 

[JPGruntfuttock]

Re: NHS

[ QUOTE ]
As I said in my email - I don't think you would be but may in the future have to get an emergency registration with a GP first. The NHS is hardening its rules about GPs being the "gatekeepers" to treatment. Once you're with a GP then you're entitled to the lot.

[/ QUOTE ]

The greater the beaurocracy and less flexible the IT programs, so the greater the need to fit everyone into precise boxes. This seems to be resulting in more and greater hurdles for those that lead even slightly less conventional lifestyles.
But, how do gypsies, tinkers and other recognised travelling folk of 'no fixed abode' manage to register with a static gp?
I ask, because they are more likely, as a group, to have protection from discrimination, than 'cruising yachties'.

 

[peteandthira]

Re: NHS

Well thank you everyone for an interesting topic. This is exactly the stuff I have been looking into. To complicate things even further, we are booking into a dentists near my bro's house where I allegedly live. They said I need to turn up every 15 months to remain registered! Where did that one come from?

We are taking the "shhhhhhhhhhhhh" option with my address being that of my bro. Pension, tax, bank etc think I live there and send me statements there. Bro phones me if anything needs attention. Doc and dentist locally have me on their books and I have a new NHS card. What can possibly go wrong?

 

[Anonymous]

Re: NHS

[ QUOTE ]
What can possibly go wrong?

[/ QUOTE ]I don't know for sure...we do not seem to have a definitive answer - maybe there isn't one. But consider this scenario...

You have chest pains while away in Spain and under the EU Health scheme they carry out a range of investigations, including an angiogram. You are advised by the Spanish doctor that you need surgery in the reasonably near future, but this is not an 'emergency' so your EU Health card does not qualify you for treatment (I think? Don't know). In any case, you don't really fancy having the surgery in Spain, away from the family and you don't speak Spanish.

The doctor clears you as fit to fly home so you fly back and you see your GP. He refers you straight to a consultant in a local hospital. You show the consultant your angiogram. It was done in Spain. (Believe me, you WILL show him the angiogram, you will not keep it quiet, or you would have to go through it all again and in any case the GP has already seen it, or you would not have had the referral). The consultant feels obliged to draw to the attention of the administration the fact that you had had this attention in Spain. Shortly afterwards, you get a call to your brother's house from the admin asking when you arrived back in the UK from Spain and when you had left the UK.

At this stage you can lie. It is pointless trying to debate here whether this is how you would behave or whether you would get away with it if you tried. They might ask for some supporting evidence and in lying, any accomplice would be part of an attempt to defraud the NHS out of tens of thousands of pounds.

So you tell the truth. There is the fairly small issue that you should have de-registered from your GP but no doubt that would be overlooked. The real issue would be whether or not you are entitled to NHS treatment.

As I see it there are three possibilities:-

a) While you were out of the country for more than 3 months you argue that you were always 'ordinarily resident' in the UK - witness the bank, cards, address, etc., driving licence still held in the UK, lack of residency in any other country. So clearly all you were doing is to take an extended holiday. Much like a youngster taking a gap year. I'm not sure that you are going to be able to make this argument in any coherent way to an uncooperative administrator who is trying to make life difficult for you, at least not without some kind of correspondence. After all, they have 'guidelines' that tell them not to allow treatment for those who have been out of the country for more than a certain time (this is fact and is not in question).

b) You concede that since you were outside the UK your status with the NHS might be questionable but that having returned to the UK you hereby declare that you are resuming residency, with effect from the instant you landed in the UK, and can prove your right to do so (your passport states that you have right of abode). This argument stems from information on one of the websites posted during this thread. What we don't know is whether there is a time delay for this to be accepted or processed. And we don't know whether hospital administrators (at the level of seniority you are likely to be dealing with) are aware of your rights in this respect (if, indeed, you have any rights!).

c) You might have private insurance and get straight in touch with them.

Let's keep in mind, if we ever have to deal with such a case ourselves, that the *hospital* is required to establish whether or not patients are eligible for treatment. They have rules and guidelines laid down by management. They will tell you what you are entitled to, they will not be very receptive to your arguments that you are entitled, in your opinion. The person you will be speaking to will not have the authority or training to alter the guidelines and the best you can hope for is for it to be referred to a higher authority in the hospital. And you may not get the chance to speak to them.

From the information we have heard during this thread, there seem to be some inconsistencies and conflicting factors. Indeed, it seems that the hospitals have conflicting responsibilities. It is by no means clear what your legal right actually is. One would hope that some Act of Parliament or Regulation would set this out clearly but there does not seem to be one, which is highly unsatisfactory. It is a matter that could usefully be taken up by an MP. I would do so myself but it would be very difficult from Spain, where we are presently not residing /forums/images/graemlins/wink.gif Maybe someone else could offer to do that?

Meanwhile, I am about to type out a sheet of A4 with the arguments, our NHS, NI numbers, etc. to remind us what the issues are if this ever arises because if it ever does become an issue we are likely to be distressed and maybe feeling unwell.

 

[abraxus]

Re: NHS

It would appear that the situation is very unclear, in which case I would if I were concerned I would make it my responsibility to ensure that all bases were covered.

In this instance I would probably go with a) and tell the truth, in the hope that in most cases they would take it no further, accept that you're a UK resident and get on with surgery. If they created a fuss, I would ask if they meant they weren't going to treat me. Personally I would feel comfortable that with a UK address, bank account etc, that it would be sufficient to see me through.

That though is just my personal feeling on the matter and if you weren't comfortable with this and couldn't get further clarification in advance the I would guess the only sure option is private medical insurance.

As an after thought, what would be the position with travel insurance cover. If you returned to the UK, they would likely say no as you were back in the UK and no longer travelling. Their refusal to treat you on the grounds of you being back home may be sufficient "proof" for the NHS to accept you. After all you're either a visitor or a resident, so you can esatblish your status legally and either the NHS or travel insurance people will have to pay depending on the outcome. Don't know if that would work.

 

[steve_cronin]

OK

From your depressing summarisation we should all do one of:-

a) Sell the boat, retire to a bungalow in Eastbourne and die of boredom.

b) lobby our MPs and get this ruling overturned - little sympathy likely here for "Idle lushes living on luxury yachts"

c) don't get ill

You obviously havn't read my posting containing a letter received from our nextdoor neighbour who has been absent, sailing around the world for the best part of six years but this didn't prevent him from getting colon surgery on on of his rare return visits.

don'y worry about it. You'll end up with hypertension /forums/images/graemlins/grin.gif

Steve Cronin

 

[boatmike]

Re: OK

If someone is going to decide that he will not get treated because he has been away he shouldn't go. Totally agree.... This will leave all the depressed sad old farts in nursing homes in the UK and all the cheerful ones like us enjoying the sunshine.... I wonder who will live the longest /forums/images/graemlins/cool.gif /forums/images/graemlins/cool.gif /forums/images/graemlins/cool.gif /forums/images/graemlins/cool.gif
See you in the Ionian in October maybe old son. ( Tis you in Corfu innit???)
That's if I don't get jammed in a lock down the French canals in the mean time, in which case I will have to return to have my blood pressure treated again.... /forums/images/graemlins/confused.gif
Mike