Registering with a doctor

[laika]

For those people at marinas which don't officially but do unofficially allow liveaboards....how do you register with a doctor? I normally avoid the medical profession but after waiting 3 hours at a walk-in clinic today I spoke to a stroppy nurse who said I needed to register with a GP. I've wandered round GPs with the marina in their catchment area and they are wanting a utility bill or official proof of address. Although the marina charges me (and other liveaboards) for rental of a mailbox, all their communications have my "official" address on which is 2 counties away.

What do others do? My default option here involves photoshop...

 

[jerrytug]

Hi Laika, there is a GP surgery in Brighton which specifically caters for the homeless, dossers, paraffin lamps, NFA etc, houseboat people, and of course Caravan Using Nomadic Travellers. A quick google should find it, cheers Jerry.

edit, Brighton Homeless Healthcare in Morley St, and they have a website.

 

[laika]

edit, Brighton Homeless Healthcare in Morley St, and they have a website.

Thanks. I'm quite pleased with my "enhanced" electricity bill and in the back of my mind I seem to recall being registered with a GP is "required" for something (Visiting hospitals? European health card?) but the Homeless Healthcare Centre does seem to be the "correct" option. Still curious to know what others do though.

Oh the glamour of this living on a yacht malarkey.

 

[ribrage]

It's funny - when I left the UK 3 yeRs ago I was concerned how we would manage not being registered for Dr and health care.

It's been easier living on a boat in the med and getting treatments than 8 years of living on a boat in the UK.

1st I got mauled by a frenchies dog , it left four puncture wounds in my calf , I was treated immediately ( no charge E 111)

2nd cracked a tooth eating nuts and treated immediately ( paid €90)

3rd taken into hospital with a suspected heart problem treated immediately ( no charge e111)

Each time registering with a local doctor for aftercare was easy in both Spain and France , yet having been born in UK and working in UK for donkeys years I had nothing but hassle when like you I tried to register at a Drs close to my marina.

 

[[159032]]

That's very interesting. I have been pondering the live-aboard life, from the hassle point of view.
The UK does seem to be more awkward. I love France, but had regarded it a more restrictive and tape-bound place. I know some friends came back to Blighty when the husband' heart condition became more serious. (It had been pretty serious before, but became less chronic, and more acute).

Your comments seem to make France sound quite viable. Do you have a repatriation escape route or have you burned your boats?

 

[laika]

2nd cracked a tooth eating nuts and treated immediately ( paid €90)

Dentists aren't a problem: Given that the NHS charges you anyway I prefer to go to my choice of dentist (mine a good way away but paranoia about teeth makes the journey worthwhile) privately. Hospitals aren't a problem either. It's just GPs (and Ironically i have a european health card but they want me to be registered somewhere before they'll see me: presumably so they can charge back "my" doctor?). Pretty galling that they fleece you through tax for a service which they then deny you because you don't have "normal" living arrangements.

 

[charles_reed]

That's very interesting. I have been pondering the live-aboard life, from the hassle point of view.
The UK does seem to be more awkward. I love France, but had regarded it a more restrictive and tape-bound place. I know some friends came back to Blighty when the husband' heart condition became more serious. (It had been pretty serious before, but became less chronic, and more acute).

Your comments seem to make France sound quite viable. Do you have a repatriation escape route or have you burned your boats?

Not only viable, but considerably in advance of the poor old creaking, rule-bound, over-managed NHS.
In all the European countries I've been treated in, the quality of medics has been high, frequently higher than most UK A&E. Quality of hospitals has been more variable - French and Spanish as good as ours, Greek and Croatian far more variable.

 

[GrahamM376]

Most GPs will (unless the system has changed) accept temporary patients who may be working or visiting friends in their area. That should solve any immediate problems and then use Photoshop to amend your marina invoice to show berth number as your address.

 

[laika]

Most GPs will (unless the system has changed) accept temporary patients who may be working or visiting friends in their area. That should solve any immediate problems and then use Photoshop to amend your marina invoice to show berth number as your address.

You need to give the give them your regular GP's address to sign on as a temporary patient. I'm not registered with any GP (my last one in London retried and closed the practice down over a year ago).

 

[[159032]]

The news about EHIC cards may make things more difficult.
If you leave the UK entirely I guess you register with a local doctor to your new home.

 

[laika]

The news about EHIC cards may make things more difficult.
If you leave the UK entirely I guess you register with a local doctor to your new home.

I don't think the PRB+H has completely seceded from the union yet so maybe not an issue. I've had some advice that a sympathetic local surgery will take me on if I show my marina contract which was on my "to do" list today but some dealings with the MCA, RYA, and possibly a couple of cat videos were above that on the list so it may get relegated til tomorrow....

 

[lukedh]

I spoke to Nicky Cambridge who is director of Health Watch Brighton the other week-end. I explained the problem Laika was having registering with a local doctor while living on a boat in the marina. She said that doctors are not supposed to require you to produce a proof of address but being doctors they often do there own thing. She said Health Watch would be happy to help and that in similar circumstances when they have phoned the surgeries they are all of a sudden willing to take the patients on. The only downside I can see is that the surgery might mark your card as being a 'problem' patient - as if they would. Anyway it seems that Laika's problem has been solved now by his own persistence.

I believe Health Watch may be run slightly differently in different parts of the country depending on the local priorities, but should always be worth the punt if you have some difficulty with the Health Service.

 

[laika]

Many thanks to lukedh and the other splendid advice I had by PM. I am now signed up (well...my application form was accepted). They still wanted "proof of address" but as per a PM sent to me were happy to take the receipt for my berthing contract as evidence despite that having my elderly parents' address on it (obviously I had to give premier another address). I wonder though if surgeries in other towns without such a large unofficial liveaboard community would be so accommodating. I was also asked for photo ID which is interesting given that having a passport is not compulsory, some of us still have paper-only driving licences and driving is in any case not compulsory. I asked what they did if people had neither. "Oh then a birth certificate". "Errr...but that doesn't have a photo on" "No but it's official ID". Hmm. Think those "rules" are all pretty arbitrary then. Fortunately I had managed to find my passport after an epic hunt through the lockers but had my YM certificate on hand in case. Out of interest I asked if they would have accepted that as photo id (pointing out the "MCA" logo) and they said probably yes.

 

[skipperwales]

Many thanks to lukedh and the other splendid advice I had by PM. I am now signed up (well...my application form was accepted). They still wanted "proof of address" but as per a PM sent to me were happy to take the receipt for my berthing contract as evidence despite that having my elderly parents' address on it (obviously I had to give premier another address). I wonder though if surgeries in other towns without such a large unofficial liveaboard community would be so accommodating. I was also asked for photo ID which is interesting given that having a passport is not compulsory, some of us still have paper-only driving licences and driving is in any case not compulsory. I asked what they did if people had neither. "Oh then a birth certificate". "Errr...but that doesn't have a photo on" "No but it's official ID". Hmm. Think those "rules" are all pretty arbitrary then. Fortunately I had managed to find my passport after an epic hunt through the lockers but had my YM certificate on hand in case. Out of interest I asked if they would have accepted that as photo id (pointing out the "MCA" logo) and they said probably yes.

Glad you're sorted, I just thought I'd put up the other side of the argument. There is no contractual requirement to ask for identification in order to register a patient, either temporary or permanent, however the Department of Health has put tremendous pressure on GPs and hospitals to ensure that there is proof of identity in order to prevent those not entitled to free treatment from obtaining it. Pracices are audited and the cost to them can be considerable if they are shown to have arranged NHS treatments for those who are not entitled.

There is also a workload issue. There is a genuine crisis in GP recruitment and workload has increased massively. I'm sure there are those who will talk nonsense about fat cat GP's spending all their time on the golf course / sailing, but the reality is very very different. It's very easy to see, therefore, why a practice may try to control its workload. Like all self employed individuals ( yes the vast majority are self employed ) they should not take on work when they do not have the capacity to manage the extra work.

 

[GrahamM376]

Life would be far simpler if we had photo ID cards as in other EC states, SWMBO has to carry hers here and we never have any problems with officialdom, banks etc. who need proof of ID.

 

[laika]

the Department of Health has put tremendous pressure on GPs and hospitals to ensure that there is proof of identity in order to prevent those not entitled to free treatment from obtaining it.

Fair enough but I did have my european health card and my NHS card from my previous doctor who retired and closed his surgery a year ago. Obviously there's the potential for identity theft: someone finds your lost wallet with a health card and goes and registers in your name at some other clinic. I would have thought that rather than leaving security up to random practice administrators identity proof would have been standardised by the government: that would also protect GPs: as long as they have followed procedure they need not fear an audit. My issue is not so much the need for proof of identity as the arbitrariness of it. It strikes me that with computer access to medical records, if banks can devise schemes to identify their customers it shouldn't be impossible for the NHS.

I also appreciate that GPs will want to minimise workload which will doubtless drive the requirement to prove that you reside in the surgery's catchment area. Again I think this is something where central government needs to standardise. There are many categories of people who may not have formal "proof of address" (utility bills etc.). I appreciate that my area does have a clinic for homeless people (as jerry pointed out) but not everywhere does and the point of the NHS is surely healthcare for all UK citizens.

 

[Tranona]

The unsatisfactory state of affairs with GPs - in more ways than the arbitrariness of registration practices dates back to 1947 when the government "bought off" the medical profession with the half baked independent contractor arrangement which left them outside the direct control of the NHS. They are not employees but self employed so do the minimum to satisfy the requirements of the NHS unless there is an incentive, usually financial. Successive governments have failed to tackle this, and indeed have reinforced it with contracts that are even more to the advantage of GPs. At the same time their services are free to users so there is no financial connection between user and provider and it is difficult for a user to go elsewhere as he has to find a GP that will accept him. To make matters worse GPs are the gateway to elective free hospital treatment so if you are not registered you can't get hospital treatment except in an emergency.

A real dogs breakfast. OK if you conform and are in the system, but step to the edges and it fails.