dreamercon

With e-borders in effect, the government will be able to tell exactly how many days each person in the UK. This was intended to capture tax evasion for domiciled individuals, but could be used for NHS fraud too.

ljaw2002uk

This is the UK we are talking about, the day they manage to link things up to that degree, it might be a country worth living in.

anotherlimey

He must have said something to arouse suspicion. The doctors/nurses have more to worry about than if someone who looks and sounds British is actually a resident.

nun

There's nothing new here, residency has been the criterion for non-emergency NHS care for as long as I can remember. I definitely don't support the Conservatives and their approach to the NHS, but I'm with them on enforcing this rule as people who move abroad should make arrangements for health care where they live.

rpjs

Except that

a) eBorders isn't in effect. The Coalition govt recently sacked (and is being sued by) the IT contractors developing it due to the project being so behind and over budget. IIRC best they've got to is tracking only 80% of entries/exits.

b) It'd be trivial to avoid eBorders by exiting through the Republic of Ireland anyway.

c) "Why yes, I was living abroad but now I'm re-establishing my residence in the UK. Good luck proving I'm not."

d) I find it hard to believe that NHS staff will have access to eBorders data or the time or inclination to do so if they do.

Having said that, I do know that sometimes the existing regulations are enforced. Once my s-i-l was visiting us in the UK and suffered an allergic reaction. We took her to the local out-of-hours GP centre and they made sure we coughed up £40 before she got to see the doc. It included the prescription fee so not too unreasonable.

nun

Expats using the NHS is probably a very small problem, just like other benefits scams. Still I hope the Government catches the small percentage that abuse the system.

I don't really understand why people need to discuss ways of hiding their residence status, just follow the rules.

Steve_

For 8 years? I thought the exemption from FICA only lasted five years, you should have moved your tax home to the US by now (unless you're acting as an agent under B-1 for example). Also if you are an LPR or a US citizen you are required to pay FICA so I see no benefit in being subjected to dual taxation. You can always do voluntary Class 2 NI contributions, but those are tiny compared to the full whack of Class 1 and income tax.

Steve_

Exactly, it was already illegal, so why are people getting wound up about something they already knew about? If you live in the EU you benefit from the healthcare provisions in that country, the whole thing is supposed to be reciprocal. Although there are provisions in the treaties that allow EU states to deny residency to people they consider to be economic migrants who are a strain on resources, which is what France did recently to the migrants Italy allowed in from Libya and Tunisia.

If you live outside the EU, well I think it should be fairly obvious if you don't pay tax there you can't use their social services. It's already been established in the ECHR that payments into NI do not entitle you to cost of living adjustments if you live outside the EU because contrary to popular belief, UK pensions are paid out of general tax revenue, not just NI contributions. (Although there is a treaty between the UK and the US that entitles recipients to the cost of living adjustments).

fatbrit

The qualification for full NHS access is residency, not paying taxes! Of course, if you're resident it would be impossible not to pay some taxes. But it would also be impossible not to drink the water......and that also is not a qualification for using these services.

NSBlake

Wouldn't your US health Insurance cover the costs of any health care whilst you were visiting the UK - assuming you were honest and said that I had to pay as I'm not resident in the UK now?

nun

As pointed out many times before free NHS care is based solely on residency in the UK, not on anything you've paid. If you move abroad you are no longer entitled to the NHS. In my case I left the UK after university and have never paid tax in the UK, but if I was to return to live in the UK I would immediately qualify for the NHS. If you have made NI contributions you will get your pensions and that can be paid abroad.

One quick question. You've been in the US for 8 years and you still pay UK income tax and non voluntary NI.....this sounds very strange. Is your salary UK source income?

kimilseung

I wonder how many of the people who are worried about tightening up on expats using the NHS, and those that have used it in the past, against the rules, as expats; are the same people who complain about benefits cheats. I think most of us have been, or would be benefits cheats, in one way or another. This has been just one white collar way to do it.

Giantaxe

Some US health insurance will cover you worldwide; mine does, for example. Medicare and Medicaid are US only, although I read an article suggesting that Medicare may cover treatment in Mexico at some point - there are a lot of Americans there and medical care is so much cheaper than in the US.

But, as I've posted here before, my experience is that the UK doctor wouldn't take payment even though I offered it - I guess it is too much hassle to do so for one patient. I presume that this kind of thing is going to be clamped down on. How they will do it is anybody's guess. It's too bad the quoted article is the Daily Fail's spin on the subject.

nun

Emergency treatment is free in the UK, but after that you have to pay if you are non-resident A lot of US health plans will pay for the rest of the treatment, but how much and what they pay for will depend on your insurer. I'm lucky as I work for the state of Massachusetts and my state health plan is excellent so they will pay for 100% of all treatment outside of the US as long as they have an itemized bill. The difficulty comes in how you pay; the NHS has no way of billing my insurer, so what often happens is the patient gets a bill, pays it and has to get reimbursed form their US insurer.

Middlemore

As a nurse who until recently worked in a London A&E, I see two main problems here.
Firstly, immigrants openly abuse the NHS system, it is common for people to arrive at Heathrow and head straight to the nearest hospital. Not for genuine emergency care, but they usually say something general like 'abdominal pain', which means they get a whole battery of tests.
Something abnormal shows up, maybe a longstanding condition, but they deny all knowledge of it. They end up getting admitted to hospital, (free), via the emergency route, and the really crafty ones then refuse to leave, so that Social Services get involved to find them somewhere to live.

I saw situations like this up to half a dozen times a day.
Some would brazenly tell me that they came to the UK because "your government give me free money, free house and free hospital".

And yet, ex-pats, who HAVE paid into the system all their working life, are denied free care.
Even as an NHS employee with 25 years service, I do not qualify for free healthcare.

Something is very wrong here.