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EXPATS

British expats left in lurch by NHS clampdown

British people living in France and other European countries could be forced to take out private health insurance, due to the latest clampdown on expats using the UK's National Health Service.

British expats left in lurch by NHS clampdown
Photo: Richard Pohle/AFP

Many British people in other EU countries return to the UK for routine doctors’ visits, and many fail to register with a local doctor in their new country, particularly in the early stages following a move abroad.

In some countries, bureaucracy means registering with local health authorities can take years.

But under new rules that come into force this month, people who make use of the NHS in the UK will be asked to declare that they are ‘ordinarily resident’ in the country. Those who live elsewhere in the EU, Norway or Switzerland, and who want planned treatment could find themselves forced to pay up-front. 

Even expats seeking emergency treatment during short visits home could also face steep charges if they don’t have their paperwork from their new country in order, as the NHS seeks to claw back £500 million a year ($746 million, €695 million) in lost revenue.

In an email to The Local, the UK Department of Health confirmed that there is no ‘grace period' following a move during which they can use the NHS – the moment they have left the country they lose their right to NHS treatment.

The new declaration could make it harder for expats to bypass the system, and new rules could leave expats with no option but to go private.

Joe Coaker of ALC Healthcare, a private insurer focused on expats

“We often hear from expatriates who question the need for international health insurance as they imagine they can return to the UK and fall back on the NHS or the State healthcare in whichever country they come from,” he said

Long-standing European arrangements state that EU citizens should seek healthcare in the country they live in, regardless of their citizenship. They can seek healthcare in other EU countries, but this must generally be authorised and billed back to their country of residence. 

But in a change to UK rules, expats who want treatment in the UK have to show a European Health Insurance Card (EHIC) issued by their new country. Until this month, former UK residents were automatically entitled to use the NHS for free if they fell ill during a visit. In practice, many expats use the NHS for planned treatment too. But now this right is being removed.

With France being renowned for the quality of its healthcare most British expats are only too happy to access the French system.

One France-based expat Ray Vaysey told The Local: "I can't imagine why you would go to UK, in the last 8 years we have had no problems at all, at any stage, and unfortunately we have given them plenty of opportunities."

While those who work in France and pay social security contributions are covered by the French system the problem arises for those who are either new to France, have early retirement or cannot find enough work to allow them access.

Some are forced to return to the UK for treatment but as the crackdown against expats continues, many will have to rethink their options.

Claire*, from London, has lived in Italy for two years, but still isn’t registered with an Italian doctor. When she needed a smear test recently, she opted to have it with her old doctor in London.

“I wanted to speak to an English doctor who I could speak with, felt comfortable with and I knew. And I knew it would be swift.”

“I haven’t registered with an Italian doctor yet as I haven’t got a residence permit in Italy yet, due to the kinds of bureaucratic delays that are typical in Italy. Without residency, I can’t register with the health service.”

The charges faced by patients without a EHIC card or proper insurance can be significant. Intensive care beds are charged at a rate of £1,800 a day ($2683, €2495) plus the cost of procedures and drugs. Even hospital outpatient visits can be costly, at £248 per visit ($369, €348).

The Royal Berkshire NHS Trust, one of 59 NHS Hospital Trusts in England, says on its website that patients who leave a debt could find their details registered with the UK Border Agency, meaning they could be stopped next time they try to enter or leave the country.

There was better news for British retirees in Europe. 

Anyone living in the EU and receiving a British state pension will be entitled to free healthcare in the UK, as long as they hold a valid S1 form, which is obtained from British authorities before moving abroad.

The move comes after the British government decided last year that it would stop paying the healthcare costs of UK pensioners who lived in other EU countries, leaving many facing big bills.

Figures revealed to the Guardian newspaper earlier this month suggested the cost to France of treating British tourists was far greater than the other way round.

The detailed DoH figures show that Spain and France, the most popular European holiday destinations for British tourists, had the largest bills, nearly £40m each, for their medical treatment. French tourists cost the NHS almost £5m, while those from Spain incurred costs of only £3m, the Guardian writes.

*The name has been changed

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EXPATS

From TV to snacks: Tips for how to get your home comforts in France

Here are some tips for how to get your favourite TV shows and snacks whilst living in France so you can enjoy at least some of the comforts from home.

From TV to snacks: Tips for how to get your home comforts in France
Photo: AFP
There’s nothing quite like sitting down in front of the TV with a cup of tea and Mars Bar or Snickers.
 
But tuning into the your favourite shows or hunting down your favourite tea bags isn’t always easy when you’re living in France.

The easiest way to tune into English-language TV from your home in France is via a satellite dish. 

For Brits living in France, installing a dish and FreeSat box will get you up to 140 TV and radio channels from back home, so you can tune into the latest series of the Great British Bake Off without a hitch. 

You make a one-off payment and then you’re set – no contract necessary.

To set your satellite connection up and pointed in the right direction, get in touch with an installer such as The French HouseDD ElectronicsDigiTV Solutions or FreeSat in France

But if you don't fancy (or just can't) install a big dish on your house then watching TV via the internet is your other option.

There are sites like Film On TV, which used to be free, but now you'll probably have to pay to watch your favourite channels, although it still offers some programmes free for a certain amount of time.

Many expats have turned to VPNs (Virtual Private Network) for their laptops which essentially disguises what country you are in, so you can watch your favourite TV programmes online.

But TV companies like the BBC and Sky are cracking down on VPNs and making it harder for expats to connect. However the EU is putting pressure on broadcasters to allow people to watch TV no matter what country they are in. SO things may change for the better in the future.

Finally, British expats who split their time between the UK and France BBC iPlayerAll4Sky Go and ITV Hub all allow UK TV licence payers to download programmes and keep them for around 30 days. So you could stock up when you go home and settle into the sofa for 30 days when you get back.

American readers missing their TV shows will be pleased to know there's an option for you too. 

Digital satellite provider CanalSat will make sports fans very happy – it broadcasts ESPN so you never have to miss a baseball, NFL, and American football game again.

You can also tune in to CNN, NBC, and even catch The Tonight Show. 

As long as you don't mind waiting a few months after the programmes have been aired, a subscription to Netflix may be the perfect solution.. 

Netflix gives you access to its latest original TV series and many others, including shows from NBC, the CW, ABC and the BBC. 

Hulu's also a great alternative, with SNL, South Park, and Modern Family ready to watch at any time, from anywhere. 

Once you’re sat in front of your favourite series, the matter of finding your favourite snacks from home can be just as difficult. 

Some French supermarkets have world food aisles where you might be able to strike it lucky.

But more often than not they're a jumble of products and you never know what you might find. 

Brits missing out on Marmite, Cup-a-Soup, and McVitie’s biscuits can place online orders with websites like British Cornershop and Brit Superstore who deliver straight to your door. 

And if you're in Paris, don't forget there's always WH Smiths on Rue de Rivoli and the numerous Marks & Spencer outlets around town, which offe plenty of snacks and indeed some decent meals.

The American equivalents, My Little America and My American Market, also promise all the Pop Tarts, Hershey's and Lucky Charms money can buy. 

If you’re based in the capital, a trip to La Grande Epicerie in the 7th arrondissement will satisfy any food cravings. 

The upmarket shop has treats from America, the UK, Italy, India and Asia

But it will come at a cost: one can of Heinz baked beans will set you back almost three euros and a box of Froot Loops cereal costs €12.25. There is also the English, Scottish, Irish epicerie at cité de Vauxhall near Place de la Republique which offers English ales, cereals and sweets.

With the American holiday season coming up very soon, make sure to stop by Thanksgiving grocery store in Paris' 4th arrondissement (for the non-Parisians, there's an online shop too). 

Aside from New York bagels, Jello, and hot sauces, the shop stocks all the must-haves for Thanksgiving and Christmas dinners: yams, cranberries, and turkeys, as well as home-made desserts. 

Amazon is also any expat's friend for finding the taste of home. 

But getting your family and friends to bring your favourite snacks from home is always going to be the least expensive, and most reliable, way to source your home comforts. 

By Anna Schaverien

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