Sunday, July 25, 2010

Department of Health, London

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An exchange of letters is occurring between myself and the Department of Health. A major problem is fighting past 'the front desk' to get to talk with someone who actually can take decisions.  [Past the doorman to the head waiter!]  My letters have been answered by the Customer Services Centre (!).  Following the presentation of my 7 page document (which see-click),  it was kicked into the long grass of this 'Centre' and a reply came from that direction.  I replied in turn with a letter somewhat written in lemon juice (though courteously) and copied this in to two MPs.  One of them intervened directly with  Andrew Lansley (The Secretary of State for Health)  suggesting that my efforts 'deserved more consideration'. I cannot say whether any activity has taken place as a result of that intervention.
However, I have had another reply from the said 'Centre' and here is an extract....

Extract of letter from the Dept. of Health, 79,Whitehall, London, SW1A 2NS, 15th July 2010-07-25
Nicolette Hartnell (Customer Service Centre)

"Further advice from policy officials states that updated EU regulations (EC) 883/2004 and its implementing regulation (EC) 987/2009, which entered into force on 1 May 2010, have introduced the facility for member states to claim reimbursement for the actual cost of the treatment provided to citizens from another member state. France has decided that this is the method by which it will now make claims for the cost of treatment provided to residents, including state pensioners from other member states. The updated regulations also introduce the requirement that, after a transition period to allow for the creation
of a new system, all information will be exchanged electronically between the authorities in all member states. However, the UK already receives claims from France, and some other member states, electronically, which facilitates efficient claims processing."
This paragraph contains a spark of hope! I have italicised the important bit!  The devil however, is in the detail.  I have replied (again) asking for clarification of the phrase 'actual cost'.  For example :- Does it really mean the cost upfront of 22 euros on a doctor's visit? and the total cost upfront of a hospital visit?  That would mean - bye bye to mutuelle insurance!   Such a system would be easy to facilitate.  It would mean that the Carte Vitale carries a message of 100% cover and all charges are transmitted (electronically) to the NHS. 
In my reply I wrote.... 

When, eventually, the French State asks that such actual costs be transmitted from the UK then that action will be in agreement with the words of Article 24 of regulation 883/2004 which I repeat here.
A person who receives a pension or pensions under the legislation of one or more Member States and who is not entitled to benefits in kind under the legislation of the Member State of residence shall nevertheless receive such benefits for himself and the members of his family, insofar as he would be entitled thereto under the legislation of the Member State or of at least one of the Member States competent in respect of his pensions, if he resided in that Member State.
This paragraph is saying, in plain speaking, that a British pensioner residing in France, shall receive health care benefits, insofar as he would be entitled to if he resided in Britain.

The following paragraph of this Article observes (again in plain speaking) that the costs shall be borne by Britain.

Finally I emphasise again, that it is necessary that the French Social Security asks the UK for both items of costs which arise within the French system and which together comprise the full actual costs, in order to satisfy the wording of Article 24 of Regulation 883/2004

I and other British pensioners in France await with great interest a detailed reply from the DoH .

[postscript-- It is necessary that the concept of provision of health care is distinguished from the process of costing for it.  EU law states that the provision is the responsibility of the State of residence, and the costing is the responsibility of the State competent for the pensioner. Moreover the provision should be as far as is possible similar to that provided by the 'competent State'.]

For your interest the address of the Department of Health is given.  You may feel that you can add something to my own efforts. You will probably need to refer to my 7 page document.  I am very conscious that it is difficult to construct a complicated letter, but a simple one of support would help a lot.  We are, in France, treated differently from other E121 (or S1) holders in Europe and if these efforts succeed we will be all treated equally.
If you do write then please notify me (click here for the email address.)
Please also remember that many British pensioners in France (49,000 of them in total) are perhaps unaware of this campaign.  One could tell those you know?