More comment on the Government Green
paper
Concerning support for health costs
in the EU
An example of why the Britons Abroad in Europe and
elsewhere need Democratic Representation.
I appreciate the comments by readers of my circulars which
have caused me to consider a further analysis of the situation on the costs of
health care in Europe.
It involves a digging out of information in the EU
regulations.
The consultative Green Paper is entitled
“Sustaining services, ensuring
fairness”
A consultation on migrant
access and their financial contribution to NHS provision in England.”
1. This Green Paper was issued in July with a
date of August 28th for the return of observations. This is my immediate concern - The situation
is unacceptable that people most affected by certain aspects are given no
direct knowledge of this green paper, and no time at all to respond!
2. The title gives no indication whatsoever that
the contents also concern the health costs of British pensioners in the
EU. It is only by rare chance in October
that I learned of its existence
and quick action ensured that the contents were widely known.
These concerns
were particularly and rightly publicised (especially by The Connexion in France) because of the effect on the health
costs of the ‘early retirees’ who would have their support for health care in
the wider EU removed.
Since then I have received
comments which result in the analysis below.
The British State
Pensioner abroad and treatment under the NHS.
The essence of
this analysis is the ability of British State pensioners otherwise resident in other
States of the EU to receive treatment under the NHS in Britain.
*See further note
below for other British State Pensioners in the rest of the World.
At this present
time – if you are a British State Pensioner and have at least 10 years of
residence in the UK, but you happen now to be resident abroad,
you are NOT entitled to free
treatment under the NHS. However many of
us have received treatment in the UK.
Maybe only an eye test, sometimes more.
[Confusion
on this is introduced by the fact that the EHIC –health card – is issued by the UK to all British State
Pensioners in the EU. This card requires
the UK to pay the health costs
of those travelling to another EU State, which is not their resident State! Thus
questioning the situation with regard to visits of pensioners to the UK.
Confusion
also exists with the EU law which enables any citizen, retired or not, to
travel to another State for treatment if that treatment is not available in
one’s State of residence.]
The Green Paper in
Annex A makes similar observations to some of the above. It elsewhere suggests that in future the
costing of health for State pensioners in
their resident State within the EU could
be thus affected:-
Clause 6.13 “The benefit to the UK of allowing state
pensioners to return for their planned treatment would be a discount
of 5% from payments to all countries to whom we make lump sum annual payments for our pensioners. “
The second phrase
underlined relating to annual payments, refers to the EU Regulation
987/2009 and to Annex 3 of that regulation.
This lists the States
claiming payment for health treatment on the basis of fixed amounts. They are:- IRELAND, SPAIN, ITALY, MALTA, THE NETHERLANDS, PORTUGAL, FINLAND, SWEDEN, UNITED KINGDOM
It is to the countries listed above that the proposal to cut
the fixed amount by 5% would apply.
All other countries claim the actual amount and would not be affected. – e.g France,
Belgium, Germany,
Cyprus. etc in
the EU… The actual amount is the amount
which the State of Residence has
to find – not, as I have ascertained, the actual amount for the treatment as charged
to the patient pensioner. So in France
the French State
asks of Britain
something considerably less than the full cost of the treatment to the patient.
The underlined phrase ‘planned treatment’ seems unnecessary.
What is the significance of that phrase?
Then we need to look at EU
Regulation 883/2004. Annex IV to
that regulation lists certain States where their Pensioner Nationals can return
to their native land for health treatment [there is no reference to ‘planned
treatment’ nor in the referenced article 27 here] – they are BELGIUM, GERMANY, GREECE, SPAIN, FRANCE, ITALY, LUXEMBOURG,
AUSTRIA
and SWEDEN.
Note that the United Kingdom is not listed. The Green Paper
would one supposes result in the UK being included in Annex IV.
One of my correspondents has informed
me that this is indeed what the Government is considering.
The result would be that qualifying
Pensioners in the EU beyond the UK could return quite legally to
receive treatment under the NHS and the
confusion and uncertainties which has previously existed would be removed.
*Other qualifying
British State Pensioners resident elsewhere in the World
would also benefit from a change in the regulations enabling treatment under
the NHS on their occasional visits.
The relationship of all this to the need for Representation in the Westminster Government.
If we had someone to represent us in
Government then this rigmarole would not be necessary. The DoH could consult with the
representatives who would seek opinion from certain groups within each
country. A real democracy could come
into being.
It is quite wrong in my view that the
Government can produce such a ‘green paper’ and be apparently quite incapable
of making appropriate contacts with the people most affected.
This is also so patently obvious with
regard to the proposed Referendum. This
would affect the British Abroad in Europe very closely and yet are not in line to be consulted.
It is essential that we are
Represented.
The address of the DoH is
International Healthcare Team
Department of Health
3rd Floor
Wellington House
133-155 Waterloo Road
London SE1 8UG
Email migrantaccess@dh.gsi.gov.uk
(Remember that the consultation on the green paper
closed on August 28th 2013)
The green paper is viewable at
