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View Full Version : Brexit expat retirees 'may cost NHS millions'



scooterscot
31st May 2017, 05:36
Young healthy Europeans to leave the UK in exchange for non-working OAPs in need of health care. £350 million a week ought to cover it. :D

Brexit, the gift that just keeps on giving.



Tens of thousands of expat pensioners may return to the UK to use the NHS after Brexit - unless a deal can be done to let them keep receiving care abroad, a think tank has warned.

The Nuffield Trust estimates the cost of treating them - on home soil, rather than abroad - could double to £1bn.

Currently, the UK gives around £500m a year to EU countries that care for Brits who have retired abroad.

Last year, spending on the NHS in England was around £120 billion.

The warning from the Nuffield Trust came as Health Secretary Jeremy Hunt told a newspaper that the NHS could suffer if Brexit "goes wrong".

Brits abroad

Around 190,000 British pensioners live abroad.

Under the EU reciprocal "S1" scheme, British pensioners have the right to go to any other EU member state and receive the same health care rights as the local population.

According to the Nuffield Trust, it may not be easy to continue with this agreement after Brexit.

If all of these pensioners decided to return to the UK - a big if - they could be expected to fill 900 NHS hospital beds a year, it says.

The NHS would need around 1,600 more doctors, nurses and other workers to provide the care, it estimates.

Also, hospitals could end up short-staffed if migration of workers from the EU slows or stops post-Brexit.

And access to medicines could also become more difficult if the UK leaves the EU's medicine licensing system.

Possible benefits

But there could be gains too post-Brexit, the Nuffield Trust says.

When the UK leaves the EU it could stop paying EU membership fees. Money from this saving could be used by the NHS.

Nuffield Trust spokesman Mark Dayan said: "It is possible that extra funds could be found for the NHS from any cancellation of Britain's EU membership fees.

"But whether or not these benefits will outweigh the significant staffing and financial costs Brexit may impose on already stretched services remains to be seen.

"That depends largely on the NHS being recognised as a significant priority as we enter some of the most important negotiations in Britain's history."

The British Medical Association urged politicians to keep the health service and its patients at the forefront during Brexit negotiations.

A Conservative party spokesman said safeguarding the rights of UK nationals in the EU and EU nationals in the UK was "one of our first priorities for the Brexit negotiations".

Liberal Democrat leader Tim Farron said: "A brighter future is possible. We will stand up to a bad Brexit deal that would hit the NHS hard, and give people the final say with a chance to remain in the EU."

Labour have not commented on the Nuffield Trust's report, but have accused the Conservatives of "starving" the NHS.


source: Brexit expat retirees 'may cost NHS millions' - BBC News (http://www.bbc.com/news/health-40095822)

Paddy
31st May 2017, 06:33
The figure of “Around 190,000 British pensioners live abroad” is way off. There are many more not registered with the British Consulate and many who are either drawing pensions in the UK but living abroad. I would estimate a figure to be more like 350,000.
.

woohoo
31st May 2017, 06:38
My understanding is if an expat in Spain uses their medical services then the Spanish hospital claims the cost back from the UK.

I'm not sure of other countries arrangements but seems like we still pay for expats now.

Fronttoback
31st May 2017, 06:39
In reality they won't be going anywhere. If an expat went to Spain and legally bought a villa, maybe got the maid pregnant and has a half-Spanish kid, learned the lingo so he can buy his fags from Diego the smuggler, spent his pension in the local bars, kept his head down and stayed out of the way of the locals by living in British ghettos, etc. You can't suddenly kick him out. There would be riots on the Costa Del Sol.

northernladyuk
31st May 2017, 06:47
My understanding is if an expat in Spain uses their medical services then the Spanish hospital claims the cost back from the UK.

I'm not sure of other countries arrangements but seems like we still pay for expats now.

This is true for retirees in the EU. The article above takes this into consideration.

I am not sure that the revenue expenditure would break the bank. It is more of a problem of staff recruitment and facilities. The former could be solved by hiring Spanish healthcare professionals.

The impact on social care may be significant, as I don't believe these services (if they even exist as funded services in Spain) are paid for by the UK.

It is worth looking at the projected age profile of the UK and then considering what happens if the UK reduces net immigration of young people while also reducing net emigration of old people.

http://www.telegraph.co.uk/news/uknews/11962587/Aging-Britain-One-in-12-will-be-aged-over-80-by-2039.html

original PM
31st May 2017, 07:32
When did anyone say Brexit means we are kicking anyone out of the UK?

You are just making this up as you go along.

northernladyuk
31st May 2017, 07:36
When did anyone say Brexit means we are kicking anyone out of the UK?

You are just making this up as you go along.

Where in this thread did anyone say Brexit means we are kicking anyone out of the UK?

You are just making this up as you go along.

original PM
31st May 2017, 07:50
Where in this thread did anyone say Brexit means we are kicking anyone out of the UK?

You are just making this up as you go along.

You still here?

thought you would have been banned you know for starting a thread to insult another poster...

or maybe some animals are more equal than others on here....

:tongue

VectraMan
31st May 2017, 07:50
In reality they won't be going anywhere. If an expat went to Spain and legally bought a villa, maybe got the maid pregnant and has a half-Spanish kid, learned the lingo so he can buy his fags from Diego the smuggler, spent his pension in the local bars, kept his head down and stayed out of the way of the locals by living in British ghettos, etc. You can't suddenly kick him out. There would be riots on the Costa Del Sol.

So...

My father and step-mother moved to France 3 years ago to retire. They'd bought a tumbledown house some years before and have spent lots of time and money doing it up, with still some work to go. My Dad's Mr DIY so basically this is his hobby.

One factor is that they generally get much better healthcare in France, although they have to pay for some of it with expensive insurance mostly the cost is paid by the NHS (that only applies if you're retired). My Dad turned 70 last year, and they both have a few health issues so this is essential.

I went to see them last week, and they were some what more gloomy about the future. In particular thanks to Brexit they're saying that if they don't get the same healthcare arrangements then they'll have no choice but to return to the UK, and this is the feeling amongst the expat community as a whole. People seem to focus on the right to stay, which is unlikely to change, but inside the EU guarantees all sorts of things that people depend on that could be all or partially taken away. And of course they're already worse off thanks to the fall in the pound.

These are not Brexit voting millionaires. They sold up their modest house in the UK, paid off the small mortgage that was left, and this gave them a chunk of cash for a more comfortable retirement than they could have had in the UK. This means for the value of their house in France plus whatever they have they have no chance of buying anything back in the UK. And it gets worse than that as the area is full of British expats it's likely the prices will plummet if people start moving out.

They've always seemed really happy out there, and it was always going to be "forever". But it was a bit shocking to hear my Dad saying, whilst boring me about his DIY plans, "I'm not sure it's worth it now. We might be leaving soon.".

:mad:

Fronttoback
31st May 2017, 08:05
So...

My father and step-mother moved to France 3 years ago to retire. They'd bought a tumbledown house some years before and have spent lots of time and money doing it up, with still some work to go. My Dad's Mr DIY so basically this is his hobby.

One factor is that they generally get much better healthcare in France, although they have to pay for some of it with expensive insurance mostly the cost is paid by the NHS (that only applies if you're retired). My Dad turned 70 last year, and they both have a few health issues so this is essential.

I went to see them last week, and they were some what more gloomy about the future. In particular thanks to Brexit they're saying that if they don't get the same healthcare arrangements then they'll have no choice but to return to the UK, and this is the feeling amongst the expat community as a whole. People seem to focus on the right to stay, which is unlikely to change, but inside the EU guarantees all sorts of things that people depend on that could be all or partially taken away. And of course they're already worse off thanks to the fall in the pound.

These are not Brexit voting millionaires. They sold up their modest house in the UK, paid off the small mortgage that was left, and this gave them a chunk of cash for a more comfortable retirement than they could have had in the UK. This means for the value of their house in France plus whatever they have they have no chance of buying anything back in the UK. And it gets worse than that as the area is full of British expats it's likely the prices will plummet if people start moving out.

They've always seemed really happy out there, and it was always going to be "forever". But it was a bit shocking to hear my Dad saying, whilst boring me about his DIY plans, "I'm not sure it's worth it now. We might be leaving soon.".

:mad:

3 years you say? Plus 2 years to brexit. Plus delays.

Easily get a permanent residency visa by then. 5 years needed.

https://www.thelocal.fr/20161116/how-do-i-get-permanent-residency-in-france

northernladyuk
31st May 2017, 08:08
You still here?

thought you would have been banned you know for starting a thread to insult another poster...

or maybe some animals are more equal than others on here....

:tongue

1. No answer to my question then.

2. What thread to insult another poster?

diseasex
31st May 2017, 08:12
3 years you say? Plus 2 years to brexit. Plus delays.

Easily get a permanent residency visa by then. 5 years needed.

https://www.thelocal.fr/20161116/how-do-i-get-permanent-residency-in-france

In the meantime i tried to get PR in Uk but apparently theres around a million of applications now and it's estimated it will take 11 years to process (100k applications a year). They have my id in an envelope :S

Fronttoback
31st May 2017, 08:28
In the meantime i tried to get PR in Uk but apparently theres around a million of applications now and it's estimated it will take 11 years to process (100k applications a year). They have my id in an envelope :S

Why don't you switch to the "exceptional talent" visa instead?
https://www.gov.uk/tier-1-exceptional-talent/overview

Alternatively try the ILR visa.
ILR Requirement - UK Visa Bureau (http://www.visabureau.com/uk/indefinite-leave-to-remain.aspx)

Or, you could enroll at a university which leads to a PR - 3 years self funded study would probably get you in:
https://www.internationalstudents.cam.ac.uk/apply-permanent-residency


You may have to invest some of your contractor gains in order to build your brand up in the UK.

diseasex
31st May 2017, 08:30
Why don't you switch to the "exceptional talent" visa instead?
https://www.gov.uk/tier-1-exceptional-talent/overview

Alternatively try the ILR visa.
ILR Requirement - UK Visa Bureau (http://www.visabureau.com/uk/indefinite-leave-to-remain.aspx)

Or, you could enroll at a university which leads to a PR - 3 years self funded study would probably get you in:
https://www.internationalstudents.cam.ac.uk/apply-permanent-residency


You may have to invest some of your contractor gains in order to build your brand up in the UK.

uhm your point being? I have houses and live here 6 years. they have all my tax data , it should be automatic, but instead you have to fill 81 pages form and then they have to process it. How thick is that

Pip in a Poke
31st May 2017, 08:31
My understanding is if an expat in Spain uses their medical services then the Spanish hospital claims the cost back from the UK.

I'm not sure of other countries arrangements but seems like we still pay for expats now.

Yes, exactlt. That's waht the E101 is for.

More scremongering.

northernladyuk
31st May 2017, 08:33
Yes, exactlt. That's waht the E101 is for.

More scremongering.

It will cost more to treat them in the UK, as the article says.

VectraMan
31st May 2017, 08:35
3 years you say? Plus 2 years to brexit. Plus delays.

Easily get a permanent residency visa by then. 5 years needed.

https://www.thelocal.fr/20161116/how-do-i-get-permanent-residency-in-france

Doesn't mention healthcare.

InsertWittyNameHere555
31st May 2017, 08:40
My understanding is if an expat in Spain uses their medical services then the Spanish hospital claims the cost back from the UK.

I'm not sure of other countries arrangements but seems like we still pay for expats now.

That is correct, however the cost of healthcare in Spain is a lot cheaper than the UK, so the same people in Europe are charging £500m a year back to the NHS, where as treating them in the UK will cost £1bn

BlasterBates
31st May 2017, 08:41
The E101 arrangement was taken into account when calculating the additional costs for the NHS:

NHS faces extra 500 million bill from returning expats, taking into account the reciprocal agreement (https://www.theguardian.com/society/2017/may/31/nhs-faces-500m-a-year-bill-post-brexit-for-returning-retirees-says-thinktank)

Fronttoback
31st May 2017, 08:41
uhm your point being? I have houses and live here 6 years. they have all my tax data , it should be automatic

6 years! Your right to remain is automatic, why are you moaning? And why are you greedily sending your ID card into a very long queue- making the problem worse for others.

My point good sir, is that I think the lady doth protest too much. Are you perhaps using this situation as a vehicle to promote your successful migration story? Are you trying to draw a distinction between you and your little Polish builder brothers on the street who did not make it big like you did? On a lighter note - just let them continue renting your bedsits out- you don't have to kick them out at brexit. Maybe put the rent up in case they do a runner. Or cash in hand in advance.

diseasex
31st May 2017, 08:43
6 years! Your right to remain is automatic, why are you moaning? And why are you greedily sending your ID card into a very long queue- making the problem worse for others.

My point good sir, is that I think the lady doth protest too much. Are you perhaps using this situation as a vehicle to promote your successful migration story? Are you trying to draw a distinction between you and your little Polish builder brothers on the street who did not make it big like you did? On a lighter note - just let them continue renting your bedsits out- you don't have to kick them out at brexit. Maybe put the rent up in case they do a runner. Or cash in hand in advance.

uhm #2
nope. just complaining on PR application and beaurocracy. They have my ID and i need it. and it turns out I will get it back in 11 years:S

northernladyuk
31st May 2017, 08:45
uhm #2
nope. just complaining on PR application. They have my ID and i need it. and it turns out I will get it back in 11 years:S

That sounds like you've been identified as having extremist views, so are in the extended vetting queue.

Fronttoback
31st May 2017, 08:47
uhm #2
nope. just complaining on PR application. They have my ID and i need it. and it turns out I will get it back in 11 years:S

Just pretend you lost it and apply for a new ID.

Do you need this much hand holding at work? No wonder you're worried now that the competition levels are increasing.

InsertWittyNameHere555
31st May 2017, 08:47
In reality they won't be going anywhere. If an expat went to Spain and legally bought a villa, maybe got the maid pregnant and has a half-Spanish kid, learned the lingo so he can buy his fags from Diego the smuggler, spent his pension in the local bars, kept his head down and stayed out of the way of the locals by living in British ghettos, etc. You can't suddenly kick him out. There would be riots on the Costa Del Sol.

It's starting to happen already, ex-pats in Spain are being required to have private medical insurance as it is, once they can no longer recharge pension medical costs to the NHS they will just make it mandatory for everyone

diseasex
31st May 2017, 08:48
Just pretend you lost it and apply for a new ID.

Do you need this much hand holding at work? No wonder you're worried now that the competition levels are increasing.

True - sending it to May's govt is as good as lost

woohoo
31st May 2017, 09:01
That is correct, however the cost of healthcare in Spain is a lot cheaper than the UK, so the same people in Europe are charging £500m a year back to the NHS, where as treating them in the UK will cost £1bn

Fair point - though I remember reading that Spain are good at claiming the cost back from the NHS but the NHS are not very good at claiming costs from other countries care providers. So guess there will be a saving there.

sal
31st May 2017, 09:22
Fair point - though I remember reading that Spain are good at claiming the cost back from the NHS but the NHS are not very good at claiming costs from other countries care providers. So guess there will be a saving there.

No there won't be, because NHS are just as poor in claiming costs from insurance providers for treating non-EU citizens. NHS has one of the highest costs per head in the world and it's not due to the tulip wages being higher here, but mostly to gross mismanagement and waste.

sal
31st May 2017, 09:25
When did anyone say Brexit means we are kicking anyone out of the UK?

You are just making this up as you go along.

Maybe not exactly kicking as in shoving them on board boats/planes at gun/spear point but the end result is the same:


The Office for National Statistics said the change was driven by "a statistically significant" increase of 40,000 people leaving the country.
These were mostly EU citizens - 117,000 emigrated, up 31,000 from 2015.

Net migration to the UK falls to 248,000 in 2016 - BBC News (http://www.bbc.co.uk/news/uk-politics-40043483)

northernladyuk
31st May 2017, 09:27
No there won't be, because NHS are just as poor in claiming costs from insurance providers for treating non-EU citizens. NHS has one of the highest costs per head in the world and it's not due to the tulip wages being higher here, but mostly to gross mismanagement and waste.

The NHS isn't really that expensive.

http://upload.wikimedia.org/wikipedia/commons/thumb/0/0b/OECD_health_expenditure_per_capita_by_country.svg/740px-OECD_health_expenditure_per_capita_by_country.svg. png

InsertWittyNameHere555
31st May 2017, 09:49
Fair point - though I remember reading that Spain are good at claiming the cost back from the NHS but the NHS are not very good at claiming costs from other countries care providers. So guess there will be a saving there.

£6bn in 8 years, so could come out as cost neutral, but I doubt anyone will report that as it's not sexy enough a story

Health tourists cost UK taxpayers nearly £6billion in eight years (http://www.telegraph.co.uk/news/2016/04/04/health-tourists-cost-uk-taxpayers-nearly-6billion-in-eight-years/)

diseasex
31st May 2017, 09:51
£6bn in 8 years, so could come out as cost neutral, but I doubt anyone will report that as it's not sexy enough a story

Health tourists cost UK taxpayers nearly £6billion in eight years (http://www.telegraph.co.uk/news/2016/04/04/health-tourists-cost-uk-taxpayers-nearly-6billion-in-eight-years/)

What about sex tourists?

original PM
31st May 2017, 09:55
Well you can take a cheap holiday to Blackpool and hang around the bars

for the cost of a bacardi breezer you will probably get laid.

But then you will need the NHS to clear up the rash.

InsertWittyNameHere555
31st May 2017, 10:22
Well you can take a cheap holiday to Blackpool and hang around the bars

for the cost of a bacardi breezer you will probably get laid.

But then you will need the NHS to clear up the rash.

Blackpool and Vegas, the two places in the world you can pay for sex with chips

Cirrus
31st May 2017, 10:26
The NHS isn't really that expensive.

And everyone note that the US spends more on public healthcare than we spend in total.

(Purely as an aside: the reason they spend so much more is not that they are more expensive. It's that they do lots more tests)

VectraMan
31st May 2017, 12:30
£6bn in 8 years, so could come out as cost neutral, but I doubt anyone will report that as it's not sexy enough a story

Health tourists cost UK taxpayers nearly £6billion in eight years (http://www.telegraph.co.uk/news/2016/04/04/health-tourists-cost-uk-taxpayers-nearly-6billion-in-eight-years/)

That's assuming Brexit stops anybody arriving from the EU.

diseasex
31st May 2017, 12:44
And everyone note that the US spends more on public healthcare than we spend in total.

(Purely as an aside: the reason they spend so much more is not that they are more expensive. It's that they do lots more tests)

US spends, not US Govt. Massive massive difference

northernladyuk
31st May 2017, 12:47
US spends, not US Govt. Massive massive difference

Who other than the US government is spending money on US public healthcare?

diseasex
31st May 2017, 12:48
Who other than the US government is spending money on US public healthcare?

Call me ignorant but is there anything like "public healthcare" in US? As far as I know , its funded from private insurances

northernladyuk
31st May 2017, 12:51
Call me ignorant but is there anything like "public healthcare" in US? As far as I know , its funded from private insurances

You are ignorant.

Medicare, Medicaid and Veterans Health are examples.

diseasex
31st May 2017, 12:55
You are ignorant.

Medicare, Medicaid and Veterans Health are examples.

it's only for elderly. I doubt it's that much as your chats showing per capita.

northernladyuk
31st May 2017, 12:58
it's only for elderly. I doubt it's that much as your chats showing per capita.

You are still ignorant.

diseasex
31st May 2017, 12:59
You are still ignorant.

Nope. I'm just telling you your chart about healthcare spending per capita is full of crap.

northernladyuk
31st May 2017, 13:01
Nope. I'm just telling you your chart about healthcare spending per capita is full of crap.

You are saying that Medicare, Medicaid and Veterans Health are only for the elderly. Which is incorrect.

diseasex
31st May 2017, 13:03
You are saying that Medicare, Medicaid and Veterans Health are only for the elderly. Which is incorrect.


Medicare provides health insurance for Americans aged 65 and older who have worked and paid into the system through the payroll tax. It also provides health insurance to younger people with some disabilities status as determined by the Social Security Administration, as well as people with end stage renal disease and amyotrophic lateral sclerosis.


Medicaid in the United States is a social health care program for families and individuals with limited resources


...

Bee
31st May 2017, 13:10
My understanding is if an expat in Spain uses their medical services then the Spanish hospital claims the cost back from the UK.

I'm not sure of other countries arrangements but seems like we still pay for expats now.

If you are a European citizen you can have the European health card, if you travel to another EU country the hospital claims the costs from traveller's country.

Switzerland is not from EU but has a bilateral agreement with some countries and you can use your Health card if you travel to Switzerland.

stek
31st May 2017, 14:07
If you are a European citizen you can have the European health card, if you travel to another EU country the hospital claims the costs from traveller's country.

Switzerland is not from EU but has a bilateral agreement with some countries and you can use your Health card if you travel to Switzerland.

Only for visitors. As soon as you are resident (after 90 days or when you become a worker or student or self-sufficient) you fall into the local system an pay either by deductions per NI in UK or by deductions, pay at the door and private cover like here in Ireland!

EHIC is not for full cover when not visiting.

VectraMan
31st May 2017, 14:39
Only for visitors. As soon as you are resident (after 90 days or when you become a worker or student or self-sufficient) you fall into the local system an pay either by deductions per NI in UK or by deductions, pay at the door and private cover like here in Ireland!

EHIC is not for full cover when not visiting.

WHS. By definition an expat is there permanently and therefore isn't covered. But retired UK expats are covered, at least mostly, by the UK state (as much as a local would be), but if you're working age you'll have to have full insurance one way or other. The government could promise to keep doing that now without any change to any agreement with anyone else; they're simply guaranteeing health care for British citizens who've paid for it with taxes for decades. But they won't.

Paddy
31st May 2017, 14:45
WHS. By definition an expat is there permanently and therefore isn't covered. But retired UK expats are covered, at least mostly, by the UK state (as much as a local would be), but if you're working age you'll have to have full insurance one way or other. The government could promise to keep doing that now without any change to any agreement with anyone else; they're simply guaranteeing health care for British citizens who've paid for it with taxes for decades. But they won't.

Yes, it's all a bit iffy especially with duel residency. To be on the safe side I pay extra insurance which is only £20pm.

stek
31st May 2017, 14:51
Wonder if any Portuguese or polish contractors are working here not paying NI and hoping an EHIC card is enough...

diseasex
31st May 2017, 14:55
Wonder if any Portuguese or polish contractors are working here not paying NI and hoping an EHIC card is enough...

excuse me? I'm paying thousands of tax each year including NI.

SueEllen
31st May 2017, 15:19
Wonder if any Portuguese or polish contractors are working here not paying NI and hoping an EHIC card is enough...

Well in the UK they are unlikely to be chased up so why should they worry?

diseasex
31st May 2017, 15:34
Well in the UK they are unlikely to be chased up so why should they worry?

From where I'm standing it's not so certain, especially how fiercefully you were fighting for that topic to be able to strip us out of laws. Albeit difficult to make my life miserable now.

northernladyuk
31st May 2017, 16:22
...

So not:


only for elderly.

Mordac
31st May 2017, 19:18
Young healthy Europeans to leave the UK in exchange for non-working OAPs in need of health care. £350 million a week ought to cover it. :D


How long before you fall into that category? :wink

InsertWittyNameHere555
1st June 2017, 12:10
That's assuming Brexit stops anybody arriving from the EU.

Might not stop them arriving, but will stop the NHS having to pay for their non-emergency treatment