# UK ex pat healthcare change



## Rabbitcat (Aug 31, 2014)

Government U-turn on NHS access for expats - Telegraph


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## 90199 (Mar 21, 2010)

Normal discrimination by the U.K. government against its citizens that choose to live elsewhere.


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## Gazeebo (Jan 23, 2015)

Hepa said:


> Normal discrimination by the U.K. government against its citizens that choose to live elsewhere.


Now come on - the government has to find the money to pay for all those coming into Britain from the EU accessing the NHS without paying in a penny - from somewhere.


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## Lynn R (Feb 21, 2014)

Gazeebo said:


> Now come on - the government has to find the money to pay for all those coming into Britain from the EU accessing the NHS without paying in a penny - from somewhere.


I think the majority of those coming into Britain from the EU are paying to use the NHS - because they have jobs and are paying National Insurance. In the same way, anyone who comes to Spain and pays autonomo contributions or social security contributions through a contracted job, is also entitled to immediate use of the Spanish state health system.


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## Gazeebo (Jan 23, 2015)

Lynn R said:


> I think the majority of those coming into Britain from the EU are paying to use the NHS - because they have jobs and are paying National Insurance. In the same way, anyone who comes to Spain and pays autonomo contributions or social security contributions through a contracted job, is also entitled to immediate use of the Spanish state health system.


Most are paying in, but not enough to pay for what they are taking out as soon as they get into Britain. I see it day in, day out. What part of Britain do you live in?


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## 90199 (Mar 21, 2010)

Gazeebo said:


> Now come on - the government has to find the money to pay for all those coming into Britain from the EU accessing the NHS without paying in a penny - from somewhere.



Quite so, from taxes deducted from the pensions of those who choose to live elsewhere.


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## Roy C (Sep 29, 2012)

I think UK NHS is residency based and Spain is based on paying in through your employee contributions?


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## Lynn R (Feb 21, 2014)

Gazeebo said:


> Most are paying in, but not enough to pay for what they are taking out as soon as they get into Britain. I see it day in, day out. What part of Britain do you live in?


If Britain's economy is so skewed that people in work (British people and immigrants alike) have to have their wages topped up by tax credits and housing benefit, which is in effect a Government (no, make that taxpayer) subsidy to private employers and landlords) that isn't the fault of the immigrants. The NHS would really be in dire straits if it weren't for all the immigrant workers (from both inside and outside the EU) working in it.

I may not live iin Britain now but all my family do and I go back there regularly. Both my sister and my aunt have Polish GPs. Cameron apparently has plans to recruit thousands more GPs over the next few years both to address the current shortage and introduce his 24-hour NHS. Where do you think they will come from, as UK born doctors are increasingly unwilling to work either in A&E or in General Practice?

You yourself are planning to take advantage of free movement within the EU to come and settle in Spain, are you not? 

There is nothing stopping the UK from making their benefits system contribution based (as it is in Spain and other European countries) - but that would still not address the fact that people in a low wage/high living costs economy will need benefit top-ups or they could not afford to live.


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## xabiaxica (Jun 23, 2009)

Roy C said:


> I think UK NHS is residency based and Spain is based on paying in through your employee contributions?


essentially yes - but new immigrants to the UK now have to pay an upfront 'healthcare surcharge'

https://www.gov.uk/government/news/uk-introduces-health-surcharge


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## xabiaxica (Jun 23, 2009)

back to the original article - basically nothing has changed for those of us living in other EU countries. The proposals had been that we would be able to elect to go back to the for planned treatment. In fact there are ways to do this anyway, if your doctors in Spain agree to it. Although in practice it's unlikely to happen since waiting times & availability of treatment are generally better in Spain, anyway.


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## Lynn R (Feb 21, 2014)

xabiachica said:


> back to the original article - basically nothing has changed for those of us living in other EU countries. The proposals had been that we would be able to elect to go back to the for planned treatment. In fact there are ways to do this anyway, if your doctors in Spain agree to it. Although in practice it's unlikely to happen since waiting times & availability of treatment are generally better in Spain, anyway.


There is also something of an inaccuracy in the article where it says that UK citizens living in the EU would have to get an EHIC card from their country of residence to access NHS treatment. In fact, UK pensioners and their dependants who live in other EU countries get their EHIC cards issued from the UK (for use when travelling to the UK or any other EU country other than where they live). Anyone living and working (therefore paying social security contributions) in another EU country could get the EHIC (called a TSE in Spain, I believe) from their country of residence. Anyone who doesn't come into either category (early retirees, for example) can't get an EHIC card from either country - which is the position we were in until the beginning of this year.


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## Rabbitcat (Aug 31, 2014)

It is indeed a bit of a mess. However one aspect I don't understand is when people complain of having " paid in for years". 

The payments are national insurance and indeed as per any other type of insurance you don't get anything back if you don't ever claim nor or you entitled to remain covered if you cease paying the premiums


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## xabiaxica (Jun 23, 2009)

Lynn R said:


> There is also something of an inaccuracy in the article where it says that UK citizens living in the EU would have to get an EHIC card from their country of residence to access NHS treatment. In fact, UK pensioners and their dependants who live in other EU countries get their EHIC cards issued from the UK (for use when travelling to the UK or any other EU country other than where they live). Anyone living and working (therefore paying social security contributions) in another EU country could get the EHIC (called a TSE in Spain, I believe) from their country of residence. Anyone who doesn't come into either category (early retirees, for example) can't get an EHIC card from either country - which is the position we were in until the beginning of this year.


yes that too


& there are of course those who have no access to state healthcare at all, neither in the UK because they no longer live there, nor in Spain, because they don't qualify for it

presumably they would have to pay


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## Roy C (Sep 29, 2012)

I think if you have worked and paid up over 35 years of NI contributions , the same as for the pension then you should at least be entitled to healthcare in the country you have paid into. Why should age make a difference.


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## Rabbitcat (Aug 31, 2014)

Roy I don't think age should come into it. But like ANY insurance if you no longer pay in you ain't covered


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## Roy C (Sep 29, 2012)

That's partly my point, pensioners don't pay into it but are covered because they have paid they required amount of contributions for their pensions etc.


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## Rabbitcat (Aug 31, 2014)

Don't get me wrong I think the whole system needs review its just sometimes people think paying premiums into what amounts to state health ins- entitles them to avail of it even if they terminate contributing

I can just imagine the reaction of my car ins company if I complained- I paid into your policy for 30 years and never claimed a penny- yet as soon as I stop paying in you wont cover me!!!


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## Roy C (Sep 29, 2012)

Rabbitcat said:


> Don't get me wrong I think the whole system needs review its just sometimes people think paying premiums into what amounts to state health ins- entitles them to avail of it even if they terminate contributing
> 
> I can just imagine the reaction of my car ins company if I complained- I paid into your policy for 30 years and never claimed a penny- yet as soon as I stop paying in you wont cover me!!!


I hear what you're saying Rabbicat but I think comparing it to car insurance or any other insurance is wrong. National Insurance contributions is a tax not an insurance policy. I believe in higher taxes and better benefits for the population as a whole but based on what you are saying this would exclude the unemployed (hypothetically) from healthcare because they have stopped paying their national insurance in real terms. 

Someone can enter the UK and pay in for a short while and get all the benefits of the NHS whereas I or people like me who aren't married to or are a pensioner are put in a position of being denied care if they needed it while travelling to the UK so it does seem a bit unfair, it won't stop me retiring early because we will take out insurance etc but I am in a position were I can do that, others may not be.


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## xabiaxica (Jun 23, 2009)

Roy C said:


> I think if you have worked and paid up over 35 years of NI contributions , the same as for the pension then you should at least be entitled to healthcare in the country you have paid into. Why should age make a difference.


you are - if you live there

also if you live in an EU country the UK pays for your healthcare there, if you are a pensioner ( and in a few other specific situations)


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## Roy C (Sep 29, 2012)

xabiachica said:


> you are - if you live there
> 
> also if you live in an EU country the UK pays for your healthcare there, if you are a pensioner ( and in a few other specific situations)


I'm aware of that but those who retire early outside the UK aren't entitled to anything.


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## xabiaxica (Jun 23, 2009)

Roy C said:


> I'm aware of that but those who retire early outside the UK aren't entitled to anything.


we didn't retire here early (if only) - but having to fund our own healthcare when we decided to leave the UK was something we had to take into account 

it's residence based, as said - that's the system whether we think it's fair or not

if we moved back though, as residents we'd be entitled to use it again


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## Rabbitcat (Aug 31, 2014)

Roy C said:


> I hear what you're saying Rabbicat but I think comparing it to car insurance or any other insurance is wrong. National Insurance contributions is a tax not an insurance policy. I believe in higher taxes and better benefits for the population as a whole but based on what you are saying this would exclude the unemployed (hypothetically) from healthcare because they have stopped paying their national insurance in real terms.
> 
> Someone can enter the UK and pay in for a short while and get all the benefits of the NHS whereas I or people like me who aren't married to or are a pensioner are put in a position of being denied care if they needed it while travelling to the UK so it does seem a bit unfair, it won't stop me retiring early because we will take out insurance etc but I am in a position were I can do that, others may not be.


Fair points Roy and yes my car ins comparison is somewhat suspect.


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## gus-lopez (Jan 4, 2010)

Roy C said:


> I think UK NHS is residency based and Spain is based on paying in through your employee contributions?


No Spain changed to an identical system to the UK on 6th January 2012. The legislation had been agreed by all parties in 2011 whilst Zappy was still in & had just to be signed into law, & was forced on Spain by the imminent multi-hundred million euro fines due against Spain for Valencia & Andalucia for failing to ensure correct treatment for EU citizens.
It was the first thing, I believe, that Rajoy had to sign off on.

Having signed it off they then went on the hunt for how to ensure that all the illegals could not gain access. It went on for multiple writings of "health care access requirements" that at one point were getting more & more desperate , & laughable, with everyone including the EU waiting to issue complaints ,until we finally ended up with the "before & after" ( as far as EU registered citizens were concerned ) of April 24th 2012.

Unfortunately by attempting to disenfranchise all the illegals they could only do it legally by disenfranchising the EU citizens as well. 
The UK could do the same with registration certificate, which failure to be able to comply would allow the UK the right not to pay any benefits & also no healthcare.


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## Lynn R (Feb 21, 2014)

Roy C said:


> I'm aware of that but those who retire early outside the UK aren't entitled to anything.


I was in that position (although we were lucky enough to get S1s for our first two years before they stopped being issued to early retirees) and we had to fund our own healthcare here for six years after that. I didn't see that as unfair, and I think we're quite lucky that the UK still pays for the healthcare of British pensioners living here (although I think that costs them no more than funding our healthcare would if we remained in the UK, and takes some of the pressure off services as another country and its staff and facilities are actually providing the care).


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## Roy C (Sep 29, 2012)

Lynn R said:


> I was in that position (although we were lucky enough to get S1s for our first two years before they stopped being issued to early retirees) and we had to fund our own healthcare here for six years after that. I didn't see that as unfair, and I think we're quite lucky that the UK still pays for the healthcare of British pensioners living here (although I think that costs them no more than funding our healthcare would if we remained in the UK, and takes some of the pressure off services as another country and its staff and facilities are actually providing the care).


Lynn that was a bit of a misquote, the bit I feel is unfair is when an early retiree returns to the UK for a holiday and if they needed treatment they wouldn't be entitled to it after having paid in for years. 

But as you have said the cost of funding would be no more to fund a UK citizen over there and would take the pressure of the NHS. That way I think everyone would be a winner. One thing I would like to make clear is I'm not knocking the Spanish system, if anything it's Osborne I'm having a pop at. At the end of the day I know moving to Spain will be my/ our decision eyes wide open. I hope


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## Lynn R (Feb 21, 2014)

Roy C said:


> Lynn that was a bit of a misquote, the bit I feel is unfair is when an early retiree returns to the UK for a holiday and if they needed treatment they wouldn't be entitled to it after having paid in for years.


Well I must admit, I didn't much like being in the position of not being able to have an EHIC card from either country for eight years, after paying tax and NI in the UK for more than 30 years and my OH for more than 40 years. The trouble is, there are so many who would abuse it and claim they were just returning to the UK for a holiday, or more likely, as in the case of several we know, maintain the pretence by using a relative or friend's address that they have never left it, going back to the UK for whatever treatment they need and not being registered as residents in Spain. They use the excuse that they paid into the system for years, well so did I, for as long or longer than they did, plus I paid more in tax and NI than they did, and it still drives me mad to see them getting away with it.


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## Roy C (Sep 29, 2012)

From what I have read about the Spanish health service ( and I know it's been hit by austerity) it sounds every bit as good if not better in a lot of areas than the NHS. We after a year will be paying into the system.


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## mrypg9 (Apr 26, 2008)

Rabbitcat said:


> It is indeed a bit of a mess. However one aspect I don't understand is when people complain of having " paid in for years".
> 
> The payments are national insurance and indeed as per any other type of insurance you don't get anything back if you don't ever claim nor or you entitled to remain covered if you cease paying the premiums


The NHS is funded from general taxation, isn't it?. NI is a fund used as its name suggests to provide cover in illness (sick pay) and partly fund state retirement pensions.
Although it's all lumped together now...
Retirees in Spain and elsewhere who are entitled to 'free' health care are covered by HM Government by the annual payment of a lump sum to cover this. Not sure how much, a couple of £thousand, I think.


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## ccm47 (Oct 15, 2013)

Mary,
The UK National Insurance is not a fund used for anything in particular. It was originally, but ceased to be many moons ago. What is collected under that heading goes into general taxation for the Treasury to allocate.

The illusion that it pays for sickness benefit was maintained because qualifying for that benefit required 2 recent years worth of minimum contributions to have been paid, calculated in pounds. A well paid earner would pay that sum on a month or so's earnings. Seasonal workers often struggled to get there and paying in voluntarily in order to qualify used not to be permitted as payment was considered to be benefit inspired. Statutory maternity pay also required a minimum payment of NI to have been paid.

Similarly a full UK pension was based on 40 years minimum contributions, which meant if you were female, did menial work whilst you were a student and did not pay voluntary contributions fairly sharpish after qualifying in your field, you could never have a full pension as you were not allowed to pay beyond your 60th birthday. These days credits are available for all sorts of reasons and the time period to qualify has been reduced.

National Insurance has always been one of the most complicated of taxes to collect, with various rates in force, with at least 5 different rates being possible for a worker according to their employment status and at least 3 for employers. Failure to pay when liable as a self-employed person used to be a criminal offence too and I have known people go to prison if they could not or would not pay up. Nowadays its a civil offence with the normal penalties of bailiffs' distraint on goods, charges put on property and bankruptcy used by the Revenue.

There have been studies done to see whether NI could be abolished but the amount that would need to be put on VAT or income tax to compensate would mean political suicide for the govt of the day. People seem to prefer to pay NI and other taxes separately even though it is costly to collect. 
The nearest thing to strategic rationalisation for collection of NI that did happen was that responsibility for its collection was transferred from the DWP's Contributions Agency to the Revenue along with the relevant staff in 2000. Resulting in the short term at least, in a drop in the amount of NI collected because so many of ex-Agency staff, like me, left or transferred to non-NI and tax related work.


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## mrypg9 (Apr 26, 2008)

ccm47 said:


> Mary,
> The UK National Insurance is not a fund used for anything in particular. It was originally, but ceased to be many moons ago. What is collected under that heading goes into general taxation for the Treasury to allocate.
> 
> The illusion that it pays for sickness benefit was maintained because qualifying for that benefit required 2 recent years worth of minimum contributions to have been paid, calculated in pounds. A well paid earner would pay that sum on a month or so's earnings. Seasonal workers often struggled to get there and paying in voluntarily in order to qualify used not to be permitted as payment was considered to be benefit inspired. Statutory maternity pay also required a minimum payment of NI to have been paid.
> ...


Thank you for that informed and well-explained reply. It is very much appreciated. 
You obviously know what you are talking about..


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## mrypg9 (Apr 26, 2008)

ccm47 said:


> Mary,
> The UK National Insurance is not a fund used for anything in particular. It was originally, but ceased to be many moons ago. What is collected under that heading goes into general taxation for the Treasury to allocate.
> 
> The illusion that it pays for sickness benefit was maintained because qualifying for that benefit required 2 recent years worth of minimum contributions to have been paid, calculated in pounds. A well paid earner would pay that sum on a month or so's earnings. Seasonal workers often struggled to get there and paying in voluntarily in order to qualify used not to be permitted as payment was considered to be benefit inspired. Statutory maternity pay also required a minimum payment of NI to have been paid.
> ...


Would you mind if I pm 'ed you about a NI related matter relating to pensions that I have a personal interest in? 
I won't be offended if you say you did mind..


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## ccm47 (Oct 15, 2013)

No go ahead Mary with the PM but I can only point you in the right direction these days as anything I say now is unofficial.


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## Gazeebo (Jan 23, 2015)

Lynn R said:


> If Britain's economy is so skewed that people in work (British people and immigrants alike) have to have their wages topped up by tax credits and housing benefit, which is in effect a Government (no, make that taxpayer) subsidy to private employers and landlords) that isn't the fault of the immigrants. The NHS would really be in dire straits if it weren't for all the immigrant workers (from both inside and outside the EU) working in it.
> 
> I may not live iin Britain now but all my family do and I go back there regularly. Both my sister and my aunt have Polish GPs. Cameron apparently has plans to recruit thousands more GPs over the next few years both to address the current shortage and introduce his 24-hour NHS. Where do you think they will come from, as UK born doctors are increasingly unwilling to work either in A&E or in General Practice?
> 
> ...


Yes, and unfortunately, those coming into the country, particularly in low paid jobs, are keeping wages low. There are enough unemployed in Britain, without taking in so many to do those jobs. That is the fault of successive governments and the nanny state Britain has become. It would be more sensible for Britain to make the benefits system a contribution based one.

I have no objections to qualified people coming into the UK, indeed, I would like to see our borders opened up to anyone whose profession is needed, perhaps along the same lines as Australia.

Yes, I am hoping to make use of freedom of borders - something which I agree with. However, when I land in Spain, I am supposed to have private healthcare, at least 600 euros per month private income, find myself somewhere to live, not expect to receive any benefits and will not have a hope in hell of getting employment. I think therein lies the difference between Britain and other EU countries.

I believe Spain and other EU countries have the better approach.


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## Lynn R (Feb 21, 2014)

Gazeebo said:


> Yes, I am hoping to make use of freedom of borders - something which I agree with. However, when I land in Spain, I am supposed to have private healthcare, at least 600 euros per month private income, find myself somewhere to live, not expect to receive any benefits and will not have a hope in hell of getting employment. I think therein lies the difference between Britain and other EU countries.
> 
> I believe Spain and other EU countries have the better approach.


Well, we agree on that point at least.

However, if the UK did adopt a similar approach to the other EU countries tomorrow, it would not prevent unskilled workers from moving to Britain as they could easily, as many do already, have contracted work lined up which would enable them to satisfy the residency conditions. A young Spanish neighbour of mine and his girlfriend both managed to be offered employment in a meat processing factory in Hull before ever setting foot in the place, earning 1,600 pounds per month each with transport to and from work provided. Oh, and they found themselves somewhere to live, they rented a terraced house from a private landlord, just the two of them. Hull is an area with higher than average unemployment, so with wages which seemed to me not at all unreasonable for unskilled factory work, why is it necessary for employers to look overseas for labour? Whilst the jobs are there for anyone who wants to work, the EU migrants will still come. 

Without them, well good luck in finding people to staff the UK's hotels, restaurants, shops, factories, farms etc. I think it's pie in the sky to believe that if employers were prevented from employing migrants they would immediately increase wages to the point where workers would not need tax credit and housing benefit top-ups - and in the unlikely event that they did, what would that do to the prices everyone would have to pay? Still, that wouldn't be your problem, would it, as you'll be living in Spain.

Large businesses are not going to give up subsidies on this scale without a fight.

http://www.cipd.co.uk/pm/peoplemana...-163-11-billion-a-year-finds-citizens-uk.aspx


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## Lynn R (Feb 21, 2014)

By the way, the UK has paid top-up benefits to people who have children and who are in low paid work ever since 1971, first by way of Family Income Supplement, then Family Credit and latterly the Working Family Tax Credit. So the problem of low pay insufficient for workers to live on existed long before workers from the EU ever began arriving in Britain.

http://www.ifs.org.uk/bns/bn3.pdf


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## Lynn R (Feb 21, 2014)

Anyone who believes immigration is to blame for low pay must surely remember that the UK didn't even have a minimum wage until 1998, again well before large scale EU migration. I remember at the time it was introduced examples being quoted of people being paid as little as 2 pounds per hour - and the Tories being strongly opposed to its introduction. From wiki

"The policy was opposed by the Conservative party at the time of implementation, who argued that it would create extra costs for businesses and would cause unemployment. The Conservative party's current leader, David Cameron, said at the time that the minimum wage "would send unemployment straight back up". However, in 2005 Cameron stated that "I think the minimum wage has been a success, yes. It turned out much better than many people expected, including the CBI."[8] It is now Conservative Party policy to support the minimum wage.[9]"


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## Isobella (Oct 16, 2014)

Funny how Spain is congratulated for having a harsh social security system and restrictions for would be immigrants whilst at the same time the UK is vilified for wanting to tighten up.


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## Isobella (Oct 16, 2014)

Lynn R said:


> Anyone who believes immigration is to blame for low pay must surely remember that the UK didn't even have a minimum wage until 1998, again well before large scale EU migration. I remember at the time it was introduced examples being quoted of people being paid as little as 2 pounds per hour - and the Tories being strongly opposed to its introduction. From wiki
> 
> "The policy was opposed by the Conservative party at the time of implementation, who argued that it would create extra costs for businesses and would cause unemployment. The Conservative party's current leader, David Cameron, said at the time that the minimum wage "would send unemployment straight back up". However, in 2005 Cameron stated that "I think the minimum wage has been a success, yes. It turned out much better than many people expected, including the CBI."[8] It is now Conservative Party policy to support the minimum wage.[9]"


I worked for the LPU an NGO campaigning for the minimum wage. We were funded mainly by the Rowntree Trust but also a couple of generous grants from two Trade Unions. A few of the Unions were half hearted about the minimum wage on the basis that if set too low it could become the norm and drive down wages. Many local officials said it was the workers own fault for not joining a Union.


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## Gazeebo (Jan 23, 2015)

Lynn R said:


> Well, we agree on that point at least.
> 
> However, if the UK did adopt a similar approach to the other EU countries tomorrow, it would not prevent unskilled workers from moving to Britain as they could easily, as many do already, have contracted work lined up which would enable them to satisfy the residency conditions. A young Spanish neighbour of mine and his girlfriend both managed to be offered employment in a meat processing factory in Hull before ever setting foot in the place, earning 1,600 pounds per month each with transport to and from work provided. Oh, and they found themselves somewhere to live, they rented a terraced house from a private landlord, just the two of them. Hull is an area with higher than average unemployment, so with wages which seemed to me not at all unreasonable for unskilled factory work, why is it necessary for employers to look overseas for labour? Whilst the jobs are there for anyone who wants to work, the EU migrants will still come.
> 
> ...


Yes, hopefully I will be living in Spain! 

The government of the day is proposing to stop companies recruiting from other EU countries only - which at present is common practice. I believe that our existing unemployed should be offered or encouraged to take those jobs before they are offered abroad. However, as you quite rightly said 'pie in the sky', especially as some just don't want to work full stop. Perhaps it should be down to numbers?

However, I do have to say that it is costing the NHS a lot of money when we see translators in our doctors' surgeries (at a cost of £70 -£80 per hour). These are not paid for by the individual patient, but taken from the GPs funds. I may be wrong, but if I go to another country, I would have to pay for this service. 

We also offer what in effect are free language courses at colleges if the person is unemployed or on a low income. And yet, the government is continually cutting funding for courses. Perhaps this is robbing Peter to pay Paul and someone has to suffer.

We do agree on some points, but it is good to have different views and a balanced discussion as it enables us to look at both sides of the story and I have enjoyed reading your comments.


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## Lynn R (Feb 21, 2014)

Thank you, likewise and I enjoy a good debate!

Personally I never agreed with the practice of providing free translation services as I don't think it does anything to encourage newcomers to learn the language of the country they have moved to (as I think we all should, Britons coming to Spain included). Free language lessons are a better option and I would have no objection if attendance was made compulsory, either.


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## mrypg9 (Apr 26, 2008)

It's interesting that Germany and Nordic countries are extremely adverse to the use of credit....perhaps because workers' compensation is sufficient enough so they don't need to pay 'on the never-never'.
Wage levels in the UK for many sectors, both skilled and unskilled, are undeniably low. Yet many small businesses - and small and medium-sized businesses form the major part of our UK economy - simply cannot afford to increase wages and stay in business. So some kind of subsidy will be required.
Although the impact is small, immigration does have a downward effect on wages in the unskilled sector. On the other hand, the UK is an ageing population and needs immigration to pay taxes to fund future welfare and pension payments.
We often see immigration only in terms of economic benefit to the UK. We forget that the countries of origin of immigrants are losing skilled, economically active people, trained at the expense of the country of origin.
We also neglect the cultural impact of mass immigration on small, rural UK communities, whose inhabitants were not consulted or forewarned about the changes that were to take place very suddenly in their communities. Change may be inevitable, the pace of change can and should be managed.
When the Single European Act permitting free movement of goods, labour, capital across the EU was signed in 1987, no-one foresaw the coming disintegration of the socialist bloc and the fact that millions of Eastern Europeans would want to take advantage of their new-found freedom to travel as economic migrants to richer western EU states.
Any renegotiation of the EU Treaties should seek to curb numbers entering the UK from the EU, as these are largely unskilled migrants, and give a more level playing field to migrants from the rest of the world who bring with them skills we lack. But there again, our gain is their loss.


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## Dunpleecin (Dec 20, 2012)

All the discussion has confused me somewhat. I'm sure I read that as of 30th April I think it was, a person of UK state retirement age (and presumably receiving their UK pension) living abroad, for example Spain, would be entitled to the same level of healthcare as a UK resident when in the UK.

Has this now been changed or is it still the case?


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## baldilocks (Mar 7, 2010)

Dunpleecin said:


> All the discussion has confused me somewhat. I'm sure I read that as of 30th April I think it was, a person of UK state retirement age (and presumably receiving their UK pension) living abroad, for example Spain, would be entitled to the same level of healthcare as a UK resident when in the UK.
> 
> Has this now been changed or is it still the case?


No it hasn't changed and No, that is not the case. If you have retired (as in drawing your OAP), you can ask DWP in Newcastle for a From S1 for yourself and dependants who will be moving to Spain with you. On processing this you will be issued with a Health card that will give you access to the Spanish healthcare system on the same basis as a Spanish pensioner.


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## Dunpleecin (Dec 20, 2012)

Thanks Baldilocks. What I meant was when one had already registered for Spanish healthcare with the S1s, if they are of retirement age they can still receive UK healthcare when in the UK?


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## baldilocks (Mar 7, 2010)

As I understand it, the same as in any other EU country - with your EHIC, but be aware that the service offered under EHIC is only the same as any other EU national would get, i.e. not the full NHS with all the bells and whistles.


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## snikpoh (Nov 19, 2007)

Dunpleecin said:


> All the discussion has confused me somewhat. I'm sure I read that as of 30th April I think it was, a person of UK state retirement age (and presumably receiving their UK pension) living abroad, for example Spain, would be entitled to the same level of healthcare as a UK resident when in the UK.
> 
> Has this now been changed or is it still the case?


This was mooted and then discussed back and forth but I think it never actually came in to law (that's how I understand it anyway).

The situation now is as Baldi states.


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## Gazeebo (Jan 23, 2015)

mrypg9 said:


> It's interesting that Germany and Nordic countries are extremely adverse to the use of credit....perhaps because workers' compensation is sufficient enough so they don't need to pay 'on the never-never'.
> Wage levels in the UK for many sectors, both skilled and unskilled, are undeniably low. Yet many small businesses - and small and medium-sized businesses form the major part of our UK economy - simply cannot afford to increase wages and stay in business. So some kind of subsidy will be required.
> Although the impact is small, immigration does have a downward effect on wages in the unskilled sector. On the other hand, the UK is an ageing population and needs immigration to pay taxes to fund future welfare and pension payments.
> We often see immigration only in terms of economic benefit to the UK. We forget that the countries of origin of immigrants are losing skilled, economically active people, trained at the expense of the country of origin.
> ...


Your point on losing skilled workers - we have had a great influx of Spanish nurses to our local hospital and it is probably going on in the rest of the UK with nurses from all over the world. I often wonder what impact it is having on Spain? It is sad that they have to come here for work, as often, they would like to stay in their country.

Also, where I live at present is a rural area and the 'locals' have not been used to other nationalities sharing their town. I am lucky that I originate from London and have experienced sharing my life with people from lots of different cultures and countries, which has certainly enriched my life.


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## Lynn R (Feb 21, 2014)

Gazeebo said:


> Your point on losing skilled workers - we have had a great influx of Spanish nurses to our local hospital and it is probably going on in the rest of the UK with nurses from all over the world. I often wonder what impact it is having on Spain? It is sad that they have to come here for work, as often, they would like to stay in their country.


It's not that the Spanish nurses are quitting jobs in the Spanish health service for better paid ones in the UK or elsewhere. The problem is that due to the austerity cuts, there are no jobs for them here so they are forced to look further afield. So yes, the health service here is suffering, but it is cuts that are to blame rather than other countries poaching their staff. If the nurses stayed here, they would remain unemployed or only on short term temporary contracts, and the vacancies in the NHS would remain unfilled.


Meet the Spanish nurses desperate for a job in the NHS | Society | The Guardian

The employment of Spanish nurses is not just a recent thing anyway. It has been going on for at least 10 years. The UK does not train enough nurses to start with. Then a substantial number decide to leave the profession due to dissatisfaction, and some move overseas for better pay and conditions. I was listening to the news this morning about the Health Secretary wanting to crack down on agencies charging sky-high fees for doctors and nurses to cover shifts in the NHS, and someone said 50% of British nurses are nearing retirement age. I believe the figures for GPs nearing retirement age are also very high. It's a big problem, and one that is only going to get bigger.


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## madcow (Jan 10, 2010)

UK state pensioners who live elsewhere in the EEA will now have the same rights to NHS care as people who live in England. This applies to all pensioners who receive a UK state retirement pension and registered for healthcare in Europe with an S1 form.

https://www.gov.uk/government/news/new-rules-to-improve-overseas-visitors-contributions-to-nhs-care

This statement says to me , we UK state pensioners who live in Spain , Cyprus etc can go back to the uk at any time for treatment . What is your opinion ?


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## xabiaxica (Jun 23, 2009)

madcow said:


> UK state pensioners who live elsewhere in the EEA will now have the same rights to NHS care as people who live in England. This applies to all pensioners who receive a UK state retirement pension and registered for healthcare in Europe with an S1 form.
> 
> https://www.gov.uk/government/news/new-rules-to-improve-overseas-visitors-contributions-to-nhs-care
> 
> This statement says to me , we UK state pensioners who live in Spain , Cyprus etc can go back to the uk at any time for treatment . What is your opinion ?


yes that was the plan - but after the elections that all changed as written in the link on the first post of this thread  


Government U-turn on NHS access for expats - Telegraph


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## madcow (Jan 10, 2010)

But did I miss something the Telegraph article just goes on about expats not in EU countries .

And the telegraph does not provide a link to a government site to back up thier story .


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## Lynn R (Feb 21, 2014)

I really can't see how a plan to allow expats access to the NHS could work in practice for the majority of people, anyway. Surely if you need an operation, for example, it's not just a question of turning up at a hospital and getting booked in. Firstly you'd need to see a GP, get a referral, have tests done (which may take weeks or perhaps months depending on the condition), then there'd be a waiting list for surgery, sometimes you get a phone call saying "we've had a cancellation, can you come in tomorrow" and other times, unfortunately, people turn up expecting to be admitted for surgery and are told sorry, your operation has had to be postponed. Unless someone has a property standing empty in the UK which they can live in temporarily, it just wouldn't be practical, would it? I know it wouldn't be for me.


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## xabiaxica (Jun 23, 2009)

Lynn R said:


> I really can't see how a plan to allow expats access to the NHS could work in practice for the majority of people, anyway. Surely if you need an operation, for example, it's not just a question of turning up at a hospital and getting booked in. Firstly you'd need to see a GP, get a referral, have tests done (which may take weeks or perhaps months depending on the condition), then there'd be a waiting list for surgery, sometimes you get a phone call saying "we've had a cancellation, can you come in tomorrow" and other times, unfortunately, people turn up expecting to be admitted for surgery and are told sorry, your operation has had to be postponed. Unless someone has a property standing empty in the UK which they can live in temporarily, it just wouldn't be practical, would it? I know it wouldn't be for me.



thing is - as I think I said earlier on this thread - your doctor in Spain can send you to the UK ( or any other country which has the agreement) for treatment including surgery

it's unlikely to happen though from Spain, since waiting times are generally less here 


I can't see how that would have worked anyway - the proposals I mean - since the UK pays for the healthcare in EU countries for pensioners - if they are then opting to use the UK NHS, that's costing twice, surely?


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## CapnBilly (Jun 7, 2011)

xabiachica said:


> thing is - as I think I said earlier on this thread - your doctor in Spain can send you to the UK ( or any other country which has the agreement) for treatment including surgery
> 
> it's unlikely to happen though from Spain, since waiting times are generally less here
> 
> ...


Just to clarify, state pensioners who are registered in Spain under an S1 are entitled to free hospital treatment, except for pre planned treatment which has to be arranged under an S2. British citizens resident in Spain not in receipt of a state pension would have to pay if they are referred for hospital treatment. Emergency treatment is free for all anyway. 

This was introduced following a consultation in 2013. That consultation also mentioned offering the same for non state pensioners who had made a minimum number of national insurance contributions. That proposal was kicked into the long grass, and is now not going to happen. That is what the article is about.

The benefit to the UK of allowing state pensioners access is that they are allowed to reduce the payment they make to Spain for each registered by S1 By 5%. So the theory us they will save money. Estimated cost reduction in all payments is about £45m.


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## Isobella (Oct 16, 2014)

xabiachica said:


> thing is - as I think I said earlier on this thread - your doctor in Spain can send you to the UK ( or any other country which has the agreement) for treatment including surgery
> 
> *it's unlikely to happen though from Spain, since waiting times are generally less here *


Perhaps less in your area but Murcia an average of 122 days wait and last week in El Pais stated that there are 77,000+ on the waiting list in Madrid around 5000 more than last year.

OECD stats show that eg. waiting time for a hip operation in Spain is 150 days whilst only 90 days in the UK. 

Agree with Lynn, having an operation in another country to where you live is not practical. Even if you can stay with relatives it puts a strain on relationships.


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