| Chapter 13: Reciprocal Health Care Agreements with Non-EEA
Countries |
Statutory/Manual
References |
| General
Arrangements |
|
| 1. The UK currently
has reciprocal health care agreements with the following non-EEA countries: |
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| List 1 Countries (see
para. 2, page 44) |
List 2 Countries (see
para. 3, page 44) |
1989 Regs 4(o), 5(c) and (e),
Schedule 2 |
| Bulgaria |
Anguilla1 |
|
| Czech Republic |
Australia |
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| Gibraltar1 |
Barbados |
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| Hungary |
British Virgin Islands1 |
|
| Malta1 |
Channel Islands1 |
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| New Zealand |
Falklands Islands1 |
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| Russian Federation |
Iceland2 |
|
| Slovak Republic |
Isle of Man1 |
|
| former Soviet Union states1(i)
Montserrat1 |
Monserrat |
|
| former Yugoslavia1(ii) |
Poland |
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|
Romania |
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|
St Helena1 |
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|
Sweden2 |
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|
Turks & Caicos Islands1 |
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1 Under the terms of the reciprocal health
care agreements with these countries, exemption from NHS charges also applies to citizens
or nationals who have been referred to the UK specifically for NHS treatment. Such
referrals normally occur where the home country cannot provide the treatment
required.
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i. former Soviet Union: Armenia, Azerbaijan,
Belarus, Georgia, Kazakhstan, Kirgizstan, Moldova, Tajikstan, Turkmenistan, Uzbekistan and
Ukraine. This does not include the Baltic States (Estonia, Latvia and
Lithuania). (See paragraph 13 for the restrictions applying to referrals for treatment of
overseas visitors from the former Soviet Union).
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ii. former Yugoslavia: Serbia and Montenegro
and successor states Bosnia, Croatia, Macedonia and Slovenia. (See paragraph 14 for
restrictions applying to referrals for treatment of overseas visitors from the former
Yugoslavia.)
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2 Non -EEA nationals resident
in Iceland and Sweden may also be covered for emergency health treatment in the UK under
separate reciprocal health care agreements with these countries. Visitors will need to
produce their home health or benefits authority medical card to qualify for exemption from
NHS charges on the same basis as any other UK resident.
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|
| Note:
The UK's reciprocal health care agreement with Hong Kong was terminated at midnight on 30
June 1997. From 1 July 1997, therefore, Hong Kong residents are no longer entitled to
exemption from NHS charges under the terms of the former agreement, although they may
qualify for exemption on other grounds. |
|
| List 1 Countries |
|
| 2. The agreements
with these countries cover nationals who are resident in the country concerned. People who
can present a passport or other credible evidence showing that they are nationals of these
countries should be treated as exempt from NHS charges in respect of "treatment the
need for which arose during the visit". |
Chapter 2 |
| List 2 Countries |
|
| 3. The agreements
with these countries cover all residents of these countries regardless of nationality.
People who can present either a passport or residence permit,
identity card or home health or benefits authority document showing that they are resident
in a listed country are exempt from NHS charges in respect of
"treatment the need for which arose during the visit". |
Chapter 2 |
| Quota Territories |
|
4. Quota arrangements
apply to the number of patients who can be referred for treatment to the UK from the
islands noted. Patients accepted by the UK under these arrangements are exempt from NHS
charges. NHS hospitals will be notified in advance of patients authorised to come for
treatment under these arrangements. The quota arrangements are monitored by the DH.
- the UK dependent territories of Anguilla, British Virgin Islands, Montserrat (see
paragraphs 7-9), St Helena, and the Turks and Caicos Islands; and
- Gibraltar and Malta
Note: Patients from Gibraltar and Malta must produce a letter from their
home health or benefits authority confirming that they have either been referred as part
of the agreed quota arrangements with the UK or are being referred and the care paid for
by the home health or benefits authority - not the patient. If neither
document can be presented the patient should be considered as a self-referral and
therefore subject to NHS charges.
5. In each case The Scottish Office Department of Health Overseas Visitors Branch
should be advised (tel: 0131 556 8400) of patients coming under these
arrangements. |
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| 6. When quotas are
exhausted in year, patients may be referred to the UK by the health authorities of these
countries but will face NHS charges under the NHS (Charges to Overseas Visitors)
(Scotland) Regulations 1989. Where doubt exists contact The Scottish Office Department of
Health Overseas Visitors Branch (tel: 0131 556 8400). |
|
| Caribbean Islands |
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| 7. Quota arrangements
with the Caribbean are limited to 4 patients (only, per year) from each island. All
such referrals must be arranged on a UK Government Department and Caribbean Island
Government Department basis. All referrals must be arranged through the Department of
Health, London. |
|
| 8. No
direct referrals from Caribbean hospitals, consultants, patients or indeed any other
mechanism should be accepted by any NHS hospital. Direct approaches should be reported to
The Scottish Office Department of Health Overseas Visitors Branch
(tel: 0131 556 8400). |
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| 9. Quota numbers
under these arrangements are determined on a UK basis by the Department of Health, London. |
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| Special
Arrangements |
|
| 10. Patients from the
Channel Islands, Falkland Islands, Isle of Man, the former Soviet Union, except Russia and
the Baltic States (Estonia, Latvia and Lithuania) (see paragraph 13) and the former
Yugoslavia (see paragraph 14) may also be referred for NHS treatment from the country of
origin. Advance arrangements should be made. Patients arriving under these arrangements
are entitled to the same NHS clinical priority as those in the UK. |
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| Channel Islands,
Falkland Islands, Isle of Man |
|
11. The islands noted
below may refer patients to the UK for treatment. While there is no limit on
the number of patient referrals their home health or benefits authorities have been asked
to ensure that advance arrangements are made with the relevant NHS hospital and that
patients bring with them credible documentation indicating that they have been referred
by their home health or benefits authority for the purpose stated.
- Channel Islands, the Isle of Man; and
- Falkland Islands
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| 12. Patients from
these islands who are in the UK undergoing full-time education or training may require NHS
treatment, the need for which did not arise in the UK. It would be
unreasonable to expect the patient to return home simply to have themselves referred back
to the UK for treatment. In such cases the patient should be regarded as exempt from NHS
charges. |
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| Former Soviet
Union states |
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| 13. Referrals for
treatment from the former Soviet Union except the Russian Federation and the Baltic States
(Estonia, Latvia and Lithuania) must be arranged on a UK Government Department and
appropriate former Soviet Union Government Department basis. All referrals must be
arranged through the Department of Health, London. No direct referrals from
former Soviet Union hospitals, consultants, patients or indeed any other mechanism should
be accepted by the NHS hospital. Any direct approaches should be reported to The Scottish
Office Department of Health Overseas Visitors Branch
(tel: 0131 556 8400). |
|
| Former Yugoslavia |
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| 14. For nationals of
the former states of Yugoslavia (ie Serbia and Montenegro and
successor states Croatia, Bosnia, Slovenia, Macedonia) all hospital treatment is exempt
from NHS charges. However, for UK monitoring purposes hospitals are asked to
notify The Scottish Office of all cases where such patients have been referred to the UK
specifically for treatment by the patient's home health or benefits authority. In such
circumstances please write to:
The Scottish Office Department of Health
Overseas Visitors Branch
St Andrew’s House
Edinburgh
EH1 3DG
Note: The Scottish Office Department of Health Overseas Visitors Branch
will submit to the Department of Health, London annual returns on patients receiving NHS
treatment under these arrangements. |
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| Australia |
|
| 15. Renal dialysis is
the subject of a specific understanding between the UK and Australia, to the effect that
such care would be regarded as immediately necessary NHS treatment, and thus within the
scope of the UK/Australia reciprocal health care agreement, subject to prior arrangement
and spare capacity in the renal unit. In view of this no NHS charge should
be made. |
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| 16. This provision is
unique to Australia and does not appear in any other agreements that the UK
has with non-EEA countries. For renal dialysis arrangements for the
treatment of nationals of EEA member states see Chapter 12. |
Chapter 12 |
| Israel |
|
| 17. There is a
limited social security reciprocal health care arrangement with Israel under which someone
entitled to industrial injuries benefit in Israel is exempt from NHS charges for treatment
arising from the industrial injury or occupational disease. The visitor should be asked to
produce credible proof of entitlement. |
1989 Regs Schedule 2 |
| Turkey |
|
| 18. The European
Convention on Social and Medical Assistance (1954) has been largely replaced by the
UK’s system of reciprocal health care agreements or EC Regulations. The only
signatory to the Convention not covered by these later arrangements is
Turkey. A Turkish national in the UK requiring "treatment the need for which arose
during the visit", could be regarded as exempt from NHS charges if
he/she can prove that they are without sufficient resources to meet the cost of immediate
care. However, exemption from NHS charges is restricted to
those nationals who are in the UK and are genuinely without resources or insurance to meet
the cost of medical assistance. The appropriate Embassy may be of help in cases of doubt. |
1989 Reg 5(d) and Chapter 2 |
| Cyprus |
|
| 19. A Cypriot
national in the UK and who requires "treatment the need for which arose during the
visit" could be regarded as exempt from NHS charges providing he/she can prove that
they are without sufficient resource to meet the cost of immediate care. However,
exemption from NHS charges is restricted to those nationals who are in the UK and are
genuinely without resources or insurance to meet the cost of medical assistance. The
appropriate Embassy may be of help in cases of doubt. |
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