New UK government contingency plans on reciprocal health care - reassurance, or smoke and mirrors?

Early this morning the UK government put out a press statement outlining its latest contingency plans on the reciprocal health care system - otherwise known as the S1 scheme. You may have heard Matt Hancock on the Today programme (we didn't, as this article was written before his interview!).

A quick reminder of what the S1 scheme is before we go any further: those with state pension and some disability benefits living in the EU have their health care funded by the UK rather than the country they live in, as do some posted workers and students. The same applies to, say, a retired French person living in the UK with a French pension, who will have her health care costs funded by France. The S1 is the name of the form used to certify those rights (it used to be called the E121).

So what does this latest government statement say? 

In a nutshell it says this: that for 6 months after a no deal Brexit the UK Government will reimburse the healthcare costs (or pay providers directly where necessary) for current holders of an S1 form. This is, it says, "to ensure people are not exposed to gaps in healthcare coverage and potentially high costs while they register for healthcare locally".

To be eligible for this support, people must apply to join their local health care schemes within local timeframes or no later than six months after we leave, whichever is the shortest." It goes on to say that "to be eligible for this support, people must apply within local timeframes or no later than six months after we leave, whichever is the shortest."

The statement adds that the government has proposed to each EU Member State that, if we leave without a deal, "existing healthcare arrangements should continue until 31 December 2020 in the same way that they do now".

And more importantly, what does it mean?

Ah, that's a little more difficult.

What we know

 The statement tells us that
  • If you're an S1 holder resident in France, the UK will continue to fund your health care for at least 6 months from the day of a no deal exit . But ...
  • In order to benefit from this you'll have to apply to join your local health care system within 6 months, or within 'local timescales' if they are shorter.

    We also know that
  • Under the French no deal ordonnance, if you're covered under the S1 scheme and are legally resident in France on the day of a no deal Brexit, you will continue to benefit from health cover for yourself and your dependents for a period of 2 years ‘under the same conditions as a person covered under the French régime’.
  • That period of 2 years may be reduced if a bilateral health care agreement is concluded with the UK that would continue a reciprocal health care system between the two countries.
  • If at the end of the two year period there is no bilateral agreement between France and the UK, then the means of access to the health care system for S1 holders will be re-examined.
See more about the French no deal planning on health care on our website, here:

What we don't know 

What we don't know, however - at least not yet - is how those two things - the UK statement and the French ordonnance - tie up. 
  • We don't know - and this is really important - whether the UK government is continuing to seek permanent bilateral agreements on health care with the various EU Member States that would continue reciprocal health care arrangements on an ongoing basis.
  • We don't know whether France is likely to reduce its 2 years health care cover in the light of the UK statement.
  • We don't know exactly what S1 holders in France will be required to do - will they have to make an application to join PUMa, and if so when? Or will the switch, if and when there is one, happen automatically?
  • And we still don't know whether, under the health care provisions of the ordonnance, cotisations to PUMa and/or social charges on pension income would be payable.
  • In other words, we don't know very much at all!

So is this good news, bad news, or what?

Honest answer? It's not great. In fact we at British in Europe aren't happy with it at all, as you'll no doubt read in the statement we've put out today. 

As Jeremy Morgan, a fellow steering team member, says "This is yet more smoke and mirrors from the UK government and another massive let-down for UK pensioners in the EU 27. Having paid UK taxes and contributions all their working lives, when they moved to their host country, they had the right and expectation to UK government funded medical treatment for life.  This was a key factor in the decision of many when moving".

Eeek - should we be panicking? 

No. Take a deep breath, because ...

First of all, if there IS a deal, reciprocal health care for life is included and your S1 rights will continue without interruption.

And secondly, if there is no deal, and even if the S1 scheme falls away after 6 months or after 31 December 2020, those of us in France are relatively lucky, as everyone who has lived here legally for at least 3 months is eligible to join the universal health care system, PUMa. Although only those with capital/investment income of more than 20k per year (pension income is excluded from the calculation) everyone would be subject to social charges of 9-10% on their pension income, just as French pensioners are.

You'll find some basic information about PUMa on this page of our website (and we'll be updating and expanding it as soon as possible):

Some of you may know that there is an old (1956, came into effect 1958) bilateral agreement between France and the UK that obviously predates the EU. Earlier this year a Parliamentary question was asked about whether this would still stand in the absence of an EU wide agreement: the answer given was that this would be considered. More recently, we've brought the issue up at meetings with officials in London, who are fully aware of the old legislation but confirm that no decision has been made whether it would be resurrected. This would be a political decision.

What now?

Well, there's no doubt for us that the withdrawal of the reciprocal health care scheme - whether that be after 6 months or on 31 Decemeber 2020 - that many people assumed would cover them for life is a travesty of natural justice. We at British in Europe will be making that point strongly this week as well as asking questions to fill in the gaps. We'll also continue to push for the rights contained in the current withdrawal agreement to be ring-fenced. Here in France, we'll be adding the questions above to our list of issues to take up with government officials. 

Rest assured that we're all fighting your corner on this.

But if you're angry about this too, whether or not you're directly affected, then please write to your MP and/or directly to the Health Secretary Matt Hancock. If you have friends or relatives in the UK, please ask them to do the same on your behalf. Our voices need to be heard.


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