Our readers will be aware that the UK government has been keen to reduce the country’s financial deficit, and one way that they have been doing this is by charging people who live abroad for using the National Health Service in England (Scotland, Wales and Northern Ireland have slightly different NHS regimes).

This means that English overseas mission workers will no longer have the right to free NHS hospital treatment when they return to the country on home assignment, although GP services are unaffected.  This situation has been further complicated by Brexit

Global Connections have spearheaded the mission sector’s response to this proposals and you can find a more complete report on this at the Global Connections website.

• try to arrange with their agency if they have one, or their sponsoring ’employer’ if they don’t, to have a UK contract which stresses the temporary nature of their overseas assignment;
• make regular, purposeful visits to England for as long as possible, balancing this with the need to avoid becoming ‘ordinarily resident for tax purposes‘!;
• pay UK tax and National Insurance where appropriate;
• if they have children, enrol them in school or playgroup when they visit England;
• maintain an English postal address and receive meaningful post there (e.g. bank statements);
• if they own a home in England, have evidence of that with them when they visit.

We also suggest that overseas mission workers consider taking out health insurance to cover their visit to England in case they are denied free NHS care, as they will be charged 150% of the cost of any treatment they receive.  Our friends at Oscar have done some research and provided a list of insurers who may be willing to cover you for the cost of treatment.

In a second phase of ‘cost recovery’, the government is planning to extend charges to non-residents to other areas of the NHS in England.  The latest update from Global Connections can be read here.

April 2019 – the latest update on registering with a GP can be found here.

September 2021 – UK citizens ordinarily resident in EU countries do not have an automatic right to free treatment but if they have an EHIC card from the country in which they live, indicating they are part of that country’s insurance system, they can claim treatment using that.  Global Connections’ update on this can be found here.  Please note that a UK EHIC card is not valid for treatment in the UK.