On Spouse Visa, 8 weeks pregnant, called PALS, still denied entitlement

This was my original post:  http://talk.uk-yankee.com/index.php?topic=12106.msg1021515#msg1021515

On Thursday, I got a phone call from the GP office manager.  She said that according to her sources, I and my baby would not be entitled to free NHS unless I've been in country for 6 months, but that she'd 'let me slide' and get me registered with a NHS number.  I did say that according to my resources (you guys), that wasn't the case but that I'd go in to complete the forms anyways.

I thought everything would be sorted.  However, I received a phone call from a Sue Foster at Private Patient Overseas Office, Wigan Infirmary and she says that my husband and I will have to pay for the delivery of our child, since I had not been in country for 12 months, unless we can provide proof that I will be permanently residing in the UK.  She said that she required:

 - A completed residency form.  She told my husband (British Citizen, my sponsor) that it didn't matter if I wouldn't be able to submit it until 28 days before my Spouse visa expired; I could just give her a copy of a completed form.
 - Proof of primary residence/property in the US sold.  We have not sold our property in the US because of the state of the housing market.  If we sold the house now, we would be taking a loss.  Therefore we are currently leasing it out and drawing an income from it.
 - A one way plane ticket stub to the UK.  It didn't matter to her that purchasing return plane tickets were cheaper and that I never used the return ticket.  She requires a one way plane ticket stub.

Sue told my husband that these requirements were per changes to the Dept of Health policies dated June 23 2011.

Sue said that she would not accept utility bills that are in both of our names.  Sue said that she would not accept proof from my husband that he has taken over the family business and has registered for VAT, etc.

Sue also said that if we paid upfront and then later it was found that we were entitled to free NHS after, that we would be refunded the money.


The midwife has now phoned back and confirmed that while I'm registered for free NHS services when treated directly by the GP, I may have to pay for midwife services.  My husband asked her to make some more phone calls to confirm her information.  She phoned back to say that NHS Trust is going to bill us and we'll have to claim it back after the fact if its found that I was entitled to free NHS treatment.  My husband conceded since we've already had to wait over a month just to be seen for pre-natal care.


We've contacted our local main officer for PALS who referred us to someone else in PALS.  My husband was told that they can't do anything because they deal with only patient complaints.


This is going in all sorts of directions.  Thoughts?  Advice?  Anyone with similar kick backs?  Where did the DoH policy change June 23, 2011 come from?

As far as I know the only proof you need to be entitled to NHS treatment is the spouse visa in your passport!

And what is up with proof that you've sold your US home?  What if you never even owned a home in the US?  What if you own a home and choose to keep it as an investment?  It's nothing to do with the NHS and none of their business, really!

What a nightmare! 

I just looked at your original thread and realized that CharmCityGirl gave the same answer as me.

What a nightmare! 

Indeed!  I mean who is this Sue person who is asking you for the impossible?  What is her problem?  A one way ticket stub after you've already gotten here on a two-way ticket?  Ridiculous! 

I wonder if they think that you are an NHS tourist ie you've just come over for free treatment and then you will return to the US. 

Yes.  I agree.

I think they might be confused about the whole returning resident and all that.

I was asked when I went to the hospital if I had moved to the UK in the past year.  I'd been here longer than that, but even if I wasn't I was still able to use the NHS.

I wonder if they think that you are an NHS tourist ie you've just come over for free treatment and then you will return to the US. 

But she's married to a British citizen and here on the proper visa, so that shouldn't even matter should it?  

Yes, but I guess it is because she and her husband recently moved back together.

Here is what CAB has to say:

You can receive free NHS hospital treatment if you:-

    have been living legally in the UK for at least 12 months when you start treatment, and did not come to the UK for private medical treatment. Temporary absences from the UK of up to three months (in England, up to 182 days) are ignored
    have come to the UK to take up permanent residence, for example, if you are a former UK resident who has returned from abroad, or if you have been granted leave to enter or remain as a spouse
    have come to the UK to work, either as an employee or self-employed person. In England and Wales, if you are employed, your employer's main place of business must be in the UK or be registered in the UK. This could be, for example, a branch of an overseas company. If you are self-employed your main place of business must be in the UK
    normally work in the UK, but are temporarily working abroad for less than five years. You also need to have lived in the UK continuously for at least ten years before going overseas.

http://www.adviceguide.org.uk/index/your_family/health_index_ew/nhs_charges_for_people_from_abroad.htm

Maybe you should call CAB?

It seems maybe people are concerned over whether you are an ordinary resident?

I always thought that certain valid visas, such as a spouse visa in your passport meant NHS entitlement
Here's some information on accessing the NHS as a foreign national from 2011 - not sure if this is what they are referring to:
http://www.dh.gov.uk/en/Consultations/Responsestoconsultations/DH_125271 

However, if you are taking up permanent residence in the UK, it would seem from this Department of Health website that:
 
'If you do not have an automatic right to take up permanent residence but have applied to the Home Office for leave to enter/remain on a settled basis, you will be chargeable for any hospital treatment up to the point your application is granted or until you accrue 12 months lawful residence in the UK. [emphasis mine]

Once you are living here permanently you will become ordinarily resident and the Regulations will cease to apply to you. Your spouse, civil partner and child will also be considered ordinarily resident if they are living permanently in the UK with you and have the right to do so.  If they are not living permanently in the UK then the Regulations will apply and in order to be entitled to free hospital treatment they will have to meet one of the categories of exemption in their own right.

In common with those ordinarily resident in the UK, anyone who meets the criteria of ordinary residence or is exempt from charges for hospital treatment will have to pay statutory NHS charges, eg prescription charges, unless they also qualify for exemption from these, and will have to go onto waiting lists for treatment where appropriate.'

From:

http://www.dh.gov.uk/en/Healthcare/Entitlementsandcharges/OverseasVisitors/Browsable/DH_074376

I'd suggest you contact CAB for advice and clarification. Good luck! 

xposted w/ bookgirl

Quote
You can receive free NHS hospital treatment if you:-

    have been living legally in the UK for at least 12 months when you start treatment, and did not come to the UK for private medical treatment. Temporary absences from the UK of up to three months (in England, up to 182 days) are ignored
    have come to the UK to take up permanent residence, for example, if you are a former UK resident who has returned from abroad, or if you have been granted leave to enter or remain as a spouse
    have come to the UK to work, either as an employee or self-employed person. In England and Wales, if you are employed, your employer's main place of business must be in the UK or be registered in the UK. This could be, for example, a branch of an overseas company. If you are self-employed your main place of business must be in the UK
    normally work in the UK, but are temporarily working abroad for less than five years. You also need to have lived in the UK continuously for at least ten years before going overseas.

Are these ands or ors?

I think if you click on the link, it seems to be bullet points. 

It seems maybe people are concerned over whether you are an ordinary resident?
 
'If you do not have an automatic right to take up permanent residence but have applied to the Home Office for leave to enter/remain on a settled basis, you will be chargeable for any hospital treatment up to the point your application is granted or until you accrue 12 months lawful residence in the UK. [emphasis mine]

See I read this as the ILE does give people an automatic right and this is talking about some other application?! Do they mean the leave to remain angle not being automatic?

It is confusing what is meant by habitual resident and ordinary resident! I know with the former (I can come back with that link that a great forum member gave me), each local authority decides on each individual situation.

'If you do not have an automatic right to take up permanent residence but have applied to the Home Office for leave to enter/remain on a settled basis, you will be chargeable for any hospital treatment up to the point your application is granted or until you accrue 12 months lawful residence in the UK. [emphasis mine]

However, if you read the next part:

"If you do not have an automatic right to take up permanent residence but have applied to the Home Office for leave to enter/remain on a settled basis, you will be chargeable for any hospital treatment up to the point your application is granted or until you accrue 12 months lawful residence in the UK.

Once you are living here permanently you will become ordinarily resident and the Regulations will cease to apply to you. Your spouse, civil partner and child will also be considered ordinarily resident if they are living permanently in the UK with you and have the right to do so. If they are not living permanently in the UK then the Regulations will apply and in order to be entitled to free hospital treatment they will have to meet one of the categories of exemption in their own right."

Say the person in the first paragraph is the UK citizen - they already have permanent residence, so they are eligible for NHS care without having to wait 12 months. The second paragraph states that their spouse will also be eligible if they are living with them permanently.

The page I've quoted below states that someone on a fiance visa is considered to be taking up permanent residence and will become ordinarily resident once they are married... so I don't see why a spousal visa holder wouldn't be considered ordinarily resident since they are in the same position as a fiance visa holder who has gained FLR(M).

From this page for people on fiance visas:
Are you coming to the UK to marry a person living in the UK?

A person who has been given leave to enter the UK by the Home Office to marry or become the civil partner of someone who is ordinarily resident here may be regarded as taking up permanent residence, and therefore exempt from charges for NHS hospital treatment.  This exemption would extend to your children (under the age of 16, or 19 if in further education) if they come to live here with you on a permanent basis.

Once you are living here permanently and have married or become a civil partner you will become ordinarily resident in your own right and the Regulations will cease to apply to you. So will your children if they are living with you permanently.

See I read this as the ILE does give people an automatic right and this is talking about some other application?! Do they mean the leave to remain angle not being automatic?

The OP doesn't have ILE, though, she's on a spouse visa.  

Regardless, a spouse visa does mean immediate access to free NHS treatment.  I suspect they're giving her a hard time because UKBA is cracking down on NHS abuse and they're afraid of making a mistake.  You've got to push your case.  Print out the UKBA page and take it to the GP.  Contact the CAB.  Remember that you are in the right and they are misinformed, and stick with it!  Good luck.  

I suppose if CAB doesn't get you anywhere, your DH can contact your local MP.