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HEALTH

Brits in Italy could face health ‘black hole’

British people living in other European countries could find themselves forced to take out private health insurance, due to a clampdown on expats using the country’s National Health Service.

Brits in Italy could face health 'black hole'
Photo: Richard Pohle/AFP

Many British people in other EU countries return to the UK for routine doctors’ visits, and many fail to register with a local doctor in their new country, particularly in the early stages following a move abroad. In some countries, bureaucracy means registering with local health authorities can take years.

But under new rules that come into force this month, people who make use of the NHS in the UK will be asked to declare that they are ‘ordinarily resident’ in the country. Those who live elsewhere in the EU, Norway or Switzerland, and who want planned treatment could find themselves forced to pay up-front. 

Even expats seeking emergency treatment during short visits home could also face steep charges if they don’t have their paperwork from their new country in order, as the NHS seeks to claw back £500 million a year ($746 million, €695 million) in lost revenue.

Claire*, from London, has lived in Italy for two years, but still isn’t registered with an Italian doctor. When she needed a smear test recently, she opted to have it with her old doctor in London.

“I wanted to speak to an English doctor who I could speak with, felt comfortable with and I knew. And I knew it would be swift.”

“I haven’t registered with an Italian doctor yet as I haven’t got a residence permit in Italy yet, due to the kinds of bureaucratic delays that are typical in Italy. Without residency, I can’t register with the health service.”

Long-standing European arrangements state that EU citizens should seek healthcare in the country they live in, regardless of their citizenship. They can seek healthcare in other EU countries, but this must generally be authorised and billed back to their country of residence.

But in a change to UK rules, expats who want treatment in the UK have to show a European Health Insurance Card (EHIC) issued by their new country. Until this month, former UK residents were automatically entitled to use the NHS for free if they fell ill during a visit. In practice, many expats use the NHS for planned treatment too. But now this right is being removed.

The charges faced by patients without an EHIC card or proper insurance can be significant. Intensive care beds are charged at a rate of £1,800 a day (€2,495) plus the cost of procedures and drugs. Even hospital outpatient visits can be costly, at £248 per visit (€348).

The Royal Berkshire NHS Trust, one of 59 NHS Hospital Trusts in England, says on its website that patients who leave a debt could find their details registered with the UK Border Agency, meaning they could be stopped next time they try to enter or leave the country.

In an email to The Local, the UK Department of Health confirmed that there is no ‘grace period' following a move during which they can use the NHS – the moment they have left the country they lose their right to NHS treatment.

The new declaration could make it harder for expats to bypass the system, and new rules could leave expats with no option but to go private.

Joe Coaker of ALC Healthcare, a private insurer focused on expats, says Claire’s situation is not unusual.

“We often hear from expatriates who question the need for international health insurance as they imagine they can return to the UK and fall back on the NHS or the State healthcare in whichever country they come from,” he said.

There was better news for British retirees in Europe. Anyone living in the EU and receiving a British state pension will be entitled to free healthcare in the UK, as long as they hold a valid S1 form, which is obtained from British authorities before moving abroad. The move comes after the British government decided last year that it would stop paying the healthcare costs of UK pensioners who lived in other EU countries, leaving many facing big bills.

*Not her real name 

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HEALTH

Covid-19: Average life expectancy in Italy dropped by 1.2 years in 2020

Coronavirus cut average life expectancy in Italy by 1.2 years in 2020, and by more than four years in parts of the country hit hardest by the pandemic, official statistics showed on Monday.

Covid-19: Average life expectancy in Italy dropped by 1.2 years in 2020
A cemetery in Bergamo, one of the parts of Italy which has suffered the highest death toll during the coronavirus crisis. Photo: Miguel Medina/AFP

Life expectancy at birth last year stood at 82 years, compared to 83.2 years in 2019, the Istat national statistics office said in a new release.

“In 2020, the spread of the Covid-19 pandemic and the resulting sharp increase in mortality abruptly interrupted the growth in life expectancy at birth that had characterised the trend until 2019,” it said in a statement.

For many years Italy has boasted one of the longest life expectancies in Europe. But with the spread of the coronavirus, its ageing population was especially vulnerable to falling sick.

Italy has recorded close to 130,000 deaths from Covid-19 in total, which have mainly been among the elderly.

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The drop in life expectancy was even steeper in some regions such as the northern provinces of Bergamo and Cremona, the epicentre of the Covid-19 outbreak in early 2020.

Men lost on average 4.3 and 4.5 years while women lost 3.2 years and 2.9 years in these areas.

More than 129,500 people with coronavirus have died in Italy, the majority in the northern regions where 36 percent of the population lives.

According to Istat, the pandemic has wiped out many of the gains made year-on-year since 2010, when Italy’s average life expectancy was 81.7.

Italy was the first European country to face a major outbreak of Covid-19 and for a time the region of Lombardy, the nation’s economic heart, became the epicentre of the global pandemic.

Quality of life has also been impacted in Italy, particulary due to the economic repercussions of the crisis.

The government has since rolled out a vaccination programme that, as of Monday evening, had almost 72 percent of the population over 12 fully immunised.

Italy has set a target of vaccinating at least 80 percent of the population by the end of September.

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