Brexit: Why British pensioners in Italy face losing access to Italian healthcare

This week, campaigners from British in Italy explain how British pensioners in the country face having their access to Italian medical care cruelly snatched away.

Brexit: Why British pensioners in Italy face losing access to Italian healthcare
Photo: Depositphotos

During January and February this year, as the shenanigans in Westminster gathered pace, many British residents in Italy were shocked to see on UK government websites (including that of the NHS) the advice to pensioners resident across the EU to obtain their S1 from the Department of Work and Pensions before 29th March 2019 to ensure their entitlement to healthcare in their country of residence.

At the bottom of the page it goes on to say that the S1 will not be valid after 30th March 2019.

It’s like reading the leaflet on some dodgy appliance you’ve purchased on the internet – “Congratulations on your new card. You are now proudly in possession of the ‘must-have’ health insurance for the elderly. Enjoy. Terms and Conditions apply. Read the small print”. and the small print says “WARNING. Your new insurance is no longer valid”.

It’s not some dark, evil joke but it could be.

What is the S1?

Unlike the EHIC card, a nice-to-have form of travel insurance for health emergencies when on holiday or moving around in Europe, the S1 is quite literally a life-saving certificate for many.

As we get older many of us develop conditions that require a cocktail of daily medication – whether it is due to thyroid malfunction or Aids-related problems, heart disease or diabetes – the S1 is like our NHS providing us with the medical care we need.

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Without it, life-saving treatments and drugs for those with cancer or kidney failure, or admission to a nursing home for the very elderly, would simply not be possible.

The S1 means we can access the health system – the Servizio Sanitario Nazionale (SSN) – here in Italy on the same terms as Italian citizens at no extra costs, paying simply the ‘ticket’ on the same basis as Italians. The UK government picks up the bill, or will do until Brexit.

What happens next?

We don’t know.

If, and that is a big if, the Withdrawal Agreement is finally approved by the UK parliament, then our S1 rights continue. But given that a No Deal is more likely, what then?

The lack of certainty is causing huge distress and alarm to the most vulnerable of us. The S1 is an EU wide scheme which for us British nationals, automatically expires with Brexit.

Despite meetings with high level officials in the DWP and DHSC in London and pleading with the government to agree to continue the payments, they have failed to do so.

We are quite simply just ‘collateral damage’.

The Italian government, perhaps understandably, is reluctant to pick up the bill outright. After all, it is not they who have chosen to leave the EU but Britain.

They have assured British in Italy that people will not be refused healthcare. In our most recent meeting on February 20th they said that the Italian government’s clear intention is, subject to further technical discussions, to work towards the protection of this access on the same terms as now – so those British residents who presently have access to the SSN without payment (other than the “ticket”) will continue to do so. 

If we’re lucky, there will be a bilateral agreement to continue it. But that requires the UK to reach 26 bilateral agreements with 26 different EU countries in the next 30 odd days.

Unlikely, given that despite endless globetrotting in the past two years, the Department of Trade and the Foreign Office between them have managed to arrange a mere 7 trade deals out of the necessary 69 needed globally to keep UK Plc afloat. And those achieved were with such important traders as the Faroe Islands and the Seychelles.

We in British in Italy will continue to campaign to persuade the UK government to continue the S1 – at least until a bilateral agreement is in place – and to encourage the Italian government to achieve their goal in this regard.

We can’t promise anything unfortunately as we’re not the participants, merely the ‘collateral damage’.

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Brexit: Brits in EU feel European and don’t want to return home

The majority of Britons who live in the EU, Norway, Iceland or Switzerland and are protected under the Brexit agreement feel European and intend to remain in Europe permanently, but many have concerns about travel problems, a new survey reveals.

Brexit: Brits in EU feel European and don't want to return home

The research also shows that problems exist and “travel is where most issues relating to the new status currently occur”. For instance, border officials are still stamping passports of UK citizens with residence rights under the EU UK withdrawal agreement, even though they shouldn’t.

“There is constant confusion around passport stamping. I was ‘stamped in’ to France on a short trip… but could not find anyway to be ‘stamped out’ again. I think I can only spend 90 days in other EU countries, but have no idea how anyone can check or enforce that – until someone decides to try. It’s a mess,” was one of the answers left in an open question.

“Every time I go through a Schengen border control, I need to provide both my passport and Aufenthaltstitel card [resident permit in Germany] and watch to check that they don’t stamp my passport. As I am currently travelling a lot that’s been 20-odd times this year…” another respondent said.

The survey was carried out by Professor Tanja Bueltmann, historian of migration and diaspora at the University of Strathclyde in Glasgow, between October and November 2022. About 1,139 UK citizens replied.

Of these, 80 per cent found acquiring their new status easy or very easy, 60.7 per cent feel their rights are secure, while 39.3 per cent have concerns about their status going forward.

Staying permanently

More than three quarters (76.6 per cent) of respondents said they plan to live permanently in the EU or the other countries of the European Economic Area and Switzerland. In fact, 65.7 per cent said that Brexit has increased the likelihood of this choice.

For some, the decision is linked to the difficulty to bring non-British family members to the UK under new, stricter immigration rules.

“My German wife and I decided we no longer wanted to live in UK post Brexit referendum. In particular, we were affected by the impact of immigration law […] We cannot now return to UK on retirement as I cannot sponsor her on my pension. We knew it was a one-way journey. Fortunately, I could revive an application for German citizenship,” was a testimony.

“My husband is a US citizen and getting him a visa for the UK was near impossible due to my low income as a freelance journalist. We realized under EU law, moving to an EU country was easier. We settled on Austria as we had both lived there before… we could speak some German, and we like the mountains,” said another respondent.

Professor Bueltmann noted that the loss of free movement rights in the EU could be a factor too in the decision of many to stay where they are.

Citizenship and representation

Among those who decided to stay, 38.2 per cent are either applying or planning to apply for a citizenship and 28.6 per cent are thinking about it.

A key finding of the research, Bueltmann said, is that the vast majority of British citizens do not feel politically represented. Some 60 per cent of respondents said they feel unrepresented and another 30 per cent not well represented.

Another issue is that less than half (47.5 per cent) trust the government of their country of residence, while a larger proportion (62 per cent) trust the European Union. Almost all (95.6 per cent) said they do not trust the UK government.

Feeling European

The survey highlights the Brexit impacts on people’s identity too. 82.6 per cent of respondents said they see themselves as European, a higher proportion than those identifying as British (68.9 per cent).

“Brexit has really left me unsure of what my identity is. I don’t feel British, and I certainly don’t identify with the mindset of a lot of British people who live there. Yet, I am not Danish either. So, I don’t really know anymore!” said one of the participants in the survey.

Professor Bueltmann said the survey “demonstrates that Brexit impacts continue to evolve: this didn’t just stop because the transition period was over or a deadline for an application had been reached. Consequently, Brexit continues to shape the lives and experiences of British citizens in the EU/EEA and Switzerland in substantial, sometimes life-altering, ways.”

Considering the results of the study, Professor Bueltmann recommends policy makers in the EU and the UK to address the issue of lack of representation, for instance creating a joint UK-EU citizens’ stakeholder forum.

The report also recommends the UK government to rebuild trust with British citizens in the EU introducing voting rights for life and changing immigration rules to allow British-European families to return more easily. 

This article was prepared in cooperation with Europe Street News.