John Mann MP reveals massive European health bill for UK

With our well known notion of fair play, it is interesting to read Labour’s point of view - that we are being taken for a ride with our health agreements with EU members. Quite a lot of health care in France is charged back to the UK whereas that seems not to be the case for French people in the UK.

UK pays France : £147,685,772 France pays UK : £6,730,292

UK pays Germany : £25,873,954 Germany pays UK : £2,189,664

UK pays Italy : £7,304,484 Italy pays UK £1,510,850

UK pays Poland : £4,336,701 Poland pays UK £1,523,402

UK pays Spain : £223,290,021 Spain pays UK £3,412,338

The link to the original is abover

FOI request from 2016 giving 2015 figures… who knows how accurate this is as records may or may not be a reflection of the truth. I remember answering FOI requests and scrabbling around in forgotten cupboards to find any old data to answer them.

We tend to export retirees to the EU and import relatively healthy workers, it skews the figures somewhat.


There really isn’t an acceptable euphemism. The figures are skewed but it is always the UK who is worst off. The French expats in the UK are usually paying contributions and are treated by the NHS but the retired people living in France need more cover statistically and some of them are unaware that the fantastic treatment in France is being paid for by the UK taxpayer.

Every person who accesses healthcare in France goes through the payment process even if it’s a bill payment. For those with S1s and people who have used EHIC cards the U.K. gets billed for their care. In the NHS it’s rare for a bill to be raised. Until Britain introduces a pay at the time of treatment the figures will never match. I presume that the NHS is reimbursed for the medical care of European visitors using their EHIC cards but I know several French residents including French citizens who were treated and their EHIC card was never asked for. The figures are not only skewed by the S1
S1s being used more by Britons living in Europe but also by the very different systems and to a certain extent the inefficiency of the NHS.


I think that most S1 holding retirees in France understand that the NHS funds their healthcare.


Agreed David Martin but the figures show clearly that the UK taxpayer is losing out. If the NHS could charge the other European nations for the care of expats, so that the cost was not always borne by us, it would be fairer.

Whether the S1 holders are aware of it or not, it is the current UK working population who pays for the NHS. The sometimes superior health care abroad is very expensive compared to the “free at the point of use” NHS and the extra cost is being paid by the UK - with no equivalent debit for the cost of giving free care to Europeans being charged.

You actually don’t know that because you don’t know the cost of the healthcare consumed by UK citizens in the EU or EU citizens in the UK - unless you can come up with an actual figure for un-reimbursed healthcare costs you cannot prove that the “UK taxpayer is losing out”. In fact the figures presented really have very little to do with the figures you want.

Unfortunately I suspect that the NHS has no idea what it costs to provide EU citizens with healthcare because of its “free at the point of use” ethos it just doesn’t do the accounting to answer that question.

The article states “Sorting this scandal out in itself would transform the financial situation of the NHS.”

But it wouldn’t, the amount is 0.5% of the NHS budget - Edit: hmmm, I fell into the same trap there. We don’t know what the real cost is, see above.


What about UK retirees living in France, that are still paying income taxe in the UK on their pension, being paying taxe and N.I contribution all their life in the UK ? Isn’t that normal they have some support and benefit ? I know one of them quite well !


It’s a UK problem. As Babeth has pointed out most of the S1 holding OAPs are entitled to have their health care funded by the U.K. having paid a lifetime of NI payments (and many still being UK taxpayers) and the NHS not having a system in place to make paying for care received straightforward.


The aim of the FOI question was to expose the huge difference in payments between what the Europeans pay for their healthcare in the UK compared with what the NHS has to pay Europe for looking after UK citizens abroad.

There is also the question of unequal treatment. UK pensioners often find it difficult to get the treatment they need whilst UK pensioners in France get a much better service.

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I have to say that we have to pay for a “mutuelle” here to have a better service. And I think it worth it !

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If the problem is the NHS, David Martin, then things will have to change. Change is slow and difficult (the outcry when a Jamaican was refused treatment) but they are changing:

Migrants, visitors and former residents of the UK must pay for their care when they’re in England. In April 2015, changes were made to the way the NHS charges overseas visitors for healthcare. This is so that the NHS does not lose out on income for services these people receive.

So, here’s a useful graphic to illuminate the discussion:

Source: Office for National Statistics

Bars are French in the UK and lines are Brits in France - look at the position of the peaks. The French in the UK are in their mid 20’s to mid 40’s - a group which consumes hardly any healthcare at all except for obstetric services perhaps.

On the contrary Brits in France peak in their mid 60’s and massively outnumber the French in the UK in every age group above mid 40’s - this is a group who are likely to consume a fair bit of expensive healthcare such as joint replacements and cancer care.

There’s also the fact that healthcare costs are different in the two countries - look at this graph comparing the cost of cancer drugs in various EU countries.


As you can see these drugs can be significantly more expensive in France than in the UK so that will drive the overall cost of care up - so even if the population demographics were the same and the healthcare delivered the same there would still be a discrepancy in charges.

@Babeth make a valid point as well, it is likely that the UK gets tax revenue fro Brits living in France and it is certain that if they were living in the UK the NHS would be picking up the tab for their healthcare.


Yes Babeth - I had a mutuelle too and it was worth it since it was paid for by the company I worked for

Perhaps you need to start campaigning for the NHS to improve their system for charging non UK residents.
You cannot claim that it’s unfair that U.K. OAPs are getting better treatment than those in the UK because the UK itself us a postcode lottery when it comes to provision and although France is considered to have a better health system and therefore those who use it profit other countries on your list are less well provided for and the UK citizens living in those places lose out.


Unfortunately Mr Mann asked the wrong questions - it does not matter one jot that there is a discrepancy, what he needed to know was whether the NHS is recovering the costs for treatment of EU citizens in the UK from their home nations - the cost of treating UK citizens in the EU and whether host nations recover this cost from the NHS is a different question and you can’t assume that if Brits in France “spent” £150 million on healthcare that the French living in the UK “cost” the NHS the same amount.

So the intelligent ones move to France.


Paul Flinders - I think you are right on both counts. There must be an awful lot of intelligent pensioners. And it is not the first time the Labour Party has asked the wrong question

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Mine is half paid by the company (compulsory now), for Bill we pay the full bill, even it’s cheaper because that’s a “mutuelle de groupe”. I just had a look about what they paid back in the last two years, and the amount is 1816.31€, not even included the hip job that was taken 100% by CPAM. Social Solidarity is the base of our system. We are not expected to compare what’s somebody else is paying. Imagine a world where people with cancer have to pay more than the one that are “healthy”, like an insurance “bonus”. Worth, if you had people who died from a genetical desease in your familly, so you could have a “malus”.