British Pensioners Look to Thailand for Affordable Care
A growing number of British pensioners are moving to Thailand in search of affordable residential and nursing care, according to a report in The Times on 5 September. The Times visited care facilities in Chiang Mai where British residents described paying considerably less than they would for comparable care in the UK. One 84-year-old resident pays about £1,400 a month for accommodation, meals, activities, cleaning and access to care, having previously paid £1,200 a week for a nursing home in England.
Operators also report a marked increase in British residents. At one Chiang Mai care resort, two-thirds of new arrivals are now said to be from the UK; another provider says its number of British residents has risen from four to almost 60 in three years.
Access to medical treatment is another attraction. Residents interviewed by The Times described rapid access to hospital care and substantially lower prices for some private procedures.
There are some potential issues, however. Britain has no reciprocal healthcare agreement with Thailand, so treatment is not covered by a UK GHIC and must normally be insured or paid for privately. The UK State Pension is also frozen for people resident in Thailand, meaning it does not receive the normal annual increases.
Nevertheless, the trend suggests that some older British citizens are now looking overseas not simply for a cheaper retirement, but as an alternative to the high cost of long-term care in Britain.
Healthcare Dispute Causes Concern in Turks and Caicos
Residents and expatriates in the Turks and Caicos Islands are facing uncertainty over the future of hospital services after a contractual dispute between the government and its private healthcare provider.
The British Overseas Territory has relied on InterHealth Canada to provide hospital services for the past 16 years. In July, InterHealth announced that it was terminating its contract with the Turks and Caicos government, saying it could not continue indefinitely amid a dispute over payments.
According to The Times, the dispute includes more than $9 million in contested invoices and has generated tens of millions of dollars in arbitration and legal costs. InterHealth is continuing to operate the hospitals during a transition period.
The Turks and Caicos government disputes the company’s account. It says clinical costs have been paid and that money withheld relates to disagreements over contractual obligations concerning hospital estates. It has also stressed that healthcare services currently remain operational and that patients should continue attending appointments as normal.
The concern is therefore about what happens next. The Times reports that, without a resolution or replacement arrangement, existing provision could be jeopardised in the coming months.
The issue is particularly significant in a territory heavily dependent on international tourism and with a substantial expatriate population. Turks and Caicos is a British Overseas Territory, although responsibility for its domestic healthcare system lies with the territory’s government.
Australia Updates Medical Cover for Government Employees Posted Abroad
Australia’s Department of Finance has recently published updated information on medical cover for Australian government employees and their families who are posted overseas.
The scheme, known as Comcover Expatriate Cover, is available to employees of participating Australian government bodies who are deployed abroad, together with their declared spouses, partners and dependants.
Two levels of medical protection are currently available. Standard cover excludes pre-existing medical conditions, while supplementary cover can include them. The scheme pays reasonable and necessary medical expenses incurred outside Australia during the overseas posting and does not impose prescribed treatment limits.
There are also some conditions. Employees and their dependants must undergo medical and dental examinations before deployment and be declared fit for the country to which they are being posted. Elective and cosmetic treatment is excluded, as is treatment for a pre-existing condition where supplementary cover has not been selected.
The scheme is backed by International SOS, which provides round-the-clock medical and security assistance. Services include locating doctors and hospitals, arranging medical transport and, when necessary, evacuation.
The updated guidance is a useful reminder that Australians posted abroad on government business have a dedicated system of medical protection, but that cover depends on pre-deployment assessment and the particular level of insurance that has been selected.
Disabled British Citizens Challenge Refusal to Fund Care While Abroad
This relates to travel rather than permanent relocation, but may affect expats who have disabled relatives. Disabled people in England are challenging NHS bodies and local authorities which prevent them from taking their existing care support with them when they travel abroad.
An investigation published by The Guardian on 2 September found considerable variation around the country. Some NHS integrated care boards and councils permit funded carers to accompany disabled people overseas, while others impose restrictions or refuse requests altogether.
The issue is not generally about asking the NHS to pay for a holiday. Those affected already have funded care packages for needs such as dressing, mobility and overnight assistance, and usually propose paying their carers’ travel, accommodation and insurance costs themselves. The dispute is over whether the existing cost of providing their care can continue while they are temporarily outside Britain.
One case involved Lucy Robinson, a quadriplegic woman who requires 24-hour assistance and travels internationally as president of the European Spinal Cord Injury Federation. Her NHS board initially refused to fund her care during overseas trips. After she threatened judicial review, the decision was reversed.
Campaigners describe the present situation as a “postcode lottery” and are calling for clear national guidance. Lawyers argue that an NHS body’s duty to meet an eligible person’s assessed needs does not necessarily disappear simply because that person temporarily leaves the country while remaining ordinarily resident in its area.
The cases raise a broader question about disability and independence: whether receiving publicly funded care should unnecessarily restrict a person’s ability to work, travel and participate in ordinary life outside Britain.