4 Apr, 2013 @ 17:49
1 min read

Expat hit with €1,180 bill for one night in NHS hospital


AN EXPAT who paid taxes in the UK for 40 years, was handed a whopping €1,180 bill for a one-night stay at a Bristol hospital.

Sue Woodman, 56, who has lived in Alcala La Real for six years was forced to return to the UK last June to care for her elderly mother, who was in the last stages of Alzheimer’s.

During her three month trip she became ill herself and was admitted to hospital after suffering a panic attack.

After a night of tests she was given the all clear and sent home to care for her mother, who was eventually taken into care.

So it came as a real shock when a few weeks after returning to Spain her sister contacted her to inform her that a bill had arrived from the NHS.

The letter also stated that if she didn’t pay the money by the end of the month, she would be detained by border control if she ever tried to re-enter Britain.

Mrs Woodman, who is a Spanish resident, said: “What upset me the most was that I have spent the majority of my life working in the UK and paying all my taxes.

“I have had only two stays in hospital my entire life which was when I had my children.

“I’d gone back to England, not for a holiday, but to care for my very ill mother. The last thing on my mind was ending up in hospital.

“But I did and now I have had to pay for the consequences.”

She added: “It has not been easy finding the money and I really dread to think how many other people have had to pay out in this way.


  1. This is the stark reality of expats who are resident in Spain and return to the UK for treatment. Paying taxes in the UK in this particular case counts for nothing since Mrs Woodman is not a pensioner and she would have lost her NHS entitlement after being resident in Spain for six years (the limit is 6 months, I recall).

    Many people think that the EU has all recripricol health arrangements but nothing could be further from the the truth. Did Mrs Woodman have a Spanish EHIC went she went back to the UK? That is a key question that has not been answered in this article. Ironically, it seems Mrs Woodman has less rights than a homeless immigrant arriving at the UK who has paid no taxes anywhere.

  2. Just because someone paid NI in the UK in the past doesn’t give them an indefinite right to treatment on the NHS. Mrs Woodman has been a Spanish resident for 6 years and treatment on the NHS is free for UK residents only. What did she expect? It’s not clear why this is even a story? Why did Mrs Woodman not use an EHIC card? There would have been no bill had she done so.

  3. I agree with JAR, why didn’t she use her EHIC card? We are always telling people to make sure they have it with them when on holiday in Europe so surely it would make sense to have used it in the UK?

  4. When you become an ex pat the DWP makes it very clear that you will no longer be entitled to free health care in the UK. As stated by others she should have got an EHIC card. However having said that there is plenty of anecdotal evidence that Brits returning to the UK whether short term or long term are treated like dirt. I suggest that should she find herself in a similar predicament she pretends she doesn’t speak English. I wonder how many other nationalities receive such bills when taking advantage of NHS treatment.


  5. Yet another example of how irrational our elected representatives can be. EHIC card or not, any european country provides free emergency treatment to anyone. The UK allows immigrants immediate access to the NHS, yet stops its own citizens from having it despite having paid NI all their life. Even more stupid is asking a pensioner friend of ours who is seriously ill, resident in Spain, entitled to treatment here (charged back to the NHS) but not entitled to treatment in the UK until he is back for 6 months.
    These are the same people that got us in this financial mess and who have the finger on the nuclear self-destruct button…. God help us :-)

  6. Still seems unfair that The UK system makes a person lose all their entitlement after paying NI for so many years. Surely those years of payment should count for something? That aspect of the system needs to change in my opinion. Records of peoples contributions are kept in the UK (for example to pay pensions abroad) so there should be a calculable maximum limit of what can be claimed for health treatment in the UK if the person is no longer resident there. It should not be indefinite, but it should be something. They have paid for it, after all.

    Spanish EHICS can take quite a time to arrive depending on what region of Spain you are in. I also noticed that they they expire in a shorter period than the UK EHICs. Certainly a complex area, but one that needs to be simplified and made fairer for those who have worked and contributed.

  7. The answer to this problem is for expats requiring treatment on the NHS is to say that they an homeless immigrant from anywhere in the world. Hey Presto, the treatment will then be free and unlimited.

  8. I had an inheritance and could not get not domiciled in the uk and had to pay tax, seems like they change the rules when they feel like it.
    You were entitled to free health care , we returned to the uk and within 2 weeks my husband was diagnosed with a serious illness and got free health care , operations etc and no we didnt know he was ill before we left.
    We were resident in spain for 12 years

  9. What exactly is the EHICS card ? Where can you apply for one ? How long does it last and what does it cover. I have the national health card here in spain but i am confused as to whether the EHICS one is different when travelling .Can somebody please put me right .Thank you.

  10. Susan – you can apply for the Spanish Tarjeta Sanitaria Europea here: “https://sede.seg-social.gob.es/Sede_1/Lanzadera/index.htm?URL=98” if you have a social security number in Spain. Mine arrived in three days. Note that if you’re in receipt of a UK pension you should apply for your EHIC from the UK.

  11. What some people don´t realise is that an EHIC card is a residence based card. So if the original poster is under retirement age for the UK and is not paying into the Spanish system, then she is not entitled to an EHIC card from Spain nor from the UK.
    If you are active in any system, then you are OK.
    She needed to have travel insurance or private insurance to cover eventualities.
    Since last October, I, like many others find myself now in limbo re. healthcare provision, having previously worked and paid in in Spain

  12. I know several people who are permanent residents in Spain
    who return to the UK to see a doctor, because they do not speak Spanish. When they left the UK they did not de-register
    from the doctor. The doctor keeps their names on his list and
    gets the capitation fee.

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