Priests and Religious working abroad will no longer be eligible for free NHS care

Missionaries based overseas will no longer be eligible for free NHS treatment on visits home to the UK under newly introduced regulations.

The changes, which have just come into force as part of the Government’s austerity measures, mean British citizens living and working overseas will no longer have automatic free access to “blanket” health care when visiting England, and could be liable to substantial fees if they decide to access health services.

Explaining the changes, a Department of Health spokes­person said: “The NHS is a residency-based system. This means people who are lawfully settled here are entitled to free health care. Those who choose to live elsewhere, and thereby cease to make a contribution through UK taxes, are welcome to come back and use the NHS, provided they pay for it.”

Until now, British nuns and priests who are members of religious orders working in other parts of the world have been exempt from NHS charges and entitled to all NHS services whenever they returned to England. However, under the new regulations they will be charged 150 per cent of the cost of secondary health-care services – i.e. planned medical treatment – unless they can claim to be “ordinarily resident” in the UK, which many are not. So a heart bypass, for ­example, would cost upwards of £7,000.

The Government hopes to recoup £500 million a year by the changes to NHS regulations; currently these only apply to NHS England, but other parts of the UK might follow the English lead. 

The Department of Health spokesperson confirmed that there would be “no exemption for missionaries, voluntary and charity workers or workers posted temporarily overseas, other than any employed by the UK government”. 

But if missionaries return to the UK on a settled basis they will be classified as ordinarily resident, and therefore will immediately become eligible for free NHS care. 

The spokesperson said National Insurance contributions have no impact on eligibility for free NHS care, and that treatment in accident and emergency departments, and at GPs’ surgeries, remains free for all.

Br James Boner, the general secretary of the Conference of Religious, England and Wales, said: “It certainly came as quite a surprise that this is now legislation. We will be sending this information to all of our members asking them to write to their respective MPs.”

Martin Lee, executive director at Global Connections, the UK’s biggest network of evangelical mission agencies, expressed concern over the changes this week. “It is vitally important that churches and mission agencies are aware of the implications of these changes for their mission partners overseas,” he said.

Under the new guidelines, every patient embarking on a new course of treatment will be asked certain baseline questions that indicate whether they might not be “ordinarily resident” in the UK. If there is any uncertainty about whether they qualify, they will be investigated by health service managers. The Department of Health guidelines say services considered to be primary care will remain free of charge to those that are registered either as a full NHS patient, or a temporary resident NHS patient if they are to be in the country for between 24 hours and three months. The exception is prescription charges, unless the individual is entitled to free prescriptions.