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 Your new insurance is no longer valid”.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.
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’.