COPY LINK

BREXIT

‘In the dark’: Why Brits in Italy are still unable to prove rights to free healthcare

Despite UK and Italian authorities confirming that British residents covered by post-Brexit rules are entitled to healthcare in Italy, many still face "significant problems" in accessing it, the British government has said.

Published: 22 May 2024 13:38 CEST
Updated: 23 May 2024 11:57 CEST

'In the dark': Why Brits in Italy are still unable to prove rights to free healthcare

The San Filippo Neri hospital in Rome. Despite official clarifications, Italy's health services remain inaccessible to some British residents. (Photo by VINCENZO PINTO / AFP)

Cancer patients are among those in need of treatment but unable to access the Italian national health service amid confusion over post-Brexit rules, campaigners say, after clarifications from the UK and Italian governments have so far failed to resolve bureaucratic deadlocks at local authority level.

Since the end of the Brexit transition period in 2021, many British nationals resident in Italy covered by the Withdrawal Agreement (WA) have reported difficulties in proving their right to free healthcare under the Italian public system.

The problem was exacerbated this year after the Italian government in January hiked the minimum annual fee for ‘voluntary’ healthcare registration from €387 to €2,000, which many said they were unable to pay.

The British government in February stepped in to clarify that UK nationals covered by the WA should not be subject to charges for healthcare, and on its Living in Italy website it advised those affected to show their local health authority office (Azienda Sanitaria Locale, or ASL) an official note published by the Italian health ministry on February 15th which sets out their rights (find it here, in Italian.)

WA beneficiaries “can compulsorily enrol (iscrizione obbligatoria) with the Italian National Health System,” states the final section, pointing out that the deal, “in Article 23, provides for equal treatment with domestic nationals.”

But for some local health officials, even this written confirmation does not appear to be enough to clear up the confusion.

The UK government on Friday, May 17th, updated its guidance to say it had become aware that “some beneficiaries of the Withdrawal Agreement are facing significant problems accessing health services and renewing their healthcare cards,” despite its advice to show local health authorities the official note.

British nationals continue to report that local health authorities around Italy remain unwilling to issue them with a health card, while campaigners say the situation is further complicated for some by the fact that Italian authorities have also refused to issue proof of their permanent residency status, which entitles them to free healthcare.

This was the case for Graham Beresford, a British citizen living in Abruzzo who has been diagnosed with a rare cancer and remains unable to access the free healthcare he is entitled to, as he says local authorities don’t understand the post-Brexit rules.

Graham told The Local in April that the government’s clarifications on the issue had made little difference – his ASL continues to demand he pay the 2,000-euro charge.

“Every time I go to my ASL office, I always feel like I’m dismissed,” Graham said. “I told the ASL worker I need medication for my cancer and she replied lots of people come in here with sob stories.

“There genuinely seems to be no compassion whatsoever.”

Graham’s story was reported in The Guardian on May 12th ahead of UK foreign secretary David Cameron’s first major meeting with European commission vice-president Maroš Šefčovič to discuss post-Brexit relations.

Campaigners also wrote to Cameron in April to appeal for help with the “desperate” situation faced by those unable to access care in Italy.

In its update to the Living in Italy website on Friday, the British government stated: “Since [the health ministry’s note] was published, and particularly in recent days and weeks, it has become clear to us that not all Italian authorities are consistently following this guidance.”

“We are urgently speaking to all relevant parts of the Italian government to clarify the situation so that we can give clear advice to those affected as soon as possible.

“We also know that this problem is linked to the many difficulties some are experiencing with obtaining an attestazione di soggiorno permanente and/or the Carta di Soggiorno permanente. We are working to help with these issues too.

“We will update this page as soon as we have further news.”

Clarissa Killwick from Beyond Brexit, a group for UK citizens in Italy, said the situation “should never have been allowed to happen” and that there had been “a series of communication failures and inconsistencies.”

“We’re not far short of five months after the introduction of the €2,000 new minimum for voluntary contributions and there is still no clarity,” she added.

“There are fraught exchanges in public offices because people on both sides of the counter are in the dark or with conflicting information.

“People need information they can rely on, unequivocally. What do you say to someone who is waiting for an operation but has no idea what is going on?”

Member comments

Anonymous - 24 May 2024 at 21:49 CEST

I must admit that I have had absolutely no problems with either obtaining my health card or with accessing medical services. The permanent residence card was more complicated, and subject to more bureaucracy but still fairly straightforward.

Become a Member to leave a comment.

INTERVIEW: 'A lot of people think Brexit is done, but it's not for Brits in Europe'

In the early days of 2021, after the United Kingdom had left the EU and completed the final stage of Brexit, many British citizens returned to their home countries in Europe only to face a grilling at the border.

Though the Withdrawal Agreement (WA) technically guaranteed their right to live and work in the countries they’d settled in before Brexit, there was widespread confusion about these fundamental rights and many were treated like new arrivals.

Over time, the chaos at the airports subsided as border officials and airlines were given clearer guidance on the treatment of Brits. But three years later, a number of Brits who live on the continent still face problems when it comes to proving their post-Brexit rights.

This was the reason campaign group British in Europe decided to set up their new EU-funded ICE project. Starting this year in March, it aims to build valuable connections between UK citizens abroad and mentor the next generation of civil rights advocates around the continent. The acronym stands for ‘Inform, Empower, Connect’ and the project’s organisers describe it as “the first project of its kind”.

“It’s a completely innovative project – especially the fact that it’s across so many countries,” Jane Golding, chair of British in Europe and one of the project’s founders, told The Local.

Bringing together groups from 11 EU member states, the project aims to train up volunteers to understand both the Withdrawal Agreement and EU Charter of Fundamental Rights, as well as learning skills like advocacy and communication, using real-life civil rights cases that are referred to British in Europe.

“The ultimate goal is to amplify the messages across the wider group,” said Golding. “You start with the volunteers, they go back to their groups, then the people that we train, they go back and train people. Then they pass on that knowledge to the wider groups, on their Facebook accounts and through social media, and hopefully it all snowballs, not just in their countries but across the EU.”

‘Far-reaching repercussions’

So many years after Brexit, it’s hard to believe that there’s still a need for a project like ICE that empowers Brits to protect their rights. Indeed, the future of groups like British in Europe and regional groups like British in Germany and British in Spain felt uncertain just a year or two ago.

But Golding says there are still serious issues cropping up for Brits in several countries around Europe – they just have a different quality to the problems that arose at the start.

“In some ways it’s needed even more because as we predicted right at the beginning, at the first stage of implementation, you’ve got the more routine cases,” she explained.

“What we’re seeing now is not as many cases, but when the cases come up, they’re complex. They can have such far-reaching repercussions on people’s lives. And of course, memories start to fade. A lot of people think Brexit is already done, but it’s not.”

Volunteers in British in Europe ICE project

The volunteers of the British in Europe ICE project pose for a photo at the kick-off meeting in Brussels on May 21st, 2024. Photo courtesy of Jane Golding

Though the rights set out in the Withdrawal Agreement apply across the continent, different countries have taken different approaches to implementing them.

That means that while in Germany, for example, UK citizens simply had to declare that they lived in the country, people in neighbouring Denmark had to apply for their rights.

This led to a notorious situation in Denmark in which as many as 2,000 Brits were threatened with deportation after not applying in time or completing the right application process. According to Golding, this had a lot to do with the fact that people who arrived in 2020 weren’t given the same information as other UK migrants who arrived before.

In Sweden, meanwhile, the situation is still difficult for many Brits who lived there prior to Brexit.

“There have been issues with an anomalously high numbers of refusals compared to other countries, and they seem to be taking a very strict approach on late applications,” Golding explained.

Portugal has been another difficult case. Although the country opted for a declaratory system where Brits could simply exchange old residence documents for a new ID card after Brexit, reports suggest that the authorities have taken years to issue these cards, leaving many of the some 34,000 Brits in the country in limbo.

“While people are still waiting to have their status confirmed and have their card in their hand, it’s difficult to access a whole range of services, like health services, or applying for jobs or dealing with the authorities, or even going to the bank,” Golding said. “All of these problems just affect people’s lives.”

A French border guard checks a passport at the border

A French border guard checks a passport at the border. Photo by DENIS CHARLET / AFP

There are also concerns about the EU’s new exit and entry system (EES), due to come into force in October, which is based on biometric documentation.

“We still do not have clear data on how many people in declaratory countries like Germany, where it wasn’t compulsory to apply for the card, don’t actually have a card,” Golding said. “How is that going to play out if it’s a document-based digitalised system?”

A lack of support

In the immediate aftermath of Brexit, funding from the UK’s Foreign, Commonwealth and Development Office (FCDO) was still available to support NGOs in Europe helping Brits with their migration and civil rights issues. But that temporary funding soon expired, leaving groups like British in Europe largely on their own.

“The whole point is people’s lives change at very different paces,” Golding said. “And now this project is really going to start to pick up some of those cases and report on those issues, which is really crucial and exciting for the precedent that it sets, and it’s very clearly necessary still, because people don’t just sort their lives in the 18 months that the FCDO chose to supply that funding.”

This feeling of being left alone and increasingly isolated from the UK is one that many Brits in Europe have felt in the aftermath of Brexit. But the upcoming UK election on July 4th could be a game-changer.

This time, following a change in the law, Brits who have lived abroad for more than 15 years will be able to vote for the first time.

Polling station in the UK

A polling station in the UK. Photo by Elliott Stallion on Unsplash

When it comes to the election, the message from British in Europe is clear: “Make your voice count now, make your vote count, make sure you use it,” Golding said.

With the June 18th registration deadline fast approaching, BiE is advising UK citizens abroad to apply for a proxy vote as soon as possible, rather than relying on a postal vote from abroad. Since the 15-year rule was abolished on January 16th, more than 100,000 British citizens have registered to vote, according to official statistics. It is unclear how many were registered before the change in the law.

With an estimated 5.5 million Brits currently living abroad – 1.3 million of whom are in the EU – this could have a significant impact on the electoral landscape, Golding says. But most significantly, the change is creating a feeling of connection and belonging that wasn’t there before.

Nurturing this sense of belonging is one of the main goals of ICE.

With these bridges being built, British in Europe hopes to create a network of support that spans across borders.

“Now we’ve met. We’re going to meet,” said Golding. “We know we’re going to meet again in Berlin in October and then we’ll meet again in the new year in 2025 as well. It means a huge amount because even British in Europe, our steering team, we’ve only met physically three times.”

This opens up the possibility of people sharing their knowledge from country to country, Golding explained.

“There is crossover and the reassurance of having that EU wide view and knowing that you’re not alone and knowing that in this country, we managed to get this solution,” she said. “And then you can go back and say to the authorities in your country, well, in that country they did that – all of that helps. It’s really good.”

SHOW COMMENTS

Url copied to clipboard!