• January 28, 2010

The United Kingdom has caused great consternation in Mannin/the Isle of Man, not least
amongst those who have only moved to the Island in recent years, by ending the
existing reciprocal health care agreement (RHCA).

The reciprocal health care agreement was not a `free-ride’ for Manx residents;
the Isle of Man government paid the UK a lump sum of several millions pounds per
annum to ensure health cover for Manx residents when in the UK via the

Anger over the UK’s action is deep-seated. It appears that many ex-servicemen
including those who have fought in World War 2 and other conflicts will be
denied UK health care. Tensions are further compounded by the fact that
nationals from a broad range of countries internationally will continue to enjoy
health provision. One frequently cited example is the United Kingdoms reciprocal
health agreement with the despotic regime in Uzbekistan. While Uzbeks (and
others) go free the Manx reach for their cheque books

There is however one `Manx Resident’ who will enjoy the best of both worlds –
the Islands Governor. The resident incumbent will probably be `on his way out’
when the `realpolitik’ of the new Anglo-Manx health care arrangements enters
into force. However his successor is unlikely to be `billed’ by Manx Health
Chiefs if he needs a spell in hospital.

The Manx people and their government are real mugs! The United Kingdom gets to
pick the Governor (usually some redundant military type looking for a
comfortable sinecure for a few years), then the Manx pay his bills and now pick
up his health care provision.

Let us hope the next incumbent is in good health!

The statement below from the IOM DHSS website explains the RHCA changes:

“Letter from the Minister

The Reciprocal Health Agreement between the Isle of Man and the UK allows
residents of both countries to receive free emergency health care if they are
taken ill when visiting the other country. The agreement has been in place for
many years but the United Kingdom Government has decided to bring the agreement
to an end. This will happen from 1st April 2010.

After 1st April 2010, if a Manx resident requires treatment at a UK hospital
Accident and Emergency Department, a “walk in” centre or immediately necessary
treatment from a UK GP, this will still be provided free of charge. What will
change is that if an Isle of Man resident has to be admitted to hospital in the
UK as an emergency case, charges will be made for that in-patient treatment.
From the same date, the UK will no longer meet the costs of its residents who
require emergency medical treatment in the Isle of Man. It is very important to
understand that this change has no effect on patients who are referred to UK
hospitals by their Consultant in the Isle of Man. This treatment will continue
exactly as before and will not involve any charges to Manx residents as it is
paid for by the Department of Health and Social Security.

The UK has also ended its reciprocal health agreements with both Jersey and
Guernsey, though this is happening sooner than with the Isle of Man. Notice has
also been given to terminate agreements with other Crown Dependencies and
Overseas Territories. The Isle of Man Government is considering how it intends
to respond to the changes that will take effect next year in terms of Manx
residents visiting the UK who may require in-patient emergency medical
treatment, and how it will deal with UK residents who are taken ill when on the

These Frequently Asked Questions will provide you with more information about
the ending of the Reciprocal Health Agreement at the present time. The
Department of Health and Social Security will continue to provide information to
the public as decisions are made by the Isle of Man Government about future
arrangements. If you have any further questions after reading this leaflet,
e-mail the Health Services Division at healthservices.dhss@…, or telephone

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