The latest twist in the CSI story: the UK Government appears finally to have accepted that access to the NHS counts as CSI, following a 2023 ruling to that effect by the Court of Justice of the European Union (CJEU).

This confirms what many had long suspected, that the UK Government has, for years, been wrong to insist that EU nationals hold separate health insurance of any kind.  Sadly, the new clarity comes far too late for the countless would-be British citizens already affected.

This latest development makes doubly frustrating the comments made by ministers in 2022 that no citizenship application had actually been refused for lack of CSI.

Essentially, the message from the Home Office could be interpreted as follows: we kind of suspected that the NHS might be CSI so we never actually refused an application on that basis, we just didn’t tell anyone until now.

If you’re a would-be British citizen previously deterred by a CSI problem, now could be the time to submit your naturalisation application.  We’d be happy to help.  Contact our immigration experts today.

What was the ‘CSI problem’?

For those lucky enough not to know, CSI stands for Comprehensive Sickness Insurance.  CSI is a complex web of overlapping regulations and guidance, but the key threads are as follows:

  • When someone applies to naturalise as a British citizen, they need to show that they have been lawfully resident in the UK for five years, or three years if married to a British citizen.
  • By a separate and somewhat hidden requirement, they must also show that they have not been in the UK unlawfully at any time in the last ten years.
  • According to EU Regulations, a European citizen will be considered lawfully resident in another EU Member State (as the UK was), if they are a qualifying person.
  • A qualifying person is defined as a worker, a self-employed person, a student with CSI, or a self-sufficient person with CSI.

It was that last bit which often caught people out.

How did the CSI problem affect Europeans?

UK universities were a popular choice for Europeans, many of whom arrived here to study as young adults and stayed after graduation.  The requirement for students to hold CSI was poorly publicised and generally unknown, especially given that EU students could readily access the NHS and many never needed to.

A lack of CSI therefore appeared to work away in the background to make residence unlawful for thousands of Europeans who had no idea they were doing anything wrong.  They then had a nasty shock when, years later, they came to apply for British citizenship.

The application would reveal chunks of time in an applicant’s history where, completely unknown to them, they had been unlawfully resident in the UK, at least in the estimation of the Home Office.

This appeared to be a serious threat to their eligibility for British citizenship.

CSI and Brexit

The CSI problem was complicated and compounded by Brexit.

Under the EU Settlement Scheme, Europeans could be granted settled or pre-settled status in the UK without too much analysis of their immigration history.  Many saw this as a ‘green light’ for their immigration history, compounding the shock of a CSI problem at the next, more complicated, stage of applying for British citizenship.

Truth Legal and CSI

In late 2020, our Head of Immigration Louis MacWilliam published a blog article entitled ‘Naturalisation and the CSI Problem’.  The article proved extremely popular among would-be British citizens tackling the thorny issue of CSI.  We updated our position in 2022.

So where are we now?

At last we have some clarity that access to the NHS amounted to meaningful health insurance for Europeans living in the UK.  Students and the self-sufficient were qualifying persons, and therefore lawfully resident, as long as they had access to the NHS.

The tragedy is that this comes far too late to be of comfort to many would-be British citizens.  We will never know the number of EU nationals who abandoned or withdrew citizenship applications, sought costly legal advice for their CSI problem, or paid for expensive health insurance neither needed nor required, all to meet a condition which should never have been imposed.

How to approach CSI in 2023 and beyond

Home Office guidance now recognises that a person “affiliated” with the NHS will be considered to have held CSI.  To be so affiliated, an EU national must have been “ordinarily resident” in the UK.

A person will be ordinarily resident in the UK if their residence is voluntary, lawful, and for a settled purpose, terms elaborated upon in separate guidance.  Crucially, a person can be considered ordinarily resident without being a qualified person, thereby disrupting the connection between CSI and lawful residence.

We can at last have some confidence that a CSI problem will not be fatal to an application for British citizenship.  However, the application and its various requirements are still tricky, and we will always recommend caution when dealing with the Home Office.

More information

If you’re worried about absences, you might find our specialist content useful: Will Excess Absences Affect my Naturalisation Application?

And get in touch if you’d like to discuss any aspect of your naturalisation application with one of our immigration specialists.  No Truth Legal client has ever had a naturalisation application refused.  It’s a record we’re very proud of, and one we won’t be risking anytime soon.

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Catherine Reynolds
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