The Healthcare System in Gibraltar: Access for a French National, Doctors, Emergencies and Medicines

The Gibraltar Health Authority was created by the Medical (Gibraltar Health Authority) Act of 1987. The Gibraltar government indicates that it provides primary, secondary and mental health care on a model closely linked to the British NHS, and that some tertiary care is entrusted to NHS hospitals and Spanish hospitals given the proximity. The government considers the standards of care comparable to those of most Western European countries. The official pages consulted do not describe the private sector or its establishments.

Funding comes in particular from social insurance contributions: the Income Tax Office indicates that weekly contributions, proportional to income between a minimum and a maximum, also fund the Group Practice Medical Scheme. The Primary Care Centre provides information on this scheme.

The GHA describes the GPMS as a contributory system whose rules are set out in the GPMS law and its regulations. Insured persons and their dependants can register, as well as people who are "ordinarily resident" in Gibraltar; registration is Monday to Friday from 9 a.m. to 12:30 p.m., or online with an eGov account, and incomplete files are not accepted. There is a form to add a dependant and another to renew the health card.

• Employee or self-employed person settled: social insurance contributions from the activity in Gibraltar fund access, the insured person's dependants being included; the page living in Gibraltar describes residency.
• Cross-border worker living in Spain: the published text of the EU-UK agreement concerning Gibraltar provides that benefits in kind are provided at the place of residence by the local institution on behalf of the competent institution, and during a stay at the place of work by the competent institution itself. The 2022 notice indicates that the Income Tax Office stopped issuing S1s to cross-border workers outside the Withdrawal Agreement from 01/07/2022; no later operational notice was read.
• Visitor: the GHA no longer treats visitors covered by the Spanish system free of charge since 01/07/2022. The pages consulted publish no tariff for a French visitor: the GHA answers billing questions.

The technical notice of 28/06/2022 traces the development: on 31/12/2020, healthcare reciprocity arrangements with the European Union ended, softened for Spain by a Spanish transitional measure extended until 30/06/2022. As Spain did not renew this measure, the Gibraltar government in turn ended free care for visitors covered by the Spanish system, and GPMS insured persons who go to Spain, even for a few hours, must have travel insurance with medical cover, failing which they pay for care themselves, including in an emergency.

No social security agreement links France to Gibraltar (CLEISS list), and the EU-UK Trade and Cooperation Agreement does not include this territory. The page healthcare reimbursement in Gibraltar details the situations.

The Primary Care Centre is the entry point to the system: health, prevention, vaccinations, tests, treatments, prescriptions and referrals. Appointments are made on +350 200 52441 or online on the eGov portal. Calls for same-day consultation are made from 8:15 a.m. to 11 a.m., those for the evening emergency clinic from 4 p.m. to 6 p.m., and deferred appointments, tests, driving medical certificates and prevention consultations from 11 a.m. to 3 p.m. At weekends and on public holidays, an urgent consultation is booked from 8:30 a.m. to 9:30 a.m. and from 3:30 p.m. to 4:30 p.m.

Prescription renewals are requested using an online form on the GHA website. Outside the centre's hours, the GHA's 111 directs the patient.

St Bernard's Hospital (Harbour Views Road) is the only hospital in Gibraltar, according to the British government. The GHA reserves emergencies for what is life-threatening: loss of consciousness, chest pain, breathing difficulty, bleeding, severe burns, stroke, major trauma, and specifies that emergencies do not replace a doctor's appointment. 999 calls the ambulance and the police; the GHA's 111, free and reachable at any hour, directs non-urgent cases.

For less serious problems, the GHA recommends self-care for coughs and colds, minor cuts, sprains, sore throats, earache, constipation and headaches; if symptoms return or do not improve within two days, 111 or the Primary Care Centre take over. Pharmacies advise and treat without appointment, with the possibility of a private consultation in the pharmacy. The GHA's motto sums up the approach: call before you go. The British government specifies that some emergency treatments may require a transfer to Spain and invites you to contact your insurer quickly when you are directed to a care facility.

When specialist treatment does not exist locally, the Sponsored Patients Department arranges care outside, subject to prior approval from the Tertiary Referral Board; treatment arranged without this approval is neither reimbursed nor reviewed afterwards (+350 200 76423). The Gibraltar government specifies that some tertiary care goes to NHS hospitals and Spanish hospitals.

• Medicines: £5 per item on prescription, capped at £15 (GHA). Pharmacists advise and treat without appointment fever, coughs, urinary or ear infections, rashes, conjunctivitis, and measure blood pressure and blood sugar; pharmacy locations and hours, including the on-call pharmacy, are published on the GHA website (gha.gi).
• Travelling with your treatments: France Diplomatie recommends medicines in their original packaging, with a prescription stating the international non-proprietary name; HM Customs Gibraltar specifies the legal status of a medicine.
• Dental care: public dental care is reserved for children; adults are seen only in an emergency (GHA).

The GHA offers a maternity service made up of midwives, doctors and sonographers for pregnancy, childbirth and post-natal follow-up. Pregnancy is registered using an online form, and the service answers on +350 200 07124, 07125 and 07126. The GHA also provides mental health care, according to the Gibraltar government, and the GHA website presents its public health services.

France Diplomatie publishes no health recommendations specific to Gibraltar; its United Kingdom page invites you to keep your vaccination schedule up to date and to protect yourself against general risks (ticks and tick-borne encephalitis depending on the stay, sexually transmitted infections, road safety). The British government refers to TravelHealthPro and the NHS website for vaccines, to be consulted at least eight weeks before departure. The pages consulted detail no vaccination requirement specific to Gibraltar; TravelHealthPro is the reference cited.

For travel and settling, see expat health insurance, the page repatriation and assistance and the Gibraltar page. The page living in Gibraltar describes the settling-in formalities. Expavy helps you compare these options against your situation.