{"id":2116053,"date":"2026-09-04T01:05:32","date_gmt":"2026-09-03T23:05:32","guid":{"rendered":"https:\/\/kohenavocats.fr\/2026\/09\/04\/french-hospital-refuses-uk-health-welfare-lpa-brexit-consent\/"},"modified":"2026-09-04T01:05:32","modified_gmt":"2026-09-03T23:05:32","slug":"french-hospital-refuses-uk-health-welfare-lpa-brexit-consent","status":"publish","type":"post","link":"https:\/\/kohenavocats.fr\/en\/2026\/09\/04\/french-hospital-refuses-uk-health-welfare-lpa-brexit-consent\/","title":{"rendered":"French Hospital Refuses a UK Health and Welfare LPA After Brexit: What Can a British Patient Do?"},"content":{"rendered":"

A British national living in France may expect a registered health and welfare Lasting Power of Attorney (LPA) to speak for them in every medical setting. That assumption can fail at the hospital door. An LPA made in England or Wales is a UK legal instrument. French healthcare law uses different mechanisms: the patient\u2019s own consent, a personne de confiance<\/em> (trusted person), directives anticip\u00e9es<\/em> (advance directives), and, in a different setting, a French mandat de protection future<\/em> (future protection mandate). A hospital may therefore ask for more than the UK document, particularly when the patient cannot communicate, when treatment is serious, or when a relative asks for confidential information.<\/p>\n

This does not mean that an English or Welsh LPA is worthless in France. It is important evidence of the patient\u2019s wishes and of the attorney\u2019s appointment. It may also contain instructions that are highly relevant to treatment. The practical issue is whether the hospital can verify its scope, its registration, its translation and the circumstances in which the attorney may act under French law. The answer is different in an emergency, for ordinary treatment, for end-of-life decisions and for access to medical records. This article explains the distinction and gives a document-first route for a British patient or family member whose LPA is refused. It is written for England and Wales; Scotland and Northern Ireland use different power-of-attorney systems.<\/p>\n

I. Can a French hospital treat a UK health and welfare LPA as authority?<\/h2>\n

A. What does a UK health and welfare LPA authorise after Brexit?<\/h3>\n

An LPA is created under the law of England and Wales. A health and welfare LPA allows the donor to appoint one or more attorneys to make personal welfare decisions if the donor cannot make those decisions for themselves. The official UK guidance distinguishes it from a property and financial affairs LPA. A health and welfare attorney may be involved in choices about care, daily routine, medical treatment and where the donor should live, but the instrument must be registered before it can be used. The practical starting point is the complete registered LPA, not a letter from a family member saying that an LPA exists. The official overview is on GOV.UK\u2019s power of attorney page<\/a>.<\/p>\n

The wording matters. The donor may give instructions, record preferences or limit the attorney\u2019s role. The LPA can also state whether the attorney has authority to give or refuse consent to life-sustaining treatment. That choice is not a minor administrative detail. A French doctor reviewing a copy of the LPA needs to see the relevant pages, the registration information, any continuation pages and any restrictions. Sending only the first page, an unregistered draft, or a bank-related LPA can produce a legitimate refusal even when the family believes the attorney has broad authority.<\/p>\n

The attorney\u2019s authority is also conditional in England and Wales. A health and welfare attorney generally acts only when the donor lacks the mental capacity to make the particular decision. If the donor can understand, retain, weigh and communicate the relevant information, the donor remains the decision-maker. The UK guidance on health and welfare attorneys<\/a> explains that the attorney acts when the donor lacks capacity and must act in the donor\u2019s best interests. A French hospital will still assess the patient\u2019s current ability to understand and express a choice under French healthcare law. An attorney cannot use an LPA to silence a patient who is presently capable of deciding.<\/p>\n

There is a second limit: the LPA is not itself a French personne de confiance<\/em>. The French expression means a person chosen by an adult patient to be consulted and to report the patient\u2019s wishes when the patient can no longer express them. It is a statutory healthcare role. A UK attorney may be the ideal person to fill that practical role, but the appointment does not automatically prove that the person has been designated under the French form or recorded in the French medical file. The hospital may therefore ask the patient to complete a French designation as well as producing the LPA.<\/p>\n

The same distinction applies to an English advance decision. An advance decision may be powerful evidence of a person\u2019s wishes under the law of England and Wales, and a registered LPA may contain instructions about treatment. France has its own concept of directives anticip\u00e9es<\/em>, which concerns the patient\u2019s wishes about continuation, limitation, withdrawal or refusal of medical treatment if the patient later cannot express them. The two instruments should be placed side by side, translated where necessary and analysed for consistency. A hospital should not be asked to guess whether a sentence in an English document is an instruction, a preference, an appointment or a choice about life-sustaining treatment.<\/p>\n

Brexit makes the administrative task more important. A British document no longer arrives in a setting where staff can assume that an EU-facing form, a familiar language and an established local record will answer every question. That is a practical consequence of the change in the relationship between the United Kingdom and France, not a conclusion that every UK document has no effect in France. The correct approach is evidence and compatibility: establish who signed the document, who registered it, what decisions it covers, when the attorney may act, and how the document can be relied on in the French clinical setting.<\/p>\n

For a patient from England or Wales, the minimum UK evidence normally includes the registered LPA or a certified copy accepted by the Office of the Public Guardian, the donor\u2019s identity document, the attorney\u2019s identity document, the registration details, and every continuation sheet. If the LPA was revoked, replaced or suspended, that history must be disclosed. A hospital that discovers an earlier document or an unclear signature may pause recognition while it verifies the position. Concealing an adverse document can destroy trust at the moment when cooperation is most needed.<\/p>\n

Translation is not a cosmetic exercise. The hospital must understand the powers and restrictions in the document, not merely the title. A complete French translation by a qualified translator is usually more useful than a family member\u2019s informal summary. Keep the original English document with the translation. A translator cannot give the document French legal effect, and a translation cannot expand the power actually granted. It should reproduce dates, names, registration references, signatures, schedules and defined expressions accurately.<\/p>\n

An apostille may also arise. An apostille is an official certificate used to authenticate the origin of a public document for use abroad; it does not turn every statement in the document into a French legal act. Whether it is required depends on the document, its issuer and what the recipient is being asked to do. The French diplomatic guidance on foreign documents and the notarial guidance on a power of attorney abroad should be checked for the particular document. The safe request to a hospital is not \u201cthe apostille proves everything\u201d, but \u201cplease identify the formal defect that prevents you from considering this document, so that it can be corrected or explained\u201d.<\/p>\n

That point is supported by a useful, but fact-specific, decision. In First Civil Chamber, 14 April 2016, appeal no. 15-18.157<\/a>, the Cour de cassation examined an Australian notary public\u2019s power used in a French mortgage transaction. The court upheld the conclusion that the foreign form was not equivalent to the French formalities for that authentic act. The decision does not decide the recognition of an English health and welfare LPA in a French hospital. It does show why an apostille, standing alone, cannot answer every question about substance, form, capacity or the protection required by the French transaction. Use it as a warning about proof, not as a blanket rule of invalidity.<\/p>\n

The regional origin of the LPA must also be checked. \u201cUK LPA\u201d is often used loosely, but the English and Welsh LPA system is not the Scottish welfare power of attorney system and is not the Northern Irish enduring power system. A patient who signed in Edinburgh or Belfast should not present the document as an England and Wales LPA without obtaining advice on the correct instrument. The hospital needs the governing jurisdiction and the legal status of the document before it can decide what weight to give it.<\/p>\n

Finally, an attorney\u2019s role is not a licence to demand unrestricted information from every department. Confidentiality, consent, the patient\u2019s wishes and the proof of authority remain relevant. A request may concern treatment decisions, a copy of the medical record, an insurance form, discharge arrangements or a financial matter. These are not interchangeable. The request should state exactly what information or decision is sought and why the LPA covers it.<\/p>\n

B. What does French law require for consent, a trusted person and advance directives?<\/h3>\n

At the date of publication, the current French framework must be read in the version in force from 28 May 2026. The central provision is Article L. 1111-4 of the Code de la sant\u00e9 publique<\/a> (French Public Health Code). It begins with the patient\u2019s participation: \u201cToute personne prend, avec le professionnel de sant\u00e9 \u2026 les d\u00e9cisions concernant sa sant\u00e9.\u201d In English, the person makes health decisions together with the healthcare professional, taking account of the information and recommendations provided. The wording matters for a British patient because the default is not that a relative, attorney or hospital administrator decides instead of the patient.<\/p>\n

The same article states: \u201cAucun acte m\u00e9dical ni aucun traitement ne peut \u00eatre pratiqu\u00e9 sans le consentement libre et \u00e9clair\u00e9 de la personne.\u201d The quotation means that a medical act or treatment requires the person\u2019s free and informed consent. Consent may be withdrawn. Where the patient cannot express a will, the article directs the doctor, subject to an emergency or impossibility, to consult the French personne de confiance<\/em>, then the family or, if necessary, a close person. \u201cConsult\u201d is the key word. It does not convert every person consulted into a general attorney with power to authorise any treatment.<\/p>\n

There is a separate rule where the adult is already subject to a French legal protection measure involving representation in personal matters. Article L. 1111-4 contains specific rules for obtaining the protected person\u2019s consent when they can express a choice and for the representative\u2019s authorisation when they cannot, with a judicial route for disagreement outside an emergency. A UK LPA is not the same thing as a French court-ordered protection measure. The hospital should therefore be told whether any French measure exists, rather than being asked to infer one from the title \u201cattorney\u201d.<\/p>\n

The role of the trusted person is defined in Article L. 1111-6 of the Code de la sant\u00e9 publique<\/a>. An adult may choose a parent, close person or treating doctor. The trusted person is consulted if the patient is unable to express their wishes and receive the necessary information. The text provides that the trusted person reports the patient\u2019s will and that \u201cSon t\u00e9moignage pr\u00e9vaut sur tout autre t\u00e9moignage.\u201d The testimony therefore has priority over other testimony about the patient\u2019s wishes, but the role remains tied to reporting those wishes and the clinical process.<\/p>\n

French law requires the designation to be written and co-signed by the person designated. It has no fixed time limit unless the patient or trusted person provides otherwise, and it can be revised or revoked at any time. On admission to hospital, the patient should be offered the opportunity to make the designation. A British patient with capacity can often reduce the dispute immediately by completing the French designation, naming the same person as the UK attorney if appropriate, and asking the admissions team to place it in the medical file. A French form does not cancel the LPA; it gives the hospital a familiar healthcare record for the consultation role.<\/p>\n

Do not confuse a trusted person with a next of kin, emergency contact or person who pays the bills. A contact may receive a telephone call without having a role in expressing the patient\u2019s wishes. A next of kin may be consulted where no trusted person is available, but that does not create a universal power to consent. An attorney may have broader duties under English and Welsh law, but the French hospital will still need to identify which part of the request concerns the patient\u2019s clinical wishes, which part concerns disclosure and which part concerns representation.<\/p>\n

French advance directives are governed by Article L. 1111-11 of the Code de la sant\u00e9 publique<\/a>. An adult may write them for the situation in which they later cannot express their will. They concern the conditions for continuing, limiting, stopping or refusing treatment or medical acts, especially in relation to the end of life. The current article says that they are revisable and revocable \u201c\u00c0 tout moment et par tout moyen\u201d. It also states that the doctor must follow them, subject to a vital emergency needed to assess the situation and where the directions appear manifestly inappropriate or not conforming to the medical situation.<\/p>\n

The latest directive prevails if several versions exist, regardless of their medium. A British family should therefore send the current French directive, any English advance decision, the LPA and any later written expression together, with dates. A short handwritten note from the patient may be clinically important even though it is not a French advance directive in the statutory sense. It should be labelled as evidence of current wishes rather than presented under a misleading French legal title.<\/p>\n

Medical secrecy adds another layer. Article L. 1110-4 of the Code de la sant\u00e9 publique<\/a> protects private life and the confidentiality of information concerning a person receiving care. A hospital may therefore insist on proof before emailing a full medical file to an attorney in the United Kingdom. The confidentiality rule does not mean the patient\u2019s chosen representative can never receive information. It means that the hospital must identify the lawful basis, the scope of the consent or authority, and the information strictly needed for care or the particular request.<\/p>\n

The patient\u2019s own access rights should be used constructively. Article L. 1111-7 of the Code de la sant\u00e9 publique<\/a> gives a person access to the health information held by healthcare professionals and establishments, including consultation, intervention and hospitalisation records. The current text also addresses access where an adult is subject to a French protection measure involving representation. A UK attorney should ask the hospital to state whether it refuses access because the LPA is not accepted, because the patient\u2019s consent is missing, or because a particular document contains information from a third party. A precise reason allows a precise correction.<\/p>\n

Communication must not be mistaken for incapacity. Since 28 May 2026, Article L. 1111-6-2 of the Code de la sant\u00e9 publique<\/a> provides that, where an adult is partly or wholly unable to express themselves, alternative and augmentative communication should be put in place to seek informed consent. The text states that, where possible, non-verbal means have the same legal value as direct verbal expression when assessing the person\u2019s wishes. For a British patient, this supports asking for an interpreter, written English information, a communication board or an appropriate device where needed. It does not by itself appoint the attorney or remove the need to assess the patient\u2019s wishes.<\/p>\n

The Civil Code supplies a related autonomy principle. Article 415 of the Code civil<\/a> sets the protective framework for adults: the protection must respect the person\u2019s freedoms, fundamental rights and dignity and promote their autonomy. Article 425 of the Code civil<\/a> concerns a person who cannot look after their interests alone because of a medically established impairment affecting mental faculties or bodily faculties in a way that prevents expression of their will. These provisions help explain why a French doctor will ask both \u201ccan this patient decide now?\u201d and \u201cwhat reliable evidence shows what the patient wanted?\u201d<\/p>\n

In a clinical emergency, the sequence changes. Article L. 1111-4 expressly refers to consultation subject to \u201csauf urgence ou impossibilit\u00e9\u201d. If a British patient has severe symptoms, call 15 or 112 or go to the nearest emergency department. Take the LPA if it is available, but do not delay urgent treatment while a family member argues about apostilles. The document dispute can be recorded and escalated after the immediate clinical assessment. The Service Public guidance on patients\u2019 rights during hospitalisation<\/a> also provides a practical route for understanding patient rights and complaints.<\/p>\n

II. How can a British patient challenge the refusal and secure care in France?<\/h2>\n

A. What should you send to the hospital immediately?<\/h3>\n

The first objective is to turn a general refusal into an identifiable issue. Ask the hospital in writing: \u201cAre you refusing the treatment, refusing to consult the named person, refusing to disclose information, or refusing to recognise the LPA as a document?\u201d These are four different problems. A doctor may be willing to treat but unable to disclose details to a person whose authority is unverified. An admissions office may reject an incomplete translation even though the medical team would consider a complete copy. A written question prevents each department from assuming that another department has dealt with the issue.<\/p>\n

Send one organised bundle, with a short cover letter in English and, where possible, French. The cover letter should state the patient\u2019s full name, date of birth, hospital number, current location, the date and nature of the refusal, the urgency, the attorney\u2019s contact details and the exact decision requested. Avoid a long family history. A doctor needs a reliable map of the legal documents, not a chain of emotional messages.<\/p>\n

The core bundle should contain the following documents:<\/p>\n