FAMILY MATTERS

Pregnancy healthcare

If you are a British citizen and pregnant at the time of moving to France, you should speak to your doctor and local health authority to find out what steps you need to take to ensure your health and benefit entitlements.

You must declare your pregnancy before the end of the third month to your Caisse d’Assurance Maladie, and to the Caisse d’Allocations Familiales or CAF (family benefit centre). To do this you must hand in the premier examen médical paréntal form duly signed by your doctor. You will receive a carnet de maternité with vouchers for the services to which you are entitled.

The services to which you are entitled free of charge are:

• 1.Pre-natal and post-natal examinations.
• 2.Eight pre-natal sessions to help you prepare for the delivery.
• 3.Twelve days’ free hospital treatment in a conventionné hospital or clinic, or one which is agré (approved).
• 4.From the first day of the sixth month of pregnancy, all medical expenses (whether related to the pregnancy or not) are reimbursed by the caisse at 100% (except certain types of drugs).

These rights are limited by the number of hours worked and the amount of money you have paid, or your husband or partner has paid, in the preceding months. You will have to pay as usual for all the services you receive, but will receive reimbursement at 100%. Vouchers should be stuck to the feuille de soins each time that you send in a claim for reimbursement, if that system is still in operation.

The current cost is €160 for a delivery by a midwife (sage-femme).Extra costs are incurred for a night-time delivery, for Sundays and bank holidays. All costs are reimbursed at 100%.

Maternity leave pay

Once again, the number of hours and level of contributions made is one of the deciding factors in whether you receive paid maternity leave. You must also have been enrolled in the Sécurité sociale at least 10 months by the expected date of delivery of your baby.

To obtain maternity pay, you must send the attestation de salaire (salary certificate) signed by your employer to the Caisse d’Assurance Maladie as soon as you begin your maternity leave. You must then send a similar form to the caisse at the end of your maternity leave. The pay is calculated on the basis of your salary for three months before you stopped work, and works out at 84% of your daily wage. At the end of your maternity leave, you must also send a certificate from your employer to your local caisse stating that you have returned to work.

If you are already receiving maternity allowance when you leave the UK, you may be able to persuade your British social security office to carry on providing that benefit.

Maternity leave

For a first or second child, the normal leave period is six weeks before delivery and ten weeks afterwards. From the third child onwards, it is eight weeks before delivery and 18 weeks afterwards. For twins, it is 12 weeks before delivery and 22 weeks afterwards; and for triplets (or more!) it is 24 weeks before delivery and 22 weeks afterwards. In the case of premature delivery, the total leave period is not reduced. In medical necessity, a doctor may prescribe an extra two weeks.

Paternity leave

The new and popular paternity leave is reimbursed in exactly the same way as maternity leave pay. Employers are obliged to accept requests for paternity leave.

You automatically have the right to three days’ leave when your child is born. To apply for paternity leave as well, you need to send a registered letter to your employer with receipt (lettre recommandé avec accusé de réception-see Chapter 12) at least one month before the start date of the paternity leave requested. A model letter to your employer can be found on www.social.gouv.frjfamille-enfance. A second registered letter, either from you or your employer, must be sent to your caisse, together with a salary certificate (attestation de salaire) and a copy of the birth certificate (extrait d’acte de naissance), or of your updated livret de famille with details of your new child, or of an official statement from you recognising fatherhood of the child (acte de reconnaissance).

You may take up to 11 days, but leave must be taken in one go (ie, not a few days here or there). Weekends are included in the time calculated. It must be taken within four months of the birth. For multiple births paternity leave entitlement rises to 18 days.

Registering the birth

You must register the birth of your new child within three working days, ie, if your child is born on a Thursday, you have until the following Tuesday at the latest. Otherwise, you cannot register your child’s birth without making an application to the courts. The registration should take place at the mairie of the place where your child was born, and the following documents are required:

• The déclaration de naissance completed by the hospital, doctor, or midwife (sage-femme).
• A piece of official identity (carte de séjour, driving licence, passport) for the person registering the birth.
• The mother’s carnet de maternité (see page 315).
• The livret de famille if you have one. You will only have this if you were married in France
• Your passports (if you and your wife have separate passports)
• You should also register your child’s birth at your own embassy to ensure the nationality rights of the child for the future. Contact the consular services to find out how to do this.

Once you have registered the birth, you need to send a copy of the birth certificate (extrait de certificat de naissance)or the livret de famille to your local caisse. You should also add one of your 100% exemption vouchers. The caisse will you send a guide for medical ‘surveillance’ of your child up until the sixth birthday. You will also receive vouchers corresponding to the obligatory examinations which must be undertaken. These should be taken to the examining doctor on each occasion together with the carnet de santé (personal health notebook) of the child.

Maintaining foreign citizenship rights

The information below was published in 2000 by the American Embassy in Paris and the Paris-based magazine Living in France, www.parisfranceguide.com.

Regulations change frequently, and it is important that you check with your own embassy as to the requirements for the correct registration of the nationality status of your children.

For American citizens, registration is by appointment-only at the American Embassy (tel: 01 43 12 46 71). You will need to request a registration pack which must be completed before the appointment and bring the originals or certified copies of the following documents, and also your child:

• (a)French birth certificate, extrait de l’acte de naissance intégrate.
• (b)Evidence of parent(s) US citizenship (eg, passport, naturalization certificate).
• (c)Parents’ marriage certificate plus livret de famille if the wedding took place in France.
• (d)If either of the parents has been previously married, either the decree of dissolution or divorce, or the death certificate of the previous spouse.
• (e)Two recent passport-size photographs of the child for his/her passport.
• (f)Fees in cash or travellers cheques – check the exact amount required when you make your appointment.

If the child has only one parent with US citizenship, the parent must have lived in the US for at least five years, for two of which they were over the age of 14.

A child born in France with two Australian parents has automatic Australian citizenship. Registration should occur either at birth or upon demand of a passport. Children with only one Australian parent need to apply to the immigration department of the Australian Embassy.

British parents are not obliged to register their new-born children at the embassy. A child may have a British passport providing at least one parent is British, and both parents agree in writing. Remember that all British citizens of no matter what age are now required to have their own passport, and children may no longer be registered on their parents’ passports.

Any child born with at least one parent who is a Canadian citizen is entitled to Canadian citizenship. Certificates of Canadian citizenship can be obtained at the Paris embassy.

Support groups for English-speaking mothers

There are two principal Paris-based support groups for English-speaking mothers:

• 1.MESSAGE (www.messageparis.fr, e-mail: info@mes-sageParis.org). A network of English-speaking mothers and future mothers in and around Paris. Meetings and activities for mothers and children, specialising in early parenting.
• 2.The Junior Service League of Paris (JSLP), tel: 01 47 20 00 03, and 01 46 21 55 72. A wide-ranging women’s social welfare network and group including health and child welfare, and training courses for childminders.

These organisations, and regional consulates, will be able to put you in touch with regional associations.

Child benefit and family allowance

The current level of family allowance is €112.59 per month for two children, €256.83 for three children, €401.08 for four children, and then increases by €144.25 per child for more than four children. For children aged 11–16, the amounts are increased by €31.67 per child, and for those aged 16–21 (still at the charge of their parents), the amount is increased by €56.21 per child. However if you only have two children, these increases only apply for the second child.

To apply for these benefits, you need to register at your local Centre d’Allocations Familiales (CAF). If your child is born in France, and you have declared the pregnancy (see above), the CAF should contact you automatically. Details of state assistance to which you may be entitled can be found on www.caf.fr. In January 1998, the Socialist government introduced means testing for allocations familiales.This takes into account the salaries of both parents if they are working.

A number of other benefits are available from the CAF under certain conditions for parents who are forced to give up work to look after their children:

• L’allocation de présence parentale.Valid initially for four months and for up a total of one year, the APP is available to parents to care for sick, handicapped or disabled children.
• L’allocation parentale d’education. Valid if you have given up your employment to look after your child up to the age of three years.
• L’AFEAMA (aide à la famille pour l’emploi d’une assistante maternelle agrée).The level of aid offered depends on the total family income. The level of support is reduced from the age of three years, when the child could enter a public school.

One Parent Benefit and Child Benefit from the British authorities normally ceases if you move abroad permanently. However, if you or your child stays in the UK, you can receive these benefits. Any UK insurance contributions you have paid may help in persuading the French authorities to pay you the French allocations.More information is available from, Department of Work and Pensions Child Benefit Directorate, (Washington), Newcastle upon Tyne NE88 1BR. Tel: 0870 010 0547 (in the UK), or +44 870 from abroad. E-mail: Child.Benefit@dwp.gsi.gov.uk.

SEXUALLY TRANSMITTED DISEASES

Your nearest hospital will be able to put you in touch with services and clinics for venereal disease. Information in English on HIV and AIDS-related issues is available from FACTS (see Figure 16). For free AIDS information ring the SIDA information service on 0800 840 800 (24 hours a day, seven days a week).

HELP WITH DISABILITY

There are numerous support groups in France to help disabled or handicapped people and those who care for them. Your doctor should be able to direct you towards the appropriate association. You should also apply to the Bureau de l’Aide Sociale of your local mairie for a Disabled Person’s Card which will entitle you to certain discounts and assistance.

If you are receiving Severe Disablement Allowance in the UK and you want to go to another EU country, including France, you must contact the Pensions and Overseas Benefits Directorate, Department of Work and Pensions, International Pension Centre, Tyneview Park, Whitley Road, Benton, Newcastle upon Tyne NE98 1BA. The decision as to whether you continue to receive this allowance will depend upon your age, how disabled you are, and how long you have lived in the UK.

If you are receiving any form of disability working allowance or carer’s allowance, and you move to France, you will not be able to continue receiving British support. Visiting France may also affect your UK allowance. Contact your local benefits authority to see what help they can offer in transferring your rights gained by British national insurance contributions to the appropriate French authorities.

Services of interest for those with disabilities or handicaps who are living in France include:

• The English Language Library for the Blind (35 rue Lemercier, 75017 Paris. Tel: 01 42 93 47 57, www.ell-b. online.fr Tuesday – Thursday 09h00–17h00) supplies a wide variety of recorded books on cassette in return for an annual subscription.
• France Telecom provides a range of products called ‘Arc-en-Ciel’ (rainbow) which are designed to facilitate communication for the disabled. These include telephones with flashing lights for those with sight disabilities, and a system known as the bôitier Dialogue which allows communication via Minitel for the hard-of hearing or speech-impaired at an increased speed. Ask at France Telecom agencies for details.
• The RATP provides details of RER and metro stations and bus lines which easy access for passengers with disabilities. More details can be found on their website www.ratp.fr.
• The French national railways service, SNCF, offer a variety of travel discounts and arrangements for disabled travellers. These include first class travel at second class tariffs. In some cases the accompanying person will be entitled to travel free. To qualify for these advantages, apply at the bureau de l’aide sociale of your local mairie for the appropriate card.Similar offers may be offered by other travel companies, so do check.
• FAVA (tel: 01 42 45 17 91) is the Franco-American Volunteers Association for the mentally retarded, providing programmes for children and adults.

SERVICES FOR ENGLISH-SPEAKING PATIENTS

Many French doctors do speak some English. But unless you are reasonably fluent in French and familiar with medical terms, you could experience difficulties, especially if the illness or problem is serious. Help can be found at the following places:

• English-language consulates have lists of English-speaking doctors.
• Private health insurance companies and travellers’ associations (eg, American Express, Automobile Association) often have help packs they can provide to their customers before they leave.
• The American Hospital in Paris, 63 boulevard Victor-Hugo, 92202 Neuilly-sur-Seine Cedex. Tel: 01 46 41 25 25. Emergency service number 01 47 47 70 15, patient access department 01 46 41 27 27. This expensive hospital may be accessible to you via your mutuelle, but otherwise do not count on receiving much reimbursement from the Sécu for access to this hospital.
• The Hertford-British Hospital, 3 rue Barbé, 92300 Levallois-Perret. Tel: 01 46 39 22 26, 01 46 39 22 22 for emergencies, fax: 01 46 39 22 26. A full range of treatment available in a small modern hospital within the French social security system with English and English-speaking staff.
• The English-language group of Alcoholics Anonymous can be contacted on 01 46 34 59 65.
• A cancer support group is based at the American Hospital and can be contacted on 01 46 41 25 25.
• FACTS – English-language support for those testing HIV positive and people with AIDS. Tel: 01 44 93 16 32.
• SPRINT (tel: 02 33 21 48 16 or 01 34 86 93 41) is an association of English-speaking therapists for children with special needs.

FINDING OUT MORE

• British citizens should check the two relevant government websites, Department of Work and Pensions (www.dwp.gov.uk);and Department of Health (www.doh.gov.uk I traveladvice). The NI Contributions Office International Services Helpline is 0845 915 4811 (+ 44 191 225 4811 from outside the UK), e-mail: internationalservices.ir.sbg@ir.gsi.gov.uk. The DWP International Pension Centre (covering all benefits)can be contacted on 0191 218 7777 (+ 44 191 outside the UK), e-mail: tvp.customer-care@dwp.gsi.gov.uk
• www.cmats.fr. The national site of the French health authority, with links to your local health authority websites and addresses. Click on your region and enter your town name to find your nearest office. Site in French only.
• www.caf.fr. The family benefits unit, for everything from maternity and paternity leave information to child benefits, to housing benefits. Site in French only.
• www.securite-sociale.fr. This website acts mainly as a springboard for more detailed health agency sites. All of these sites are in French only. The Centre des Relations Internationales of the Securite sociale is at 175 rue de Bercy, 75586 Paris cedex 12 (next to the Gare de Lyon). Tel: 01 40 19 53 19.

Travel guides for disabled and handicapped travellers are available in the UK from:

• RADAR, 12 City Forum, 250 City Road, London ECIV 8AF. Tel: (020) 7250 3222.
• Tripscope, The Courtyard, Evelyn Rd, London W4 5JL. Tel: (020) 8994 9294.
• Mobility International, 2, Colombo St, London SE1 1JX. Tel: (020) 7403 5688.