Budget’s Immigrant Health Surcharge hike will hamper the NHS Coronavirus fight

11 March 2020

In Wednesday’s budget, the Chancellor of the Exchequer announced a big increase in the Immigration Health Surcharge – up from £400 to £624 – more than triple the £200 when it was introduced in 2015. He added that children would pay a lower charge. The health surcharge is payable when applying for or extending a visa.

Chancellor Rishi Sunak announced a welcome £30 billion to fight Coronavirus COVID-19 in the budget, including sick pay rebates for employers and a boost for the NHS.

However, the hike in the Immigrant Health Surcharge to £624 will add to people’s visa costs when it comes in. – And that includes the medical, technical and nursing staff the NHS urgently needs.

The immigration health surcharge and the way Rishi Sunak framed it during his budget speech as a charge to stop people abusing the system, smacks of dog-whistle politics, perpetuating the myth of the ‘health tourist’ – see below.

Budget announces funds to fight Coronavirus – while making it harder to hire NHS staff

Rishi Sunak announced a fiscal stimulus totaling £30 billion to fight the spread of Coronavirus COVID-19, including welfare and business support, sick-pay changes and local assistance. This includes a welcome £7 billion for businesses and families and £5 billion for the National Health Service (NHS).

£2 billion sick-pay rebates for up to 2 million small businesses with fewer than 250 employees will also be welcome news to many employers.

However, the hike in the Immigrant Health Surcharge is not. It just adds to the costs for employers and employees of one of the most expensive visa and sponsorship regimes of any country in the world.

The healthcare fee rise also adds an extra cost to deter the medical, technical and nursing staff the NHS urgently needs to keep attracting from around the world – especially if the Coronavirus starts to overwhelm current health service capacity and the government genuinely intends to build the 40 new hospitals that the Chancellor promised again on Wednesday.

At £1,220 per person, or £900 for those on the shortage occupation list, visa fees are among the highest in the world.

The myth of the ‘health tourist’

The hike in the Immigration Health Surcharge and the way Rishi Sunak framed it during his budget speech as a charge to stop people abusing the system, smacks of dog-whistle politics, perpetuating the myth of the ‘health tourist.’

The British Medical Association estimates actual health tourism – people seeking medical care who aren’t entitled to it – costs the NHS just 0.3 per cent of the health budget.

The Immigration Healthcare Surcharge is aimed at people applying for a visa to work, study or join their family in the UK for more than six months. As the Migration Advisory Committee concluded in their 2018 report on EEA migration in the UK, there is “no doubt that EEA migrants contribute more to the health workforce than they consume in health care.”

According to NHS workforce statistics, 13.3 per cent of NHS staff in hospitals and community services in England are not UK nationals. Among doctors, the proportion is 28.4 per cent.