NHS Migrant Surcharge Scrapped for NHS Workers

In a dramatic U-turn, on 21 May 2020, British Prime Minister Boris Johnson scrapped the controversial healthcare surcharge for migrant NHS workers and care workers.

This came after a week of controversy in which Mr Johnson and his party's popularity plummeted in the opinion polls.

Although discontent over migrant NHS workers and care workers paying the surcharge, which is set to rise to £624 per year in October, has been present since March, negative media comments became too great to ignore last week.

"Clap for them, then charge them". That was the opening sentence of a brutal Guardian opinion piece by Maya Goodfellow. She argued that it was abhorrent that the people who sacrificed so much and saved so many lives have to pay more than anyone else to access healthcare. This is in reference to the fact migrants pay taxes, National Insurance, and on top of that, the healthcare surcharge.

Condemnation of the healthcare surcharge for NHS and care workers came from all quarters.

The British Medical Association council chair said the surcharge, which was first introduced in 2015, penalized hard-working staff who were risking their lives by working on the response to coronavirus.

Dr Chaand Nagpaul said:

"The BMA has consistently said that all healthcare workers should be exempt from paying the immigration health surcharge – and this is more important now than ever. "These staffs are also already paying tax and national insurance like everybody else – meaning they are being charged twice for NHS treatment."

Dame Donna Kinnair, the chief executive and general secretary of the Royal College of Nursing, stated:

"We are urging the home secretary to reconsider and waive this charge for healthcare staff from overseas as a matter of urgency. We have already received devastating accounts from members who are struggling to pay the charge and the impact that it is having on their families' lives.

"The current pandemic has served to reaffirm the importance of our internationally educated staff. Without them here, patient care would be at risk."

The shadow home secretary, Nick Thomas-Symonds, argued:

"This issue has been mishandled by the UK government from the start of the coronavirus crisis.

"These additional health fees for NHS staff are no way to mark the extraordinary service of those at the healthcare frontline. Our NHS and care workers are working tirelessly to help support all those most in need."

The SNP's Dr Philippa Whitford, who has worked as a frontline medical doctor for the past two months in Scotland, said that at most, the healthcare surcharge could only be justified for the initial year someone came to the UK because they would not have paid into the tax system yet.

"It’s divisive and hypocritical to have politicians making a big deal of clapping for carers on a Thursday night and they say you’ll have to pay £625 to use the service they’re working in. Non-EEA migrants are already paying through tax, so to raise it to £625 is another barrier for them.”

Related Article: Read more on ‘£624 Immigration Health Surcharge (IHS) fee Increase by October 2020’

What is NHS surcharge?

The NHS surcharge is a one-off payment that all non-EU/EEA migrants must pay to access the NHS. Dependents who are coming with the visa applicant must also pay the charge which was implemented in 2015. The fee is payable upon filling out the visa application form and can be paid online or by post.

What makes the healthcare surcharge controversial is that a) it is expensive and b) migrants feel they are paying twice, once through the surcharge and again through tax.

The full fee has to be paid upfront for the visa holder and his or her dependents. For example, after October 2020, for a Tier 2 migrant bringing a dependent and three children, the upfront cost will be £15,600. This breaks down as:

£624 x five people x five years (the length of a Tier 2 visa)

This is a considerable expense for migrants wanting to come to the UK. Fortunately for Tier 2 migrants, often the sponsoring employer will pay the healthcare surcharge (or at least part of it).

Students and their dependent family members will be required to pay £470 per year from October (up from £300).

The path to fairness

When confronted with the contradiction that migrants were paying twice for the very care they gave to others, Home Secretary, Priti Patel gave the standard government response that the matter was “under review”.

A factor that has also contributed to the outrage regarding migrant NHS and care workers paying the healthcare surcharge is that many have died on the frontline. According to reports, up to 25% of Filipino healthcare workers have died from Covid-19 whilst working in the NHS. Although not all BAME healthcare workers are migrants, the fact is that a majority of healthcare workers who have been killed by Covid-19 (61%) were from an ethnic minority background.

On Thursday night, just hours before the 8 pm clap for the NHS was about to begin, Mr Johnson, who had “been thinking about the issue for a long time” instructed the Home Office to make arrangements for the surcharge to be scrapped for NHS and care workers.

Health Secretary, Matt Hancock told reporters:

"The PM has clearly himself been a beneficiary of carers from abroad and talked many times about the enormous contribution they give.

"The purpose of immigration health surcharge is a fair one; the purpose is to ensure everybody contributes.
"The PM has made that decision and asked us to make it happen."

All other non-EU/EEA migrants will have to pay the new surcharge rate. And from 1 January 2021, when freedom of movement ends in the UK, EU/EEA migrants will also have to pay the full surcharge upfront before entering the country.

The only decent thing to do

Given the tumultuous week the British Government has had, thanks to the Dominic Cummings breaking lockdown fiasco, finally acknowledging the enormous sacrifice and hard work migrant NHS and care workers have done in the face of this pandemic may bring about some goodwill.

Because at the moment, Boris Johnson needs all the support and positive news he can get.