New migrant ‘health surcharge’ – an election stunt full of loopholes

22nd March, 2015 11:16 am

The government announced yesterday that migrants will be subject to a new ‘health surcharge’. The fee comes into effect next month. The surcharge is £200 per year payable upfront with students required to pay £150 annually.


The health surcharge is an election stunt full of loopholes. The policy begins on 6 April – a week after Parliament is expected to dissolve and during a national election campaign. The timing of it is hardly coincidental.

But the bigger problem is this: government rhetoric fails to meet reality. The public are told the surcharge will offset the costs to the NHS from treating migrants. However, thousands of migrants will not need to pay because of several exemptions and restrictions. It’s a clear case of government saying one thing, but doing another.

The health surcharge will only be imposed on non-EEA citizens in the UK temporarily for more than 6 months. EEA citizens from Europe are unaffected. There are 11 different exemptions from the surcharge include anyone visiting the UK for under six months, intra-company transfers, children under 18 years in care, and nationals of Australia and New Zealand.

There are further concerns that the funding raised may not be used effectively. Migrants paying the surcharge must do so upfront and the money collected is distributed to the relevant health department in England, Wales, Scotland or Northern Ireland. The problem is that migrants don’t always stay in the same place. If a migrant moves from England to Wales, the funding raised by the surcharge does not appear to follow the individual. This will mean the new funds might not go to the authorities that need it most.

It is true that migration has put pressure on public services, such as the NHS. But it is also true that the government lacks concrete figures about the actual costs that migration adds to the NHS bill. If health tourism is about migrants dropping in for free procedures and then leaving the country, this is not tackled by the new health surcharge as it does not affect anyone coming to the UK for less than 6 months even if a visa is required for entry.

A better alternative would be to bring back the Migration Impacts Fund launched by Prime Minister Gordon Brown in 2009. Like the new health surcharge, the Migration Impacts Fund was a levy on application fees paid for by non-EEA citizens. Over two years, it helped raise £70m to provide English language training, extra support teachers and improve emergency services. Local authorities would submit bids and the funding would go to those areas where support was needed most. It wasn’t ideal, but a step in the right direction.

The government ended the programme shortly after entering 10 Downing Street. Baroness Hanham CBE said that ‘In light of the overall fiscal position the government concluded it was not a priority funding stream’. And so it was stopped. But while the Fund was terminated, the levy remained with the extra funding going to other programmes.

The upshot is that the pressures on public service have not gone down while government support for relieving such pressures – through instruments like the Migration Impacts Fund – were cut. If our health service requires urgent support because of migration, then the government shares some of the blame for too quickly scrapping a useful programme.

Moreover, migration-related pressures on public services are not confined to health services alone, but also education, transport and other areas. The Migration Impacts Fund was a programme that addressed all of these areas. The government’s new health surcharge speaks to only one and leaves the others exposed.

The government should have considered a new Migration Impacts Reduction Fund, as I have called for recently. A small levy of £25 on immigration fees could raise an extra £11.7m of new funding to help provide necessary services without increasing costs for hardworking taxpayers while improving public services for all. Instead, the government’s health surcharge might not support the NHS in the way it has been announced – and it will do little to improve public confidence in either the seriousness that government officials take migration issues or in championing the many genuine contributions that migrants bring to the UK. And I should know first-hand: I am a migrant to the UK (and British citizen since 2011) who has paid into the Migration Impacts Fund. So I do not advocate a programme I haven’t contributed to myself.

The government should stop seeing immigration as a political football and instead as a serious policy area that deserves far more serious policymaking.

Thom Brooks is Professor of Law and Government at Durham University

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  • Sunny Jim

    No votes in opposing this.

    Move along – nothing to see.

    • Thom Brooks

      Disagree. An ill-thought gimmick that will hardly improve public confidence. Issue would have been handled much better if coalition government did not scrap Labour’s Migration Impact Fund, which addressed not only migration-related impact on health but other public services, too. Tories gimmicks a poor substitute for Labour’s policies. The problem is that these gimmicks need to be exposed clearly – and loudly.

  • SC4649

    The new surcharge also applies to migrants already in the UK who needs to extend their visas. The strange thing about this is that those migrants if they have been working here, have already been paying taxes, thus already supporting NHS, education and other public services. Plus, they pay local council taxes so they support local public services as well.

    Treating migrants as if they are not hard-working tax payers is wrong.

    The new surcharge being levied on tax-paying migrants is wrong.

    Visa application fees cost an arm and a leg already, currently at £514 for Tier 2 General (under 3 years) plus the same fee for every dependent person including infants – infants! The surcharge is £200 per year per person (including dependant children). What happened to ‘protect the children’? So if you’re a family of three already in the UK and need to apply for a three year extension, that’s £1800 on top of the £1803 (£601 extension fee per person), a whopping £3603!

    Where does all this money go to?

  • Grouchy Oldgit

    Like Labour’s pledge card it shows immigrants are a convenient scapegoat for society’s ills like the housing shortage, NHS waiting lists, overcrowded classrooms, falling wages etc. A myth stoked up by extremists like UKIP, but unfortunately there are votes in it.

  • Tommo

    This is a sensible policy.

  • stephenbooth

    From what I’ve seen issues from migration are rarely with those staying for significant periods or with a view to becoming UK citizens. Issues stem mostly from employers exploiting short to medium term migrants to keep down wages and avoid their legal duties.

  • Anonymous

    Its unfair that a Spouse of a British Citizen has to pay this surcharge. A spouse should be considered as a settled person due to their intention to settle after the probation period.

    Application fees for a spouse visa and extension are very high as it with the latest fee hike coming into force today.

    The surcharge fees should just apply to students and migrant workers only.

    • SC4649

      I disagree about the migrant workers. As I’ve outlined in my comment already, if you’re working, you’re paying tax, thus paying into the NHS.

  • Chenzo

    Why is it called a SURCHARGE?

    Legal Migrants (who are working) are already contributing towards the health service so why is it that they have to pay a surcharge?
    What about illegal immigrants who doesn’t contribute at all, how are we going to stop them from using the health service or any other services?

    It’s simply unfair and I don’t think that this will improve immigration status in the UK, it will probably increase the amount of illegal immigrants, as a lot of people will not afford to pay the SURCHARGE!!!

  • Pete

    This is likely one of the most abusive regulations a country in plain democracy has ever issued against its own British people and their families, people coming to contribute to their own country.

    We treat them like rats, blame them for everything, abuse them whenever we can, there are even businesses who have migrants on test run for a few months and benefit from their work, they bring new clients, etc. They promise migrants sponsorship, squeeze them and then close the door on their noses right before their time of permanence is about to expire. They basically destroy the life of these people, no respect whatsoever. We want them to pay ridiculous amounts of money, amounts we ourselves don’t need to pay and we don’t even give them the right to vote, so they can’t change and help to bring a better government to the country they help to shape.

    It is shocking this has not ended yet in the International Court of Human Rights.

  • UK Resident

    This is ridiculous.

    UK Government is overcharging the visa fees. Who on earth would deter from applying/coming to the visa – by charging an additional £200 pp per year?

    This only results in causing a very bad reputation of the UK and causing unnecessary burden on hardworking taxpayers/students from Non-EEA. They are coming to this country with a lot of hope and our stupid politicians are just playing gimmics by doing these kinda of things.

    UK is already suffering on innovation index for losing talent to other countries and these things will only further aggravate this situation.

  • thornpuller

    I just found out about having to pay the health surcharge next time I renew my spouse visa. Yet another ‘f*$k you’ to an educated Canadian citizen who is married to a Brit and is in full time employment, paying my taxes for years. I’m employed by a multinational technology company who pays for me to have private health care, ergo I won’t be using the NHS anyway, and yet I will have to cough up £500 when I get my visa extension. I’ve lived in the UK legally for close to 8 years and and it’s insulting that the government tars me with the same brush as a ‘health tourist’. I intend to move away from the UK with my husband in the next year.

    • Patti Sweet

      I feel your pain as I’m in the same boat. I didn’t even notice this came into play until I just received a letter from the Home Office on my ‘further limited leave to remain’ application, requesting I pay this new fee. It makes my application fee for a spouse visa increase from £600 to £1,100 – for a visa that only lasts 30 months and for which we’ll need to reapply again after that. We’ve been married for almost 3 years and now have a child together, I’m employed and pay the same NHS fees through taxes, but now the application fee is almost doubled. Between this and the record backlog from the first time we applied in 2012, my husband and I are also planning to leave the UK within the next few years. It’s ridiculous. My husband is an industry leading researcher and I’m an educated, well established professional so it confuses me as to why the government would want to push us away so aggressively.


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