Unions and campaigners are calling on the government to extend the NHS surcharge waiver to all migrant workers, including teachers, bus drivers and charity workers.
It follows a policy U-turn on Thursday when Boris Johnson announced that overseas NHS staff and care workers would no longer have to pay the controversial fee of £400 a year, which is due to rise to £623 in October.
Immigration groups also asked the government for clarity over whether the shift in policy would mean the families of healthcare workers would also be exempt from the charge.
The U-turn came after the prime minister was put under pressure from his own MPs as well as the Labour leader, Kier Starmer.
What is it?
Any worker who comes to the UK from outside the European Economic Area pays the fee to use the health service. The surcharge costs £300 a year for student visas and £400 a year for all other visa and immigration applications. It is set to rise in October. A migrant’s dependants usually need to pay the same amounts.
Who does not need to pay?
You don’t pay this fee if you are applying for indefinite leave to enter or remain, or if you are a diplomat or member of a visiting armed forces. Other exemptions include a dependant of a member of the UK’s armed forces and a family member of a European national, as well as asylum seekers and victims of slavery or human trafficking.
Rehana Azam, a national secretary at the GMB union, said it was calling on the government to scrap the fee for all migrant workers, who she said played a key role outside health and social care. “Migrant workers are on the frontline in so many of our essential services across the public and private sectors, not just in our NHS and care sectors,” she said. “From police to public transport these workers are putting themselves at risk to ensure that our day-to-day lives can continue.” She added that the charges should be refunded.
The general secretary of Unison, Dave Prentis, said it should be dropped for family members and more widely for all migrant workers: “It’s a moral injustice to ask migrant staff to make double the contribution of others and pay extra for the very services they help provide. This must also apply to the workers’ families. And the government should go further by removing the charge for all migrant workers.”
Charities supporting migrants affected by the charge and high visa fees say they are seeing huge debt problems caused by low-paid workers having to find thousands in fees.The surcharge is paid as a £1,000 fee every two and a half years along with other visa fees.
Nazek Ramadan, the director of charity Migrant Voice, also said the NHS surcharge should be waived for all migrant workers.
She said: “The partial U-turn by the government doesn’t go nearly far enough. From October, a family of four renewing their 2.5-year visas will have to pay £6,240 just for the NHS surcharge – that’s on top of the £4,000 cost of the visas. Just like British workers, migrants contribute to the NHS through taxes. This surcharge is not only unfair, but, added to the extortionate cost of work visas, crippling for many.
“At our meetings with our members, we learn that teaching assistants, cleaners, bus drivers and other workers across the country are drowning in debt and struggle to feed their children.
“To abolish the charge for some but not others is cruel and indefensible. It feeds a poisonous narrative – one that has flourished during the Covid-19 pandemic – that says some migrants are worth more than others.”
James Skinner, a former A&E nurse who is a campaigner for Medact, which lobbies for access to healthcare, said: “We don’t want anyone to have to pay the immigration health surcharge. It’s a discriminatory double tax that hits people in poorly paid jobs the hardest. We’re not the only essential workers; bus drivers, teachers, unpaid carers, cleaners, and so many more are all vital to keep society going – and yet they’re forced to pay extra for the NHS.
“The government have accepted that the surcharge is unfair, now they need to scrap it for everyone.”
Caroline (not her real name, who works in a canteen in a university in northern England, said her debts are spiralling as she tries to meet the fees.
“Usually I would save in advance to pay the surcharge and fees but because of maternity leave I wasn’t able to. I’ve borrowed £1,000 from my mum, another £500 from my sister, and still I’m not quite there and I need to pay next month. I have two children, they are British – they need me to be here. My sister works in care and has now had the fees dropped.
“I have paid tax all along, I look at it, at where I’ve come from in Jamaica, and I think yes, the UK give you an opportunity, you can come and work here. But then they use the other hand, they pull it all back.
The Home Office said it was unable to provide any further clarity. The Downing Street press office has been contacted for comment.