Scrap the Immigration Health Surcharge – don’t increase it

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  • Chancellor Rishi Sunak announced on Wednesday 11th March that the Immigration Health Surcharge (IHS) – paid at point of visa application/renewal would rise from £400/year currently to £624/year
  • Docs Not Cops has always opposed the IHS, even before the charge was introduced in 2015 (at £200/year). It is a regressive, punitive and racist charge targeted at migrant communities and designed to restrict access both to the NHS and to safe immigration status’. 
  • The extra cost on visas forces working class people to live apart from their families
  • The Immigration Health Surcharge is a form of double taxation – people living in the UK already pay in to the public pot through income and other forms of taxation
  • The charge represents a move away from the fundamental principle of the NHS as a universal, rather than contributory, health system – opening the door to an insurance system for all, where access is dependent on ability to pay rather than need 
  • A Tier 2 visa for 5 years, including the new charge, will cost £3,589. For a family of 4 for 3 years, the new Immigration Health Surcharge rate equates to £6,564 on top of visa fees

A policy costings document accompanying the 2020 budget states 

“The Immigration Health Surcharge [will be raised] from the current level of £400 per year to £624 per year for each surcharge liable non-EEA temporary migrant (including dependants). The measure also increases the discounted rate for students, their dependents and those on the Youth Mobility Scheme from £300 to £470. The surcharge will also be set at £470 for all children under the age of 18.

This will be implemented in October 2020 and expanded to include future EEA temporary migrants at the increased rate from January 2021.”

These increases are outrageous, but we do not only oppose the increase. Docs Not Cops continue to believe that the Immigration Health Surcharge should be scrapped in its entirety. The NHS should be a universal system – treating patients on the basis of need, not ‘contributions’ – as it was designed to be. Charging for NHS access isn’t about economics – it’s about the govt finding excuses to tear up the principle of universal health care. It’s about adding an additional tax on migrants – deterring people from moving to the UK or forcing people into undocumented status/out of the country when they cannot afford visa renewal. It’s about furthering xenophobic and racist narratives.

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High visa costs – including but not limited to the impact of the Immigration Health Surcharge – are already ruining lives, breaking families apart. In May 2018 the Independent reported the case of Evaline Omondi, an NHS nurse from Kenya, who had to send her two youngest children home to Kenya because she could not afford an immediate payment of £3,600, to cover three years of fees for two adults and her four children.

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Omondi said at the time: “The fees had to be paid immediately, so we had to take out loans to cover them which still affect my family to this day. But on top of the visa charges, and childcare costs, we could not meet the cost and my children had to move back to Kenya. A family who came together is now in pieces, scattered all over the place. I try to speak to them on the phone before they sleep but it is hard with the time difference and my work, so I sometimes don’t get to talk to them.”

We have long called for investment in our NHS and an end to the privatisation and marketisation that wastes resources. There has been plenty of evidence already, but the current pandemic is dramatically exposing the effects of decades of undermining of the NHS. The Immigration Health Surcharge is not an effective, nor a fair way to fund the NHS.

In his announcement the Chancellor misrepresents the way entitlement to the NHS works in order to justify increasing the harm caused by this restrictive policy. The NHS is a system designed to pool risk as a society to ensure that everyone is able to access their human right to health. Paying tax currently, or having paid tax historically, has quite rightly never been a factor in a person’s entitlement to the NHS – this would exclude many people who rely on it to survive. It is not a system that relies on someone having ‘paid in’ to be entitled to access its services. This framing is used to suggest that it is somehow ‘unfair’ that certain groups of people are able to access the NHS – it is not only incorrect in terms of NHS funding arrangements, but also seeks to stoke the baseless, xenoracist idea that migrants are a “burden” on our public services. On the contrary, the NHS was built with and today still runs on the labour of migrants. Everyone who is in the UK for any length of time pays taxes of one form or another when here – whether VAT on purchases or income tax. There is no economic justification for making people pay to access healthcare on top of their visa charges and contributions through tax.

The NHS charging system – of which the Immigration Health Surcharge is just one part forces health services to question people’s immigration status, to ascertain whether they have the right piece of paper which guarantees them the free treatment we currently enjoy. We see how this leads to racial profiling and discrimination, and deters people from seeking treatment. The administrative infrastructure is an expensive bureaucracy that threatens to expand to exclude more and more people and turn our health system into one in which ability to pay or your immigration status are the sole things that govern a person’s access to care.

Finally, we wish to reiterate our long-held position that the Immigration Health Surcharge – along with the wider NHS charging system and the hostile environment – should be scrapped. It is impossible to write this statement without referring to current events. While the government’s stated policy is that tests and treatment for Covid-19 are exempt from the government’s charging system, this has not been clearly communicated (unlike in New York City, for example). Further to this the Department of Health and Social Care will give no assurances that peoples’ data won’t be shared with the Home Office, further deterring people from seeking treatment during this global public health emergency. Making a major policy announcement about increasing a charge for migrants to access the NHS will do nothing to address the widespread fear of accessing health services for fear of encountering charging or being reported to the Home Office. That the government has chosen to prioritise furthering it’s migrant-bashing agenda at this time is particularly disgusting.

No one should be afraid to go to the doctor, either because they can’t pay or might be punished. No health workers should have to police the people they treat.

What can you do?

  1. Sign our letter to the Health Secretary:
  2. Support people facing charging using the toolkit
  3. Join us:
  4. Learn more about charging: Patients Not Passports: Challenging Healthcare Charging in the NHS

Footnote: The Immigration Health Surcharge was introduced on 6 April 2015, under the Immigration Act 2014. Until January 2021 the surcharge has affected non-European Economic Area (EEA) nationals who come to the UK to work, study, or visit their families for a period of longer than six months, and to non-EEA nationals who are already in the UK and applied to extend their stay after 6 April 2015. Docs Not Cops was founded to oppose the introduction of the IHS.