Forcing NHS staff to pay health surcharge up front 'wrong and unnecessary', warns BMA

NHS staff recruited from overseas will continue to pay an 'absurd' health levy despite government promises that they would be exempt, in a move doctors' leaders say is 'wrong and wholly unnecessary'.

BMA chair Dr Chaand Nagpaul (Photo: JH Lancy)
BMA chair Dr Chaand Nagpaul (Photo: JH Lancy)

The government this week unveiled plans that will allow health and care staff charged the 'immigration health surcharge' fee - which can cost families arriving in the UK thousands of pounds - to claim reimbursement.

But doctors' leaders say the move falls short of a government promise earlier this year that the fee would be scrapped for staff in the health and care sector.

The promise came after prime minister Boris Johnson was forced into a U-turn after initially insisting in parliament that forcing NHS staff recruited from overseas to pay the levy was the 'right way forward'.

Health surcharge

The immigration health surcharge is a £400 annual fee charged to people coming into the UK from outside the EU to work or study. The fee was set to rise to £624 from the start of October, but the rise has yet to take effect.

The charge will be levied from thousands of EU workers in addition to those from outside the EU once Brexit goes ahead at the end of the year.

BMA chair Dr Chaand Nagpaul said: 'The NHS and social care system would not be able to function if not for the vital contributions of our international colleagues, whom we all owe a debt of gratitude. The BMA had been calling for the immigration health surcharge to be scrapped for all healthcare workers since the fee’s introduction, and we welcomed the government’s long-overdue announcement in May that this would be done.

'It’s positive that refunds are now being issued to doctors who have already paid the fee, but today’s announcement confirms that those who fall outside of the Health and Care Visa, and this includes doctors in other categories such as those on the medical training initiative and Tier 5 visas, will still have to pay it upfront and then claim back reimbursements.

NHS workforce

'This is wrong and wholly unnecessary. Those who come to the UK to work in the NHS through routes other than the Health and Care Visa are disproportionately likely to be on lower rates of pay. The annual surcharge fee for a family of four is £1,600 on average, which many health and social care workers can ill-afford to pay. It makes no sense to require them to incur an upfront cost only to jump through bureaucratic hoops and wait to be reimbursed by the government. '

Health union Unison said the government had broken its promise on the health surcharge, and warned  that a family of four on a four-year visa would have to find almost £7,500 to cover the cost while they waited for reimbursement.

Doctors’ Association UK chair Dr Rinesh Parmar said it was 'appropriate' that the contribution of migrant health and care workers had been recognised by reimbursing the surcharge.

He called on the government to go further and grant indefinite leave to remain 'to those who have served and continue to serve our health and social care system in its time of greatest need'.

Dr Parmar said: 'I urge the home secretary to think again, to right the wrongs and missteps of previous years and recognise the dedication and contribution of migrant workers in health and social care. Our country has a strong and proud history of making the right moral choice, as was made with the Gurkhas. We are calling on the government to do the right thing by granting indefinite leave to remain to all migrant health and social care workers.'

Announcing the reimbursement scheme this week, health and social care secretary Matt Hancock said: 'I am incredibly proud of all the fantastic health and care workers from all over the world we have working in our NHS who provide such an invaluable service, from cleaners to care workers to porters.

'We can now deliver on our promise as the reimbursement scheme will benefit those who have given so much this year to protect us all from COVID-19.

'This will encourage overseas health and care workers to continue to come and work in the UK and help those already living here to provide first-class care and support for patients.'

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