Government forced into U-turn over NHS surcharge for health and care workers

Doctors' leaders hailed a moral victory as the government announced plans to scrap the immigration health surcharge on overseas health and care staff, just 24 hours after Boris Johnson insisted retaining the fee was the 'right way forward'.

Prime minister Boris Johnson (Photo: Leon Neal/Getty Images)
Prime minister Boris Johnson (Photo: Leon Neal/Getty Images)

Health and social care secretary Matt Hancock said at a Downing Street briefing on 21 May: 'The prime minister has asked the home secretary and I to work on how we can remove NHS and care workers from the NHS surcharge as soon as possible. I am very pleased to be able to do that.'

The comments marked an abrupt U-turn from the prime minister's response just a day earlier to questions from Labour leader Sir Keir Starmer in the House of Commons.

Mr Johnson said on 20 May: 'I understand the difficulties faced by our amazing NHS staff and I have been the personal beneficiary of people who have come from abroad and frankly saved my life.

Immigration health surcharge

'On the other hand we must look at the realities, this is a great national service and it needs funding and those contributions help us to raise about £900m and it is very difficult in the current circumstances to find alternatives. So with respect I do think that is the right way forward.'

Announcing the reversal of this stance, Mr Hancock said details of how health and care staff would be removed from the surcharge would be announced in the coming days. The BMA called for the change to take effect 'immediately'.

Scrapping the fee could save overseas health and care workers thousands of pounds. 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 is set to rise to £624 from October and 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.

Data from the Office for National Statistics suggest more than half a million staff from outside the EU are currently being penalised by the levy - with many facing bills for thousands of pounds over the course of a five-year work visa if they have a partner or dependants, for whom the fee must also be paid.

NHS staff

The BMA has called imposing the charge on overseas health and care workers 'unfair and illogical' because they already pay tax and national insurance, meaning the fee effectively forces them to pay twice to use the very services they help to run.

The Doctors Association UK (DAUK) has also spoken out strongly against the surcharge - and criticism of the government's stance emerged within the Conservative party ahead of the U-turn. The Labour party plans to table an amendment to the Immigration Bill currently going through parliament that would scrap the surcharge for health and care staff.

Following the government U-turn, BMA chair Dr Chaand Nagpaul said: 'This announcement is long overdue but is testament to the BMA’s persistent lobbying for this surcharge - unfair to so many NHS workers from overseas - to be abolished. This is without a doubt a moral victory and brings huge relief to those facing bills of up to thousands of pounds - as well as the insult of having to pay for the very services they are working so hard to provide.'

DAUK president Dr Samantha Batt-Rawden said: 'At a time when doctors and nurses from overseas are putting their lives on the line, exempting them from the surcharge is only right in recognition of their service to our country.

'We now must move forward in acknowledging the enormous contribution healthcare workers to our health service. DAUK will continue to call for indefinite leave to remain for all frontline healthcare workers who have served in the NHS during the pandemic.'

Mr Johnson told MPs on 20 May that more than 300 NHS and social care staff have died from COVID-19 during the pandemic.

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