How much have healthcare workers paid through the immigration health surcharge?

“Every Thursday, we go out and clap for our carers. Many of them are risking their lives for the sake of all of us. Does the Prime Minister think it is right that careworkers coming from abroad and working on our frontline should have to pay a surcharge of hundreds, sometimes thousands of pounds to use the NHS themselves?” 

Keir Starmer, 20 May 2020

“…we must look at the realities. This is a great national service—it is a national institution—that needs funding, and those contributions help us to raise about £900 million.” 

Boris Johnson, 20 May 2020

At this week’s Prime Minister’s Questions, Boris Johnson claimed that health surcharges paid by international care workers “help us to raise about £900 million.”

To clarify, £900 million is the total amount international residents working in all sectors have paid towards the immigration health surcharge over four years, not just the amount paid by healthcare workers themselves, as might have been understood by the Prime Minister’s comments. 

The government has since said it will scrap the charge for international health staff and care workers. 

How does the immigration health surcharge work?

The immigration health surcharge is currently paid by nationals of countries outside the European Economic Area (EEA) who are:

• making a visa application to come and work, study or join family in the UK for more than six months, but not permanently,
• living in the UK already and are making an immigration application to stay in the UK for any period of time, but not permanently.

You don’t need to pay the surcharge in a number of other circumstances, for example if you’re an asylum seeker, or have a family member who is an EU national.

At the moment, the surcharge costs £400 per year (with the exception of students or those coming to the UK on a youth mobility scheme for whom it costs £300).

The government plans to increase this surcharge to £624 from October 2020 and extend it so that EU and EEA nationals also have to pay it when they come to the UK. A discounted rate of £470 will apply to all under 18s.

How much is raised from healthcare workers, and in total?

Annual reports from the Home Office show that, since its introduction in 2015/16, the surcharge has raised around £920 million, with £300 million raised in 2018/19. By comparison the health spending in England in 2018/19 was around £129 billion.

Newsnight reported that NHS workers (which doesn’t include social care workers) contribute around £35 million a year of that total, data sourced to the House of Commons Library, a service which provides briefings to MPs. 

The Library told us the data behind the figure was produced for Seema Malhotra MP, but that, as responses to enquiries from MPs are confidential, it could not share the figures with Full Fact. We have asked Ms Malhotra’s office to share the data.

We’re not sure how many healthcare workers currently pay the surcharge, and according to a parliamentary question earlier this year the Home Office does not collect that data. Torsten Bell of the Resolution Foundation has pointed out that there were around 88,000 non-EU international workers in the NHS in England and a further 134,000 in the adult social care sector in 2019, though added that some of these people will have permanent right to remain in the UK and so won’t be paying the surcharge.