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The home secretary raised expectations when she hinted at concessions for migrants working in the NHS themselves, as she praised their “extraordinary contribution” during the Covid-19 crisis.
But The Independent has now learnt there will be no changes to what ministers consider the “important” principle that everyone coming to work in the UK contributes extra for the NHS.
It means the immigration health surcharge is still due to soar from £400 a year to £624 from this October – to be and extended to all EU citizens from next January, when Brexit is completed.
Because it is also paid by spouses and children, the total cost can reach a crippling £8,000 for a family of four on a five-year work permit, or with limited leave to remain in the UK.
The Home Office is now saying there was no “review”, beyond waiving the surcharge where visas had been extended for one year – despite Ms Patel describing it as such on national television.
The British Medical Association (BMA) said the decision “beggars belief”, given the public’s “huge outpouring of support for our frontline staff” in recent weeks, while Labour called it “unconscionable”.
The Royal College of Nursing (RCN) said it had written to the home secretary after her announcement, but had received no reply, and insisted: “This charge must be stopped.”
Health groups had long protested the surcharge as unfair because migrants paying tax and national insurance are effectively paying twice, even before the acclaim for all health staff prompted by the pandemic.
It cannot be deferred, or paid annually, but is demanded in advance for the entire duration of an applicant’s visa or residency permit. Meanwhile, nurses and junior doctors in training have starting salaries of only between £18,000 and £23,000.
Around one in every seven NHS workers is foreign-born – a dependence that has attracted growing attention as they have been on the front line of the fight against coronavirus.
On 25 April, at the Downing Street press conference, Ms Patel appeared to bow to pressure, when she was asked if she would “scrap” fees for overseas NHS staff, “given they too are fighting this pandemic”.
She replied that it was “under review”, saying: “We are looking at everything, including visas and surcharge. We are speaking about the healthcare professionals, the medics, the doctors and nurses and allied healthcare professionals who have come to the UK.”
But the Home Office has told The Independent that no review took place beyond the arrangements for a one-year extension for health staff whose visas will expire before 1 October this year. “This is completely free of charge and includes an exemption from the immigration health surcharge,” a spokesperson said.
A RCN spokesperson said: “Nursing staff already contribute through taxes and national insurance. To ask them to pay twice is simply wrong. We await a response and commitment to act on this.”
Dr Chaand Nagpaul, the BMA council chair, said: “In the last two months, we’ve seen a huge outpouring of support for our frontline staff, including those talented colleagues who have come to work here from overseas.
“I’m sure they would be dismayed to find that the government is continuing to penalize them with this absurd fee during the crisis.”
And Justin Madders, Labour’s shadow health minister, said: “Ministers frequently tell us how proud they are of the incredible effort being made by NHS staff, yet when they have the opportunity to do something tangible to demonstrate their appreciation they pull the rug up.
“The NHS would fall over without overseas staff and in the current climate it is simply unconscionable for this government to be slapping extra charges on them.”