The U.K. Needs Immigrants To Work In Its Health Service. The Chancellor Just Gave Them A Reason Not To Come.

Self-defeating move, it would appear:

Immigrants to the U.K. will have to pay more into the National Health Service, whether or not they use its services. By making it more expensive for migrants to come and work, this surcharge may in fact disincentivize the very workers the health service needs at a time of intense labor shortages.

Conservative Chancellor Rishi Sunak announced the increase while presenting his first budget to the U.K. House of Commons. Immigrants coming to the U.K. with a visa to work or join family for more than six months will now have to pay, alongside other fees, a surcharge of £624 for every year of their visa, an increase of more than 50% from where it was at £400, which was itself an increase from £200 in late 2018 (under the new system children will be charged a little less than adults, £470 per year). The funds from the surcharge go into the country’s National Health Service, or NHS.

The stated aim of the surcharge is to prevent migrants from burdening the NHS, as the Chancellor made clear in his speech to the commons: “Migrants benefit from our NHS. And we all want them to do so, but it’s right that what people get out, they also put in. There is a surcharge already, but it doesn’t properly reflect the benefits people receive.”

The specific amount of £624 appears linked to previous claims made by the Conservative party that migrants incur costs to the NHS of around £625 per year. The Guardian fact-checked this claim in 2019, and absent any source for the number, declared it unverifiable.

Nonetheless, the perception that migrants burden the NHS is a common one in post-Brexit Britain, with plenty of anecdotal stories of over-full waiting rooms and months-long waiting times. But research into the economic contributions of immigrants to the U.K., particularly those from the European Union (who will soon be subject to the NHS surcharge), suggests they are not the burden people think they are. A comprehensive review of EU immigrants’ contribution to the country’s public finances commissioned by the government in 2018 found that on average those migrants paid more into, and took less out of, the public purse than native Britons.

In any case, framing the issue as how much immigrants take out and put into the NHS is deceptive. Immigrants who work in the U.K. already contribute to the public finances by paying tax and contributing to national insurance, the country’s social security scheme. As the above-mentioned Guardian piece pointed out, immigrants already “pay for the NHS all year round”.

In this light, the NHS surcharge can be seen as double taxation, and it’s worth noting it will soon be extended to EU citizens, who make up a large proportion of the migrants coming to the U.K. Professor Jonathan Portes, senior fellow of the UK in a Changing Europe, said: “The overall impact of immigration on the NHS is positive, as the Government’s own Migration Advisory Committee concluded. Given that, it’s very hard to justify extending the double-charging that already applies to non-EU migrants to those from the EU.”

The surcharge may also work against the Chancellor’s stated intention of bolstering the NHS. By making it more expensive for workers to come, it could put off some of the people the NHS needs most.

For example, a qualified nurse wanting to come to the country under the Tier 2 skilled visa scheme could expect to pay £464 for the visa fee, and £1872 for three years’ worth of NHS surcharge. If they are coming with dependents, that’s an additional £1410 per child and £1872 for a spouse. According to the Royal College of Nursing, the average starting salary a qualified nurse coming to the country could expect to get is around £25,000, well below the national average salary for full-time work.

The issue is that nursing is one of the many NHS jobs that are currently on the U.K. government’s shortage occupation list. That is to say, it’s one of those jobs the U.K. desperately needs people for to prop up its health service. By increasing the price of entry for those nurses, the surcharge gives them less incentive to come to the country.

The Royal College of Nursing released some analysis last year, before this latest increase, showing that, if a nurse from a non-EU country came with two children to take a job at Band 5 (the average starting band for NHS nurses), “they would have to work from the start of the year until 22nd January, or for 116 hours, just to pay the £1,200 they will be billed under the current charge.” That was back when the surcharge was still £400. It is now 50% higher.

“Hard-working nurses from overseas who give their all for patients in the UK must not be penalised in this way any longer,” says Dame Donna Kinnair, Chief Executive and General Secretary of the Royal College of Nursing. “The Government must abolish this cruel and heartless charge for nursing staff”.

It’s not just nurses. There are many NHS role the country badly needs people to fill, not to mention other sectors. Shara Pledger, associate at the specialist immigration law firm Latitude Law, said the combination of the surcharge and regular contributions into the NHS via taxation is an unpalatable one.

“The announcement today of a further increase to £624 is unwelcome. Brexit, the end of free movement, and negative immigration rhetoric already serve to undermine the government message that Britain is ‘open for business’. Increases to the cost of relocation do not encourage migration. This is particularly problematic when a large cohort of workers the U.K. is trying to attract are future NHS staff; they face effective double taxation to pay themselves.”

Source: The U.K. Needs Immigrants To Work In Its Health Service. The Chancellor Just Gave Them A Reason Not To Come.

About Andrew
Andrew blogs and tweets public policy issues, particularly the relationship between the political and bureaucratic levels, citizenship and multiculturalism. His latest book, Policy Arrogance or Innocent Bias, recounts his experience as a senior public servant in this area.

One Response to The U.K. Needs Immigrants To Work In Its Health Service. The Chancellor Just Gave Them A Reason Not To Come.

  1. Dave says:

    What?, now the UK doesn’t have enough immigrants that will work. Is that because the welfare collecting, immigrants there now who are mainly responsible for the tolerated rape & grooming gangs are uninterested in legitimate jobs. Not to mention the over 23,000 islamists under watch of the “government” – How about repatriating the scourge first. Start with the no-go zones.

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