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Minister rejects plea to waive NHS fee for overseas nurses


Immigration minister Caroline Nokes has rejected pleas for oversea nurses to be exempted from extra charges to use the NHS, insisting it is “only right” they pay.

Her comments came during a debate in which MPs supported plans to increase the immigration health surcharge from £200 to £400 per year.

“The UK is facing an NHS staffing crisis, and we desperately need to attract doctors and nurses from abroad”

Afzal Khan

The amendment to the legislation was approved by nine votes to eight and will now need backing from the House of Commons before it can be signed into law.

Tory Ms Nokes said she recognised concerns about the financial impact on foreign nurses but insisted that the recently agreed Agenda for Change wage rise would ease the pressure.

The immigration health surcharge was introduced in April 2015 and is paid by people from countries outside the European Economic Area who are staying in the UK for longer than six months but do not have permanent residency.

The fee is paid up front as part of the immigration application process and is required on top of visa costs.  The charge, which is discounted for students, allows the payer to use NHS services in the same way as a UK citizen.

Following the announcement of the proposed hike, the Royal College of Nursing called for the fee to be scrapped for overseas nursing staff and their dependents all together.

It claimed the increased fee risked further destabilising the nursing workforce at a time when rising numbers of EEA nurses were leaving or deciding not to join the NHS due to concerns about Brexit. The college encouraged its members to write to their MP urging them to vote against the “unfair” policy.

During the debate of the Eleventh Delegated Legislation Committee yesterday, shadow immigration minister Afzal Khan raised fears about the potential impact of the increase on the nurse workforce.

“The answer is not to exempt nurses from the charge but to increase their pay”

Caroline Nokes

“The UK is facing an NHS staffing crisis, and we desperately need to attract doctors and nurses from abroad, to at least plug short-term gaps,” he said.

Mr Khan, who said Labour would be voting against the motion, reiterated a statement made by the chair of the RCN, Maria Trewern.

It said: “The immigration health surcharge not only imposes an enormous personal cost on hardworking nurses and health care assistants, but risks driving away overseas staff at a time we need them most.”

He added the immigration health surcharge was “not a fair contribution”, because the majority of migrants were taxpayers so would effectively be paying for NHS treatment twice.

Stuart McDonald, spokesman for immigration for the Scottish National Party, said he echoed Mr Khan’s concerns about the recruitment of nurses.

Ms Nokes said she was “aware” that there had been calls for NHS professionals be exempt from the charge but said it was “only right” that they paid the fee.

“Government fully recognise the important contribution that international healthcare professionals make to the UK, but it is only right that they also make a proportionate contribution to the long-term sustainability of the NHS,” she said. “In that regard, NHS professionals are in the same position as other providers of essential public services, including teachers.”

She added: “I recognise that there are some concerns about the financial impact on nurses. However, the answer is not to exempt nurses from the charge but to increase their pay, and that is happening. All NHS nurses will benefit from a pay increase as set out in the Agenda for Change framework.”

Ms Nokes said the immigration health surcharge had raised more than £600m for the NHS since 2015 and that the proposed increase was estimated to bring in a further £220m a year. The additional contribution could fund roughly 4,000 additional nurses in England alone, Ms Nokes added. 

Conservative Party

Caroline Nokes

Caroline Nokes

She said the new proposed fee would “better reflect the cost to the NHS of treating those who pay it” – which has been reviewed by the Department of Health and Social Care as £470 per person per year.

The immigration minister noted that the government was in the process of “negotiating reciprocal healthcare arrangements with the European Union” following Brexit.  

A date for the vote in the House of Commons on the motion to double the immigration surcharge has not yet been set, a parliament spokesman said.


Readers' comments (4)

  • Have we asked the question of whether nurses outside of the EEA are too desperate to come to UK to help sort out the vacancy crisis that will plague us post Brexit?
    Should scraping fees for overseas nurses not be used as added incentive for the very people, who are leaving their homeland to care for the very vulnerable in UK. Hmmm..... I just wonder if Commonwealth soldiers that have been asked to come to UK are expected to pay NHS fees as well? It almost sounds like it's a privilege for people outside of the EEA, to come work here. Should people from Commonwealth countries not have priority and be entitled to free health care, whilst they are contributing to the UK society. I just find it very ironic to ask the people to pay for the very service that they provide.

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  • How does Nokes think that the Agenda for Change increase will help? It is a derisory amount that will go nowhere. I'd like to see how she'd manage on a nurse's wage, and especially if she had to pay the surcharge.
    In other developed countries which have non socialised health care, health insurance is a staff benefit. What a mean minded mealy mouthed crew we have in government.

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  • Does this mean that when they work here they are exempt from paying national insurance and tax? Why pay NI if they are not benefitting from it?

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  • Shame on the UK Government is what I say for pandering to right wing rhetoric. You know very well that these nurses pay NI and Health surcharge .
    Lots of noise about EU staff ( which is right as they have been treated appallingly); however we forget that NON-EU staff have been serving the NHS since it's inception and we continue to be treated as second class citizens.

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