Controversial plans to double the fee overseas nurses must pay to use the NHS have crossed the final hurdle in parliament despite strong opposition.
The immigration health surcharge for temporary migrants from outside the European Economic Area (EEA) will now increase from £200 to £400 per year.
“This is an unacceptable cost that is bad for our migrant nursing staff and bad for the capital’s services”
The Royal College of Nursing had opposed the move and had campaigned for the fee to be waived all together for international nurses and their dependent families.
The college has vowed to continue to fight the decision.
The amendment to legislation scraped through the House of Commons on November 21 by 300 votes to 232.
The move went before the House of Lords for the final stamp of approval on November 28 and although it was passed it did not receive universal backing by members.
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Labour’s Richard Rosser warned that the doubling of the fee could “worsen the skills shortage” in the health service particularly in nursing.
“At present, there are apparently some 40,000 such nursing vacancies in England, a figure that is estimated to rise further,” he said.
“There appear to be no guarantees that the immigration health charge will not be applied to EU citizens after Brexit and potentially make skills shortages even more acute,” Lord Rosser said.
Brian Paddick, of the Liberal Democrats, noted that many of those who were required to pay the surcharge would “effectively by paying twice for any treatment” from the NHS because they were also paying income tax and national insurance.
“We will continue the fight to have these charges waived for nursing staff”
Dame Donna Kinnair
He said the increased fee could make coming to the UK “unaffordable” for some people when added to “already excessive” visa costs.
Lord Paddick added: “The irony of the government’s whole approach to immigration and the punitive charges levied by the Home Office is encapsulated by the case of nurses from non-EEA countries coming to work in the NHS.”
He claimed that because Brexit had caused an “exodus” of EEA nationals from the UK, the NHS was instead having to rely on non-EEA workers to fill the gaps.
However, Lord Paddick said the NHS had to pay an additional £1,000 per non-EEA national employed per year in “immigration skills charges”.
Revenue from the immigration skills charge goes into training UK citizens to reduce the need for skilled foreign workers but Lord Paddick said the abolishment of the student bursaries for nurses was discouraging Britons from training and therefore “creating more demand for nurses from overseas”.
He highlighted how applications to study nursing had declined by 16,580 since March 2016 – the last year in which the bursary was available – with mature students particularly hard hit.
“This government are creating not only a hostile environment for immigrants but a hostile environment for common sense and decency,” he said. “This order is very much to be regretted.”
Conservative peer Susan Williams outlined the government’s position on the rise to the surcharge.
She said she recognised there were concerns about the financial impact on nurses but said the government was compensating them with the Agenda to Change pay rise agreed this summer.
“It better reflects the actual costs to the NHS”
“It is important to remember that the charge offers access to healthcare services that are more comprehensive and at a lower cost than those in many other countries,” Baroness Williams added.
Lord Rosser noted that nurses’ pay had not been doubled in line with the increase of the immigration health surcharge.
It is understood the increase will come into effect this month.
Dame Donna Kinnair
Reacting to the passing of the motion, Dame Donna Kinnair, acting chief executive and general secretary of the RCN, said: “The very people who deliver healthcare should be the last people to have to pay spiralling extra charges for it.
“We will continue the fight to have these charges waived for nursing staff,” she added.
Nursing staff from outside of the EEA make up almost one in five of those providing care in the NHS in London.
Jude Diggins, regional director of RCN London, said: “Doubling this charge is not only a gross insult to nursing staff who come to work in London’s NHS but also an act of self-harm which could do real damage to the ability to recruit and retain overseas nursing staff.”
She highlighted that a typical family of four would now have to pay £1,600 up-front when applying to work in the country.
“This is an unacceptable cost that is bad for our migrant nursing staff and bad for the capital’s services which are already running with record numbers of vacancies,” Ms Diggins added.
She said RCN London would continue its campaign to have the charge scrapped for its members.
The immigration health surcharge was introduced in April 2015 and is paid by non-EEA nationals who are staying in the UK for longer than six months but do not have permanent residency.
Students are only required half the normal rate but under the change in legislation this will rise to £200.
The policy has raised more than £600m for the NHS and the rise is expected to bring in an additional £220m a year.
A Home Office spokesman said: “We welcome long-term migrants using the NHS, but we believe it is right that they make a fair and proportionate contribution to its long-term sustainability.
“Parliament agrees and has approved the order we proposed to increase the immigration health surcharge so it better reflects the actual costs to the NHS,” he added.
He said the extra money raised would go directly towards sustaining and protecting the NHS.