Is the increase in the Immigration Health Surcharge the final blow to the NHS?

Yet the NHS is currently in what has been described as its gravest crisis in British history. Despite celebrating its 70th birthday this year, the survival of the UK’s vital health service is plummeting towards flatlining, irrespective of a Brexit deal or not.

The backdrop of ever-growing vacancies and rota gaps are becoming too burdensome for workforces to handle. Staff regularly work overtime and late throughout the night for little reward. As a result, the NHS currently has more nursing staff leaving than those joining, aggravating concerns that shortages could rise to 51,000 by 2021. Currently, NHS Improvement’s latest quarterly report shows a shortage of 41,722 nurses and 11,576 doctors – both significant increases from the health regulators’ previous report. While the vacancies are there, residential talent equipped to fill them are not. Staff are now stretched so thin that critics are calling the NHS in a state of ‘national emergency’.

The NHS has long relied on healthcare professionals from overseas. Just last year, chancellor of the exchequer Philip Hammond touched on the ‘very high numbers of foreign workers keeping our NHS going’. In fact, as high as 144,000 of the current 1.2m NHS staff members are non-UK nationals, accounting for one in every eight workers.

If Brexit wasn’t causing enough damage, just weeks ago the Home Office announced the Immigration Health Surcharge imposed upon migrants when entering the UK will double in price this December. The charge is implemented for migrants so that they are medically covered throughout their stay and will be treated in the same way as UK citizens.

Although the charge has been publicised at a jump from £200 to £400, for healthcare workers – and most other migrants – a five-year Tier 2 Visa entails that the surcharge increases from £1,000 to £2,000. According to the British government, the scheme has brought in over £660m to the economy since its launch in 2015. By increasing it, the Home Office expects to bring in a further £220m to be pumped into the NHS.

Immigration minister Caroline Nokes welcomed the change since the ‘NHS is a national, not international health service’ propelled by British taxpayers. However, such a statement is short-sighted to the bigger picture: the NHS is propped up the hard-working hands of international immigrants. Not only do they contribute so immensely to the NHS by alleviating the strain, but their taxes and visa fees bring in more to the public purse in net terms per year than the average British citizen.

The prevailing problem is that the doctors, nurses, carers, midwives and paramedics recruited from across the Channel and beyond are aiding an underfunded and understaffed system for little benefit other than they want to help. The Royal College of Nursing (RCN) has long campaigned to waiver the fee completely for nurses coming to the UK for this reason. Chairwoman of the RCN Council, Maria Trewern, stated that the charge risked ‘driving away overseas staff at a time when we need them most’ and that the RCN was committed to seeing the ‘punitive charges lifted for those dedicating their time to our NHS”.

However, assuming the Brexit bus battles through and the UK leaves the EU as it has poorly planned to do so, the government are only serving to exacerbate the NHS’ situation. Irrespective of a deal or not, the government has decided to implement the current immigration system onto EU settlers post-Brexit – despite warnings from many leading organisations. This means that doctors and nurses from the EU will face applying for Tier 2 Work Visa as well as paying the increased surcharge (benefiting from only a marginal discount since these roles are featured on the UK’s Shortage Occupation List).

As for the vast array of allied health professionals that the UK is also in shortage of, once the UK leaves the EU, future applicants will be subjected to paying the full visa fees and the doubled Health Surcharge. What’s worse is that while managers will have to apply for a Sponsor Licence, pay for the application and issue a Certificate of Sponsorship for every non-UK applicant, migrants will face a lengthy, bureaucratic and financially burdensome process before they even set foot in the UK, let alone a hospital ward. The likes of technicians, administrative and clergy staff, healthcare scientists and researchers, psychiatrists, social care workers, physiotherapists, carers and orthotists could even be refused entry. If migrants don’t fall victim to the £30,000 income threshold requirement of Tier 2 Visas, then they could fail to secure a place before the annual visa cap of 20,700 is filled.

The united voices of concerned healthcare professionals are falling on deaf ears. Even Hammond’s Budget fell short at delivering the injection of quick cash the NHS desperately needs right now. Relying on UK talent to absorb the vacancies is just not an option: rising tuition fees coupled with axing nurse bursaries are deterring students from taking up a medical degree.

At a time when the NHS is doing everything it can to keep afloat, the UK government turns around to counteract any efforts. As we batten down the hatches for flu season and another cold winter ahead, the increased surcharge lands on incoming migrants just in time for Christmas.

Although Brexit is on the rocks, the deadline looms at little over four months away. Yet ministers still standing in the Home Office have time to steer the NHS away from a ‘cliff edge’. A post-Brexit immigration plan is still desperately needed for EU nationals. Without one, the increased Immigration Health Surcharge may very well be the final blow to our NHS that knocks it to its knees.

Olivia Bridge is a content writer and political correspondent for the Immigration Advice Service