The Immigration Health Surcharge

The IHS was introduced in April 2015 in a clampdown to so-called “Health Tourism”. It applies to migrants from outside the European Economic Area (EEA) who want to stay in Britain for at least six months.

The main rate at that time was set at £200 per annum which meant that an applicant applying for spouse entry clearance or an applicant applying for a work visa under the Points based System (PBS) faced an additional cost of £500 on top of the relevant visa fee.

In November 2018, the government announced their intention of doubling the IHS with effect from the beginning of 2019. This means that migrants are now expected to pay £1,000 in addition to the visa fees, (which rather like national rail fares), are increased annually by the Home Office.

When the time comes for a migrant to apply for further leave to remain, (typically after 30 months in Britain), he/she is required to pay the IHS once more. Most of these individuals have come to this country to work and are paying income tax and national insurance like most of the workforce. Notwithstanding that, they are being forced to pay an additional levy for access to the NHS or face losing their visa and therefore their right to live and work in Britain.

But the IHS doesn’t just apply to “temporary” migrants as the Home Office likes to call those who have not yet attained Indefinite Leave to remain, (ILR) or settlement. It also applies to individuals in this country who have lived here all their lives and who are on what is known as the “ten year route” to settlement.

Individuals on the ten year route face renewing their visas every 30 months over that period. Therefore following the increase in the IHS, an individual on the ten year route will have to stump up £2,033 every 30 months, (£1,033 visa fee plus £1,000 IHS), to remain lawfully in the country.

While those who are lucky to be high earners may have no concerns about their ability to pay the IHS, (even if they consider it unfair), many on the ten year route earning the average wage, (or below the average wage), face constant worry and stress about how they can meet these charges knowing that failure to do so jeopardises their right to remain in Britain.

One of the justifications for the IHS put forward by the government is that it helps fund the NHS. What an irony it is then when no less than the British Medical Association, (BMA), have warned that Government’s pledge to increase the costs of the immigration health surcharge could ultimately put off badly needed doctors and medical staff from coming to Britain. It is estimated that nearly a quarter of the NHS medical workforce received primary qualifications outside the EEA, with this figure rising to almost 50 per cent of staff, associate specialist and speciality doctors.

There is simply no justification to charge individuals who are already paying tax and national insurance a further £1,000 (per person) by levying an additional charge for the NHS. A British citizen paying their tax and national insurance is not subject to additional charges for the NHS. So why should a non- Briton also paying their tax and national insurance have to do so?

Nelam Trewin, March 2019

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