Pressure is mounting on the government to drop the “grossly unfair” fee overseas nurses who migrate to the UK must pay to use the NHS themselves.
The Royal College of Nursing has written to the home secretary asking her to drop the policy, while the Labour Party had pledged to use legislative interventions to challenge it.
“The proposed increases will serve to exacerbate hardships”
Migrants who come to the UK must pay an immigration health surcharge (IHS) for the NHS each year, whether they use its services or not.
While previously the fee was only charged to those from countries outside of Europe, the policy will soon be extended to all migrants when freedom of movement ends post-Brexit.
The RCN has long led a campaign for the IHS to be waived for health and social care professionals.
However, on the contrary, the government doubled the fee from £200 to £400 at the end of 2018, and in October 2020 it is due to go up again to £624 per adult, with additional fees for dependents.
The fee is paid on top of income tax and national insurance contributions.
In the wake of the coronavirus pandemic, the government announced that health and care staff working during the pandemic and whose visas were due to expire before October would be granted a free year-long extension, including a one-off exemption to the IHS.
However, the Home Office has confirmed that there will be no review of the IHS beyond this.
Dame Donna Kinnair, chief executive and general secretary of the RCN, has this week written to home secretary Priti Patel urging her to “urgently reconsider”.
In the letter, Dame Donna said: “The IHS represents an unfair and unjust additional financial burden on our international workforce.
“Not only do healthcare professionals make a significant contribution towards our health and care system by virtue of their work, but they also already pay taxes and national insurance that pay toward our services.
“The proposed increases will serve to exacerbate hardships and will act as a significant barrier to individuals considering working in the UK at precisely the time that they are needed most.”
With the bill that will pave the way for the UK’s new points-based immigration system currently progressing through parliament, Dame Donna said now was “opportune moment” to make a change.
The college’s calls have been backed by the Labour Party whose leader Sir Keir Starmer today raised the issue in prime minister’s questions.
Sir Keir revealed that Labour was tabling an amendment to the Immigration and Social Security Co-ordination (EU Withdrawal) Bill, for health and social care workers to be exempted from the IHS.
In response, Mr Johnson said the IHS raised £900m for the NHS and added: “It’s very difficult in the current circumstances to find alternative sources.”
However, he did show sympathy to the argument, noting that overseas health professionals had “frankly saved my life” after he was taken seriously ill with Covid-19.
In his retort to Sir Keir, Mr Johnson also appeared to acknowledge that NHS staff were currently not paid enough and indicated that it was the intention of the government to address this.
He said: “I think that it is important that we support our NHS and that we invest massively in our NHS and this government….is determined to invest more in our NHS than any time in modern memory and we have already begun that.
“We will want to see our fantastic frontline workers paid properly, that is I think the best way forward.
“I want to see our NHS staff paid properly, our NHS supported, and I want to continue our programme not just of building 40 more hospitals, but recruiting 40,000 more nurses and investing hugely in our NHS.”
The prime minister’s comments stand in contrast to those made by health and social care secretary Matt Hancock on Monday when he said nurses had already received a “very significant” pay rise in recent years.
In a statement provided to Nursing Times in response to the RCN’s letter to Ms Patel, a government spokesperson said: “To bring peace of mind and to recognise the contribution of frontline NHS nurses and other eligible health workers during this pandemic, we announced free and automatic visa extensions for them, including an exemption from the immigration health surcharge.
“NHS trusts and other employers also offer schemes to support NHS staff in making the payment – in many cases covering the cost of the surcharge themselves.
“In the longer-term it is right that we ensure a contribution is made to reflect the cost of providing NHS treatment and the surcharge has raised £900m for the NHS.”
“One would think the government would have learned the lesson about not leaving people vulnerable in our care homes”
The second reading of the Immigration and Social Security Co-ordination (EU Withdrawal) Bill was passed on Monday at 351 votes to 252.
The bill was first introduced in December 2018 but failed to get through to the final stages under former prime minister Theresa May’s minority government.
This time round, the bill, which repeals freedom of movement, is likely to pass due to Mr Johnson’s 80-seat majority.
Connected to this, the government has indicated its plans to push ahead with a new points-based immigration system from 1 January 2021.
The passing of the bill has reignited concerns about what this new system will mean for the health and care workforce.
Under the plans, visas will be granted to those who gain enough points based on criteria including qualifications, salaries and ability to speak English.
The applicant will be able to get extra points if their chosen profession is on the UK list of “shortage occupations”, meaning it is desperately short of staff.
Registered nursing is currently considered a shortage occupation, but social care is not.
One of the main determiners that will grant an applicant a visa if their occupation is not on the shortage list is whether they meet the minimum salary threshold of £25,600.
Opposition MPs, unions and health commentators have warned that the new system will exclude overseas social care workers from entering the UK at a time when the importance of their work has never been more evident in light on the coronavirus outbreak.
During the second reading debate, Labour MP Nick Thomas-Symonds noted that the average salary for a care worker was £19,104, and said that around 115,000 care workers currently working here were from the European Union.
He warned: “The care sector in England was not properly prepared going into this crisis and it seems that no lessons are being learnt from that lack of resilience and that lack of proper preparation before the crisis began.
“One would think the government would have learned the lesson about not leaving people vulnerable in our care homes, but it seems they have not. Indeed, they want to create conditions where the situation could become even worse.”
Meanwhile, Unison assistant general secretary Christina McAnea was among those outside of Westminster who hit out at the decision by the government to continue with its immigration plans.
In a strong-worded statement, Ms McAnea said: “Pushing ahead with the Immigration Bill is a triumph of bloody-mindedness over common sense.
“Migrant workers are in the frontline of the fight against Covid-19 in care homes, propping up a neglected system that would collapse without them.
“Hundreds of thousands of care jobs are unfilled, yet the government is intent on cutting off a source of skilled workers just when the UK needs them the most.
“The pandemic has taught us that low pay doesn’t mean low-skilled. Out of touch ministers measuring value only in pounds and pence – and decreeing that those earning less than £25,600 can’t contribute – clearly have never been to a care home.”