Immigration Health Surcharge is a fee paid in addition to a UK visa fee. It applies to all types of visas except visitor visas and short-term visas of less than six months in duration. Health and care workers are exempt from paying the Health Surcharge.
In essence, the Immigration Health Surcharge (IHS) is a tax levied on foreign nationals coming to work or study in the UK, or to join their partners. The IHS amount usually exceeds the visa fee, sometimes several times.
About the Immigration Health Surcharge (IHS)
The IHS was introduced in 2015 to raise money from “migrants” for the National Health Service. It started with £200 per year and was raised to £624 per year, and then to £1035 from 6 February 2024. The amount of IHS depends on the duration of the visa and the age of the applicant or the type of visa they are applying for. For children under 18 and applicants for a student visa or youth mobility visa, the new IHS fee is £776 per year. For others, it is £1035 for each year of the duration of the visa.
As an immigration lawyer, I have long wondered about the efficacy of this money collection. Generally, justification for the introduction of the Immigration Health Surcharge was to cover the cost of the NHS care for the newcomers.
Whereas it may be partly justified in family immigration scenarios, the IHS is often viewed as one of the most draconian immigration measures due to its intrinsic unfairness on a national scale.
So what’s unfair about the immigration health surcharge?
- People coming to work in the UK are subject to UK taxation and will be funding the NHS from their taxes in the same way as British citizens. There is no reason why foreign nationals should bear the burden of paying for the NHS.
- Another reason is that the IHS is charged independently of any pre-existing conditions, as would be the case with private medical insurance. It is only natural that people coming to the UK knowing that they are likely to need an expensive treatment due to a health concern they well know about, may be required to pay a higher premium than those who are not expected to be using the NHS during their stay.
- The third reason is that there is no possibility to opt out of the use of the NHS. A large proportion of foreign nationals may choose to go back home or use private medical care if they need treatment. There is no reason to impose the NHS on them as an unsolicited and unwelcome blessing.
- The IHS is not refundable if the visa is not required for its full duration, is curtailed by the Home Office or surrendered by the visa holder. For example, a sponsored worker may have lost the job due to redundancy or for any other reason. If they surrender the visa and return to their country of residence, there is no option of getting an IHS refund. There is no option of paying in instalments or on pay-as-you-go terms.
- On top of this, the IHS is not transferrable to another immigration category. A worker who gets married and chooses to switch to the spouse visa route will have to pay the IHS once again, even if there is still a considerable amount of “unused” IHS on the previous visa. Even changing employment or changing the SOC code for the job will require a new visa and a new payment of the IHS.
In addition to all this, there is another reason which, in my view, outweighs all the above considerations. The IHS is clearly designed to deter legal migration. If a family of four is to pay nearly £20,000 in health surcharge for a 5-year sponsored work visa, small companies may find it too burdensome to cough up the full amount from the start together with the entry clearance fees. And nationals of the countries with a weaker currency than the UK would a priory be unable to pay this sum of money. Even if it were not to be paid upfront, it could still amount to a full year’s pay that some sponsored workers may expect to receive in the UK. Would they wish to pay one year’s salary to secure a visa?
So, if the IHS is a deterrent, why is its double purpose in the funding of the NHS? Is the NHS not in total disarray anyway to be dependent on the money the source of which is undesired – a discouragement, comparable to a fine?
As a comparison, you may imagine a local authority being dependent on the fines for litter offences. You will see slogans on the billboards “By breaking the law and paying the fines you are supporting good governance”.
If waste collection is dependent on the fines for litter offences, there soon will be no waste collection and litter offences will proliferate to a degree where fining will no longer be possible. Or, to bring the example closer home, if patching a hole in the roof of a decrepit building depends on the proceeds from the sale of expensive tickets to a party under the leaking roof, you are likely to end up with no party and a collapsed roof.
But at least, this will deter foreigners from the more prosperous environments.
Helena Sheizon is the founder and managing director of Kadmos Immigration Consultants. She was called to the bar in 2005 and has been specialising in UK immigration law since 2006. Helena’s expertise goes beyond legalities, offering practical advice to employers of non-British workers and individuals seeking to build a new life in the United Kingdom.