Boris Johnson has ordered the removal of the NHS migrant surcharge from health and care workers, in a humiliating U-turn a day after telling the House of Commons it would stay.
The climbdown came amid intense pressure on the prime minister over the £624-a-year charge, branded “immoral and monstrous” by former Conservative chairman Chris Patten.
It followed an earlier U-turn by home secretary Priti Patel when she extended a bereavement scheme for NHS migrant workers to include support staff like porters and cleaners alongside doctors and nurses.
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And it came just days after The Independent revealed that Ms Patel had quietly dropped a review of the surcharge issue which she had promised.
Royal College of Nursing general secretary Dame Donna Kinnair welcomed the move, but said it was “a shame it took this pandemic for the government to see sense”.
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Staff react outside Salford Royal Hospital in Manchester during a minute’s silence to pay tribute to the NHS staff and key workers who have died during the coronavirus outbreak
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Staff inside Camberwell bus depot in London, during a minute’s silence
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NHS staff at the Mater hospital in Belfast, during a minute’s silence to pay tribute to the NHS staff and key workers who have died during the coronavirus outbreak.
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Shoppers observe a minute’s silence in Tescos in Shoreham
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Firefighters outside Godstone fire station
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Hospital workers take part in a protest calling on the British government to provide PPE across Britain for all workers in care, the NHS and other vital public services after a nationwide minute’s silence at University College Hospital in London
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A school children’s poster hanging outside Glenfield Hospital during a minute’s silence
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A man holds a placard that reads “People’s health before profit” outside St Thomas hospital
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Staff members applaud outside the Royal Derby Hospital, following a minute’s silence
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Cabinet Secretary Mark Sedwill, Prime minister Boris Johnson and Chancellor of the Exchequer Rishi Sunak, stand inside 10 Downing Street, London, to observe a minutes silence in tribute to the NHS staff and key workers who have died during the coronavirus outbreak
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Hospital workers hold placards with the names of their colleagues who have died from coronavirus as they take part in a protest calling on the British government to provide PPE
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Staff at Waterloo Station in London, stand to observe a minute’s silence, to pay tribute to NHS and key workers who have died with coronavirus
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Medical staff at the Louisa Jordan hospital stand during a UK wide minutes silence to commemorate the key workers who have died with coronavirus in Glasgow
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An NHS worker observes a minute’s silence at Chelsea and Westminster Hospital
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NHS staff observe a minutes silence at Mater Infirmorum Hospital
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NHS workers hold a minute’s silence outside the main entrance of Derriford Hospital
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NHS Frimley Park Hospital staff at the A&E department observe a minute’s silence
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People applaud after a minutes silence in honour of key workers
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Wreaths laid outside Sheffield town hall
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A group of trade unionists and supporters standing outside Sheffield town hall
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First Minister Nicola Sturgeon stands outside St Andrew’s House in Edinburgh to observe a minute’s silence in tribute to the NHS staff and key workers who have died during the coronavirus outbreak
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Staff stand outside the Royal Derby Hospital, during a minutes silence
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Police officers observe a minutes silence at Guy’s Hospital
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A woman standing outside Sheffield town hall
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NHS workers during a minute’s silence outside Glenfield Hospital
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Staff react outside Salford Royal Hospital in Manchester during a minute’s silence to pay tribute to the NHS staff and key workers who have died during the coronavirus outbreak
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Staff inside Camberwell bus depot in London, during a minute’s silence
PA
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NHS staff at the Mater hospital in Belfast, during a minute’s silence to pay tribute to the NHS staff and key workers who have died during the coronavirus outbreak.
PA
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Shoppers observe a minute’s silence in Tescos in Shoreham
Getty
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Firefighters outside Godstone fire station
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6/30 Salford Royal Hospital
Getty
7/30 Salford Royal Hospital
PA
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Hospital workers take part in a protest calling on the British government to provide PPE across Britain for all workers in care, the NHS and other vital public services after a nationwide minute’s silence at University College Hospital in London
AP
9/30
A school children’s poster hanging outside Glenfield Hospital during a minute’s silence
Getty
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A man holds a placard that reads “People’s health before profit” outside St Thomas hospital
Getty
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Staff members applaud outside the Royal Derby Hospital, following a minute’s silence
PA
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Cabinet Secretary Mark Sedwill, Prime minister Boris Johnson and Chancellor of the Exchequer Rishi Sunak, stand inside 10 Downing Street, London, to observe a minutes silence in tribute to the NHS staff and key workers who have died during the coronavirus outbreak
PA
13/30 University College Hospital, London
Hospital workers hold placards with the names of their colleagues who have died from coronavirus as they take part in a protest calling on the British government to provide PPE
AP
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Staff at Waterloo Station in London, stand to observe a minute’s silence, to pay tribute to NHS and key workers who have died with coronavirus
AP
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Medical staff at the Louisa Jordan hospital stand during a UK wide minutes silence to commemorate the key workers who have died with coronavirus in Glasgow
Getty
16/30 London
An NHS worker observes a minute’s silence at Chelsea and Westminster Hospital
Reuters
17/30 Chelsea and Westminster Hospital in London
AFP via Getty
18/30 Belfast, Northern Ireland
NHS staff observe a minutes silence at Mater Infirmorum Hospital
Reuters
19/30 Plymouth
NHS workers hold a minute’s silence outside the main entrance of Derriford Hospital
Getty
20/30
NHS Frimley Park Hospital staff at the A&E department observe a minute’s silence
Getty
21/30 Mater Infirmorum Hospital
People applaud after a minutes silence in honour of key workers
Reuters
22/30 Waterloo Station, London
AP
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Wreaths laid outside Sheffield town hall
PA
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A group of trade unionists and supporters standing outside Sheffield town hall
PA
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First Minister Nicola Sturgeon stands outside St Andrew’s House in Edinburgh to observe a minute’s silence in tribute to the NHS staff and key workers who have died during the coronavirus outbreak
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Staff stand outside the Royal Derby Hospital, during a minutes silence
PA
27/30 London
Police officers observe a minutes silence at Guy’s Hospital
Reuters
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A woman standing outside Sheffield town hall
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29/30 Royal Derby Hospital
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NHS workers during a minute’s silence outside Glenfield Hospital
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Hours before Mr Johnson’s announcement, the RCN – which has campaigned for two years for an exemption for health staff – published figures showing that newly-qualified NHS nurses born overseas would have to work for a whole month to pay off the fee when it rises from the current £400 to £624 for adults and £470 for children in October.
Dame Donna said: “Of course, nursing staff will only breathe a sigh of relief when they hear the details of how the Immigration Health Surcharge will be lifted. Overstretched health and care services will struggle to pay this from their existing budgets and government must consider that, and any action must not be limited to the NHS.”
Labour leader Keir Starmer described the government’s U-turn as a “victory for common sense”.
“It’s the right thing to do, we can’t clap our carers on a Thursday and charge them to use our NHS on a Friday,” said Starmer.
And he said that the end of the coronavirus crisis would have to see a “settlement” in favour of frontline workers like supermarket staff who have kept the country going during lockdown.
“I think there’s going to be a re-evaluation across the board at the end of this crisis because many people on the frontline are underpaid and undervalued,” said Sir Keir. ”We’ll wait until we get there but I do think there is going to have to be a rebalancing of where we’re at and how we value people.”
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Just 24 hours before his climbdown, Mr Johnson told the House of Commons that imposing the immigration health surcharge on foreign-born NHS workers was “the right way forward”.
Facing demands to ditch the charge from the Labour leader at prime minister’s questions on Wednesday, the PM insisted he understood the difficulties faced by foreign NHS staff, including those who “frankly, saved my life” when he was in intensive care with coronavirus.
But he said the charge raises £900 million a year for the NHS which it would be difficult to find from other sources.
Two senior Tory backbenchers spoke out against his refusal to drop the fee, with veteran MP Sir Roger Gale warning that failure to do so would be “mean-spirited, doctrinaire and petty” and select committee chair William Wragg calling for “generosity of spirit” on the issue.
And Lord Patten told BBC Radio 5 Live’s Emma Barnett show: “It’s appalling, it’s immoral. We depend in our care homes on people who come from other countries.
“I think this is monstrous that people who come from overseas to help and risk their lives in really difficult circumstances aren’t treated properly.”
Meanwhile, Downing Street revealed that some NHS trusts are covering the cost of the charge for staff – meaning the health service was effectively paying to fund itself.
Mr Johnson’s official spokesman had no figures for the numbers of trusts making payments, but told reporters: “Many NHS trusts have schemes in place where they choose to cover the cost of the surcharge for their staff … If NHS trusts choose to do that that is of course a matter for them. But the money raised does go into the NHS.”
After a day of disquiet in Tory ranks, a 10 Downing Street spokesman announced the surprise U-turn, saying: “The PM has asked the Home Office and the Department for Health and Social Care to remove NHS and care workers from the NHS surcharge as soon as possible.
“Work by officials is now underway on how to implement the change and full details will be announced in the coming days.
“As the PM said in the House of Commons, he has been thinking about this a great deal. He has been a personal beneficiary of carers from abroad and understands the difficulties faced by our amazing NHS staff.
“The purpose of the NHS surcharge is to benefit the NHS, help to care for the sick and save lives. NHS and care workers from abroad who are granted visas are doing this already by the fantastic contribution which they make.”
Critics of the scheme argue that it effectively means migrant workers are paying twice for their healthcare – once through their taxes and again through the surcharge.
The increase in the level of the levy, which has raised £900m since its introduction in 2015, will go ahead in October. But all NHS staff – including porters and cleaners as well as doctors and nurses – will be exempted, along with independent health workers and social care workers.
Syrian refugee and NHS hospital cleaner Hassan Akkad, who went viral on social media with a video plea to the PM for fairer treatment for support staff, sent a message of thanks to members of the public, campaigners, trade unions and journalists who forced the change of heart, telling them: “Britain is great because of you.”
Akkad, who calculated he would have to work for 10 days to pay off his personal fee, said: “Today’s message is to you, to the British public. Thanks to you and to the unions and the campaigners and to the journalists who helped us get our message across – like Piers Morgan and James O’Brien to mention a few – thanks to all of you who tweeted and put pressure on the government, they U-turned.
“Yesterday, I’m going to be honest, I lost my faith. But you restored my faith and my colleagues’ faith in this country.”
The president of the Doctors’ Association UK, Samantha Batt-Rawden, said it should not have taken a pandemic for the prime minister to recognise the value of foreign-born personnel to the NHS.
Welcoming his climbdown, Dr Batt-Rawden said: “At a time when doctors and nurses from overseas are putting their lives on the line, exempting them from the surcharge is only right in recognition of their service to our country.
“We now must move forward in acknowledging the enormous contribution of healthcare workers to our health service. DAUK will continue to call for Indefinite Leave to Remain for all frontline healthcare workers who have served in the NHS during the pandemic.”
Public sector union Unison’s general secretary Dave Prentis described the exemption as “long overdue”.
“The pandemic has shown the enormous contribution of overseas workers to our health and care system,” said Mr Prentis. “They’re putting their lives on the line every day to keep us safe.
“It’s a moral injustice to ask migrant staff to make double the contribution of others and pay extra for the very services they help provide.
“This must also apply to the workers’ families. And the government should go further by removing the charge for all migrant workers.”
Professor Andrew Goddard, president of the Royal College of Physicians, said: “We are delighted to see the government have paid heed to our calls for health and social care staff to be exempt from the immigration health surcharge. It has never made sense to make the very people whose jobs it is to care for our nation, pay inordinate charges to access care. But the government’s job isn’t done yet.
“We’re calling on the government to grant all of those who worked in health and care during the pandemic indefinite leave to remain, and asking them to extend the proposed NHS visa to social care. Until this happens, we won’t have truly recognised just how vital international staff have been during this period.”
Liberal Democrat home affairs spokesperson Christine Jardine said: “This is a positive step from the government but the PM must go further. All migrants working in the NHS and social care during this crisis should be given the right to stay in the UK, with no visa fees and no bureaucracy.”
