Boris Johnson has insisted foreign NHS staff must continue to pay huge fees for the service, despite admitting they “frankly saved my life”.
Labour urged the prime minister to axe the controversial policy – which The Independent revealed would stay, despite a promised “review” – calling it “a gross insult”.
In reply, Mr Johnson acknowledged nurses from overseas had saved his life from coronavirus, but claimed the NHS would otherwise be left short of essential funding
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“We must look at the realities,” he warned, claiming it was “very difficult in the current circumstances to find alternative sources” of cash.
The immigration health surcharge – due to soar from £400 a year to £624 from this October – contributed £900m to the NHS every year, the prime minister said.
Keir Starmer announced that Labour would table amendments to the immigration bill, saying: “For a care worker on the national living wage that will require working for 70 hours to pay off the fee.”
He added: “Every Thursday we go out and clap for our carers. Many of them are risking their lives for the sake of all of us.
“Does the prime minister think it’s right that care workers coming from abroad and working on our frontline should have to pay a surcharge of hundreds – sometimes thousands of pounds – to use the NHS themselves?”
Because the surcharge is also paid by spouses and children, the total cost can reach a crippling £8,000 for a family of four on a five-year work permit, or with limited leave to remain in the UK.
And it will be extended to all EU citizens from next January, if the Brexit process is completed by ending the transition period.
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The Royal College of Nursing backed Labour’s move, calling the fees “a grossly unfair financial burden on our international workforce”.
“The government must drop this charge as a matter of urgency,” said Donna Kinnair, the college’s chief executive.
Put under pressure in the Commons, Mr Johnson said he had “thought a great deal” exempting NHS workers from the surcharge – but had decided against it.
“I do accept and understand the difficulties faced by our amazing NHS staff and, like him, I’ve been a personal beneficiary of carers who have come from abroad and, frankly, saved my life,” he told Sir Keir.
But he added: “On the other hand we must look at the realities – this is a great national service, it’s a national institution, it needs funding and those contributions actually help us to raise about £900m, and it’s very difficult in the current circumstances to find alternative sources.”
The surcharge has been attacked as unfair, because migrants paying tax and national insurance are effectively paying twice to use the NHS.
It cannot be deferred, or paid annually, but is demanded in advance for the entire duration of an applicant’s visa or residency permit.