UK NHS Health Surcharge

[theoldgit]

At the end of the day this is a charge on a person who is not a UK citizen,or pays UK taxes.

Or it could be a charge on spouses of UK Citizens who are also going to be UK taxpayers and contributors to the UK National Insurance scheme.

Yes it's of tremendous benefit, and very cheap, for long term medical tourists who will benefit from this scheme but could well price out those people who will ultimately be nett contributors to the UK Economy.

I'm afraid this is just another knee jerk reaction by a Government trying to appease those who see immigrants as the root cause of all the problems in the UK and specifically the challenges the NHS faces.

[FiestyFarang]

I would say then returning expatriates returning to the UK and not having paid NI for more than 2 years should also be paying a one of fee of £400.

Basil, I paid in to the NHS for decades and fortunately I think they made a good profit from me, yes fortunately I managed to generally keep well and away from doctors and I also had private medical insurance but still had to pay the NHS! The NHS did not give me a penny back now I am non-registered, I even had to pay to see a doctor there when I was on holiday. They made £10,000's from me and you think I should pay £400 if I go back! I am glad you are not running the country. On another issue these sums are way too low it costs £1000's even for a basic operation even to see a doctor twice a year probably exceeds the amounts asked for and a specialist well £400 a visit?

[Jay Sata]

As you say Feisty the sum is low compared to real costs of an operation etc.

However there are some who would complain if it was a pound a week.

This is an across the spectrum charge for the NHS by non UK visitors.

It is not targeted at those bringing a spouse in to the UK.

However any foreign partner having an operation or indeed a baby will cost well in excess of £200 a year.

As is the case with all forms of insurance there will be winners and losers.

Edited January 20, 2015 by Jay Sata

[7by7]

<snip>

I paid in to the NHS for decades and fortunately I think they made a good profit from me, yes fortunately I managed to generally keep well and away from doctors and I also had private medical insurance but still had to pay the NHS! The NHS did not give me a penny back now I am non-registered, I even had to pay to see a doctor there when I was on holiday. They made £10,000's from me and you think I should pay £400 if I go back! I am glad you are not running the country. On another issue these sums are way too low it costs £1000's even for a basic operation even to see a doctor twice a year probably exceeds the amounts asked for and a specialist well £400 a visit?

As said previously, only 2.05% of NICs go to the NHS; the rest comes from general taxation.

Taxes also pay for the fire brigade; would you want some form of refund because you've never had a fire?

Taxes also pay for the police; would you want a refund because you've never been the victim of a crime?

[steve187]

how many 20 hour a week worker earn in excess of £10,000 a year, if students are coming here and paying thousands of GBP a year, surely thay can afford the £3.00 a week even if it is in a lump sum, how do they manage in the U S of A

[Tony M]

I found this article from http://www.medicalprotection.org/uk/casebook-september-2014/healthcare-for-all has some good info :

Impact of recent legislation and proposals

The Immigration Act was passed in May 2014 and introduces two major changes regarding healthcare. Firstly, only those non-EEA nationals who have ‘indefinite leave to remain’ status will be entitled to free NHS secondary care. As this phrase refers to an immigration status only open to those who have resided in the UK for more than five years, this change will exclude many people who previously would have been entitled as being ‘ordinarily resident’ in the UK.

non-EEA nationals coming to the UK for a period of longer than six months will be required to pay an ‘immigration health surcharge’

Secondly, non-EEA nationals coming to the UK for a period of longer than six months will be required to pay an ‘immigration health surcharge’ with their visa application fee. This is likely to be in the region of £150 for students and £200 for all others, and will entitle applicants to free NHS primary and secondary care. Secondary legislation is awaited to give further detail of how these changes will be implemented.

In addition to the changes brought in by the Immigration Act, the Department of Health has published its own proposals for increasing NHS income from charging overseas visitors and migrants. The ‘Visitor and Migrant NHS Cost Recovery Programme’7 was published in July 2014 and sets out the government proposals for tightening existing charging mechanisms in secondary care, incorporating administrative systems to meet the requirements of the new health surcharge, and introducing new charges for A&E services and aspects of primary care.

Proposed charges for primary care relate to prescriptions, optical services and dental care, as well as some other community services. At present there are no proposals to charge any patient for doctor or nurse consultations in primary care.

A further new proposal includes charging for access to emergency services. This is currently being explored further through the DH proposals, to provide more explicit proposals for how this may be implemented.

Ensuring patients are not denied access inappropriately

With so much change it is almost inevitable that some misunderstandings and errors will occur, and it is vital to avoid denying access to care for those entitled to it. It is important to remember that asylum-seekers, victims of trafficking, EEA nationals and those from countries with bilateral healthcare agreements with the UK will retain their current entitlement to free secondary care. Those who have paid the health surcharge will also be entitled to free care, but a mechanism will be required to check whether this charge has been paid.

Those who fall outside these categories, such as undocumented migrants, are currently able to access some secondary NHS services free of charge. Treatment for some communicable diseases, such as TB and measles, is and will remain free to everyone. This is also true for sexually transmitted infections, including HIV, for family planning services and for treatment under the Mental Health Act. Access to immediately necessary treatment, or urgent care, should also continue to be provided even if the patient is not entitled to free care and has no means to pay the charges. Neither the Immigration Act nor the DH proposals alter this position.

It is a time of change that will introduce significant challenges for those providing care to migrants and visitors to the UK. While proposals are finalised by government it is vital that providers are well-informed about the current position to ensure that those entitled to healthcare continue to receive it.

[Jaggg88]

I would think it applies to all people that the TB test applies to, all people that are granted a visa that allows them to stay over 6 months

What would happen if as in many cases the visa is refused, would the prepaid NHS money be lost as well

what about the euro immigrants!!!!!!!!!!

Good point about the visa refusal. It should only be payable as and when the visa is granted.

The UK government has reciprocal agreements for healthcare with most major euro countries inc Switzerland. UK citizens get a free EHIC card.

[fbf]

I've just found this thread and tried to get my head around the NHS charges and the Immigration Act.

I might be the last person here to find it but can't see a link in this topic, although ThaiVisaExpress posted an excerpt.

gov.uk summary

Immigration Bill "home page" (well, if parliamentary bills have a home page, this is it)

I'm no expert on how these things work, but it seems even though the bill has royal assent, some aspects require further legislation to fill in the details. (Hopefully it will take them a while!)

Something I noticed in the Health factsheet that answers Jaggg88 and steve187's points above:

How we are going to do it:

Ensure that a person subject to immigration control who applies for limited entry clearance or limited leave to remain in the UK for more than 6 months will be required to pay a health surcharge as a precondition of entry. The surcharge will be paid at the same time as the fee for an entry clearance application or a fee for a leave to remain application. It will be refunded only where an application for leave to enter or remain is refused.

(my emphasis)

So, part of the visa application fee (the NHS surcharge) will be refundable even in the case of refusal.

Also I agree with theoldgit about double charging - someone who is working and paying tax (income tax, not just the NI) is effectively paying twice. I'd find this easier to swallow if the person settling in the UK then got a higher tax code, effectively refunding the fee as it goes along in the event that they're working. Although, even then, it's still unfair for a couple with one breadwinner, because a sole income British household doesn't have to pay NHS tax for the non-worker.

Edited February 11, 2015 by fbf

[MAJIC]

"This will include

the Department making the necessary changes to the NHS Charging Regulations so

that those who have paid the surcharge will be able to access NHS care in the same

way as a person who is ordinarily resident".

I would think that those bringing in their Spouses on a settlement Visa,will be upset to have to pay yet another charge,

but personally If I had to start again,I would consider it a privilege to only have to pay £200 for health care for my wife,at Visa times!

Just take a look at the crippling cost of Private Health care,assuming you could purchase Private Health Care,under these conditions?

Sign up for this deal before they change their mind! and realise it's probably another loser for the NHS.

[fbf]

Whether or not everyone agrees with the NHS charge, it represents a substantial shift in principle and sets the following precedents:

1. Within our society, some people will have access to healthcare and some won't.

2. The NHS will need to place a payment/id gateway between the patient and its service

So in the first instance, the argument about whether NHS represents value for money or not doesn't make it fair that some members of society have to pay and some don't. Once you start getting into who deserves access to the NHS, should we also say certain families with a long history of claiming benefits must pay for NHS, or have their access to some services restricted (like fertility treatment perhaps... yes, that's nasty, but that's my point!) Or, if the NHS is a "birthright", then should it be subject to inheritance tax?

In the second instance, I think it's a win-win situation for a government that wants to turn the NHS into a free-market insurance provider but knows it can't get elected without the "free at the point of use" promise. It seems to me that once everyone needs to start showing documentation in order to receive healthcare, it gradually establishes the principle that this is a paid service. Although to be fair, I already had to pay for my Hep B jabs before going to Thailand - handing over bank notes at my GP surgery feels so wrong!

So, value for money or not, I feel it's an unfair principle. Also correct me if I'm wrong but I don't think the prices are set in stone, they're just indicative, and I'm willing to bet they'll rise faster than inflation.

[moobie]

No. 40. fbf, Just for the record GP's are a private enterprise attached to the NHS. They are really running their own business.

That is why in my GP practice I received all my travel jabs* for "free" whilst a friend in another had to pay for some of his. As you seemingly did.

* These being the usual ones, tetanus, polio, heps's, etc. (Others such as rabies, yellow fever, etc, I would have had to pay for.)

Incidentally, I wouldn't be surprised if the following (GP surgeries requiring proof of Nationality) is also applied retrospectively with other enforcement in the future -

http://news.sky.com/story/1421597/gp-patients-to-be-asked-for-proof-of-nationality

[fbf]

Ah thanks for clarifying moobie, that's very helpful.

In the linked Sky article, it says only residents with indefinite leave to remain are entitled to free healthcare.

Seems I know less about this subject than I already thought! Does that mean currently an immigrant with a settlement visa (join partner in the UK) gets no free healthcare at all and needs health insurance for everything?

[moobie]

fbf, this link may help as a further explanation :-

http://www.nhs.uk/chq/pages/1087.aspx?categoryid=68&subcategoryid=162

PS. The previous Sky link refers predominantly to GP's seeking proof of residency from other Nationals from the EU in order that the UK Government can bill their Governments accordingly. A thing in which the GP's & NHS have been lax in doing. This will be done via the EHIC cards. But as I said I wouldn't be surprised if this "requirement of proof" was rolled out retrospectively and throughout the system. Could be one to keep a close eye on.

(One point to remember about the EHIC cards when travelling in the EU is that they only cover the basic level of care that a citizen/subject of that country could obtain. Since many of the countries within have a Health care system which is funded through income-style tax and then a further payment billed to the patient on treatment it often pays to have adequate Health insurance also whilst on your travels.)

[fbf]

Thanks for the link.

So I guess this quote from the above means she will be able to get access to the NHS, same as me:

If you move to the UK, you will not be charged for NHS hospital treatment from the date that you arrive as long as:

• you intend to live permanently in the UK, and
• you have the right to live permanently in the UK or have a "route to settlement" that will allow permanent residence in due course

(my emphasis in bold)

Although I don't know if the following text on the same page contradicts the above:

If you're not entitled to live in the UK permanently but you've applied to the Home Office to enter or stay, you'll be charged for hospital treatment until:

• your application is granted, or
• you have 12 months' lawful residence in the UK

(again, my emphasis)

What does that bit I've emphasised actually mean? Because it seems to me if the settlement visa is granted then she will have non-permanent leave to stay in the UK (33 months), and therefore won't be entitled until she's lived in the UK lawfully for 12 months.

So either I'm misunderstanding or the two are contradictory (or both!)

And that's before any rule changes discussed in this topic come into effect.

[7by7]

Ignore your second quote; it is the first that applies to your wife as she will have a "route to settlement" that will allow permanent residence in due course; i.e visa, FLR, ILR.

You second quote applies to people in the UK on visas such as a Tier 1 worker or Tier 4 student, who have applied to convert that visa to settlement.

[fbf]

Fantastic, thanks. So nothing to worry about there.

And about the subject of this topic, if the rules happen to change quickly (not unlikely given a May election) then I'll be hit for an extra c.£500 bill initially (more in 2.5 years), but I presume the healthcare available will be the same as now.

[7by7]

Yes, your wife will be entitled to the full range of NHS care, as now.

Once this iniquitous rule is in force, the only difference will be that in addition to paying for NHS care through the direct and indirect taxes sponsor and applicant will be paying, they will also have to stump up an additional £500 for the initial visa and again (plus whatever increase the government decides upon) for FLR.