Immigration (Health Charge) (Amendment) Order 2020

Lord Paddick Excerpts

Wednesday 23rd September 2020 Lords Chamber

[Lord Paddick (LD)]

My Lords, as the Minister has said, the 2019 Conservative Party manifesto contained a commitment to

“increase the health surcharge to ensure it covers the full cost of use”.

As a result, this statutory instrument, as the noble Lord, Lord Rosser, has said, increases the full immigration surcharge to £624 a year. However, in April 2019, the Department of Health and Social Care, using 2017-18 data, estimated the cost to the NHS of treating immigration health surcharge payers at £624 per year—the amount that the SI increases the charge by—but re-ran that estimate using 2018-19 data, putting it at £646 a year. Why are the Government using the old estimate and not the current one?

My understanding is that the Home Office takes a cut of the £624 charge to cover its costs. The amount therefore paid to the NHS is even less than the outdated £624 a year. What does the Home Office take out of the £624 allegedly taken to fund the National Health Service? Taking those two factors into account, the Government are falling short of their manifesto promise to cover the full cost of use.

I strongly disagree with the noble Lord, Lord Mann, not just on ID cards but on the statutory instrument. The flaw with the immigration health surcharge is that it takes no account of income tax, national insurance contributions and VAT, which are funding sources for the National Health Service paid by working migrants who also have to pay the IHS. The difference between the UK and most other countries with which the noble Lord was making a comparison is that they do not have health services that are free at the point of need, as we have in this country.

Analysis by Oxford Economics for the Migration Advisory Committee estimated that in 2017-18, the average non-EEA migrant made a net fiscal contribution of £310 more than the average UK adult. The average EEA migrant made a net contribution—that is, paid more in tax than they received in benefit from the state; for example, in healthcare, education and benefits —of £1,940 more than the average UK adult.

This analysis shows that migrants already pay more than the average UK adult towards government services, including the National Health Service, so why should they pay the immigration health surcharge on top? Even if we ignore the baseline figure, surely a further option the Government should have considered is discounting non-EEA migrants working in the UK by £310—the amount they contribute in addition to that contributed by the average person in the UK—and exempting EEA migrants altogether. Surely, this would cover the full cost of the use of the NHS. Or, why not charge migrants who do not work and not those who do?

These provisions are estimated to raise £177 million a year, a tiny fraction of the 2018-19 NHS budget of £114 billion, yet the impact on reducing the number of migrants seeking to come to the UK is estimated to be 2,500 people per year. Can the Minister confirm that the main objective of the immigration health surcharge, along with the vastly inflated sums charged for visas, is to reduce migration into the UK by pricing those least able to pay out of the market?

We then have the farcical situation whereby migrants working for the National Health Service have to pay the immigration health surcharge. Yes, there are exemptions, but these are for the more highly paid professionals such as doctors, dentists and pharmacists. Those least able to pay the IHS, such as porters and cleaners, are not exempt. NHS and social care staff from other countries—many of whom are working on the front line of the coronavirus pandemic, as the noble Lord, Lord Rosser, said—should have the right to stay in the UK without having to renew their visas or pay the immigration health surcharge. That is why Liberal Democrats in the other place have tabled legislation to give them indefinite leave to remain.

There is no justification for imposing the immigration health surcharge on working migrants, who already contribute not only more to the Exchequer than they cost it, but more—in the case of EEA migrants, considerably more—than the average person in the UK. Failing to exempt all NHS and social care workers from the IHS adds insult to injury. We support the Motion of the noble Lord, Lord Rosser, and if he presses it to a Division, we will vote with him.