This week the Immigration Health Surcharge (IHS) increased by 100% to £400 per year, despite concerns from Coram Children’s Legal Centre and others that this will have a severe negative impact on children and young people who have grown up in the UK but do not yet have settled status.
What is the Immigration Health Surcharge (IHS)?
The IHS was introduced under the Immigration Act 2014 in a clampdown on so-called ‘health tourism’ and as part of attempts to improve the identification of, and cost recovery from, temporary migrants. The IHS currently applies to all non-EEA nationals making an immigration application either to enter or remain in the UK for any length of time and is payable until the person is granted indefinite leave to remain in the UK, or returns to their own country at the end of their visa period. Paying it means that they will not be charged for accessing secondary National Health Service (NHS) healthcare.
Why is the surcharge increasing?
The Department of Health and Social Care announced in February 2018 that it intended to double the health surcharge to £400 a year (or to £300 for students) in order ‘to better reflect the actual costs to the NHS of treating those who pay the surcharge’. With this rise the government estimated that the NHS spends ‘£470 on average per person per year on treating surcharge payers’. The Immigration (Health Charge) (Amendment) Order 2018 introducing this increase was laid in October 2018 and, despite being opposed by both the Labour party and the SNP in the Commons, was subsequently approved by parliament.
What impact will this have?
The surcharge is aimed at temporary migrants, and it is this broad group who are discussed in the Impact Assessment published alongside the regulation. Indeed, for some migrants, such as high rate tax payers, the rise will not cause particular concern; the proposed higher costs are not significantly different from the cost of private health insurance in other European countries, and are less than is paid in some developed countries outside the EU. However, this increase will have a significant impact on some particularly vulnerable groups of migrants already living in the UK, including those on lower incomes, who have a right to remain under Article 8 of the European Convention on Human Rights but are already struggling to afford high immigration fees. This includes children and young people who have grown up in the UK.
In the past six years, the immigration system for children and young people with uncertain status has changed significantly. Before 2012, most children and young people who had grown up in the UK could expect to acquire indefinite leave to remain after six years and two applications or in some cases after two years and one application. Now, if able to make an application for leave to remain, these children are on very long routes to settlement: they will have to make four applications over the course of ten years, costing £6,521 in application fees (at 2018 rates) and now an additional £4,000 in IHS before they will have been granted settled status (indefinite leave to remain). The doubling of the surcharge brings the total cost of securing settled status to £10,521 over a ten year period.
Payment of the IHS must be made at the same time as an immigration application is made and non-payment may lead to an application being deemed invalid. Submitting an invalid application can remove a person’s right to work, rent, drive, hold a bank account and access healthcare.
Although the published Impact Assessment states that the government is ‘considering options to mitigate the consequence an increase in Surcharge may have for applicants’ affordability’, that will not help those children and young people with human rights cases to live in the UK, who from today must pay this enormous up-front cost to remain legally in the country where they are at school or college.
Can children and young people avoid paying the surcharge?
Asylum seekers, those applying for humanitarian protection and those applying for discretionary leave to remain in the UK as a potential victim of trafficking (or their dependants) do not need to pay the IHS. Neither do children under 18 who are looked after by a local authority, who are exempt.
Immigration application fee waivers are also available on specified human rights routes and where this fee is waived, the requirement to pay the surcharge is also waived. However, concerns have been raised about the effectiveness of the current fee waivers system and the low grants of feed waivers to children – less than 8% of children who applied were granted fee waivers in 2016.
Increasing the IHS compounds the unaffordability of Home Office application fees and disproportionately affects young people and families with human rights cases. The government should commit to broadening the exemptions so that vulnerable children and young people aren’t blocked further from having secure immigration status in this country.
For more information on the IHS and recommendations for change, read the Refugee and Migrant Children’s Consortium briefing on the Immigration Health Surcharge
For more information on barriers to regularisation faced by young migrants, read our report ‘This is my home: Securing permanent status for long-term resident children and young people in the UK’