Bioethics Blogs

Is the NHS surcharge just?

Not long ago the UK implemented an NHS surcharge – an extra fee that non-EEA nationals (Australia and New Zealand are also exempt) applying for leave to remain in the UK must pay. It costs £200 per year, and must be paid up front. So, for example, if you are applying for a work visa for 3 years, and you have a family of three, you must pay £1800 to cover the surcharge for you and your family (on top of other visa costs).

It is difficult to find much public discussion in the UK regarding this surcharge, outside of a few articles that recently noted that the surcharge is unlikely to do what we were told it would do – namely, benefit the NHS. (See here)

Is the surcharge a just policy? As some have pointed out, it might make sense for students, who pay nothing into the NHS. (Then again, it makes studying in the UK more expensive for such students – and this might discourage talented students from studying here.) But working people do pay into the NHS – migrants as much as UK nationals. What justifies adding a surcharge to people who already pay, or to people who will pay (given that they are applying for a work visa for a job already offered to them)?

Here is how Immigration and Security Minister James Brokenshire justified it, in a press release:

“The health surcharge will play a vital role in ensuring Britain’s most cherished public service is provided on a basis that is fair to all who use it.

The views, opinions and positions expressed by these authors and blogs are theirs and do not necessarily represent that of the Bioethics Research Library and Kennedy Institute of Ethics or Georgetown University.