An unfair fee for overseas staff

The RCN is campaigning to make nursing staff exempt from a charge international workers have to pay to use the NHS. We speak to Johanna, a Filipino nurse, to find out why

Johanna has been working as a nurse in the NHS for almost three years. She moved to the UK from the Philippines in 2016 and has been paying National Insurance and taxes, both of which help fund the NHS, since she received her first pay cheque. 

In January, she will need to renew her working visa which means she’ll once again have to pay the Immigration Health Surcharge (IHS); a fee non-EEA (European Economic Area) nationals must pay per year of their working visa to use NHS services. A fee which, under government plans, is set to double from £200 to £400 next year.

The RCN is campaigning to see the IHS waived for overseas nursing staff like Johanna, who are working in the UK, and their dependents.

“It hurts to think we’re not valued by the Government,” says Johanna, who worked as a nurse in the Philippines for four years before relocating to the UK.

When I’m at work, I feel like my patients and their families do value my contribution. They’re appreciative and know I’m helping to keep the NHS running. It’s sad the Government doesn’t feel the same

In Johanna’s unit, three in 10 members of nursing staff are from countries outside Europe. Elsewhere in the UK, international nurses make up a significant amount of the workforce too. As of September this year, there were 70,491 nurses and midwives from outside the EEA on the NMC register.

Johanna says: “Nurses are included in the shortage occupation list. We’re helping with the nursing shortages and yet we’re forced to pay twice for a service we’re a part of. I don’t mind paying for the NHS. It’s important that we do, but we’re already paying for it with our National Insurance and tax payments just like everybody else.”

Soaring fees

Johanna and her colleagues were among the first people who had to pay the IHS which was introduced in 2015. The IHS – which has to be paid up front – is already a huge financial burden for many, especially for families who must pay the fee for every family member for each year of their working visa. For a family of five, the cost is £1,000 per year and this is set to soar to £2,000 in 2019.

Some of Johanna’s friends and colleagues have had to make the difficult decision to leave their immediate family back home as it’s not financially viable for them to pay.

Overall, Johanna says her experience of working as a nurse in the UK has been positive: “It’s been a good move for my career and a great experience for me. I’ve specialised, my friends have been promoted and we’ve had amazing support from our managers and employer. They’ve helped us right from the beginning; supporting us to register with the NMC and they’re supporting us now too.”

The RCN has launched an online tool to help members and the public quickly find and email their MP, asking them to write to Sajid Javid MP, the Home Secretary, urging him to waive the IHS for non-EEA nursing staff.

Johanna says: “I’m so thankful that the RCN’s campaign has made it easier for me to circulate information that allows people to support this cause. I’ve sent messages to friends, friends of friends, anyone I can think and all over the country, asking them to email their MP.”

“We’ve been working so hard to establish ourselves here but we’re still treated as though we’re not entitled to things.

“Sometimes it feels as though no-one is listening but the RCN’s campaign has helped me with that. It’s great to know we have support and people value the work we do

“I would urge everyone to email their MP today as it will really help. If the surcharge was waived, I would feel so valued, and I know so many others would feel the same.”



Could you help? 

Visit the RCN’s online tool to email your MP and ask them to take urgent action to waive the Immigration Health Surcharge for non-EEA nursing staff.

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