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IMMIGRATION AND HEALTHCARE: At what cost?




The austerity years of the second world war period which saw rationing of food, scarcity of fuel, bitterly cold winters, delayed harvests, economic crises, housing crises and inflation are hauntingly resonant even today.


The treasured NHS created in post war Britain in July 1948 as part of the reconstruction effort following the apocalyptic effects of strife within Europe, was founded on the principle of healthcare based on need where it is funded collectively through taxpayer money.


The following article in the Independent makes one regret that another great stalwart institution, that was Made in Britain in the aftermath of war-torn Europe (and the envy of the world), is being placed at such tremendous pressure that it could quite easily give way:



Migrant labour has propped up the NHS for many years. The departure of many EU nationals following the exit of the UK from the EU, the psychological and economic pressures of the Pandemic, have caused an exodus of staff from the NHS.


The Health and Care visa introduced in August 2020 to meet some of the needs arising from the Pandemic to recruit overseas “qualified doctors, nurses and allied health professionals who have been trained to a recognised standard and who have good working English” seeks to counter some of these effects. It is operated under the Skilled Worker visa regime but is designed to be far more attractive. It is cheaper, faster and generous in that the Immigration Health Surcharge (I H S) does not apply.


The I H S is a hefty £624 per annum – tripled from £200 since its introduction in 2015. Other migrants are taxed twice in that a family of four (a Skilled Worker accompanied by a partner and two children would pay National Insurance contributions alongside PAYE income tax) as well as the I H S of £12480 for a five-year visa on top of the visa fees of £4880. (There are reductions for those jobs on the Shortage Occupation List). In addition, the employer must pay an Immigration Skills Charge, a kind of tax for not hiring a settled worker instead.


The morality of “poaching” much needed staff from developing nations who are facing severe shortages of medical staff is a separate issue. Covid vaccines inequity whilst some of our stockpiles are due to expire soon was highlighted by Gordon Brown in this Guardian article:



Leaving aside inequity and the morality or otherwise of zealous nationalism, should a more sensible co-ordinated approach be adopted to avoid a kind of “global karma” hurtling back like a boomerang towards us?


Wouldn’t such a responsible approach protect our interests more long-term?


Author: Nilmini Roelens




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