Plans to extend and increase healthcare charges for migrants announced

28 July 2014

The Department of Health has published the Visitor & Migrant NHS Cost Recovery Programme: Implementation pla​n 2014-16, which sets out the department’s plans for charging migrants for NHS healthcare, and how these will be introduced over the next two years. 

The most significant changes that will affect the NRPF client group are as follows:

  • ​The implementation of the provisions of the Immigration Act 2014, by spring 2015, which:​
- extend charging for sec​ondary healthcare to wider groups of migrants,
- require those applying for limited leave​ to enter or remain for more than six months to pay a surcharge to enable them to access to NHS treatment, and 
- amend the NHS (Overseas Visitors Charging Regulations) 2011 that set out the current exemptions to charges to include exemptions for vulnerable groups, which are not currently specified. ​

  • Migrants currently liable for secondary healthcare charges will face increased costs for the services they receive, as non-EEA patients liable for charging will be charged 150% of the NHS standard tariff in order to "compensate for the additional workload created for providers in order to identify chargeable patients and recover costs".  
  • ​The Department of Heath will be working with healthcare providers to increase their reporting of "the most serious debtors" to the Home Office for the purpose of refusing immigration applications on the basis of NHS debts of £1000 and above.​​​
  • ​Sanctions will be levied against a healthcare provider if they fail to identify chargeable patients; details of these will be published before April 2015.
  • ​Liability for charging may be recorded on primary care systems (such as those maintained by a GP) by the end of March 2016.
  • Changes will be announced in 2015-16 regarding the extension of secondary health care charging to A&E service and to non-NHS providers of NHS care, as well as being introduced for some primary care services, including pharmacy, optics, dentistry and community services, although GP and nurse consultations will remain free to all.
The Department of Health has confirmed that immediately necessary and urgent treatment will not be delayed or denied to those liable for charging, but may be limited to what is clinically necessary and payment will be sought after treatment. Failure by the NHS to provide immediately necessary treatment may be unlawful under the Human Rights Act 1998.


It is likely that, in the immediate future, these changes will result in an increase in the numbers of local authority supported migrants being charged for secondary healthcare when they do not meet one of the current exemptions from charging. Local authorities are concerned that as a result, they will need to provide more resources to support NRPF service users, who, do not receive treatment, are issued healthcare bills they cannot afford to pay, and are refused leave to remain in the UK on the basis of non-payment of charges. We will be undertaking further wor​k to ensure that these concerns are considered as the charging plans are implemented.​