Immigration is once again at the forefront of UK politics. Public concern has climbed to one of the highest levels since records began in 1974 [1], and immigration now regularly tops polls of the nation's biggest issues. Yet the numbers behind the debate often tell a very different story.
According to official figures reported by The Guardian (Michael Goodier, 14 Sept 2025), net migration has fallen sharply, almost halving in 2024 compared with the previous year. Much of this decline is down to fewer work and study visas, as well as restrictions on dependants. Applications for student visas are down, and non-EU work visa applicants fell by nearly half year-on-year. Long-term immigration has dropped back below one million.
Who is actually coming to the UK matters as much as the headline figures. Around 47% of arrivals are students, contributing to the higher education sector and often moving into the labour market afterwards. A further 20% arrive on working visas, with 11% more as dependants. Far from being passive, many of these dependants are in employment: two-thirds of health and care worker dependants, almost half of skilled worker dependants, and a quarter of senior or specialist visa dependants had PAYE earnings. Within only a few years, non-EU migrants are typically earning at or above the UK median wage.
The debate has increasingly focused on health and care visas. This route has been vital for the NHS and social care, plugging staffing shortages that domestic recruitment has struggled to fill. Cases of abuse have rightly been highlighted, leading to recent policy tightening. However, critics suggest that restricting these visas, and making the UK less attractive for overseas staff, could be seen as a step towards the gradual privatisation of the NHS. The reasoning is that if staffing shortages worsen, governments may feel compelled to rely more heavily on private contractors to deliver services.
At present there is no firm evidence in the data or policy documents that visa rules are being used explicitly to drive NHS privatisation. The available evidence points instead to political pressure to reduce net migration figures. Yet the link between immigration and the NHS workforce is undeniable. When visa restrictions limit recruitment, the gap in staffing does not vanish; it has to be filled somehow. If the public system cannot recruit enough staff, private providers may step in by default.
This is why the debate cannot be reduced to numbers alone. Immigration is not simply a headline figure, it is a source of growth, a lifeline for universities, and a cornerstone of the health and care system. To characterise it as a "burden" ignores the clear economic and social contributions being made. At the same time, legitimate questions remain about whether current immigration policies could, intentionally or otherwise, push the NHS further towards private provision.
The central question remains: is immigration being misused as cover for NHS reform or is it simply being scapegoated?
[1] The reference to 1974 highlights that public concern over immigration is now near its highest level since polling on this question began. Ipsos started asking Britons about immigration in 1974, so comparisons are made against this long-term record to show how concern has evolved over the past 50 years