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66% increase in Immigration Health Surcharge to be implemented on 6th February 2024


Immigration (Health Charge) (Amendment) Order 2024 was made on 16th January and takes effect 21 days later

Date of Publication:
18 January 2024

The 66% increase in the Immigration Health Surcharge (IHS) that was announced by the Government in July of last year will be implemented on 6th February 2024. The Immigration (Health Charge) (Amendment) Order 2024 was approved by Parliament on Tuesday and was published in the early hours of this morning.

Image credit: UK GovernmentThe surcharge will be increased from £624 to £1,035 per person per year for adults and from £470 to £776 per person per year for children under 18, students and their dependants, and applicants for the Youth Mobility Scheme.

It was initially expected that the increase would take effect on 16th of January, as that was the earliest date given in the original draft order published last October. House of Commons Library researcher CJ McKinney noted on X last month that the increase would be debated in the House of Commons on 10th January, meaning that it could not come into force on January 16th.

The draft order stated that it would come into force either on the 16th January 2024 or the twenty-first day after the day on which it is made depending on which date was the later. As the Order was approved by Parliament and made on 16th January 2024, it will now come into effect on 6th February 2024.

The Home Office published a detailed equality impact assessment on the increase in October 2023. It says that the increase is being implemented to continue to deliver the Conservative Party's 2019 election manifesto commitment to ensure that the surcharge covers the full cost to the NHS of treating people required to pay it.

As the equality impact assessment explains, the IHS is set at a fixed amount which takes no account of an individual's usage: "The charge is based on how much healthcare an 'average' Health Charge payer is expected to use and not directly linked to the healthcare usage of each individual payee."

Lord Sharpe of Epsom, the Parliamentary Under-Secretary of State for the Home Office, stated during a House of Lords debate last month that the new IHS rate "reflects the increases in healthcare expenditure and revised assumptions of migrant use of healthcare services" and it was based on "more recent and representative data".

Lord Sharpe said the Government had undertaken "robust and detailed analysis" of the annual cost to the NHS of treating migrants who pay the IHS to determine the increase.

The House of Lords Secondary Legislation Scrutiny Committee considered the Immigration (Health Charge) (Amendment) Order 2023 in a report published last month. The report highlighted that the Order's explanatory memorandum provided no details as to why the surcharge was being increased at a rate well in excess of NHS spending, which has only risen by 25% since the IHS was last increased.

The Secondary Legislation Scrutiny Committee examined some calculations used by the Home Office to justify increasing the surcharge by 66%. It found that increases in the Home Office's 'NHS migrant cost factor' was the key reason that the IHS is now increasing much more rapidly than the NHS budget. The factor increased from 28% in 2020 to 52% in 2023. The Home Office said this was because of a different method of calculating migrants' use of the NHS that had indicated "high levels of use" by IHS payers for some areas, including community and mental health services.

The Committee also found that the Home Office's calculations had overstated the current per capita cost for NHS spending when compared to all spending, which meant the IHS was set higher than it otherwise would be. While the difference was only minor (£1,013 instead of £1,036), the Committee called the calculations "unconvincing" and said it was "worrying that the Home Office should use such a questionable methodology and it may cast doubt on the accuracy of other underlying calculations that we have not scrutinised."

In addition, the Committee said it was disappointed that the Home Office had taken so long to respond to its questions, thus delaying parliamentary scrutiny of the Order.

The report stated: "This draft Order was laid before Parliament by the Home Office on 19 October 2023. We asked the Home Office two sets of questions, the second of which we sent on 31 October 2023. The Home Office did not reply until 28 November 2023. We appreciate that the Home Office needed to consult the Department of Health and Social Care, and that an intervening reshuffle may have delayed responses. Nonetheless, we are disappointed that the response time was significantly longer than we would expect and has meant that Parliament's scrutiny of the draft Order has been delayed unnecessarily."

For background information on the IHS, see the House of Commons Library report published in November 2023, which can be read online here or downloaded here.