21/10/2026
Are We Paying Twice for the National Health Service (NHS)?
New Study Shows Migrants Are Subsidising UK Healthcare
By Crystal Dias, Solicitor
If you have ever applied for or renewed a UK visa, you know how expensive the Immigration Health Surcharge (IHS) is. At £1,035 per year for adults and £776 per year for children, it adds thousands of pounds to your visa costs before you even set foot in the UK.
A landmark report from the independent UK health think tank Nuffield Trust reveals that migrants are actually paying far more than the healthcare services they consume.
Here is the complete breakdown of what every Filipino in the UK needs to know.
1. How Did the Fee Get So High?
When the UK government introduced the IHS in 2015, it was set at £200 a year. The initial idea was for migrants to make a small, fair contribution toward their healthcare, while the rest was covered by normal workplace taxes.
Over the last decade, successive government hikes raised the fee to £400, then £624, and finally to £1,035 a year in 2024. By 2024/25, total government revenue from the IHS reached nearly £2.5 billion—making up 1% of the entire NHS budget.
2. Who Is Exempt and Who Pays?
To understand how the IHS affects our community, it is essential to look at the different visa categories:
Health and Care Worker Visa Holders AND Their Family Dependants (EXEMPT):
Filipino healthcare professionals (such as NHS nurses, doctors, radiographers, and allied health staff) and their eligible partners and children pay £0 in IHS. This full family exemption rightly acknowledges their direct, frontline service to the UK’s health system. (Note: While care workers who were already in the UK before March 2024 retained their dependent rights, new care workers are restricted from bringing dependants, though those who qualify remain IHS-exempt).
Other Non-Health Migrant Workers & Dependants (SUBJECT TO IHS):
Filipinos working in IT, finance, hospitality, engineering, education, corporate services, as well as international students and family visa holders, must pay the full £1,035 annual surcharge (£776 for students and children) upfront for every family member for the entire duration of their visa.
3. The Truth About Healthcare Usage: Are Migrants a "Burden"?
The UK government set the £1,035 fee based on an estimate that the average migrant uses £1,036 worth of NHS care each year. However, the Nuffield Trust found that this estimate is significantly inflated:
Younger and Healthier Population: Most migrants moving to the UK for work or study are young adults. Only 1% of the IHS-paying cohort is over 60 years old (compared to 25% of the general UK population).
Lower Hospital Usage: Matched NHS hospital data shows that visa holders use 45% to 50% LESS hospital care than UK residents of the same age.
Realistic Cost: When factoring in actual hospital and community care usage, Nuffield Trust estimates that average healthcare usage for IHS payers is closer to £800 a year, meaning non-health migrants are being overcharged by hundreds of pounds annually.
4. The "Double Tax" Reality
For working Pinoys subject to the surcharge, paying the IHS means contributing twice for the very same healthcare system:
Tax Contributions: From day one of employment, migrant workers pay standard Income Tax and National Insurance directly from their paychecks, just like UK citizens. Around 27% of these tax revenues go straight to funding the NHS.
Upfront IHS Surcharge: On top of monthly payroll taxes, non-health migrants pay £1,035 per person upfront for every year of their visa.
How much do non-health migrant households actually contribute?
Single Skilled Worker (£55,000 salary): Pays enough in workplace taxes and IHS to contribute over £6,300 a year directly to the NHS—more than 5 times their estimated healthcare usage!
Family of Four (£55k main earner + £15k part-time spouse + 2 kids): Contributes over £9,300 a year to the NHS budget through combined taxes and IHS—more than double what their entire household consumes in healthcare.
Overall, Nuffield Trust calculations show that the IHS-paying cohort contributed at least 60% MORE to the NHS budget in 2023/24 than the total estimated cost of the healthcare services they used.
5. Why Falling Migration Threatens NHS Finances
When you apply for a 3-year or 5-year visa, you must pay all your IHS fees upfront. The government transfers that money to the NHS in the first year, and the NHS spends it immediately to cover current operating deficits rather than setting it aside for future years.
As UK net migration dropped in 2025/26, IHS revenue fell by over £100 million. Because the NHS spent those upfront fees right away, it now faces funding shortfalls—even though migrants who paid for 3 to 5 years upfront remain living in the UK and fully entitled to NHS care that they have already paid for.
The Bottom Line
The Nuffield Trust report provides hard statistical proof of what our community has long known: migrants are not a financial drain on the NHS—they actively fund and subsidise it.
Whether serving directly on the hospital floor with zero IHS fees, or working in other vital industries while paying thousands in upfront surcharges and monthly taxes, the global Filipino community plays an indispensable role in keeping Britain’s health service running.
