NHS faces billions-shortfall as immigration health surcharge contributions tumble
A Nuffield Trust report says the NHS now relies heavily on the immigration health surcharge, which dropped to £2.3 billion last year, risking a multi-billion funding gap.
Research by the Nuffield Trust shows the NHS has become increasingly dependent on the immigration health surcharge, with contributions expanding tenfold from 2015-16 to 2024-25 before slipping to £2.3 billion last year. The decline reflects reduced numbers of foreign workers and a rise in the annual charge from £200 to £1,035, pushing the surcharge’s share of the NHS budget from 0.1 % to roughly 1 %. Fellow Stelios Vassiliou cautioned that a reversion to early-year levels would create a shortfall of billions and called for government scrutiny of visa-rule impacts.
He also questioned whether the surcharge is meant to fund the NHS, ensure migrants pay their fair share, or deter migration. In response, Prime Minister Andy Burnham pledged an additional £140 million for urgent-care schemes and ambulance upgrades, while Health Secretary Yvette Cooper stressed the need to back staff during winter pressures. A Department of Health and Social Care spokesperson defended the surcharge as a fair system that requires migrants to pre-pay for any NHS treatment they might need.
Why it matters
The NHS could face a multi-billion funding gap if surcharge revenues continue to fall, affecting health services nationwide.
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