The fee will rise to £625 a year and extend to EU nationals, but how was this figure calculated?

Claim

The Conservatives have said people on a work, study or family visa incur NHS costs of £625 per year on average but pay only a £400 surcharge for the service. Increasing the charge and extending it to EU nationals will ensure “they are making a sufficient contribution towards our health service”, the party says.

Background

People coming to the UK for more than six months from outside the European Economic Area are required to pay an immigration health surcharge of £400 a year when applying for a visa. Most are charged upfront, so someone applying for a five-year visa will pay £2,000 with their application.

Once they have paid, they are entitled to NHS treatment on the same basis as permanent residents for the entirety of their stay. EU nationals who live in the UK get free healthcare.

The Conservatives propose increasing the payment to £625 a year and extending it to all foreign workers, including EU nationals after Brexit. “UK citizens pay for the NHS all year round through their taxes and it is only fair that new migrants make a fair contribution for its long-term sustainability,” the party said.

Reality

The surcharge was introduced in April 2015 and was initially £200 a year for most migrants, and £150 a year for students and young people. In January this year the charges were doubled.

In a written statement to parliament justifying the change, the immigration minister Caroline Nokes said a review by the Department of Health and Social Care had found that the average annual cost of NHS usage by those paying the surcharge was around £470.

The government quoted that estimate repeatedly in 2018. The new figure of £625 means the average appears to have jumped by a third since the review.

It is not clear how the figure was worked out. In a written answer to a question from a Labour MP, the former health minister Stephen Barclay said the department had looked at surcharge-payers who used the NHS between April 2015 and December 2017 and estimated an average.

It is unclear if a similar exercise has been done for a later period, if the first figure has been extrapolated, or if the new estimate is based on different data.

The higher fees would raise more money for the NHS but would be unlikely to help with recruitment, as staff joining from overseas would have to pay them. Under the new regime if they were staying for five years they would need to find £3,125.

The Conservatives have announced separately that NHS workers would be able to pay the surcharge through their salaries but they have ignored calls to offer an exemption.

Verdict

The figure of £625 has not been sourced and represents a large increase from the sum being cited just last year. Without any details of how it has been worked out, it is impossible to prove or disprove.

What is certain is that the surcharge is in addition to any tax and national insurance those workers pay in the UK. Migrants who are doing a full-time job also “pay for the NHS all year round”.