Do these new NHS rules affect my wife whos on FLR on a spouse Visa?

The NHS is the National Health Service, for UK nationals. Perhaps people just use the name NHS without thinking about what it's an abbreviation for? The UK government has made it quite clear for years, that they intend to "return the NHS to the national health service and not the world health service it has become", so this shouldn't really be a surprise.

It's still very generous and they haven't yet gone to the lengths some western countires go to protect their health service for their nationals. i.e. medicals to pass before a visa. Although I suppose those who are fit and healthy would rather have a medical and then get free NHS, but what about those immigrants with existing health conditions or weight problems?

What on earth does this reply have to do with KFDancer's post about paying her taxes?

I think you may be the one confused about the context of the term 'national' here. The NHS isn't for UK nationals specifically, it is a national service available to ANYONE resident in the UK (just like education and the police and the fire brigade). This has always been the case - it was never intended for UK nationals only... when it was set up in 1948, the NHS was available to everyone in the community, even temporary residents. As it is funded by taxes and many people paying taxes are not UK nationals, it's not fair that they should not be allowed to claim treatment that they are already paying for.

Even now, they aren't trying to restrict the NHS to UK nationals only (people with ILR are not UK nationals but they will be exempt from the levy), they are simply trying to stop people who don't live here or who only have temporary permission to live here from abusing the system by coming to the UK simply for free treatment, without contributing to the cost, and then leaving again.

Susan, you really confuse me.  You spend so much time on immigration websites when you are very anti-immigration.  At times you come off as caring and helpful if someone runs into troubled times.  But on this board we have a lot of hard working immigrants, who contribute a lot more to the UK system than what they receive in government services.  Yet you seem to think we are a group of people looking for government handouts.

The thing is all visitors were never allowed unlimited free access to NHS, and to my knowledge no one with half a brain has ever advocated for that. Tourists were and are billed for services. A recent article showed where the NHS actually turns a profit, and quite a large one, from people around the world popping in and paying for medical treatment. It helps offset costs. It is a direct reflection of the quality of treatment available.

Many visitors (most?) carry health insurance.

So what is this all about?

Where is the money from these new charges going? Are they putting it back into medical services? I doubt it. I keep reading that the administrative costs will end up being higher than any 'savings'.

What they have done is raise the price on certain categories of applicants and painted it as some sort of NHS savings - very transparent PR aimed at pacifying racists and bigots.   

Again, I believe what they say about the NHS being in danger. It will require some very clever management to even keep it stumbling along in its present form. This little tweak does nothing for anyone.

What on earth does this reply have to do with KFDancer's post about paying her taxes?

KFDancer was the one who linked her paying taxes to using the NHS.
Firstly, I pay 45% of my salary in taxes, plus NI.  I just didn't pay at the point of service.  Big difference.

I think you may be the one confused about the context of the term 'national' here.

It seems that you haven't read the relevant Immigration Act 2014 as your version of "national" is not what the UK government stated in the Immigration Bill, nor has been saying for years. I mentioned this bill months ago and then put up the relevant links on this site in the visa section when it became law in May 2014 and mentioned the NHS changes. I even put up the link to the fact sheet that said.

“We have been clear that the UK has a national health service, not an international
health service.These proposals will ensure that migrants here temporarily
make a fair contribution to the cost of health services in the UK.”
https://www.gov.uk/government/uploads/system/uploads/attachment_data/file/249315/Factsheet_08_-_Health.pdf

Even now, they aren't trying to restrict the NHS to UK nationals only (people with ILR are not UK nationals but they will be exempt from the levy),

If you read the Immigration Act 2014, you will see that they say something along the lines of 'that those with ILR show commitment to the UK" and that is why "ILR" is mentioned in the Act, with "nationals". Don't forget that those with ILR are also allowed to claim UK welfare in their own name and it stands to reason that they wouldn't allow one without the other.

 

they are simply trying to stop people who don't live here or who only have temporary permission to live here from abusing the system by coming to the UK simply for free treatment, without contributing to the cost, and then leaving again.

Then why didn't they put that in the new Immigration Act 2014? If you read the Immigration Act 2014, you will clearly see that the provision is there to charge a levy on anyone who is not a UK national or on ILR (EUs excepted I assume as we have free health agrements with those countries).They haven't stated which visa groups they will start charging this NHS levy too, but the way the law is written, they can charge all the groups. Nor have they set how much the levy will be.

Susan, you really confuse me.  You spend so much time on immigration websites when you are very anti-immigration.  At times you come off as caring and helpful if someone runs into troubled times.  But on this board we have a lot of hard working immigrants, who contribute a lot more to the UK system than what they receive in government services.  Yet you seem to think we are a group of people looking for government handouts.

I'm not anti immigration, I'm anti uncontrolled, low skilled immigration. However what these high numbers of low skilled immigrants have caused, is to make the UK goverment look at the impact on services and act (excuse the pun) accordingly, with new laws. New laws that will go deeper than before. More new laws to come in.


I have been helping with these NHS changes, but nobody on here believed me. Or perhaps they didn't think it would affect them because it was coming across as a Bill that would be stopping illegal immigrants?

Don't believe what the papers say, read the Immigration Act 2014.

KFDancer was the one who linked her paying taxes to using the NHS.
Firstly, I pay 45% of my salary in taxes, plus NI.  I just didn't pay at the point of service.  Big difference.

I know that... but your reply had nothing to do with taxes, so why did you quote it?

It seems that you haven't read the relevant Immigration Act 2014 as your version of "national" is not what the UK government stated in the Innigration Bill, nor has been saying for years. I mentioned this bill months ago and then put up the relevant links on this site in the visa section when it became law in May 2014 and mentioned the NHS changes. I even put up the link to the fact sheet that said.

“We have been clear that the UK has a national health service, not an international
health service.These proposals will ensure that migrants here temporarily
make a fair contribution to the cost of health services in the UK.”
https://www.gov.uk/government/uploads/system/uploads/attachment_data/file/249315/Factsheet_08_-_Health.pdf

That still has nothing to do with UK nationals. National means that it's only accessible within the physical boundaries of the UK and not internationally across the world.

If it was for UK nationals only, then any UK national across the world could use the NHS for free whenever they liked, whether they had contributed towards it or not... which isn't true, because the NHS can only be used for free by those who are 'ordinarily resident' in the UK.

And with these new rule changes, 'ordinarily resident' is being redefined from 'non-EEA citizens whose primary residence is the UK' (i.e. anyone who has legally made the UK their main residence, either temporarily or permanently) to mean 'non-EEA citizens who hold ILR in the UK' (i.e. you need permanent residence in the UK). Nowhere does it state that you have to be a UK national to be ordinarily resident.

If you read the Immigration Act 2014, you will see that they say something along the lines of 'that those with ILR show commitment to the UK" and that is why "ILR" is mentioned in the Act, with "nationals". Don't forget that those with ILR are also allowed to claim UK welfare in their own name and it stands to reason that they wouldn't allow one without the other.

Yes, but they are still not UK nationals, which contradicts your statement above that the 'National' in NHS means it's for UK nationals only.
 

They haven't stated which visa groups they will start charging this NHS levy too, but the way the law is written, they can charge all the groups. Nor have they set how much the levy will be.

Actually they have.

I'm beginning to wonder if you've actually read the official Department of Health document linked in the OP, published on July 14th 2014 because it's all stated in there (and is more detailed and up to date than your immigration act link).

I even quoted the expected fee in my post above and highlighted the charge in bold red.

But here it is again for you:

This is expected to be £150 per year for students and £200 per year for others, and will be paid upfront for the duration of the visa.

And as for who will be charged:

Who will be charged?

Non-EEA temporary migrants (including students and workers)
Will be expected to pay a health surcharge as part of the visa process, unless they are exempted. This will mean they are entitled to use the NHS, as an ordinarily resident patient would, whilst they have valid leave to remain (usually between 6 months to 5 years).

Non-EEA visitors
Those in England for less than 6 months continue to be chargeable (unless covered by a country specific reciprocal agreement or other exemption) but will be more likely to be identified and charged.

Expatriates
Under current rules, expatriates are normally chargeable for NHS care (or should use EHIC/S2 mechanisms if residing in another EEA country) on the grounds that they are not ordinarily resident in the UK. However, the Government is considering whether to exempt from charges expatriates who have made significant National Insurance contributions in the past. No final decision on this has been taken.

Vulnerable groups who are not currently exempt
We are considering strengthening exemptions, or other ways of ensuring necessary treatment is provided, for victims of domestic violence, human trafficking and vulnerable children.

People who are here illegally
Will continue to be chargeable, as they are now.

The thing is all visitors were never allowed unlimited free access to NHS, and to my knowledge no one with half a brain has ever advocated for that.

Some visitors to the UK (non resident Brits included ) travel without health insurance as they just go to A&E for minor ailments as treatment is free for all at A&E. A poster on this site was recently told to do just that with their daughter's ear infection, as they hadn't brought health insurance for their visit.

A&E is for what it says in the the name. Abuse something for too long and it will end. That's why free for all at A&E is ending, apart for life threatening things (heart attacks was the example used for the Immigration Bill). Now visitors, illegals, those with a visa that doesn't allow an NHS levy, will be billed at A&E. Minor proceedures by GPs will be billed too, for the same people.

For those popping in just to use the NHS, we will all now have to provide proof for using the NHS for free, as the UK moves to finally stop NHS abuse.

Again, I believe what they say about the NHS being in danger. It will require some very clever management to even keep it stumbling along in its present form. This little tweak does nothing for anyone.

Until we get those who run a  large successful business to run countries, we aren't going to get value for money.

On the subject of NHS waste, from one of my favourite programmes from years ago, Yes Minister. The second series was Yes Prime Minister.

These snippets from the one where he finds out about unions, admin state workers and empty hospitals.

The empty hospital - Yes Minister - BBC comedy

Get some patients - Yes, Minister - BBC

I can't find the part where he then walks into the empty hospital's typing pool, but they are all busy typing! 

38Immigration health charge

(1)The Secretary of State may by order provide for a charge to be imposed on—

(a)persons who apply for immigration permission, or

(b)any description of such persons.

(2)“Immigration permission” means—

(a)leave to enter or remain in the United Kingdom for a limited period,

(b)entry clearance which, by virtue of provision made under section 3A(3) of the Immigration Act 1971, has effect as leave to enter the United Kingdom for a limited period, or

(c)any other entry clearance which may be taken as evidence of a person’s eligibility for entry into the United Kingdom for a limited period.

(3)An order under this section may in particular—

(a)impose a separate charge on a person in respect of each application made by that person;

(b)specify the amount of any charge (and different amounts may be specified for different purposes);

(c)make provision about when or how a charge may or must be paid to the Secretary of State;

(d)make provision about the consequences of a person failing to pay a charge (including provision for the person’s application to be refused);

(e)provide for exemptions from a charge;

(f)provide for the reduction, waiver or refund of part or all of a charge (whether by conferring a discretion or otherwise).

(4)In specifying the amount of a charge under subsection (3)(b) the Secretary of State must (among other matters) have regard to the range of health services that are likely to be available free of charge to persons who have been given immigration permission.
http://www.legislation.gov.uk/ukpga/2014/22/section/38/enacted

This is the link to the online (original verson) of the  Immigration Act 2014 (as oppose to the Immigration Bill) if anyone is interested. It's a Bill first, then when it becomes law, it's an Act. http://www.legislation.gov.uk/ukpga/2014/22/contents/enacted

I'm happy to be corrected if I haven't read it correctly.

A&E is for what it says in the the name. Abuse something for too long and it will end. That's why free for all at A&E is ending, apart for life threatening things (heart attacks was the example used for the Immigration Bill).

We are in agreement (and apparently on our feelings for some classic British television)!

But is it really visitors using A&E for non-emergency services causing the problems?

I watched a programme once and they took a camera in on a Saturday and most of the people at least looked and spoke like 'natives' (whatever that is supposed to mean). Turns out the local after hours system had been shut for the weekend as the new computer system had crashed.   

I'm happy to be corrected if I haven't read it correctly.

Huh? No one is disputing what that says.

It's just that this thread is discussing the new Department of Health documentation information, released yesterday, which gives a lot more detail about how this Immigration Bill will be implemented.... but you seem to have ignored that this new document exists and you keep referring back to information that was published 9 months ago instead.

- You stated that the levy fee has not been decided yet... but the Department of Health document has given a figure of £150 per year for students and £200 per year for others.

- You stated that they haven't said who will be charged yet... but the Department of Health document gives more detail about who will be charged.

- You stated that that National in NHS means it's for 'UK Nationals'... and that's just not true. It's for anyone who is legally resident in the UK, and it always has been.

There are a lot of things that bother me about the logic of the charge for people holding visas of more than 6 mos.

The purported logic behind implementing this charge is to not allow those who are not contributing to the UK (presumably via income tax, since that is what funds the NHS) to use the NHS.

I can somewhat understand this for Tier 4 holders, since although they are allowed to work, it is only 20 hours/week.  However, Tier 4 holders will also be contributing hugely to the UK economy by virtue of the fact that they are paying international fees to their university (i'm paying nearly £14k for my masters).  Like I said though, as this is not direct tax contribution, the £150 charge seems reasonable, given that it is far far less than I'd pay for my healthcare here in the US.

However, past Tier 4, the rest of this really doesn't line up with "contribution to the UK" reasoning.  Firstly, for most PBS migrants, they are there specifically to work, so they are guaranteed to be holding a job that pays a certain amount and are thereby guaranteed to be contributing a minimum amount of tax.  So although the fee (£200) is pretty much nominal, it hardly seems fair or inline with the "contribution to the UK" reasoning to effectively charge them twice when they are already present as highly skilled workers who are paying taxes.

As for FLR or spouse visa holders, they are pretty clearly showing a commitment to the UK by having a settlement visa in the first place (not to mention absolutely exorbitant cost of obtaining that visa).  But even beyond that, if the real reason for the minimum income requirement for those visas is keep spouses from becoming scroungers, then giving them NHS without an extra charge is the only logical thing that follows.  Because the UK government has already determined an income level at which we are not a drain on the UK economy/taxpayer.  On top of that, many, if not most, FLR and spousal visa holders will have a job and be paying tax personally.

I'm not debating the fact that this law was passed, or the amount of these charges really, just the premise upon which they are being implemented. 

I'm not debating the fact that this law was passed, or the amount of these charges really, just the premise upon which they are being implemented. 

Exactly. It just doesn't make logical sense.

Why should someone who lives and works in the UK, who pays taxes to the UK government, who contributes to the NHS the same as a UK citizen does, have to pay an extra levy to access those NHS services, just because they haven't lived here long enough to gain ILR yet?

What makes that person different to me or any other UK citizen in the same position? Why should they have to pay £200 per year more than us for the same services we are all paying for anyway?

It's a crazy law and one I doubt other western countries have. They seem to be trying to be fair, but for some it is fairer than others. At one end you could have the healthy person who would pass a medical, paying high rate tax to the UK. At the other end, you could have an immigrant with health problems/an unhealthy life style, that could cost the NHS loads. Yet the levy is set by visa routes and not by the persons health. Although the Act does seem to allow to charge a person and not a visa route.

I can see why they wanted to do as other countries have done when they protect their  health service for it's citizens, but I don't know why they just didn't operate the tried and tested "must pass a medical" that other western countries with free health systems, use. Then that person gets full access to the healthcare system when they arrive.

So does this mean I can stop paying income tax and NI?

Oh, I have lived here for nearly 10 years - does that not show commitment to the UK? I educate your children and was educated here. I resent this policy hugely. Not that my country is any better *cough* Bill O'Reilly *cough*.

If I already qualified for ILR and/or citizenship, I would have applied long ago! Instead, why make us pay THOUSANDS of pounds more than we are already penalised for being born where we were?

Rant over.

Exactly. It just doesn't make logical sense.

Why should someone who lives and works in the UK, who pays taxes to the UK government, who contributes to the NHS the same as a UK citizen does, have to pay an extra levy to access those NHS services, just because they haven't lived here long enough to gain ILR yet?

What makes that person different to me or any other UK citizen in the same position? Why should they have to pay £200 per year more than us for the same services we are all paying for anyway?

THIS!!! THIS!!!