Question to the Department of Health and Social Care:

To ask the Secretary of State for Health and Social Care, what information his Department holds on (a) the cost to the public purse of providing NHS services to non-UK nationals and (b) what proportion of this cost the NHS Health surcharge covers.

National Health Service care is provided free at the point of use to people who are ordinarily resident in the United Kingdom, including people who were born abroad, if they are not subject to immigration controls. As free at the point of use access to the NHS is based upon ordinary residence and not nationality, we do not collect or hold information on the nationality of people accessing NHS services.

The Immigration Health Surcharge (IHS) is one of the NHS migrant cost recovery methods and is designed to recover NHS costs attributable to migrants requiring a visa longer than six months. In 2024/25, the IHS generated £2.6 billion in income for the NHS in the UK.

For those who are not covered by the IHS or ordinarily resident in the UK, their healthcare costs are covered in one of two ways. The first is through reciprocal healthcare agreements that the UK has with other countries, where costs are recovered from those countries. The second is where individuals are directly charged by NHS trusts providing care. The Department publishes data on this income in its annual reports and accounts.

The current IHS fee of £1,035 came into force in February 2024. It was calculated as the value of the healthcare budget for 2023/24 that an “average” IHS payer accounts for and reflects the Department’s most recent analysis of the cost of providing NHS services to IHS payers. The full methodology can be found in Annex A of The Immigration (Health Charge) (Amendment) Order 2024, a copy of which is attached.