End of health surcharge ‘a huge contribution to equality’

by Tim Tonkin

The doctor who helped spearhead the BMA’s campaign against the immigration health surcharge has spoken of his relief at the Government’s decision to scrap the fee.

Location: International
Published: Tuesday 26 May 2020

Shiang Kwan (pictured), who 10 years ago came to the UK to study and then work in the NHS, helped raise awareness of the issue of the surcharge through a successful and well-received motion at the BMA’s 2016 annual representative meeting.

Last week, the Government agreed to scrap the £400 annual charge for non-European Economic Area healthcare workers.

Dr Kwan said the issue of the health surcharge had been one that he had been passionate about and lobbying against for a number of years, and to see the Government committing to scrapping the fee was immensely welcome.

He said: ‘I’m just very grateful the Government has made this decision especially during this pandemic and the crisis that the NHS is facing.

‘I think my colleagues in the BMA have done a marvellous job in getting the message out there to put some pressure on the Government.’

He added: ‘I think it’s a huge contribution for equality and diversity.’


A clinical research fellow, Dr Kwan began studying for a PhD at Nottingham University last August, working on a project on acute kidney injury in chemotherapy patients.

Following the COVID-19 outbreak in the UK, he was shifted to a clinical setting but unfortunately contracted the virus just a week into his re-deployment.

Thankfully now fully recovered from his illness, Dr Kwan has returned to research and is assisting with studies into kidney problems in COVID-19 patients, a role which he hopes will make an important contribution in the fight against the pandemic.

Dr Kwan said the decision to scrap the fee would make all the difference to migrant workers in the NHS, by giving a level playing field and making it easier for staff to focus on their work providing high-quality care to patients.


Portrait of BMA chair Chaand Nagpaul NAGPAUL: 'Overseas health workers should be exempt'

He added the decision to scrap the surcharge had given him hope ministers might take further steps to support overseas staff in the NHS.

He said: ‘I am just very happy the Government has come to the realisation that these [overseas] workers should be treated equally.

‘It gives us overseas staff in the NHS a boost of morale at a time where we want to be focusing on fighting COVID-19 without having to worry about financial difficulties.’

BMA GPs committee England executive team member Farah Jameel, who wrote and proposed the 2016 ARM motion calling for an end to the surcharge, welcomed the news that the Government would be scrapping the fee.

Dr Jameel said: ‘The NHS has for many years relied on overseas staff, and for too long government chose to continue to chip away at their morale by charging them and their families this large surcharge.

‘Finally, through continued lobbying for years and a pandemic, this government has recognised their existence, the value they bring and taken a step in the right direction to address the inherent inequality, by abolishing this surcharge. This is at long last, very welcome news.’

Long overdue

The charge, which was due to be increased to £624 in October this year, has been long opposed by the BMA, with association council chair Chaand Nagpaul describing the Government’s decision to abolish the fee as a ‘moral victory’.

He said: ‘This announcement is long overdue but is testament to the BMA’s persistent lobbying for this surcharge, unfair to so many NHS workers from overseas, to be abolished. This is without a doubt a moral victory and brings huge relief to those facing bills of up to thousands of pounds – as well as the insult of having to pay for the very services they are working so hard to provide.

‘The BMA has consistently said all overseas healthcare workers should be exempt from paying the charge so at last, the prime minister has listened to our concerns.

‘This is the least the Government should have done to recognise the effort these workers make – some have even given their lives. It’s absolutely crucial, that we recognise and value healthcare workers from overseas, who as this pandemic has clearly highlighted, provide an invaluable service protecting and looking after the health of our nation.

‘The scrapping of the surcharge must come into effect immediately to show our gratitude for the effort and dedication our overseas workers give to the NHS and to their patients.’

The BMA is calling for automatic indefinite leave to remain for all international doctors working in the UK.