Anger as most overseas care workers must still pay upfront fees to fund NHS, despite Boris Johnson’s promise to exempt them

Six-month wait for refunds attacked as perpetuating 'unjust financial burden' for lowly-paid staff

Most care workers from overseas will still have to pay upfront fees to help fund the NHS and wait six months for a refund, despite Boris Johnson’s promise to exempt them.

The Royal College of Nursing has hit out at a decision to opt for a reimbursement scheme for the immigration health surcharge – rather than a simple exemption – as details were finally published.

“Many staff – particularly those working in social care – will still have to pay this grossly unfair financial charge upfront in order to work in the UK,” said Donna Kinnair, the RCN’s chief executive.

“The proposed system of reimbursement for these workers does not go far enough. They must be reimbursed immediately in full to compensate for the initial, unjust financial burden imposed.”

The Home Office is blaming the complexities of arranging a scheme for workers who arrive in the UK other than on a sponsored visa.

Officials also say the announcement is more generous than the prime minister’s original pledge, by providing refunds for anyone effect since the end of March, rather than mid-May.

On 21 May, Mr Johnson was forced to grant the exemption, for health and care workers, after The Independent revealed Priti Patel had decided the fees must stay without carrying out a promised “review”.

The £400 health surcharge, rising to £624 from this October, is also paid by spouses and children, meaning the total cost can reach £8,000 for a family of four on a five-year work permit.

The Home Office has now confirmed that the new post-Brexit health and care visa – being introduced from 4 August – will included exemption from the surcharge.

But the RCN pointed out that some nurses from overseas, and the majority of care workers, did not start work after arriving through the visa route.

The need to apply for refunds will continue even after most foreign care workers are barred by tougher immigration rules, for those arriving through a “youth mobility scheme.”

Dame Donna pointed to the burden for poorly-paid staff, adding: “The government is running out of time to resolve the issues facing the social care sector.

“If they continue to ignore the warning signs, health and care services across the UK will be put at risk, as will the care of patients and those supported by social care.”

The Department of Health and Social Care is now working to “set up operational arrangements for reimbursing health and social care staff outside the scope of the health and care visa”.

They will “commence from 1 October in six-month reimbursements”, the Home Office said.

Officials said refunds of payments made by healthcare professionals on Tier 2 visas who have paid since 31 March 2020 had already started.