Falling migration 'costs the NHS ￡100m a year' The Times Eleanor Hayward, Health Editor Falling migration 'costs the NHS ￡100m a year' Fewer visa holders paying the health surcharge has led to a fall in revenue which is forecast to get worse in coming years, a think tank says new The NHS has become reliant on revenue from visa applicants after a tenfold increase in a decade, the Nuffield Trust says Alamy Eleanor Hayward , Health Editor Tuesday October 20 2026, 12.01am BST , The Times Listen 0:00 / · 5:42 min Share Share this article Email Twitter Facebook Link Save The NHS is losing ￡100m a year because falling immigration has cut the number of foreigners paying a “health surcharge”, analysis shows. Foreign citizens applying for a UK visa must pay an annual fee of ￡1,035 to access free healthcare, and it has become a significant source of income for the NHS. Most commented 1 Russian strikes 'leave half a million Ukrainian homes without power' Russia-Ukraine war 388 comments 2 'We're 34 — we can't wait to start being landlords' Property & Home 78 comments 3 The beauty expert's all-time favourite hair products Beauty 19 comments Revenue from the immigration health surcharge (IHS) peaked at ￡2.42bn in 2024-25, about 1 per cent of the entire NHS budget. Top stories 1 Clodagh McKenna: I always get up at 6am on holiday. I love the calm Inspiration 2 16 of the best safaris in Africa Africa 3 13 of the best affordable hotels in New York New York City Since then immigration has fallen significantly under reforms by Shabana Mahmood, the home secretary. Net migration last year was 48 per cent lower than the year before . As a result, income from the IHS fell by more than ￡100m to about ￡2.32bn in 2025-26, and is projected to fall further in the coming years, which “threatens to further destabilise already precarious NHS finances”, the Nuffield Trust think tank said. Advertisement Yvette Cooper, the health secretary, had asked the Treasury for more money in the budget to cover this shortfall. But her plea was rejected by Andy Burnham and John Healey, the chancellor, The Times revealed last week. Yvette Cooper, the health secretary Jeff Overs/BBC/PA The Nuffield Trust analysis found that immigrants were “significant net contributors to the NHS's financial resources”, which is “in contrast to the common belief that migrants cause a drain on the health service”. Top stories 1 The ten companies fund managers think will make them billions Saving & Investing 2 'Mum is dating a fraudster. What can I do?' Family Finances 3 Prepare now for the inheritance tax mess coming for your pension Tax On average migrants pay 60 per cent more towards the NHS budget than they use, the think tank calculated, when taking account of the surcharge and tax on their income. In the case of a skilled worker on a salary of ￡55,000 with no dependants, they would on average pay five times more than the cost of their NHS care each year. A worker on the same wage with three dependants would still pay more than twice the average cost of healthcare. But those on students visas, who pay a reduced surcharge and generally do not pay much tax, contribute 25 per cent less than the average cost of NHS care. Migrants no longer have to pay the surcharge once they have been granted settled status, after a minimum of five years in the UK, meaning that their net contribution fades over time. Immigration also adds demand to stretched GP surgeries and hospitals. Advertisement The Labour government is being urged to take into account the “unforeseen” consequences to the health service of its crackdown on immigration , including stricter rules on who can access working and student visas. Net migration to the UK dropped to 171,000 in the year ending December 2025, down from a peak of 944,000 in the year ending March 2023. The IHS was introduced under the coalition government in 2015, set at a ￡200 a year. Since then a large increase in the fee and the numbers paying it means revenue from the IHS has risen tenfold as a share of the NHS budget in a decade. Stelios Vassiliou, a Nuffield Trust fellow who wrote the report, said: “Whether by accident, by design, or a combination of the two, the immigration health surcharge has grown to a prominence that cannot be ignored. “If the level of income from the charge was to fall back to that seen at its inception in 2015-16, the NHS would be left facing a shortfall in the billions, as it has grown reliant on immigrants in this group contributing substantially more to the NHS than they take out. Our analysis should give politicians pause for thought about this unforeseen, and possibly overlooked, consequence of changes to visa rules. Advertisement “With around a fifth of the NHS workforce hailing from overseas, it's well understood that immigration affects NHS staffing. This analysis shines a light on migrant contributions to our health service that receive far less attention. “The government needs to think carefully about what it's trying to achieve with the surcharge. We need clarity on whether this policy is about migrants paying their fair share, topping up NHS funding, or discouraging migration in the first place.” The Department of Health said: “The IHS is an entirely fair system that means migrants who apply to enter or remain in the UK for more than six months pay the costs upfront for any NHS treatment they may end up needing while they are here.” UK Healthcare Share Share this article Email Twitter Facebook Link Save