Northern Ireland’s health service received more than £81m last year from a tax on immigrants using the NHS.
The Immigration Health Surcharge is a mandatory upfront payment towards the NHS for most people applying for a visa in the UK, now costing £1,035 a year for adults.
Exceptions include certain health care workers, asylum seekers and those applying for indefinite leave to enter or remain.
Figures revealed in an Assembly Question to the Health Minister Mike Nesbitt by DUP MLA Diane Forsythe showed the department has received more than £239m from the tax in the last five years.
This has increased each year from £10m in 2020/21 to over £81m in 2024/25 – a jump of 800%.
“Immigration Health Surcharge (IHS) is collected by the Home Office as part of the UK visa and immigration application process. As such, the IHS is operated and monitored by the Home Office,” Mr Nesbitt said.
“All UK administrations then receive a pro-rata share of the income generated, in line with the Barnett formula.”
Mr Nesbitt added that the IHS was impacted by the pandemic due to “important exemptions and refunds,” particularly for health and social care workers.
When it was first introduced in 2015, the IHS cost £200 a year for adults before being increased to the current rate of £1,035.
By 2024, the scheme was estimated to have generated a total of £6.9bn, according to the House of Commons Library.
In November, the Reform Party leader Nigel Farage called for the charge to be increased even further to £2,718 a year, claiming it would raise £5bn for the economy.
Lillian Seenoi-Barr from the North West Migrants Forum
Lilian Seenoi Barr is CEO of the North West Migrants Forum.
“We do not see this surcharge as an added burden on families who come here to work and build a future,” she told the Irish News.
“We see it as a fair contribution into the healthcare system by those who live and work here. Since 2020, close to £240m has flowed into the economy through fees attached to the majority of visa applications.
“Last year alone almost £82m was paid directly from the pockets of visa applicants and their dependants to access the healthcare system we often take for granted.
“These are not insignificant figures. They demonstrate that migrants are not only contributing through their labour and skills but are also making substantial financial contributions to public services.”
She continued: “The disappointing reality is that these positive contributions are rarely highlighted in public debate. Instead of focusing solely on what migrants may cost, we should also acknowledge what they give back, economically, socially and culturally and recognise the enormous value they bring when given the chance to thrive.”
Last year, Ulster University academic Dr Luqman Saeed from Pakistan also told the Irish News about how his family pays around £4,000 a year to use the NHS.
Challenging the incorrect assumption that all migrants in Northern Ireland were on benefits, he said: “That’s what the perception is. But not only do I work and pay my taxes, I pay a surcharge for the NHS which at the moment is about £1,000 per year, per person.
“So for a family of four, we’re paying an extra £4,000 a year on top of taxes and national insurance.
“I cannot be on benefits, because my visa would be revoked without question.”