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Feature Migrant Health

Restricting access to the NHS for undocumented migrants is bad policy at high cost

BMJ 2015; 350 doi: (Published 16 June 2015) Cite this as: BMJ 2015;350:h3056
  1. Lilana Keith, interim programmes director, Platform for International Cooperation on Undocumented Migrants, Brussels, Belgium,
  2. Ewout Van Ginneken, senior researcher, Berlin University of Technology, Berlin, Germany
  1. lilana.keith{at}

Charging migrants for access to health services will not reduce strain on the NHS, say Lilana Keith and Ewout van Ginneken


The shocking loss of life among migrants crossing the Mediterranean and the UK government’s refusal to contribute to European search and rescue efforts despite public outcry have thrown into sharp focus the dehumanisation of migrants through negative political rhetoric and policies. Migrants’ right to life is also challenged by limited access to healthcare, particularly in the United Kingdom, where the first of several measures restricting access to NHS services for migrants, in a supposed “crackdown on health tourism,” came into force on 6 April 2015.1 But what are the real effects of such measures?

Immigration health charge

The new policy imposes an up-front surcharge to guarantee access to NHS hospital care for people from outside the European Economic Area when they submit an application to work, study, or visit their families in the UK for a period of longer than six months or when they are already in the UK applying to extend their visas.2 The surcharge is £200 (€275; $310) a year (£150 for students) for the maximum period of time that could be granted—for example, £400 for a two year visa (in addition to the application fee). Those who cannot pay will automatically have their application rejected.

Some applicants do not need to pay the surcharge, such as asylum seekers and victims of human trafficking. However, not all …

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