Boris Johnson was forced into the first major U-turn of his premiership on Thursday, as he announced that overseas NHS staff and care workers would no longer have to pay a controversial visa surcharge.
The prime minister had faced escalating tension from within his own ranks on the fee, after the Labour leader, Keir Starmer, raised the issue in the House of Commons on Wednesday.
Tory MPs and peers told Johnson the policy was “mean-spirited and immoral” and that he risked a humiliating rebellion on a Labour amendment to the immigration bill.
Amid fears that the government had backed itself into a corner, and with emotional appeals from NHS staff and care workers emerging online and former health secretary Jeremy Hunt voicing his opposition, government sources briefed that the prime minister was “thinking hard” about the surcharge – and it was dropped shortly before 5pm.
The reversal, hailed as a “victory for common decency” by Starmer, was introduced just hours before the prime minister was expected to take part in the weekly Clap for Our Carers event, which had been highlighted by critics as an example of government hypocrisy.
It brings to an end a controversy that has run for almost a month, since the home secretary, Priti Patel, said the policy was under review – only for the Home Office to subsequently row back on the pledge, saying: “All government policies are continuously kept under review.”
After the row came to a head, Downing Street said Johnson had considered the issue “a great deal” and understood the difficulties faced by NHS workers before giving the green light for a policy change.
“The prime minister has asked the Home Office and the Department for Social Care to remove NHS and care workers from the surcharge as soon as possible,” a spokesperson said.
The current surcharge is £400, rising to £624 this October. It is due to be removed for all NHS staff, including health workers, porters and cleaners, as well as independent health workers and social care workers – many of whom are on the minimum wage. Doctors, nurses and paramedics are also included. They had been previously given a one-year exemption.
However, just 24 hours earlier, at prime minister’s questions, Johnson had dug in over the charge in an exchange with Starmer. He justified the fee because of the financial contribution it made to the NHS, which he estimated at £900m.
Figures from the House of Commons Library showed that £917m was raised over four years from all migrants paying the surcharge. The library estimated it would cost about £35m a year to exempt all NHS staff, and more for care workers.
The SNP, Lib Dems and other opposition parties also voiced their concerns about the charge, while emotional social media videos by Syrian hospital cleaner Hassan Akkad on the plight of the lowest-paid healthcare workers during the coronavirus pandemic have been shared thousands of times.
Jeremy Hunt was among the leading voices calling for the U-turn, despite introducing the fee in 2015 during his time as health secretary. The now chair of the health select committee urged the government to change its mind just as No 10 announced it was dropping the surcharge.
Speaking to Nick Robinson on BBC Radio 4’s Political Thinking podcast, he said: “Given the sacrifices that we’ve seen during the coronavirus pandemic, low-paid frontline health and care workers need to be thought about differently, and I think one of the ways that we could do this is by looking at that surcharge, so I very much hope the government will do something.”
Despite the mounting pressure, Tory MPs were still surprised by the speed at which Johnson changed tack. An increase to the surcharge was a manifesto promise in last year’s general election campaign.
The education select committee chair, Robert Halfon, who was one of the four Tory MP rebels who said the charge should be abandoned, added: “I had no idea this was going to happen – not in a million years. I think it’s impossible to say to NHS workers in very low-paid work, who are risking their lives to look after us, that we are going to whack a few hundred quid charge on them.
“It was just unpalatable to the British people. I welcome that the prime minister has listened. This raises a much bigger issue, and if there’s any silver lining to Covid-19, I hope this means a relentless focus on how we can help the low-paid.”
Conservative MP William Wragg, who was the first to say he would support Labour in its bid to scrap the surcharge, said Johnson had “shown true leadership” and had listened and reflected.
Former Conservative cabinet minister David Mundell said the shift was the right thing for Johnson’s government to do. “It was inconsistent with the deep gratitude everyone feels for NHS staff at this time,” he said.
Earlier in the day, former Conservative party vice-chair and MP for North Thanet, Sir Roger Gale, said it would “rightly be perceived as mean-spirited”, while Andrew Boff, a senior Tory on the Greater London assembly, said: “I’m very proud of my party, but this is not its finest hour. These people have saved lives, then we give them a bill.”
The former Tory party chair Chris Patten said the fee would be “immoral and monstrous”.
Another senior Tory, Bob Neill, chair of the justice select committee, said the charge was “a small sum in the overall scheme of things” and the government should show generosity of spirit as a nation.
Tory MPs in Scotland and London were said to be very uneasy with the fee as they are the regions that rely most heavily on migrant labour in the healthcare sector and where immigration policies can be hard to defend. The Royal College of Nursing had also wanted health workers to be exempt from the “unfair” charge.
So far during the crisis, 181 health service and 131 care staff have died, according to government figures.
The reversal is being viewed as a victory for Starmer. Following the announcement, he called the decision “the right thing to do. We cannot clap our carers one day and then charge them to use our NHS the next.”
