Nuffield Trust questions fairness of the immigration health surcharge
23 Oct 2026
If you pay the immigration health surcharge (IHS) on a work or study visa, a new Nuffield Trust briefing looks at what you pay and why. It was published on 20 October 2026. It is research, not an announced change. No fee has changed and nothing in it asks you to act.
The briefing says the IHS rose from £200 a year in 2015 to £1,035 a year today. It says the charge is now meant to cover full costs. The Department of Health and Social Care (DHSC) estimates healthcare costs of £1,036 per payer per year. The Nuffield Trust says that figure depends on assumptions about non-hospital care. It says hospital data show IHS payers use 45-50% less hospital care than the age-matched England average. Applying that figure would give roughly £800.
The authors also look at tax. They estimate that payers contributed at least 60% more to the NHS in 2023/24 than the government's estimated cost of their care. In the briefing's words, "Visa holders pay the surcharge on top of the same taxes that fund the NHS for the wider population." The Trust also warns that NHS funding from the surcharge is exposed if migration falls. Income fell by over £100 million between 2024/25 and 2025/26.
The briefing says the IHS applies to most people on work and study visas. That includes Skilled Worker visas, student visas, the Graduate route and dependants. Students and child dependants pay a discounted rate. For now, the surcharge you pay is whatever the current rules and the GOV.UK fee pages say. Check those pages before you apply.
Sources: