As of July 2013 the government unveiled proposals to introduce levies on foreign workers and students from outside the EU, who plan to remain in the UK for more than six months. The price for accessing NHS services has been proposed at £200 a year, with the intention of recuperating funds that the NHS loses as a result of treating foreign migrants, but particularly those who abuse the system through “health tourism”. However, is this proposition justified when foreign students from outside of the EU are at present expected to pay higher tuition fees in order to study in the UK?
According to Department of Health estimates, the total number of migrants using NHS services each year stands at 2.6 million, with the total cost to the National Health Service estimated to be £2 billion of the NHS’s £110 billion annual budget. The £200 figure would therefore seem justifiable, in order that international students make a contribution to their healthcare in the UK that is free at the point of use. According to the Health Secretary Jeremy Hunt, the figure could exclude certain treatments like IVF, cosmetic surgery, organ transplants and antenatal care for pre-existing pregnancies. Furthermore, such a figure is considered competitive in comparison to what other countries have charged foreign students for healthcare. Currently 300,000 students from outside of Europe are studying at British universities, with official projections suggesting that this figure will rise to more than 480,000 by 2025.
It is, however, important to stress that students from outside the EU have to pay up to four times the fees charged to UK students. According to a recent survey by the Complete University Guide, undergraduate fees charged to international students in 2013-14 can start at £7,450 for lecture based courses and rise to £35,000 per annum for undergraduate medical degrees. Daniel Stevens of the NUS has criticised the rise in fees for international students, saying: “It is scandalous that non-EU students are charged fees that can be thousands of pounds higher than those of other students… universities that truly value their international students should be clear about the real cost of their courses allowing them to budget properly.” Any further cost to studying in the UK has the potential of discouraging international students from applying to British universities, but with the number of non-EU students expected to rise in future, any further treatment costs will place extra strain on NHS resources.
For too long the National Health Service has been treated as a free public resource, with no cost attached. This is of course a false assumption. The NHS has to be paid for, and is, through general taxation, particularly National Insurance contributions from the British taxpayer. However, as a consequence of exempting certain groups of individuals from contributing to the funding of NHS services, including international students, certain health care trusts may have their resources further stretched. In recent years research has provided an increase in the number of drugs, diagnostic and treatment related technologies, all of which require additional funding in order to deliver these to patients. Furthermore, the government has suggested that GPs extend their opening hours in order to relieve the pressures being exerted on A and E departments across the country. GP leaders have, however, estimated an extra cost of £1.5 billion to enable the proposals to be realised. Therefore, any strategy implemented by government to deliver NHS services further emphasises that there is an almost indeterminable burden on the public purse.
The charging of international students to access NHS services is likely to raise less than £100 million, yet from the evidence presented it remains a justifiable proposal from the government. The real question now is how the levy is paid? In August 2013 the UK Council for International Student Affairs (UKCISA) raised the prospect that universities could ‘bulk buy’ the annual £200 health levies for international students. Given the already large sums in tuition fees that students from outside the EU are expected to pay, it would be a fairer solution to a contentious issue, as well as indicating that British universities truly value their international students. It is regrettable that non-EU students are charged higher fees; however, NHS funding has its limitations, and exempting certain groups from financial contributions only serves to increase the pressures on an ever expanding national health service.
