Fighting an unfair fee

For Eva Omondi, the fight to remove the immigration health surcharge (IHS) for health care workers from overseas was personal – in order to pay it, she was forced to work extra shifts, separate from her children, and take out loans that she is still paying off now. 

This May, under pressure from Eva’s campaigning, the RCN and others, the UK government finally promised to scrap the IHS for health care workers. 

The fee, which sees all migrants who come to the UK from non-EEA countries pay £400 a year for the NHS, whether they use its services or not, is due to increase to £624 a year from October.

Speaking out against unfair government policies is not an easy decision and many others in the same position feared what would happen if they raised their voices. However, Eva, an NHS nurse, who is originally from Kenya, was determined to fight for her family and other overseas nursing staff.

Unfair charge

In 2015, Eva paid the IHS fee when she applied for her work visa. After saving money to pay for visas for her family, she then discovered the IHS also had to be paid for every individual family member and paid upfront for the number of years each visa lasted. This meant £3,600 on top of their usual visa fees.

“It didn’t make sense,” Eva says. “The NHS has relied on overseas workers to sustain it. We come here as legal residents and we pay National Insurance and taxes.”

But it wasn’t simply a matter of paying the extra upfront fee. To afford it, Eva and others have had to borrow money. To pay the money back, they’ve had to work overtime. To work overtime shifts, they had to find childcare. Overseas workers have no recourse to public funds and therefore can’t access government-subsidised childcare and are unlikely to have extended family in the country who could help out for free, leaving Eva and others stuck in a vicious cycle.

“This was an issue that could make someone easily lose it,” says Eva. “Currently I am a theatre nurse, so you can be called at any time. The only option was to look for cheaper childcare, which meant taking my children back home to Kenya. That separated me from my little ones.”

Action at Congress

As an RCN steward and RCN Eastern region board member, Eva is used to standing up for the nursing profession, so she began to research and draft a resolution opposing the IHS, to be debated at the RCN’s national Congress in 2018.

Her resolution was accepted and, as Congress approached, it gained media attention. “It was on the radio and in newspapers,” Eva says. “I realised that this was important, and many other people identified with it.”

At Congress, other RCN members approached Eva with questions about the IHS, expressing disgust at the policy. “It was something that was silently sneaked into the system,” Eva says. “Unless it affects you, you wouldn’t know about it.”

Eva presented her resolution on the main stage and was encouraged to hear Janet Davies, RCN Chief Executive & General Secretary at the time, championing the cause: “The manner in which she read that motion and spoke with such passion about it was incredible.”

Congress delegates passed the resolution almost unanimously and the RCN took up the cause to end the IHS for health care workers.

Media attention

Media interest increased, and Eva was interviewed by ITV local news, the BBC, local radio and newspapers. Meanwhile, the RCN put pressure on the government to cancel the unfair charge.

There was an early setback when the government announced later that year that it was doubling the fee to £400 and it announced another planned increase in 2020. “That was like a slap,” Eva says. “The government was not considering how valuable we are.”

But throughout it all, Eva says: “The RCN has been alert to any opportunity to support the campaign to end the IHS. I cannot say how grateful I am for the support from RCN members and leadership.”