Noble Lords will be aware of the background to the immigration health surcharge, which I set out in the debate on these amendments in Committee.
There are significant practical difficulties in introducing the incremental payments, proposed by Amendment 79, which would place additional burdens on the Home Office and the NHS. It is not simply a question of changing Home Office IT, but of introducing a mechanism through which the Home Office could monitor payments, chase those who had missed them and take action against those who refused to pay. Around 560,000 migrants are expected to pay the surcharge each year, and many of these may take the opportunity to pay in instalments. The resource implications for the Home Office of administering an instalment system could, therefore, be significant. If we were unable to recover unpaid instalments from some migrants, the NHS would suffer a loss of income. An instalment system might also be open to abuse from those seeking to come to the UK in order to receive NHS care, as they could simply stop making their payments once treatment had been received.
Amendment 80 would exempt all children under the age of 18 from paying the charge, together with those who are victims of domestic violence. I do not think it unreasonable for parents or guardians of a migrant child to bear the responsibility of paying the charge for their child. Further, and as set out during our previous debate, exemptions are already in place, in certain circumstances, for children and victims of domestic violence.
I have also reflected carefully on the points raised in Committee. At the invitation of the noble Lord, Lord Alton, the noble Baroness, Lady Doocey, and I had a very productive morning at the Cardinal Hume Centre. I know that a number of noble Lords are involved there in different ways—I was talking to the noble Lord, Lord Touhig, today and he said that he was involved. The noble Lord, Lord Alton, does a huge amount of good work in connection with the centre. I was amazingly impressed by the quality of the staff who undertake the cases there.
When we were there, we talked with officials and wondered whether there was a way we could engage more structurally with organisations like the Cardinal Hume Centre. The centre gave us a list of cases relating to the visa waiver and made the point that it used to be possible to secure the waiver but that, following some change, it was now more difficult. We took those cases away but, for reasons which I totally understand, the Cardinal Hume Centre was not able to give us the individuals’ names and contact details, which made it difficult for us to check. However, we have been in
contact with the centre again this morning to see if we can set up a meeting to explore how the relationship might work. There would be benefits for both parties—from the Home Office point of view we would have another external validation system. The centre staff are deeply caring but not overly sentimental about it: they just want to provide practical help to people. Partnering with organisations like that can be immensely helpful and I am grateful to noble Lords for setting that up
To clarify the situation, applicants will qualify for a fee waiver if they provide evidence to show that they are destitute or would be rendered destitute by payment of the fee, or there are exceptional circumstances relating to their financial situation. Where an applicant is in receipt of local authority support and has their accommodation and other essential living needs met, they will not be destitute. To qualify for a fee waiver, they must show that they would be rendered destitute by payment of the fee or that there are exceptional circumstances. As they are unlikely to have additional disposable income and there may be no prospective change in their financial circumstances that would enable them to pay the fee, we need to ensure that they are required to provide evidence that they meet the fee waiver policy in as straightforward a manner as possible.
It is important that the Home Office is able correctly to establish whether an applicant qualifies for a fee waiver. It will not surprise the House to learn that some applicants seek not to pay the fee that is properly applicable in their case. From 6 April 2015 to 28 February 2016, there were around 11,130 applications for a fee waiver. Of the fee waiver applications considered in that period—around 11,140, including some predating that period—around 84% were refused. This underlines the importance of the work the Home Office is doing to protect an important revenue for the NHS of around £100 million per year. It also underlines the importance of ensuring that those applicants who are able to show that they qualify for a fee waiver are enabled to do so as effectively as possible.
If the applicant qualifies for a fee waiver, the health charge is also waived, so there is no need for an exemption or for payment by instalments. There are also exemptions in place, as I have described, for vulnerable children, such as asylum seekers or victims of trafficking, and for victims of domestic violence who apply for limited leave under the destitute domestic violence concession.
Amendment 81, in the name of the noble Baroness, Lady Kennedy of The Shaws, on student support for care leavers, would give student loan access to care leavers with limited leave to enter or remain who have been ordinarily resident in the UK since they were granted that leave. It would also require that such cases, as well as care leavers with an outstanding asylum claim or immigration application, be charged home rather than international student fees.
The Government are currently considering their response to the public consultation by the Department for Business, Innovation and Skills on the terms on which those without settled status and who are not otherwise able to access student support by virtue of our international obligations should be eligible for
student support. The consultation followed the Supreme Court ruling in July 2015 in the case of Ms Tigere that the policy of refusing access to a student loan solely on the grounds that the person did not have settled status in the UK was not compatible with the European Convention on Human Rights. The Supreme Court left it to the Government to consider the options for a revised policy. The Supreme Court judgment also upheld the Government’s policy of requiring all persons—with the exception of refugees, who are given immediate access to support—to be lawfully resident in the UK for at least three years immediately prior to starting their course.
We think it is appropriate that there should be some distinction between a person who is a British citizen or who has long residence here or an immigration status of the sort that means they now have a solid connection with the UK—for example, refugee leave, humanitarian protection status or indefinite leave to remain—and a migrant with limited immigration status, or none at all but with an outstanding asylum claim or immigration application, who has not yet established a solid connection of that sort with the UK.
Turning to the questions that were raised, the noble Baroness, Lady Lister, asked about domestic violence exemptions. Those who pay the charge will be eligible to use the NHS free of charge for the duration of their stay without any further treatment charges being imposed. However, a person who applies for limited leave under the Home Office destitute domestic violence concession is exempt from the charge and will receive free NHS care for the period of that leave, during which they will make an application for permanent status in the UK. Those are the circumstances in which a victim of domestic violence gets free healthcare. The noble Baroness asked whether it would be possible to simplify the process by exempting all children and victims of domestic violence. We think that sufficient safeguards are in place for ensuring that vulnerable children and victims of domestic violence are able to use the NHS without charge, and a blanket exception is therefore unnecessary.
I was asked whether the Home Office could not make an exception from collecting all the charges upfront. Any move to an instalment approach, including setting up separate systems for exceptional cases, would be costly and administratively difficult. But it is not just that. The Home Office would also need to ensure that payments were made when due and would need to chase payments if they were not made and take enforcement action which could involve curtailing the person’s leave.
I was asked how much had been collected. In the first six months since its introduction, the immigration health surcharge collected more than £100 million—I correct my previous comment that it had produced £100 million in a year. That was in the first six months so, annualised, it is going to be much more than that.
The noble Baroness, Lady Doocey, and the noble Lord, Lord Alton, asked how charge payers access the NHS. Those who pay the charge and are subsequently granted entry clearance or leave to remain receive NHS care in the same way as a permanent resident. I was asked why the charge cannot be paid in multiple payments. I have addressed that point.
The noble Baroness, Lady Kennedy, said that the numbers of those requiring support by local authorities for tuition fees are very low. We disagree with that. Even one or two cases create a significant burden for local authorities. International fees range on average from £12,000 to £15,000 per year. These costs are also a significant disincentive to local authorities participating in the voluntary transfer of unaccompanied asylum-seeking children.
I was asked what the criteria were to qualify for the fee waiver. The qualification is that an applicant is destitute or would be rendered destitute by payment of the fee because they are unable to pay the fee now or to save the required amount within a reasonable period—which is 12 months, as determined by the rules—and they have no ability to borrow the required amount from friends or family, or that there is no basis for concluding that their financial circumstances are likely to change within that reasonable period, or there are exceptional circumstances relating to their finances.
In relation to the visa fees, I totally understand the point made by the noble Baroness, Lady Doocey, about the very significant increases. We changed the policy here and introduced a policy based on the belief that the user should pay; in other words, that the resident taxpayer should not be picking up the bill for people who are getting the benefit of coming to this country to study, visit or secure their citizenship. Therefore, the view was that that should be self-financing and the increases in the fees reflect that imperative.
I was asked how migrant families could be expected to pay the upfront amount. Migrant families entering the UK will be aware that they need to pay the health charge if they are here for more than six months in a temporary capacity, and will therefore need to plan their finances accordingly.
There is another letter to add to the many, which is the letter I sent to the noble Baroness, Lady Kennedy, on 8 March. I notice that that was not shared with other Members. I can place a copy in the Library, but if other Members are interested in seeing a copy of that and the reasons set out for student support for care leavers, I am very happy to make that available. I have written to the noble Baroness on these issues and have asked if she would be willing to meet Ministers at the Department for Business, Innovation and Skills to discuss her concerns. It is important that we frame the eligibility criteria for student loan access in a way which takes proper account of immigration status and is fair across all categories, including to the resident population.
While I might not have gone all the way in addressing all the concerns raised by noble Lords, I hope that with these explanations we have at least moved a little further down the road to addressing some of them and explaining the reasons why we cannot move further in other areas.
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