The government is right to U-turn on the NHS surcharge – but embarrassingly late

As brazen a performer as Boris Johnson is, he looked mildly uncomfortable at Prime Minister’s Questions this week. Under pressure from Keir Starmer, Mr Johnson attempted to justify his government’s policy to charge migrant NHS and care workers to access the very health service they are supporting, sometimes on less than the living wage.

All Mr Johnson could offer, apart from the usual platitudes about the heroes, who “frankly saved my life”, was that the fee raised £900m of income for the NHS. That’s less than 1 per cent of the NHS budget, but in any case was a predictably inflated figure, with the Institute for Fiscal Studies (IFS) estimating the total is around £90m.

Morally indefensible in normal times, the surcharge became politically untenable at a time when these people are being asked to put their lives on the line. Many are from black, Asian and minority ethnic backgrounds, for whom the mortality rate is distressingly higher than average. They should not be charged for the privilege of helping to save the lives of others.

Perhaps the prime minister, the home secretary and the health secretary had an attack of conscience. Priti Patel only recently denied that the policy was being reviewed, having previously implied that it was up for change. She used the careful formulation that, like many things in government, it was “under review”, a crucial bureaucratic obfuscation. The Home Office told The Independent that no substantive review had taken place.

The Brexit-based desire to look tough on immigration was behind the original idea of an NHS surcharge. The policy was always a mistaken way to deal with so-called health tourism and abuse of the system, and the desire has been partly abandoned. In any case, the cabinet has executed an unashamed U-turn. The shift is a victory for The Independent, which campaigned for the surcharge to be scrapped.

It seems ministers have at last woke up to the outpouring of public sentiment towards health and social care professionals. Watching emotive viral videos by cleaners about them having to pay for their own treatment would become painfully embarrassing for the Conservatives.

Trying to pursue such an unpopular policy would have inflicted further damage on the government’s weakening poll ratings on how they are handling the Covid-19 crisis. The prospect of a parliamentary defeat on the policy will also have concentrated minds. Tory ministers clapping for carers would be mocked for their cynicism and hypocrisy.

The move will be seen as a more tangible national recognition for hard-working health and care workers who happen to come from abroad. Politically, it is a quickly won victory for Labour’s new leader. Despite the usual awkwardness of a sudden change in policy, it is also a wise move from the prime minister to get this done before he was forced to do so. Even with a majority of 80, Mr Johnson’s administration is far from free to do as it likes; just as well.