The Johnson government was forced last week to abandon plans to penalise migrant workers in the National Health Service (NHS) and social care. The intended Tory attack affected migrant workers from outside the European Union (EU) and European Economic Area.
The government had insisted that only doctors, nurses, and paramedics would be made exempt from the NHS surcharge and that only their families qualified for indefinite leave to remain (permanent residence) in the event of their death.
The NHS surcharge is a form of double taxation on non-European migrants which was introduced in 2015. In addition to paying for the NHS through standard taxation they must pay an additional tax upfront in a lump sum. The yearly surcharge has doubled since then from £200 per person to £400 and will be hiked to £624 in October. The rate for children, students, and those on the youth mobility scheme will be £470. The fee must be paid for family members. An individual applying for a 5-year Tier 2 visa would have to pay £3,210 at the new rate.
Following public uproar, the government relented and extended this exemption and leave to remain to all support staff, social care workers and their families in both the NHS and private sector.
During the height of the pandemic, while risking their lives every single day, overseas health and care workers have had to live with the threat of having their families deported if they died and experience a punishing increase in the NHS surcharge. Cleaners, porters and carers are among the lowest paid workers.
The hypocrisy of the Conservative government became a focus for rising anger and discontent. Following his own hospitalisation in March with COVID-19, Prime Minister Boris Johnson had hailed the contribution made by NHS staff from overseas, stating that he owed his life to nurses from Portugal and New Zealand.
Such proclamations proved insincere and short-lived. The government intended to resume its onslaught against migrant workers and the NHS. In parliament May 20, Johnson outlined his plans to press ahead with his original plans, declaring that exempting all NHS staff would cost £900 million. He arrived at this inflated figure by citing the total cost over four years of the immigration surcharge. Even this represents less than a single percentage point of the NHS’s overall budget and pales into insignificance against the cuts imposed by the Tories.
The NHS could not function for a single day without staff from overseas. Almost one in four UK hospital workers were born outside the UK. The first recorded deaths of NHS staff from COVID-19 were two doctors from Sudan.
The mendacity of the government’s claims to be celebrating the “heroes” of the NHS was made more politically sensitive because Johnson’s speech was delivered one day prior to the weekly Clap for Carers. The national event, which started independently when lockdown commenced, as an act of public solidarity, has been utilised by the government to detract from its own criminal actions and multiple failures—including denying adequate PPE and gagging whistle blowers when the death toll among NHS and care staff has exceeded 300.
The conduct of the Labour leader Sir Keir Starmer during Prime Minister’s Questions has been hailed by a section of the media as an example of “effective opposition.” What they mean is that Starmer has calibrated his remarks to demonstrate only “constructive opposition” at a time when a chasm has opened between the working class and the government. Starmer’s concern was that the government’s measures would undermine the pretence of national unity and calls for shared sacrifice. He asked, “Does the prime minister think it is right that care workers coming from abroad and working on our front line should have to pay a surcharge of hundreds, sometimes thousands of pounds to use the NHS themselves?”
Johnson said yes, he did. He wrongly mistook this neutered criticism for the general mood and thought he could proceed as planned.
Hassan Akkad, a Syrian hospital cleaner in London, made a public appeal via a Twitter video which asked for public support in overturning the decision to deny leave to remain to the families of all bereaved NHS support staff which went viral. The issue was taken up on Good Morning Britain with Piers Morgan and LBC Radio with James O’Brien.
Senior Conservative Party figures began to break ranks. Sir Roger Gale, the former Tory vice chairman, warned, “not waiving the fee would rightly be perceived as mean-spirited, doctrinaire and petty.”
The hypocrisy of those calling for “more compassion” was summed up by former Tory health secretary Jeremy Hunt joining in. Hunt was responsible for implementing the NHS surcharge in the first place. To stoke anti-migrant sentiment, he had stated previously that “the NHS is a national health service—not an international one”.
By the next day, the government had announced that NHS and care workers would be exempted from the NHS surcharge and their families granted the right to remain in the event of their death.
The government’s critics rushed to smooth things over. Starmer declared that the government U-turn was “a victory for common decency.” Gale stated, “It is a humane and a generous decision, and one that will enable all those out on the doorsteps this evening to clap and cheer with greater enthusiasm than before.”
Akkad, posted another short Twitter video thanking his supporters, declaring, “Britain is great because of you.” Akkad, it must be noted, has in fact been cultivated more broadly within the media for more reactionary political purposes. He is presented as a BAFTA award-winning documentary maker who highlighted the plight of refugees fleeing warn torn countries. But this reputation has been utilised to provide a humanitarian fig leaf for military action against Syria and to support the regime change operations of the UK and US governments. In 2018, he called for air strikes and denounced anti-war protestors.
The backtracking by the government has meant an immediate reprieve for NHS and social care workers but has also confirmed the second-class status for non-EU/EEA migrant workers. It sets up an arbitrary distinction between “deserving migrants” and “undeserving migrants” to maintain a toxic atmosphere of nationalism and to justify further austerity.
As the WSWS explained in its opposition to the NHS surcharge “It is a policy of divide and rule in the face of the biggest spending squeeze in the history of the NHS.”
More broadly, the attack on migrants continues. During the pandemic, the Home Office has refused to accept unaccompanied children and vulnerable adults from refugee camps on the Greek islands. Asylum seekers have been refused the uplift of £20 benefits in line with the increase in Universal Credit and are forced to survive on between £37.15 and £35.39 per week. At Yarl’s Wood detention centre, where a case of COVID-19 was reported in March, the government refused appeals for its closure.
The assault on migrants and the disregard for their contribution in tackling the pandemic in the NHS, or in other essential services, is the thin end of the wedge of a broader war the Johnson government is waging, not against COVID-19 but against the working class. The fight against the pandemic and the defence of workers rights, migrant or native, will not be secured in a sordid trade-off with the Johnson government—which is committed to a class war agenda and provided a protective political shield by the Labour Party and the trade unions—but through class struggle.