Nishta Mauree came to the UK from Mauritius in 2006. During that time, she has only used the NHS once: to give birth to her baby daughter in 2022. And yet from Tuesday, she faces a bill of more than £1,000 every year just to access basic healthcare.
The Hackney mother and charity worker is among tens of thousands of migrants that will be affected by a 66 per cent rise in the immigration health surcharge (IHS) from February 6.
The fee, jumping from £624 to £1,035 a year for most migrants, is paid in a lump sum by most visa or immigration applicants who are staying in the UK for more than six months.
Under the changes, a family of four will pay more than £3,500 a year to use the NHS, despite already contributing to the health service through tax. Charities have warned that the rate rise could push thousands of people into poverty and financial hardship.
"I am scared for the future of my family. My visa renewal is coming up in four months and I don't have the savings to cover it or know whether it will even be possible to pay," Ms Mauree, 31, told the Standard.
"Thank god I am healthy at the moment and I hope it stays like that. I have always paid my taxes and played my part, so it is outrageous to be put in this situation."
The rise in the standard rate comes on top of a significant hike in visa fees and other restrictions on migrants. Last October, work and visit fees went up by 15 per cent while family and settlement visas increased by 20 per cent.
From March, care workers will no longer be able to bring family members to the UK, and an increase in the minimum salary required for those arriving on a skilled worker or family visa comes into force later this year.
'This money could go towards my daughter's future'
Ms Mauree is currently on the ten-year route to settlement pathway, which means she has to pay the NHS surcharge every two and a half years as well as fees for her renewal application, which cost £1,258.
An adult entering the ten-year route to settlement now will have paid the Government more than £18,000 by time they are allowed to remain in the UK indefinitely.
"I know a lot of people in the immigrant community who won't use the NHS, no matter how sick they are. People are really struggling to make ends meet as the cost of living is immense," Ms Mauree, who lives in Hackney, said.
"My daughter is a British citizen - this money could be going towards her future. There are times at the end of the month where I don’t have any money left and I have to borrow it from friends and family even though I work a full time job. It's really hard."
A House of Commons research paper published in November quoted a Home Office estimate that around 1.5 million visas or visa extensions were granted on routes liable for the surcharge in the year to June 2023.
In a written statement last month, legal migration minister Tom Pursglove said that people coming to the UK on a visa should make a "sufficient financial contribution" towards the cost of services such as the NHS.
The rate rise, he claimed, would "reflect the increases in healthcare expenditure and better reflects NHS service use by payers". Prime Minister Rishi Sunak has also justified the rate rise on the basis that it will help fund a pay rise for NHS workers, including nurses.
"I am hoping that Mr Sunak will change his mind and give us a way to pay this. If he wants a good night's sleep, he needs to think about what he is doing to people," Ms Mauree said. "We didn't come here to take people's jobs or benefits... it upsets me because many people have no choice, they have to come to this country to be safe."
'Immigrants can't just go home'
Josephine Whitaker-Yilmaz, policy and public affairs manager at Praxis, a migrant help organisation, said that the rate rise would leave many families unable to afford their bills.
"This is going to cause great levels of financial hardship and more people pushed out of lawful immigration status. Contrary to common perception, many migrants can't just 'go home' when they can't afford their visa fees. For many people the UK has been their home for decades and they have family here," she told the Standard.
"People who can't afford this are going to slip into undocumented status, which will create barriers for them to get the healthcare they need. A lot of migrants will put off getting treatment until their condition has got really bad, which will push up the cost of treating them in the first place."
She also raised doubts over the accuracy of the Government's calculation for raising the charge by 66 per cent.
"We have seen MPs and peers recently question how the fee has gone up so much. It seems to be an entirely political move and certainly not one that is based on how this is going to impact the poorest households."
A Home Office spokesperson said: “While recognising migrants’ contribution to the United Kingdom, the government mandates a financial contribution from those using public services including the NHS.
“From 6 February, the Immigration Health Surcharge will be raised by 66 per cent to £1,035. The new rate reflects increases in healthcare expenditure and better reflects the NHS use by migrants, who are provided with near comprehensive access to health services in return.”