Owing a debt to the NHS is one of the general grounds for entry clearance application refusal. Overseas visitors are required to make a fair contribution to the National Health Services (NHS) in return for the healthcare provided to them.
Moreover, patients should be made aware that their inability to pay healthcare bills could result in future immigration sanctions under the Home Office Rules.
Does NHS Debt Affect the Visa Application?
The National Health Service (Charges to Overseas Visitors) Regulations 2015 allows NHS trusts to charge overseas visitors up to 150% for all medical treatments in secondary care.
NHS debts can result in refusal of applications for entry clearance, leave to enter, or variation of leave to stay in the UK. A set of general grounds for refusal are outlined in Part 9 of the Immigration Rules; Appendix FM (family members) and Appendix Armed Forces.
Refusal – NHS Debts
This is a discretionary ground for refusal which means that the Home Office may refuse the application but does not have to for outstanding debt to the NHS.
In case of unpaid NHS debt, the authorities may refuse the visa application if any of the following apply.
- The applicant with outstanding healthcare debt of £1000 or more incurred on or after 1 November 2011
- The person with a cumulative debt of £500 or more incurred on or after 6 April 2016
An individual who has incurred less than £1000 before 6 April 2016 can not be refused on this basis after 6 April 2016 unless
- They incur additional charges of £500 after 6 April 2016
- They incur additional charges after 6 April 2016 making the total NHS healthcare debt since 1 November 2011 more than £1000
Appendix FM and Appendix Armed Forces
Under Appendix FM and Appendix Armed Forces, the Home Office may consider refusing the application if any of the following apply
- The person has an unpaid NHS debt of £1000 or more incurred after 1 November 2011
- The person has outstanding healthcare debt of £500 or more on or after 24 November 2011
An applicant having an NHS debt of under £1000 before 24 November 2016 can not be refused on this basis after 24 November 2016 unless
- They incur additional charges of at least £500 after 24 November 2016
- They incur additional charges after 24 November 2016 making the unpaid NHS debt since 1 November 2011 over £1000.
When is an NHS Debt Overlooked?
Refusal on the basis of outstanding debt is not mandatory, meaning that the Home Office does not have to refuse all immigration applications where the applicant owes £500 or more.
The Home Office may not refuse the application in case of ‘compelling or compassionate circumstances or human rights considerations.
Refusal of Permission to Remain or Indefinite Leave Application Based on NHS Debt
The safest course of action is to pay the NHS loan and the healthcare provider should guide the person on how to do so. The applicant can pay off the healthcare bills at once or consider agreeing to a schedule of payment by instalments. Provide evidence, receipts, or written confirmation that the debt has been paid.