The Representation of Migrants in Policy and Parliament: A Bacchian Analysis of the UK’s Immigration Health Surcharge

Abstract

Despite the promise of the NHS being open to all, charging regulations and policy for nonUK citizens have been introduced. This article reports an analysis of policies and parliamentary debates linked to the UK’s Immigration Health Surcharge. We use Bacchi’s ‘what’s the problem represented to be’ approach to understand how migrants and their healthcare access are represented and problematised within current health policy and related parliamentary debates. Core problem formulations relate to historic over-generosity of the NHS to migrants and overseas visitors; a lack of fairness in contributions to the NHS by British taxpayers compared to migrants; and a threat to the NHS’s long-term sustainability due to migrants’ and overseas visitors’ misuse. This represents migrants as a financial drain on the NHS and, consequently, a risk to its continuation. Together, the problem formulations produce a justification and rationale for the Immigration Health Surcharge and its subsequent increases.