THE IMPACTS OF THE IMMIGRATION HEALTH SURCHARGE ON

INTERNATIONAL STUDENTS: A HUMAN RIGHTS PERSPECTIVE IN UK.

Student’s name

Institutional affiliation

Date

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Abstract

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Acknowledgement

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Declaration

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Table of Contents
1.1 Research Background.....................................................................................................................6
1.2 Aim and Objectives.........................................................................................................................6
2.1 The Immigration Health Surcharge...............................................................................................7
2.2 Access to Healthcare........................................................................................................................7
2.3 Human Rights Perspective..............................................................................................................7
2.4 Theoretical review...............................................................................................................................7
2.4.1 Human Rights and Access to Healthcare....................................................................................7
2.4.2 Non-Discrimination and Equality.......................................................................................................8
2.4.3 Social Determinants of Health.....................................................................................................8
2.4.4 Financial Barriers and Higher Education...................................................................................8
3. Methodological framework...............................................................................................................8
3.1 Research Design...............................................................................................................................8
3.2 Quantitative and Qualitative Phase................................................................................................9
3.3 Sampling...........................................................................................................................................9
3.4 Data Collection.................................................................................................................................9
3.5 Data Analysis...................................................................................................................................9
3.6 Ethical Considerations....................................................................................................................9
4. Planning and Critical Analysis.........................................................................................................9
4.1 Limitations.......................................................................................................................................9
4.2 Gantt chart......................................................................................................................................11
5. Conclusions......................................................................................................................................11
References................................................................................................................................................12

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 1. Introduction
1.1 Research Background
International education is essential to worldwide academic interchange and cultural variety,
with many students studying abroad (Dorling, 2019). With its top universities and institutions,
the UK attracts international students looking to enhance their education and expand their
perspectives. Despite the intellectual, social, and cultural benefits of studying in the UK,
overseas students confront several hurdles (Perreira et al., 2018). International students from
non-EEA countries face the Immigration Health Surcharge (IHS).

The IHS adds to the financial burdens of tuition, housing, and living expenditures for
international students (Wood & Devakumar, 2020). This extra, which must be paid in advance as
part of the visa application process, has prompted concerns about its impact on international
students' healthcare access and socioeconomic status. Non-EEA nationals entering or staying in
the UK for more than six months must pay the Immigration Health Surcharge, which was
implemented in April 2015 (Dorling, 2019). It helps pay for healthcare during their stay. The
premise of supporting healthcare is sound, but the IHS has created severe arguments. This thesis
critically examines the Immigration Health Surcharge's human rights impact on international
students in the UK.

1.2 Aim and Objectives

This thesis will investigate the impact of the immigration health surcharge on
international Students: a human rights perspective in the UK.

1.2.1 Objectives
1.2.2 To investigate the barriers created by the IHS on the access to healthcare by
international students in the UK.
1.2.3 To assess the impacts of the IHS on the socioeconomic status of international
students.
1.2.4 To evaluate the alignment of the IHS with international human rights principles,
particularly those related to non-discrimination and access to healthcare.
2. Literature review

The Immigration Health Surcharge (IHS) in the UK helps the NHS cover the cost of treating
non-EEA nationals (Kang et al., 2019). The IHS tries to guarantee these individuals pay for their

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healthcare, but it has drawn criticism. This project will review the research on the IHS, its effects
on international students, and its compliance with international human rights.

2.1 The Immigration Health Surcharge

In April 2015, the Immigration Health Surcharge was welcomed with mixed reviews
(Dorling, 2019). Critics say it harms disadvantaged groups, especially overseas students, while
supporters say it is fair and necessary to decrease NHS costs. Murphy et al. (2018) suggest that
the IHS disproportionately affects international students' financial stability and well-being during
their studies. Murphy et al. (2018) found that the IHS adds significantly to international students'
high tuition and living costs.

2.2 Access to Healthcare

` Health care is a human right under the Universal Declaration of Human Rights and the
International Covenant on Economic, Social, and Cultural Rights. Academic literature worries
about the IHS's impact on healthcare access. The IHS may hinder international students'
healthcare access, according to Imiela et al. (2020).

2.3 Human Rights Perspective

No matter nationality or immigration status, international human rights norms require non-
discrimination and equal healthcare access. The IHS has questioned its compliance with these
guidelines. According to Whelan (2019), international human rights organisations have raised
concerns about the IHS since it may violate the right to health and non-discrimination.

2.4 Theoretical review

The theoretical review section of this proposal aims to establish the theoretical framework
and concepts that will guide the analysis of the Immigration Health Surcharge (IHS) and its
impact on international students from a human rights perspective.

2.4.1 Human Rights and Access to Healthcare

The theoretical foundation of this work is built on human rights theory. Access to healthcare
is recognised as a fundamental human right in numerous international human rights documents,
notably the Universal Declaration of Human Rights (1948) and the International Covenant on
Economic, Social, and Cultural Rights (1966). These instruments establish that everyone has the
right to the maximum achievable standard of physical and mental health without discrimination

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of any kind (Nellums et al., 2018). This principle serves as the basis for measuring the IHS's
alignment with international human rights standards.

2.4.2 Non-Discrimination and Equality

The human rights principle of non-discrimination is central to this investigation. International
human rights law forbids nationality and immigration discrimination. Non-EEA nationals are
treated differently under the IHS, which raises problems regarding discrimination. The work of
equality and non-discrimination scholars like Dorling (2019) is crucial to understanding how the
IHS may violate human rights.

2.4.3 Social Determinants of Health

The WHO's social determinants of health paradigm stresses that income, social status,
education, and healthcare access affect health outcomes. International students' well-being may
be affected by the IHS's financial burden. Hiam et al. (2018) study on health inequalities and
social determinants provides a foundation for investigating how the IHS may worsen foreign
student health disparities.

2.4.4 Financial Barriers and Higher Education

International students' socioeconomic position is affected by higher education costs.
International students encounter financial obstacles, including tuition, living expenses, and the
IHS, according to Murphy et al. (2018). These financial issues may hinder overseas students'
education. This perspective is crucial for examining the IHS's impact on education access.

3. Methodological framework
The research technique section describes how this thesis will handle its research
questions and goals. It will use mixed approaches to study the Immigration Health Surcharge
(IHS) on international students and its human rights implications. This allows qualitative and
quantitative data collecting, offering a complete picture.

3.1 Research Design

This research will be inductive, and due to its pragmatic nature, a sequential explanatory
design will collect and analyse quantitative data before collecting and analysing qualitative data
to better comprehend the findings. This design suits multiple research questions.

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3.2 Quantitative and Qualitative Phase
Data sources and surveys with open-ended and closed questions on the IHS and
international students will be analysed in the quantitative and qualitative phases. Government
reports, university statistics, and other relevant datasets will be used. Critical quantitative data
will include the IHS's financial burden on international students, any relationships between the
surcharge and healthcare use, and affected students' demographics. The qualitative data will
provide international students' views on the IHS and its effects on healthcare, socioeconomic
position, and well-being.

3.3 Sampling
Purposive sampling will pick a broad group of IHS-regulated overseas students for the
qualitative and quantitative phases. To capture diverse viewpoints and experiences, the sample
will comprise participants from different nations, universities, and academic programs.

3.4 Data Collection

A survey with open-ended and closed questions will be used to collect both qualitative
and quantitative data. Existing databases and reports will also be analysed for quantitative data
on overseas students. Depending on participants' availability and preferences, surveys will be
performed either in person or online.

3.5 Data Analysis

Quantitative data analysis will involve statistical techniques to examine relationships
between the IHS, financial burden, and healthcare utilisation. Qualitative data will be analysed
through thematic analysis to identify recurring themes and patterns in participants' responses.
Data analysis software, SPSS, will be used to manage and analyse the data.

3.6 Ethical Considerations

This research will follow ethical criteria, including informed consent, anonymity, and data
security. University ethics committee permission is requested.

4. Planning and Critical Analysis

4.1 Limitations
A thorough investigation into "The Impact of the Immigration Health Surcharge on
International Students: a Human Rights Perspective in the UK" may be hindered by the lack of
publicly available data on the Immigration Health Surcharge (IHS) and its effects on
international students (Perreira et al., 2018). The sample of international students may impact the

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study's conclusions interviewed, not correctly representing the UK's international student
community. In addition, recollection bias and participants' subjective interpretations may lower
the reliability of qualitative interview data. If immigration rules, notably the IHS, change
throughout the investigation, the conclusions may not apply. Time, money, and staff may also
limit the study (Hiam et al., 2018). Finally, the project covers public health, immigration law,
human rights, and education, which may take a lot of skill and teamwork to examine thoroughly.

However, I will collaborate with relevant authorities, universities, and healthcare

institutions to gain access to necessary data as well as utilise official reports, published studies,
and available statistics (Wood & Devakumar, 2020). I will also employ rigorous sampling
techniques such as purposive sampling to ensure a diverse representation of international
students. Additionally, I will use well-structured interview protocols and cross-verify responses
where possible. Consider triangulating qualitative data with quantitative data. Throughout the
research, I will regularly monitor policy changes and incorporate the latest information into the
research. Conduct interim analyses if policy changes occur during the project.

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4.2 Gantt chart
Task Start Date End Date Duration
project proposal 25th Oct, 2023 15 Nov, 2023 21
design questionnaire and interveiw questions 10th Dec, 2023 17th Dec, 2023 7
conduct survey 18th Dec, 2023 30th Dec, 2023 12
data collection 31st Dec, 2023 20th Jan, 2024 21
data analysis 25th Jan, 2024 10th Feb, 2024 16
interpretation 15th Feb, 2024 15th March, 2024 24
conclusion 16th March, 2024 5th April, 2024 20

Duration
0 5 10 15 20 25 30

project proposal

design questionnaire and interveiw questions

conduct survey

data collection

data analysis

interpretation

conclusion

5. Conclusions
The research proposal is a solid plan to examine the Immigration Health Surcharge's
human rights effects on international students in the UK. The mixed-methods technique, which
combines quantitative analysis and qualitative interviews, makes the study more complete. The
theoretical framework, based on human rights, helps explain and assess the IHS's effects. The
researcher has prioritised teamwork, rigorous methods, and policy change monitoring to
overcome obstacles. This exhibits dedication to accurate and meaningful findings. In conclusion,
the research proposal is well-structured and intelligent, focusing on the IHS's human rights
impacts on overseas students. This study could shed light on immigration rules, healthcare
access, and human rights in UK international education if conducted as planned.

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References
Dorling, K., 2019. Immigration health surcharge.Children and Young People Now,2019(1),
pp.45-45.
Hiam, L., Steele, S. and McKee, M., 2018. Creating a ‘hostile environment for migrants’: the
British government’s use of health service data to restrict immigration is a very bad
idea. Health Economics, Policy and Law, 13(2), pp.107-117.

Imiela, J., Strzemieczna, M. and Pawlak, M., 2020. HEALTH CARE FOR IMMIGRANTS IN
THE UNITED KINGDOM.PolitykaSpołeczna,553(4), pp.17-29.

Kang, C., Tomkow, L. and Farrington, R., 2019. Access to primary health care for asylum
seekers and refugees: a qualitative study of service user experiences in the UK. British
Journal of General Practice, 69(685), pp.e537-e545.

Murphy, L., Dobbin, J. and Boutros, S., 2018. Understanding changes to NHS charging
regulations for patients from overseas.British Journal of Hospital Medicine,79(6),
pp.C94-C96.
Nellums, L.B., Rustage, K., Hargreaves, S., Friedland, J., Miller, A. and Hiam, L., 2018. Access
to healthcare for people seeking and refused asylum in Great Britain: a review of
evidence.

Perreira, K.M., Yoshikawa, H. and Oberlander, J., 2018. A new threat to immigrants’ health—
the public-charge rule. N Engl J Med, 379(10), pp.901-903.

Whelan, I., 2019. The effect of United Kingdom immigration policies on migrant access to
sexual and reproductive healthcare.BMJ Sexual & Reproductive Health,45(1), pp.74-77.
Wood, L.C. and Devakumar, D., 2020. Healthcare access for migrant children in England during
the COVID-19 pandemic.BMJ PaediatricsOpen,4(1).

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