Foreign Nationals and Eligibility to UK State Benefits

Towards Fair and Inclusive Solutions

With politics and reforms trending, the movement of people across borders for work, study, family, or refuge is both natural and essential, yet a source of controversy. The UK has long been a destination for foreign nationals seeking opportunity, safety, and a better quality of life. However, questions frequently arise about who is entitled to state benefits and NHS healthcare, particularly among non-British residents. Striking a balance between protecting public resources and ensuring fair treatment for all, regardless of nationality, is a pressing challenge.

Here we explore the eligibility of foreign nationals to state benefits, the role of National Insurance Contributions, and how the NHS can provide care without discrimination or violating human rights. It also suggests practical policy solutions to ensure no one is left behind.

Eligibility to State Benefits: The Current Framework

People who arrive in the UK by small boat and claim asylum, often referred to as “boat people”, do not automatically receive full access to state benefits or housing. While their asylum claim is being processed, they may be eligible for basic support under Section 95 of the Immigration and Asylum Act 1999. This includes modest financial assistance (currently £49.18 per person per week) and accommodation, though they cannot choose where they live. They are also entitled to free NHS healthcare, including prescriptions, dental care, and eye tests, as well as free education for children aged 5 to 17. However, access to mainstream benefits like Universal Credit or council housing is only granted if they are formally recognised as refugees. Misconceptions about generous entitlements are widespread, but the reality is that asylum seekers face strict eligibility criteria and limited support while their claims are under review.

Foreign nationals’ (legal migrants) access to benefits in the UK is governed by a complex mix of immigration law, welfare policy, and residency requirements. Key determinants include:

1. Right to Reside and Habitual Residence Test (HRT)

To claim most UK benefits, foreign nationals must pass the Habitual Residence Test. This usually involves:

Having a legal right to reside in the UK.
Demonstrating that the UK is their genuine and main home.

EU, EEA, and Swiss nationals who arrived before the end of the Brexit transition period (31 December 2020) may have rights under the EU Settlement Scheme. Others may need visas that confer the right to work and reside.

2. Recourse to Public Funds (NRPF)

Many foreign nationals, especially those on work or student visas, have a “no recourse to public funds” condition, meaning they cannot claim most state benefits, including:

Universal Credit
Housing Benefit
Child Benefit (in most cases)

This exclusion can place people in precarious positions, particularly during times of illness or job loss.

3. Contributory vs Means-Tested Benefits

Contributory benefits (e.g., New Style Jobseeker’s Allowance or Employment and Support Allowance) are based on National Insurance Contributions (NICs). Foreign nationals who have worked and paid into the system may qualify — this aligns with the idea of “you get out what you put in.”

Means-tested benefits, however, depend on income and residency status. These often exclude those with NRPF.

Opinion: Contribution-Based Entitlement as a Fair Benchmark

It is a reasonable and widely held view — including this author’s — that access to benefits should largely be based on an individual’s contributions to the system. This principle of fairness ensures that those who have worked, paid taxes, and integrated into society can access a safety net during periods of hardship.

Yet, contribution-based access should not preclude basic humanitarian support, especially for:

Victims of domestic abuse
Asylum seekers awaiting decisions
Those with long-term illness or disabilities
Children in low-income migrant families

No one should be destitute or denied healthcare in a civilised society.

The NHS and Foreign Nationals: Duty to Treat Without Discrimination

The National Health Service (NHS) operates under the founding principle of providing healthcare based on clinical need, not the ability to pay. However, NHS eligibility rules vary depending on immigration status.

1. Primary Care Access

GP services are generally free for all, regardless of immigration status.
Foreign nationals can register with a GP and receive treatment — including refugees, asylum seekers, and undocumented migrants.

2. Secondary Care (Hospital Treatment)

NHS hospital care is free for those considered “ordinarily resident”.
Foreign nationals may be charged for hospital treatment unless they are:
- Refugees or asylum seekers
- Victims of trafficking
- Children in care
- Receiving treatment for a communicable disease (e.g., COVID-19, TB, STIs)

Unfortunately, hostile environment policies have led to delays, confusion, and fear among migrants, especially those who fear being reported to immigration enforcement when accessing care.

3. Human Rights Considerations

Denying essential care — especially in life-threatening situations — can amount to a breach of Article 3 (prohibition of inhuman or degrading treatment) and Article 8 (right to private and family life) of the European Convention on Human Rights. The UK is legally bound to uphold these rights.

NHS practitioners have a moral and legal duty not to discriminate.

Solutions to Prevent Exclusion and Promote Fairness

To create a more just and effective system, the following changes could help ensure no one is left out:

1. Contribution-Based Fast-Track System

Implement a NIC-linked digital verification system so that migrants who have worked and contributed can easily access benefits during hardship.
Prioritise transparency and automation to reduce bureaucratic delays.

2. Humanitarian Support Fund

Create a national fund for people with NRPF facing emergency hardship (e.g., serious illness, domestic violence, homelessness).
Local authorities could administer temporary support with strict oversight.

3. NHS Charging Reform

Clarify rules so that NHS staff are not put in the position of gatekeepers.
Abolish upfront charging for essential care, particularly maternity, cancer, and mental health services.
End data-sharing between the NHS and immigration enforcement, which deters people from seeking help.

4. Awareness and Training

Equip DWP and NHS staff with training on migrant rights and obligations.
Fund campaigns to inform foreign nationals of their entitlements and responsibilities.

5. Pathway to Permanent Status

Offer a clear route to settlement for long-term migrants and their families.
Reduce arbitrary visa renewals and allow integration into the welfare system once residency is established.

Conclusion

Foreign nationals (legal) are a vital part of British society; they work in our hospitals, build our infrastructure, teach in our schools, and contribute to the economy. A fair welfare and healthcare system should recognise their contributions while safeguarding public resources. Basing access on contributions, coupled with compassionate exceptions for those in genuine need, strikes the right balance.

Healthcare should never be denied based on nationality. A nation is judged by how it treats its most vulnerable, and the UK must strive to ensure that no one is left out or left behind.