Immigration and the NHS - what do voters think?

As election day draws closer, we're taking a look at how the public sees the NHS. 

First, we’ve looked at immigration and the NHS. These two issues individually are top concerns for Brits in the lead up to the election – but how does the public perceive the connection between these issues?

While the public generally has a balanced view of immigration, concerns have been on the rise. Although more people believe immigration has a positive effect on Britain (40%) than a negative one (35%), these figures have shifted since 2020, when they were 48% and 27% respectively. For the first time since early 2020 a majority of people want to see immigration reduced, and concern about immigration as an important issue for Britain has recently risen and is the highest it’s been since 2017.

Meanwhile, the NHS is currently seen as the most important issue facing Britain. Further recent polling shows that nine in ten people (89%) are concerned about the pressure NHS services are under and more than half (53%) say they are very concerned. 

Politicians have often drawn a link between immigration and pressure on the NHS, an argument that has been repeated during this election campaign. It will of course be true that the NHS will be dealing with more people as a result of immigration, though the cost of this is partly offset by migrants paying taxes and the NHS surcharge. But the narrative that migrants put extra strain on the system does resonate with the public, with a significant majority (70%) believing migrants add pressure to the NHS. 

The public are also more likely to say that migrants tend to use NHS services more (32%), or about the same (30%) as the UK born population, rather than less (20%). This is contrary to the evidence, which suggests that migrants tend to use the NHS less than UK-born residents. However, even amongst those who are aware of this, there is a tendency to believe migrants put extra pressure on the NHS (57%).  

Despite this, when asked about the biggest challenges facing the NHS, the public put migration relatively low down the list. A range of factors – lack of funding, poor government policy, poor management and inefficiency are all seen as more significant pressures on our health service. 

Staff shortages in particular are seen as a major problem, and the Conservatives, Labour and Lib Dems have all made manifesto commitments to recruiting thousands more NHS workers. Immigration also plays an important role here, and the public recognise this: three-quarters (75%) say the NHS relies on migrant workers a fair amount or a great deal. The public are also roughly accurate in their perception of the proportion of NHS workers who are migrants, estimating this at 42%. (Currently, one in five workers in the NHS is a non-UK national; however, the proportion of migrants in the workforce will be higher, likely around one-third, because many have taken UK citizenship.)

We have previously shown that there is support for increased immigration to fill health and care roles, specifically doctors, nurses, and care home workers. Around half would like to see the number of migrants who are doctors or nurses to be increased (51% and 52% respectively), and four in ten (42%) would like to see more care home workers, with fewer than one in five wanting fewer migrants from any of these groups.

So, while some politicians link long NHS waiting lists with immigration, the public, while concerned about this, are even more worried about other issues. Given the central role of staff shortages, immigration is also seen as part of the solution, with public support for recruiting migrant workers to fill these vital roles. This shows the complexity of the issue, and the important role that evidence should play when talking about it. But we also recognise how difficult it can be to present complex and emotive issues like this one to the public. 

Therefore, we will soon be undertaking some new research exploring how best to do this, something that we hope will be useful for NHS leaders as they move forward after the election, whatever its outcome.