Foreign NHS workers and carers are still being charged for using the health service, despite the prime minister’s pledge to scrap these fees “as soon as possible”. On 21 May, in a remarkable U-turn Boris Johnson said that the £400 annual fee paid by non-EU migrants to use the NHS – on top of other mounting visa costs – should be removed for health and care workers. But a poll conducted by Doctors Association UK exclusively shared with the Guardian showed 158 NHS workers reported having to continue to pay for immigration health surcharge, while just eight reporting said they did not. The doctors’ group said “the utter failure to follow through on this promise is an insult to our colleagues who have served this country during our time of need”. Those applying for new visas said officials have told them they cannot guarantee fees paid now would be refunded. Others are being told that the rule will only apply to the workers and not their immediate families. The date of when fees will be scrapped is still not known and guidance has not yet been released by the Department of Health and Social Care. Doctors have also been given conflicting information saying the rule only applies to people renewing from within the UK. It comes after a spokesperson said in May that Johnson had asked the Home Office and the health and care department to remove NHS and care workers from the surcharge “as soon as possible”. The Royal College of Nursing has written to the prime minister to confirm that all health and care workers will be exempt from the charge on a permanent basis, including those employed in the NHS, independent settings and the social care sector. They also asked for confirmation that the spouses and dependants of health and care workers will also be exempt and that health and care staff that have paid the charge in advance will be refunded. Dr Dolin Bhagawati, a spokesperson for the Doctors’ Association UK, said: “These workers are paying up to four times over for the NHS – through their service, taxes, this surcharge and in some tragic cases with their lives. It is not too much to ask that this government does the honourable thing: stop this extortion and scrap this charge as soon as possible for NHS and care workers as well as for their dependants.” He added: “The utter failure to follow through on this promise is an insult to our colleagues who have served this country during our time of need.” Dr Reem Saad, a registrar doctor in surgery, said: “My husband and I are tier 2 doctors. I am going to start a new job in August and whenever someone starts a new job they have to pay a health surcharge depending on how many years they are asking for an extension visa. My training programme is three years and I still have to pay the surcharge.” She added: “My colleagues who have applied, even yesterday, one of them said he had to pay for himself, his wife and four kids so that is £6,000 between five of them. The Home Office is still saying that, at the moment, nothing has been implemented and unless that happens they cannot promise a refund.” Another person, speaking anonymously, said: “My partner is one of the cases where we’re trying to apply for a tier 2 visa for an NHS role but the application process still has the NHS surcharge payment as a mandatory step for the application. However, they did add an exemption list which surprisingly doesn’t include NHS workers.” Dame Donna Kinnair, chief executive and general secretary of the Royal College of Nursing, said: “We welcomed the commitment to remove the charge but now we need assurances that this will apply to all health and care workers and their families. The contribution of our overseas nurses, across all settings, has been incredible particularly during the pandemic and it is essential this can continue. Action must be taken now to ensure all those who come here to dedicate themselves to our patients are not penalised for doing so.” A government spokesperson said: “We are incredibly grateful for all the hard work that health workers and care workers continue to do in the fight against coronavirus. We are working through how to implement changes to the immigration health surcharge. We know that it is important to get this right and further details will be announced shortly.” Christina McAnea, assistant general secretary of Unison, said: “Every day that goes by without ministers saying exactly how the surcharge is to be scrapped for NHS and care workers, makes people grow more anxious. The government should go a step further and ditch the surcharge for all overseas workers paying taxes that contribute to the economy and the NHS.”