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I am Hong Kong CML holder with BNO. I have enquiry about the UK NHS System


Hi. My Name is Terris Tam from Hong Kong

I am the Hong Kong BNO holder of CML patient for about 7 years. I know I should not put the policitcal issue on the CML support group but I do have serious enquiry about CML treatment in UK. I am taking 50mg  sprycel daily with log 5 result recently.

I know you may know UK governement just announce the 5+1 programe pathway for getting UK citizens for BNO holders due to unstable social environement in Hong Kong. The programme annuence that those BNO holder who willing to come to UK need to pay immgration health surcharge (IHS) for UK NHS service.
However, the charge did not cover the presecription drugs but only for medicine service. However, when I check NHS website, cancer patient may be the exemption cases to claim back the charge of prescription drugs. I am confused of the information of that becasue I really not familiar with UK medicial service.

I have questions that if I paid that 624 pound (IHS) for NHS. May I claim the fee of sprycel? You know the cancer target drung is high cost. I want to know more.I trust other cancer patients or long term illness person BNO holder all have such questions.

Appreciate your help

Terris Tam


Hello,I am not sure if you will get your Sprycel for free  because you haven't paid into the NHS system and Sprycel is very very expensive  .We pay into the NHS throughout our working life ,it comes out of our wages every month so it isn't really free as we have been paying instalments in a way  .I am not sure if that would change after a few years of you earning in the UK and paying your taxes and National Insurance .


Hi Terris

I'm not an expert on immigration rules and I don't know all the details of the new BNO HK scheme - so you must make your own enquiries and seek advice to make sure there are no surprises - but I have had a quick look on the information available on the UK Gov website.

I think the situation is probably this: under the BNO HK route, so long as you pay the IHS (Immigration Health Surcharge) for the period of "right to remain" (5 years - you need to be resident here for that time and you need to pay the surcharge every year I think), once you apply for settled status the surcharge goes (I think) and access to the NHS is the same as for resident British Citizens. Once you are a British Citizen, again so long as you are ordinarily resident in the UK you don't pay a surcharge.  Obviously, as a UK resident (whether with a right to remain, settled status or citizen) you will be liable to UK taxation on your income etc, which is what funds the NHS.

Payment of the surcharge will entitle you to access to the NHS without further charge, apart from certain things like dentistry and eye tests which most people pay for. The reference to "free" prescriptions may confuse you - in the UK, everyone pays a prescription charge (£9.15 per prescription) unless they have an exemption.  Cancer patients have a medical exemption from the £9.15 charge, which is what you have seen.

So, apart from the IHS I don't believe you would be subject to further charges for access to the NHS (including drugs such as those used in CML) in the UK if you went down the BNO route.  It would be sensible to check with the British Consulate in Hong Kong in case there are any health restrictions but I suspect this might count as discrimination contrary to our Equality Act if there were.  I haven't seen any relevant ones - there is just a reference to having to have a tuberculosis test.

I spent my childhood and teens in Hong Kong so it is a place very close to my heart. Been back many times and will do so again.


Dear Richard,

Thank you for your reply. You message is useful.

If really as you said, Iis is very reasonable or even privilege for patient BNO holders.

For HK CML patient or other cancer patient, the cost of medicine were far more than 624 pound per year although UK charged higher tax rate for citizens.

In fact, I know UK governemnt still need time to draft the detail of the BNO offer so just keep patient for the detail announcement.

Thank you very much for your information.

Keep in touch


Glad it was helpful. It may be useful to remember that the NHS is funded on a collective not individual basis. Contributions to tax and national insurance never match an individual’s usage of UK state resources - it is all pooled. That will be the case with BNO applicants too although a contribution to the NHS in addition to tax and national insurance is now required for those coming to the UK during the conversion to long term residency and citizenship. UK tax is quite a bit higher than HK but there are also more public services such as the NHS. 


It isn't really about "paying in instalments" or not, it's about eligibility. Children of this country don't pay anything to the government, but of course we don't ask their families to pay for their NHS treatment - they're eligible. Migrants to this country - and I'm one of them - become eligible for certain things depending on a whole bunch of criteria. 

As Richard has pointed out so well, the situation for HK residents who may have a path to citizenship here in the UK is at a quite early stage of evolution but I can't imagine they would be at less of an advantage than any other migrant who enters the country legally.


Dear all,

Thank you you guy explain me so much abou the NHS and IHS. 

I think even give IHS for the 5+1 period and can used NHS serivce already nice enough for me and the other chronic illness patient from HK.

May I know more about CML consulting in NHS? In Hong Kong, once you diagnosed CML, you may need the specialist referral letter to refer the case to govenement hospital. However, the waiting time for your case is different for the patient. Some have rapid arrangement but some need half year.

In UK, May I know the procedure of referring the CML case to NHS? Any document needs? How long will take for the whole process?