I recently wrote about the difficult subject of immigration, an issue that is so often used to silence debate on the EU. Instead of immigration, let's talk maths. According to the NHS Confederation, there are currently 7,875 GP practices in the UK, serving 64 million people. This equates to approximately one practice per 8,000 people. If, as predicted by the Office of National Statistics, the UK population rises to 74 million in 25 years and there isn't a material rise in the number of GP practices, each one will then serve approximately 9,500 people, an 18% increase. In order to keep our ratio of people to practices the same, the UK would need to fund an additional 1,400 GP practices.
If the government wants to engage those who are worried about immigration, it needs to outline a public investment program to demonstrate that mass immigration will not impact the quality or availability of public services. The government needs to point to the 1,400 new GP practices, the hundreds of schools, and dozens of hospitals that it will build to maintain existing standards of public service. By failing to implement such investment, the government is tacitly expecting people to accept a drop in their standard of living. If immigration is such a boon to the economy, there should be no question of the country being able to afford a massive program of investment and it should be demanded by both the leave and remain camps as the minimum price of our continued membership of the EU.
Someone very close to me recently had an experience that illustrates why the people of Britain are not being offered increased investment in public services in return for staying in the EU. This person, let's call them Bob, was rushed to a major hospital on a Wednesday morning with a serious medical emergency. Bob was put on a trolley, as were a dozen other seriously ill patients who all languished in a corridor because there were no treatment rooms available. Bob's attending doctor made an educated guess at a diagnosis of pulmonary embolism, which has a mortality rate of 25%, but wanted to consult a cardiologist before administering treatment. The doctor also told Bob that he'd need a CT scan to confirm diagnosis but that the next available slot on the scanner was Saturday morning - 3 days later.
Bob and the doctor waited for 6 hours to see a cardiologist, but were told that no one was available. In the end, not wishing to continue running the risk of dying, Bob instructed the doctor to treat him for pulmonary embolism, which was done in the corridor because there were still no treatment rooms available. The doctor informed Bob that he'd have to be admitted but that there were no beds either, so Bob would have to spend the night on a trolley in a brightly lit corridor lined up with a dozen similarly ill, distressed people until a bed became available.
Bob had a brainwave and asked about going private, and within 25 minutes was in a private room two floors above the crowded corridor. For the sum of £500 per night, Bob had literally risen above the crowd, was seen almost immediately by a consultant cardiologist, and was booked in for a CT scan on the hospital's brand new private scanner first thing the following morning - two days sooner than he could be scanned by the hospital's overworked NHS machine.
Bob was in hospital for four nights and spent £3,000 on his care. Once he'd made the decision to go private, treatment was quick and stress free, but of course Bob was in the privileged position of being able to afford private care. Most people in this country would be unable to find the thousands of pounds needed to rise above the crowd and, like the people Bob left behind, would be doomed to spend a night on a trolley waiting for a bed, a consultant, and a scan, running the risk of dying in a hospital corridor in the fifth richest country in the world.
Many leading figures advocating continued membership of the EU will never go near an NHS hospital or comprehensive school. They will never experience the consequences of a massive, unmanaged increase in population, because, like Bob, they have the money needed to rise above the crowd. When they argue that unmanaged immigration is good for the country, they are not making any sacrifices in their quality of life - quite the opposite; EU membership is good for them because the influx of people keeps labour costs low, enabling their money to go further. If we remain in the EU, our leaders need to be held to account and we must have a mature debate about how we invest in our public services to ensure they keep up with Britain's growing population.
Without such an investment program, continued EU membership will be yet another instance of the poor being asked to shoulder an unfair burden because they will see a fall in the quality and availability of the public services they rely on, while those with money can buy their way out of the problem. Those trapped in poverty have no choice and are often the worst affected; they usually live in the poorest, most crowded areas, can only afford to use the NHS, and have to rely on the state to educate their children.
Whether you're campaigning to leave or remain, surely we can all agree that asking the poorest in society to shoulder the greatest burden is a raw deal? But by refusing to address the very real consequences of EU membership, the maths of immigration, and the required investment in public services, a raw deal is exactly what's on offer.