I’ve worked as a GP in the UK for decades, and I have never seen a situation as absurd and scary as the one we find ourselves in 100 days before we’re scheduled to leave the European Union.
It is currently far from certain we will be able to get medicines to British patients who need them after March 29 next year.
There is no better demonstration of the great value of frictionless trade with the EU than the ease with which medicines flow back and forth across our borders (we import some 37million packs of medicine from the EU a month).
Matt Hancock, the Health Secretary, announced yesterday he has become the world’s leading buyer of fridges, so he can stockpile medicines in the event of no deal.
How on earth has it come to this?
People tell me that it won’t be as bad as all that. This is all just negotiating bluster. The government will never commit an act of national damage as grievous as a no deal Brexit.
That may be true, let’s cross everything and hope the worst visions of a no deal Brexit do not come to pass. But one thing is certain: this could not be further from what we were promised in the referendum campaign of 2016.
The NHS buying fridges to stockpile vital medicines? No-one wrote that on the side of a bus.
When I speak to colleagues in the NHS about Brexit, they are fearful. They fear what any kind of Brexit - deal or no deal - means for their livelihoods, for the NHS they have devoted their careers to, and for the country which they call their home.
Colleagues of mine who have lived in the UK for years have decided to leave. Others have been forced to move because they or their partners work for organisations like the European Medicines Agency, which transferred work away from London after the Brexit vote.
Each of these instances is incredibly sad for the individuals concerned, their friends and family, but taken together they represent a tragedy for the NHS.
Be in no doubt - medical professionals the length and breadth of the UK are fearful for their futures and voting with their feet.
The Nursing and Midwifery Council has reported that 3,962 EU nurses and midwives left their register last year, 29% more than the year before. They were replaced by just 805 EU nurses and midwives joining the register, down from 6,382 the previous year.
In my field of General Practice, we have 1,000 fewer GPs working in the UK now than in 2015. The government is so far off its target to add 5,000 to the ranks by 2020 that NHS England has announced £10m worth of GP retention funds in a desperate attempt to keep doctors in the profession.
The UK used to be the leading recipient of research funding from the EU. Since 2016 Germany has overtaken it to claim first place. If the UK decides to limit immigration to only those ‘skilled’ migrants who earn over £30k after Brexit, then we will automatically shut the door on PhD students who are the bedrock of our university research.
These are just some of the myriad ways that Brexit is already making it harder for our healthcare system to function and costing the taxpayer money.
In the minds of medical professionals from our European neighbours Britain is now seen as at best an uncertain place to come to work, and at worst downright unwelcoming.
Maybe we could deal with all these hardships if there was some enormous Brexit benefit for the NHS. If the promises of windfalls on the sides of buses had been in any way true. But the dismal truth at the heart of Brexit is that we are causing great harm to our country for no clear benefit whatsoever.
As far as the NHS is concerned, the deal we currently have with Europe works brilliantly. Over recent weeks it has become crystal clear that any other kind of deal will be worse.
There is no deal on offer that gets us free access to the best medical and scientific talent from across the European Union. Nor is there a deal that promises medicines will flow over the border as easily as they do today. There is no deal that guarantees us access to Horizon 2020 - the next series of European science funding.
The only way out of this mess is a people’s vote, with remain an option on the ballot paper.
All of the Brexit options, deal or no deal, are dreadful. They are nothing like what was promised in the referendum campaign. Before we take any decision that risks so much harm to our healthcare system, the people must have a chance to have a final say.