When Bevan launched the NHS in 1948, he had a vision that bound healthcare and equality. Uniting our citizens, the NHS is iconic to our nation, but as it approaches its 70th birthday, it is sad to think its demise may not be too far off. As it is, the NHS faces huge pressures which put it on the brink of collapsing – could Brexit be the tipping point? Leaving the EU will impact staffing, funding and research to name a few, and unless negotiations are made with utmost vigilance, the NHS will collapse.
Firstly, the idea that the increase in immigration due to free movement of people across EU borders is placing a burden on our public services, is wholly unsubstantiated. In actual fact however, the free movement of people is beneficial – the EU’s policies mean professional qualifications are recognised throughout the EU aiding the NHS, with EU citizens making up approximately 10% (150,000) of the health and care workforce.
What’s worrying is that EU nationals have envisaged a bleak future of the NHS and refrain from coming to work in the UK. The rate of those leaving outweighs those entering to settle in the UK; since the Brexit vote, there has been a 96% decrease in EU nurses registering to work in the UK. International recruitment is vital in plugging staffing gaps, and after Brexit, it is highly likely the NHS may face a workforce crisis, ultimately rendering patients at high risk.
Secondly, it is common knowledge that the Leave campaign promoted that the money spent on the EU membership would be redistributed, leaving “£350million a week to the NHS” – a short lived claim that swayed Leave voters, much to their resultant disappointment. However, it may not all be bad. The Nuffield Trust has recently calculated that there would be a 4.1% increase in the Department of Health budget in 2020-21, that’s an extra £100m per week. But are you ready for the catch? It requires the economy to be stable, if not progressing, post-Brexit. That itself is unlikely considering the public services are forecasted to have a hit to their funding, leaving the NHS with £2.4bn reduction in annual spending in 2020-21. Post-Brexit, the economy will be in a mode of instability and uncertainty and the repercussions will be projected on the NHS. It will get worse before it gets better, but in that dip, will we lose the NHS all together?
A third implication of leaving the EU will be on medical advances and treatments – both access and development. Currently, pharmaceutical products available to those residing in the EU are approved by the European Medicines Agency (EMA). Leaving the EU could mean two things; the UK will have to devise a new licensing strategy for current medications, while new drugs could be received up to a year later than in EU countries. Alongside a profound negative implication on quality of care, both these strategies place an extra financial burden on the NHS,
While the UK will still have access to the latest research and medical developments, and supply of medications (albeit delayed), exiting the single market may affect customs and trade and could increase (already inflated) costs of drugs, putting an even greater strain on the NHS. Ultimately, patients will be deprived of advanced, effective, evidence-based treatments.
As negotiations continue on our future with Europe, it is abundantly clear that the EU’s priority will not be the welfare of our NHS – and, why should it? It is for our side to fight. Negotiators ought to advocate for two key terms: - the future of EU nationals and staff certainty, and increasing the number of health professionals being trained and subsequently serving in the NHS. These will help fill the void and oil the cogs whilst the economy stabilises post-Brexit.