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In Health and Care no matter how you ask the question Brexit is not the answer

Professor Paul Burstow comments on the impact of Brexit on the NHS and social care


Being outside the EU would be bad news in so many ways for the UK in general and for the NHS in particular.

I make no secret that I am a long term supporter of the EU, preferring to be inside helping to shape the rules that will impact on UK citizens and believing that so many of the challenges, economic, environmental, public health and political facing us require collaboration across borders. The EU is an essential part of the international institutional arrangements to facilitate that collaboration.

Professor Paul BurstowThe initial shock to the UK economy, followed by the protracted uncertainty of the negotiations to define the UKs new relationship with the EU and renewed domestic uncertainty surrounding Scotland’s future in the Union will all be bad for growth in the UK economy.  Growth is critical to the UKs ability to fund the NHS and meet the ever growing demand for healthcare.

The present austerity hitting the NHS may seem like the ‘good old days’ in the uncertain and insecure world of a Brexit vote.

It is not just the Treasury analysis that suggests the UK economy would be hurt both in the short and long term by Brexit, there are others, including from the London School of Economics, the CBI and Oxford Economics, that evidence the adverse impact of an exit on the UK economy and the government’s ability to maintain current let alone higher levels of funding for public services.

Not only would Brexit hit the finances of the NHS it would impact on the workforce of both the NHS and social care.  Again there is uncertainty about the aftermath of a Brexit vote, would existing EU nationals working for the NHS or social care have to leave if they were not earning at the level to be eligible for a visa? There are staff shortages across both health and social care a Brexit would limit access to key staff from across the continent.  Even if in the long run we were to expand domestic training the impact on the economy would take its toll here too.

It’s not just the negative impact on the NHS and social care workforce, Brexit would damage UK interests in research.  Around 20% of the academic workforce are nationals of another EU member state. Just as Brexit would complicate workforce planning in the NHS it would make it harder for these academics by requiring them to get visas and work permits.

Our membership of the EU makes it easier for NHS clinicians to benefit from and contribute to EU research programmes. Between 2006 and 2013 the UK benefited from over £700 million of EU funding for medical research projects. This was more than any other European country.   At stake now is a further £60 billion of research funding.

It is not just research that would be impacted, the way we regulate the marketing and authorisation of new drugs would also be thrown into confusion. The European Medicines Agency (EMA) is the hub of EU pharmaceuticals regulation; it is based in London.

Were the UK to leave the EU medicines regulation system completely the post Brexit Government would face a huge administrative undertaking to establish a separate regulatory system for pharmaceutical safety.

Taken together these changes would make the UK a far less attractive place for life science investment.

Leaving the EU would undermine the UKs defences against infectious disease.  The European Centre for Disease Prevention and Control, in Stockholm, co-ordinates networks, has improved reporting mechanisms, and through training has helped to plug gaps in the response of member states to infectious disease.  Given recent threats from Ebola and Zika virus, this hardly seems a good time to weaken our defences.

Behind these big numbers are real lives.  For millions of UK citizens their health and care needs will become more uncertain.

For example, there are over 400,000 UK pensioners who have retired to Spain, with more in France and other EU countries.  There would be no guarantee that current arrangements for these pensions would be protected,

Whether the question is about staffing the NHS and social care today, or research funding and collaboration, or the safety that effective medicines regulation assures, or investment in new facilities or medical technology a Brexit vote is not the answer.

Note: The views expressed in this post are those of the author and not of the City University London.

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