Critical Condition: What Brexit Means for the NHS

The UK has voted to leave the EU. Vote Leave insisted that this would be beneficial for the NHS, supposedly in the form of £350 million extra per week. But how will Brexit really affect the NHS?


The biggest problems for the NHS are not necessarily anything EU-related, but instead an ageing population and the rise of chronic disease. (Photo: PA)

The biggest problems for the NHS are not necessarily anything EU-related, but instead an ageing population and the rise of chronic disease. (Photo: PA)

What did Vote Leave claim?

The charges were serious: the UK was spending £350 million a week on the EU, which could have been spent on the NHS. Increasing numbers of immigrants entering the UK from the EU would add to increasing pressure on the NHS, increasing waiting times as well as costs, worsening the standard of care and threatening patient safety. But do these claims add up to Brexit being the most beneficial road to take for our NHS?

There has been much criticism of the Leave campaign’s arguments in relation to the healthcare sector. In particular, Vote Leave’s assertion that £350 million a week was being spent on the EU which could otherwise have been spent on the NHS was rejected by the UK Statistics Authority. The gross figure was presented with the implication of it being a net figure, ignoring the application of the rebate as well as other flows of money from the EU to the UK public sector. A more accurate figure would be £136 million per week. EU spending on the UK also includes a portion of the nearly €80 billion funding available for research programmes (across all EU nations, not just the UK) through Horizon 2020, which would have greatly boosted Britain’s competitiveness and leadership in scientific research.

Researchers at the London School of Economics investigated whether immigration from the EU would actually harm the NHS. In addition to the fact that a smaller proportion of immigrants claim benefits (being economically active instead) compared to the British people, there is no “greater usage” of health services by immigrants compared to those born in the UK. “Little effect” is also found on waiting times due to said immigration. EU immigrants are also less likely to use the health services compared to non-EU immigrants as they tend to be younger.

How will Brexit affect the NHS?

By leaving the EU, we would be inflicting greater financial strain on the NHS, not less. The economic shock following a Brexit will lead to incomes falling. The IMF has even warned that leaving the EU could lead to a loss of 5.5 per cent of GDP as the UK heads into another recession. What this means is that government revenue will inevitably fall as incomes fall. As the NHS is a publicly funded organisation, this will lead to even more austere budget plans for the healthcare sector. In light of its present dire financial situation, with massive deficits reaching £2.45 billion during the latest financial year, Brexit will only serve to worsen the quality of healthcare and the efficiency of service. Waiting times will increase, but not due to rising demand from immigration.

Waiting times will increase, not due to rising demand from immigration, but due to the fiscal consequences of a Brexit. (Photo: Thinkstock)

Waiting times will increase, not due to rising demand from immigration, but due to the fiscal consequences of a Brexit. (Photo: Thinkstock)

This may be a short- to medium-term concern, but there are also many other healthcare benefits that will be lost as the UK leaves the EU.

The UK does not train sufficient doctors and other healthcare workers to meet demand. About 3.6 per cent of the NHS workforce are EU nationals, and although that may be a relatively small number, in light of increasing demand from an ageing population, anything that may introduce uncertainty and cause such foreign workers to leave the UK, or lead to migration of such skilled workers being restricted, will undoubtedly be detrimental to the NHS. In light of the recent junior doctors’ strikes and problems within the NHS, one cannot entirely say that medicine will continue to attract applicants from the UK, however popular it may currently be. In the future, foreign nationals will be required to fill the gaps, and the need to make this a simple process must be considered in any negotiations the UK may enter with the EU after Article 50 has been triggered.

In addition to the healthcare sector, the research and pharmaceutical sectors too will be affected. Pharmaceutical companies will be less willing to invest in opening R&D sites in the UK, if access to the single market is lost. Previously, the European Medicines Agency (EMA), which is located in London, played a key role in creating regulations that ensured that the medicines on the market in the EU are “safe, effective and of high quality.” Once the UK leaves the EU, pharmaceutical corporations may have to go through another set of costly regulatory filings and applications, something which will add to their costs and potentially negatively affect any investment decisions they may take in the future. The EU allowed better access to research centres and laboratories across multiple nations, as well as made research collaborations easier to accomplish due to free movement laws. Such opportunities for British science will undoubtedly be lost, including some research opportunities and collaborations for British medical researchers.

The UK remaining in the EU would have meant that the British could continue to enjoy access to state-funded healthcare (just as ordinary citizens would) when visiting other EU countries, through the European Health Insurance Card (EHIC). As the availability of the EHIC is uncertain for UK residents once the country leaves, UK citizens may have to pay for insurance when visiting the EU, increasing travel costs. Under the EHIC system, EU nationals could also seek NHS treatment. Now that we have left, another system would need to be introduced to charge EU nationals, adding to the excessive bureaucracy and paperwork that healthcare professionals in the NHS already have to face. Not ideal at all for efficiency. The UK should therefore aim to agree upon a deal to secure free treatment similar to what it already has in place with other countries such as Australia and Israel.

Brexit on the whole will be damaging to the NHS. It is unlikely that any negotiations with the EU will recover these losses, as the benefits to the NHS came from the fact that the UK was an EU member. Instead, the government should look to further encourage non-EU healthcare professionals to migrate to the UK without compromising on standards of care and competence. It should also be prepared to provide the necessary financial support to the NHS despite any fiscal difficulties that may become apparent following the UK officially leaving the European Union.

The British people voted to leave, and we should be proud of our democracy which protects their right to decide on the matter. Like our democracy, the NHS is also one of our greatest institutions. The Brexit vote was a great self-inflicted injury. It is vital that we act now to stop it becoming the NHS’s biggest emergency.

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Bushry Basheer

Health and Science Correspondent at Filibuster
Bushry Basheer is a 17-year-old writer from London. He is currently studying biology, chemistry, physics and maths at A-Level and hopes to study medicine at university. He is interested in medical ethics, and what being a member of the “Noble Profession” is all about. As a Dementia Friend with the Alzheimer’s Society and a volunteer at a care home, Bushry also tweets at @mbbdementia on the latest research, information and stories about various dementias, especially Alzheimer’s disease. He can also be found at his blog, discussing various topics on the medical profession that comes to his mind.
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