For the NHS, bigger problems are

● The concerns for the NHS are real and pressing, but the out-turn of the Brexit decision is far from settled

probablyknowasmuch about her approach as anybody else does” “I can see the risk that a great tragedy would unfold of a shrunken Britain retreating into

itself at a time of “Even two years after the Uk-wide vote to leave it is still utterly unclear what the nature of our relationship with the EU will be” particular global peril”

How long ago it seems when a Brexit campaign bus toured the country emblazoned with the claim that leaving the EU would free up an additional £350 million a week for the NHS.

Now, barely a week goes by without some alarming forecast that Brexit will damage our health service. Fears range from an exodus of Eastern European nurses to restrictions on access to drugs and pharmaceutical research.

“The NHS is already in crisis – Brexit could finish it off ” was the headline on a chilling piece in the New Statesman earlier this year. On that £350m a week claim, “the reality”, it intoned, “is quite the opposite.”

Labour MP and former health minister Ben Bradshaw has warned that Brexit would destroy the NHS “step by step… Our pharmaceutical companies are already having to divert money that could have been spent on research into new treatments into preparing for Brexit – and the collapse in the value of the pound means that costs for medical equipment have been ratcheted up.”

Scotland is particularly concerned to ensure that any change in immigration policy does not inhibit the flow of badly needed skilled workers to Scotland and that we do not lose GPS. Here the most blood-curling prediction of an NHS “facing ruin” came from Scottish government health secretary Shona Robison, and the heads of the British Medical Association in Scotland and the Scottish leader of the Royal College of Nursing.

Robison said the health Tory MP Jacob Rees-mogg service in Scotland is facing it’s greatest-ever crisis because of the threat Brexit poses to overseas staff. She highlighted the restrictions Scotland faces on recruitment of medical staff after leaving the EU and single market, saying the loss of doctors and nurses– “the beating heart of the service” – would leave Scotland’s NHS in ruins.

So what is the reality? Are these fears justified? Is the uncertainty over Brexit already adding to the formidable problems facing the NHS? Or could it be obscuring a more profound problem ahead on funding our health system?

The reality is that little can be treated with certainty at present. It’s not just that extricating the UK the European Union has proved Former Labour foreign secretary David Miliband

“You can trust me to deliver. I will not let you down”

far more complex than breezily assumed when the UK voted. It is also that, even two years after the Uk-wide vote to leave it is still utterly unclear what the nature of our relationship with the EU will be.

There is even doubt as to whether we will leave the customs union, let alone achieve the clean break that Brexiteers campaigned for.

One possible outcome – a fragile set of ambiguously worded compromises – the all too familiar ‘fudge and mudge’ that has characterised the UK-EU 0 The Leave campaign’s famous slogan placed the NHS at the heart of the Brexit campaign relations for 30 years – could well result in an outcome little different from current arrangements – dubbed by critics “Brexit In Name Only”.

Certainly UK government declarations that we will leave the EU single market and customs union, cease free movement and leave Brussels regulation well behind have come to look ever more tentative and Prime Minister Theresa May unconvincing. All this has done nothing to assuage fears about the impact of Brexit on the NHS. This massive activity of the British state – an institution with a workforce of 544,000 and a planned budget of £125 billion – has already long been the subject of political dogfight – and never more than now, when searching questions have arisen over its future funding if it is to provide acceptable standards of care for an ageing population and longer life expectancy.

The most immediate and