Looming than Brexit
acute concern is over the NHS reliance on EU workers. Around 10 per cent of doctors and 5 per cent of nurses are currently from the EU. Adding in social care, there are more than 160,000 EU/ EEA nationals working in the sector. So the fine detail of the new UK migration policy will be critical for the NHS.
There are other worries. The UK is a member of the European Medicines Agency, which regulates the approval of medicines to be placed on the EU market. There is now uncertainty on whether it will be possible for the UK to maintain some form of collaboration or participation in this system post-brexit.
UK organisations also benefit from EU health research funds in Europe, with €760m in EU funding having supported research Former Labour leader Lord Kinnock criticises Jeremy Corbyn’s policy on the customs union
excess, fills graveyards” “Until some clarity is reached on the terms of the UK’S exit, caution should be exercised on the claims and counter claims on the impact on the NHS” “Under no circumstances can the Prime Minister be given a blank cheque to crashtheukoutoftheeu without a deal”
in the UK between 2007 and 2013.
Then there is the European Directive on patients’ rights in cross-border healthcare, with participation dependent on membership of the EU/ EEA. If the NHS was no longer allowed to take part in this flagship initiative post-brexit, this, warns Elisabetta Zanon, director of the NHS European Office, “will impact negatively on the NHS’ international profile and, most importantly, may deny some patients access to the best possible clinical knowledge and expertise for their condition”.
Now these concerns are real and pressing. But the out-turn is far from settled as we await the fine details of negotiation. Until then the claims and counter claims need to be placed in context and balanced in the light of available data.
For example, between December 2013 and April last year, overall NHS staff levels have grown by more than 74,000 or per cent, more than twice as fast as UK population growth.
There are also more EU nationals working in the NHS than ever before: almost 62,000 as at end June last year, up 55 per cent in the last three and a half years. And their numbers have continued to rise after the Brexit vote. In all this, we should not forget the contribution made by NHS staff workers from the rest of the world. More than 75,000 NHS workers (6.4 per cent of the total) are non-british or non Eu.however, while the percentage of EU nurses has more than doubled from 3.2 per cent to 6.8 per cent in the last four years, the growth in numbers has stalled and even slightly declined postreferendum. But how much of this is due to Brexit? EU nationals also increased in every other role – support, science/technical, doctors, ambulance and midwives. The decline may be due to the introduction of an English language test for nurses in 2016, acknowledged as a factor by the Migration Advisory Committee and NHS trusts themselves.
Until some clarity is reached on the terms of the UK’S exit, caution should be exercised on the claims and counter claims on the impact on the NHS. The problem is heightened by accusations that some are seeking to “weaponise” the NHS as a means to undermine negotiations and weaken the government: all fair in political love and war, you may think. But let’s not lose sight of the bigger problem. Last week the Institute for Fiscal Studies (IFS) and the Health Foundation issued a joint report, arguing that there is no feasible alternative to putting up taxes to meet the growing demands of the next 15 years – driven by changing demographics, chronic illnesses, and rising staff and drugs costs. IFS director Paul Johnson set out the tough choices: higher taxes and a health system which meets public demands, or taxation at current levels which will mean the NHS delivering less and less. The “alarm bell” number in the report was that nothing less than £2,000 extra taxation per household would suffice.
And that, surely, is the biggest problem that the NHS faces Brexit or no.