As the implications of Brexit remain uncertain we asked our readers for their thoughts on its potential impact on the NHS
Alison Hill, former deputy chief knowledge officer, Public Health England
The impacts on patients and service users could be profound. If the economy now falters there will be less money for the public services and the NHS, already struggling to live within its means, won’t be spared. Cuts in social care will further increase pressures on the service. The NHS employs over 1,000,000 staff and are currently dependent on 100,000 EU workers. There aren’t enough trained staff in the UK to provide the necessary workforce and there are shortfalls in staffing now. While there’s uncertainty about future employment status there could be an exodus of EU nationals to other EU countries, creating further pressures on an already fragile service.
Rob Douglas, practice manager, NHS South Manchester CCG
I don’t see any difference in the short-to-medium term as a lot of the pressures on the NHS are from native Britons who need to be re-educated about what is self-treatable and what isn’t; they need to be less pampered. The rise in the number of foreign nationals accessing the NHS will diminish as the immigration issues are dealt with by the new government in the longer term. The NHS doesn’t require or need more of the hard-pressed taxpayer’s money, it needs the freedom to spend where needed and not to be governed by ‘ring-fenced money’ or penalties for performing with an underspend at the end of each financial year. The issue of recruitment is slightly more complex; in the short term we need to recruit from abroad. We need to provide British citizens with the education to complete the medical training to become doctors and then we need to make the pay and conditions attractive enough to keep them.
Najam Bangash, practice manager, Fernbank Medical Centre
Brexit should at the least stop the further privatisation of the NHS as it should also enable Britain to reject the TTIP (Transatlantic Trade and Investment Partnership). Our hope is that the next government will be able to reverse the internal marketing within the NHS and to coalesce it into an integrated service as it used to be prior to the Tories and the Blairites getting their way with it.
Greg Bull, Dispex
I think that the impact of Brexit on the NHS could be more significant than people think. There are plenty of current NHS workers from inside the EU at GP and consultant level who may feel that, psychologically, they’re now surplus to requirements. The NHS is already under pressure and the impact of any GPs leaving will lead to further pressure on primary care. The loss of free movement of Europeans into the UK could have a serious impact on the NHS. However, it may well be that this shortfall is made up by doctors moving to work in the UK from non-EU countries such as Australia or the USA or former Commonwealth countries. The government needs to ensure that working conditions in the NHS are such that it can attract the best quality GPs from wherever. The NHS requires guaranteed funding to ensure the current high standards are maintained following the decision to leave the EU.
Dr Richard Ma, NIHR in-practice fellow, department of primary care & public health, Imperial College London
The EU may appear bureaucratic, but it protects the rights of citizens, and regulatory frameworks ensure safety of medicines. We now know the EU funds some of the poorest areas of the UK which, ironically, voted leave. The original campaign unleashed divisions within political parties and society. It offered a platform for nationalistic sentiments to legitimise xenophobia and racism. These affect many people who work for the NHS as well as some of our patients.
Alyson Scurfield, chief executive, TSA
The UK is a major centre of innovation in technology and particularly healthtech. It’s vital that future plans following the recent EU referendum continue to recognise the importance of investment in products and services that help grow the economy as well as make a major difference to quality of life. Many innovations have grown out of EU-funded programmes and partnerships – it will be important to ensure that investment in collaborative research is maintained in the future. In a connected world, we need to network across borders without barriers to support communities to flourish. Our investment in technology and technology-enabled care will need to help make this happen across Europe with the UK still an integral partner.