Brexit means the NHS on a platter in trade deals - and both main parties are ducking crucial questions

Both a hard Tory Brexit or a soft Labour one would worsen every aspect of the NHS crisis, from staffing to drug prices to privatisation. Why aren't we talking about this more?

Louise Irvine
30 April 2019, 11.06am
NHS hospital ward
Peter Byrne/PA Images

The latest lifeline thrown by the European Union extending the Brexit deadline to the 31st of October was greeted with joy in some corners – especially by those hoping that the longer the UK remains a member of the EU the closer we will come to revoking Article 50 – and dismay by those who believe the UK should be gone already.

However, I am not here to make the same arguments for remaining in the EU that many – and better qualified analysts – have made before. The National Health Action Party - the party I represent - has already made its views clear on this: we believe the UK’s interests are best served by remaining a member of the European Union. We believe now that the country really knows more about what Brexit entails, that it is only right that the people make the final decision of as to whether we leave or remain.

The Leave campaign’s fraudulent promise of an extra £350 million a week became a potent rallying point for support to leave: the NHS is one of the last institutions in our country that still puts people before profit, is founded on the principles of social solidarity and the mutual sharing of risks. And that is why in the remainder of this article my message - and the message of the National Health Action Party - is addressed to those who voted to Leave in the belief that doing so would benefit the NHS and our public services.

We sincerely ask you to re-think your decision and to cross the divide. This is not about point scoring or those who voted remain self-righteously indulging in “I told you so’”. Instead it is a rallying cry to work together to fight for a better NHS. Because right now, our health service needs all the support it can get and the longer we allow Brexit to rumble on, and the longer we remain fixated on parliamentary infighting, the more we fail to give attention to the attacks currently being launched against the service which led many to vote leave in the first place.

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Let’s take back control of our NHS

The NHS is in the midst of a staffing crisis. This crisis has not been brought about by Brexit. But Brexit is making it considerably worse. Recent figures show the NHS currently lacks approximately 30,000 nurses and 3000 GPs. The Nuffield Trust, King’s Fund and Health Foundation jointly predict that these figures could rise to 70,000 nurses and 7000 GPs within the next five years. One of the solutions in preventing this is to recruit internationally, but Brexit seriously hampers us in doing so. For example, figures from the Royal College of Nursing (RCN) reveal that since 2016 there has been a 91% drop in new registrations of EU nurses coming to work in the UK. Those same figures reveal that 7000 already working nurses from the EU left the UK between 2016 to 2018.

But this isn’t just about numbers. Brexit also means the end of freedom of movement. This will have devastating effects on the people of Northern Ireland, where many nurses from the Republic of Ireland cross over the border everyday in order to work. Any decrease in the numbers of nurses and other workers coming from the EU will have a drastic effect on both health and social care. A&E’s are already seeing the knock-on effects – performance is currently at an all-time historic low.

However, staffing is only one side of the matter. The economics of Brexit, and in particular the issue of international trade, poses further risks to the NHS. Under Labour’s Brexit plans for a customs union with the EU – one which will supposedly be buttressed by exemptions from EU state aid rules – the UK will become a rule taker with little to no say over EU laws, including rules on competition and procurement. At the same time, Labour’s approach is flawed by the fundamental dishonesty of pretending it can exempt the UK from EU rules on state aid enshrined in the Treaty on the Functioning of the European Union whilst remaining in a customs union. But things get considerably worse when we look at the Conservatives.

The government is currently attempting – and not for the first time – to privatise the NHS in England on a wholesale basis through the NHS Long Term Plan. The “plan” includes the creation and rollout of Integrated Care Systems (ICSs), and Integrated Care Providers (ICPs), formerly known as Accountable Care Organisations (ACOs), across the entirety of England by over the next few years. There are no guarantees these organisations won’t be made up significantly of private healthcare providers. They won’t be accountable to patients and communities as they aren’t statutory bodies. There has been no vote in Westminster legislating for the creation of these bodies. But they will have the power to decide who does and who does not receive care and how to manage and spend billions of pounds for 44 long-term health care budgets covering entire regions of England. The creation of these organisations will also involve the mass closure of services.

Consequently, if you support Brexit – or what some are now also calling “Lexit” – then you have to ask yourself the following question, “can I trust the Conservatives not to offer up the NHS on a platter to larger economies such as the US or China in order to strike trade deals?”. Anyone with a shred of intellectual honesty must admit that they can’t, as Theresa May’s remarks on the issue have made clear. It’s clear from the soundings coming out of the Department for International Trade that they are desperate to take the UK into free trade agreements such as the Comprehensive and Progressive Agreement for Trans-Pacific Partnership (CPTPP). This free-trade agreement would open huge swathes of the NHS up to private companies, and make drugs more expensive, which leading Brexit experts have warned would be a complete catastrophe for the NHS. It would also prevent any future progressive government from being able to renationalise the NHS; as the agreement would be underpinned by the UK being subject to Investor State Dispute Settlement Mechanisms.

So if you want to save the NHS from the government induced decline that it is currently being subjected to then you cannot support any version of Brexit. All types of Brexit will leave the country worse off economically, reducing our ability to fund public services. All types of Brexit reduce the UKs international bargaining power and increases the risk that the NHS will be offered up to entice foreign investment. If we wish to beat diseases, if we wish to know how to improve care and help those most in need in our society, then we need to have access to international research and development networks. Networks that have been instrumental in developing life-saving treatments and the sharing of best practice across the continent. Brexit undermines all of this. By leaving the EU we are not taking back control, we are throwing it away.

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