So the referendum is over and the UK, or at least England and Wales, will likely be out of the European Union. Most economics forecasters are predicting a period of financial uncertainty and this will likely impact on the NHS both directly in terms of funding but also through the effect on other public services.
At a time when the NHS is facing its biggest funding crisis, public sector spending looks likely to be squeezed at best and face huge cuts at worst. The “protection” of health funding by the government may have been mostly smoke and mirrors - ie it was cut but just not as drastically as other public services. But now even this slight protection may disappear.
But the most immediate issue is probably for the 60,000 NHS staff and at least 40,000 care workers who come from the EU, who face a worrying and unsettling time.
It is vital that the immediate message that goes out to them, and indeed to all other NHS staff, is that their contribution is valued and that they are welcome.
Employers and NHS organisations must make clear their support for these staff and the fact that any abuse or discrimination will not be tolerated.
For trade unions, it is time to reassure our members that we will continue to support them and fight to protect their rights.
On a practical level, there are a range of issues we as trade unions will be working on. We will be seeking early assurances on the rights of existing EU workers to remain in the UK. We will be making the case to keep free movement for NHS staff, otherwise we risk losing access to workers with the skills and qualifications essential for the NHS. And we need to audit the terms and conditions of NHS staff that derive from EU regulations and ensuring these can be protected, including the provisions of the working time directive, and cross-EU recognition of qualifications.
At this moment, many EU staff may be planning to return to their home country or to relocate to another EU country. The NHS cannot afford for this to happen.
Unions and employers must work together to reassure these staff that they continue to have a future in the NHS in the UK.
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