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June 22, 2016

Private Eye Medicine Balls 1420
Filed under: Private Eye — Dr. Phil @ 11:27 am

Why are so many doctors and scientists in favour of Remain?

No-one takes much notice of doctors, least of all politicians, but all the doctors MD has spoken to are in favour of the UK staying in the EU. Indeed, MD cannot trace one prominent national medical, research, or health organisation that has sided with Brexit. This is partly because of the un-evidence based fantasy bollocks of the Brexit camp and partly because, on balance, doctors and scientists overwhelmingly believe the UK is better off, healthier and safer in Europe.

The best guess of the net saving of withdrawing from Europe if there was no pursuant economic crash is £27 million a week. Even if every penny was spent on the NHS it wouldn’t even wipe out the current deficit. If there was an economic crash, it would wipe out any saving and make the NHS funding crisis even worse. The EU is not a prominent threat to the NHS as Article 168 clearly states that the organisation and delivery of health services is a national responsibility. A far greater threat to the NHS is the current UK government’s creeping privatisation and outsourcing of vital services, and a lurch to the right from Brexit is likely to accelerate this.

National health services are not included in the trans-Atlantic trade and investment partnership trade deal. (TTIP). The UK government has stated that it has no intention to broaden the scope of the deal to include the NHS at any point in the future, but a change of leadership and personnel in the Tory party post Brexit could well signal a change of intention and a new trade partnership with the US, with a ‘Privatise the World’ agenda that further opens up a £130 billion NHS market to American buyers.

Migration is more complex, and clearly puts strain on public services. However, EU migrants tend to be of working age, use the NHS less and pay taxes to fund it. The failures in NHS provision come from poor capacity and workforce planning, not because EU migrants aren’t paying taxes. Some even return home for healthcare because they can get quicker access to specialists than in the UK. There are 135,000 non-British European citizens working in the NHS and social care, about 10 per cent of the total, at all levels of the service from consultants to carers. There are also widespread staff vacancies at every level, and a current shortage of 50,000 staff in the NHS alone. How many would be able to stay or take up jobs post Brexit is unclear, as is how many of the 2 million British people living in other EU countries – including about 650,000 British pensioners – who would return home particularly for health reasons, as they lose eligibility for EU citizen health services.

As for the impact on research, Brexit would sacrifice our right to participate in the European Medicines Agency. We would have to pay to keep access to the centralised authorisation system, but have no influence on policy. The National Institute for Health and Care Excellence (NICE) would lose its vital European health technology assessments. To date, the UK has been the most successful country at winning competitively awarded EU funding for research and development in life sciences. After Brexit, the UK would have to pay to keep access to funding but have no influence in setting priorities in research and development.

As for the wider implications, a sense of belonging and connection is fundamental to mental health. Many NHS staff want to feel part of a Europe where compassionate collaboration triumphs over profiteering and virulent nationalism. Some people will do very nicely out of Brexit, and their health may even improve because of it, but it won’t be the people who depend most on the health and social care system, or those who work in it.

To believe that the UK can be a gated community, immune to consequences of millions of displaced citizens and a resurgence in right wing nationalism in Poland, Hungary, Austria, and beyond is fantasy. The refugee crisis has created a public health disaster, as has civil unrest and war in Ukraine, with a resurgence in multidrug resistant tuberculosis. Clearly the EU can be a wasteful, bureaucratic nightmare and needs continuous improvement. But denial and refusal to engage in Europe-wide solutions to such urgent and dangerous problems will not keep the UK secure or healthy for long.

References:

Policy briefing report jointly published by the Institute of Global Health Innovation and the LSE Health. The original briefing report is available here.

Why doctors should vote to remain in the EU on 23 June: BMJ 2016; 353 doi: http://dx.doi.org/10.1136/bmj.i3302 (Published 14 June 2016) Cite this as: BMJ 2016;353:i3302

The Brexit debate. www.bmj.com/brexit

80k workers in social care (Source: Skills for Care, September 2015: https://www.nmds-sc-online.org.uk/reportengine/GuestDashboard.aspx?type=Nationality

55k workers in NHS (Source: Health and Social Care Information Centre, September 2015: http://www.hscic.gov.uk/media/20194/All-staff-by-staff-group-nationality-and-HEE-region—full-time-equivalents-and-headcount—Sep-2015/xls/Staff_groups_by_nationality_and_HEE_region_FTE_and_HC_-_Sep_2015_-_Final.xlsx)

“Academics across Europe join ‘Brexit’ debate” Nature 530, 15, 2016 http://www.nature.com/news/academics-across-europe-join-brexit-debate-1.19282

“The EU: what’s best for UK cancer research and patients?” Lancet Oncology Volume 17, No. 5, p556–557 http://www.thelancet.com/journals/lanonc/article/PIIS1470-2045(16)30063-8/abstract

“If Mark Carney is right, then that is a severe concern for the National Health Service, because it would be very dangerous if at precisely the moment the NHS is going to need extra funding, actually the economy goes into a tailspin and that funding is not there.” Simon Stevens, CEO of NHS England http://www.bbc.co.uk/news/uk-politics-eu-referendum-36353145

“HM Treasury analysis: the immediate economic impact of leaving the EU” https://www.gov.uk/government/uploads/system/uploads/attachment_data/file/524967/hm_treasury_analysis_the_immediate_economic_impact_of_leaving_the_eu_web.pdf

Governor of the Bank gave evident to the Treasury Select Committee that leaving the EU carried the risk of a “technical recession” http://www.independent.co.uk/pugpig/7026821

Letter from 200 health professionals to The Times April 4, 2016 http://www.thetimes.co.uk/article/the-benefits-to-the-nhs-of-staying-in-the-eu-dnjnp8b82

“Paediatric research and the Brexit debate” Letter from six doctors at Great Ormond Street to The Times June 11, 2016 http://www.thetimes.co.uk/past-six-days/2016-06-11/comment/paediatric-research-and-the-brexit-debate-njtgztr6k

“EU boost to science” Letter from 150 members of the Royal Society to The Times, March 9, 2016 http://www.thetimes.co.uk/tto/opinion/letters/article4709281.ece

Torjesen I. EU exit would have a detrimental effect on the NHS, academics warn. BMJ2016;353:i2953.http://www.bmj.com/content/353/bmj.i2953?trendmd-shared=0doi:10.1136/bmj.i2953 pmid:27220718.

EU members. UK cannot be an island in science. Guardian 2016 Feb 27. http://www.theguardian.com/politics/2016/feb/27/eu-membership-uk-cannot-be-an-island-in-science

Wessely S. Why health of NHS will be at risk if UK leaves EU. Yorkshire Post 2016 Apr 8. http://www.yorkshirepost.co.uk/news/opinion/professor-simon-wessely-why-health-of-nhs-will-be-at-risk-if-britain-leaves-eu-1-7840583

Wollaston S. Brexit should come with a health warning for the NHS, public health, and research. BMJ2016;353:i3295.

A response to the RCP’s ‘call for views’ on the EU referendum, 2 Jun 2016. https://www.rcplondon.ac.uk/news/response-rcps-call-views-eu-referendum

Why should we Vote Leave on 23 June? http://d3n8a8pro7vhmx.cloudfront.net/themes/55fd82d8ebad646cec000001/attachments/original/1463496002/Why_Vote_Leave.pdf?1463496002

Dilnot A. Letter to Dominic Cummings, 27 May 2016. https://www.statisticsauthority.gov.uk/wp-content/uploads/2016/05/Letter-from-Sir-Andrew-Dilnot-to-Dominic-Cummings.pdf

Institute for Fiscal Studies. Brexit and the UK’s public finances. 2016. www.ifs.org.uk/publications/8296.

House of Commons Treasury Select Committee. The economic and financial costs and benefits of the UK’s EU membership. 2016. http://www.publications.parliament.uk/pa/cm201617/cmselect/cmtreasy/122/122.pdf

Centre for Economic Performance. Brexit and the impact of immigration and the UK. 2016. http://cep.lse.ac.uk/pubs/download/brexit05.pdf

National Institute for Economic and Social Research. Impact of migration on the consumption of education and children’s services and the consumption of health services, social care and social services. 2011. https://www.gov.uk/government/uploads/system/uploads/attachment_data/file/257236/impact-of-migration.pdf

Mason R. John Major: NHS at risk from Brexit pythons Johnson and Gove. Guardian 2016 Jun 5. http://www.theguardian.com/politics/2016/jun/05/john-major-nhs-risk-brexit-pythons-johnson-and-gove

Economist Intelligence Unit. Healthcare markets in Europe: what would be the impact of Brexit? 2016. http://www.eiu.com/public/topical_report.aspx?campaignid=BrexitHealth

Dearden L. “A dark day for Europe”: EU reaches agreement to send refugees back to Turkey despite legal concerns. Independent 2016 Mar 18. http://www.independent.co.uk/news/world/europe/eu-turkey-refugee-deal-what-is-it-erdogan-a6939156.html.