After voting Thursday to leave the European Union, citizens of the United Kingdom now face the consequences, including the potential impact on their health care services.
The UK’s National Health Service famously provides medical checkups and most treatments free of charge to all residents.
In the runup to the Brexit vote, the chief executive of the National Health Service England declined to publicly support either side of the leave-or-stay debate, but implied that remaining with the EU was the better decision. Simon Stevens’ viewpoint was firmly rooted in financial realities.
“We’ve got a clear plan to improve cancer services, saving 30,000 lives over the next five years. We need to upgrade our mental health services. We need to strengthen primary care, and in order to put the fuel in the tank we need the proceeds of economic growth,” Stevens said. “Anything that puts [more investment] at risk is a deep concern.”
His comments followed a warning from Bank of England Governor Mark Carney that the Brexit could lead to a “technical recession” in the UK.
“When the British economy sneezes, the NHS catches a cold,” Stevens told the BBC on May 22, adding, “this would be a terrible moment for that to happen.”
A few days after Stevens’ comments, NHS Providers, a trade association representing more than 928,000 NHS staff members, released the results of a survey sampling leadership views. Forty-five chief executives and chairmen from the UK’s hospital, ambulance, mental health and community trusts reported their thoughts on the impact of a potential Brexit.
Three-quarters felt that leaving the EU would have a negative impact on the NHS as a whole. In terms of finances, 40% reported that leaving the EU would have no impact on funding, while slightly less (38%) felt that leaving would have some or even a very negative impact. However, four out of five respondents believed that leaving would have a negative impact on access to funds specifically for research and innovation and recruiting health care staff.
A total of 56,063 EU nationals worked in the NHS as of February, reported the Health and Social Care Information Centre, a government entity providing services to the NHS, in a recent NHS Workforce Statistics Report. Essentially, one in every 20 people within the NHS workforce claimed original citizenship in EU countries. However, the report said that records for about 95,000 NHS staff members — nearly 8% of total staff — did not contain useful data, with people either not asked to, or choosing not to, specify their nationality.
Britain has two years to work out arrangements with the EU. Though the fate of EU nationals living in Britain is unclear, repatriation could result in a NHS staffing shortage.
Before Thursday’s Brexit vote, a former health minister for the Labour Party backed leaving the union. Lord David Owen’s primary concern, repeated in various speeches and editorials, was to “take back control and protect the NHS from the EU.”
In particular, Owen argued that the Transatlantic Trade and Investment Partnership, a proposed trade and investment agreement between the United States and the EU, placed the NHS in danger.
On his website, Owen cited a legal analysis that states the partnership will pose a serious risk to the future ability of UK governments to regulate the NHS. Owen also said he believed that the treaty would open the NHS to competition.
“In truth, since 2002 the Labour government, the Coalition government and now the Conservative government have accepted an EU market in health,” he wrote. “If we vote Leave — we will be able to protect our NHS from EU interference.”
After the Brexit vote, his words spark hope. Whether it faces a staffing crisis or funding issues, the NHS — and Britain as a whole — undoubtedly will keep calm and carry on.
