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Brexit is pushing the NHS to the brink. Time is running out to save it ǀ View

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Opinion piece by Hadley Stewart

Brexit’s infamous red bus was paraded up and down the UK, informing voters prior to the EU referendum that voting Leave would result in more money for our country’s cash-strapped National Health Service (NHS). Yet, since the fog lifted after 23 June 2016, it is becoming increasingly clear that the NHS may be worse off once we leave the European Union. A decline in the number of EU healthcare professionals coming to work in the country’s health system, uncertainty about medication supplies and a general anxiety about the future health of the NHS have alarm bells ringing up and down the British Isles.

The UK government’s mishandling of the situation has resulted in apprehension regarding the future functioning of the NHS. For a system that was already under pressure before the EU referendum vote, this is unacceptable. In fact, it is somewhat surprising that the government did not foresee this as being a potential consequence of a Leave result. Today, it is plain to see how this oversight and lack of forward planning will now cost the NHS and the people that use it every day.

Concerns about the future of the NHS are not new, but Brexit seems to have heaped added pressure on this struggling sector. Given the very real prospect of a ‘no deal’ Brexit, apprehension for the future of the post-Brexit NHS is at an all-time high. The most recent indication of the government’s sensitivities concerning the NHS after Brexit came when the news broke that blood donations in Dover and Folkestone would be halted in the weeks before and after the Brexit deadline. Concerns about the possibility of miles-long queues on roads leading to Channel ports prompted officials to announce the suspension of local collections. They quickly backtracked with the Department of Health saying these plans were not authorised. It was a move that some might argue demonstrates the government’s commitment to present false reassurances about Brexit’s impact the NHS, despite health officials having a very different stance.

A nervousness about Brexit is also palpable amongst frontline clinical staff. Many EU healthcare workers voted with their feet and walked out of the doors of their NHS hospitals and community centres for the last time in the months following the Brexit announcement. According to figures released from the Nursing and Midwifery Council last year, the number of EU nationals joining the register is in free-fall. This trend, coupled with a major haemorrhage of EU staff already working in the UK, suggests the health service’s staffing levels are in grave danger. Once the UK leaves the EU, depending on the withdrawal agreement, it may be near impossible for the government to reverse the downward trend in numbers of EU nurses coming to the UK.

The number of doctors working in the NHS might also take a hit once the UK-EU divorce is completed. Although the General Medical Council has said that the number of doctors joining their register from the European Economic Area (EEA) has remained steady since the EU referendum result was announced, it doesn’t mean the trend won’t change once the terms of a Brexit deal are finalised. The UK relies heavily on medics from abroad, with the Republic of Ireland, Greece, Romania, Italy and Germany being the top five nationalities on the country’s medical register. Currently, there are 22,000 EEA doctors registered to practice in the UK. Many of them are plugging holes left in less desirable, rural workplaces; areas that will doubtless be hit the hardest in the event of a mass exodus of EU doctors.

But even if there isn’t a mass-walkout of EU doctors and nurses once the Brexit deal is finalised, those wishing to come and work in the UK might be put off from doing so. Currently those coming from the EEA benefit from an expedited process of having their qualifications recognised. It is more than likely that this agreement will be changed, perhaps resulting in significant delays in European doctors and nurses joining their respective registers in the future. We could, therefore, see a situation where the UK cannot get enough doctors and nurses onto its register at the same rate that the UK is losing native healthcare professionals to places like Australia, New Zealand and America. The latter is a likely post-Brexit scenario, which would see staffing numbers plummet even further.

The contagious uneasiness surrounding Brexit has also spread amongst patients, with some expressing concern about medical supply chains being stopped or delayed in the weeks and months after the Brexit deadline. Patients living with chronic conditions have spoken out recently about their attempts at stockpiling medications, to avoid them running out in the event of a ‘no deal’ Brexit. It’s clear that the government’s reassurances of not needing to stockpile haven’t gone very far in alleviating patients’ concerns. Patients were simply misled by Leave campaigners, who failed to highlight the potential for medicine supplies being interrupted after Brexit, resulting in vulnerable groups of people not being able to access their treatments in a timely manner.

In order to assuage these concerns amongst patients and staff, the government needs to now demonstrate that it has a clear plan in place for the NHS for the days, weeks and months after the UK leaves the EU. Unfortunately, as there is still so much uncertainty hanging over parliament at the moment, it is unlikely that a long-term plan to manage Brexit-related healthcare issues will be put together in time.

The government needs to continue offering assurances to EU professionals working here; that their working lives won’t be impacted by Brexit and that any EU healthcare professionals thinking of coming to work in the UK are welcome. New partnerships should be built with other non-EU countries, for example, in order to recruit healthcare professionals rather than rely on the EU. However, this will be a lengthy process and won’t be in place soon enough to avoid a further potential dip in the number of healthcare professionals working in the UK.

The NHS remains close to the hearts of those living in the UK, but in the lead up to the Brexit deadline, it’s clear that many hearts have been broken. Brexit was presented by the Leave campaign as being a positive way forward for the NHS but it’s evident that this won’t be the case. The government has failed to lay out clear plans about how it will manage potential scenarios after Brexit, which could see a dramatic decline in the number of EU professionals coming to work in the UK, EU workers leaving the NHS and an interruption in life-saving medical supplies.

Time is simply running out, and with a shroud of uncertainty engulfing the NHS, it may be already too late to minimise the potential fallout.

Hadley Stewart is a London-based writer, broadcaster and medical journalist

Opinions expressed in View articles are solely those of the author.