What might Brexit mean for the NHS?

 The Brexit event is huge, and will surely impact the NHS significantly.  In the first instance the economic downturn, which has already begun, will mean less UK tax revenue and probably a cut in expenditure on the Health Service.  This is likely to mean that the £119 billion a year that has been negotiated with the Treasury by the NHS for 2020 probably won’t happen, let alone the much debated “extra £350 million a week” (£18 billion a year) that the Brexiteers said would be spent on the NHS.  But there will be many more effects of the plebiscite beyond just a squeezing of NHS finances.

For one thing we know that in a recession there will probably be many more demands on the health service as a result of unemployment, mental health issues, and possibly an increase in crime.  These will put pressure on the NHS at a time when it is least able to cope.  There will also be pressure because of a departure of some foreign workers – this will happen because those EU workers who already feel less welcome may leave the country, but also because their UK earnings when translated into their home currency are already 10-15% lower as a result of the brexit-related devaluation of sterling.  And that is before considering the effects on finding good NHS employees as a result of a formal curtailing of the free movement of labour.

The NHS will also see some of its costs rise – the direct effects of the currency devaluation will be that machinery and drugs bough from abroad will go up in price but the indirect effect will be pressure on wages.  As Doctors, nurses and other staff see their costs of living go up from the devaluation (petrol, electronics, holidays for example) they will push hard for wage increases.

Research too will be hit hard.  I recently met a health researcher dependant on EU funding who said that his funding was cut on the Friday 24th June – immediately after the vote itself.  European funding has over recent years become a main driver of UK research and this is one field where the UK has been a leading world player – without this funding we are sure to lose prominence as well as effectiveness.  More immediately the EU’s drug testing facility is in the UK and will surely now relocate to Europe costing about 600 direct jobs and with many more indirect effects.

Pharmaceutical firms are big generators of foreign earnings but it is to the UK’s advantage that some of the largest pharma companies are UK-based, including GSK and Astra Zeneca.  Leaving the EU might well tempt these and other companies to look at relocating to an EU country such as Ireland or even Germany.

With the UK population ageing rapidly and pressure on the NHS from increasing numbers of older people with chronic diseases it is tempting to say that the older generations who voted heavily for Brexit have brought this crisis upon themselves, but on the other hand we have to start from where we are and the role of the NHS has always been to work for the health of the population regardless of other considerations.  Let’s hope that the NHS isn’t overly optimistic over the effects of Brexit and that ALL effects of leaving the EU are taken into account in their plans for the future.

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