We often talk about the pain and distress caused by losing our job or not having enough money to see us through the week. If it’s a consequence of Brexit, this will probably be declared as being a small price for someone else to pay for the imagined benefits of leaving the EU. To such people, Brexit means that Britain can halt immigration and have money left over to spend on the NHS. But not only that has now been exposed as a false promise, but it has also revealed the real physical pain that will be caused for many by its damage to the NHS.
Without any government commitments on residence, Brexit is clearly bad news for EU qualified medical professionals who want to live in Britain and build a career in the NHS. But it is looking to be even worse news for those of us who cannot afford private medical care and rely on the NHS for all of our medical needs. We may not be personally affected by the anticipated job losses in a Brexit battered Britain, nor may we be worried about substantial price increases arising from the pound’s loss of value, but we will all feel the effects of a NHS that is starved of funds and manpower.
NHS figures already acknowledge that Brexit will result in a loss of staff originating from the EU. Around 4.5 per cent of the total NHS workforce of about 1.3 million comes from the EU. They work as doctors, nurses, health professionals such as radiologists and physiotherapists and also as the lower skilled health care assistants who keep the hospitals and care homes running. The NHS admits that it currently needs to recruit another 40,000 nurses. Nobody knows where they might be coming from but we can be pretty sure that it won’t be from the EU. Since the Brexit referendum, the NHS has confirmed that 10,000 staff from EU countries have already left and there is nothing to suggest that this trend will be reversed. In fact, since the referendum, there has been a 96 per cent drop in the number of nurses from the EU applying to work in the NHS. The newly hostile attitude to immigrants and the low value of the pound now make Britain an unattractive destination as a place to live and work. This is likely to persuade health industry workers from the EU and elsewhere in the world to keep away from the UK for the foreseeable future.
To some, the idea of 4.5 per cent of the NHS workforce possibly leaving to seek employment elsewhere may not sound like a big disaster as that figure can probably be absorbed. Unfortunately, that 4.5 per cent is not spread evenly across the country but is concentrated around London and the South East. The region’s health care network is therefore disproportionately dependent upon EU staff which means that any absence or reduction in workers will be far more noticeable.
It is important to remember that a high percentage of people attending hospital do so because they are in some form of physical pain. A broken ankle, a worn hip joint, a cancer that needs surgery, agonising kidney stones. Unlike the emotional pain of redundancies, these afflictions really hurt and due to the predicted staff shortages and funding cuts caused by Brexit, these people can expect to be enduring their pains for significantly longer.
A recent article in The Lancet has explained that after a ten-year financial squeeze imposed by the Conservative government, the NHS is not in any condition to put up a robust defence against its difficulties. Yet the effect of the NHS losing staff from the EU will mean more than just a reduction in manpower. For many of the NHS’s customers, it will amount to a genuine continuation of physical pain. The patients who found themselves waiting for hours on trolleys in the corridors outside A&E centres last winter can attest to knowing something about real pain. The signs are now that in future, patients must be resigned to even longer waits.
When a hospital is short of resources, whether staff or funding, everything slows down. If it relates to the predicted loss of the 10 per cent of doctors who come from the EU or of the lower skilled health care assistants who keep the hospitals functioning, any reduction in their number will affect the hospital’s ability to treat its patients.
It is important to note that this is not Project Fear. Just do the maths. When, due to its inability to recruit or retain staff from the EU, a care home is unable to take-in more residents, patients without independent support cannot be moved from their hospital beds. This means that the trauma victims in pain who are waiting in a hospital’s A&E must remain on their trolleys until a bed becomes available upstairs.
The same predicament affects local GP practices. If two GPs in a small surgery can deal with around 100 patients per day, there is no leeway if one of them decides to return to their home in the EU. Replacements can take months or years to find and the remaining doctor has no capacity for seeing more people in one day. This means that potential patients may be waiting for weeks of pain, discomfort or worry before they can have an appointment with a GP.
Watching loved-ones waiting in pain for an operation that is repeatedly postponed is likely to become a more real consequence of Brexit as the NHS struggles to cope with the increasing demand caused by an ageing population. As the Lancet article pointed-out, being a tax-funded system, any economic shocks that reduce tax revenues will have an impact on the NHS. Its funding may be ring-fenced by the Treasury at present but two thirds of NHS Trusts are already in deficit. They cannot be expected to compensate for the post-referendum devaluation of the pound which is increasing the cost of medicines and vital equipment. This can mean that potentially life-saving drugs may not be available to those who need them and their pain and suffering will continue.
The European Medicines Agency (EMA) oversees medicines regulation in Europe and has become one of the first organisations to announce its plans move back to Europe due to the UK’s intention to leave the EU. Once a new medicine is approved by the EMA it becomes immediately available for clinical use throughout Europe. When the UK leaves the EU it will no longer have access to those new medicines and must quickly establish an approvals organisation of its own. This has happened to Switzerland which has discovered that the majority of new medicines only gain approval for use in the country after a six-month delay. Pharmaceutical companies prefer to have their products approved for the big markets such as the USA and the EU first. Small markets such as Switzerland and, potentially, the UK have a lower priority for costly and time-consuming approvals processes. In medicine, a six-month delay before a potentially life-saving drug becomes available is likely to be too long to wait for many families. Britain will be at the back of the queue for new medicines and is likely to remain there indefinitely.
When Nigel Farage surrendered to his lack of will-power and resumed smoking cigarettes, his excuse was that, thanks to his detailed knowledge of modern medicine, he believed that “the doctors have got it wrong about smoking.” He must now be hoping that he is right and that he will never need to call-upon the services of the NHS. However, as the instigator of Brexit he is probably fully aware of the consequences that his actions will have for ordinary people. If he subsequently discovers that doctors really did know more about lung disease than he did, we must not be surprised if we find that he has gone private.