Dr Kailash Chand OBE, Deputy Char of BMA, comments on the latest political developments and its impact on the NHS. The NHS faces disintegration in the wake of the vote to leave the EU. The prime minister-select Theresa May is being projected as a moderate, but if you look at her record, she is anything but, particularly in her views on immigration and the NHS. She is a staunch supporter of removing NHS restrictions on treating private patients and over the course of her six-year tenure as Home Secretary her contentious rhetoric, aimed at pacifying UKIP swing voters, stoked the anti-EU fires long before Boris defected to Leave. She also introduced a £200 annual ‘immigrant health surcharge’ for those in possession of work visas. May is also the architect of the minimum salary for immigrants who have already lived in the UK for five years to £35,000, if they simply want to continue to stay. This could hugely impact on the NHS recruitment
In voting to leave the EU, the UK has embarked on a journey without the foggiest idea of the road ahead. No surprise, Brexteers have already started to row back on two of their most hyped campaign promises: reducing EU migrant numbers and boosting investment in public services with the money saved from Britain’s current EU contribution. Leave EU campaign, touted a figure of £350 million which, they claimed, UK paid to EU every week and would be freed up after Brexit to be invested in NHS. Of course, it was an open secret all along that both these pledges were based on dodgy ‘facts’, but they continued to peddle lies to his gullible followers. It is these lies that are now coming home to roost.
The entire referendum exercise, wholly unnecessary to begin with, has not only damaged Britain’s relations with Europe, but will diminish its role in international affairs and weaken its economy, tipping it into another recession, resulting in starving funds and resources to public services, particularly the NHS. Our underfunded NHS now faces potentially catastrophic financial consequences of Brexit. Any further cuts to the NHS budget would start to have a significant direct impact on front line services.
The vote for Brexit and the economic and political instability it has ushered in, is a recipe for huge risk, and uncertainty for NHS. I fear for the future of the NHS. I fear for those who need to use it – the old, vulnerable and sick. I fear for those who work in the NHS. The events of last week have not changed the challenges facing the NHS one bit, but they have likely made it much harder to meet them. What we are left with is confusion and uncertainty. The NHS is at a crossroads in so many areas that it is a recipe for indecision, which in turn could harm the service and those it serves.
Cuts, in the name of ‘efficiency savings’, have eaten away at the NHS to the point where it is down to its bare bones.
Health spending is facing almost unimaginable cuts over the next five years. Every health think-tank has done its best in recent months to sound the alarm. This isn’t shroud-waving – the figures show the NHS is on its knees. Faced with a collapsing economy and an NHS struggling to control increasing demands, the Treasury might finally lose patience and take an even firmer grip on the services’ finances. If the nose diving of economy, as predicted, come true, the Chancellor of a new administration could even seek to end the service’s already flawed funding ring-fence.
The NHS England chief executive, Simon Stevens, at the NHS confederation meeting, warned that there would be what he referred to as a “re-set on the money” for the NHS in July. Mr Stevens also stressed that he accepted how “bloody tough” the coming years would be given the funding situation.
Simon’s political influence may diminish significantly with the departure of David Cameron and George Osborne, who oversaw his appointment, and with whom he has worked closely. His much acclaimed ‘five year forward plan’ is in danger of becoming redundant even before it started working.
The sizeable negative impact on the economy will have an inevitable, damaging knock-on effect on our ability to fund the NHS and social care. The National Health Service will face budget cuts, falling standards and an exodus of overseas doctors and nurses.
It’s not a secret that the NHS is heavily reliant on skilled overseas workers in order to keep it afloat. Currently about 10% of doctors come from the EU. Fifty-five thousand of the 1.2 million staff in the NHS are citizens of other EU countries. The most toxic consequence of leaving the EU will be to discourage this EU talent from working in an NHS already suffering from a recruitment and retention crisis.
A vacuum of political oversight in the coming months means reduced access, safety and quality of patient care. The repercussions of Brexit, with leadership of the likes of Theresa May or Michael Gove (on record as wishing to replace the NHS with US style insurance system) could be so catastrophic that it would destabilize the NHS to the point it would disintegrate.
Theresa May is being projected as a moderate, but if you look at her record, she is anything but, particularly in her views on immigration and the NHS. She is a staunch supporter of removing NHS restrictions on treating private patients and over the course of her six-year tenure as Home Secretary her contentious rhetoric, aimed at pacifying UKIP swing voters, stoked the anti-EU fires long before Boris defected to Leave. She also introduced a £200 annual ‘immigrant health surcharge’ for those in possession of work visas. May is also the architect of the minimum salary for immigrants who have already lived in the UK for five years to £35,000, if they simply want to continue to stay. This could hugely impact on the NHS recruitment .
The pre-vote claims by Leave campaigners of a larger NHS budget were misleading, simplistic and complete and utter nonsense. As a matter of fact, on the contrary, the economic downturn predicted would starve the NHS of necessary funding. Leaving EU would also lead to further shortages of key NHS staff such as doctors, nurses and care workers, affecting most of essential services in the NHS. My real worry is, a more, right-wing government, would use NHS funding crisis to tell British public that a free universal health care is not affordable, and wash its hands of the NHS.