George Stevenson looks at the prospects for the NHS post-referendum, following that message on the red bus.
It’s no secret that one of the most potent messages in the EU referendum was the suggestion (promise?) that UK contributions to the EU budget could be diverted to fund the NHS. The ‘£350 million per week’ figure has almost taken on a mythical status, and the director of the ‘Leave’ campaign has admitted that without it, ‘Leave’ may not have won the referendum. Who knows what the truth is, but maybe such an emotionally-loaded statement persuaded some voters who otherwise didn’t have a strong view either way to back ‘Leave’.
However, 18 months later, there seems little sign of the money, and the government’s own economic analysis (such as it is) suggests that in any scenario, leaving the EU will result in the economy being smaller. As a result, there will be less money available for any public services, not more. Brexit also poses an even more fundamental threat to the NHS.
Put simply, there just aren’t enough UK-trained doctors coming through the training system. The training period is long, junior doctors have to work long and unsocial hours, and whilst the pay for doctors just out of medical school isn’t bad, it’s not very high when compared to some other jobs which would be suitable for someone of that age. Not surprisingly, many drop out of clinical medicine, and move to jobs that pay better or offer better working conditions. Jeremy Hunt’s ideological battle with the junior doctors will only have exacerbated the position. Exactly the same considerations apply to nursing staff as well- many nurses are from overseas, and the dropping of bursaries for nursing students has made studying for the profession less attractive for UK applicants.
The solution up until now has been to recruit doctors, at both junior and consultant level, from overseas. Freedom of movement within the EU has meant that it has been easier to recruit from elsewhere in the EU, as successful candidates don’t have to apply for visas or other authorisations. However, the number of applicants from within the EU has declined rapidly recently, again, not surprisingly, and there is some evidence that doctors working here are now starting to return to their original countries as a result of the uncertainty and downright hostility which Brexit has brought about.
At the same time, it is still difficult to recruit from outside the EU, as a concentration on reducing immigration has made it much more difficult for successful candidates to obtain visas or work permits. Even if they are successful, it can take a long time for all the necessary authorisations to be sorted out, leading to a constant struggle to keep up with a turnover of staff.
To sum up, Brexit will reduce the money available for the NHS, meaning it won’t be possible to improve junior doctors’ pay and conditions to make it a more attractive profession. At the same time, it won’t be possible to fill the gap by recruiting doctors from overseas. How do you feel about your claim, now, Boris? Let’s hope you don’t fall ill over the next few years.
The solution, of course is to cancel Brexit, whilst developing proper long-term plans for funding the NHS. We might call it the ‘Adonis Doctrine’, or the ‘Cable Doctrine’. We can continue recruiting skilled doctors (from within the EU and elsewhere) to fill the gap, whilst working out how we can fund the NHS properly, and improve pay and conditions for junior doctors so that we’re not so reliant on overseas recruitment in the future.
Now that would be in the spirit of the founding fathers of the NHS!