Brexit and the NHS: what now for digital health?
The country is in turmoil. The outstanding sense just days after UK public opinion had won the right to leave the European Union, is that nobody is sure of anything regarding how things will change over the coming months and years until the Brexit move is officially triggered and completed. There is certainly a lot of dismay and sharing of a sense of shock – especially among those who voted to leave while not believing it could even happen. The driving force for this referendum has many reasons behind it, not all explicit and not all based on corroborated facts.
Promises like “£350M/week to the NHS”, which though not proposed directly by Nigel Farage, leader of UKIP, was explicitly used in the Leave campaign and has already been retracted as a “mistake” by him and as “not guaranteed” by the others in the Leave camp, just hours after the UK successfully won a Brexit vote on June 24th.
Conflicting advice regarding our vote to leave, states that from the Leave perspective, the NHS will get £8bn/year back because of not having to pay the currently required fees to Brussels in order to maintain EU membership. Set against this, is a slightly higher amount of money (£10.5bn) that the Labour government, mostly representing the Remain campaign, suggests will be needed if the UK leave the EU – potentially cutting the Department of Health’s budget severely and resulting in the loss of around 1000 nurses and 150 doctors. It’s a mess.
Quite apart from the fact that by making partnerships and working relationships with our progressive European cousins much harder to maintain and align with, the NHS is at danger of being cut off from the talent and high-quality of healthcare that has been accessible across borders in both directions during the forty-odd years that the UK has been in the EU.
Nobel prize Laureate and president of the Royal Society, Venki Ramakrishnan, has stated that the EU have provided money, some £1bn/year, that is essential to supplement UK research funds in the area of science and technology. Figures state that 16% of Britain’s university researchers are made up of members from other EU countries. All indications now, are that the NHS will not have the same level of access to this pool of influential thinkers, technological and evidence-based talent once the transition is done – not without attaching a hefty price-tag in order to do so.
Paul Nurse, another Nobel prize winner and director of the Francis Crick Institute, states: “This is a poor outcome for British science and so is bad for Britain,” he said. “Science thrives on the permeability of ideas and people, and flourishes in environments that pool intelligence, minimizes barriers and are open to free exchange and collaboration.”
The cost of this uncertainty and declaration of intent to shun one of the largest free trade agreements available to us, will of course create huge ripples throughout every facet of society and industry both in the UK and the EU, with the NHS as one of the main targets of the inevitable cuts and re-structuring.
The recently planned NHS England offering of free medical devices and apps to all of the UK’s population, as was discussed in an earlier article, may come under a renewed threat. Simply deciding who that population includes may be tricky enough to start with, let alone justify the extra cost to provide the tech in the light of these changes.
The new “autonomous” UK may see a radical change in population demographic, as those who had been contributing to the economy by working and providing unique skills and talents from other EU countries will likely leave the UK and instead, all the millions of British expats, many of whom, have quite rightly, exited the employment market in order to retire, may be forced to return to the UK for fear of losing their pensions. This will simultaneously bump up the aging population and reduce the proportion of tax-paying citizens, which would’ve provided much needed income and present an extra pressure on the NHS for healthcare demand than ever before.
If this does happen, ironically novel technological solutions would be needed more urgently than ever before to help stave the gaping wounds from the NHS budget cuts and every penny will have to be spent wisely. Whether this can be achieved will have to be seen and all eyes are on the brand new government in the weeks and months to come.