As the debates over the crisis in the NHS and the forthcoming EU referendum rage, the two seem to have become interlinked. Though Britain has been a member of the European Union for more than 40 years, those in favour of British withdrawal from Europe have begun to argue that the NHS is unravelling under the weight of immigration into the UK due to EU membership. In fact, the reasons for pressure on the NHS are much more simple.
It is true that migration is increasing. Net migration into the UK was estimated at 178,000 in 2014. The NHS, as it is currently funded, cannot cope with such an increase in demand on its services unless supply is equally elastic. In other words, as the population grows, so must public spending on the health service.
But that hasn’t happened. What should be a relatively healthy relationship between population size and government funding is amounting to barely a casual acquaintance. Though immigration to the UK from the EU has increased, NHS funding has not. And the NHS financial black hole – predicted to be £22bn by 2020/21 – is the single most important reason for health systems struggling to cope.
Blaming this on tax-paying migrants is not only divisive, but it ignores the more chronic problems of an under-funded NHS.
Some Brexiteers continue to argue that leaving the EU will save money, because we will stop paying into the union, and that funding can be injected into domestic public services. Yet countries such as Norway and Switzerland, who have no say in EU decision-making, must pay similar amounts to fund their cumbersome arrangements with the EU market.
What about those EU “free-riders”, who come to the UK solely for the benefit of NHS treatment?
In 2013 the Department of Health estimated the total cost of EU health tourism – where people travel to the UK specifically for treatment which they are not entitled to at home – at between £60m and £80m per year. This compares to the annual NHS budget of £113bn (less than 0.1 per cent), and under current agreements with the EU, the NHS can partially recoup the costs of treatment from the patient’s country of origin.
Whether you agree with it or not, health tourism is not to blame for the woes of the NHS. Leaving the EU would barely cause a ripple in the NHS pool of debt. Meanwhile, the NHS actually benefits from EU membership through direct financial aid. Since 2003, €450m has poured into the UK to finance a wide range of health projects.
The Eurosceptic brand of pessimism will have you believe that EU migration is only detrimental to the success of the NHS. A 2015 report published by the Health and Social Care Information Centre, however, found that 8,307 out of 106,638 doctors (8 per cent) working in the NHS in 2014 originally qualified in the European Economic Area, excluding the UK.
The British healthcare system is facing unprecedented problems with recruitment and retention of its own domestic trainees. Low workforce morale and poor working conditions are profoundly worrying with a poll of over 4,000 young medics showing that more than 70 per cent would prefer to work as a locum, move abroad or change career under the new junior doctor contract proposals.
Such uncertain conditions in the NHS indicate that in the short term the UK healthcare system will be dependent upon foreign trained healthcare professionals – including those from elsewhere in the EU.
In 2012, the EU won the Nobel Peace Prize, an acknowledgement of its vital global role in protecting human rights. Its collaborative, humanitarian ambition transcends local governments and permeates through national law. Policies such as the EU Working Time Directive protect the rights of those who work in healthcare, and the EU Clinical Trials Directive is vital for the advancement of medical research in the UK.
The EU is not the cause of our financially malnourished NHS, but has formed a part of many of its successes. Clamping the cord connecting the UK and the EU may be described as a quick-fix, but it is not the way to stabilise our turbulent healthcare system.
Vageesh Jain is a medical student at King's College London and was the winner of the 2015 Policy Idol competition for his work on tackling Ebola
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