Feature EU Referendum and Health

What Brexit would mean for employment of doctors

BMJ 2016; 353 doi: https://doi.org/10.1136/bmj.i2928 (Published 24 May 2016) Cite this as: BMJ 2016;353:i2928
  1. Anne Gulland, freelance journalist, London, UK
  1. agulland{at}bmj.com

Anne Gulland assesses how leaving the EU would affect working conditions

Would working hours change for doctors?

The European Working Time Directive is the key piece of European Union legislation affecting doctors’ working hours, limiting the working week to 48 hours. The regulations were implemented in 1998, but all junior doctors were not included until 2009.

Some specialties, particularly surgeons, have been concerned that the 48 hour week limits training. Doctors can opt out of the 48 hour limit, and a Royal College of Surgeons (RCS) review of the directive called for more widespread use of the opt-out.1 The UK is one of the few EU countries to use the opt-out.

Jason Heyes, professor of employment relations at the University of Sheffield, believes that the working time regulations, the UK law enacting the EU directive, is one of the employment laws most likely to be repealed or reformed if we leave the EU.

“The regulations are a particular bugbear as they’re seen by many Conservative politicians as an unnecessary and damaging burden on employers,” he says.

However, the British Medical Association is likely to resist any large increase in hours worked. In a statement published at the time of the RCS review, Mark Porter, BMA council chair, said, “No one wants a return to the days when doctors were working dangerously long hours.”

But Heyes adds, “Without the protection of the legislation, changes in working time and holidays would probably play out differently sector to sector. If the legislation is repealed it might reduce the bargaining strength of trade unions, and workers in non-union environments would have no protection.”

Would retirement age and pensions change?

Doctors with an NHS pension are unlikely to see changes if we leave the EU. The rules of the NHS pension scheme are laid down in regulations agreed by parliament, and pensions are funded by taxation rather than relying on investments. Doctors with private pensions may be affected, however. A report from the Society of Pension Professionals said the resulting uncertainty after a vote to leave would be detrimental to financial markets and therefore pensions in the short term. But in the long term Brexit could “create new opportunities for UK pensions to avoid potentially crippling liabilities in the future.”2

Like most of their fellow European citizens, UK workers will see their retirement age increase over the coming years. By 2028 it will be 67, rising to 68 by 2046. The UK already has one of the highest retirement ages in Europe, and the trajectory for retirement age is only upwards, regardless of whether the UK is a member of the EU.

Would maternity rights change?

Women in the UK have the second longest maternity leave entitlement in the EU. Mothers are allowed to take 52 weeks’ leave (39 weeks of which is paid), well above the EU statutory minimum of 14 weeks. However, it is harder to compare maternity pay as EU countries’ policies vary greatly.

Like most occupational maternity schemes the NHS maternity scheme is more generous than the statutory scheme. Because this is an NHS agreement it is unlikely to be affected by Brexit.

However, other social protections have been introduced by EU law, such as the right to parental leave. This directive, implemented in the UK in March 2013, gives mothers and fathers the right to take 13 weeks’ unpaid leave per child before its 5th birthday. It also gives workers rights to paid leave to look after a sick child or other dependant, although it does not specify how much time should be taken.

The EU has also introduced laws ruling against discrimination on the grounds of disability, age, religion, and sexual orientation. However, Heyes believes there is little appetite in government to roll back on any of these social protections.

“Once these things become embedded and employers start to change their procedures they don’t necessarily clamour for legislation to be repealed,” he said.

Would Brexit affect my job security?

Another law based on an EU directive that Heyes believes could be a target for reform or repeal in the event of Brexit is the law governing agency workers. These regulations give temporary workers, including locum doctors, the same working conditions and employment rights as a permanent employee. Again, they are seen by employers to present an unnecessary burden.

In a report assessing the effect of the regulations a year after their implementation the Confederation of British Industry said that businesses’ costs had increased while “positive impacts for temps were unclear.”3

Gisela Stuart, Labour MP for Birmingham Edgbaston, who is campaigning to leave the EU, said: “Most of our work place protections were introduced by the House of Commons before our membership of the EU or go further than the protections in other EU states. Britain has a very strong tradition of institutions in civil society–the trade unions, labour movement, the voluntary sector and churches–campaigning for the advancement of social rights and providing a check on attempts to erode them.”


  • Competing interests: I have read and understood BMJ policy on declaration of interests and have no relevant interests to declare

  • Provenance and peer review: Commissioned; not externally peer reviewed.


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