Intended for healthcare professionals

Rapid response to:

Feature EU Referendum and Health

What would the NHS look like if the UK left the EU?

BMJ 2016; 353 doi: (Published 02 June 2016) Cite this as: BMJ 2016;353:i3027

Rapid Response:

Re: What would the NHS look like if the UK left the EU?

Both sides can be criticised for pedalling hypothetical estimates as fact, in this debate. The vote leave campaign suggests that the UK will be able to invest in public services as a direct consequence of leaving the EU. Where is the evidence for this? To use such a notion to persuade the public to vote out is irresponsible. It completely disregards the unknown long-term costs which would be attached to negotiating new trade deals with European countries. If we add this to the depreciating value of the Sterling and widely forecasted economic downturn resulting from Brexit, surely it cannot be said with any certainty that leaving the EU will result in a growth in NHS spending, particularly given recent (non-EU) trends in public sector government spending.

Second, the question of NHS privatisation. The article mentions TTIP - but as the esteemed professor McKee is quoted as saying, the biggest threat to NHS privatisation comes from within the UK. The NHS Support Federation found that 70% of NHS contracts awarded between 2013 and 2014 went to the private sector. In keeping with this trend, 88% of NHS trusts were forecasting a deficit for the last financial year. The role of the private sector has steadily been increasing through private-finance initiatives (PFI) under past UK governments. Increasingly, people are finding themselves at BMI healthcare, for an NHS appointment. How does this fit in with the EU? Under the burden of PFI debt, and a lack of adequate supply of NHS services (providing a breeding ground for the likes of BUPA and BMI), many expect the British healthcare system may move further toward privatisation in future, or at least remain in it's quasi-public state. In such a scenario, few trade barriers, low business costs and the free movement of people are all aspects of EU membership, which, (through competition) may help to regulate the currently unchecked, overpriced, growing, private insurance system in the UK.

Competing interests: No competing interests

04 June 2016
Vageesh Jain
Medical Student