Intended for healthcare professionals


NHS should be “first port of call” for potential Brexit savings, says Hunt

BMJ 2017; 359 doi: (Published 08 November 2017) Cite this as: BMJ 2017;359:j5191
  1. Abi Rimmer
  1. The BMJ

The NHS should be first in line to receive any financial savings that come about as the result of Britain leaving the European Union, England’s health secretary has said.

Speaking at the NHS Providers conference in Birmingham on 8 November, Jeremy Hunt said that, despite no government commitment to increase NHS funding because of Brexit, this should happen if possible.

Referring to a proposal by the Vote Leave campaign to increase NHS funding by £350m (€396m; $458m) a week if Britain left the EU, Hunt said, “As you know, it wasn’t a government promise; it was a promise by the Leave campaign, but what I very much agree with is [that] if there is a Brexit dividend [and] if we end up having less pressure on public finance because of not making contributions to the EU, I believe that the NHS should be the first port of call.”

He added, “[This is] because it is the most important public service, it is the public service the British people care about the most, and, when they voted to leave the EU, in many people’s minds it was one of the reasons why they wanted to switch resources.

“I think we do have to bear that in mind, but there is a big ‘if,’ which is that we are in the middle of these difficult negotiations and we don’t yet know what the outcome will be.”

Speaking at the same event, Simon Stevens, chief executive of NHS England, called for the Vote Leave campaign’s proposal to be honoured. “The NHS wasn’t on the ballot paper, but it was on the ballot bus: ‘Vote leave for a better funded health service, £350m a week,’” he said.

Rather than criticising the campaign proposal, Stevens said he thought that the public just wanted to see it honoured.

“By the end of the next financial year for the NHS, March 2019, the United Kingdom will have left the European Union,” he said. “Trust in democratic politics [would] not be strengthened if anyone now tried to argue, ‘You voted for Brexit, arguably for a better funded health service, but arguably because of Brexit you now can’t have one.’”

Responding to questions from the floor, Stevens added, “I think that what the Brexit referendum shows, as attested to by those who ran the campaign, was there was a strong and enduring appetite in this country for a properly funded health service, and that was partly expressed through the Brexit referendum result.”

Earlier in his speech, Stevens had warned that the NHS could not continue to function at the same level with its current funding. He said, “The budget for the NHS next year is well short of what is currently needed to look after our patients and their families at their time of greatest need. After seven years of understandable but unprecedented restraint, on the current budget outlook the NHS can no longer do what is asked of it.”

Stevens said that current funding constraints meant that it would be hard to expand mental health services and improve cancer care. “Crucially, on the current funding outlook the NHS waiting list will grow to five million people by 2021,” he warned. “That is an extra one million people on the waiting list, one in 10 of us waiting for an operation—the highest number ever.”

Nigel Edwards, chief executive of the Nuffield Trust, said that Stevens was right to draw a link between Brexit and the NHS.

“The reality is that Brexit is likely to have a profound impact on our health service,” he said. “Without a deal we could be facing an exodus of clinically trained staff, disruption to supplies of medicine and equipment, and additional costs of £500m to pay for the care of returning expat pensioners.

“We have a duty to negotiate a Brexit deal that is in the interests of patients and NHS staff alike.”

Chaand Nagpaul, BMA council chair, said that the promise of extra funding for the NHS had been a key issue during the Brexit referendum. He said, “With the budget only weeks away, bold action to deliver on this pledge, as proposed by Simon Stevens, is urgently needed and has the backing of the BMA.

“This is vital in order to address the current crisis in our health service, protect and improve patient care, and put the NHS on a sustainable footing for the future.'”