Parties may lead to his downfall, but is this the worst of what Johnson has done?

Dear Editor

I should like to respond to the article “Parties may lead to his downfall, but is this the worst of what Johnson has done?”[1], published on the 24th January 2022.

In respect of Brexit, it is impossible to attribute responsibility for it to one particular individual and so therefore to try and castigate Boris Johnson for his involvement in it only has significance as he is presently the Prime Minister.

In January 2014, the NHS had 985,388 staff, and of these there were 101,541 doctors and 300,537 nurses (including 21,136 midwives). Of the total workforce, 778,595 (79.0%) of the staff were British. Of the remainder, 37,992 were from EU/EFTA countries. As Ireland has a specific set of Immigration rules in relation to the UK to the rest of the EU, their number, 11,060, must be subtracted from that figure. Accounting for this, 26,932 (2.7%) NHS staff were from EU/EFTA countries, excluding the Republic of Ireland. Of the doctors, 69,256 (68.2%) were British. Of the remainder, excluding the 1,800 (1.77%) doctors from the Republic of Ireland, 6,756 (6.65%) doctors were from EU/EFTA countries. Of the nurses and midwives, 231,351 (77.0%) were British. Of the remainder, 8,063 (2.68%) were from EU/EFTA countries. This number excludes 4,143 nurses and 305 midwives, (together, 1.48% of the total) from the Republic of Ireland[2].

The relevance to the year 2014 is that it is the year where the first material steps towards Brexit took place. In May 2014, the UK Independence Party (UKIP) won the European Elections[3]. The election result was widely described in the media as a “political earthquake” [4] [5] [6] and it was the first time that a party other than the Labour Party or the Conservative Party had won in a UK wide election since 1906. The manifesto produced by UKIP states their aims as wanting to leave the European Union and wanting to end Free movement, which would withdraw the right for EU citizens to live and work in the UK[7]. At the time, Boris Johnson was the Mayor of London and had yet to give an opinion on Britain’s continued membership of the European Union.

This followed a pledge made in 2013 by British Prime Minister David Cameron who said that if he was Prime Minister after the next election, he would hold an in/out referendum on membership of the European Union[8]. This pledge was included in the Conservative Party Manifesto for the 2015 General Election[9]. The Conservatives subsequently won the General Election and, following a negotiation on a new relationship with the European Union, held an in/out referendum on the 23rd June 2016, with 51.9% voting to leave. Article 50 of the Treaty on the functioning of the European Union (also known as the “Lisbon Treaty”) was triggered on the 29th March 2017. This was set to expire with the United Kingdom leaving the European Union on the 29th March 2019. This deadline was delayed twice. During that delay the Brexit Party won the 2019 European election. The United Kingdom formally left the European Union on January 31st 2020. Freedom of Movement, the right for EU citizens to live and work in the United Kingdom, ended on December 31st 2020.

This does not apply to citizens of the Republic of Ireland. Following Irish Independence in 1922, a Common Travel Area was imposed throughout the UK, the Republic of Ireland and Crown Dependencies. As is stated on the UK Government’s website “British and Irish citizens can move freely and reside in either jurisdiction and enjoy associated rights and privileges, including the right to work, study and vote in certain elections, as well as to access social welfare benefits and health services.” This is not dependent on EU membership[10].

“The supply of EU health workers on which the NHS has long depended has reduced markedly…” the article claims. This is totally incorrect. The number of staff from the European Union as a proportion of all staff has risen from 4.8% in 2014 to 5.4% in 2021. The percentage of doctors from the European Union has increased from 8.4% in 2014 to 8.7% in 2021. While nurses from the EU made up 7.4% in 2016, and make up 5.6% now, this is still up from 4.15% in 2014[11].

Even if there had been a mass exodus due to Brexit, one would presume that the seven years from the start of it to its conclusion should have been long enough for the NHS to mitigate the effects of it, which appears to be the case when one see the numbers of non-EU nationals now working for the NHS. There is, of course, the obvious questions as to why we simply can't train more Healthcare Professionals in the UK and why we haven't been doing that since the political shift of 2014 but that is a different discussion.

References

1. Wenham, C., McKee, M., Burgess, R. A., & Yamey, G. (2022, January 22). Parties may lead to his downfall, but is this the worst of what Johnson. British Medical Journal(376), o196. doi:10.1136/bmj.o196
2. NHS. (2018, January 31). Hospital and community health services staff by nationality and age band, January to December 2014. Retrieved January 30, 2022, from NHS Digital: https://digital.nhs.uk/data-and-information/find-data-and-publications/s...
3. European Parliament. (2014, September 22). Results of the 2014 European elections - Results by country. Retrieved January 31, 2022, from European Parliament: https://www.europarl.europa.eu/elections2014-results/en/country-results-...
4. BBC. (2014, May 26). Eurosceptic 'earthquake' rocks EU elections. Retrieved January 31, 2022, from BBC News: https://www.bbc.co.uk/news/world-europe-27559714
5. Wintour, P., & Watt, N. (2014, May 26). Ukip wins European elections with ease to set off political earthquake. Retrieved January 31, 2022, from The Guardian: https://www.theguardian.com/politics/2014/may/26/ukip-european-elections...
6. Collins, C. (2014, May 26). Political earthquake in Brussels. Retrieved January 31, 2022, from Deutsche Welle: https://www.dw.com/en/political-earthquake-in-brussels/a-17664127
7. UKIP. (2014, April 22). UKIP European Election Manifesto 2014. Retrieved January 31, 2022, from Maniffesto: http://www.maniffesto.com/documents/ukip-european-election-manifesto-2014/
8. BBC. (2013, January 23). David Cameron promises in/out referendum on EU. Retrieved January 31, 2022, from BBC News: https://www.bbc.co.uk/news/uk-politics-21148282
9. The Conservative Party. (2015, April 15). The Conservative Party Manifesto 2015. Retrieved January 31, 2022, from Theresa Villiers MP: https://www.theresavilliers.co.uk/sites/www.theresavilliers.co.uk/files/...
10. Cabinet Office and Home Office. (2019, February 22). Common Travel Area: rights of UK and Irish citizens. Retrieved January 31, 2022, from Gov.uk: https://www.gov.uk/government/publications/common-travel-area-guidance
11. Baker, C. (2021). NHS staff from overseas:. Westminster: House of Commons Library. Retrieved January 31st, 2022, from https://researchbriefings.files.parliament.uk/documents/CBP-7783/CBP-778...