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What would Brexit mean for the NHS, social care and disabled people?

Alongside the economy and immigration, the NHS has emerged as a key battleground in the EU debate. That is because the leave campaign decided early on to deploy the health service as a core argument in their plea to voters. Leave leaders Boris Johnson and Michael Gove have said consistently since campaigning began in April that Brexit could free up up to £8bn extra a year to spend on the NHS.

Leaving the EU would not, however, provide more money to spend on the NHS, according to the Institute of Fiscal Studies. “Rather, it would leave us spending less on public services, or taxing more, or borrowing more.”

Labour has dismissed the leave campaign’s claim of a bigger NHS budget as “misleading, simplistic and complete and utter nonsense”. Its own analysis concludes that a post-Brexit economic slump could force the government to cut the Department of Health’s budget by £10.5bn – the equivalent of every hospital in England having to shed 1,000 nurses and 155 doctors.

And last week, Tory MP and former GP Sarah Wollaston defected from the Vote Leave campaign saying its claim that Brexit would unlock up to £350m a week for the NHS “simply isn’t true”.

Once Britain’s EU rebate is factored in, the maximum extra that could be spent on the NHS would be £1.4bn, which would not even cover its £2.45bn deficit, say health academics at the London School of Economics and Imperial College London. In addition, the Economist Intelligence Unit (EIU) estimates that “should the UK vote to leave the EU, by 2020 healthcare spending would be £135 lower per head than if the UK were to remain in the EU. This is in addition to the £22bn efficiency savings the NHS [in England] is still expected to deliver by 2020.” The EIU has also cited other “substantial risks” to healthcare from Brexit. The future of the 10,000 NHS doctors and other health professionals who come from EU countries would become more uncertain. And the UK, a leader in the global pharmaceutical trade, would become “just one isolated market that cannot be entered using the EU centralised drug authorisation pathway”.

Britain would also no longer have any influence over the European Medicines Agency, the regulator that approves drugs for use within the EU. Medical research could be hit too, because Britain currently gains disproportionately from current funding streams.

The Faculty of Public Health also points out how EU membership has brought benefits such as cleaner air and water and pan-European joint working on threats to health that cross national borders, such as antibiotic resistance and combating pandemics.

The FPH lists other advantages too. “Health and safety at work legislation is basically European; likewise legislation ensuring the safety of food, medicinal products and medical devices. The social chapter mandates generous maternity and paternity leave, guaranteed holidays, the 48-hour working time directive; equal rights for part-time workers and protection against unfair dismissal. All are powerful social determinants of health from which UK citizens have benefited.

“Once outside the EU, the UK would be free to sacrifice them in the name of efficiency or austerity, or further develop worker protections if the political will is present”, it says. So leaving the EU would be bad for our health.

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