With just over a month to go until the European Union (EU) referendum, the debate raging over whether to leave or remain is heating up, and every day brings news of yet another public figure or organisation wading into the debate. The arguments put forward by both sides mainly focus on how membership of the EU affects immigration, jobs, the economy, and security. Something that has yet to be discussed as much are the potentially far-reaching consequences Britain leaving the EU could have for public health.
One topic that is being argued about is the NHS; long a source of pride for many in Britain, it always provokes passionate feelings. So it is no surprise that both campaigns, Vote Leave and Vote Remain, are using the NHS as a way to gain the upper hand. Vote Leave claims that by leaving the EU and not having to pay billions of pounds into the EU budget every year, we can use the extra money to fund the NHS, thus protecting it from government cuts and improving quality of care. However, there are a few problems with this argument. Firstly, though the long-term impact of Brexit is unclear, most economists agree that the shock of Britain leaving the EU would lead to short-term economic damage. Therefore, any monetary gains made from leaving the EU would be outweighed by the economic damage caused by Brexit, at least in the short-term.
The NHS relies heavily on foreign staff. Though a smaller proportion of NHS staff come from EU countries than from former Commonwealth countries, they still make up a significant portion of the NHS workforce. The NHS is already suffering from staff shortages and looking to recruit more staff from abroad, including from EU member states. Leaving the EU would limit access to health workers from across Europe, negatively impacting care and possibly putting patients at risk. Therefore it comes as no surprise that most NHS workers back Britain remaining in the EU.
Those wanting to leave the EU often blame ‘uncontrolled migration’ from the EU for putting huge pressure on public services such as the NHS. However, the reality is that EU migrants themselves are usually younger than British nationals, more likely to be in work and pay taxes, and less likely to draw benefits. Therefore, they are a net contributor to public services, and so help to support the NHS, which is increasingly under strain due to an ageing population. What’s more, the EU enables the free movement of people out of the UK and into other EU countries; about 2 million people, mainly retirees, are living in other EU countries like Spain and Italy, enjoying the right to access public services, including healthcare. This effectively saves the UK money on healthcare spending. If Britain left the EU, it is uncertain what their status would be, or what rights they would be entitled to.
Research into new medicines and health treatments is also at risk from Brexit. EU funding props up spending on research and development, which in the UK is only 1.7% of GDP, below the OECD average. If Britain leaves the EU, this funding may dry up. Being part of the EU makes it easier to collaborate on research across borders and helps Britain’s research industry be world class. Leaving the EU could jeopardise this by restricting the mobility of those involved in cross-country scientific research, and may threaten the EU’s own Horizon 2020 science research programme.
The EU also protects public health in Britain through legislation. Though many moan about the bureaucracy of Brussels, the numerous directives, standards and guidelines issued by the EU vastly benefit public health. The rights workers have to paid maternity leave, equal pay, and protection from discrimination are all enshrined in EU law, making it very difficult for the UK government to undermine them. While it would be politically toxic to overturn these rights, if Britain left the EU these protections could be at risk. Furthermore, the EU protects workers by stipulating numerous health and safety rules; two-thirds of all health and safety rules enacted in Britain over the past 20 years originated in Brussels, and could also be under threat if Britain votes to leave.
Much of the UK’s legislation on food standards originates in the European Union, protecting consumer health. Chemicals that may be dangerous to human health are banned in food production and in livestock use, and businesses selling food are required to adhere to stringent safety standards to ensure that all food being sold is safe for consumption. The Leave campaign has criticized this legislation, often saying that it is too strict. Boris Johnson has famously said that the EU dictates that EU law states that bananas cannot be sold bunches of more than three (which is obviously untrue, though the EU does set rules on what types of bananas can be sold as class I). While it’s true that EU health and safety standards and legislation on food may often be overcomplicated and unnecessarily bureaucratic, surely this is better than having too few guidelines, putting consumers’ safety at risk.
All in all, membership of the EU benefits the health of the UK population. Being part of the EU makes it easier for the NHS to hire staff from EU countries to fill staffing shortages, protects the rights of British citizens living in other EU countries to access healthcare abroad, allows more effective collaboration between scientific researchers investigating new medicines, and protects the health of workers and consumers through various directives and standards. Leaving the EU would threaten all of this, and so threaten to harm public health. A vote to remain is a vote for a healthier UK.
Featured image © Giampaolo Squarcina
Helena Reut-Hobbs recently graduated from UCL with an MSc in Global Health and Development, after studying Biomedical Sciences as an undergraduate. She has worked on development projects in Tanzania, and is interested in health inequalities, the effects of climate change on health, and health policy.