Winter has arrived and, for most clinicians, the primary challenge is coping with increasing demand while sustaining already low workforce morale. But just as the pressure could start to drop in the New Year, the still unknown impacts of 29 March will loom larger.
The Royal College of Physicians has been clear that patients and patient safety must be at the heart of Brexit negotiations. The public rightly expects candour from health professions, and frankly, at the moment, it’s just not possible to reassure patients that their care won’t be negatively impacted by the UK exit from the EU.
Over two years on from the referendum, Theresa May’s Brexit deal is but a start. For the first time we finally have a vision on paper for what could come to fruition in reality. But it’s the unknowns that keep me up at night. While the draft withdrawal agreement has provided clarity on a small number of issues - including mutual recognition of professional qualifications and a statement of intent on data sharing - much more has been kicked into the long grass.
The future of our relationship with the European Medicines Agency is still up in the air, we remain in the dark about the Home Office’s plan for immigration, our continued access to research funding and networks is in serious doubt, and hard-fought progress on air pollution is in jeopardy. Not to mention the potential economic impacts, which could squeeze already stretched NHS budgets.
Just a matter of weeks ago, we warned that the NHS could face a new Brexit immigration cost pressure of up to £490 million a year within three years. The costs could end up being the least of our problems though, if the government doesn’t start sending loud and positive messages that EU and international staff are welcome and valued in the NHS. Staffing shortages could go from bad to worse, with a direct impact on patient safety.
There are significant concerns about shortages of medical supplies, exacerbating current supply issues and creating the very real the possibility that lifesaving medication could be delayed from making it across the Channel. We don’t know how this will turn out and the potential impossible situations patients and doctors will be put in, but we do know that it is entirely avoidable.
This week MPs will face a meaningful vote on the draft withdrawal agreement. Many commentators with greater knowledge of parliamentary procedure are speculating about the possible outcomes. One option, which will no doubt enjoy increased profile, is a ‘no-deal Brexit’. This summer saw the government drip-feed planning guidance, a small start, but if even the Health Secretary acknowledges he can’t guarantee patient safety in the event of a no-deal then should it really be considered a serious option?
Just as MPs will face constituents in surgeries across the UK, so will NHS staff face patients and their concerns. There is no doubt that MPs have a defining decision ahead of them, and they must look at the evidence in front of them to make the best choice. They must put themselves in the shoes of patients and staff, and seriously ask themselves: Based on what we know now, should we be pressing ahead with what’s on the table?