With crossroads lying ahead for Britain’s departure from the European Union, the impact that either an agreed deal or a no-deal could have on the healthcare sector is a pertinent one. Alice Williams of the Immigration Advice Service continues that for the NHS, already gripped by a staffing crisis unrelated to exterior Brexit factors, further negative influences could lead to an unmitigated disaster for Britain. Staffing levels, access to fundamental research, the cutting of funding for rare diseases and even a nation-wide shortage of crucial medicines are all real threats.
Medical vacancies left unfilled
Currently in Britain, the British Medical Association has recorded that there are around 12,000 qualified doctors currently working in the health sector. In an incredibly concerning statistic, they have estimated that 45 per cent of those skilled individuals are considering leaving the UK due to the uncertain times that lie ahead for them in the wake of Brexit. Furthermore, more than 30 per cent of NHS hospitals in England say that Brexit would have a negative impact on their workforce, and – with staff shortages at crisis levels – this is not something that the NHS will comfortably weather. In the latter part of last year, NHS Employers prioritised staff retention reports in order to try and tackle the growing issue for medical cohorts faced with a staff exodus. The NHS currently has more nursing staff leaving than joining and therefore is faced with a shortage of 41, 722 nurses and 11,576 doctors. With one private retention report advising senior figures to ‘deliver thank you cards’ to members of new staff, things are clearly getting desperate.
To dissuade those looking to come from abroad to help Britain’s healthcare sector would therefore seem foolish. However, if the British Government’s post-Brexit immigration plan is actually rolled out, then it seems that this is exactly what will happen. Currently, nearly 139,000 of the 1.2 million NHS staff members are non-UK nationals, accounting for one in every eight workers. Directly matching this, one in eight nursing positions in England is unfilled. For those already here, the government has attempted to reassure them of a cemented place in Britain with the EU settlement scheme. Published June 2018, this promises that EU citizens currently living in the UK ‘will be able to stay and continue their lives, with the same access to work, study, benefits and public services that they enjoy now.’ While this is a positive for those already here, the UK’s health sector clearly would greatly benefit from being able to pool medically skilled individuals from abroad post Brexit.
Barriers for migrants wanting to work in healthcare
Two months ago, the Home Office made the announcement that the current immigration health surcharge that is imposed upon migrants when they are applying for entry into the UK will double in price. The Royal College of Nursing strongly opposed this, with their chair, Maria Trewern, stating that it “risks driving away overseas staff at a time we need them most.” This means that migrant NHS staff not only have to meet the Tier 2 requirements, but they will also have to fork out up to £2,000 to have access to the NHS when they are in the UK.
Currently, the process that comes with this charge and that any potential overseas healthcare workers would have to complete would be an application for a Tier 2 work visa. Currently, the are based around a 70-point system. This is made up of: ·
- 50 points for a job offer and a certificate of sponsorship from the company looking to employ you (in this case the NHS)
- 10 points for proof of English language ability
- 10 points for adequate maintenance funds - the amount of maintenance required changes if you are applying with dependents.
With a multitude of healthcare roles listed on the UK Shortage Occupation List, the UK clearly needs to attract those capable of these roles. Neurophysiology practitioners, orthotists, clinical radiology consultants and paediatric doctors are just some of the positions that the UK Government has identified as being at crisis levels of shortage.
While staff shortages have been the most prevalent issue for the NHS in past years, a new and more frightening potential challenge is emerging. The government recently revealed that it was stockpiling crucial medicines in the event of a no-deal Brexit, and the NHS’s chief pharmaceutical officer, Dr Keith Ridge CBE, was forced to release a letter from the Department of Health and Social Care (DHSC), advising GPs and nurses as to the correct procedures. While aiming to reassure, the information that the DHSC had indeed felt it was necessary to stockpile six weeks’ worth of medicine is alarming, along with the necessary alternate transport routes that will prioritise prescription-only medicine and the introduction of a ‘serious shortage protocol.’ With his final words warning that it will put nationwide patient health at risk if registered pharmacy professionals are to stockpile medicines locally, the potential dangers if a no-deal Brexit goes ahead are too great to comprehend.
Alice Williams is a content writer and commentator for the UK’s leading Immigration Advice Service.