My Lords, I declare my interests as outlined in the register. I will focus my remarks on my area of expertise. The questions before us are of great importance; I am aware that the vote in the other House will inform the future of the UK’s relationship with the EU.
A no-deal Brexit could result in the possibility of an immediate risk to both the provision of safe and effective healthcare and collective efforts to improve public health. Following the UK’s vote to leave the EU, nurses and midwives from Europe are leaving the UK register at a faster rate than those joining because of the uncertainty about their right to remain.
Healthcare leaders have consistently argued that there needs to be a transition period following our withdrawal from the EU, particularly in relation to free movement of workers. A no-deal Brexit without a transition period would likely cause significant challenges for the health and social care sector. Indeed, my noble friend Lady Campbell told me yesterday that four of her five personal assistants are from the European Union.
In the NHS in England, there are 41,000 registered nurse vacancies despite the fact that 30,000 European registered nurses work here. In addition to filling vital gaps in our workforce, nurses from Europe and all our international nursing staff add to the cultural richness of the NHS.
A no-deal Brexit also poses significant risks to our public health efforts. The EU plays a vital role in maintaining public health across all its member states. There are sector-wide concerns that Brexit and the withdrawal of EU funding for public health measures could negatively impact on the health of the UK population, especially if the UK were to crash out of the EU without a deal. The UK could even lose its membership of the European Centre for Disease Prevention and Control, which would mean our exclusion from important reporting mechanisms about emerging public health threats, comparing important surveillance data on communicable diseases and other health threats.
Other risks of a no-deal Brexit may include our loss of access to immediate medications and a lack of protection for workforce regulations. There is a possibility that the UK will find it more difficult to access medicines and medical devices, which may cause delays in new drugs and repeat drugs being made available for patients. I know that there is considerable stockpiling, but there would still be a significant risk with a no-deal Brexit.
Making any changes to the EU regulatory framework for clinical trials would also significantly increase the burden on UK researchers and pharmaceutical companies. In fact, this could make the UK a much less attractive place to conduct clinical trials, with knock-on effects for access to new medicines and international participation in multi-centred trials.
A no-deal Brexit and its potential economic impact could have significant implications for EU-derived worker protections. Were there to be a significant economic hit from a no-deal Brexit scenario, the UK Government may be tempted to reduce worker protections in order to cut costs. This could negatively impact on patient care, further undermining nursing as a career of choice if nurses find themselves left exhausted and unprotected in their employment terms.
In May 2018, Royal College of Nursing members debated the implications of Brexit, resulting in a vote to campaign for a referendum on any final deal. As the debate made clear, the implications of Brexit for the health and social care system are numerous. The UK’s nursing shortage risks being further worsened because of uncertainty surrounding the status of EU nursing staff. Settled status has been guaranteed by the Home Office irrespective of whether there is a deal or no deal with the EU before March 2019. I welcome the introduction of the settled status pilot scheme for invited EU staff working at selected trusts in the north of England. However, its rollout appears to be very slow.
The Prime Minister has made a convincing argument for recommending that Parliament accepts the withdrawal deal that has been negotiated and that no better terms are available. It is difficult to find a more realistic solution, although several noble Lords have suggested some today. In reality, it is the Government’s responsibility to keep the people they represent safe in terms not only of security but also in terms of the nation’s health and wealth.
Many people who voted to leave the EU believed it would result in a more prosperous United Kingdom. While this may be so in the long term, current forecasts suggest that in the short term we will be significantly worse off. Poverty is detrimental to people’s health. Major investment in the NHS has been announced and yet we know that it will be almost impossible to achieve the NHS five-year plan without sufficient staff to meet the needs of the service.
Many nurses from the EU wish to remain in the UK but not at the expense of being unable to retain their full rights to return home. In the absence of the paper on immigration which we have been promised, it is not surprising that some NHS staff from Europe are considering returning to their homelands earlier than planned.
Therefore, I believe that if the other House supports the deal on offer, we should accept this decision and move towards the next phase of our negotiations secure in the knowledge that we have at least two years to reach long-term solutions to the UK’s future relationship with the EU. However, under no circumstances would a no-deal Brexit guarantee protecting the health of our nations. I will therefore support the Leader of the Opposition’s Motion to ensure that we do not have a hard Brexit.