Much of the EU debate is conducted at the level of insults and unsupported claims and assertions. But, if we care to look, there are many areas where it is not difficult to identify the effects of Brexit. Health and health services are one such area – and Brexit could be devastating.
European health insurance cards, which have for many years guaranteed emergency treatment for Britons wherever they are in the EU would of course disappear in case of Brexit – leaving the UK government to negotiate new arrangements with each individual country. While this is widely known, the right of EU citizens to undergo any kind of healthcare anywhere in the EU is perhaps less familiar – possibly because it is the result of much more recent EU legislation. It is now not unusual for UK residents to choose to have hip replacements in France, or to travel to Belgium for spectacles, or to Budapest for dental treatment, all paid for (as according to EU legislation) by the local UK “purchaser”.
Of course the 1.2 million Brits living in other EU countries – including around 300,000 in Spain – rely on these facilities. And we should not forget this freedom of movement works both ways – to our benefit. It is thanks to an influx of medical professionals from around the EU that the NHS and care services are able to continue to operate at such a high standard. Would all these vital health care workers suddenly no longer be welcome?
The UK is a world centre for health and medical research. To a large extent this is the result of the substantial EU research budget. We receive substantially more research funding from the EU (16% of the whole) than the 11% that we pay in. Brexit would result in a substantial downgrading of UK health research, prolonging the wait periods for development of new treatments and pharmaceutical products. The single market has also allowed our country to become the centre of the pharmaceutical industry. The centralised EU system for licensing new products is based in London at the European Medicines Agency. After a Brexit it would move to another European country, taking many of our pharmaceutical firms with it.
The freedom of movement which allows the best scientists in Europe to follow the money and travel to UK research centres should also not be discounted. This does not only contribute to south-east England, but also benefits employment in universities and other research centres throughout the nation. That is not the only way that the wider UK is helped. The massive budget of the European Regional Development Fund (ERDF) plays a huge role; the rebirth of the City of Liverpool where I work has been made possible by this. Economic development itself leads to improved health, but within the current ERDF budget, €5bn has been “top-sliced” for exclusive spending on health and health services. Just one example is the major hospital complex, Altnagelvin, in Northern Ireland that has been developed using these funds.
Public health security at present relies substantially on the EU. Surveillance of developing epidemics and the appearance of brand new infectious disease hazards is centralised in the European Centre for Disease Prevention and Control. Denied access to this, the UK would stand alone in Europe in a dangerously exposed position. This is not the only relevant agency. The European Food Safety Authority, based in Italy, where guarantees on the safety of the food marketed for us all to buy are based is vitally important – just think of the problems in recent times with contaminated chicken.
Similarly, legislation on what is allowed to be included in food and how it is labelled is all of EU origin. The food industry complains loudly about being forced to comply with these safety measures. Could we really rely on any UK government to maintain these safety standards, in the face of the powerful lobbying of the food industry, without EU support?
When we think of one of the biggest challenges facing humanity today – climate change – it is the EU that leads the world in combating it. European agriculture is a major source of global warming gases, and the EU is seeking ways of reforming farming to solve the problem. Farmers are already beginning to protest loudly; the UK is in a far stronger position to fight this battle in cooperation with other European governments than alone.
Control of environmental standards is also an EU responsibility – we have Europe to thank for our cleaner bathing beaches and the high standard of our water, which only improved in the 1980s after the EEC passed a raft of water quality directives. Air quality standards in London are falling below EU required standards – with terrible effects on public health. Fortunately we have the European court of justice to chase the UK government on this and threaten fines. Without that there is no reason to believe it would be a priority.
The original EEC was founded to guarantee peace in Europe, where war had ravaged the continent for half a century. The EEC and its successor the EU have been very successful in this respect. Maintenance of peace is the perhaps the first public health priority above all others. We should not threaten this by beginning to break up the EU.
