NHS and Social Care: Impact of Brexit

Baroness Masham of Ilton Excerpts

Thursday 21st July 2016 Lords Chamber

[Baroness Masham of Ilton (CB)]

My Lords, I thank my noble friend Lady Watkins of Tavistock for having secured this most important debate and congratulate her on her speech.

Since the European Union referendum result in England, there have been some most unfortunate incidents of rudeness and abuse to people from other European countries. If these people do not feel wanted and valued, they may not wish to stay and help us. People who have skills to work in our NHS and social care service are desperately needed.

The Library Note for this debate gives numbers of the various Europeans from different countries, but not of those people who are working in private hospitals or are employed privately helping disabled and elderly people living in their own homes, saving social services millions. The private sector must not be forgotten—it employs many people from overseas. We have an explosion of elderly people, many of whom have complex conditions and need help. Many of the carers themselves are also getting older. With this increasing problem of people needing care, there needs to be replenishment with younger active people as the needs increase.

Over the years when my husband was ill, we employed many helpers from the EU and other places such as Belarus. Carers for severely disabled people have to be honest, be willing and have a work ethos. Every person with a severe disability has different needs—I declare an interest in that I train my own helpers. I do not think many people who voted to leave the European Union realised that they would be creating so many difficulties and causing so many insecurities in a very unstable world. I think many people thought life would be better, with more money.

There is a crisis in social services. Unless the Government look at the workforce and realise how we might become isolated from the European Union, there will be a disaster in medical, nursing and social care. I received a letter from a friend of mine, a retired senior nurse from St Thomas’ Hospital, who happened to be in hospital with a complication during the referendum vote. I quote from her letter to me about the morning after: “The day staff came on duty, markedly more subdued than yesterday, and there was a palpable sense of gloom and anxiety—we’ve left”. Among the small group of staff looking after just her little patch of the ward were a Portuguese nurse, an Italian nurse and a Romanian nurse, plus a Lithuanian cleaner, previously a nurse, from Vilnius. Later in the day, she met a Slovenian radiographer and a Polish porter. Without exception, she wrote, their English was excellent.

It is undoubtedly true that the NHS benefits from the use of already trained staff from the EU and elsewhere abroad, and it will not survive without them. At least one London teaching hospital has recently had to send a recruiting team to Italy because there are insufficient British-trained nurses for its needs. Should these trained and untrained National Health Service staff be asked to leave this country because the UK is about to leave the EU, can they be replaced? There is already a national shortage of nurses and doctors despite our friends from the EU.

For some time, morale in the NHS has been very poor. It is no good pretending otherwise. Since the referendum vote, there are not only worried staff but very worried patients, especially the most vulnerable. I now declare an interest as president of the Spinal Injuries Association. I ask your Lordships to think for one moment what it would be like to be paralysed from the neck down and dependent on a respirator to breathe. Many such patients who live at home have to rely on trained carers. What will happen if the supply dries up? As it is, it is not easy to get the right people with the correct skills.

In the UK, there are 750 to 1,000 new paralysed patients a year, about 10 to 15 per million of the population. They have a multisystem physiological impairment and malfunction dynamic. They need specialised care and treatment. In Germany, there are 1,200 special beds for spinal injury patients in special units, while the UK has only 430 spinal beds. The population of both countries is about the same. This means that paralysed patients living in the community often do not get the correct treatment when they need it, as the units are full. Because the work is demanding, these units often have to rely on medical and nursing staff coming from other European countries and beyond.

The Royal College of Physicians has considered the implications of the EU referendum. It states that doctors from the EU make up a significant proportion of the NHS doctor workforce—about 10%. The UK is already facing significant recruitment problems: 40% of advertised consultant posts remain unfilled. The number of medical trainees has decreased by 2.3% within the past year. This is creating significant implications for the future delivery of care, particularly as the needs of patients increase.

Care England has told me that one of its larger corporate members was due to go to Portugal this month to recruit care workers, but, further to the result of the referendum, more than 50% of the people in Portugal who had expressed an interest withdrew their names. This period of uncertainty is causing problems. I cannot understand why the Government cut funds to Health Education England, which trains medical and nursing staff. It seems extraordinary.

I end by saying that it is depressing to see that our results in cancer care are at the bottom end of the European ladder. There is no doubt that working together in research is vital. The UK has been very successful in attracting research funds from Brussels. Losing generous sources of financial support will set research back. Senior researchers are likely to find ways in which to keep direct bilateral collaboration going with colleagues overseas, but the opportunity to take a lead role within EU funding programmes will disappear—very sad.

Probably the biggest loss will be for the younger generation of science graduates, whose options will be reduced. Biomedical science relies on shared ideas, international co-operation and professional ability. It will take time to find alternative pathways for young scientists. The uncertainty over the specific nature of Britain’s role in Europe could make for a bumpy ride for British science.

I was very sorry to hear that the department responsible for life sciences has gone, along with the post of the excellent Minister, George Freeman, who did so much to raise morale and interest in this highly important subject. The National Health Service and social services need good morale.