Brexit: Health and Welfare

Baroness McIntosh of Pickering Excerpts

Thursday 29th March 2018 Lords Chamber

[Baroness McIntosh of Pickering (Con)]

My Lords, I congratulate the noble Baroness, Lady Brinton, on securing this debate and so eloquently setting the theme. On a personal note, I am a doctor’s daughter, a doctor’s sister and a doctor’s niece. The noble Baroness mentioned that this year is the 70th anniversary of the founding of the NHS, and I am extremely proud that my father was one of the first NHS doctors, having come back from serving with the Royal Army Medical Corps in Hamburg, where he met my mother, who had come down from Copenhagen to work for the British Army at that time. Less savoury was the fact that he was referred to as a panel doctor by my uncle, who was a surgeon, but I am very proud of the service that my family has given to the NHS. As declared on the register, I also work with the board of the Dispensing Doctors’ Association, which represents GPs in rural practice.

As we speak today, what concerns me most is that we need be in no doubt as to what the impact will be on the health and welfare of those working in the NHS and those benefiting from it in this country of the proposed withdrawal from the EU of the United Kingdom. What is missing here is a sense of urgency on the part of the Government. If this debate serves no other purpose, I hope that the Minister in summing up will take back a strong message to the department that we need to tackle the issues. Let us look at the sheer volume and scale of the problem. We are told on page 19 of the report, EEA-workers in the UK labour market: Interim Update, that 4.1% of professionals working in health and 5.1% of those working in residential and social care come from the EEA. That means that just short of 10% of the total workforce of health and residential and social care comes from the EEA.

The UK is therefore heavily dependent on our EU and EEA membership for our doctors, nurses and other health professionals. Yet the Minister recently confirmed in a Written Answer that there is as yet no accreditation scheme that will apply from 29 March next year. We are rightly told that this will be on the basis of mutual recognition. How many years did it take us to achieve mutual recognition the first time? I do not believe it took so long for lawyers like myself, or for doctors like my brother, who has now retired from general practice, but for architects it took 21 years to agree, on the basis of mutual recognition, that their qualifications would be recognised. I hope that the Minister will confirm today that this will be a top priority for the Government, because we are haemorrhaging. I know that from personal experience: a Danish friend of mine and her New Zealand husband are consultants in the health service, operating at the highest level, and they are returning to Denmark to work because they simply do not know what continuity of service they will have.

We learned today from the Brexit Minister that there will no longer be free movement of people and professionals between the UK and the EU; I understand that that would be from the end of the transition period—if we have an agreement and there is a transition period. Yet we know from the briefings provided to us today that 9.3% of UK doctors working in the NHS emanate from the EU.

We are currently on course to subscribe to and apply the falsified medicines directive. This will have huge cost implications, particularly for general practice, and yet, as I speak there is no clear guidance as to what the IT provisions will be. The drug will need to be scanned when it comes in and scanned again when it goes out, and there is obviously a question mark over who will pay. I hope that the Minister will take the opportunity to explain today to what extent we will apply the falsified medicines directive.

The noble Baroness, Lady Brinton, also spoke about clinical trials, which we debated in the EU (Withdrawal) Bill Committee. It is extremely important that we have a commitment that we continue to benefit from those clinical trials. It appears that we will no longer have access to EU Horizon 2020 funds, yet the briefings we had today show that we do not just pay into the current R&D programmes but are a major beneficiary of them. Again, it would be a huge potential loss if we were no longer allowed to participate in those programmes.

On our membership of the single market and customs union, let us remember that prior to 1992 we were not in the single market. I am proud that the single market was a Conservative initiative, but we did not benefit from it until it was set up and we joined in 1992. However, we currently benefit from both, and they are vital for both the exporting and importing of our pharmaceuticals. I hope that the Minister will reassure us that those will continue even though we are due to leave the European Union.

On the exchange of blood and vital transplant organs, these are extremely perishable and cannot possibly be held at the borders, yet from the exchanges we had at Question Time, it is still not clear what the arrangements will be. The noble Baroness, Lady Brinton, mentioned the current free flow of health professionals and indeed patients across the Irish border, but we do not know what the customs arrangements will be—not just in Ireland but between the UK and our current European partners.

It is a fact that we are certainly dependent. The Royal College of Physicians is recommending that the UK must continue to welcome new doctors to work in the NHS and provide express and urgent guarantees that EU doctors currently working in the NHS will be able to permanently remain in the UK even in the event of no deal. I know for a fact that the Minister and I share a rather charming dentist who happens to be French in origin and qualified in the EU, and I am sure we would wish to continue to benefit from his services. At the moment, though, it is still not clear, until the mutual recognition accreditation schemes are set up, what the arrangements will be.

The Government are asked specifically to grow and expand the medical training initiative by increasing the number of visas available and, in addition, to seek to establish a scheme similar to that for DfID or for low-income and middle-income non-priority countries, particularly those such as Australia that have similar training programmes to the UK and where we can recruit more doctors through such training places. The RCP reports calls by the medical Royal Colleges and the BMA to keep the current cap on restricted certificates of sponsorship for the short term and exclude applications for shortage occupation roles from the allocation process. The UK is currently considered a world leader in medical research, producing around 25 of the top 100 prescription treatments. As I have mentioned, we are still a net beneficiary of research grants and very successful, so I hope the Minister will continue to give an assurance today in that regard.

I conclude by asking the Minister to give a sense of urgency to the concerns being expressed in the House in this debate. The Prime Minister has stated that she wants a Brexit that works for everyone living in the UK, so will the Minister give the House an assurance that we will continue to welcome doctors from the EU and the EEA; that health professionals currently in practice here will be allowed to remain; that we will have a certification scheme in place as a matter of urgency; that we will continue to have access to the EU research and development funds; and that we will have smooth access to vital organs, perishable medical products and clinical trials in future? I am delighted to support the noble Baroness, Lady Brinton, in this debate.