Outcome of the European Union Referendum

Baroness Walmsley Excerpts

Tuesday 5th July 2016 Lords Chamber

[Baroness Walmsley (LD)]

My Lords, I am proud to speak from the Liberal Democrat Benches, where we have a leader whose position is secure and who has the support of all of us. I am also proud that it was a Liberal Democrat MP, Tom Brake, who took the only real action to secure the position of EU citizens living and working here. Yet these are small consolations to me today because I have such concern about the effect on the NHS.

Of all the disasters that will result from the EU referendum, one of the worst is the effect on our health and social care services, on which the outcome is likely to inflict significant damage. It was also the subject of the biggest, fattest lie of the leave campaign, one of those that was retracted almost before the ink was dry on the result. “Three hundred and fifty million pounds extra per week for the NHS” was plastered all over the campaign buses and, even though it was frequently pointed out that this could not happen, the leave campaigners cynically waited until after the result reluctantly to admit that it was not true. Where does that leave those who voted leave because they thought it would help the NHS which so desperately needs more funding? Betrayed and angry, that’s where it leaves them. They were conned into delivering their precious votes into the hands of a bunch of charlatans. I know that the noble Baroness the Leader of the House would prefer us to sweep these facts under the carpet and be positive, but they matter—not least because some of those now seeking to lead this country had every opportunity to correct this misinformation, and they did not take it.

So where are we now? We have an NHS which has to rely completely on funding from a thriving economy if it is ever to be able to deliver on the needs of an ageing population—one that rightly demands the benefits of the latest medical and scientific research. It also relies on immigrants. It is estimated that 10,000 EU doctors and 52,000 EU nurses are working in our NHS today. What have we heard from the Government and from those wishing to lead it about these people? Only that they are to be used as pawns in the negotiations to leave the EU. There are 335 EU citizens working in the Norfolk & Norwich University Hospital alone. They do not know what will happen to them in two years’ time. How would that hospital manage if they got fed up waiting for some assurances and went home? It is disgraceful to play a game of poker with these people’s lives and their contribution to our health service. The Government must do the right thing now and give these workers the confidence of knowing that the UK wants to keep them here, contributing to our care and to our economy. What about the thousands working on very low pay in our social care sector, caring for the old and vulnerable and putting up with minimum wages for doing a very difficult job? It is time that the Government took the initiative and said that these EU citizens will be allowed to stay if ever the UK leaves the EU.

Then there is the effect on our ability to recruit the best research talent from abroad and on the pharmaceutical companies that have to invest millions of pounds to develop new drugs and treatments. Reducing corporation tax is not going to reverse the damage to them. Investment decisions are already being made or postponed. Why would highly qualified researchers and medical staff come here when they do not feel welcome and have to jump through all sorts of hoops to get here? The UK is part of a worldwide marketplace for talent and there is a chronic global shortage of highly qualified research and clinical staff. We have just made it more difficult to attract the best.

On the big issue of resourcing, we have heard many times in your Lordships’ House about the £30 billion gap in NHS funding and the £6 billion gap in social care funding. My right honourable friend Norman Lamb has long called for a new Beveridge commission, an independent commission to look at how health and social care should be funded. This is needed now more than ever because the economy is in crisis and it is our taxes that pay for the NHS.

In the next few months, the biggest threat to the NHS will come from a recession-driven round of additional spending cuts, hitting non-ring-fenced budgets such as social care. Such cuts would be almost as bad for the NHS as direct funding cuts and would significantly exacerbate the financial problems of the acute hospital trusts. The promises from the current Chancellor and at least one of the candidates for Conservative leader to abandon their manifesto promise to remove the deficit by 2020 is quite sensible, as they are hardly likely to be able to deliver it if we have an economic recession. While I welcome this pledge, I cannot see how a failing economy will be able to deliver the funding that public services need to survive. The Government need to steady the ship, but we have no captain. This captain is to be elected by 0.03% of the electorate. I do not call that democracy.

Changing models of care are essential for the sustainability for the NHS, but there are now far too many uncertainties to allow health service managers to plan for change. Uncertainty is just as bad for the NHS as it is for the City of London. One recent change with great potential for patient benefit has been the devolution to Manchester of the powers to deliver health and social care. However, even if the Government remain committed to this kind of devolution, the Civil Service will be so busy disentangling us from Europe that they will not have the capacity to do the work. In the longer term, there will be issues about the working time directive. The junior doctors and all the other staff will have to negotiate new maximum working hours and all the other elements of contracts that have been so hard-fought.

Will the Government now pledge that there will be no further cuts to public services? Brexit could undermine staffing, research, service reform, devolution and funding. I find it very difficult to obey the exhortation of the most reverend Primate the Archbishop of Canterbury in his excellent speech to be hopeful and positive. The only thing that gives me hope is the ability of the NHS and care staff to keep calm and carry on in the interests of their patients, despite the turbulent waters into which we have been steered by the man without a plan.