Health and Social Care

Lord Wigley Excerpts

Thursday 24th November 2016 Lords Chamber

[Lord Wigley (PC)]

I am delighted to follow the noble Lord and the trenchant points he has made. I thank the noble Baroness, Lady Finlay of Llandaff, for initiating this timely and far-reaching debate. I also take this opportunity to thank her for her tremendous contribution to the health and social care services in Wales over many years. She spoke today from a position of immense knowledge and experience. The Government would be foolish to ignore her warnings and, indeed, the warnings of others who have brought their expertise and viewpoints to this debate.

I wish to make it clear where I am coming from on this issue. I have always been an ardent European and regard the Brexit vote as an absolute tragedy. Therefore, before I address the specific healthcare dimension, I wish to say a word about the state of play on Brexit. I accept that, regrettably, we are likely to leave the EU. The vote on 23 June in the advisory referendum asks the Government to take such a step. The referendum did not in any way advise the Government on what new alternative relationship the UK should have with our current 27 European partners. Several alternatives were mooted during the referendum campaign by the Brexit backers. Some advocated a Norwegian-type relationship, some an arrangement more similar to that of Switzerland, and some even proposed Albania, Turkey or Ukraine as possible models. Others looked to the long-negotiated deal that Canada has secured. Others on the hard Brexit extreme advocated basing new arrangements on World Trade Organization rules, and essentially walking away from our European neighbours.

Not one of these alternatives was endorsed or rejected by the referendum. The Government have no mandate from either the referendum or the 2015 general election manifesto to adopt any of these alternatives as the way forward. They have not yet even asked Parliament to endorse any preferred course of action. Unless they secure a prior mandate from Parliament laying down the negotiating objectives—not necessarily in all the intricate detail, but by way of broad strategic targets—they must face the possibility two years down the line of returning with a set of proposals that Parliament then rejects. In these circumstances, Parliament would have every entitlement to instruct—yes, instruct—the Government to withdraw their Article 50 application, which lawyers now accept is legally possible. It therefore now behoves the Government to seek a mandate from Parliament for their strategic objectives, and I approach this debate on the potential implications for the NHS from that angle.

Improving, not undermining, the NHS was a serious factor which influenced many people to back Brexit, believing that the NHS would gain £350 million a week and thereby recruit more doctors and nurses, many of them from the European Union itself. The NHS is massively dependent on staff who have been recruited from overseas. Some 20% of the entire NHS workforce is from overseas: about half from the EU and half from other overseas countries. More than 10,000 NHS doctors come from other EU countries, as do more than 20,000 nurses, and they come predominantly from Ireland, Poland, Spain, Portugal and Italy. In Wales, a staggering 30% of all doctors were trained abroad—2,687 of them.

The Brexit vote has done two things. It has raised in the minds of NHS staff from other EU countries the question of whether they will be sent home when we quit the EU. These fears were exacerbated by the Prime Minister’s ill-advised comments at the Tory Party conference and her subsequent refusal to give assurances that all EU citizens currently working in the UK will, in all circumstances, be guaranteed the right to continue to work in the UK indefinitely. The only definitive statement made by the Prime Minister on these matters has been to rule out the Australian-style immigration system. The uncertainty created by the inept way the Prime Minister has dealt with these issues has led NHS staff, particularly in specialist jobs, to start looking around for suitable vacancies in other countries. No one can blame them. If in two years they find that they have to go, they might not then easily find a job in their home country. Indeed, they might face much greater pressure as other medical specialists in the UK also turn back to look for jobs at home.

The pressure to leave the UK is not just on EU-originated NHS workers. Many from Commonwealth countries have faced the horrid racial abuse that has mushroomed as a direct result of the Brexit campaign. Racially motivated crime has escalated, as the police have told us, and many NHS staff from non-EU countries are asking themselves whether they want to remain in a narrow, inward-looking, racially prejudiced Britain—indeed, whether they want to bring up their children in such a hostile climate. It is an absolute tragedy that all the hard work that has been done to break down the barriers of prejudice and racial hatred have been so disastrously undermined by the tone of the Brexit campaign, the outcome of the referendum and the Government’s inability to handle the situation.

I ask everyone, throughout the UK, to look around when they go to their hospitals and note the number of overseas workers on whose backs all that depends, and to look at the lists of names of doctors in the departments they visit and see the many names from foreign countries. My wife recently went to an NHS hospital in Wales, and of the 14 names on the plaque by the department no fewer than 12, at least ostensibly, were from overseas. I ask people to think what they would do if such staff went home, as some are told to do on the pavements of British cities. I ask them to consider the dependency of other services, such as home helps to support disabled people, or the staff in homes for the elderly who look after their parents or grandparents.

I ask the Government, taking all these aspects into consideration, to do three things. First, they should announce forthwith that every EU national—indeed, every overseas national—working in the UK will be entitled to remain here irrespective of the Article 50 negotiations and their outcome. Secondly, such a guarantee will have no ifs, no buts and no conditions; it will be absolute and not time-limited. Thirdly, it will be in the UK’s negotiating position, if we are leaving the EU, to retain our rights vis-à-vis the single market—if necessary, specifying a customs union deal—and accept the free movement of working people throughout the EU into the UK. Anything less than this will leave a bleeding wound that will hit many sectors of the UK economy, but none worse than health and social services, from which the haemorrhaging of vital staff could lead to the end of the NHS as we know it.