We all know that the Brexiteer promise of an extra £350 million per week for the NHS is a lie. I know it. You know it. Even Boris Johnson knows it, which is why Sir David Norgrove of the UK Statistics Authority has very publicly called him out on this continued ‘surprising and disappointing’ fib.

But what else do we know about the likely impact of leaving the EU on the NHS? It’s probably telling that the key health message from the hard Brexit lobby is based on fiction, because the facts make for depressing reading. This is particularly the case for thinking about the NHS workforce and the future for health sciences in the UK. 

There is already a staffing crisis in the NHS, with three quarters of medical specialities facing staff shortages at a time when demand for the health service is only increasing. Currently one in ten doctors are nationals of another EU country, plugging a critical gap. There’s a sad irony to the fact that the places worst affected by the NHS recruitment crisis are those that typically voted to leave the EU, with the north of England having the highest level of unfilled vacancies in the country.

Yet Brexit is creating a toxic environment which threatens to make this even more unsustainable. With eighteen months still to go before we leave the union, there’s already been a 96% drop in EU nurses registering to work in the UK since the referendum. When we do leave, we will need to have in place new arrangements for recognising the qualifications of healthcare professionals who trained in the EU, as our streamlined process of mutual recognition will no longer apply. This might seem technical but it has potentially huge implications. What happens in future, for example, for the professionals who work fluidly across the border between Northern Ireland and the Republic of Ireland?

The common riposte to these concerns is that we should train up more UK doctors and nurses. This is, of course, a fine aspiration. But this takes time and resource that isn’t there.  It takes up to seven years to train for a medical degree, and we’re starting from a shaky position where applications to university medicine courses have been in decline since 2014. It also requires more senior healthcare professionals to have the time to teach new recruits. How we find this time when services are so stretched is anybody’s guess.

The implications for health sciences are equally bleak. Since the leave vote, the government is pushing for an industrial strategy which keeps the UK at the top table for research and innovation. It is hard to imagine though how this can be achieved if the government is happy to forego the aspects of EU membership which have got us there, such as freedom of movement for research talent, or the additional funding to higher education institutions and research establishments brought in by EU students and funding for collaborative projects.

The saga of Brexit and the NHS will be a tale of marginal losses if it continues to unfold without clear planning or consideration. It’s hard to encapsulate this in a pithy “We send the EU £350 million a week. Let’s fund our NHS instead!” because the list of what we gain – and what we stand to lose - from EU membership is long and complicated. Meanwhile, talk of the Prime Minister’s Brexit negotiations dominates the news but drowns out any public conversation about what this will really mean for people’s lives. If we care about the health service, we have a responsibility to keep talking about this, loudly, and to raise public awareness in any way we can. The risks of keeping quiet are too great.

Natasha Wynne is a Young Fabian and Comms officer for the Health Network.

 This blog post is based on discussions at a recent event on Brexit and the NHS organised by the Young Fabians Health and International Networks. Thanks to our speakers Dr Rob Davidson (CEO for Scientists for EU), Dr Jeeves Wijesuriya (BMA Junior Doctors Committee), Jos Bell (SHA London) and Chair of the YF Health Network, Dr Sonia Adesara.