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MPs say NHS must be at the heart of Brexit talks

Commons Health Committee calls for guarantees to ensure continuity for staff and patients

Mark Gould

Friday, 28 April 2017

An influential committee of MPs says that the next government must place the NHS and the health of the UK at the heart of its negotiations on Brexit.

A new report by the House of Commons Health Committee says that the government’s plan for the UK's post-Brexit future should both ensure that health and social care providers can retain and recruit the brightest and best from all parts of the globe and that the value of the contribution of lower-paid health and social care workers is recognised.

It calls on the government to undertake an audit to establish the extent of the NHS’s and adult social care’s dependence on both the European Union (EU) and the wider international workforce in low-paid non-clinical posts as well as in clinical roles. It also wants the system for recruiting staff to the NHS, social care and research post Brexit "to be streamlined to reduce both delays and cost".

The MPs support the principle that all clinicians working in the UK should be asked to demonstrate relevant language, skills and knowledge competence. "Nevertheless, the UK has an opportunity to negotiate a more pragmatic approach to the mutual recognition of professional qualifications directive within the British regulatory model," the report says.

However, it concedes that attention needs to be paid to the balance between patient safety as served by regulatory rules, which may restrict access to the profession, and patient safety as served by having a workforce sufficient to meet the country’s needs. "Regulation should not evolve into unnecessary bureaucratic barriers which inhibit the flow of skilled clinicians in to the NHS. Therefore, automatic recognition of some qualifications should not be excluded from possible future regulatory arrangements," says the report.

Any future regulatory arrangements should be established by a process which involves consultation with all stakeholders and full Parliamentary scrutiny.

The MPs call on the medical profession to "take the lead" in examining the opportunities which would arise were the UK no longer bound by the requirements of the EU working time directive. They call on the profession to advise how the junior doctors’ contract could be adapted to improve training, team working and flexibility.

In terms of patients, the report says that the government’s negotiating objective should be preservation of the existing system of reciprocal healthcare so that EU nationals in the UK and people insured by the UK in other EU countries can maintain their access to healthcare.

Professor Jane Dacre, the president of the Royal College of Physicians (RCP), welcomed the recommendations and said the RCP share the committee’s concern that research and innovation in the NHS could be compromised by further restrictions to freedom of movement arising from Brexit.

"We welcome the committee’s focus on workforce - particularly ‘our post-Brexit future should both ensure that health and social care providers can retain and recruit the brightest and best from all parts of the globe and that the value of the contribution of lower-paid health and social workers is recognised.’ We also welcome the committee’s recognition of the RCP in raising the public health issues that we believe will be a priority for the government during Brexit negotiations."

Dr Mark Porter, BMA council chair, said the report is right to point out that the impact on morale from Brexit is "concerning and unwelcome".

"For the thousands of European doctors working in the UK, Brexit has led to anxiety and uncertainty as to whether they and their families will have the right to stay here.

“Almost half of the 10,000 EEA doctors working in the NHS are considering leaving the UK in light of the referendum, which would seriously impact patient care across the country and only increase what are often already unacceptable delays for treatment," he said. 

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