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Independents' Day

A hard Brexit will jeopardise general practice

A 'no-deal' Brexit threatens the quality of healthcare GPs will be able to provide, National Assembly for Wales member and GP Dr Dai Lloyd warns

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As both a GP and a politician, I have been privy to the conversations around the UK’s withdrawal from the European Union in both sectors. What is surprising is the extent to which the conversations are so radically different in tone and understanding of what is at stake.

The prospects of a ‘no deal’ exit from the European Union have become ever greater as delusional Etonianism strengthens its grip on the levers of government. This means that general practice and the NHS is likely to become even more affected by the loss of the benefits that EU membership has given us, the networks it enabled us to access, and the health organisations that worked tirelessly behind the scenes to smooth the journey of medicines from laboratory to patient, and medical professionals from classroom to practice.

Such is the extent to which EU frameworks have governed our modern day healthcare system that they touch upon all aspects of general practice. A ‘no deal’ Brexit will bring significant changes for us.

There are numerous European frameworks governing the licensing of medicines, the extensive funding of cross European health research and collaboration, and the shipment of medical isotopes used in scans and cancer treatment. Over 40 years, relationships and agreements have helped advance the treatment of patients. From the EURATOM agreements that helped govern the transport of radioactive materials crucial in cancer treatment, to the European Centre for Disease Prevention and Control - the list of organisations and agreements formed by the EU that we will no longer have helping our profession is long.

The European Centre for Disease Prevention and Control’s main purpose is to help prevent the spread of infectious diseases. It does this largely through data collection and analysis, hoping to predict and then prevent pandemics, and supporting member states strengthen their own health systems to do this. Now it’s fair to say that I can’t envisage a situation where in the event of a pandemic, it wouldn’t remain helpful to the UK in preventing the spread of disease – not least because it is in the interests of neighbouring countries to prevent such a spread. But not sitting at the table and being full participants will I believe carry a long term cost.

It isn’t just the membership of such organisations that we will lose. The collaborations, networks and cultural exchanges have proven vital in advancing scientific understanding of many diseases. Such networks will probably continue to exist following the UK’s withdrawal from the EU, but in the long run it will mean less funding for UK-based research, it will mean fewer young scientists wanting to stay in the UK, and it will mean the most interesting projects and their commercial spin offs happen elsewhere. It’s the cumulative effects over several years and decades that is the real worry.

I know of several pharmaceutical companies who have already chosen not to invest in developing medicines here, but in different EU countries. These decisions collectively will do more to reduce patient access to the latest treatments than any ministerial directive to NICE on increasing value for money thresholds.

Of course, we cannot fail to mention that the UK has over 2,000 EU-born family doctors working in general practice, which is 2,000 doctors the UK can ill afford to lose. We’re already seeing that they’re feeling unvalued in the post referendum climate, and of course we can’t measure the numbers who would have considered coming to work here, but who may now think better.

As well as being a GP, I am of course a politician and chair of the National Assembly’s Health Committee. I have been endeavouring to enlighten my political colleagues of these dangers, but I am not seeing any recognition of the dangers of a hard Brexit to the health service within Westminster.

That’s why Plaid Cymru has been working at Westminster with all parties to raise these concerns and push for a substantially better Brexit that aims to preserve as many of our relationships with the European Health frameworks as possible, maintain the professional standards and quality of our work, and make sure we can still treat our patients with the best available treatments. Our patients deserve it.

Dr Dai Lloyd is a National Assembly for Wales member and Plaid Cymru shadow cabinet secretary for social services and public health


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Readers' comments (8)

  • Azeem Majeed

    Good points Dr Lloyd.

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  • Er --- I don't think so. Disingenuous brexit blaming does not help the cause of a harmonious dissociation. I was agnostic but I have to say as time has gone on I understand the psyche of those who voted to leave. Especially when I read articles like this,
    There are many countries that survive and thrive outside the EU, the proposed 100BN divorce settlement tells me just how much it would have cost to stay in.
    Dr Lloyd you are a politician.. have faith and be positive about the country you represent and respect a democratic decision.

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  • Complete bollocks!
    Of the 195 countries in the world only 28 are in the EU.
    The UK will finally be able to trade fairly and employ workers from anywhere in the world without interference for the first time in decades

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  • I think Brexit will NOT disadvantage NHS provision! European Working Time Directive has been dreadful for medical training and the GMC will be able to manage Standards more effectively Post Brexit! NHS needs £5Billion Now to Survive! Brexit will have little effect

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  • think most of us see thru this BS. Think global, not EU.....

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  • AlanAlmond

    Oh what pain changes causes. There will be no end to the whining of those embedded in the status quo until we’ve left. The sad fact is most people weren’t happy with the status quo. Those in power very much were...and they are so very sad to see their comfortable world upended. Of cause we need to negotiate the best deal we can, but please don’t use the NHS as a means to push for keeping everything the way it is/was. Who said leaving a dysfunctional undemocratic money wasting wanna be superstate would be easy? That doesn’t mean we should just bow our heads and stay.

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  • Vinci Ho

    (1) Brexit is Brexit . I stick to this even though I voted Remain (after tossing a coin with my practice nurse as a witness). The referendum was an exercise of direct democracy , although there is an argument that the timing of the referendum was not right and things had changed dramatically since then. A second referendum is not currently favoured even by those voted Remain , according to various polls(yes , you have the right not to believe them)
    (2) But the ‘process’ of reaching the endpoint of Brexit is undoubtedly a distraction to every other issues vital to this country. To me , the story was just written in such a way that Brexit was the beast in the minds of the prime minister and her close aides(gone now) for grabbing more power in an ‘unnecessary’ general election. She was punished simply because of being out of touch with real people. You can argue Jeremy Corbyn managed to swing the ship called Populism in the right direction to gain more seats in House of Commons.
    (3) Domestic issues including health and social care were always there before the referendum. They have been simply ignored since the PM took the helm of this government because she spent all the time in Brexit , being obsessed with a ‘deal’ or ‘no deal’ with EU. The incompetence of those hard core Brexiteer cabinet colleagues(the ones she fearing )had not helped . Ultimately, domestic issues are proven to be more important than Brexit , at least , through indirect democracy in the general election.Even the divine power (or if you believe in God) sent her strong , painful messages through Grenfell Tower , cyber-attack on NHS and a series of terror attacks.
    (4) As far as the EU negotiation goes , one thing has become more apparent that this ‘divorce’ is not really bilateral; UK wants to break away but EU wants us to stay . And if it is a fine line between negotiation and extortion, it is ultimately about the word Power. This UK government is essentially powerless right now with a prime minister whom everyone is guessing how long will she survive for her leadership. I think this is something those strongly believing in Brexit must remind themselves all the time. Problem is there is nobody with a vision and audacity qualified this premiership with a historically unattractive job description. The prime minister also has nobody to turn to right now and the bankruptcy of trust and belief from people continues.
    (5) Whether Brexit will make UK great again(sounds like Mr Trump) in the future remains an academic argument to me. The financial system in the City(London) , being 10 times the size of our own GDP, is at least ready to take off one way or the other , growing eventually to 20 times bigger in 25 years , if things go ‘well’. BUT uncertainty is a slow poison. Perhaps, Mark Carney deserves some credit in sustaining the ship with all the measures from Bank of England since the result of the referendum while he had been under constant assaults from those hard core Brexiteer politicians. I think getting rid of his ‘baggages’ and setting an early ‘personal Brexit’ date in 2019 certainly had helped him to break his shackles.
    Unfortunately for our own GDP or economy, there is only so much Bank of England can do. The government needs the courage and vision to invest in new infrastructures(airports ,rail and housing etc )and new technologies to drive up economic growth . There is also an issue of low productivity in whole UK and hence , it is not just about the prosperity of the City . To achieve any progress on these , one needs a, once again , strong but honest government.
    (6)Talking about honesty , I do think Simon Stevens finally showed his spine in anti-spinning the argument of £350 million per week for NHS to put pressure back on the government. Use the lie to find the truth and it clearly states that we need the money for health and social care right now. If it is to raise tax or national insurance, so be it .Desperate times need desperate measures , simply put.
    (7)So where does this really lead us to? I still think it depends on May’s Choice. She has a Chancellor (arguably in a love and hate relationship with her) to announce the Budget soon and a deadline of ‘making up your bloody mind by December’ ultimatum from EU. Time is running out fast and furious .
    I honestly think we should move on with this Brexit or no Brexit dispute and stop the war between the two tribes. This reality needs to be shared by all of us and focus on the process . Sending abuses or even death threats to each other is only polarising the country even more......
    What is ‘important’ but what is more ‘important’ ? We are witnesses of history .

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  • Well, at least NHSE and Trusts will not have to shed tears when they have to pay salaries to EU staff and consider this as a waste. They are loathe to give equal pay to migrant workers and bully and harass them to the extent that your hear from GPs in retirement age who have spent their entire lives in the system warning younger GPs not to fight the establishment because 'your colour is not right'. The fear is ingrained in BMEs and migrant, so get on with it. NHSE bosses and Trusts will be happier to get rid of unwanted EU staff - the Agenda is privatization and the sorrier the state of NHS, the easier it will be to Yankize the system.

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