Jonathan Ashworth speech at the European Parliament
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Jonathan Ashworth, Labour’s Shadow Health Secretary, speaking to MEPs and European health experts at the European Parliament in Brussels today, said:
Good morning and thank you for this invitation to speak to you today. It was my friend Rory Palmer MEP who invited me to Brussels today to outline Labour’s thinking on impact of Brexit on our National Health Service. I look forward to talking directly with many of you about the issues I’m discussing this morning.
2018 is the seventieth anniversary of the founding of the NHS.
It is a year for us to reflect on its achievements and to be proud of its reputation as the best health service in the world.
It is also a year for us to look forward to the NHS’s future in the decades to come.
My argument today is that we cannot look to the NHS’s future without looking at Britain’s future relationship with the European Union.
Britain’s health as a nation – like its economy – is intrinsically linked with Europe.
So today I want to talk about Labour’s approach to Brexit.
The UK is leaving the European Union.
That decision was taken in June 2016.
I campaigned for Britain to remain, the city I am proud to represent in Parliament –Leicester – voted to remain but I accept the British people chose for us to leave.
We cannot relive the arguments of the referendum, we must now look to the future.
The debate about Brexit is complex.
The single market. The customs union. Alignment. Divergence. Soft Brexit. Hard Brexit. Red, white and blue Brexit.
But look beyond the technical rhetoric and buzzwords it boils down to a simple question: does Britain want to stay close to Europe or does it want to be distant?
That is a question Labour can answer. We want to stay close. We want to collaborate. We want a future based on our shared values of internationalism, solidarity and equality, as well as mutual benefit and fair trade.
That is what Jeremy Corbyn, the Leader of the Labour Party set out last week.
And today I want to set out what that vision means for healthcare, innovation and medical science.
Quality in provision of healthcare is absolutely dependent on a quality high skilled workforce.
In recent days the United Kingdom has battled with snow, ice and sub-zero temperatures. Throughout our big freeze the dedication and commitment of health and care staff has been extraordinary.
Nurses and doctors sleeping in hospitals to keep in close contact with their patients, community nurses and care workers battling through blizzards, walking miles in the snow to make their appointment with the elderly and vulnerable for whom they care. Paramedics cycling through treacherous elements to emergencies because their vehicles couldn’t get through the snow.
Many of these amazing NHS and care staff maintaining our universal health service whatever the difficulties will be, of course, EEA Nationals. The NHS would not function effectively if it was not for the thousands of European nationals who work in it.
They care for our families and cure our loved ones seven days a week, 365 days a year. They are our friends and neighbours.
Across our health and care sector approximately 167,500 European nationals are employed, including 90,000 in adult social care and around 60,000 in the National Health Service itself.
Between 7-10 per cent of doctors currently working in the UK are from the EEA working in nearly all specialties, including some that are facing severe workforce shortages such as general practice, emergency medicine, paediatrics, occupational medicine, radiology and psychiatry. We have 21,000 nurses from the EU, and over 13,000 clinical support staff.
We owe each and every one of them a huge debt of gratitude and, as we go through these difficult negotiations, we must never forget that.
Our NHS is absolutely reliant on these staff. And if they left the NHS the workforce crisis our NHS currently faces would become a catastrophe.
NHS Improvement recently confirmed this warning, with research which revealed vacancies for 100,000 staff across the NHS.
And the sad truth is – because of the pay cap, cuts to development funds, increased workload and the ongoing financial squeeze – for first time in years more nurses are leaving the profession than joining.
Which is why as NHS Providers said at the end of last year “there is a continued need for provider trusts to recruit and retain staff from the EU and the rest of the world to mitigate the workforce gap.”
But because of Brexit uncertainty many EU nationals have left the NHS in recent times. NHS figures released in September showed 10,000 EU employees — including nurses, doctors and other staff—had already quit. Meanwhile NHS recruitment from the EU has fallen sharply since the vote for Britain to leave the European Union.
The number of nurses and midwives coming to work in Britain from Europe fell by 89 per cent in the year after the UK voted to leave the EU. The sharp fall coincided with a rise of 67 per cent in qualified Europeans leaving the Nursing and Midwifery Council’s register.
And the number of doctors coming to the UK from the European Union fell 9 per cent in 2017 to an eight-year low, according to the General Medical Council.
The British Medical Association has found that 45 per cent of EEA doctors were considering leaving the UK and moving to another country.
No wonder hospital leaders are expressing alarm, saying “we would not be able to maintain high-quality care for the people we serve without our diverse workforce. The current lack of progress in the Brexit negotiations is creating unhelpful uncertainty in an already challenging workforce environment.”
And the Royal College of Nursing has warned that “lack of certainty is undoubtedly a key reason that EU nurses are no longer choosing to work in the UK, which is already putting pressure on staff and services.”
So what is Labour’s response? We accept our immigration system will change and freedom of movement will as a statement of fact end when we leave the European Union. But Labour will offer EU nationals certainty.
As Jeremy Corbyn said last week, our priorities are jobs and living standards not bogus immigration targets. So Labour will design an immigration policy around the needs of the economy based on fair rules and the reasonable management of migration. We would not do what the current government is doing, start from rigid red lines on immigration and then work out what that means for the economy afterwards.
We would start on the principles of fair rules, the reasonable management of migration and recognition of the contribution that nationals from across the world play in our public services.
And that means both guaranteeing the rights and status of existing EEA nationals but also ensuring our NHS and care sector can recruit the staff needed to care for our sick and elderly now and in the future.
It’s my ambition that our NHS isn’t just fully staffed but one of the very best places to work as well.
Much of UK employment law that originated from the EU provides absolutely key protections for health and social care staff – whether that’s health and safety at work, such as the legal frameworks to reduce risks of musculoskeletal disorders, or on stress offering vital support and protection especially to, for example, nursing and care staff.
Or for example safeguarding TUPE arrangements which have increasingly been needed as staff are transferred with NHS services outsourced and privatised in recent years.
Leading Conservatives see Brexit as an opportunity to deregulate our economy still further – driving down rights at work, consumer protections and environmental standards. Several cabinet ministers have made clear their opposition to rights at work such as the working time directive.
Labour would ensure there will be no reduction in rights, standards or protections, and instead seek to extend them. A deregulatory race-to-the-bottom would damage people’s jobs, living standards and quality of life.
Let me now turn to our continued cooperation in the treatment and care of patients.
Throughout its 70 years the NHS has been at the forefront of innovation, research and advances in medicines and technology. Antibodies and DNA were discovered in the UK. Our life sciences sector is worth £64 billion and employs around 233,000 people.
Thanks to the strength of our pharmaceutical base every month, 45 million packs of medicine move from the UK to the EU, with 37 million packs going from the EU to the UK. Half of the UK’s medicines exports go to France, Germany and the Netherlands.
So given the scale of trade between the UK and the EU on medicines, but more fundamentally given disease knows no borders and that we share many similar health and demographic challenges, it would be great folly to dismiss the huge benefits that the UK and the EU 27 have gained from our close relationship over the past forty years.
The reality is effective joint working with our European partners has been vital for the NHS over recent years on everything from infectious disease control to the licensing, sale and regulation of medicines.
We know that developing new medicines depends on the international co-operation that is fundamental to access to clinical trials. Patients in the UK are able to access EU-wide trials for new treatments and the UK has the highest number of phase 1 clinical trials across the EU, as well as the highest number of trials for rare and childhood diseases.
So it’s absolutely paramount for improving health outcomes in the UK and EU that the UK can continue to access these networks.
The Prime Minister has now given a commitment to explore the terms on which the UK could remain part of the European Medicines Agency. But we need certainty now from the government on timings and membership throughout the transition period to ensure patients have access to the continued supply of medicines from day one post-Brexit.
Because just as the United Kingdom could lose out on access to key research, if no clarity is offered during the coming stages of negotiations then certain medicines and medical technologies – some of them life-saving – may be delayed in reaching patients or may even become unavailable to patients.
Take the example of Switzerland. Despite having a number of bilateral trade agreements with the EU, it is estimated that Switzerland, which is not in the EMA, gains access to new medicines on average 157 days later than the EU.
And the Brexit Health Alliance offers the devastating example of a prostate cancer drug under development in Britain. Faced by the possibility of a no deal Brexit scenario, the manufacturer has begun planning the duplication of quality testing and release facilities in an EU27 location. However, the calculated duplication time for the manufacture and quality control testing is at least 42 months, with a risk of taking longer.
This would affect the supply of this cancer treatment to patients, including up to 120,000 patients in Europe each year. Due to the technical complexity of the analytical methodology and specific equipment required, it will be extremely challenging to transfer such knowledge from the UK to testing laboratory within the EU27 by April 2019.
Or what happens when medicines and devices need to move across borders quickly when time is of the essence? Customs checks could cause delays to care and treatment of critically injured during emergencies.
It is anticipated that post-Brexit customs checks could result, in one of the best-case scenarios, in a delay of five hours according to an investigation by the House of Commons Home Affairs Committee. These five hours are critical in life and death situations where critically injured patients need care and treatment as soon as possible.
It is utterly unacceptable to put patient safety at risk like this because of lack of certainty about medicine regulation post Brexit.
Labour will not sign off on a Brexit deal that turns the clock back on medical innovation or sees patients in the UK having to wait longer to get access to life-changing treatments. It is an unacceptable red line for me and it is an unacceptable red line for the Labour Party.
We would not seek to deregulate our standards of medicines regulation or to place barriers to the supply chain.
Labour does not wish to rip up the standards, rights and protections that we have developed together for many decades.
We want to maintain them and, where necessary, work together to improve them. Close cooperation between the UK and EU in the area of medicines regulation is in the interests of patients in the UK and EU. Slow progress on reaching a deal could mean delays in accessing potentially life-saving treatments, harm patients and public health in both the UK and EU.
Last week Jeremy Corbyn pledged to maintain a new and strong relationship with the single market that includes a floor under existing standards. Also we would not seek to duplicate existing structures and systems where current arrangements have served us well.
That is why I can confirm today that a Labour Government would seek to continue to be a part of the European Medicine Agency and adhere to the EU regulatory framework on the authorisation and conduct of clinical trials, because it serves our national interests, the interests of the EU27 and most importantly it serves patients’ interests.
We would not put ideological red lines before the nation’s health.
We are leaving the European Union, but that does not mean we should not remain partners in those areas that are in our shared interests.
So with respect to research, we know research is increasingly international and scientific breakthroughs are not made in isolation.
Just look at the collaboration and joint working we have built on genomics and biodata to see how crucial it is to maintain ongoing co-operation. Or our joint working and funding, which facilitates greater research into rare disease with the UK co coordinating the highest number of European registries of all EU states, including for childhood lung diseases and Huntingdon’s disease.
Given our strong science base in the UK and our commitment to support the new life-saving treatments and medicines of the future we believe we must safeguard and indeed strengthen our joint research co-operation.
As we said in our manifesto last year, Labour would seek to stay part of Horizon 2020 and its successor programmes and of course continue to welcome research staff to the UK.
The EU’s Horizon 2020 scheme is due to invest billions in health research across the EU over the next five years. This is significant funding, whose long-term nature is vital to give security to those medical institutions and universities planning major research projects. Institutions cannot just wait and see what will happen after the First of April 2019. We need clarity now.
Finally, let me turn to the issue of reciprocal healthcare.
It is a vital principle that British citizens can obtain free healthcare elsewhere in Europe, just as they would here at home from the NHS.
That is a vital safety-net for British holiday-makers, and for UK citizens living elsewhere in Europe.
The Brexit debate in Britain is often bogged down in the technical details about our future trade relationship or the jurisdiction of the European Court of Justice. But, what is equally important for people and my constituents is the issues that affect their day-to-day life. Nobody voted leave because they wanted to lose access to shared healthcare across Europe.
Agreement has not yet been reached between the UK and the European Union about the future of these arrangements.
This issue cannot be ignored. We need to see progress and we need to see it as a priority of the negotiations.
So I can confirm today that a Labour Government would seek to prioritise the negotiation of continued access to existing EU reciprocal healthcare schemes, or the creation of comparable alternatives.
For the UK, this approach would ensure continuity of care for its citizens living abroad and ease of access for UK citizens visiting the EU or EEA and avoid increased demand on and costs for the NHS.
Our Labour colleagues in the House of Lords have been challenging UK Ministers over just these issues as the EU Withdrawal Bill goes through their end of Parliament, tabling and moving amendments to prioritise negotiation of continued access to existing reciprocal healthcare schemes, as well as fighting hard for our future relationship with Euratom and on medicines and clinical trials as well
Of course the Brexit-NHS debate in the UK often rotates around Boris Johnson’s utterly dishonest claims the NHS would be funded by an extra £350 million a week post Brexit.
The truth is a fully funded National Health Service will only be possible at the next election with a Jeremy Corbyn Labour government.
But despite the bogus claims of Boris Johnson, Michael Gove and Liam Fox it’s obvious there are huge implications for our NHS from Brexit.
Labour will not let patients suffer through an understaffed NHS or let access to life-saving treatments be delayed through a poor Brexit deal.
As Jeremy Corbyn said last week “Brexit is what we make of it together, the priorities and choices we make in the negotiations.”
I have confidence we can resolve the issues we face in order to offer patients in the UK and across the EU the certainty so obviously needed.