Day Two of our series on the 70th anniversary of Scotland’s NHS

WITH the clock ticking down inexorably to March 2019, we have finally moved beyond “Brexit means Brexit” into discussing the real impact of leaving the EU on ordinary people. The mess is due to a chronic, and ongoing, schism in the Tory Party over the EU but also because politicians and the media rarely celebrated any of the protections, rights and opportunities gained from EU membership over the last 40 years. With regards to health, the EU has made significant contributions to individual, public and environmental health.

READ MORE:Key Scottish sectors will be jeopardised by leaving the EU

For patients, the most noticeable contribution is likely to be the doctors and nurses who look after them. Despite the claims of the Leave campaign, EU nationals are low NHS users as they are younger on average than UK citizens. Across the UK, 130,000 EU nationals contribute to our health and social care by working as nurses, doctors and care workers.

READ MORE: We depend on EU nationals – that’s why Scotland must set its own immigration policy

Workforce shortages are causing increased waiting times in all four UK health services and surveys have shown that 14% of EU doctors in Scotland are in the process of leaving the UK as they do not feel secure here, particularly after the Windrush scandal. People from the UK travelling in the EU have been protected by the European Health Insurance Card (EHIC), while pensioners have been able to use the S1 system to transfer their healthcare rights to the EU country of their choice.

Better maternity rights, employment protection and health and safety regulations have improved the safety of the workplace. What some criticise as red tape may save life or limb! As a young surgeon, I saw workers with chemical or thermal burns and horrific limb injuries from poorly protected machines. Product standards in the single market have protected children from burning nightdresses and dangerous toys. Standards on water quality have improved sewage processing and cleaned up our beaches while pollution controls tackled the acid rain which was killing forests. However, nitrous oxide and particulate pollution from vehicles is still responsible for up to 40,000 UK deaths each year – yet we have seen how reluctant the UK Government is to tackle the problem. Who would apply that pressure

after Brexit?

Theresa May’s rejection of the European Court of Justice (ECJ) excludes us from the regulatory agencies of the EU, despite the fact that any supra-national agreement requires a supra-national arbiter.

The European Medicines Agency (EMA) symbolises much of what we have gained from the EU in the last 40 years. It evolved from the regulatory systems of EU countries into a single streamlined licensing system which speeds up the availability of new drugs for patients and controls costs for the pharmaceutical industry.

Quality control testing of medicines must be carried out within the EU, so many of these jobs will move to the continent while Asian pharmaceutical firms are likely to move their European offices from London as the EMA headquarters relocates to Amsterdam. While the UK Government recognises the impact of leaving Euratom, the nuclear regulatory agency, on the nuclear energy industry, the Royal College of Radiologists has highlighted the effect on the steady supply of medical radioisotopes for diagnostic scans and cancer treatments.

As the Government points out, these materials are not fissile so can be purchased on the open market but, since a world shortage in 2008-10 which affected many cancer patients, the Euratom Supply Agency has ensured a secure supply.

Funding schemes such as Horizon 2020, and the ability to collaborate and share data, have made the EU into the largest research network in the world with the UK, until now, the biggest beneficiary. Scotland punches well above its weight in academic research due to its strong university, medical and pharmaceutical sectors, but may now lose its collaborative partnerships.

Considerable EU health research is focused on challenging conditions such as dementia, obesity, and emerging antibiotic resistance. The latter requires not just a change in practice by doctors, but the curbing of their use in livestock farming, and would need to apply across Europe.

It’s far from perfect but the EU has brought 28 countries together to face the difficult challenges of our time. It is, certainly, about much more than just trade!

Dr Philippa Whitford is a breast surgeon and SNP MP for Central Ayrshire