Speaking on behalf of the Britain Stronger In Europe campaign, leading nurse academic Professor Anne Marie Rafferty makes her case to Nursing Times readers to stay in the European Union.
Health is one of the key issues in the EU referendum debate and rightly so because the EU exerts a major influence on health and employment rights within the UK. The results are likely to have a big impact on nurses across the country.
The central question is whether or not our NHS would be in a better shape in or out of the EU? A strong NHS needs a strong economy – and it’s clear our economy is stronger in the EU.
Experts ranging from the governor of the Bank of England, Mark Carney, to Christine Lagarde, head of the International Monetary Fund, to president Obama himself, argue that cutting ourselves off from our biggest market will cost Britain dear, as the cost of selling abroad rises and jobs are lost. Such economic damage would reduce the money available for the NHS, and put it under further financial strain.
The chief executive of NHS England, Simon Stevens, has warned that “when the British economy sneezes the NHS catches a cold” and that “this would be a terrible moment for that to happen at precisely the time the NHS is going to need that extra investment”.
The independent Institute for Fiscal Studies has projected that leaving the EU would create a £40bn black hole in the public finances. That’s the equivalent of NHS England losing over a third of its budget.
The NHS could face massive cuts with serious consequences for the quality of healthcare that we enjoy, and for pay and conditions for people working in the NHS. Hospitals, ambulance services, and health professionals are all at risk if we leave Europe.
Over 130,000 EU nationals work in the health and social care sector. If we left Europe, our ability to staff the NHS would be put at risk, causing waiting times to rise, the quality of care to go down, and staff to be overstretched and even more pressurised.
The support to remain from NHS workers and experts is strong. The Royal College of Midwives and the biggest trade union representing NHS workers, have both publicly supported Britain to remain in Europe.
Four former health secretaries – Alan Milburn, Patricia Hewitt, Andy Burnham and Alan Johnson – have also said remaining in will be better for the NHS. They commented that leaving would risk “frightening consequences for staffing, waiting times and levels of service care”. And the Royal College of Physicians has indicated that most of its members back remaining in the EU.
I believe staying in Europe is better for the NHS and makes nursing in the UK stronger. We benefit from common standards of education across the EU and access to research funding, second only in size to the US Military R&D budget.
Without this we would not have been able to undertake our major cross national study of nurse staffing and patient outcomes under the banner of RN4Cast. This study has been influential in the debate in safe staffing in the UK and informed the evidence base underpinning nurse to patient ratios in Wales.
But it is not just the NHS that we should look to for impact and repercussions. Leaving the EU could have a major impact on higher education for nurses and how we train and educate nurses and midwives; build capacity for exchange of expertise across Europe and most of all to protect standards of education. We are one of the last nations to mandate a Bachelor’s degree as the entry into practice in the EU in England.
Pegging practice at this level brings us into line with the EU and acts as a ballast against the ‘dumbing down’ of nursing education, which our research from RN4cast has demonstrated can be so deleterious to patient mortality and outcomes. In employment terms, the EU protects vital workers’ rights, including paid leave, parental rights, holidays and anti-discrimination laws.
These are issues that rarely make the headlines as we are often unaware of their impetus and origin. But in nursing they have impacted health and safety issues such as the management of needle stick injuries in practice.
Leaving the EU would be a leap in the dark that would rebound on our economy, health, educational and employment sectors, impacting recruitment and retention within the profession as well as mobility and movement of talent to the NHS.
The EU referendum is a once in a generation choice to secure Britain’s place in Europe and protect the NHS and Britain’s health for generations to come.
- Visit the Britain Stronger In Europe website to learn more about its campaign
Professor Rafferty, fellow of the Royal College of Nursing and dean of the Florence Nightingale School of Nursing and Midwifery, was writing in personal capacity