The economic damage caused by Brexit would hit tax revenue
UNISON has weighed up the arguments and concluded that to leave the EU would put the NHS at significant risk.
Our members are not politicians; they contact us about real issues that matter to them. And there are specific threats for nurses as a result of a potential Brexit.
Put simply, leaving the EU would mean less money for the NHS and more staff shortages.
To begin with, Brexit would damage the UK economy, meaning less money for public services such as the NHS and potentially endangering nurses’ jobs and their standard of living.
Supporters of Brexit claim that money that goes to the EU could be better spent on the NHS. But every day we see how a weaker economy has led to cuts in public spending, with a severe impact on services such as the NHS.
Some of the most vociferous campaigners calling for the UK to leave the EU are now saying that the money should go to the NHS. It’s hard to believe when people like Michael Gove or Douglas Carswell, who have a track record of supporting increased privatisation in the NHS, suddenly become its strongest supporters.
The economic damage caused by Brexit would hit tax revenue, wiping out at a stroke any saving the UK made from not paying into EU budget. So there would be less money for the NHS, not more.
This would likely have a knock-on impact on nurse salaries. UNISON modelling based on government data suggests that public service pay could reduce by £740-£4,824 per annum. Within this, a nurse could be as much as £1,200 worse off each year.
The NHS is dependent on EU migrants helping to fill staff shortages in nursing and the wider health workforce. There are 50,000 citizens from the Europe Economic Area currently working in the NHS, a figure that rises to 130,000 if social care is added to the mix. Around 6% of nurses come from the EU.
The Social Market Foundation claims almost 90% of EU nationals working in the public sector would not meet current visa rules under Brexit. And issues such as work permits, a tougher migration regime and passport difficulties could be expected to deter many nurses from even trying to come and work in the NHS in the first place.
With four-fifths of hospitals now in deficit, the National Audit Office estimates that the NHS has a shortage of around 50,000 clinical staff. In the past two years this has led to thousands of EU nurses being recruited to the NHS.
Any further reduction in the numbers of nurses available to the NHS could place greater pressure on the service and on those nurses who find their workloads becoming intolerable as they are required to cover gaps in staffing.
There would also be potential danger for nurses’ rights at work and for health and safety if the UK were to leave the EU.
Many of the regulations that nurses rely upon to protect them at work are enshrined in EU law and upheld by the European Court of Justice.
Leaving would mean that hard-won rights such as paid holiday, breaks, fair working hours, equal rights for part-time workers, and maternity and paternity leave would no longer be guaranteed unless introduced in domestic legislation – and that would depend entirely on having a government that would support this.
And the agency work directive is designed to make life easier for agency nurses.
Changes to the European Working Time Directive made in the EU automatically flow through to nurses’ contracts, ensuring a basic level of safety for nurses from extreme over-work. The directive has helped reduce critical incidents and errors in health systems across EU from tired staff.
EU legal processes have also ensured that healthcare staff are paid properly for things such as on-call work or sleeping-in at work
Similarly, needle stick injury regulation has come about directly as a result of trade unions working through the EU. And there is ongoing work in this area to ensure the regulations do not just apply to employers but are extended to pharmaceutical manufacturers as well.
So the decision to back the Remain campaign was not one that UNISON took lightly. But it is clear that nurses benefit from our membership of the EU and that a Brexit would have very harmful consequences for both the NHS, its patients and its workforce.
Christina McAnea is UNISON’s head of health