Pippa is a third-year medical student at the University of Cambridge. She is a member of the Oncology Society and the vice president of Caius Medical Society She is also a tutor for science, maths, and medical school entrance exams. She writes blogs and is a BMAT Tutor for theMSAG.
As part of our NHS Hot Topics series of blogs, we are aiming to educate you in a series of areas relevant to the health service which you may be asked to discuss in your medical school interview. The aim is to help you with your expert interview preparation, whether it be for a panel interview of multiple mini interview (MMI). At MMI circuits, it is extremely likely that one station will be focused on your insight into medicine, so it is critical that you prepare.
We’ve discussed a number of other NHS hot topics so far, but this one focuses on how Britain exiting the European Union will affect the National Health Service (NHS). We don’t know for sure what’s going to happen, but the majority of doctors and nurses think that Brexit will have a negative effect on the NHS.
EU citizens are also entitled to a European Health Insurance Card (EHIC) when travelling abroad. This provides insurance so that they can access healthcare for free or reduced cost in EU member states. This means people have access to medicines and can be treated in a&e departments etc without having to worry about the financial burden. In the event of Brexit, it is highly likely that this EHIC card will be disbanded, and UK residents will have to purchase expensive travel insurance. This could be difficult for people with complex disorders, who may not be able to travel due to the high costs of obtaining insurance.
The European medicines agency (EMA), an EU body, must approve most medicines marketed in the UK. Post-Brexit, drugs would need to be approved in the UK, but additional approval would be needed before they are marketed elsewhere.
The EU regulation adopted by all member states including the UK also controls the hours that public can work, capping it at 48h a week through the working time directive. This protects both the workers and patients. Some people are concerned that post-Brexit these laws may be relaxed, which could be dangerous. There is a worry that health and social care may be affected. On the other hand, the working time directive is quite stringent and being able to interpret it in a more flexible way in the UK could better fit local needs and be a positive.
The UK is the largest beneficiary of EU health research funds in Europe. Public health and the NHS has benefited greatly from these research funds, with much being injected into clinical trials. Many professional researchers may no longer wish to travel to the UK to participate in research and clinical trials. Since the UK decided it wanted to leave the EU, we have already seen a drop in EU funded collaborative research in the UK. This will inevitably affect new treatments arriving into the UK and impact patient care and well-being.
Additionally, the EU is developing a new system of monitoring clinical trials, but there is a concern the UK may not have access to these databases post Brexit. This makes it hard for the UK to take part in international clinical trials, and thus may affect the health of NHS patients as there will be fewer opportunities for them to participate in clinical trials. People are also concerned about the UK having to remove itself from the reference network for rare and complex diseases. In the event of a new epidemic, it is possible that those living in the UK may experience delayed treatments due to a lack of information sharing.
The biggest threat to all of the above is uncertainty. If a Brexit deal is not reached and plans for leaving the EU do not fall into place, issues the NHS will face won't be about whether the UK has enough staff to treat patients, but whether needles, ECG machines, beds, medicines etc can actually enter the UK soil without too much delay. Brexit will restore the customs border between the UK and the EU implying additional lengthy formalities, customs and non-customs controls (sanitary and phytosanitary controls) and additional duty costs.
There are some positives that could come from leaving the EU. Although it is unlikely that there will be an additional £350million available per week, it is possible that some of the money the UK saves on EU membership could be injected into the NHS. Additionally, it may mean that more medical students can be educated at home, reducing competition for the extremely popular degree course. Finally Brexit may lead to an increase in demand for UK based private practices as they face less competition from similar organisations in the EU.
In all honesty, no one really knows what is going to happen, and the plans for leaving the EU are yet to be finalised. Make sure you keep updated with the news and see how the story develops!
We hope that this was a helpful overview of this NHS issue and you feel more confident tackling it if it comes up as a question. Don't hesitate to send us any questions or comments by email at hello@theMSAG.com. Good luck in your interview!
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