The vote to leave the EU has created a context of profound political and economic uncertainty. What does this change of circumstances mean for the future of the NHS?
The impending resignation of David Cameron, the battle within the Conservative Party to succeed him and the turmoil within the Labour opposition have created an unprecedented party-political vacuum. It seems likely that whoever becomes the next Prime Minister will require a new mandate to govern, making an early general election more than likely. It would be hard to overestimate the importance that this election will have for the mid- to long-term future of the country. Until the political uncertainties of the post-Brexit landscape have been resolved, insecurity will become the new normal. Moreover, the referendum result has serious implications for the country’s economic prospects, creating widespread financial uncertainties, not least over plans for the future organisation and funding of the NHS and social care.
The existing challenges facing the NHS now appear even more serious, making careful planning, protection and stewardship of the NHS more than ever needed. Key issues – the adequacy of NHS finances, changing demographics and disease burdens, recruitment and working conditions, rising health inequalities, the quality of primary and secondary care, already drastically reduced social care spending, and mental health services provision – will require even closer critical attention. So will the role of the private sector in providing NHS and social care services, a cause to which prominent politicians in the campaign to leave the EU have long been committed. While many of these issues may be harder to address, given the uncertainties we face, those committed to securing the future of the NHS must continue to work to see them resolved.
Given the importance of the NHS’s budget as a share of total spending, and as a share of GDP, renewed downward pressure on both of these will mean that the NHS is bound to remain a key political battleground subject to competing interests, ideologies and agendas; with a heightened risk that those seeking to take advantage of the political vacuum caused by the referendum may seek to use the NHS to further their own agendas at the expense of preserving it as a public good, free and available to all at the point of need – a danger illustrated all too clearly by the Vote Leave campaign’s promise to redirect the sum of £350 million, allegedly paid weekly to the EU, to fund the NHS instead, a commitment reneged upon as soon as the result was announced.
Given what the referendum vote has revealed about the deep inequalities that deface and divide British society, the pervasive sense of disenchantment and discontent, and the willingness of some politicians to make the NHS an instrument of other agendas, the need for properly evidenced critical research of the kind which the CHPI aspires to do seems to us if anything more important than ever. We will do our best to meet this need, and trust that we will have continued, and hopefully increasing, support from everyone who shares the same commitment.