View from the ground, by Dr James Thambyrajah

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Dr James Thambyrajah

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In writing this article I am not trying to be overtly political or anti-Brexit, it is simply my attempt to process how Brexit will affect my CCG, my colleagues and friends, and most importantly, my patients. I have been contemplating what Brexit means to me (and you) as a GP, and reading every news update about Brexit. Naturally, we try to process politics through our own individual view points. Why do I care so much about Brexit? To quote the late Charles de Gaulle: ‘Politics is too serious a matter to be left to the politicians.

If you’re a fisherman off the coast of Scotland, you might be hoping that the Government keeps its promises about prioritising regulations so you can fish openly in our nation’s surrounding waters, without fear of European fishermen taking all the fish. If you run a small business that relies on trade via a single market and a solid customs union, you might be fearing for the livelihood of your business if that union is broken. As a GP, what I worry most about is my patients’ access to vital medicines. 

The Health Secretary recently implored GP practices and pharmacies not to locally hoard medicines as preparations are put in to place to prepare for a ‘no-deal’ Brexit. It is estimated that £2 billion will be needed to set aside 6 weeks’ worth of vital medicines in an attempt to avoid supply disruptions in the event of a no-deal Brexit.

When people voted for Brexit, did they honestly think they would be asking the Government to stockpile medicines?

Additionally, the EMA has dramatically cut Britain out of its contracts 7 months ahead of Brexit meaning that we will not be evaluating new medicines. This is a horrific blow to British pharmaceutical companies who are already recovering from the loss of the EMA’s London headquarters, which resulted in 900 job losses.

When it comes to the NHS workforce, 62,000 NHS staff in England are EU nationals—that is 5.6% of all staff. Additionally, 12.5% of all NHS staff state that their nationality is not British. Nearly 4000 staff from the European Economic Area (EEA) left the Nursing and Midwifery Council register between 2017 and 2018. Just a few weeks ago the RCGP released a statement expressing concern about the latest NHS Workforce Statistics, describing them as ‘demoralising and distressing’. 

Helen Stokes-Lampard, RCGP Chair, has emphasised the importance of NHS England following through on its commitment made in the General practice forward view of 5000 more GPs and an extra £2.4 billion funding, but if an extra £2 billion is required to stockpile medications in the event of a no-deal Brexit, where will we find another £2.4 billion to pay for General practice forward view?

At the start of 2018, the Department of Health was renamed to the Department of Health and Social Care. I considered this as a step in the right direction as it has been clear that social care has not been prioritised enough with regards to the health of our patients. Figures from the Institute of Fiscal Studies state that local authority spending on adult social care decreased by 8% between 2000 and 2017. This statistic is very personal to me as, like many GPs, I regularly look after patients at a nursing home. I have seen the impact that reduced social care spending has on the general health of our patients. 

Many of the healthcare assistants and nurses that I work with are EU nationals. For example, I have a nurse colleague (and friend) who is Romanian and lives in London with her husband (a builder, also Romanian) with their 7-year-old daughter who was born in the UK. I asked her what she thinks about Brexit and she told me: ‘I’m scared for the future, we’re settled here but Brexit may change everything. We may have to go back to Romania—I don’t want to go back as this is our home.’ My friend is one of the most hard-working colleagues I know, a great team member, and an excellent nurse for her patients. We cannot afford to lose individuals like her. 

Stockpiling of medicines, job losses, and a mass-exodus of highly skilled NHS workers—is that really what ‘Vote Leave’ campaigned for?

Dr James Thambyrajah

Full-time salaried GP, Cheam Family Practice, Sutton