Our health care abroad
UK citizens obtain health care in other member states all the time. We’ve researched this in detail over many years. They include the estimated 2.2 UK citizens living in other member states, people who fall ill on holiday and use their European Health Insurance Card to get treatment on the same basis as those in the country in which they are tourists, and those with rare illness who are sent abroad by the NHS for highly specialised treatments.
The last group is often overlooked. There are many diseases, often genetic in nature, which are so rare that even the biggest countries have only a few cases. It makes no sense for everyone to try to establish treatment facilities. The EU has created a network of centres of excellence so that these unfortunate individuals can get the best available treatment. Again, many of these things could be organised if the UK left the EU. But it would be a massive task, and for what possible gain?
In the meantime, millions of British citizens would face profound uncertainty. Take the over 400,000 British pensioners who have retired to Spain, with more in France, Italy and other member states. Those supporting Brexit have made much of the Vienna Convention, arguing that these individuals could retain “acquired rights”. Unfortunately, this is quite wrong. Article 70 of the Treaty specifies that, where a Treaty has a termination procedure, as the Lisbon Treaty has, it “releases the parties from any obligation further to perform the Treaty”. Consequently, there would be no guarantee whatsoever that the current arrangements and entitlements for these UK pensioners abroad would be protected.
The EU supports our health care at home
Europe isn’t just about people moving to get treatment, it’s also about people moving to provide it. Yet migration seems to be one of the main concerns of those supporting Brexit. They talk of the burden placed on the NHS, even though the evidence is clear: if you see a migrant in a NHS hospital, they are far more likely to be treating you than competing for a place on a waiting list. At a time when many hospitals are dependent on migrant staff, and even with the present level of migration struggle to fill all their posts, this doesn’t seem like a good time to make it more difficult to recruit from abroad. Indeed, it is not going too far to say that, without the EU, the NHS would have already collapsed. By harmonising professional qualifications and creating mechanisms to ensure the quality of those moving within Europe, it has meant that we have been able to recruit the health workers we need. The same is true for academic researchers. The UK is a world leader in research, but 20% of the academic workforce are nationals of another EU member state. It hardly seems a good idea to make things difficult for them by requiring them to get visas and work permits.
The EU helps us stand up to private health care threats
There’s one other aspect of health care that some supporters of Brexit focus on. They argue that the EU is a pawn of global corporations, including those that want to undermine the NHS. We on the core team are as concerned about the role of global corporations as anyone else. And of course, within the EU, there are many competing agendas, jostling for influence. Brexit supporters are particularly concerned about the Transatlantic Trade and Investment Partnership, or TTIP. So are we. A particular concern is that corporations will be able to take governments to secretive tribunals, where decisions are made not by judges but by negotiators, and where the powerful dominate. They rightly argue that this could threaten public services like the NHS. But what they ignore is how the EU has listened.
Look at the position the European Commission is arguing in negotiations. It wants a new investment court that would be led by real judges, randomly assigned. The hearings would be in public and all documents would be online. The judges wouldn’t be allowed to swap between being a judge and representing a client. And there would be an appeal mechanism. This is totally different to the Investor State Dispute System that has been used in trade agreements previously and addresses our major concerns. Would the UK be able to agree a similar mechanism on its own? We doubt it.