Last week, the “Healthier in the EU” website launched. The campaign's message is that the EU allows the UK to pool resources with our closest neighbours to tackle important issues from public health (air pollution, tobacco, chemicals) to health innovation (medicines approvals, research networks) to large frameworks of healthcare (cross-border healthcare, international patients’ groups).
But what might be the implications for the private healthcare sector of an in or an out vote?
Impact on cross border healthcare
One of the supporters of the "In" campaign is John Bowis, former MP, UK Health Minister and MEP. He says:
"Our EU membership has brought many health benefits, not least the right to go abroad for treatment and have the bill paid by the UK, which is the essence of the Cross-Border Health directive, which I piloted through the European Parliament.”
The "EU Directive on patients rights in cross-border healthcare" has been around for a couple of years now. But there isn't a great deal of evidence that it has changed the way that healthcare works within the EU. In theory, UK patients, frustrated by NHS waiting lists, can opt to go to another EU state for their healthcare. They pay the costs of their treatment up front to the overseas provider, and then claim back the cost from the NHS. They can only go abroad for treatment to which they already have a right under the NHS, and will only get reimbursed up to the NHS tariff rate. They can choose a public or a private hospital in another EU state. But so far, the number of patients who have exercised this right are very few.
In the same way, patients in other EU countries have the same right to "import" their healthcare to the UK. A French patient could opt to cross the Channel and have their operation in a UK NHS or private hospital. But again, there is little evidence that this is actually happening.
Exchange of knowledge and expertise
Another supporter of the "IN" campaign, Trisha Greenhalgh, OBE FMedSci. Professor of Primary Care Health Sciences, University of Oxford, says:
“I am a European citizen, a European doctor and a European scientist. To withdraw from the EU would diminish my identity, compromise my clinical practice and reduce my ability to produce world-leading scientific research”
This is a valid point. If we were outside of the EU would we have the same sharing of knowledge and expertise with others in the EU that we have now? One of the aims of the EU Directive is the establishment of European Reference Networks. These are intended to bring together the best specialists from across Europe who can combine their efforts to tackle complex or rare medical conditions that require highly specialised healthcare and a concentration of knowledge and resources.
London's private healthcare sector is to some extent successful. It brings together multinational expertise, much of it derived from London's teaching hospitals, and makes it available to a global patient audience. If we exit the EU, will centres such as Paris and Berlin slowly replace London as the centres of knowledge and expertise in some specialties?
Where will we find the staff....?
Perhaps the biggest impact on the UK's private healthcare sector would be the added difficulty of recruiting staff for the UK's private hospitals. One thing our membership has done is to make it easier for other Europeans to come to the UK to work. The "No" campaign focuses on the negative aspects of this.... "they're coming over here and taking our jobs". But, that's certainly not the case in the healthcare sector.
The private healthcare sector, particularly in London and the South East is becoming more and more dependent on importing expertise from the EU and elsewhere. In a recent personal experience of daycase surgery in one of BMI Healthcare's private hospitals, what was noteworthy was the number of nursing and ancillary staff who were from other EU countries. Only the lady who served me my tea would be described as "White British" on a census form. If we erected the barriers to the many excellent staff attracted to the UK from countries such as Spain, Portugal and Greece, how would we replace them?
Better off in...
My personal view..... membership of the EU is good for the UK economy and the healthcare sector. The UK's healthcare system is an international healthcare system, that attracts expertise from across Europe and from around the world. If we erect barriers to the transfer of people, expertise and knowledge, it can only be a backward step.
My prediction.... a close vote but one that will go in favour of staying in.