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NationCymru A news service by the people of Wales, for the people of Wales.

Opinion

We must not pull the plug on the NHS – the Single Market is its life support

By NationCymru

Rhun ap Iorwerth AM

It is often said that in the NHS, you are more likely to be treated by someone from the EU than you are to be sitting next to them.

Whilst this is currently the case, with almost 20 percent of doctors in the Welsh NHS coming from the European Union, it will not be like this for much longer.

Since the vote to leave the European Union and the triggering of Article 50 by the UK Government, 45% of EU doctors in Wales have said they are considering leaving the UK, and 12% have already made firm plans to leave.

We have not left yet, but the uncertainty caused by Brexit, coupled with the poor planning of the Labour Welsh Government and the failure to properly fund the health service by the Tories in Westminster has led to Wales becoming one of the European countries with the fewest number of doctors per head.

Risk

By being a member of the European Single Market, EU doctors and nurses can come to live and work in Wales freely, looking after our sick and our old, and, most importantly, making our country their home.

If the UK Government negligently, irresponsibly and recklessly revokes our membership of this highly beneficial union, we will lose the ability to attract doctors and nurses that our NHS so desperately needs.

Leaving the Single Market threatens to turn our NHS staffing crisis into a catastrophe. Yet, the UK Government are putting the ideology of their boorish, blundering Brexiteers ahead of the health and well-being of our people, and the Labour Party are doing absolutely nothing to stop them.

In Wales, we have been warned that if we leave the Single Market, we not only risk losing our EU doctors back to the EU, but also to London.

Hospitals in London and the South East, which are more affluent than ours in Wales, would be in a position to offer more money to EU doctors already in the UK to plug their staffing gaps. This risks draining Wales of our desperately-needed doctors.

Choice

It does not have to be like this.

If we remain in the EU Single Market, as Plaid Cymru has consistently been calling for, we will continue to have a flow of doctors and nurses coming to work in our NHS, feeling confident about their future in our country.

Not only this, but remaining in the European Single Market removes the unnecessary and highly dangerous risk of withdrawing from the EU Medicines Agency, which would cut the UK off from the market we rely on for medicines and vital supplies.

The NHS is operating at full capacity. It does not have the breathing space to cope with the unprecedented upheaval that Brexit presents.

We have two options: we can take the ever-increasing risks, leave the European Union and bear the all-encompassing costs of this, or we can remain in the Single Market, continue to enjoy the economic and social benefits of this and retain the stability and growth that are fundamental to our crucial public services like the NHS.

I know which option I choose. The Tories and Labour must now make their choice.

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18 comments

Angharad

Whilst I am completely with you in the thrust of what you're saying, could you explain your statement "the failure to properly fund the health service by the Tories in Westminster"? I realise that the Barnett formula means that if the English NHS is underfunded, Wales gets less overall. But it's still up to the assembly how to divide up the money it receives. I guess that's what you meant, but as it stands this serves to reinforce people's misperceptions of how NHS Wales is funded.

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Cyffin Thomas (@Cyffin_Thomas)

Cytuno'n llwyr!

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JD

I'm against the NHS as it stands. No, I don't want a fully private, uncaring American system but I'm bored titless of people unwilling to discuss mature, grown-up, and realistic ways of providing healthcare. The NHS doesn't work. 50% of Welsh cash is being spent on it and it's a bottomless money pit. Prescriptions should not be free and people need to start paying to see their GP. It's not that hard. If you're unemployed, homeless, a student, a child or unemployed then of course you should be excepted. But the current situation is unsustainable and can't go on. I really hope that Brexit will be a kick up the backside and make us realise that a socialist healthcare system is unsustainable and pretty much immoral when people are dying in corridoes and waiting for ambulances. Same goes for all the money wasted on third sector non-jobs in Wales.

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Eos Pengwern

Completely agree. "Imitation is the sincerest form of flattery", and there are good reasons why no other country has sought to imitate the NHS. Unfortunately it long ago ceased to be an agency for making sick people better, and became a totem that had to be worshipped by all who seek political office. Mrs. Thatcher did more to reform and improve it than anyone else has done, but no-one since her has had the guts. The American system is probably the worst in the world in terms of value for money - it gets comparable outcomes to most European systems, but at about twice the cost-per-head - but there are plenty of other examples of how to do things better. In almost all cases they involve some mix of basic state provision coupled with an insurance element, and a reasonable amount of private-sector involvement. The sooner it's recognised that the NHS as we know it today cannot continue, the sooner we'll have the chance of putting something better in its place. Brexit may turn out to be just the tonic that's needed.

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jim humphreys

Eos, I have my opthalmologist bill in front of me. Specialist was about 45mins, costing 90 euros. OCT scan was 190 euros and the reception costs were 17.50, totalling 297eu. The state automatic subsidy was 42.50, so total bill, 255 euros. Okay, it isn't a big reduction, but I had good treatment , and my eye drops also get subsidised. That is the Finnish system. You can also get reduced cost treatment from the state health system and it is very good, but I believe the clinics do reduce the pressure and their small, intimate atmosphere is relaxing. You don't need to go to a large hospital, fight for parking space or bus, as they are generally located in the town centre.

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In reply to jim humphreys

jim humphreys

I've just found out, the cost to see a State doctor starts around 12.50 euros. Someone told me they had a series of tests and it was 20.80 euros. Chronically ill folk go for free after an initial consultation. One generally goes to a "Health Centre", normally located in a local hospital. (In the countryside they are a bit like cottage hospitals.) Last time I was at one, the waiting room was full of the united nations, so there must be some pressure there. Private clinics are mushrooming, though as yet they only do minor operations and certain special sports injuries. The government seems to be finding great difficulty in marrying the private and public sector. Perhaps Wales could have clinics and the state do the very expensive stuff?

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In reply to jim humphreys

Eos Pengwern

I have no first-hand experience of the Finnish model, but what you describe sounds altogether sensible. A mixed public/private model already works well in the UK for ophthalmology (I should know, I've just started wearing glasses as of last week) and reasonably well in dentistry (again, I should know, since my wife is a dentist who works part-time in both private and NHS clinics - though I could tell some stories, which I'll save for another time). Of course it works very well in education - over the border in Shropshire they have both some of the highest rates of children attending independent schools and some the best-performing state schools in the UK.

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In reply to Eos Pengwern

jim humphreys

Interesting. Of course, I don't expect anyone to take this up, but it led me to think of small private Welsh owned clinics, not conglomerates, whose patient's bills and medication could be subsidised, and the chronically ill, of course, totally free. Such clinics, because of their small size, could be located in town centres. So you would have, general clinics, dental clinics, and opthalmology, (a good use put to all those small empty buildings in towns? (Elderly people might also like to live centrally? ) This could free-up A & E, and you would know far better than I what the state hospitals could do?

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Thomas Moseley

My recollection is that immediately after the referendum vote Leanne Wood announced, ostensibly on behalf of Plaid Cymru, that respect had to be given to the majority vote in favour of leaving the EU. Lord Wigley appears still to be of that opinion: I refer to his recent article on the issue in Nation Cymru. It follows that it is not my recollection that PC has 'consistently been calling for' remaining in the EU single market but am glad that one prominent Plaid AM is now in favour of that policy. Plaid Cymru's policies on the issue have in my opinion been muddled and inconsistent. Can we hope that there has been a re-think on the issue and that PC is now firmly in the remain camp?

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Dimondfi

I think it wasn't immediately after the referendum (tweets seem to confirm this), but at the autumn conference. That disappointed me too, though I think is part of the game playing that other parties are also playing. Plaid are clearly, still, firmly pro-EU. Of that I have no doubt (otherwise I would have handed back my membership card). I think the signs are better now than before. There's still a bit of game-playing going on, internally there's no question what they want, but I too think the public position is shifting a little.

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Rob Bruce

The UK voted (narrowly) to leave the EU - the political union. Membership of the Single Market and/or the Customs Union was not on the ballot paper. Indeed many Leave campaigners including Farage himself argued that the 'Norway option' (membership of the Single Market but not the political union) would be available to the UK should we leave. Plaid's position has been consistent - we voted to leave, but we must ensure that we leave on the best possible terms, including continued membership of the Single Market on which so much of the Welsh economy depends. The fact that (thanks in large part to the petrified silence of Labour in Westminster) the parameters of Brexit have been hi-jacked by the far right of the Conservative Party and its allies in the right-wing press, and that conceptually Brexit is now widely understood to mean what used to be referred to as Hard Brexit is a massive coup for those that see this as an opportunity for the UK to get a head start in a race to the bottom. Plaid, along with the SNP and the Lib Dems deserve credit for being consistent in their opposition to the catastrophic approach being taken by the big two parties in Westminster.

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Richard Perkins

Very well said. In addition to the points made in this article it should also be remembered that the fall in the value of the pound due to the Brexit vote has increased the costs of medical equipment, bought from abroad.This places even further pressure on NHS Wales budgets. This is hardly the benefit that was promised before the referendum . If you see a person about to walk off a cliff do you take the view that it is their free choice or do you intervene to stop them? We have a parliamentary democracy of sorts not a direct democracy. This means that our MPs and AMs are representatives and not delegates. They should exercise their own judgement on the basis of the available evidence and their talk of 'respecting the vote' is, in my opinion, politicians' cant, a sop to a poorly informed majority of people who voted to leave. Brexit, is in the opinion of the majority who have taken the trouble to research the matter, a no win situation for all save a few wealthy individuals and perhaps some fishermen. We shoot ourselves in the foot and our friends in the back. Staying in the single market will help stop the worst happening. As we approach our national day it seems we might see MPs of the four countries and all parties realizing that there is an existential issue here and then being brave enough to come together, independent of party allegiances to do what they are elected to do and vote for what they know is in the best interest of their country and not worry so much about their own skins.

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Graham John Hathaway

A strange coincidence of Rhun's article, I think you timed it for my benefit, that I've spent these last few days (night) many hours in Prince Charles hospital with a close relative. Waiting , unfortunately 8 hours wait for a bed in GP out of hours service (A and E). And on metal seating. But not on our own. I cannot thank the staff well enough or loudly enough. They don't walk then run. It wasn't to keep fit. But help. We were seen by 3.doctors during this time. All were nationals from others Countries. Asian, Irish and middle eastern. Excellent. Each one, besides the support staff. This is one of the most highly regarded hospital I know, we must protect. And fight for it. Free at the point need and delivery. Always. Keep the faith, support Rhun and the open doors to Europe, and the world. Enough said.

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Tame Frontiersman

If NHS staff vacancies cannot be filled with European nationals then it means recruiting more widely and from countries with a poorer doctor population ratio than Wales and who can surely ill afford the poaching of their doctors and nurses. This is a shameful situation.

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Graham John Hathaway

We cover our shortfall of trained medical staff because of poor planning, under investment, but clever campaigns of recruitment abroad , with those who qualify here exercising options of choices of where best to work, and in what specialisms. The issues of morality and ethics when recruiting abroad is secondary to the dire consequences of a very political problem of what to do when you fail to fund a very costly and dynamic health service. It never stops developing new techniques and medicines. Yes costly. But so these large companies not paying proper taxes. I know, privatise. Now that to some is a brilliant Idea. Pass the responsibility to the private sector. Snaffle staff from anywhere. Run the service to breaking point. Quitting the EU provides every opportunity to downgrade and sell if off to the highest bidder. In comes America. Or the City. And, as already been spoken off begin the slow process of charges, GP appointments to start, consultations next, medicines shortly afterwards, and roll out buying insurances to cover hospitalisation and surgery. Job done. Unless we unite now and campaign to protect this last free at the point of need and delivery, the NHS will slowly diminish and collapse. It's all about money and the spectre of large profits. Wales can stand outside of this kind of politics, if it chooses to. By popular demand,

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sianiflewog

Seems even Corbyn - who can be trusted to blow all directions in a wind from any particular direction - has sussed that leaving the eu will cause a contraction in the economy and the subsequent pain that follows - less money for health and education. But people chose wilfully to believe the self-confessed liar Ffaridge (rhymes with parrage). Can an election/referendum fought using bare-faced lies be taken as a mandate to do anything. Sadly another referendum even if contested on fact would probably be lost. Large numbers of Uk population hate the eu due to decades-long 'eu-hate' propounded by the likes of mail, sun and express. The concept of shared 'sovereignty' to achieve a wider aim is, arguably, too complex for those who read (look at the pictures) in organs mentioned above. As we are now seeing, absolute sovereignty isn't that effective when 'negotiating' with a bigger more powerful interlocutor. And the eu is relatively civilized - just let Uk see what happens when trying to conduct trade deals with Us and china - try saying to them 'Ah, but we are a sovereign state and see how far it gets 'em. As a member of the sub-working class, or as the BBC describes us, 'the precariat', i am concerned at the thought that a visit to the offthalmist (or whatever they choose to call themselves - ?Augenarzt?) would cost me ca 200 euros . I've just seen one under the nhs, and thought it took a year to get, it was free (fairly low priority, i undrerstand).

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edrydparry

this has project fear written all over it. we are leaving the EU not Europe. If you are already living and working in a country and are settled in that country why would you consider leaving because of changes to a trade agreement. The UK government has already said that the rights of those EU nationals already living and working in the UK when we leave will be protected just like those of UK nationals will be protected in Europe. there will be no mass exodus of health professionals or anyone else when we leave the EU because for the majority of those of us who get up each morning and go to work very little will change.

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Gillian Jones

I live in a small market town, which has a large number of English retirees . A few weeks ago I was the only Welsh person in a packed surgery. These English immigrants have paid their dues to the English NHS but it is the Welsh NHS that is paying out as they get older .

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I've just found out, the cost to see a State doctor starts around 12.50 euros. Someone told me they had a series of tests and it was 20.80 euros. Chronically ill folk go for free after an initial consultation. One generally goes to a "Heal...

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