The £350 million per week question: What will Brexit really mean for mental health and the NHS?

BrexitOn June 23, Britain, by way of public referendum and by a 52-48% margin, became the first member state to vote to leave the European Union (EU). Nobody had planned for this.

As a tiny amount of Brexit dust begins to settle, it remains to be seen exactly what this unprecedented decision will mean for the National Health Service (NHS) and mental health services in the United Kingdom. However, one point already seems clear: it will not mean the redirection of the £350 million per week previously sent to the EU that the leave campaign claimed could be used to fund the NHS.

Many in the health sector are calling for this claim – a carrot that was dangled to entice voters to vote for the exit – to be honoured. The fact that leave campaigners have distanced themselves from the claim ever since does not bode well. First things first though. Two weeks on, and we still are none the wiser as to when, or even if, Article 50 – the notification of Britain’s formal decision to withdraw from the EU within two years – will be triggered.

Many in the health sector are calling for this claim – a carrot that was dangled to entice voters to vote for the exit – to be honoured. The fact that leave campaigners have distanced themselves from the claim ever since does not bode well.

Unfortunately, the stark reality in the UK is that mental health funding falls low on the list of political priorities. That list got significantly longer when the UK voted to leave. What’s more, following David Cameron’s resignation, Theresa May became Britain’s second female prime minister on the 13th July. It remains to be seen what importance she will attach to the NHS and mental health and when the next general election will be – traditionally a time for bold promises around health care to be made – is also up in the air. The ongoing debate around private influence will continue, and as usual, the Conservatives are likely to be more receptive to this than Labour.

All in all, nobody’s got a clue, really.

Potential risks to mental health

The Health Service Journal has highlighted that the biggest risk to the NHS – which many with mental health problems depend on – comes from the possibility of recession. Undoubtedly, Brexit’s most important influence on the NHS and mental health funding will be the performance of the economy; given the UK’s HM Treasury’s grim prediction that should Brexit occur “in the longer term, the UK will be permanently poorer,” the signs are not good. If these claims are true, then public spending cuts could well follow, and the implications for an already squeezed service could be huge. If the British Sterling experiences a prolonged decline in terms of its value, then goods and services the NHS purchases from abroad, including some drugs, will become more expensive.

Then there’s the risk to staffing levels. To date, Theresa May has failed to guarantee the status of EU workers in the UK. The NHS is home to 55,000 of them, and 80,000 work in adult social care, although exact figures for mental health are unclear.

Undoubtedly, Brexit’s most important influence on the NHS and mental health funding will be the performance of the economy; given the UK’s HM Treasury’s grim prediction that should Brexit occur “in the longer term, the UK will be permanently poorer,” the signs are not good.

Brexit itself has been accused of causing the number of mental health referrals to mushroom, and at a time when services are under intense pressure already, some clarity and guarantees would be most welcome. We haven’t even begun to talk about what will happen to the volunteer sector, but things are no clearer there either.

Watch this space.

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