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Whatever your view on the outcome of the EU referendum, there is no doubt of the profoundly destabilising force it has exerted upon the country.
As doctors, our priority remains the care of our patients, but we have been dragged into a situation that may compromise our ability to practise in a number of highly significant ways, and which has raised fundamental questions about the funding and workforce of a service already in crisis.
While none of us can confidently predict the political future, or give all the reassurances we would wish to give, I can tell you some of the practical steps the BMA is already taking during this highly volatile situation.
Our first priority, as always, is the safety and wellbeing of our members in order that they can continue to deliver high-quality patient care.
I know you will share my utter disgust at the individuals who have taken the referendum result as a green light to vent their hateful and xenophobic attitudes at the people who care for them.
We are one profession, we stand by every single one of our colleagues, and we know that the National Health Service is enriched by the contribution of doctors from every country in the world.
The picture above, which has proved very popular on social media, shows a team from a hospital in London. Three are Spanish, while the others are German, Greek, Irish and there is a British doctor of Pakistani heritage. Anyone who raises the Blimpish question of whether people of different nationalities can work together need only spend a day in an NHS hospital to find out the answer.
I urge those in need to make use of our Doctors for Doctors counselling service, and for our members to share both their concerns and messages of support on the ‘connecting doctors’ part of our website.
In addition, we plan to write to local negotiating and local medical committees to encourage them to work with trusts and employers in supporting European and other overseas colleagues. The growing number of trusts who have pledged their strong support to staff has been a welcome and necessary retort to those poisonous and xenophobic incidents.
And we can all show our support individually. You do not need me to tell you that this is a time when we should be particularly mindful of our overseas-born and trained colleagues, who may be feeling shocked and betrayed, and I would also urge you to support the #safetypin at an appropriate time and #loveourEUstaff campaigns which started on social media.
The implications of the referendum decision will be felt for many years to come, and at the BMA our policy staff have already started work on areas such as professional regulation, public health and employment law. It means that when the government and parliamentary committees begin their consultations on these vast areas of public policy, we will be ready to contribute meaningfully to them.
Our work in Brussels has not diminished as a result of the referendum, it has intensified. Our office there, the first to be established by a national medical association more than 20 years ago, is continuing its important work shaping European policy in areas from trade deals to trans-fats.
We have already written to reassure some of the European organisations that we will do all we can within the new arrangements to continue our close working relationships. They share our commitment. The Standing Committee of European Doctors agrees that ‘we together should overcome the challenges ahead thereby staying committed partners’.
In the UK, we are also contacting the many organisations with which we work, such as royal colleges, unions and patient groups, to explore the ways in which we can work together.
This situation befalls an NHS already facing, in England alone, £22 billion of further cuts on the top of the existing deficit by the year 2020. In a massively more uncertain economic climate, and at a time of great political instability, we will press with even greater commitment for the NHS to be funded to the level that patients need and which politicians have promised.
This is the worst possible time for politicians to be playing games with the health service for their own political ends. I told the BMA annual representative meeting last week that the Leave campaign’s promise of £350 million a week of additional funding for the NHS if the UK left the European Union was ‘beyond irresponsible’.
Even by the sorry standards of recent elections, I cannot think of a promise from which politicians have so swiftly sought to retreat.
That is simply unacceptable. I will be writing to the prime minister and health secretary to pursue the funding the NHS needs, and that which the public have shown clear support for, and to make the point forcefully that our colleagues and patients deserve better than to be the subject of an empty bribe.
While the BMA is working on many fronts, I wish I could offer, especially to my overseas colleagues, the certainty and reassurance they deserve as to their status in the UK. I am afraid that even – perhaps especially – the architects of the current situation cannot offer that. There are many questions already, and many more that have not yet even been considered. This will be the age of unknown unknowns.
But what the BMA can do is offer the strongest possible support at this deeply unsettling time. This is the year in which we have shown in our disputes and campaigns that we are united. We now face some fundamental issues - the right of doctors to be treated equally in their pursuit of high quality care, and the right of patients to a functioning and adequately funded health service. More than ever, we must remain one profession.
Very difficult time and time to come. The architect of exit compain seems not knowing what to do and how to handle. Another recession may be eminent
The fear of open borders with certain countries has been expressed to me many times. It is not the principle of the EU, but the safety of it in the future is worrying.
Well done Dr Mark Porter, in showing strong leadership to promote doctors and protect patients. Your and your team's input at the ARM and SRM has been superb. Moreover, this is a good time to mend fences with the Conservative Government and the Labour opposition by negotiating with them behind closed doors and avoiding confrontation visible to media. Politics is a science for dealing with realities and Academics is aimed at achieving highest standards in the NHS. Doctors and patients need both; please lead on. Certainly, you and your team has our full confidence and support. Dr Bashir Qureshi, Life Member of the BMA. London.
I voted No in the first referendum in 1974 and saw to come true all the disadvantages I predicted as well as a few I had not forseen. I had no difficulty in voting leave and I am delighted with the result. What has not delighted me is the strong and abusive words of Dr Porter who apparently thinks I am "xenophobic and hateful". I am a caring doctor, racism disgusts me, I don't even notice or care about anyone's skin colour, I love foreign travel and I have a fairly good grasp of Spanish. I think the only hating as well as intolerance is coming from elsewhere not from my direction. I should be allowed my view even if it is not the 'official' BMA standpoint. As has been said we are one profession. Let us always respect the opinion of our colleagues as long as it is held sincerely and without prejudice.
I left my UK unit to work abroad. Our unit births rose 30% over a 4 year period departmental statistics demonstrated that this rise was due solely to births to immigrant mothers. We did not receive a commensurate increase in staffing or intra structure and it was the impossible working conditions that drove me to leave.
Failure to address concerns regarding the impact of immigration has resulted in the leave vote not racism or xenophobia. If the BMA had put greater effort into addressing the aforementioned then the remain voters may have won.
I am waiting for some serious operations, if these actions mean i have to wait longer for my operations then so be it,i am 100% behind the doctors,they are life savers and trying to force them to work under conditions the politicians would never even consider doing is so wrong,ive worked 7 days a week and it's soul destroying as well as sapping all your energy and it prevents you having any kind of normal life,so although im in a lot of pain right now,im still prepared to wait longer form operations, we need to look after our life savers otherwise we will severely suffer in the end, the politicians are ok because they have private health insurance and doctors on call 24/7 as well as beds kept deliberately to ensure immediate treatment paid for by the taxpayer, this is another case of im ok so i don't care about you.
The NHS will suffer a lot of defects in health provision if no overseas practitioners work in UK.
The BMA should have been neutral on the EU referendum but they championed the remain vote and thereby are guilty of collusion – not with patients but with an EU organisation that is unelected, unregulated and unaccountable. Would the BMA so champion a British DOH that was similarly corrupt? At least there is the hope of getting rid of Jeremy Hunt in our current Sovereign system of Parliament
I would like to thank Mark Porter for his words. As an Italian national who has lived in the UK since I was 12, worked in the NHS for 22 years and now train future GP's as a GP Trainer, it has been nice to hear that somebody believes and cares that EU Nationals contribute to the Health of the UK and all its residents. I am also a member of the BMA so seek the reassurance that my organisation will do everything it can to protect me in these uncertain times. It saddens me though that, while I am viewed as a useful commodity and therefore worthy of remaining here, the Portugese cleaner who has worked in my surgery for 10 years or the hard working Polish factory workers I treat are not viewed or treated with the same respect.
The uncertainty regarding the security of domicile and work of EU nationals in the UK post-Brexit,including those working in the NHS,has not been created by the leaders of the Leave campaign(what you have described as "the architects of the present situation").You have failed to make it clear that all these Leave leaders have stated categorically that ALL EU nationals and their families currently in the UK are welcome to remain permanently if they so wish.This contrasts with the views of our incoming Prime Minister and current Foreign Secretary,both of the Remain persuasion,who are both shamefully planning to use these EU nationals as mere bargaining counters in post-Brexit negotiations.Now that's what I would refer to,using your very partial words,as"poisonous and xenophobic".
Emeritus Professor R C Fraser CBE.
I get the impression that Dr. Porter is truly and honestly apalled by the latest developments in the UK. But this is not the general feeling in large parts of the population.
I am a European National and have worked many years in the UK as a Consultant. The xenophobia was always lingering and was expressed even by colleagues.
I left the UK more than two years ago, because I had become increasingly concerned about the ways in which I was forced to treat my patients, i. e. not because of xenophobia, which I could handle rather well.
There were of course still many positive aspects about working in the NHS and living in the UK and I was asking myself whether I had taken the right decision. But following these latest developments I am glad I got out in good time and would advise everybody else in a similar situation to consider leaving. If the economy is truly going to dive, the xenophobia is only going to get worse.
I am sure many of our colleagues from other countries out of the EU voted leave as many think that we came to robe their jobs, many have purposed english test and more filters to join the GMC as they felt delouse of our natural right to work in England. I know that the process for people from outside from EU is really difficult but WE DID NOT created the rules! There is a double moral and hypocresy. Bravo for the leavers, perhaps, at the end, they will receive the treatment that they deserve. I was temped to use a T Shirt at work saying "I just to came here to help".
Immigrants go where there are jobs for them. I have been 19 years in this country and it was always obvious to me that we foreigners do the jobs that the brits do not want to do: this goes from preparing coffees to having a corner shop to medicine. I am a consultant in a speciality in permanent recruitment crisis. So who exactly within the immigrant population the LEAVERS do not want?