The significance of Brexit combined with Government rhetoric about ‘home-grown’ doctors has left many medical workers from the EU feeling marginalised to the point of leaving the UK. Tim Tonkin reports
'I feel like a disposable commodity.’
‘The result of the referendum has made me feel not welcome any more.’
‘Brexit has been a great disappointment to me.’
Those were the stark assessments offered up by EU doctors working in the NHS, in a BMA consultation into the impact of the UK’s vote to leave it.
Taken by 1,193 respondents, the study sought to shed further light on the experiences and perspectives of those European doctors who collectively make up almost 7 per cent of doctors working in the NHS.
With around 135,000 EU nationals working in an NHS and social care system wracked by underfunding and staffing shortages, many of the findings will not make for comforting reading.
When asked whether they were considering leaving the UK as a result of last year’s referendum result, 42 per cent of those surveyed conceded that they were, whilst 23 per cent said they were unsure.
On a scale of 1 to 10, European doctors stated they feel significantly less committed to working in the UK in light of the EU referendum result. From an average of nine out of 10, commitment dropped to six out of 10.
Salaried GP Tatjana Street is one of those doctors who is considering her future, having moved to the UK from Germany with her British husband in 1996.
As a junior doctor at hospitals in Cornwall and the Midlands, she would work 56-hour shifts every third week, occasionally working as much as 120 hours a week, before finally qualifying as a GP.
After returning to Germany on a sabbatical prior to last year’s referendum vote, Dr Street has kept in touch with colleagues in the NHS about the fall-out from Brexit.
Although she has great admiration for the NHS, Dr Street said that she is now unsure about whether she will return to the UK.
She says: ‘It [the referendum] has certainly made me think about whether I come back or not. I love the NHS; working in it is a great privilege as it feels like you’re contributing towards a greater good and making people’s lives better.’
Dr Street said that the Government’s handling of the Brexit vote had added to her unease, pointing to health secretary Jeremy Hunt’s rhetoric about the need for replacing overseas doctors with ‘home-grown’ ones.
She added that she thought ministers’ approach to EU staff in the NHS had been ‘completely disgusting’.
She said: ‘I always loved Britain because the people were open-minded and tolerant of each other and there’s a real mix of skills and cultures. Now, it seems as though it is becoming a more inward-looking society.
‘There has not been any support for EU or international doctors since the referendum and no recognition of what we have done for the health of the nation.
‘I am keeping my options open but I do not know how it is all going to pan out. The Government needs to give people more clarity about what’s likely to happen, so that they can plan for their futures.’
An absence of either clarity or support from those tasked with overseeing and implementing Brexit were common themes among many EU doctors.
Lack of support
In its survey the BMA found that 55 per cent of respondents said they did not feel that the UK Government does enough to support international doctors from within and from outside the EU compared to only 9 per cent who do.
Consultant anaesthetist Luis Fernando Jimenez Zaratiegui first came to the UK from Spain in 1989 as an adventure, with no intention of staying for any length of time.
During the past 27 years he has worked in hospitals across England and Wales and is based in Swansea with his wife and daughter. As much as he has enjoyed his life in the UK, Dr Jimenez Zaratiegui said that he feels his future is now uncertain as a result of Brexit.
This sense of uncertainty was highlighted two weeks ago when, for the first time in his life,
Dr Jimenez Zaratiegui was stopped and questioned at UK border control following his return from an anaesthetics conference in France.
He says: ‘They were asking whether I was coming to the UK as a visitor or whether I lived here. I have never had any problems like this before and I felt insulted – I have a right to come to this country.
‘I love this country. I have had chances to go back to Spain but I’d rather stay here as I’ve always been treated very, very well in this country.
‘I understand that the British people voted to leave, and I respect that … The Government has to understand that there are a bunch of EU nationals in this country, some of whom have been here for a long, long time paying taxes. They [the Government] should come out and clarify our [EU nationals’] situation one way or the other.’
Not a second thought
Hubertus von Blumenthal, who works as a GP partner in Cambridgeshire, has lived in the UK for almost 30 years.
He says that until the referendum the thought of his immigration status virtually never crossed his mind.
He says: ‘I have worked as a GP in the UK since 1989, and for the first time in almost 30 years, I feel like a foreigner here.
‘Patients say to me, “Oh you won’t need to leave, you can stay because you’re a doctor. We like you. We didn’t mean you,” but the reality is that the Government sees EU nationals like me as a bargaining chip in negotiations, with no consideration of what we’ve contributed to the UK.
‘For myself and many colleagues this situation is unnerving, and although it’s not something I want to do, I have to consider whether it’s time to move to another country.’
Dr von Blumenthal says that he was exploring options over his future in the UK, adding that a return to Germany or move to his wife’s home country of the Republic of Ireland were possibilities.
He says that while remaining in the UK was possible he was concerned by the lack of clarity on issues such as how his pension might be affected as a non-British citizen.
He says: ‘They [the Government] need to simplify the process of right to remain and voting rights, that is the decent thing to do. Why should I be forced to take citizenship? What difference does it make to Britain? I am happy to be a German living in Britain and what is wrong with that?’
Despite the uncertainty of his own situation, Dr von Blumenthal says that he also had grave concerns as to the ‘serious fall out’ that a potential exodus of EU health staff could have on the health service.
He says: ‘With the NHS already over-stretched, it worries me that doctors like myself have been left in this situation because without them the health service will struggle to cope.
‘You have GP practices in this country where just the loss of a single doctor could result in that practice collapsing. People leaving is going to have an enormous impact on the provision of safe healthcare services in this country.’
Prior to its survey, the BMA had already called for the Government to prioritise health in a post-Brexit UK, to take account of how much it relies on overseas doctors to continue to provide a safe level of care in the NHS and do more to support those European staff already here.
Its recommendations include granting permanent residence to all existing NHS staff from the EU, and for future immigration policy to remain flexible enough to allow gaps in workforce to be filled by doctors from overseas with the skills needed.
Without it, BMA council chair Mark Porter warns that the uncertainty and anxiety being imposed on EU medical staff owing to Brexit threatens to destabilise the entire NHS.
He says: ‘Thousands of overseas and EU doctors work in the NHS with many more in public health, academic medicine, and medical research. While doctors work to provide the best possible care for patients, many from the EU are left feeling unwelcome and uncertain about whether they and their families will have the right to live and work in the UK after Brexit.
‘These are the people who staff our hospitals and GP surgeries, look after vulnerable patients in the community, and conduct vital medical research to help save lives. Many have dedicated years of service to healthcare in the UK, so it’s extremely concerning that so many are considering leaving.
‘At a time when the NHS is close to breaking point and facing crippling staff shortages, this would be a disaster for our health service and threaten the delivery of high-quality patient care. But this isn’t just about numbers, having a variety of skilled professionals enhances the experience and expertise in the health system which is beneficial to patient care.’
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