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Dr Dominic Pimenta @juniordrblog
, 15 tweets, 5 min read Read on Twitter
Dear @MattHancock.

I’ve been trying to understand the WTO/No Deal scenario. For the NHS, there is no contingency plan for “No Deal” that won’t stop people dying.

/thread
Firstly, here is my attempt to understand WTO rules and what happens to us if we leave on no deal:



I’ll wait.
2/ The NHS, long before Brexit, from your govt & your mate Jeremy, is in poor shape.
- We don’t have enough staff (100,000 short total, 40,000 nurses, 10,000 doctors)
- we don’t have enough funding (~£26b)
- Demand continues to rise by 4% every year

google.com/amp/s/www.bbc.…
3/
All the NHS alarms are blinking red:
- Worst A&E waiting times on record
- Longest ever operation wait on record
- Worst ever cancer referral wait on record
- GP numbers falling
- Nursing numbers falling
- Deficit at est £6b (£500m surplus 2010)
nuffieldtrust.org.uk/files/2017-08/…
4/ This isn’t just inconvenient, the stakes are human lives.
- Nursing numbers/patient are vital to surviving illness
- 120,000 deaths in U.K. since 2015 due to NHS cuts
blogs.bmj.com/bmjopen/2017/1…
5/
It feels insane to have to say this as “background” but in healthcare money really MATTERS.
Like “Gran won’t be with us for Christmas” matters.
6/
To No Deal. Firstly May’s proposed NHS funding boost was linked to a “Brexit dividend”. There is no “dividend”.
fullfact.org/europe/does-br…
Your govt themselves est No Deal will cost 8% GDP over 15 years- that’s £159b. Thats the entire NHS AND schools budget combined.
7/
So money will be tighter. So will staffing levels.
Post Brexit EU nursing applications fell by 96%. Currently there are 55,000 EU NHS.

No Deal will mean these citizens have no legal basis to work or live or receive pensions here.

We cannot afford to lose any more staff
8/ Other parts of our NHS are tied up in the EU:
- The European Medicines Agency approves drugs. With no deal we will have to approve our own, a long & costly process.
- Drug companies will de-prioritise the U.K. for new medicines, like new cancer drugs.

ema.europa.eu/ema/index.jsp?…
9/
We also import a lot of medicines. Leaving the EMA and customs union without a licensing agreement will stall future medicine imports for months if not years.
10/
EURATOM monitors, stores & transports nuclear material.
We use these for diagnostics including cancer, heart disease & treatments for thyroid & bone diseases.
With No Deal we don’t have a solution to do this ourselves: scans and even cancer treatments will stall until we do.
11/
Horizon 2020 is a £500m European research initiative, funding cutting edge research in the U.K. Since Brexit these projects are no liable for funding beyond 2020. With No Deal they cease entirely before then. gaeu.com/item/brexit-im…
12/ Lastly health isn’t just determined by the resources available to treat disease, preventing is just as if not more important.
- Further social care cuts precipitate worsening mental and physical health
- Economic hardship worsens mental and physical health
13/ A No Deal Brexit will have a massive knock on effect on the nation’s health and it’s healthcare.

People will die as a direct consequence of this decision.

And that is on your government @MattHancock , contingency or otherwise. /end
Addendum. Case Study 1.

This is what a #NoDeal #Brexit may look like to an individual.

This is what terrifies me.
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