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Stephen Dorrell

Stephen Dorrell was Member of Parliament for Charnwood until 2015, and served as Secretary of State for Health from 1995-1997. He chaired the Health Select Committee from 2010-2014.

Political arguments seldom present a choice between right and wrong – almost always they offer a balance of advantages and disadvantages.

Until recently the EU referendum debate had seemed to be a good example.

Although I am a strong supporter of the Remain campaign, I had thought that the Brexiters had some good tunes. In particular they appeared to challenge us to show how EU membership serves the objective of developing the open and liberal society which most British people believe reflects their values.

As the campaign has developed, however, the Brexiters seem to be deserting their best arguments in favour of a toxic cocktail of prejudice and isolationism.

First, they allow an entirely legitimate concern to ensure that we are able to manage migration pressures to degenerate into a series of innuendos which make them look like the UK branch of Donald Trump’s election campaign.

Now they appear to be deserting their most important single challenge which is to show how the EU supports the core economic interest of all European citizens in open markets.

The Treaty of Rome represented a historic choice. The original six members chose to build their societies on open markets and their populations have enjoyed rising living standards and improving public services as a result. Other countries, including the UK, made other choices at the time, or had choices imposed upon them, but have since joined the EU primarily to allow their populations to participate in widening and deepening the internal market of the EU.

The Brexiters’ original challenge was to show how the internal market is inconsistent with the increasing globalisation of trade and a 21st century view which recognises that the common interest in open markets extends well beyond the frontiers of Europe.

More recently they appear to have forgotten this argument and started seeking support for Brexit on the basis that it is a vote to Leave is a vote against TTIP.

Leaving aside question of whether Britain outside the EU would really want to stand aside from transatlantic trade, the latest arguments for Brexit expose the incoherence of their position.

TTIP represents the answer to precisely the question which the Brexiters pose – is the EU interested in open markets and globalisation or is it inward-looking and protectionist? The answer is that, in an imperfect world, the EU is a more reliable advocate of the benefits of open markets than the Brexiters.

Even more importantly it exposes the extent to which the Brexit camp is prepared to clutch at populist straws in an increasingly desperate attempt to arrest an argument which is running against them.

The attempt to argue that TTIP is a threat to the NHS (as Peter Lilley did on this site on Monday) is a classic case in point.

Every European country is committed to the principle of equitable access to healthcare. Each has its own national arrangements for securing this social policy objective and the EU treaties are explicit that this is a matter for national competence, reserved for national governments. EU institutions have repeatedly stated that they have neither the power nor any interest in prejudicing this principle which is as important in every other EU country as it is in the UK.

Time and again the EU’s Trade Commissioner has made clear that TTIP will in no way be forced to open public health services to competition from private providers.

But facts do not appear to be relevant to the Brexiters. The opportunity to argue that “the EU is a threat to the NHS” is too good to miss, particularly if it can be linked, however implausibly, to the supposed ambition of US healthcare companies to “privatise the NHS”.

Not only is the argument dishonest, it also, in my view, ignores the very real interests of the NHS which genuinely are at stake in the EU Referendum debate.

First and most obviously, the NHS has a vital interest in the stability and success of the UK economy. The NHS budget cannot be insulated from the effect of economic uncertainty. More fundamentally, if health policy is concerned about human outcomes we should recognise that economic uncertainty also brings pressures on individual citizens which undermine wellbeing and create demand for health and care services.

It is hard to credit the cavalier way in which supporters of Brexit breezily concede that a vote to leave would create up to a decade of unnecessary economic uncertainty. It would be a decade in which avoidable funding pressures would impose yet further demands on services which we know are already extreme pressure.

Rather than indulging in dishonest scare tactics, the Brexiters should explain why they advocate a course which they must know would have negative consequences for both the health of individual citizens and the state of NHS services.

Furthermore, I believe that the NHS interest in the outcome of the referendum goes beyond funding uncertainties.

The NHS is also a major direct beneficiary of UK participation in the EU internal market which we would put at risk if we vote to leave the EU.

Modern medicine is not static or insular; it is built on a global commitment to apply the fruits of scientific advance to the benefit of individual patients. That commitment requires the open exchange of knowledge and free movement of both goods and people, as well as a global commitment to enforce standards of safety, quality and efficacy.

The EU internal market is an important building block in that global system. While Brexit would not divorce us wholly from the process, I believe it would distance us from the European mainstream and would, over time, undermine the leading role which we currently play in clinical research and development programmes, which in turn would threaten both economic growth and the quality of healthcare in the UK.

More fundamentally it would represent a substantial step down a protectionist and isolationist road which is fundamentally at variance with the strongest argument which the Brexiters say concerns them.

As the campaign develops it becomes increasingly clear that, far from being a voice for an internationalist vision, the Brexiters support the Albanian option – which doesn’t find much support in Albania, because they tried it.

49 comments for: Stephen Dorrell: Brexit would harm, not help, the NHS

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