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Recruitment Article: NHS and Care Homes after Brexit

Author: Eastern Europeans. 2016

The question is what effect a British exit (Brexit) from the European Union (EU) might have on care homes for the aged in the United Kingdom (UK). Even before enactment of the European Union Referendum Act 2015, there was a chronic shortage of UK nursing care homes and healthcare workers generally due to low pay, chronic stress, and poor morale. A November 2015 report from the International Longevity Centre warns of shortages "exasperated" by proposed restrictions on immigration from non-EU areas and on the healthcare industry's ongoing inability to recruit enough UK-born workers to nursing occupations.

In Europe, many countries have a minimum wage rate plan in place except for countries like Denmark, Italy and Sweden. Comparison of minimum wage rate in different countries exposes the fact that there are minimum wage rate differences. However, there are also differences in the strength of the different economies. The cost of living is also put into perspective as the money earned is also likely to influence how it is going to be spent. Other factors that are used to compute wage rate include; the age of the worker, the occupation industry, regions and pay across other sectors.

The UK Office for National Statistics estimates that 91,000 UK care workers, one in seven, are non-EU immigrants. Another statistical estimate is that 71,600 social care jobs, one in 20, twice the rate for the UK labour force as a whole, are unfilled.

The report urges relaxation of visa requirements for those who come to the UK to work in healthcare. The growing aging population drives demand for more caregivers, but high staff turnover, an aging workforce, and immigration restrictions make these positions very difficult to fill. And now the prospect of UK withdrawal from the EU, which provides for entirely unrestricted migration among member states, raises more concern over how to relieve the chronic nursing shortage in an economic sector highly dependent on personnel from abroad.

Care Home Finances
To enter UK care homes, candidates undergo assessments of their needs and financial conditions from their local councils and assessments by nurses if they require nursing care. Care home costs are means-tested. At the lower capital limit, all candidate income from pensions, savings, and other sources goes toward care home fees except for a small, regular personal expenses allowance. The local council pays any remaining contribution.

The UK National Health Service (NHS) funds the whole care home placement if the resident meets the criteria for NHS continuing health care determined by a multidisciplinary assessment.

The NHS Role
The NHS faces budget cuts, sliding standards, and a drain of foreign doctors and nurses if the UK leaves the EU, says UK Secretary of State for Health Jeremy Hunt, because Brexit would put NHS service and investment levels at risk with a loss of key personnel on the NHS front line.

As the 23 June date for the leave-or-stay referendum approaches, the government wonders whether the still high numbers of undecided voters could decide to back Brexit. Hunt argues that the NHS budget, already squeezed and stretched, can maintain necessary funding levels only if the UK economy stays strong. He cites a series of economic surveys as evidence of adverse Brexit effects on the UK economy and on the government's ability to continue to provide public services.

Hunt suggests that to leave the EU would stall the government's progress in employing 11,000 more doctors and 12,000 additional nurses and cause UK health and social care systems to lose many if not all of its 100,000 skilled EU workers, who would emigrate over visa and residence uncertainties. Matthew Elliott, chief executive of Vote Leave, an organization campaigning since October 2015 for the UK to leave the EU, attacks these suggestions as unreasonably alarmist, like comparing Brexit to a nuclear disaster. "Does this government's scaremongering know no bounds?" he asks.

Practical Considerations
Though some Brits take an intellectual interest in Brexit economic issues, most ordinary people care about how the decision on the referendum would affect their daily lives. An important consideration is healthcare. With the NHS and many care homes already struggling to carry on, would a vote to leave the EU help or hurt these ailing institutions?

Brexit would be unlikely to affect day to day access to healthcare. The government claims constant commitment to a health service free at the point of use despite controversies over junior doctor contracts and privatisation within the NHS. Most other EU countries have no national health services; they rely on medical insurance systems.

British citizens are entitled to European Health Insurance Cards for access to free or discounted medical care in all EU countries. If the UK left the EU, its citizens no longer would be eligible. The UK would have to negotiate for new card terms, and there's no guarantee that the EU would allow British citizens affordable healthcare after a Brexit.

If the UK leaves the EU, the number of doctors and nurses at work in the NHS and in care homes could drop sharply and rapidly, though this result is not clearly inevitable. But thousands of NHS and care home workers come from EU countries, their skills and expertise are invaluable to UK healthcare services, and millions of patients could suffer if these workers suddenly left.

Though the government is likely to encourage NHS workers from the EU to remain on their jobs even if Brexit goes through, the difficulties and uncertainties of working outside the EU may induce many to return to their home countries. How exactly and ultimately the outcome of the Brexit debate will affect UK healthcare is difficult to predict. In any case, it is probably safe to say that however the outcome affects the NHS will affect care homes similarly.

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