On June 24 at 6:30 a.m., just a few hours after the result of the Brexit vote became clear, Nigel Farage, one of the leading voices calling for the UK to leave the European Union, sat down in a TV studio to crow about his victory. The interview made headlines not just for his victory speech, but for the shameless speed with which he reneged on the Leave campaign’s highest-profile pledge: a commitment to dramatically increase investment in Britain’s National Health Service (NHS).
For weeks, the Leave campaign had toured the country in a bus with a huge claim written on the side: if we leave the EU, we can take the £350 million the UK sends to Brussels every week and spend it on the NHS instead. Alongside the vague but emotive tagline Take Back Control—a dog whistle to anti-immigrant sentiment—the Leave campaign used false data to whip up public concern for the future of the much-loved NHS. The speed at which the commitment was dropped once it had served its purpose betrayed a shocking depth of cynicism.
The country is still reeling from the Brexit result, and as the political fallout continues, it is clear that the fight for the future of the NHS will be a central battleground. Though a beloved national institution, it has been seriously undermined by the government’s failure to match investment with escalating costs and growing demand.
The damaging effects of the biggest restructuring in its history are still being felt. The reforms opened up more and more of the NHS budget to the private sector, reducing the efficiency of the public service and allowing profits to be skimmed as health outcomes worsen. Waiting times are soaring beyond their targets, medicines are increasingly unaffordable, and hospital trusts are going bankrupt. Alarmingly, even more resource-intensive reforms are underway, which advocates believe will accelerate the privatization of health and hasten the end of the NHS.
During the EU referendum campaign, former Conservative Prime Minister John Major said those campaigning for Leave could be trusted with the NHS like a hungry python can be trusted with a hamster. Many of those most empowered by the result have a long and vocal record of wanting to privatize the NHS entirely. That political strategy is playing out before our eyes now.
One of the most visible metrics of the health of the NHS is the availability of medicines. Increasingly, the NHS cannot afford the pharmaceutical industry’s rising prices. For instance, faced with the prospect of paying the pharmaceutical company Gilead £400 per person per month for its patent-protected HIV preventative drug PrEP, rather than the £2.69 it can be bought for when that patent monopoly is removed, the NHS chose to fight the wrong battle. Instead of the government taking action to bring down the unjustifiably high price, the NHS is instead fighting though the courts to avoid responsibility for footing the bill.
According to the British Medical Journal, this is part of a pattern in which the NHS, alarmed by the impact of Big Pharma’s prices on its precarious budget, seeks to avoid responsibility for providing those extremely expensive medicines rather than find ways to make them more affordable. A restructured Cancer Drugs Fund, for instance, was relaunched on June 29, and is expected to result in a long list of oncology treatments being withdrawn from use in England due to unjustifiably high prices.
The pharmaceutical industry’s profiteering is forcing the rationing of medicines and withholding of care. Ultimately, it is threatening the public’s trust in the NHS and, in turn, the very future of the health service.
Civil society must mobilize to defend the right to health and battle to reform the corrosive influence of the pharmaceutical sector. Already we have seen greater debate on the role of the pharmaceutical industry and the sustainability of the health service. We must expand that debate and build allies across the progressive movement. Patients and families must be the heart of the campaign to save the NHS and reform the industry. Post-Brexit, this organizing can be a vital part of their reconnection to politics and power.
Perhaps most importantly, as the UK struggles to regain its sense of self, there is an opportunity for that most British of institutions, the NHS, to help Britons form a new national identity. The NHS is a proud achievement, born from the ashes of World War II, staffed by everyday heroes from every corner of the globe, used by every member of UK society, and founded and operated on the ethos of equality and solidarity. If there is any idea or institution that can underpin the fight against the divisions of the Brexit vote, it is the National Health Service.