In the aftermath of the referendum on EU membership, uncertainty reigns. As I write this, members of the Conservative Party are considering leadership options following the resignation of David Cameron as Prime Minister, the Labour Party is in turmoil following the vote of no confidence in Jeremy Corbyn, and Scotland may once again seek independence from the UK. The only thing that seems absolutely clear is that the Leave campaign never had a plan in place for what would actually happen if they won.
The NHS was, predictably, a pawn in the game for both sides during the campaign. We should be used to this sort of thing. I can't remember, certainly in my adult life, a general election in which the health service was not used as a bargaining chip. It is widely accepted that the British public values the NHS, so politicians bend over backwards to convince us that theirs is the best way of running, saving or improving it. And so it was with the EU referendum. On one side we had the Remain campaign suggesting that a weakened post-Brexit economy could have a dire impact on our already cash-strapped health service. On the other, the Leave campaign made the now infamous claim that we send £350 million a week to the EU—which we don't—and should instead spend this money on the NHS—which, they have since admitted, we won't (McCann and Morgan, 2016). Now that the campaigning is over, unlike after a general election, the dust has far from settled. There is a lack of clarity about when, how and even whether we will extricate ourselves from the EU, and the debate and discord show no sign of abating any time soon.
The economy is already starting to feel the effects of Brexit, as social and political instability is mirrored by the fluctuating value of the pound. This is not good news for underfunded maternity services. There is a shortage of 2600 midwives in the UK, the large proportion of midwives aged 50 or over means the sector faces a ‘retirement time bomb’ (Bonar, 2015: 2), and cuts to student bursaries (Bhardwa, 2016a) are likely to exacerbate this crisis. Considering the extensive legislative changes that will be required to facilitate the UK's departure from the EU, it seems certain that the purse strings are only going to get tighter. Meanwhile, researchers report that bids for EU funding are being put on hold (Warwick, 2016). The ramifications of the UK's decision to cut ties with the EU may reach further than many people anticipated.
And, of course, it's not just a matter of economics. Reports of racism and xenophobia have risen since the referendum result was announced (Turner, 2016), provoking leading figures in health care to speak out in support of the many NHS staff who come from outside the UK (Bhardwa, 2016b). The Royal College of Midwives has pledged to fight for midwifery, aiming to defend employment rights that have hitherto been protected by EU law (Warwick, 2016).
Every day, there is news of further upheaval; by the time you read this, yet more may have changed. We can only wait and see what kind of place post-Brexit Britain turns out to be, and what this will mean for the NHS and British midwifery.