This document is about the impact of a “No Deal Brexit” , published by the British Medical Association a few days ago.
This is posted only for your information. It is describing the worse case scenario. Reasonable discussion is ok , any offensive comments will be removed. If you only want to read the pages referring to the impact on rare illnesses which will include #Vasculitis, scroll to pages 11 - 14
About BMA:
The BMA's stated aim is "to promote the medical and allied sciences, and to maintain the honour and interests of the medical profession"
The British Medical Association (BMA) is the professional association and registered trade union for doctors in the United Kingdom. The BMA has a range of representative and scientific committees and is recognised by National Health Service (NHS) employers as sole contract negotiators for doctors.
They say “We have a duty on behalf of our members and patients to set out the consequences of leaving the EU without a deal in place. Our latest document outlines all of the ‘no deal’ scenarios from our briefing papers:” bma.org.uk/-/media/files/pd...
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The decision to leave the EU was taken over two years ago. Surely the BMA should have completed their view of how to deal with this long ago? The BMA is not supposed to be a political organisation and it is not for Dr. Nagpaul to propose a second vote at this stage. Where has he been for the last two years? Why have the BMA not been advising the Minister of Health of the possibilities and how best to deal with them?
The duty of the BMA was to view the democratic decision, to work out the dangers it represented for the NHS and how best to deal with them.
Dr Nagpaul says "At our annual representative meeting in June 2018, doctors made it clear that they believe
Brexit poses a major threat to the NHS and the nation’s health. With less than eight months
to go until the UK leaves the EU, there is still far too much uncertainty and confusion around
the implications of Brexit for patients, doctors and wider health services." Did they only notice this in June 2018? Shocking. I can only guess that they have sat on their hands waiting for something to happen when actually, it has been quite clear from the start that the EU do not intend to negotiate.
We decided to leave, it is up to us to deal with the decision instead of wasting two years hoping for someone else to deal with it hoping that 17.4 million people were suddenly going to change their minds and now whingeing that he only has 8 months to sort it.
The referendum vote was an expression of intent with no detail of what would be involved and what the outcome would be like.
The UK government decides on policy and health care and is the UK governments responsibility, not that of the BMA. The BMA has no formal responsibility to advise the department of health. It is the responsibility of the Minister of Health, formerly Jeremy Hunt, to identify issues affecting healthcare in the wake of leaving the EU.
As part of his consideration this should have involved consulting with the BMA and other groups which would be affected. It is the UK government which has dragged its heels in engaging in meaningful discussion with those affected parties and the EU.
The BMA is a professional body which represents the voice and the interest of its members, not the NHS. The UK government meet on a daily basis unlike the membership of the BMA Who only meet at their AGM. The BMA made its statement following its AGM.
It really doesn’t need 17.4 million people to change their minds, it only needs 865,000 people, who voted leave to change their minds.
The majority of people who voted leave were over 65 years of age, 2 years on some will no longer be with us but a far larger number of under 20’s will be eligible to vote. The under 50’s are the group who will have to live their lives after Brexit where as most of those who were over 65 in June 2016 will no longer with us in the next 15 years.
Why should the EU negotiate? It was the UK government who stated its intention to leave the EU so the UK has to bear the consequences. If we are a member of a club or organisation and we make the decision to leave, we cannot expect to continue receiving the benefits of membership and there is no requirement for the club or organisation to negotiate the terms under which we leave.
Forgive me if I deal with your last point first as I think it covers the main part of the discussion. This is paragraph 2 of Article 50 of the Lisbon Treaty so you will see that by their own laws the EU is bound to negotiate with us :
"A Member State which decides to withdraw shall notify the European Council of its intention. In the light of the guidelines provided by the European Council, the Union shall negotiate and conclude an agreement with that State, setting out the arrangements for its withdrawal, taking account of the framework for its future relationship with the Union. That agreement shall be negotiated in accordance with Article 218(3)[9] of the Treaty on the Functioning of the European Union. It shall be concluded on behalf of the Union by the Council [of the European Union], acting by a qualified majority, after obtaining the consent of the European Parliament."
As you see, it is the legal obligation of the Council (elected in their own countries) to carry out the negotiation and to decide the conclusion by qualified majority and with the consent of the European Parliament (elected), not by the alcoholic appointee of the Commission (unelected) or Mr. Selmayr (unelected and so fraudulently installed as General Secretary in March).
With regard to the BMA having no reason to research the problems which they consider Brexit will engender or to discuss this with the Minister for Health, why is Dr. Nagpaul doing so now? I don't think anyone could feel that this government has handled this situation in any sort of sensible or satisfactory way but surely it would have been much more useful if the BMA had asked to be consulted from the beginning and had made their feelings and doubts known at that time, even after its first AGM following the referendum. There is no doubt that the government really did need specialist advice.
Your reasoning regarding the age of voters is honestly not very sensible. If the votes of everyone who died since the last general election, local election or the referendum were discounted and replaced in an ongoing way by those of school leavers would anything ever get done? Age also has its virtues, youth has energy and growing knowledge, age has wisdom. The young had equal opportunity to vote but a great number of them decided not to. Surely those decisions were just as free and valid as those who did vote.
I also don' t think that 865,000 votes can very correctly be referred to as 'only 865,000'. It is quite a lot pf people who bothered to get up and vote! Elections in this country are decided on a first past the post system. This may or may not be the best way to decide but the fact is, it is the way elections are run in this country. The choice was to Leave or to Remain, not an expression of intent. The country chose to Leave. That is Democracy whatever the individual may think of the result.
The referendum was not actually intended to be binding, the result was expected to be advisory only. It’s pretty clear that the EU stated it’s position , it was the UK which wanted an exception to the rule. We now know that the UK never had a plan so there was nothing to negotiate on. The EU cannot negotiate on its own. It has taken 2 years for the UK to give some sort of indication of what we expect post Brexit. But it seems that even now there is no clear consensus in the UK of what we actually do want. This is not a negotiating position. Your idea of negotiation seems to be that the UK should declare what it wants in an ideal situation and the other 27 EU states should accede.
In the initial stages of the preparation for leaving, the UK government were certainly not open to any sort of expert advice even from the Governer of the Bank of England or leaders of commerce and industry. Remember that idiotic slogan “Bexit means Brexit” which was quoted so often by the PM.
There are many on the right wing of the Conservative party who will only be satisfied if we crash acrimoniously out of the EU. They certainly do not want to retain any ties or links with the EU. This group probably have their own selfish agendas but certainly they are not interested in the future welfare of the ordinary British people. At the time of the referendum Boris Johnson spoke about “Glittering Horizons” and Andrea Leadsom spoke about “Sunny Uplands” , 2 years on we have yet to even glimps those promised lands. The public were lied to on a big scale.
Those in favour of remain warned of the consequences of Brexit such as the weakening of stirling, rising prices and loss of investment. Because these things did not occur immediately after the vote to leave it was described as scare mongering. 2 years on, these are all happening but the Brexiteers ignore the facts.
The change in demographics is very relevant because the population which has to cope with effects of Brexit will be very different from the population who voted for in favour of Brexit.
Unlike China and other near-totalitarian states we don’t elect our political leaders for life. We have elections every 4 years and the people can choose a government which will take them in a new direction.
Since June 2016 it has become very obvious that the electorate were misinformed and misled. They should be given the opportunity to reconsider their decision in the light of evidence which has emerged over the last 2 years. The facts and the situation have changed dramatically, we should be given the opportunity to change our minds. If the Brexiteers are so confident of the rightness of their cause they should be happy to have a further referendum in the expectation that more people will vote in favour of Brexit.
Just to add - it is very interesting to see how the major drivers of Brexit are now covering their backs..... Rees-Mogg is expanding his business in Dublin, Farage has dual UK German citizenship and has now applied for his children to have the same, Nigel Lawason has applied for French residency, Hunt has urged the Danes not to copy Brexit, John Redwood is advising investors to pull their money out of the UK and put it into Europe, others are moving their businesses out of the UK into Europe.
It is obvious they have little confidence in the future of the UK without Europe but a lot of confidence in the EU without the UK.
Sound argument - one waits with baited breath. I live in France, and, with a rare disease...Ho-Hum.
I can’t sensibly engage with the broader content of this discussion because I’m not feeling well enough to get my head around the two central arguments.
Thinking only of how this will impact on those of us with rare diseases - my observation is that NHS rheumatologists (and other relevant specialisms) just have not got the time to research rare diseases or rare presentations of relatively rare diseases. Nor have they the time any more to attend the international gatherings where rare conditions are discussed amongst their international colleagues. This means that many are increasingly out of touch with the latest research on diagnosing and treating rare diseases.
I strongly suspect, if asked, most doctors would say that increasingly they are just fire fighting now. So inevitably those of us with rare diseases or rare presentations or combinations are absolutely going to suffer more than those with relatively treatable or cut and dry common conditions.
There will be higher numbers being misdiagnosed with chronic disorders such as Fibromyalgia, IBS and ME.
The simple logic of this to my tired and foggy mind is that the first class specialists required to identify and treat those with rare diseases will no longer be attracted to the UK - and if they are here already, will only be found in London.
For myself, I’m Scotland, with a rare presentation of Sjögren’s and an underlying Vasculitis, I’m experiencing this daily already through GPs and my many specialists.
My rheumatologist yesterday mopped her brow and tried frantically to piece together the jigsaw - but had to concede defeat after about 25 minutes of googling autonomic dysfunction and leukocytoclastic vasculitis in primary Sjögren’s Syndrome. She welcomed my own theories based on my symptoms and research with visible relief. She can’t offer me further treatment options because she hasn’t had time to research where I sit within the criteria for IViG or Rituximab and other Biologics and is too concerned about the severe side effects I’ve already experienced to previous immunesuppression to put me back on any of these yet. She said she needs to time to discuss this with the M.D. team and get back to me. This isn’t meant as a further delaying tactic because she knows I’m really unwell. But it’s all about lack of funds, lack of research time, increasing lack of contact with her international colleagues.
I had to think very hard about the impact of medical isolationism in the run up to the Scottish Indi Referendum. I recall a consultant from the hospital which has since become mine, speaking at a tv Indi ref Question Time against independence due to the impact on her rare disease patients. This made a deep impression on me then.
However I didn’t have to think at all hard about what to vote when it came to Brexit. So I’m with Suzy 100% as a rare sufferer myself and as a parent of three bright and highly skilled young men who are all now sadly talking about leaving the UK before it’s too late.
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