The Impacts of The EU Referendum on The NHS

Tomorrow evening, on the 23rd June 2016, the future of the United Kingdom will be placed in the hands of the British Public as they decide whether to remain within the European Union or to leave. Too young to vote, and still undecided on the matter, I have no preference towards the leave or remain campaign. However, as a student wishing to study medicine in the future, the possible impacts of the vote on the NHS concern me. The referendum has highlighted the ugly side of politics, with both the leave and remain campaign manipulating statistics and playing on fear in a desperate attempt to convince the public towards their case. Therefore, I have attempted to sift through the propaganda and create a non biased analysis of the ramifications that both remaining in and leaving the EU could cause.

The EU's Role in The NHS

• Founded in Maastricht, Netherlands in November 1993, the European Union has both supported and influenced the NHS. According to the NHS European office "Whilst health policy and the organisation, financing and management of healthcare is a national responsibility of member countries, the EU also undertakes health-related activities, in particular, by supporting co-operation between member states in order to protect and promote public health and to enable the free movement of people around the EU"The referenced "health-related activities" include EU- wide public health works such as building awareness of HIV/Aids and cancer, anti-smoking campaigns and controlling public health threats such as communicable diseases.
• The single market rule allows health care staff to work anywhere within the EU due to the recognition of professional qualifications. In the UK,135,000 EU migrants work within the NHS and care sector, providing public services and contributing to the Government's  tax  base.
• The EU provides the public with the European Health Insurance Card (EHIC), entitling them to medical care in European Economic Areas including Iceland, Switzerland, Norway and Liechtenstein. However, the individual may be charged for medical expenses which occur.

If We Leave 

The vote leave campaign push the slogan claiming that "£20bn a year or £350m a week" is sent to Brussels by the UK, which could otherwise be spent on the NHS, improving public services. If the statistics are true, EU expenditure equates to the cost of a new hospital development each week.  In addition, former mayor of London, Boris Johnson, said that Brexit  would help put an end to long waiting hours in A&E by increasing available funding and reducing the pressures of an increasing population, partially caused by EU immigration. However, the chair of the Statistics Authority states that the figures produced by the leave campaign could be "potentially misleading". Furthermore, the Institute for Fiscal Studies calculated that the UK's net contribution for 2014 to the EU was actually only £5.7bn.
During the campaigning process, Priti Patel, the minister of employment said that "the EU is putting the NHS under threat" as 288,000 new immigrants per year cause "unsustainable pressure on our resources". In spite of her claim, I do not believe immigration will be the downfall of the NHS, but instead has been used to evoke fear amongst the public. In the UK,immigrants from the EU contribute £5bn to the economy each year, broadening the tax base and thus providing money for health care. If we were to vote out, a reduction in immigrants could reduce the money available for public services, leading to potential cuts in the NHS. In addition, the trade uncertainty could reduce the funding of public services.

If we Remain

Leading the remain campaign, David Cameron has warned that the out campaign is misleading and that leaving the EU could be very problematic for the health sector. The campaign states that directing money spent on EU contributions towards health would reduce aid to poor regions and payments to farmers.  By  remaining within the EU, we partially ensure £1.4 bn in research grants and guarantee health care for British citizens within other EU countries.
The out vote is ultimately a very daring leap into the dark, the economic uncertainty it creates irrefutably threatens the sustainability of the NHS, with 9 out of 10 economists saying brexit will damage the economy. Simon Stevens, the chief executive of the NHS certified that it "would be very dangerous if at precisely the moment the NHS is going to need extra funding... the economy goes into tailspin and that funding is not there". Therefore, although brexit has the potential to increase funds, it is an uncertainty and the remain vote creates more stability for the future of the NHS.

The impacts of TTIP

The Transatlantic Trade and Investment Partnership (TTIP) is a proposed trade agreement between the European Union and the United States, set up in the hope that increased trade will result in economic growth. According to the Independent, one of the aims of TTIP is to "open up Europe's public health, education and water services to US companies." Ultimately, this has the potential to result in the privatisation of the NHS and as a result of Investor State Dispute Settlements (ISDS), third party companies could sue the UK Government if NHS contracts are lost. 
Conversely, Trade Minister, Lord Livingston, told a journalist that "The idea that this will lead to privatisation of the NHS is not true." In addition, the Government claims that TTIP could add £10bn to the economy due to the removal of import tariffs on American goods, providing money for NHS Investment.  However, even though the plan is strongly supported by Labour, UKIP,  the SNP  and Liberal Democrats, all of the parties have expressed caveats over the NHS.


The outcome of the referendum will greatly affect my generation and those to come, please use your vote wisely and base your decision on logical facts rather than the scaremongering tactics used by politicians.

GCSE Revision tips

Although exam season may be over (cheers enthusiastically) I still think this post is needed for everyone preparing for a career in medicine. We're all so used to hearing that we need good grades, however during the lead up to my IGCSE exams I noticed that so many people have never specifically been taught how to revise. Having survived year 11, I thought that I'd share my favourite revision tips with you.

Whiteboards













If I've learnt anything from my exam experience, it's that paper can become really expensive, especially if like me, you use about 5 packs each week. However, whiteboards are a great alternative. In almost any supermarket you can pick up a whiteboard and pens for a couple of pounds, not only is it better for the environment, but it also makes revision more varied, so you don't get bored as quickly. It's particularly useful for subjects like history or geography where you need to draw mind maps or write out case studies.

Apps

Although the majority of teachers and revision guides would tell you that you should put your phone away during revision, I actually think that they're incredibly useful if used properly. The best way to check if you have revised thoroughly is to test yourself, but it's always quite time consuming to write out all of the questions for a topic, making apps a better alternative
My Favourite Apps
1. Busuu- The best way to learn a language is through practice of speaking and writing rather than mindlessly learning vocab for hours on end. Busuu is a social network style language learning site/app, which allows you to learn grammar and send written answers to native speakers to be marked. I used this quite a lot in the lead up to my French writing exam, the site provides 12 languages to learn, including Spanish, German and Italian.
2. Gojimo- The self testing exam preparation app is great practice for short answer exam questions for subjects such as biology, chemistry and physics. However, because it is a relatively new app, the range of exam boards isn't that great, for example I sat AQA IGCSE sciences, for which there were no questions.
3.Quizet- A teacher first introduced me to this app 3 years ago and I have been using it ever since. It provides digital flashcards that you can fill in and then be tested on. Originally I only used this for French, but this year I found it quite useful for learning history dates and other definitions.

Stairs
For subjects like Biology, you need to know quite a lot of information for a particular topic, which you can quote from the syllabus in order to gain full marks on long answer questions. Instead of writing it out again and again, I like to write out a sequence of events, such as the malarial cycle or sexual reproduction in plants, onto separate flashcards. After shuffling them up, try to place them back in the correct order, with the stages progressing going up each stair. After you can do that, turn the cards face down, and at each level, try to state what is written on the card without looking. Although it may seem slightly odd, and may annoy other people in your family, if you are a kinaesthetic learner this will be really useful.

Timelines
For subjects like History, it's really important to have a good idea of how events progressed over a period of time. By writing out timelines and taping them onto a wall to read, it is so much easier to answer exam essays because you can go through chronologically, showing the examiner a greater extend of understanding. In addition, during the exam you remember the events which followed each other, aiding the revision process. 

Running

I'm sure you are probably sick of hearing it, but running or any other form of exercise is one of the best things you could do before revising. Although on the night before a big test it may be the last thing you want to do, exercise stimulates the hormone epinephrine, which increases awareness and therefore increases your ability to focus. In addition, the refreshed and energized feeling you get motivates you to study. So before your next exam, leave behind the books and go and explore your local running tracks.






Start Early!!!
Procrastination is the kryptonite of all students. Even if you feel like your exams are far away, they quickly approach leaving you stressed and panicked as you cram in 2 to 3 years of work. In order to avoid the last minute struggle, begin your revision early. For your GCSE exams, your revision should really begin by the Christmas holidays, even if you only revise for 2-3 hours a day, it soon adds up and makes life so much easier during exam time.



Good Luck!