Lost Leaders? EU Health and Brexit

It was inevitable, of course, following the UK’s referendum in June, that Brexit would loom large over September’s annual European Health Forum Gastein (EHFG) meeting in Austria. But the tone of dismay among some of the speakers did sometimes unsettle the overall mood of cautious optimism and open-armed inclusiveness, not to mention the sense of confidence and self-congratulation that the event generally strove to convey.

When the Michael Jackson-Lionel Richie song “We Are the World” played over the room’s loudspeakers at the end of the Opening Plenary, it added a touch of emotional defiance to Director of the European Observatory on Health Systems and Policies Joseph Figueras’s comment in the first two minutes of the session that Europe is experiencing “a new type of divide between those economies open to global trade and those who are not”. From the outset, it looked like the UK's assertion of independence was not something that was going to be treated with a great deal of sympathy.

Nevertheless, EU policy expert Nick Fahy followed with an attempt at level-headedness, pointing out that the Brexit vote “wasn’t really about the EU - it was principally a backlash against globalization”. What is needed in response to further globalization, he said, is global protection. For British and European citizens, the pace of change has been “too much, too fast, and with little protection, and the results have undermined people’s sense of community and solidarity”.

But “Beyond Brexit”, the event’s “Late-Breaking Topic” session, would see the unleashing of the European health establishment’s less equivocal take on the UK’s vote to leave the EU, not least in Martin McKee’s virtuoso attack on the process and the new UK government’s attempts (or non-attempts) to begin negotiating it. Pulling no punches, McKee, Professor of European Public Health & Medical Director at ECOHOST, which is based in London, said Brexit is a “looming disaster” and the priority now is “to limit the damage”. He went on: “We’re going to lose a billion pounds a year in direct income to the UK. We’re going to lose a large chunk of the pharmaceutical industry. We’re going to lose the pharmaceutical part of the Unitary Patent Court.”

Noting that a wealth of funding currently comes to UK SMEs and large companies not just from the Directorate-General for Research and the Horizon 2020 initiative, but also from the European Regional Development Fund, the European Investment Bank, the European Social Fund and European Fund for Strategic Investment, McKee asked: “Does anybody know how much money this is? Does anybody know how much money it will cost to replace these? We need a very clear roadmap to work out what it is we need to put in place to overcome what we are losing. We need to monitor our declining fortunes”.

McKee was further exasperated that the UK government “hasn’t got a clue” what it is doing as far as Brexit is concerned. “Prime Minister Theresa May has appointed her three least competent ministers (Liam Fox, David Davis, Boris Johnson) to oversee it,” he said, observing that “they can’t even set up an office properly”. (Evidently they have had to hold meetings in a local Starbucks because they couldn’t get wi-fi at their new premises.) “All three of them have made speeches that reveal they should have spent their summer reading ‘European Exit for Dummies’. Each day, [they] display their abject ignorance of the basics of international trade.”

Professor Martin McKee lays it on the line at Gastein.

He did see a potential opportunity if the UK was to keep the EU regulations as they are, but perhaps with “some deviations” where necessary. But his one glimmer of hope was that Brexit may never actually happen, as many countries hold referenda but do not implement the result. Otherwise, he added bluntly, “we’re going to end up in the shit”.

No less passionate was Shada Islam, Director of Policy, Friends of Europe, who said the narrative offered by the anti-EU campaigners “has been built on lies and encourages fear”. But such a narrative cannot be countered with roadmaps and blue prints, she said. Brussels needs to respond with the same level of passion and emotion. “What are these commissioners doing?” she demanded. “They need to go out there and engage. They need to go on TV, go to the schools, to national parliaments. Europe is not lost. Its leaders are lost.”

If the Brexit response brought some further drama to Gastein this year, it must also be said that it pushed some of the issues dogging the EU in many of its member states further into the spotlight, and added extra urgency to the need for a rethinking of the Commission’s MO, especially around the issues of immigration and transparency. There seemed to be, for example, a stronger recognition and acceptance of the deepening divide between the political elite and the people. EHFG President Helmut Brand admitted that “it will not help just to tell people more about the EU”, while Zsussanna Jakab, Regional Director of WHO Europe, asserted that Europe “needs to regain the trust of its citizens”.

Perhaps the most astute observation came from the eminently sensible Nick Fahy. “The challenge now,” he said, “is moving from addressing the disparities between our societies to addressing disparities within our societies”.