The survival of the NHS and its capacity to improve hinge on three core needs: more money, more people and more research.
Each of these will be negatively impacted should we leave the EU.
NHS funding depends on the performance of the wider economy. When businesses are expanding and consumers spending, more money from taxation is available for the National Health Service. So how would leaving Europe affect the economy?
We might save a small amount of money from our contribution to the EU’s budget, but of course there is no guarantee all or even any of it would find its way into the NHS, and not for example be used to plug the deficit.
The vast majority of economists and businesspeople believe that cutting ourselves off from our biggest market will cost Britain dear, as the cost of selling abroad rises and jobs are lost. Such economic damage would reduce the money available for the NHS, and put it under further financial strain.
Moving onto people, it is often said that immigrants are putting the NHS under “intolerable strain”.
First, let me declare a conflict of interest. Without migration, I wouldn’t be here. My father came to this country in 1939 aged 13, saved by the late Sir Nicholas Winton, who rescued thousands of Jewish children from the Nazis.
Had he stayed in his country of birth, Czechoslovakia, he would have shared the fate of his parents. As it was, he settled in Hull, and then Sheffield, where I was born and brought up.
So I am not neutral on this subject.
But without migration, it is most unlikely the NHS would be here either. Put simply, the NHS has always depended upon migration.
Most health costs are incurred in the last year of a person’s life. But most migrants are both younger and fitter than the general population, and so use health services less. Instead, they get jobs and pay the taxes that sustain the NHS. Indeed, many of them find work in the NHS itself.
Go to Accident & Emergency, and you will soon realise that you are more likely to be treated by an immigrant than stand in a queue next to one.
Some 11 per cent of NHS staff are from abroad, including at least 26 per cent of its doctors.
We are already facing a shortage of consultants and general practitioners across the country, meaning we will need more, not fewer, EU doctors to keep the show on the road for some time to come.
And what about the people who allegedly swarm across the Channel to claim their free healthcare here? EU visitors are indeed entitled to basic and emergency care. But the NHS can and does recover the costs from their home EU country. And it works both ways. If you travel to an EU country (every year we make 42 million such visits) and are unlucky enough to have an accident or fall ill, you can obtain free emergency care. And don’t forget that if you decide to retire to the sun, as over two million of us have, you will receive health care in your old age similar to that at home.
Medical research has underpinned the NHS from its foundation in 1948. But much has changed since then. Now, most major advances come from international collaboration. The UK punches well above its weight in international league tables for scientific research, with five UK schools in the global top 10.
In my own field, King’s College London recently overtook Harvard to be the best in the world for psychiatry and mental health research. Britain is very good at medical research.
Therefore, we get much more back from the EU science budget than we pay in. Likewise, about one third of all EU- funded science collaborations are led from the UK.
If we leave, this will come to an end, as the EU member states which decide science policy will want a larger slice of the pie for themselves. It is no surprise that 83 per cent of the UK science community supports remaining in Europe to find new cures for devastating diseases, improving all our qualities of life.
My father taught me that the peace and prosperity of this country depended on the peace and prosperity of Europe.
As a refugee from fascism, he knew the debt he owed this country, and from his service in the Royal Navy during the war, continuing throughout his career as a teacher and a charity worker, he spent his life repaying that debt. He died last year aged 90.
The year before, he was admitted to a Sheffield hospital. For a long time, he seemed trapped in a vicious circle – too ill to come home, but getting worse the longer he stayed.
It took an enthusiastic young social worker to bring my father back to his home of 60 years. The social worker’s name was Eugene Turcanu, and he came from Romania.
Simon Wessely is Professor of Psychological Medicine at King’s College London, and a member of the Healthier In group.