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Health and Brexit

From SARS to Avian Flu to Bioterrorism, infectious diseases do not recognise national borders. EU membership has enabled us to pool information, preventative measures and resources, to tackle such threats in collaboration with our closest neighbours. We have set up a European Centre for Disease Prevention and Control in Stockholm, to work together on early warnings and shared monitoring of health threats. We have taken action together to enhance public health through collaborative action to tackle air pollution, to improve port and airport health measures, to raise standards on clean water, beaches and soil quality, to reduce the harm that comes from tobacco and to tighten the control of hazardous chemicals. We have established a European Medicines Agency in London that ensures safe medicines and I continue to chair a series of round tables on health innovation, from personalised healthcare to biosimilars and rare diseases.

Freedom of movement and collaboration on research within the EU have brought together the best mix of highly specialised skills and experience, have boosted our capacity and have helped make our health service one of the most efficient in the world. They have also brought new rights to our citizens to travel, work or study in other EU countries, safe in the knowledge that our E-Health Card gives us immediate access to local health care, should we need it. Now the Cross Border Healthcare initiative, has given us the right to go abroad specifically to receive treatment and to have the bill covered by our own health service, thus avoiding unacceptable delays at home. It also provides centres of excellence for rare diseases and enhanced collaboration on e-health and health technology assessment.

Brexit campaigners consistently asserted during the Referendum that the NHS is crumbling because of EU nationals living and working in Britain. This is mischievous and damaging nonsense. The main causes for hospital and GP surgery attendance increases are not EU migration. Increased numbers largely consist of British-born people and, if migrants, they are mostly from countries other than the EU. EU migrants tend to be young and healthy, they contribute more in taxes than they claim in public services such as healthcare, and 130,000 of them improve NHS capacity by working in the health sector as doctors, nurses and care workers. A real NHS and Social Care crisis will come if those 130,000 are expelled from our country. Brexit campaigners talked much about the ‘£350million’ a week cost of our EU membership, which they promised they would spend instead on the NHS – a bogus figure and a bogus promise they now say should never have been taken seriously.

Our scientists, our academics, our doctors, our nurses, our patient groups have all spent years building up links throughout Europe. They share knowledge, experience, expertise and good practice with each other and with policymakers. The value of this is incalculable.  None of them understand why or how you can be healthier by severing the links to the creative lifeblood of our European family.

Advocating the unilateral guarantee of EU citizens’ rights in the name of fairness

The rights of EU citizens after Brexit have wrongly become the hot subject of the moment. Wrongly because it doesn’t belong to the Brexit debate and should have been settled on June 24th. But the absence of commitment at the top has left three million EU citizens in limbo with one last chance before article 50 is triggered.

On June 24th, the referendum results were sending shockwaves through the political establishment. l, like many EU citizens in the UK and British citizens in Europe, felt sick at the feeling that my world had been turned upside down after 21 years of living in Britain.

But fairness and responsibility evaded our political elite and simple reassurances in the form of a unilateral guarantee that EU citizens could stay after Brexit never materialised. Instead, the ambiguity of the language used has helped to fuel an unprecedented rise in hate crimes towards continental Europeans and created a mass anxiety due to the uncertainty over our future in the country to which we came, in good faith, many years ago.

It’s worth remembering that the United Kingdom was previously praised across Europe as an example of tolerance and integration and its reputation has suffered greatly as a result of the recent verbal and physical violence towards EU citizens (and other minorities). My friend Sénateur Olivier Cadic told me that he asked a French audience at a public meeting in London to raise their hand if they had suffered or knew someone who had been the victim of a hate crime incident. Everyone raised their hand. I would have as well.

The story unfolding during the following months has not made for better reading. As I became more involved with the3million to defend EU citizens’ rights, I also became better informed and immigration law practitioners were all telling us the same story of hostility from the Home Office, making our future status post-Brexit even more precarious without the protection of EU Treaty rights.

While the application form became increasingly bureaucratic, going from 5 to 12 to 85 pages while Theresa May was in charge of the Home Office, the sheer inadequacy of the process means that it could take around 49 years to register all EU citizens. And unfair rules are lacing the legislation, creating needless uncertainty. For example, being married to a British citizen or having British children does not provide protection in terms of asserting one’s right for permanent residence. Similarly, ‘economically inactive’ EU citizens such as students or mothers at home who did not have the little known Comprehensive Sickness Insurance (CSI) are also refused. A Kafka-esque tale for 3 million EU citizens in the UK which could have serious human rights consequences after Brexit.

We are now probably just days away from the triggering of Article 50 and nothing has changed in terms of guarantees and assurances but EU citizens have now found a political voice through organisations such as the3million. We recently organised a mass lobby in Parliament which over 1,000 EU citizens attended with their British spouses, children, neighbours and colleagues. Many met their MPs to tell them about their personal stories and appealed to them to do the right thing when the bill returns from the Lords, hopefully with an amendment to protect the rights of all EEA and Swiss citizens living in the UK.

This is important because fairness must be restored and the 3 million EU citizens who came in good faith the UK (and the 1,2 million UK citizens in the EU) deserve to be given guarantees so they can continue with their lives.

There is a strong argument that the Government will have a stonger hand in the forthcoming negotiations if the Prime Minister were to offer a unilateral guarantee to EU citizens. Not only is the current hardline damaging Britain’s reputation on the international stage but the argument of reciprocity used to justify their position doesn’t stand the scrutiny of facts.

Firstly, all major organisations of UK citizens resident in Europe are supporting the3million in asking for unilateral guarantees, as they are 100% certain that it will leave the EU no other option but to replicate the offer as soon as article 50 is triggered (see their letter here).

Secondly, the referendum was about the UK leaving the EU but both camps agreed that EU citizens would remain in the UK after Brexit so our rights were not on the political agenda and there is absolutely no justification they can be negotiated as part of the Brexit negotiation.

Finally, there is a strong moral argument that treating people as bargaining chips is wrong and undermines the perceived legitimacy of the negotiating process.

The Brexit journey for EU citizens has been one of betrayal by their host nation so far and we can only hope that the Parliament will restore the guarantees we deserve.

Nicolas Hatton, co-chair of the3million

The European Union

In the immediate future, Parliament will be debating and dividing on the implementation of Article 50 and, consequently, triggering the formal negotiations for United Kingdom to leave the European Union. This is not something I campaigned for; indeed, my whole political life – starting as it did in my teenage years – has been founded on internationalism, free trade, liberal democracy, pluralism and Keynesian/mixed economy economics as core beliefs, all, of my mind, protected and enhanced through EU membership.

I welcome the Supreme Court’s decision earlier this week that Parliament must have a vote on triggering Article 50 – an important decision confirming that Parliament, not any particular government of the day, is ultimately sovereign.

While I am obviously proud of the 55% Stroud Constituency vote to remain in the EU, the overall national referendum result cannot be ignored. Certainly, it would be highly risky to overrule the majority vote in support of leaving the European Union (just as the 1975 vote was widely acknowledged for forty years) so soon after it has taken place and without any significant movement in public opinion. This is why I and the vast majority of the House of Commons – including most Labour MPs – will be voting to implement Article 50.

This particular vote is not the end of the matter; rather is a staging post in the long and complicated process. The real debates are for later as the continually moving tectonic plates – in political and economic terms – need to be navigated and the UK confronts issues associated with having to deal with unbridled national self interests across the globe. Leaving the EU is not just a domestic function but the beginning of a redefinition of the UK’s place in the international sphere.

In order to help influence these debates, I have established an independent think tank – Modern Europe – to examine the fundamentals behind the negotiations, and to signal steps to ensure the UK remains connected to Europe, has the capacity to trade effectively wherever possible and can continue a constructive part in world affairs. Ultimately, I imagine a situation where the EU is reformed and our relationship with it is based on mutual respect and exceedingly close ties.

My values will continue to inform my approach to Europe and I am certainly ready to engage with ideas about how we can prepare the UK for the challenges ahead and the opportunities arising from the changes in the balances of economic power now underway.

I welcome the commitment to a concluding parliamentary vote in 2019 and I reserve judgement until the shape of the final deal becomes clear.

Thoughts on the UK, the European Union and Brexit

David Grayson

We are a bitterly divided country. A majority voted on June 23rd to leave the EU. Remain voters need to accept that. I don’t think, however, it helps for Leave supporters to claim it was a decisive vote.

The pre-Referendum quote from Nigel Farage that a 52:48 vote wouldn’t ‘settle things’, has been widely quoted. Of course, he was postulating 52:48 in favour of remain – but what is sauce for the goose is sauce for the gander. At the very least, Leave supporters would be well advised to recognise the June 23rd vote was more finely balanced than they are currently acknowledging.

Secondly, people should calm down about the High Court ruling on Article 50. We don’t have a fully written constitution. That has strengths and weaknesses. It does mean that the part which relies on conventions, is living and, therefore, evolving. The parliamentary vote on deploying forces in Syria in 2013, effectively established that the Royal Prerogative was no longer sufficient, to deploy British armed forces internationally. The decision to leave the EU is so much more momentous.

The Royal Prerogative is insufficient to initiate Article 50. Given the poorly drafted Referendum Act, the judges were simply articulating current constitutional law. Face obviously requires the Government to appeal. If, however, the Government’s timetable to activate Article 50 by end March is to be met, there should be an urgent bill brought before parliament to authorise this. Given the referendum result, parliament should pass this bill.

I do not envy Mrs May’s position. She has to try and find a way through a fiendishly difficult situation. She has put Brexiteers in charge to see what they can deliver. The current (albeit relatively narrow) majority of the UK electorate, which voted on June 23rd, currently want to leave the EU.

No one can be certain about what were the main “red-lines” of the Leave voters. The detailed, post-Referendum analysis by pollsters and researchers does suggest that the pace and scale of immigration is a key concern for many of those Leave voters; and has to be addressed in one way or another. This should include making the positive case for the benefits of immigration – not least in keeping our NHS and paid care services running.

Personally, I can only hope that wiser minds than me, can find an acceptable agreement that does enough to address immigration concerns in the UK, whilst minimizing the economic and societal costs of limitations on our access to the Single Market. I fear, however, that that will not be possible. Instead, we will face a stark choice: a BREXIT which is much harsher (not just hard) than many currently imagine – or – by popular vote – deciding – despite everything – to row back and de-activate Article 50. Yes I know, it is not absolutely clear that a country, having activated Article 50, can later, unilaterally, de-activate it. However, those closest to the drafting of Article 50 do seem to suggest it is possible – and if there is a clear indication of a settled change of mood amongst the electorate, we should be prepared to try and do so. Clearly, this could only come about if there was a further vote to that affect – either through a second referendum or a General Election.

Those of us who voted Remain, have to accept the result of June 23rd. In a democracy, however, we are free to campaign democratically to over-turn the result if we believe it is profoundly wrong and damaging to the future of the UK. We should respect the current mandate of Leave supporters to negotiate a leave deal – whilst simultaneously organising so that, if appropriate, we can oppose the implementation of a bad leave deal and seek to persuade a majority of voters to over-turn the June 23rd vote. This should include reaching out to moderate political forces on the continent. The Leave campaign would not have shut up shop on June 24th if it had been 52:48 to stay. Remainers should be no less persistent.

David Grayson
The author is writing in a personal capacity.



Brexit and Article 50

Neil Carmichael MP

The referendum result means the United Kingdom is on course to leave the European Union. Triggering Article 50 – ironically a process introduced by the much maligned Treaty of Lisbon – starts the process for ‘negotiation’ with a target of early 2019 for completion.

The recent court case over Article 50 is, essentially, about how it is triggered. Broadly speaking, the issue is around the role of parliament in authorising treaties (agreements between nation-states) and whether it also should have a role in subsequent treaty changes. The Government is of the view that the Royal Prerogative is sufficient but the court thinks it is not.

This question and the furious reaction following the judgment goes to the heart of our constitutional settlement as it rests on the rule of law, supremacy of parliament and independence of the judiciary. The Government is appealing to the Supreme Court but the obvious alternative approach would be to have a parliamentary vote which would, almost certainly, mean the timely triggering of Article 50.

It is important to avoid damaging our constitution and democratic processes in pursuing Brexit in a reckless and ill-considered manner. Brexit, itself, will be a catalyst to many changes to our individual rights, international standing and social structure so we will need secure, fair and consistent parliamentary and judicial mechanisms to see us through some challenging and, potentially, divisive times over the next decade or so.

Much more important than the actual triggering of Article 50 is the negotiation process and the outcomes we aspire for post Brexit. This is where parliament should have a role and is why debates about the Government’s intentions are of significance and votes over the proposed Great Repeal Bill and other key stages in the process are called for.

Article 50 should not be confused with the complex and contestable decisions once the Brexit process begins. Many ‘tectonic plates’ will be moving and some will be out of our control, unexpected, seemingly unrelated to the problems at hand and, occasionally, threatening. We must be ready for any eventuality and outcome.


One week to go: beware the false prospectus, and Vote Remain!

Edward Bickham

I still believe that the Britain I know and love will vote to Remain in the EU next Thursday. We are a country of instinctive moderation albeit a dangerous stridency and xenophobia has been stoked by the ‘Leave’ campaign.

The British people are told that Turkey will soon join the EU and flood us with migrants; in reality Turkey has no prospect of meeting the membership requirements and there is a queue of countries ahead of us who would veto them. We are told that we are about to be engulfed in a European Super State. Not true. There is no appetite for such a lurch in the rest of Europe and David Cameron has negotiated a carve-out for Britain from the objective of ‘ever-closer union’. We are told that Britain is being strangled by EU bureaucracy and yet we rank in the top 10 of the World Competitiveness Index and of the World Bank’s Doing Business Index. We are told that immigration is out of control and that EU migrants – who make up less than half of the total – are stealing our jobs and causing public services to collapse. In fact we have almost full employment and EU migrants contribute significantly more in tax than they cost in services. We are told that we cannot trade freely with the rest of the world and yet Germany manages to sell four times as much to China as we do. The Leave Campaign, intent on scapegoating the EU for Britain’s ills, is perpetrating a massive fraud on the British people.

With less than a week before polling, as patriotic Conservatives we must persuade our fellow Britons to reject the ugly face of nationalism. The EU has provided a framework for the reconciliation of countries who twice in the last century suffered the slaughter of millions of their people. Peace is a huge prize and should not be taken for granted. The EU has underpinned prosperity and pluralism in Eastern Europe which might otherwise have been a crucible of conflict and instability. Britain is more prosperous than ever and the EU Single Market lies at the heart of this. Through the EU we amplify our ability to protect our interests and to project our influence on issues like climate change and Russian aggression in Ukraine. The EU allows us to work with our like-minded neighbours to solve problems in a world of many risks – terrorism, organised crime, pandemics and migration. Why would we reserve vitriol for our friends when the world abounds with enemies?

Let’s vote to Remain and redouble our efforts for reform of the EU as a whole, not just negotiating British opt-outs. Let’s complete the Single Market in areas like energy, financial services and the digital economy and add 7% to our GDP. Let’s deepen our co-operation in fields like foreign policy, security and crime. Let’s get the EU to do fewer things better. Let’s preserve opportunities for our young people to live, study and work across our continent.

Let’s win the referendum and then take a lead – after all, it is our EU too.

Edward Bickham was Special Adviser to the Foreign Secretary during the negotiation of the Maastricht Treaty and is a Vice Chairman of the Conservative Group for Europe.

Two weeks to go: we are Healthier care in the EU

Neil Carmichael MP

Over 200 leading health professionals, covering physical and mental health, and including professors, doctors, nurses, specialists and therapists recently signed a letter to the Times, saying’ “….we write to highlight the valuable benefits of continued EU membership to the NHS, medical innovation and UK public health”. Since then, such views have been endorsed and embellished by many healthcare bodies – for more information look at

There are several reasons why the NHS will be stronger, safer and better off in the European Union. Firstly and, perhaps, most immediately, is the benefits migration – a two way street – enables the best mix of highly specialised medical skills to be available to us, the patients. Right now, this amounts to some thirty thousand doctors from the EU working day after day for our wellbeing.

Secondly, through being in the EU, all of us can make use of the E-Health Card, providing instance access to local healthcare wherever you are in the EU. This is great for holidays but, crucially, also a huge comfort to the almost two million Britons living and working in the EU. Leaving the EU would bring to an end these considerable advantages.

Thirdly, the size and wealth of our economy is now underpinned by EU membership. In short, the trade and investment flows with the EU help us to finance our public services, including the most prized – the NHS. Its worth noting that the hugely respected NHS Chief Executive, Simon Stevens, noted recently that leaving the EU would be “very dangerous” for the service.

Fourthly, through the EU we benefit from access to safe and effective new drugs and devices, ironically facilitated by the London based European Medicines Agency. As Sir Mike Rawlins, head of the UK medicines regulatory body noted recently, “If [UK] left the EU, it would have to re-register 130 products” (so much for the regulation argument).

Fifthly and poignantly in terms of UK influence, it was John Bowis, a Conservative MEP who was instrumental in setting up the European Centre for Disease Prevention and Control, enabling speedy and prompt reaction to emerging health threats.

It is clear, I believe, from these simple observations, that remaining in the EU is most definitely the healthier option for our families and friends.

– Neil Carmichael MP
Neil is Chair of the Conservative Group for Europe, the House of Commons Education Select Committee, and Member of Parliament for Stroud.

Please note these are the personal views of Mr Carmichael and not necessarily those of the CGE.

Three weeks to go: Sovereignty and Britain’s place in the European Union

Neil Carmichael MP

One of the principal debating points about Britain’s membership of the Europe Union is sovereignty and, more precisely, how it is defined and deployed. We live in an era of increasing globalisation, meaning nation-states often work together to achieve their political and economic goals. This is, in essence, the way the European Union works.

The fact we are having a referendum on our membership of the European Union proves Britain is sovereign; in short, it is possible for us to leave. Indeed, even without a referendum, Parliament as a supreme and sovereign body could take Britain out of the EU by the simple process of passing an Act of Parliament.

Incidentally, Parliament is not restricted by a written constitution (we do not have one) or any other device such as a formal ‘checks and balance’ system. Parliament is so powerful it can even extend its own life as it did during the Second World War by postponing the need for a general election.

To strengthen Parliament’s role further, the European Union Act 2011 provides for a referendum if any subsequent treaty requires powers to be transferred to the EU. The European Union is a treaty organisation – the Treaty of Rome was the first of successive treaties – where nation-states have agreed to act in concert. The North Atlantic Treaty Organisation (NATO) works in the same way, as do the thousands of treaties signed by Britain and still in force.

Working with our partners in the EU does require rules and regulations, but only ones we shape and understand to be in our interests. The best examples are where Britain has agreed to make trade easier through enabling individuals and firms to make contractual arrangements for the exchange of goods and services. More complicated, but just as useful to our economic interests, are agreements where we accept regulations but with mutual benefit.

There is an argument about the quantity of rules and regulations. Leave campaigners frequently assert that the number of ‘laws’ coming from the EU exceed some 60 per cent of total laws. This is, quite simply, incorrect. The reality is that Westminster – our Parliament – continues to be responsible for virtually all legislation and also most regulations.

– Neil Carmichael MP
Neil is Chair of the Conservative Group for Europe, the House of Commons Education Select Committee, and Member of Parliament for Stroud.

Please note these are the personal views of Mr Carmichael and not necessarily those of the CGE.

Four weeks to go: the European Union Single Market

Neil Carmichael MP

A huge number of firms in the UK access the European Union Single Market. It is the world’s largest barrier-free trading area, accounting for nearly half of our trade. The EU economy is £11.8 billion in total value, making it larger than the United States economy and, perhaps surprisingly, almost twice the size of the Chinese economy.

The Single Market was established during the 1980s and is an example of a key reform being inspired and driven by British influence and leadership. The success of the Single Market is a tribute to Conservative Prime Minister Margaret Thatcher and her Commissioner for Trade, Lord Cockfield, who together were able to drive forward a conservative, free-trade agenda in Europe. And today, Britain has, once again, pushed the agenda forward by extending the Single Market to include more services, energy and, crucially, the digital economy.

For British business, the Single Market has been a powerful stimulant to investment and job creation. Well-known businesses, such as Honda or Airbus have been able to access the markets and the workers they need, precisely because of the free movement of capital and labour around Europe. The flexibility of the Single Market offers allows firms to employ more people, thus keeping levels of employment stable in the UK.

Leaving the European Union would mean we would leave the Single Market. Some Leave campaigners do not seem to care about the advantages of free trade across Europe, while others promote ‘other arrangements’. These alternatives include the Norwegian model where Britain would pay for access but would forgo any influence on regulations and policy; and the Canadian model, which excludes financial services and automotive industries, both of massive importance to the British economy. Struggling for an answer, Leave campaigners have now bizarrely promoted Albania as an example to copy. Ironically, the Albanian people have been dying to join the European Union and Single Market for years.

If we left the European Union, Britain would be reliant on the World Trade Organisation (WTO), which would mean the putting-up of tariffs and other barriers to trade until free-trade agreements could be negotiated with around sixty states(!) to compensate for being out of the Single Market and the free trade agreements that have been made through the Single Market. This would undoubtedly harm the UK economy, slowing growth for anywhere between two and ten years. For many British businesses and consumers, this is simply unacceptable. The case is therefore clear: if we want to protect our economy, we must stay in the EU.

– Neil Carmichael MP
Neil is Chair of the Conservative Group for Europe, the House of Commons Education Select Committee, and Member of Parliament for Stroud.

Please note these are the personal views of Mr Carmichael and not necessarily those of the CGE.

Five weeks to go: alternatives to the European Union

Neil Carmichael MP

The European Union referendum campaign is now properly underway. In less than forty days, electors must make their minds up on this crucially important question. It is a decision of a lifetime because we will not be able to change our minds afterwards, at least for several decades.

One cleavage issue has been the matter of the alternatives to the European Union. This has been brought into sharper focus now that the Leave Campaign has made it clear the UK would not seek to re-join the Single Market if it was to leave the EU. Furthermore, all friendly nation states, including the USA, Australia and New Zealand, have given strong support for the UK’s continued membership of the EU.

Various alternative options have been advanced by the Leave Campaign. The Canada trade solution was suggested but this was soon rubbished because it would not cover financial services or automobile industries, both of which the UK depends on. Canada, itself, wants the UK to remain in the EU.

The Norwegian arrangement has also been covered. Norway is not a member of the EU but pays a contribution – ironically equal to the UK’s net contribution – to have access to the Single Market. Given the Leave Campaign no longer has an interest in the Single Market, this looks like a dead duck. Norway, of course, thinks the UK should remain in the EU.

Incredibly, Albania has been promoted as a natural partner for the UK if it was to leave the EU. This has been ridiculed by the Albanian Prime Minister who went on to urge the UK to remain in the EU.

Leaders of the United States have all reaffirmed the longstanding view in Washington that the UK is better off in the EU. From Presidents Gerald R Ford in 1975 to Barack Obama today, every US President has supported EU membership.

The Leave Campaign does have two ‘helpers’. President Putin of Russia and, for the moment, US presidential candidate Donald J Trump. If all Commonwealth leaders and the leaders of large economies such as Japan and the USA take a different view, it might be wise for us to follow their advice and vote to remain in the European Union.

– Neil Carmichael MP
Neil is Chair of the Conservative Group for Europe, the House of Commons Education Select Committee, and Member of Parliament for Stroud.

Please note these are the personal views of Mr Carmichael and not necessarily those of the CGE.