This week: Professor Anand Menon
Why he matters: The professor of European politics and foreign affairs at King’s College, Anand Menon, is one of the leading commentators on Brexit. The week HSJ interviewed him marked his first appearance on BBC One’s Question Time and he is a ubiquitous media figure as 29 March approaches. He chairs the UK in a Changing Europe initiative, where his blogs are required reading for politicians and political journalists alike.
“The defining feature of Brexit is that on 22 June 2016 this country was sleep walking amid a number of crises. We had an economic crisis in terms of the anger people felt over levels of inequality. We had a political crisis in terms of [the electorate’s] disengagement. We had a devolution crisis in Scotland and Northern Ireland. We had a social care crisis. What Brexit has done is added another crisis to that list whilst making all of them worse.”
Talking to Professor Menon is not a cheery undertaking – despite the academic’s bubbling good humour.
“The stark truth,” he says, “is whatever form of Brexit we have, the impact is going to be negative at least in the short to medium term, because - to simplify appallingly - Brexit is a process of making trade with your nearest and largest trading partner harder.
“That will have an impact on the economy for a variety of reasons because trade with our nearest partner will fall. It almost certainly won’t be compensated by the trade with anywhere else.”
Professor Menon “prefers not to put numbers on [the economic impact] because I think that sort of spurious specificity is the root cause of so much of our distrust of [Brexit analysis]”. But he is confident in asserting that a negotiated deal will cause the economy to grow “from a lower base”.
His concerns over a ‘no deal’ scenario are much greater. He claims the uncertainty this would create when combined with the possibility of a more “confrontational” approach to EU trading partners could spark an economic downturn in which it would be “credible to fear that current [public] spending pledges will be put under enormous pressure”.
When it comes to the impact on the NHS’s immigrant workforce, Professor Menon acknowledges that uncertainty over the nature of future relations with EU states, and a sense that Britain is less welcoming, are important factors. However, he suggests, a much less discussed consequence of Brexit is just as important, if not more so.
Since “the immigration white paper didn’t mention [the previous commitment to reduce net migration to tens of thousands], the government might be preparing to quietly ditch that”
“If [NHS workers from the EU] are sending money back home, [the fall of the pound means] it’s now worth 20 per cent less than it would have been at the time of the referendum. If you were Polish doctor or nurse, you would [now] go to a eurozone country if you wanted to continue sending the same amount back.”
So, what will happen to immigration if or when the UK leaves the EU?
“It’s impossible to say with any clarity,” acknowledges Professor Menon, but he speculates that since “the immigration white paper didn’t mention [the previous commitment to reduce net migration to tens of thousands], the government might be preparing to quietly ditch that”.
This “softening of the government position”, as well as the continuing demands from sectors like healthcare, leads him to be believe that in the short term, the number of immigrants coming to the UK will not go down.
The immigration shift
This, he believes, will not immediately cause the ructions one might expect after such a momentous decision driven in large part by concerns over immigration.
“One of the interesting side effects of Brexit has been that public opinion on immigration has liberalised massively. There’s been a marked and sustained shift to the point where immigration has dropped off the list of salient political issues for the first time in a decade.”
Why does he think that has happened?
“There are a variety of explanations put forward. One is that we’ve got it under control because it’s falling, the other is that people are more relaxed because they think they’ve dealt with it via the Brexit vote. Another possible reason is that we’ve started to appreciate the role that migrants play because it’s actually been given airplay. Although that implies the people who voted Brexit for reasons of immigration read the Guardian, which is why I’m not wholly convinced by that argument.”
Maligned notion
He says the “data is not yet good enough to give us a clear indication of why public concern has shifted” and adds: “There is a logical sense to the argument that says, [Brexit voters] didn’t want to reduce immigration, they just wanted to know that we could if we wanted to, that the government has some sort of control over it. And maybe that much maligned notion of sovereignty or control actually was far more important than many cynics on the remain side gave it credit for.”
Is there no upside from Brexit for the NHS? Professor Menon is doubtful.
“There’s already a hint of dishonesty about the government’s promise of [more] funding for NHS [as a result of leaving the EU]. The prime minister repeatedly describes this [funding uplift] as a Brexit dividend and it’s quite obviously not true, because whatever money we might save from our budgetary contributions [to the EU], will be more than cancelled out by the fall in revenue to the exchequer because of the contraction in our economy.”
When pressed he does admit that in the long term a reduced reliance on overseas NHS staff might be a good thing.
“If we’re training more of our own to become doctors and nurses,” he says, “you could see that as a good event. If people who previously hadn’t aspire to those careers for whatever reason were now able to enter them. I suppose there’s a positive in that.”
Anti-immigrant sentiment
What about the nature of a Brexit deal, how much does that matter to the NHS?
“If we ended up leaving in March or some time thereafter [with a deal], what might surprise people is the fact that the ultimate nature of our relationship [with the EU] is completely open.
“It is going to be down to the government and the prime minister of the day [to negotiate it]. And some people think it’ll be a different prime minister, if not a different government. In terms of the NHS, the closer the economic relationship we have with the European Union, the less the potential impact on funding - which is one of the arguments people make in favour of a sort of Norway plus type of model.”
And what about the pace Brexit is achieved at?
“Transition can only be extended until 2022. Thereafter, there is no obvious legal provision to extend it. It might well be that we get to 2021 and we’re having this debate again about a cliff edge, because if transition ends with no trade deal, we end up trading with the EU on WTO terms - and that would have a short-term significant [and negative] impact on our economy.”
Professor Menon also fears a slow Brexit will see a rise in anti-immigrant sentiment, as leave supporters once again grow frustrated by the process. More generally he sees the forces stirred up by the EU vote meaning the UK will conduct its politics in “primary colours” with, for example, little “space, scope or desire to have a detailed discussion about the NHS”.
Instead of a nuanced conversation about what kind of model best deals with changing demographics and expectations of patients, he worries it will simply be a case of “we’ll give it more money than they will”.
This reverence, says the professor, means other aspects of public wellbeing, such as housing, get overlooked and prevents most politicians from being a “critical friend” to the health service.
Next week: Neil Anderson, director of Migration Watch
Coming up: Paul Johnson, director of the Institute of Fiscal Studies and medicinal cannabis campaigner and CCG sceptic Sir Mike Penning MP
If there is any political figure you would like me to interview, please email alastair.mclellan@wilmingtonhealthcare.com or if you are reading this on the website leave them in the comments box.
Past bedpans
Jeremy Heywood - an appreciation
Resolution Foundation director Torsten Bell
Sarah Wollaston: part two - the role of the Commons’ health committee
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