RSPH has published the results of a new poll of its members which found that the majority believe EU membership has a positive effect on the public’s health.

Just over three in five (61%) said the UK’s membership of the EU has a positive effect on the public’s health and wellbeing. One in four (25%) believe membership has a negative effect, with 14% saying it has little or no effect either way.

In the poll of almost 500 RSPH members:

• 43% said EU membership has a strong positive effect
• 19% said EU membership has a slight positive effect
• 14% said EU membership has little or no effect
• 8% said EU membership has a slight negative effect
• 17% said EU membership has a strong negative effect

The results come on the same day as a poll by the Faculty of Public Health (FPH) found 86% of its members believe it is in the best interests of health and wellbeing for the UK to remain in the EU.

Whilst the balance of professional opinion among RSPH members is behind EU membership, the split result reflects benefits and concerns on either side of the argument. RSPH has identified a number of benefits and some limitations that affect the UK public’s health and wellbeing.

Benefits include:

• Environmental protections – environmental influencers of health, such as air and water quality, do not respect national borders and are best tackled at international level. EU regulation has improved air and water quality in the UK, as well as standards of chemical use and waste management, among others [1]. These standards may be weakened or scrapped in the event of an EU exit.
• Health research funding – the UK is a net beneficiary of EU research funding, contributing 11% of the budget but receiving 16% of allocated funding. The UK receives more funding for health research than any other EU Member State [2], having attracted more than 570 million for this purpose by 2012 [3]. The UK would lose automatic access to this funding in the event of an EU exit.
• Workforce mobility – the UK is a net importer of health and social care professionals, and 10% of this workforce is of EEA origin [4]. If the UK leaves the EU and does not negotiate a settlement that continues to facilitate the free movement of labour, this may exacerbate NHS staff shortages.

Limitations include:

• Restrictions on decision-making and innovation – decision-making in a community of 28 countries is inevitably slower and more cumbersome than in one country alone. This can restrict how fast the UK Government can respond to population health needs and implement new initiatives. For instance, the UK has led the pack with policies such as the introduction of voluntary front-of-pack traffic light labelling in an attempt to help tackle obesity, but is not able to mandate the labels as this is a reserved EU competency, and has faced the threat of legal challenges driven by some other EU Member States as a result [5].
• Potential consequences of the Transatlantic Trade and Investment Partnership (TTIP) – concerns have been expressed that the TTIP agreement currently being negotiated between the EU and the US may lead to further privatisation of health services and weakening of EU public health legislation as a result of regulatory convergence [7]. However, even if this is the case, a US-UK trade deal in the wake of an EU exit would may well lead to a comparable result.

Shirley Cramer CBE, Chief Executive of RSPH, said that while the organisation wasn’t taking a particular stance on either remaining in or leaving the EU:
“Among those working to improve and protect the public’s health, there is a clear majority who view EU membership positively. Our membership of the EU has undoubtedly created a number of tangible dividends for the public’s health and wellbeing, most notably in areas of environmental health such as water and air quality which are best tackled at an international level, and this is reflected in the results of our member survey.

"On the other hand, there may be opportunities for the UK to go farther faster in some areas of public health policy, such as food labelling, that have been slowed by decision making within an international community. Whether the UK chooses to leave or remain, it is essential that health gains are not rolled back and a legislative environment that encourages progressive public health measures is maintained.”