{"id":44486,"date":"2019-04-24T16:31:24","date_gmt":"2019-04-24T15:31:24","guid":{"rendered":"https:\/\/blogs.bmj.com\/bmj\/?p=44486"},"modified":"2019-05-30T21:16:16","modified_gmt":"2019-05-30T20:16:16","slug":"martin-mckee-waiting-for-brexit","status":"publish","type":"post","link":"https:\/\/blogs.bmj.com\/bmj\/2019\/04\/24\/martin-mckee-waiting-for-brexit\/","title":{"rendered":"Martin McKee: Waiting for Brexit"},"content":{"rendered":"<p class=\"standfirst\">As we wait to find out what will happen next, the damage is being done<\/p>\n<p><!--more--><br \/>\n<span style=\"font-weight: 400\">With the approach of the third anniversary of the UK\u2019s referendum on EU membership, a brief reflection is in order. \u201cBrexit day\u201d, the 29<\/span><span style=\"font-weight: 400\">th<\/span><span style=\"font-weight: 400\"> of March 2019, when the UK was due to leave the EU, has come and gone. Almost all of the \u201c40 trade deals\u201d that were promised to replace the UK\u2019s existing ones with the rest of the world are <\/span><a href=\"https:\/\/www.theguardian.com\/business\/2019\/feb\/13\/brexit-uk-trade-deals-eu\"><span style=\"font-weight: 400\">as far off as ever<\/span><\/a><span style=\"font-weight: 400\">. It seems very likely that the UK will soon vote in the elections for a new European Parliament. Despite negotiating what is arguably the only deal with the EU that comes close to complying with her \u201cred lines\u201d, the Prime Minister has failed repeatedly to gain support for it in the House of Commons. <\/span><\/p>\n<p><span style=\"font-weight: 400\">Those seeking to understand the Brexit process seem, even if subconsciously, to be drawing on Oscar Wilde\u2019s observation that \u201clife imitates art\u201d. John Cleese has been a particularly valuable source of analogies. One <\/span><a href=\"https:\/\/www.theguardian.com\/commentisfree\/2019\/apr\/09\/brexit-basil-fawlty-towers-sitcom\"><span style=\"font-weight: 400\">perceptive analysis<\/span><\/a><span style=\"font-weight: 400\"> argues that Basil Fawlty personifies the Brexit mentality, with his combination of arrogance, insecurity, and fear of foreigners. Cleese appears again in the Brexit discourse when Dutch Prime Minister Mark Rutte compares Theresa May to his <\/span><a href=\"https:\/\/www.politico.eu\/article\/mark-rutte-likens-theresa-may-to-monty-pythons-limbless-knight\/\"><span style=\"font-weight: 400\">Black Knight in <\/span><i><span style=\"font-weight: 400\">Monty Python and the Holy Grail<\/span><\/i><\/a><span style=\"font-weight: 400\">, who only suggests calling it a draw after having all his limbs hacked off. Fintan O\u2019Toole\u2019s incisive analysis of the politics of Brexit, seen from an Irish perspective, invokes a wide selection of literary contributions, even extending to the use of <\/span><a href=\"https:\/\/www.irishtimes.com\/culture\/books\/fintan-o-toole-has-nailed-us-to-the-floor-with-a-nine-inch-nail-1.3714502\"><i><span style=\"font-weight: 400\">Fifty Shades of Grey<\/span><\/i><\/a><span style=\"font-weight: 400\"> to describe the more masochistic elements of the English character (and O\u2019Toole is very clear that Brexit is an English rather than a British phenomenon). But perhaps the most widely invoked example is from another Irish author, Samuel Beckett, who was educated close to the Irish border and spent most of his life in France. At frequent intervals since the referendum, the <em>Financial Times<\/em> commentator David Allen Green has <\/span><a href=\"https:\/\/twitter.com\/davidallengreen\/status\/1114083611706384384\"><span style=\"font-weight: 400\">tweeted<\/span><\/a><span style=\"font-weight: 400\"> the same three lines (with subtle variants as each of Theresa May\u2019s deadlines passes) from his play Waiting for Godot:<\/span><\/p>\n<p><span style=\"font-weight: 400\">Estragon: Well, shall we Leave? <\/span><\/p>\n<p><span style=\"font-weight: 400\">Vladimir: Yes, let&#8217;s Leave. <\/span><\/p>\n<p><span style=\"font-weight: 400\">(They do not Leave)<\/span><\/p>\n<p><span style=\"font-weight: 400\">By the end of the play the audience knows no more about Godot than they do at the beginning. Godot, like Brexit, never comes. It is easy to see why a frustrated Xavier Bettel, the Luxembourg Prime Minister, <\/span><a href=\"https:\/\/luxtimes.lu\/european-union\/36824-bettel-brexit-deal-is-like-waiting-for-godot\"><span style=\"font-weight: 400\">also invoked Beckett\u2019s play<\/span><\/a><span style=\"font-weight: 400\"> as he waited in vain for a clear indication from the UK about what it actually wanted. Yet Waiting for Godot seems to anticipate many other aspects of the Brexit process, especially its confused and often mindless ramblings, repetition, and nostalgia. <\/span><\/p>\n<p><span style=\"font-weight: 400\">So where is the Brexit process now? After much discussion, the European Council (minus the UK) agreed an extension until the 31<\/span><span style=\"font-weight: 400\">st<\/span><span style=\"font-weight: 400\"> of October 2019, but with a get out clause allowing an earlier exit should agreement be reached. The decision by the EU27 was accompanied by a clear message to Theresa May. As she has so far failed to achieve a Parliamentary majority, she must reach out to the opposition parties. In practice, this meant Labour as the Prime Minister has pointedly refused to engage with the <\/span><a href=\"https:\/\/www.snp.org\/theresa-may-is-still-not-listening-as-she-drags-scotland-off-brexit-cliff\/\"><span style=\"font-weight: 400\">Scottish National Party<\/span><\/a><span style=\"font-weight: 400\"> on any substantive issues related to Brexit. The talks with Labour have now begun but there is no evidence they are going anywhere. Accounts from those involved indicate that the government steadfastly refuses to make any meaningful and legally binding concessions beyond vague statements of intent. Labour, in turn, demands assurances that anything agreed will not be rejected by Theresa May\u2019s successor, with polls among Conservative Party members suggesting that Boris Johnson is by far the <\/span><a href=\"https:\/\/www.telegraph.co.uk\/politics\/2019\/04\/22\/boris-johnson-pulls-17-points-clear-closest-tory-leadership\/\"><span style=\"font-weight: 400\">most favoured candidate<\/span><\/a><span style=\"font-weight: 400\">. He is <\/span><a href=\"https:\/\/www.politico.eu\/article\/no-deal-is-closest-to-uk-voters-idea-of-brexit-says-boris-johnson\/\"><span style=\"font-weight: 400\">on record<\/span><\/a><span style=\"font-weight: 400\"> as supporting a catastrophic \u201cno deal\u201d, rejected by the House of Commons, but supported by a secretive and well-funded <\/span><a href=\"https:\/\/www.theguardian.com\/politics\/2019\/apr\/22\/facebook-ads-by-lynton-crosbys-firm-part-of-push-for-hard-brexit\"><span style=\"font-weight: 400\">Facebook campaign<\/span><\/a><span style=\"font-weight: 400\"> led by Sir Lynton Crosby, widely seen as being linked to Johnson\u2019s ambitions. The situation is complicated further as Labour is also divided on Brexit and has only managed to avoid a more serious split by maintaining ambiguity about its intentions. It has little incentive to take ownership of a policy that will alienate the <\/span><a href=\"https:\/\/www.theguardian.com\/politics\/2019\/jan\/02\/most-labour-members-believe-corbyn-should-back-second-brexit-vote\"><span style=\"font-weight: 400\">estimated 90%<\/span><\/a><span style=\"font-weight: 400\"> of its members who reject Brexit altogether.<\/span><\/p>\n<p><span style=\"font-weight: 400\">Given the inability to find a form of Brexit that can actually be implemented, some are now asking whether it will ever happen. For months, opinion polls have shown a clear, and increasing margin <\/span><a href=\"https:\/\/www.businessinsider.com\/brexit-polls-leave-remain-second-referendum-vote-2019-3?r=US&amp;IR=T\"><span style=\"font-weight: 400\">in favour of Remain<\/span><\/a><span style=\"font-weight: 400\">. The idea that Brexit is \u201cthe will of the people\u201d was always problematic, given the clear lack of any agreement on what it actually meant, but it is now simply implausible. To return to the literary allusions, Theresa May\u2019s oft-repeated statement that <\/span><a href=\"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/2041905817702740\"><span style=\"font-weight: 400\">\u201cBrexit means Brexit\u201d<\/span><\/a><span style=\"font-weight: 400\"> recalls Lewis Carroll\u2019s Humpty Dumpty when he said that <\/span><span style=\"font-weight: 400\">\u201cWhen I use a word it means just what I choose it to mean.\u201d <\/span><span style=\"font-weight: 400\">And even if the UK could reach agreement on the Withdrawal Agreement, this would only be the start of a very long process. If Brexit is to take place it must be concluded by the 31<\/span><span style=\"font-weight: 400\">st<\/span><span style=\"font-weight: 400\"> December 2020, when the new European Commission implements its next <\/span><a href=\"https:\/\/www.consilium.europa.eu\/en\/policies\/eu-budgetary-system\/multiannual-financial-framework\/mff-negotiations\/\"><span style=\"font-weight: 400\">Multiannual Financial Framework<\/span><\/a><span style=\"font-weight: 400\">, covering 2021-2027. Given the glacial pace of negotiations so far, this seems incredibly optimistic. <\/span><\/p>\n<p><span style=\"font-weight: 400\">Meanwhile, the damage is being done. Although estimates differ, there is little argument that the British economy is now <\/span><a href=\"https:\/\/assets.publishing.service.gov.uk\/government\/uploads\/system\/uploads\/attachment_data\/file\/760484\/28_November_EU_Exit_-_Long-term_economic_analysis__1_.pdf\"><span style=\"font-weight: 400\">considerably smaller<\/span><\/a><span style=\"font-weight: 400\"> than it would otherwise have been and even those who support Brexit suggest that any economic benefits may not be seen <\/span><a href=\"https:\/\/www.theguardian.com\/politics\/shortcuts\/2018\/jul\/24\/two-50-or-100-years-when-do-leavers-think-brexit-will-pay-off\"><span style=\"font-weight: 400\">for 50 years<\/span><\/a><span style=\"font-weight: 400\">. Leaving aside these broader economic issues, <\/span><a href=\"https:\/\/theconversation.com\/what-else-could-the-uk-government-spend-its-4-2-billion-brexit-contingency-fund-on-109110\"><span style=\"font-weight: 400\">huge sums of money<\/span><\/a><span style=\"font-weight: 400\"> that could benefit the NHS are being spent on Brexit contingency planning, including the now notorious <\/span><a href=\"https:\/\/www.bbc.com\/news\/business-47592812\"><span style=\"font-weight: 400\">ferry debacle<\/span><\/a><span style=\"font-weight: 400\">. The NHS is already facing <\/span><a href=\"https:\/\/www.theguardian.com\/society\/2019\/mar\/26\/my-gp-practice-struggling-brexit-worse-staff-shortages\"><span style=\"font-weight: 400\">severe staff shortages<\/span><\/a><span style=\"font-weight: 400\"> but a <\/span><a href=\"https:\/\/www.telegraph.co.uk\/politics\/2019\/04\/22\/theresa-may-warned-post-brexit-immigration-strategy-could-close\/\"><span style=\"font-weight: 400\">leaked memo<\/span><\/a><span style=\"font-weight: 400\"> reveals concerns by NHS executives that the government\u2019s proposed post-Brexit immigration policy is the <\/span><span style=\"font-weight: 400\">\u201cmost destructive policy proposal for NHS recruitment\u201d and there are fears that it could force some hospitals to close \u201c25 per cent of services\u201d. There are increasing accounts of shortages of medicines, and while the government has gone to great lengths to argue that they are unrelated to Brexit, many are unpersuaded, not least because of <\/span><a href=\"https:\/\/www.bbc.com\/news\/health-47774042\"><span style=\"font-weight: 400\">concerns about the secrecy of the planning process<\/span><\/a><span style=\"font-weight: 400\">. The number of clinical trials registered in the UK has <\/span><a href=\"https:\/\/twitter.com\/sciencesplained\/status\/1118844645545476097\"><span style=\"font-weight: 400\">collapsed<\/span><\/a><span style=\"font-weight: 400\"> relative to France. But perhaps the greatest threat is to the machinery of government. Vast resources, in both money and personnel, have been redeployed for \u201cno deal\u201d planning, leaving very little capacity for other things. Health professionals are most concerned about the government\u2019s failure to meet its own deadline for <\/span><a href=\"https:\/\/www.instituteforgovernment.org.uk\/blog\/government-must-not-continue-delaying-social-care-green-paper\"><span style=\"font-weight: 400\">reform of social care<\/span><\/a><span style=\"font-weight: 400\">. <\/span><\/p>\n<p><span style=\"font-weight: 400\">Just before the end of Waiting for Godot, the two main characters decide to hang themselves. They try to use Estragon\u2019s belt, causing his trousers to fall down. One wonders if the US commentator Thomas Friedman had this episode in mind when he wrote, in a widely cited <\/span><a href=\"https:\/\/www.nytimes.com\/2019\/04\/02\/opinion\/brexit-news.html\"><span style=\"font-weight: 400\">New York Times article<\/span><\/a><span style=\"font-weight: 400\">, that the UK was \u201c<\/span><span style=\"font-weight: 400\">determined to commit economic suicide but can\u2019t even agree on how to kill itself<\/span><span style=\"font-weight: 400\">\u201d.<\/span><\/p>\n<p><em><strong>Martin McKee<\/strong> is professor of European public health at the London School of Hygiene and Tropical Medicine.<\/em><\/p>\n<p><em><strong>Competing interests<\/strong>: None declared.<\/em><\/p>\n","protected":false},"excerpt":{"rendered":"<p>As we wait to find out what will happen next, the damage is being done [&#8230;]<\/p>\n<p><a class=\"btn btn-secondary understrap-read-more-link\" href=\"https:\/\/blogs.bmj.com\/bmj\/2019\/04\/24\/martin-mckee-waiting-for-brexit\/\">More&#8230;<\/a><\/p>\n","protected":false},"author":1,"featured_media":44489,"comment_status":"open","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[14774,14776],"tags":[],"class_list":["post-44486","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-brexit","category-martin-mckee"],"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v27.4 - 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