The monumental European Union Brexit decision awaiting the United Kingdom this week

This Thursday 23rd June the United Kingdom will be voting in the most important election for the country since World War 2. It’s a story that hasn’t really gained much media attention (yet) in America, but expect some major news and fluctuations in the world’s markets should the UK vote to Leave the European Union.

A bit of background: After World War 2 and the terrible fighting that has plagued Europe for most of history, the idea of the European Union was born. The (excellent) idea was that nations which are engaged in happy trading are more likely to coexist peacefully and cooperate. A full economic union rather than a competitive race. However, over the last 20 years, the organization has evolved into more of a political union, with member countries essentially losing increasing amounts of sovereignty to an overly complicated and excessively bureaucratic Brussels (the headquarters of the EU). The guaranteed free movement of all EU citizens has also resulted in a mass migration of Eastern Europeans westwards, to countries like the UK.

British Prime Minister David Cameron, and his Conservative Party, won last year’s general election with a manifesto pledge to give the UK a simple in-out referendum on either staying in or leaving (Brexit) the European Union. Earlier this year, he announced that this election would be held on June 23rd. This was only after he had attempted to renegotiate some key terms of Britain’s membership with the rest of the EU, in a last ditch attempt to satisfy an increasingly skeptical British public.

All of the main political parties, UK big business and industry, and many leading celebrities, are supporting the UK’s continued membership of the EU. Their main argument is an apparently compelling economic reason for remaining a central member. The UK benefits enormously from the trading zone, free movement of people (or at least big business does) and the ability to negotiate with the rest of the world as an EU member.

Yet despite so much bipartisan political support, most opinion polls are pointing to a nail-biting result. Two of the main leaders of the Leave Campaign are Nigel Farage— the leader of the UK Independence Party, who has made it his life’s work to campaign for an independent UK—and Boris Johnson, the Conservative Member of Parliament and former London Mayor, who is widely seen as the next leader of the party. Their political clout is nowhere near the rest of the politicians combined. So why are the opinion polls still so close?  Well, speak to a few British people on the ground and you may soon find out. From a constitutional perspective, there is huge concern that the European Union has the power to overrule most of the nations’ Supreme Courts. How can it be right for sovereign nations to have their own democratically elected governments powerless to stop laws and policies being dictated by Brussels? Despite the fact that people in member nations elect the European Parliament, there’s still a widespread perception that the institution is undemocratic and too bureaucratic.

With regards to the free movement of people, the United Kingdom, for a small island, has seen millions of new immigrants come into the country over the last decade. This has put a tremendous strain on many government run services including hospitals and schools. Being primarily a healthcare blog, it’s appropriate to discuss this here, as the pressure on the National Health Service (NHS), and the fact that the British population are having to wait longer for appointments and tests, may well be another deciding factor.

There was already an acute housing shortage in the entire country, and adding millions of people to the equation has only made the situation much worse. I personally am pro-immigration (obviously considering my own history!), but this has to be controlled sensibly—especially on a small island.

I have thought over which way I was going to vote for a long time.  Considering the history of Europe, the ideals of the EU are wonderful. I remember in 2012 when the EU won the Nobel Peace Prize, many skeptics scoffed at the notion. But one particular primetime reporter put everything in great context: All you have to do is wander around the cemeteries in Northern France to see how horrific things were when Europe couldn’t exist in peace. Up until the formation of the EU, Europe was a complete blood bath. Surely that alone is a strong reason to support the European project?

On the other hand, a strong economic union and trading agreements in the modern world may well help prevent repeats of pre-EU Europe, but is closer political union between so many vastly different countries the answer?

Ultimately however it came down to the central issue of sovereignty. America, as a shining example, would never allow foreign countries to have control over our own internal affairs, immigration policy and repeatedly overrule our own Supreme Court. It’s perfectly possible for the UK to follow the example of Switzerland or Norway, and exist amicably and prosperously with the rest of Europe. Freedom movements throughout history have always cited self-determination as the central tenet of any nation state. We may not be at such an extreme point in our history, but surely that same ideal always holds true. World peace and prosperity is what we all aim for one day. However, we still live in times of strong national identity and cultural uniqueness. That’s something to be celebrated while we seek to live peacefully and harmoniously with all our neighbors.

And that’s what tipped it for me as I filled out my postal vote.



Suneel Dhand is a physician, author, speaker and healthcare consultant. He has experience in a number of different healthcare environments, having worked up and down the East coast and also internationally. His specialty areas include hospital QI, optimizing healthcare IT, and improving the patient experience. He is the author of 3 books, including most recently “The Ultimate Patient Advocate in Your Pocket”, designed to help hospitalized patients. He is also the founder of HealthITImprove, an organization dedicated to improving and optimizing information technology at the frontlines of healthcare.

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