A Cardiologist Views Brexit

Historic NHS

John Martin draws from his personal experience as a member of the European Society of Cardiology to explain the benefits of European cooperation in medical research and beyond. He stresses the need for the UK to join the moral leadership championed by the EU in the world.

I am as British as any Brexiteer. I served as Regimental Medical Officer in the Ghurkha Field Force in Hong Kong. An ancestor lost a leg at Waterloo. My family members were decorated in several wars. Thirty members of my family served around the world in the East Yorkshire Regiment and the Northumberland Fusiliers. Imperial glory runs in my veins. I feel the tingle of a special relationship when in Delhi or in “The Commonwealth of Connecticut”. But the past belongs to the past, I belong to the future; I enjoy reverie as part of my personal culture, however it does not determine my destiny.

I am now a European first, a Yorkshireman second and British third. I have taken my British past and incorporated it into a new rich forward-looking vision as a citizen of the European Union. I lived this vision as a member of the board of the European Society of Cardiology (ESC) for eight years. The ESC is a forum for European cardiologists to discuss science and clinical practice. In its Practice Guidelines, following rigorous analysis, it brings the best practice in one member state to the attention of the others. This is important in itself but it also balances the commercial importuning of industry. (These guidelines are often different from the US equivalent.) The ESC’s Annual Scientific Meeting is the biggest professional congress in the world. I want to be there at the heart of the decision making process of the ESC just as, alas, I wanted the UK government to be at the heart of EU decision-making.

The ESC is the living European Union. Doctors sit around a table in mutual respect critically analysing science and medicine. The combined brain, seeing questions from a variety of angles, gives a higher quality of decision than can be achieved from one national view. Free movement of labour in the EU also helps with exchange of trainee doctors between countries. (Many of the NHS’s senior posts in cardiology are now held by EU nationals).

I am also a scientist who studies the prevention and treatment of heart attacks. What determines success in science is the quality of the creative idea. This is enhanced if the research question is examined from different angles by scientists of different backgrounds. Science laboratories around the UK, because of free movement of labour in the EU, host scientists from a variety of countries in the EU working shoulder to shoulder with UK scientists. (I would not attempt to appoint a scientist from the US because of the mountain of paperwork involved. Scientists from the EU are as easy to appoint as ones from Yorkshire). Integrating thought from different disciplines, cultures and backgrounds enhances creativity in manufacturing as well as science. If the success of our economy in the future is dependent on the quality of what we make and sell then we need creative ideas of quality. It is obvious that if we were making cars to sell in China they would have to be better than German cars. Leaving the EU will probably diminish our capacity to invent things that are better than things made elsewhere. We must not only work productively but also have good novel ideas. Those ideas are less likely to come from introverted nationalism than from open Europeanism.

I am dismayed at the effect of Brexit on funding for research in the UK. For years there has been a net inflow of research money into the UK from other EU governments via the European Commission. This funding was helpful in that it was for large expensive projects at a time when UK funding agencies had diminished funding capacity and so funded small projects. Also in my opinion the European Commission was more likely to fund more risky projects that, if successful, would give real advance. My colleagues and I have received   €18.5 million from the EU in the last six years for cardiovascular research. We cannot repeat this after Brexit. Was a vitally important net inflow of EU research money into the UK made clear to voters before the referendum?

Taxi drivers have told me about the corruption in the European Commission. I converted one to a Remainer by telling him that I have chaired research grant committees in the European Commission and found the process more transparent and objective than in UK research grant committees. And to another taxi driver’s belief in the EU gravy train I replied that the last EU meeting I went to I travelled on the local bus with the Commissioner as the EC would not allow taxi rides.

Working in the ESC or in the European Commission I was often asked to chair the committee, probably because I spoke native English (the language of the European Commission) and because I had learned to debate in grammar school. I regret that Britain has not in the last forty years taken up a natural leadership role in the EU. My country should have joined with Germany and France in moral leadership of the EU just as I joined with my European cardiologist colleagues to achieve an enhanced vision of cardiology. Over the next fifty years the world needs moral leadership par excellence; leadership on justice, the death penalty, euthanasia, political corruption, the restriction of the power of biological science, the appropriate regulation of capitalism and much more. Will that come from the US, China, Russia or Africa? Probably not. Could it come from the EU? Probably.

As a member of the board of the ESC I gave up some of my sovereignty in recognition that in some matters others might have a better approach. But my sovereignty was enhanced because the final outcome was better for me to have sovereignty over than in the beginning. My professional life demands that I have rigorous plans, exact execution and audited outcomes, all based on evidence. Care of the heart is important but so is care of the country. I predict that Brexit will diminish my work as a doctor and a scientist.


John Martin is Professor of Cardiovascular Medicine at University College London,  He was President of the European Society of Clinical Investigation, President of the European Critical Care Foundation and Vice President of the European Society of Cardiology.


This article was originally posted on the Provocateur and is reposted with permission.


Note: The views expressed in this post are those of the author, and not of the UCL European Institute, nor of UCL.

Leave a Reply

Fill in your details below or click an icon to log in:

WordPress.com Logo

You are commenting using your WordPress.com account. Log Out /  Change )

Google+ photo

You are commenting using your Google+ account. Log Out /  Change )

Twitter picture

You are commenting using your Twitter account. Log Out /  Change )

Facebook photo

You are commenting using your Facebook account. Log Out /  Change )

Connecting to %s