German doctor Hubertus von Blumenthal has been working in the UK for nearly 30 years. But the impending Brexit is making him increasingly anxious, and like many of his EU colleagues he's now thinking of moving away.
In the early morning hours after the Brexit referendum in June 2016, Hubertus von Blumenthal received a simple text from his daughter: "I can't believe it."
The German doctor, who has been working in the British health care system for almost 30 years, says he didn't even understand at first that this would change his life. Overnight, he said, "the atmosphere in the country changed." Patients suddenly asked if he had to leave, while others reassured von Blumenthal that they would still be needing him. "You're not going home now, are you, doctor?," they asked.
"I am home," von Blumenthal would respond. After all, he's been living in Great Britain longer than his native Germany. And he's saddened by how little his long service in the public health care system seems to count when it comes to Brexit.
Xenophobia a driving force
Von Blumenthal works in a clinic in the village of Gamlingay. In earlier times, the area's main industry was farming but these days the village is mainly a home for commuters, many of whom work in the nearby booming university city of Cambridge.
His doctor's office is tiny and gloomy — it would take a great deal of dedication to spend a professional life in such an environment. After endless cutbacks, the facilities of the UK health care system appear outdated and shabby.
In this part of the country most of the inhabitants voted for Brexit, says von Blumenthal. The people here are older and conservative, and have little experience with the global economy.
In nearby Cambridge, it's the opposite situation. Students and scientists come from all over the world and consider themselves part of the global elite. They bring prosperity and jobs to the region, but only 30 kilometers (19 miles) away in Gamlingay, locals don't see the connection.
Von Blumenthal says the "Leave" majority in Gamlingay can't be explained by poverty or social disconnection. "It's mostly based on xenophobia. Certain media here have been belittling all things foreign for years," he says, and many people have formed their opinions based on this information.
In addition, he says, few people in the area have much of an idea how the EU works. "I have always been interested in British society and politics. And the decision to leave the EU has had a more corrosive and damaging effect than anything else I have experienced here," says von Blumenthal.
Health care sector in crisis
Brexit is threatening to become a disaster for the UK's health care system, already suffering from years of cutbacks. "Our patients have to wait longer and longer and go without certain treatments," explains von Blumenthal. According to him, Britain's National Health Service (NHS) is already lacking some 10,000 doctors. "If I leave, they will find it hard to find anyone to replace me."
According to Andrew Goddard, president of the Royal College of Physicians, 5 percent of all doctors in the UK come from the European Union, and almost half of them are now considering leaving the country. Back in June, then Health Minister Jeremy Hunt even admitted that uncertainty over Brexit was driving some of the "valued colleagues from Europe" out of the country.
When he was health minister Hunt promised 5,000 new doctors by 2020. However, it remains unclear where the UK will find those doctors. Von Blumenthal explains that when the NHS tried to fill the gap, at least partially, and recruit 3,000 new doctors from the EU, only 86 people expressed an interest.
"Why would a European doctor come here when his career, the conditions for him and his family, the recognition of his qualifications, simply everything is in the air?" he asks. "We are living in limbo and simply don't know what to do next. All assurances are meaningless because the next minister can change them with a stroke of the pen."
And, von Blumenthal continues, that applies not only to doctors but also to nurses and other medical staff.
Nurses desperately needed
The Royal College of Nursing is a well-established institution headquartered in a posh London townhouse. But Maria Trewern, the college's chairperson, is bracing for battle. In a recent appeal to the government, she called for more recognition of the consequences of Brexit for the health care system and its employees. For her, the worst-case scenario appears to be coming true.
"Since the Brexit referendum, 2,000 nurses from the EU have already left. That's a significant number, and by losing them we are also losing experience and knowledge, which will really harm the health care system, especially in key areas," says Trewern.
"We need these workers, and, furthermore, we are outraged because we see how distressed our colleagues have become. They cannot plan their lives, their homes, schools for the children — nothing is certain," she says. "We do not want them to leave. We would like to keep them because we really appreciate their contribution to our community." Trewern points out that this exodus will mostly consist of young nurses, personnel the NHS badly needs.
Currently, there is a shortage of 40,000 nurses in the UK, and Trewern fears this will result in serious consequences for patients. She is now trying to recruit nurses from around the world, but that also means taking them from developing nations where they're also needed.
Trewern says these particular consequences of Brexit have not been considered by politicians. "They overlooked this because they are interested in politics and not in public welfare. But as a nurse I am concerned with the common good," she says.
Difficult to leave, difficult to stay
In Gamlingay, von Blumenthal takes a detour to the village pub after work, where he chats about personal matters. The course of Brexit negotiations in Brussels, and developments in London, have him worried. "It could be that the situation becomes untenable for us," he says.
"My wife is Irish, she works for a global company," says von Blumenthal. "We could both go to Ireland and start over there."
But although he has an emergency plan, he says it would be difficult to leave.
After nearly 30 years his roots are in Gamlingay; his children and grandchildren also live in the area.
Does he have any hope that Brexit can still be avoided by March 29, when the UK is due to leave the European Union? "Many people have a quasi-religious belief in Brexit and don't want to hear anything else, and don't want to listen to experts," he says. If those people were given the chance to vote in a second referendum and decided to vote against leaving the EU, "they would have to acknowledge that they had previously made a wrong decision. And that is sometimes difficult." Von Blumenthal believes there isn't enough time left to avoid the inevitable, and thinks political pressure is also lacking.
Not only that: he believes many Britons have had enough of all the Brexit talk and just want to go ahead and get it over with, even if it does turn out to be a "bitter pill" to swallow, believing it will somehow work out in the end.
Von Blumenthal doesn't share this kind of fatalism. "I've thought about Brexit in some way every day since the referendum," he says. But for people like the doctor, politicians such as former British Foreign Secretary Boris Johnson and his supporters, who have renewed their fight against Prime Minister Theresa May and are pushing for a hard break with the EU, have no ready answers.