There’s just over a week to go until the UK votes on whether the country should stay in the European Union and the healthcare case for remaining is hardening with the recent addition of two prominent organisations.

Yesterday The BMJ came out in favour of Remain and today doctors leaders will warn that the economic consequences of Brexit risk undermining future funding for the NHS.

Stephen Dorrell, chair of the NHS Confederation and a former Conservative health secretary, is set to take aim at the topic in his opening speech to the NHS Confederation’s annual conference in Manchester today.

He will highlight the broad consensus that leaving the EU will put economic growth - and therefore NHS investment - at risk, and say that with 65% of Trusts in deficit, the NHS cannot afford a period of economic instability.

The NHS Confederation, which represents 85% of NHS providers and commissioners, is just one of a growing number of health voices in favour of remaining within the UK.

Medical journal The BMJ has also thrown its weight behind the Remain case, saying that “it has become increasingly obvious that the arguments for remaining in the EU are overwhelming”.

“Some readers may wonder why The BMJ is intervening in a political debate,” said the journal’s editors. “We think this issue transcends politics and has such huge ramifications for health and society that it is important to state our case.”

They added: “We realised that we could not name one prominent national medical, research, or health organisation that has sided with Brexit.”

Meanwhile, the polarising debate has seen one prominent health backer of leaving the EU - Sarah Wollaston, MP and chair of the Parliamentary Health Select Committee - change her mind in the last week.

Writing in The BMJ, Wollaston (pictured) said: “We need to continue to make the case for democratic reform, but I am convinced that the case for the NHS, public health, and research is overwhelmingly in favour of us remaining in the EU,” she writes.

She points to a “bad tempered and poorly informed” campaign and “an ugly xenophobia” that has swept in to whip up fears that EU immigration could lead to the collapse of NHS services.

Post-Brexit regulatory uncertainty

The BMJ editors also say that, with London its home, the European Medicines Agency (EMA), “would have to move if the Brexiteers win on 23 June”, which is a worry given that the EMA – and operating within the EU’s ‘established and harmonised’ regulatory system - is a key benefit for the life sciences sector.

A Leave vote would consequently seem to make it untenable for the EMA - which employs 885 people in the UK - as well as the soon-to-be-launched Unified Patent Court to keep their London bases.

However, the EMA has refused to be drawn on what a UK vote to leave the EU would mean for itself, and a spokesperson told PMLiVE the referendum and the related campaigns are ‘a matter for the British government and the British people’.

She added: “There is no point for the European agencies located in the UK to speculate on the result of the referendum and its potential consequences for the UK, the EU as a whole, or the agencies.

“The political debate within the UK will not deter EMA and the European medicines regulatory network from their mission to ensure that patients and animals in Europe have access to medicines that are safe, effective and of good quality, and that patients, healthcare professionals and citizens are provided with adequate information about medicines.”

Less reticent was the chair of UK regulator the MHRA Professor Sir Michael Rawlins, who said recently that his organisation would need to hire hundreds more staff to cope with the regulatory burden of dealing with additional medicine applications.

“We’d have to enlarge ourselves hugely because we’d have to evaluate all new drugs. Not only that, I don’t know how it would be paid for,” he told reporters.

In the event of a Leave vote the UK could still remain within the auspices of the EMA, should it decide to remain part of the European Economic Area (as Norway is), but that - like so much else surrounding the Brexit debate - is a subject of much uncertainty.

Pharma: Brexit bad for business

What is not in any doubt is the support from the life sciences sector as a whole for remaining in the EU.

Last month more than 90 top executives - including the bosses of GlaxoSmithKline and AstraZeneca - added their signatures to a letter warning of "complexity and uncertainty" if the UK votes to leave the EU next week.

Meanwhile, over the weekend an influential group of MPs warned the UK needs contingency plans in place to protect its life sciences sector in the event of a leave vote in the forthcoming EU referendum.

Pharma’s UK trade association the ABPI has issued warnings of its own, including that the UK’s leading position for phase I trials will also be undermined if the country chooses to leave the EU.

Meanwhile the ABPI’s biotech counterpart the BIA says its 300-plus members also believe their sector will be stronger if the UK remains in Europe. Its position is that EU membership offers the UK ‘various advantages’, pointing to areas such as regulation, the patent ecosystem, financing and funding.

“It is the BIA’s view that EU membership brings net benefits to the UK, both in relation to the issues mentioned and, crucially, in enabling patient access to new, innovative medicines.” The trade body added: “It is vital that the UK remains engaged in the EU and takes a leading role in shaping legislative and regulatory policy developments affecting the life sciences ecosystem.”

So, eight days and counting before the vote. During that time we can expect the noise from both the Remain and Leave camps get louder - and, most likely, more shrill, but the voice of those representing the UK’s life sciences and health sectors seems clear: bad for business, research and health.