AHEAD of the Autumn Statement this week, The Herald’s Beyond Brexit series has been exploring the hazards posed by the European divorce and today we reach one of the most important: the threat to staffing in the NHS. In recent years, health and social care services in Scotland have been facing a recruitment and staffing crisis - will Brexit ramp up the pressure even further?

READ MORE: Beyond Brexit: Hospitals risk losing EU staff lifeline after Brexit warns Royal College of Nursing Scotland and BMA Scotland

The fact there are no precise figures on how many European doctors and nurses are employed by the NHS in Scotland makes it a tricky question to answer definitively, but the figures for the UK and estimates from authoritative sources create a picture of a health service that relies on staff from elsewhere in the EU. Writing in The Herald today, the Chief Medical Officer Catherine Calderwood suggests around 1 in 20 of NHS Scotland’s doctors come from other EU countries – she also points out that there are thousands of EU nationals working at every other level of the service.

The figures for the UK as a whole are also striking: they show that seven per cent of all nurses and midwives and five per cent of all auxiliaries and assistants in the NHS and private sectors are from other EU nations. And the situation is similar in the care sector, with around six per cent of staff in Scottish care homes born in EU countries other than the UK. Taken together, the picture is of health and care services that are relying on staff from other EU countries to get by.

To make matters worse, we know that, even with a significant number of staff from other EU countries working in the NHS, it is still not enough. In Scotland, more than 200 trainee posts for GPs and hospital specialists were left vacant this summer. There are similar shortfalls in nursing too - £7.5million a year is being spent on employing agency staff to plug the gap.

All of this was a serious problem before the EU referendum, but the prospect of Brexit makes it even worse by increasing uncertainty and potentially denying the NHS of a resource it badly needs. The Herald has been consistently calling for a strategy setting out what the NHS needs to look like in future, what it will cost and the staff that will be required to run it, but Brexit only adds more uncertainty - the danger is that, without a precise picture, medical staff will be lost to the service and the recruitment crisis will deepen. The Scottish Government must provide a precise figure on EU staff who work in the NHS so a plan can be drawn up to replace them if necessary.

READ MORE: Beyond Brexit: Hospitals risk losing EU staff lifeline after Brexit warns Royal College of Nursing Scotland and BMA Scotland

However, the greatest responsibility lies with the UK Government. If those proposing a Hard Brexit prevail and Britain is taken out of a single market that guarantees the free movement of people, the effect on the health service could be devastating. The UK Government may press on regardless under the misguided and meaningless banner of Brexit means Brexit, but what it must do is guarantee that NHS staff from other EU countries will still be welcome here after Brexit. It must also ensure that there are no barriers to the NHS being able to employ the staff it needs - wherever they are from. Scotland’s health service does not have the staff it needs – Brexit must not be allowed to make the crisis even worse.