How will Brexit affect UK Healthcare, Social Care, and Care Homes?

The full departure of the UK from the European Union (EU) is almost upon us. From 1^st January 2021, the countless benefits (and costs) of being a fully-fledged member of the largest trading bloc on the planet will evaporate. We may have a trade deal, but this will be far from our current relationship with the EU. As of today, we do not know the impact this will have on our vital industries and services, including the healthcare, social care and care home sectors. In this article, we will discuss the views of experts in the field of healthcare and social care on Brexit and the likely impacts it will have.

Will Brexit Positively Impact on Health and Care in the UK?

There appears to be very little if nothing at all in the way of benefits to the NHS of Brexit. Even the claim that we will send the EU £350m each week, and this money could be used to fund the NHS, has been widely debunked. On this claim, Full Fact stated, “This is wrong, it’s more like £250 million a week. In any case, the impact on the economy from changes to trade after leaving the EU is likely to be far bigger than savings from the UK’s membership fee”.

An article in the BMJ, entitled, “There is no version of Brexit which will benefit the NHS—only varying degrees of harm” went even further. The article’s authors, Sarah Wollaston who is the MP for the Totnes Constituency and Chair of the Health and Social Care Select & Liaison Committees, and Paul Williams is a GP and the MP for Stockton South and a member of the Health Select Committee, said, “Brexit is bad for our health. It will be harmful for people who rely on the NHS, research, social care and public health as well as for the workforce on which these depend. There is no version of Brexit which will benefit the NHS, social care, public health, or our life sciences sector—only varying degrees of harm. This, together with the wider economic fallout from Brexit, will have the hardest impact on the most disadvantaged people in society”.

Some may argue that Brexit will lighten the load on the NHS as migrants return to their home country. It might be true that migrants from the EU will (and are) returning home, however, the future points-based immigration system will see a lowering of the skills threshold, allowing those with RFQ level 3 skills and qualification to enter and work in the UK from any country in the world (this was necessary to compensate for the loss of EU freedom of movement); in other words, the UK will still be highly reliant on immigration for other healthcare professionals, and carers (as recently recommended for inclusion in the new shortage occupation list).

Possible Shortage of Medicines and Medical Supplies

In a paper written by the King's Fund and updated in 2019, the authors have grave concerns regarding the possible shortage of medicines and medical supplies, especially if there is no trade deal; “A no-deal Brexit clearly poses a significant risk to the supply of medicines and medical devices in the United Kingdom. Supply chains into the United Kingdom remain vulnerable, and while plans exist to create new supply routes, the additional regulatory burden is likely to be costly and time-consuming.

There is a significant risk that there will be national and/or localised shortages of some medicines and medical devices. This could see some people not being able to access vital drugs and treatment. This is an unacceptable risk. Ensuring the continued supply and access to medicines and treatments should be a top priority for the government”.

Possible shortage of staff

Perhaps the most obvious area of concern relates to the shortage of staff for our hospitals, care homes, and community care. The NHS is highly reliant on EU staff; there are 63,000 EU nationals working in the NHS, representing 10% of doctors and 7% of nurses. With the end of free movement, some will remain in the UK under the auspices of the EU Settlement Scheme, and some will inevitably return home. Another concern is that if the policy of mutual recognition of professional qualifications ends, this will make it harder for migrant workers in this sector to come to the UK. The new Health and Care visa will go some way to alleviating concerns, in part because the Home Office say they will make decisions on applications within three weeks, and also because the visa fee is relatively low (£232 for up to three years) and the healthcare surcharge will not be payable.

Regulation of Medicines and Medical Supplies

Brexit may also have a significant impact on the harmonisation of medicine regulations between the UK and EU, resulting in the UK being “at the back of the queue” when it comes to new the supply of medicines (clearly not a desirable outcome in the context of the COVID-19 vaccine). As the King’s Fund report says, “Some have also expressed concern that if the United Kingdom leaves the EMA arrangements and develops its own drug approval system, the United Kingdom may lose its ‘tier 1’ status and end up at the back of the queue for new medicines. For example, in Switzerland and Canada, which have separate approval systems, medicines typically reach the market six months later than in the European Union”.

Final Words

We will not know the full impact of Brexit on the UK’s health and care system for at least a year or two. The UK government may be forced to cooperate more with the EU if it becomes clear that there are shortages of medicines, and it may need to make changes to the new immigration system to further facilitate the flow of international staff. We will continue to keep you up to date as events unfold.

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