Brexit poses “serious challenges” to the NHS in the form of longer waiting times, staff shortages and delays in the approval of new medicines, according to a report published on Wednesday (14 March).
Although the on ‘Brexit and the NHS’ report by the UK in a Changing Europe think-tank based at King’s College London deliberately shies away from making demands of ministers, it warns that Brexit was “likely to worsen existing staff shortages” and was “likely to exacerbate” funding pressures on the NHS.
One of the most famous pledges by the Leave campaign ahead of the June 2016 referendum, popularised by Boris Johnson, now Foreign Secretary, was that Brexit would lead to an additional £350 million per week being spent on the NHS.
Leaving the EU next March is also set to mean a reduction in reciprocal patient rights abroad and delays in the approval of medicines, the report adds.
Should the UK fail to negotiate continued access to the European Health Insurance Card (EHIC), which allows visitors to another EU country to access healthcare in that country, UK citizens would be hit with a bill of an estimated £160 million per year. That would mean the government covering the costs or travellers being forced to take out private health insurance.
Around 200,000 EU nationals currently work in the UK’s health and social care sectors, accounting for almost 10% of doctors and just over 7% of all nurses.
NHS employers fear that the service could be deprived of thousands of EU nationals after the UK leaves the single market, amid uncertainty about immigration rules after Brexit.
“In the short-term it’s very hard to see (a positive effect from Brexit),” Professor Anand Menon, director of the UK in a Changing Europe, told EURACTIV.
“We have traditionally relied on doctors and nurses coming in from other countries. In the short-term, it’s going to be difficult because of uncertainty. “
In her Mansion House speech in London earlier this month, Prime Minister Theresa May suggested that the UK would seek associate membership of several EU regulatory agencies, including the European Medicines Agency (EMA).
However, it is unclear whether this will be obtained since no other third country outside the Single Market is a member of EU agencies. Current guidance from the EMA assumes that there will be ‘no deal’.
A letter from the European Federation of Pharmaceutical Industries and Associations (EFPIA) to companies on 22 February urged them to plan for changes to clinical trials, regulation, trade and supply and residency requirements for their workforce.
The bulk of the costs are expected to lie in preparing to move employees and laboratories from EU countries and in employing new regulators. Meanwhile, clinical trials on new medicines will be put on hold until there is greater certainty on the UK’s future relationship with the EU.
Switzerland starts receiving new drugs an estimated 157 days after the EU, despite having a series of bilateral trade agreements with the EU. That is because drug companies tend to target their new products at the largest markets. The UK accounts for around 3% of global drug sales compared to the EU’s 25%.
“Our sense is that no one is really thinking about this,” says Menon.
“We are trying to talk more about substance than process. We need to start to make provisions. All the big firms are doing contingency planning. This is already eating in the finances of big companies,” he added.
“Our working assumption is for between £60 to £70 million in contingency planning costs,” GlaxoSmithKline’s Global Affairs President Phil Thompson told MPs last December.