Disclaimer: Any personal views expressed by the writer do not necessarily reflect the views held by The Medic Portal.
Welcome to NHS Hot Topics! Every two weeks we dissect national and global health news topics that affect the NHS. This week’s topic is Brexit
On the 31st of January 2020, the UK left the EU and entered an 11-month transition period. It marks over 3 years since the referendum back in 2016, where 52% of the UK voted to leave the European Union.
During this crucial transition period, there are rules and deals that need to be agreed on; many of them affecting the NHS.
Immigration was one of the key battlegrounds in the Brexit debate. The NHS relies on nearly 65,000 professionals from the EU out of its 1.2 million person workforce, to provide free at the point of access care to the 66 million people in the UK.
Issues relating to the right of EU citizens to stay in the UK and acquire visas will directly affect the NHS. The number of EEA staff joining the NHS has decreased. For example, 968 nurses joined in 2018/19 which was a 91% decrease from 2015/16 – before the referendum.
Trade deals will need to be agreed, many will be important for the NHS. Medicines are an important part of healthcare which are currently approved by the European Medicines Agency.
The UK is currently part of a top priority market for manufacturers to sell cutting edge medicines. Being state-funded, it is important for the NHS to have access to these medicines at low prices.
Going forward, it will be essential to figure out relationships with other authorities to ensure smooth access to medicines and medical equipment. An example of a relationship like this is the EU’s agreement with Australia to recognise each other’s inspection of medical devices.
Currently, science and research in the UK benefit from being part of EU collaboration. There are multinational EU clinical trials that patients from the UK participate in, and trials for new drugs in the UK are subject to EU regulations.
Attempting to ensure that the UK remains at the forefront of science and research, the government has announced a fast-track visa to attract top scientists and researchers to the UK.
The Irish border is another important Brexit issue that will affect the NHS and healthcare for citizens in Northern Ireland.
Healthcare in Northern Ireland currently relies on cross-border collaboration for care in many areas. For some specialist treatment, patients are transferred to Dublin. With the issue of the Irish border subject to potential change due to Brexit, there is consequently an uncertainty about healthcare in many parts of Northern Ireland.
How does Brexit impact the NHS?
The government has created more medical school places – with an extra 1500 places announced in 2017, alongside funding to train an additional 10,000 nurses, midwives, and allied health professionals.
However, it will take time to train these professionals. In the meantime, the reduction in staff from the EU is worsening the staffing shortages. As of 2019, roughly 1 in 12 posts in the NHS were vacant.
The government is considering offering existing healthcare professionals such as pharmacists, paramedics, and physiotherapists a fast-track course to retrain as doctors to help tackle the shortage.
Under current EU regulations, a medical degree must be at least 5 years. After the UK has fully exited from the EU, the Department of Health and Social Care has said it will consider this flexible approach.
Although this would be great for boosting the numbers of doctors, it could take healthcare professionals away from these other roles, potentially creating shortages in other areas.
The full impact of Brexit on the NHS is unclear as we enter the start of the withdrawal period. There are many agreements and deals that will shape the relationship the UK has with the EU and other countries that will, in turn, affect the NHS.
There are potential benefits, such as faster and bolder action on public health issues, without having the time-consuming consultation with 28 countries.
There are also potential negative impacts such as the possible further reduction in the recruitment of nurses from EU countries.
The NHS needs to prepare for many possible scenarios that it may find itself in once the UK fully leaves the European Union.
Question to think about: How would you decrease the current shortage of nurses and doctors, both in the short and long term?
Words by: Safiya Zaloum
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