No-deal Brexit: Will the NHS be hit hardest?

Following Boris Johnson’s move to have Parliament suspended just a few weeks before the Brexit deadline, the likelihood of the UK leaving the EU without a deal is becoming more probable. While this will surely have knock-on effects for all aspects of the economy, there is a growing concern over how it will impact the healthcare industry—specifically the NHS.

According to a government memo, NHS bosses have been ordered to stick to Boris Johnson’s plan that a no-deal Brexit must happen in October. But there are several issues with this plan which could lead to shortages of both medical supplies and staff in the UK. Here are five key questions posed:

Is there going to be a medicine shortage?

According to a Whitehall dossier—Operation Yellowhammer—the UK is facing potential food, fuel and medicine shortages, months of chaos at ports, and another recession as part of a no-deal Brexit. The scarcity of medical supplies is one of the most alarming aspects of the dossier, which predicts the deficit could persist for at least six months due to delays across the channel.

The UK currently imports 37 million packs of medicine from the EU every month, while exporting 45 million packs, according to the Association of the British Pharmaceutical Industry (ABPI). In some cases, the UK is fully reliant on imports from the EU. Insulin, for example, comes from countries like Germany, Denmark, and France, and is needed for Type 1 diabetics.

It’s been reported that up to 85% of food and medicine lorries heading to France will be hit with 60-hour delays, and it could be 3 months before this traffic flow improves. This Channel crossing is where around three-quarters of our medicine enters the UK, so the delays could be disastrous for emergency scenarios. However, the Prime Minister has claimed that these are only “bumps in the road”. In a letter from MP Stephen Hammond, flying medicines in by air freight is being considered. However, there is no guarantee about which medicines will get priority status.

Will the UK have enough staff to meet demand?

EU doctors make up 9.5% of NHS doctors, while 6.4% of nurses aren’t British nationals. In London alone, 11% of NHS staff are from EU countries. A no-deal Brexit will only make it harder for new staff to come and work here, while also making it complicated for EU employees already living here. Theresa May’s Brexit agreement stated that all those currently working will have the opportunity to obtain “settled status” to allow them to stay. However, it’s not clear what a no-deal Brexit would mean for these employees.

Furthermore, it’s not just medical NHS teams that are supported by professionals from the EU. The scientific research, therapeutic, and technical teams also have significant numbers of EU nationals. Not having the right staff on hand in any of these fields will only add pressure to the rest of the NHS.

For example, with less EU nationals within the workforce and therefore less multilingualism, we may see a growing need for medical translators to overcome language barriers between patients and staff, particularly when it comes to discussing medical devices and prescriptions. As explained by translation experts London Translations, medical translations ensure the safety of patients and professionals alike. Without them, there could be terrible consequences for those who did not fully understand the content that came with the medical device or drug. Non-compliance could result in product seizures, recalls and criminal prosecution, adding further financial pressure on the NHS in the process.

Will we fall behind in terms of medical research?

Boris Johnson announced in August 2019 that immigration rules for scientists would be relaxed. However, experts aren’t convinced that this plan will actually work. Chairwoman of independent research charity the Wellcome Trust, Eliza Manningham-Buller, claims that the “damage has already been done, with loss of researchers, and influence”.

Brexit could mean that UK businesses and researchers lose out on funding from the EU’s biggest research fund. Horizon 2020 has already provided Britain with more than €30 billion since 2014. As the Brexit deadline draws ever closer, there has been a sharp drop in EU contracts for UK-based businesses, and the value of public procurement contracts has decreased by almost a third.

Groundbreaking research, like the work on treating infant soft-tissue cancers, was only possible through collaboration between the University of Würzburg in Germany, Great Ormond Street Hospital, and the Wellcome Sanger Institute. Brexit may make these collaborations more difficult and, partnered with the lack of funding, there is a very real chance that the medical research industry will suffer.

Will our European Health Insurance Cards still be valid?

In April 2019, it was reported that the number of people with a valid European Health Insurance Card (EHIC) had dropped by 23% from the previous year. While there isn’t a definitive reason behind this, it does seem likely that the uncertainty behind Brexit is a driving force. EHICs gives holders the right to the same medical treatment that locals are entitled to within EU member states, which is incredibly useful in emergencies abroad.

If the UK manages to negotiate a Brexit deal, holders will continue to benefit from healthcare provided by the state in European countries, at least until the end of the transition period. However, if the UK leaves with no-deal, EHICs may become void. According to the government, they are working with EU state members to maintain the medical cover offered by the EHIC. Whether the cards will still be valid—and for how long—depends on the deal being made by the government.

What about the £350 million Brexit dividends for the NHS?

One of the pledges in the Brexit campaign was that £350 million a week would be spent on the NHS, instead of being paid to the EU. However, after UKIP leader Nigel Farage admitted that there was “no guarantee” this would happen, the actual amount being funded to the NHS has been unclear. In fact, Boris Johnson faced legal action from a member of public, Marcus Ball, who claimed he had lied during the 2016 EU referendum. The High Court initially ruled that the case had no legal justification, but Mr Ball stated he would appeal this decision.

As there are no plans to actually funnel the £350 million into the already-underfunded NHS on a weekly basis, this continuous lack of funding may make it even more difficult to get medical help.