Brexit will cause significant harm to Britain's national health service (NHS), with a no-deal option leading to the worst outcomes, according to a review published in the Lancet.
All forms of Brexit will negatively affect the NHS, but a no-deal outcome would have negative effects on staff, financing, availability of medicines and vaccines, sharing of information and medical research, the study states.
While the withdrawal agreement negotiated between the United Kingdom and European Union, but not agreed by the British parliament, offers a more positive scenario compared to no deal, there are serious concerns about the negative impact of Brexit on the NHS beyond the transition period, say the authors.
They assessed four Brexit scenarios – no deal, a withdrawal agreement, the implementation of a backstop for Northern Ireland and the political declaration on the future relationship between the UK and the EU – to assess the likely impact on 15 aspects of the UK health service.
Remaining in the EU was not included in the analysis but is better overall for health than any form of Brexit, the same authors outlined in a paper published in The Lancet in 2017.
Little evidence exists that the UK is prepared for any of the eventualities set out in their analysis, they warn.
“Some people will dismiss our analysis as ‘Project Fear,’ ” said Prof Martin McKee, co-author from the London School of Hygiene & Tropical Medicine (UK). “But with just over a month to go to Brexit, we need to move beyond slogans. It just isn’t good enough to keep saying that “something will work out” without any details of exactly how.”
Among the concerns for Britain’s health service raised in the study are recruitment and retention post-Brexit, arrangements for reciprocal healthcare arrangements with other European states, access to financing from the European Investment Bank and continuing supply chains for medicines.
Despite British government reassurance about contingency plans – drug shortages are likely because stockpiling arrangements cannot cope beyond a few weeks – proposals that doctors offer “best alternative medication” can be distressing for patients. And some products (such as radioisotopes) cannot be stockpiled, the study notes.
Co-author Prof Tamara Hervey, from the School of Law, University of Sheffield, said: "It's critical to be clear about the practical effects of disentangling over 40 years of legal integration. This is not something that can be done hastily without potentially jeopardising people's health."
