The National Health Service at a Critical Moment: when Brexit means Hectic

Abstract

Leaving the European Union (so-called ‘Brexit’) is a ‘critical moment’ for health policy reform which can pave the way to different pathways, including, a ‘critical juncture’. Given that Brexit cannot be undone without a second referendum, it opens up opportunities to elude European constraints for reform along the lines of equity, employment rights and patient choice. Brexit deepens the financial crisis of the National Health Service (NHS) by increasing hiring costs and imposing new transaction costs to accommodate patient cross-border mobility and international public health needs. Given the weak sustainability of the NHS, it could lead to major system reform.

The Impact of Brexit on Pharmaceuticals and HTA

“…The health (and social care) budget is already pushed to breaking. There are also supply side consequences; EU migrant staff, particularly in social care, are already leaving [ 13 ].…”

Brexit and European doctors’ decisions to leave the United Kingdom: a qualitative analysis of free-text questionnaire comments

“…Moreover, the UK is no longer a member of the European internal market for information sharing and this may hinder knowledge exchange on the health workforce such as fitness to practice medicine [ 9 ]. Overall, poor economic performance and related repercussions on the health system may make the UK a more unattractive place to work for healthcare professionals, including doctors, which both directly and indirectly impacts the health system as a whole [ 4 , 10 ].…”

“…Aside from the potential for clinicians, and especially European clinicians, to be less attracted to working in the UK post-Brexit, there may also be legal barriers that affect their ability to practice. Currently, health workers’ protection from EU directives have been written into UK law, but the UK is theoretically able to change these standards, which if dissolved, could negatively impact staff wellbeing and patient safety [ 10 ]. Throughout Brexit negotiations there was seldom much enthusiasm on either side to continue the mutual recognition of medical qualifications [ 11 ], and although the UK has stated it will continue to recognise EU and European Economic Area (EEA) gained qualifications for the next 2 years, this has not been reciprocated by EU and EEA countries [ 4 ].…”

“…Once the UK no longer recognises these qualifications it may deter European healthcare workers from remaining or migrating to the UK. In the past, legal barriers have been a factor preventing migration of Indian doctors [ 10 ], so this in effect may be replicated as qualifications from the EU and EEA will no longer be automatically valid in the UK beginning in January 2023.…”

The use of the political categories of Brexiter and Remainer in online comments about the EU referendum

“…A key slogan, which we focus on in this paper, was “We send £350m a week to the EU. Let's fund our NHS instead.” This claim was contested throughout the campaign and after the referendum as “it became evident that health care underfunding had very little to do with the European Union” (Costa‐Font, , p. 783), and the costs of leaving the EU became evident (Begg, ).…”