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NHS faces unpredictable outcomes following Brexit vote

EU has subtle and far-reaching effects on health sector, beyond purely economic factors

Louise Prime

Thursday, 30 June 2016

“The EU has far-reaching and subtle effects on the health sector beyond purely economic considerations” raising many questions about what the prospect of leaving it could mean for the NHS, according to its leaders. Elisabetta Zanon, head of the NHS European Office (part of the NHS Confederation) has warned that the health service and medical research face an “unprecedented situation” as no-one can yet predict the level of impact that Brexit will have on the NHS.

Ms Zanon pointed out that about 130,000 EU health professionals currently work in the NHS, equivalent to 10% of our doctors and 5% of our nurses, and that their recruitment to fill job vacancies – and reduce dependency on expensive agency staff – has been facilitated and sped up by EU law on mutual recognition of professional qualifications. EU rules have helped Britons visiting or living in other EU countries to receive healthcare, and EU nationals to be treated when in the UK. EU standards for quality and safety of medicinal products, medical devices, blood, tissues, cells and organs have improved patient safety and facilitated the movement of these products across borders. Patients with rare or very complex diseases have benefited from specialist collaboration at EU level. And UK organisations are the largest beneficiary of EU health research funds in Europe, with €760m in EU funding having supported health research in the UK between 2007 and 2013.

Ms Zanon asked: “What’s going to happen in these areas now that our future is outside the EU? At this stage, it is not possible to predict the level of impact Brexit will have on the NHS, as we do not know what type of new relationship with the EU the UK will seek, how long negotiations will last, and what their outcome will be.”

The most critical factor, she said, was whether or not the UK will remain in the EU’s internal market.

She explained that if the UK sought to follow Norway’s model (i.e. membership of the European Economic Area, with the same access to the EU internal market as EU member states, and still having to comply with the full range of EU policy and regulations that govern the EU market, as well as contributing to the EU budget), in the long run not much would change from an NHS perspective with respect to application of EU policy and rules, ability to recruit EU staff, access to EU research funds and involvement in EU collaborative initiatives. But over the several years that negotiations on a new agreement could take, she warned, uncertainty would reign as the economy seesawed. Furthermore, the UK’s ability to influence EU policy would be “very severely jeopardised” by having no seats in the European Council or Members of the European Parliament.

If on the other hand, she said, the UK left the EU internal market, both economic and regulatory changes would be significantly greater, and the level of uncertainty much higher. But although the UK would make its own laws on migration, she said it would almost certainly want to continue to make it easy for health professionals and others in shortage occupations to enter and work in the UK. The UK would make its own decisions about competition and procurement within the context of international trade law – and scientists and researchers would want to continue to collaborate across borders, with or without EU funding.

Ms Zanon concluded: “There is no denying that under this scenario there are a wide range of possibilities, and outcomes will be unpredictable.

“This is an unprecedented situation.”

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