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Brexit poses risk to Irish healthcare, BMA warns

‘Free movement of doctors must be maintained’

Jo Carlowe

Thursday, 08 June 2017

A hard border between Northern Ireland and the Republic of Ireland post Brexit will negatively affect healthcare, the British Medical Association warns today.

The BMA in Northern Ireland is asking that doctors maintain the ability to move freely between both countries,

The Northern Ireland chair of the BMA, Dr John D Woods, will speak today to Seanad Éireann about the issues Brexit poses to healthcare delivery across Ireland. 

Speaking to the Seanad’s special select committee on the UK’s withdrawal from the European Union, BMA Northern Ireland’s council chair John Woods will highlight the potential impact for patients and medics on both sides of the border.

“The unique situation in Northern Ireland, sharing a land border with another European country, will present a range of challenges to health care in Northern Ireland and the Republic of Ireland.

“If the appropriate agreements are not negotiated and put into place, then the UK’s decision to leave the European Union will have a hugely negative impact on doctors’ working lives, and will detrimentally affect patient care on both sides of the border.”

Dr Woods will outline the impact Brexit would have on the workforce in Northern Ireland, with many doctors working in the north having qualified at a medical school in the Republic of Ireland, and the need for permanent residence to be granted to both EEA citizens working as doctors in the UK, and UK citizens working as doctors in other EEA states, even if they have been resident for less than five years.

Dr Woods will refer to a number of successful cross-border health care initiatives including the all-island paediatric cardiac service and the new cancer centre in Derry, as examples of how services have been developed and delivered to meet the needs of patients throughout Ireland and how they would be negatively impacted by a hard border.

“Health services in Northern Ireland and the Republic of Ireland working separately often do not have sufficient demand to provide services in a cost effective and efficient way.

“We believe that the existing open border arrangements, together with the expansion in the provision of all-island healthcare provides a number of significant benefits for patients across the whole of Ireland meaning they can receive treatment without having to undertake lengthy journeys or to travel to England.  

“The re-introduction of a hard border would stop such innovative co-operation and would have unthinkable repercussions for example on a heart attack patient living in Donegal who could no longer access timely lifesaving treatment in Derry.”

The BMA is also asking that doctors in Northern Ireland and the Republic of Ireland maintain the ability to move freely between both countries, and that the mutual recognition of medical qualifications between Northern Ireland and the Republic of Ireland continues. 

Dr Peter Maguire, a consultant anaesthetist who lives and works in Newry in Northern Ireland but also works across the border in Monaghan in the Republic of Ireland, added: “I am one of a number of Northern Ireland doctors who regularly travels south of the border to care for patients. If a hard border is introduced following Brexit, it will present a number of difficulties for the health service, and will leave me with no choice but to leave the NHS and move to the Republic of Ireland.

“It’s not just cross-border movement that will be an issue for patients. 54% of the exports from Ireland are pharmaceuticals and huge amounts of medical equipment are made and come from Ireland. What will happen if there are tariffs? What will happen to the cost of drugs with the change in the Euro?

“Medication that I already have to make a business case for to access in Northern Ireland will potentially become even less available to patients who truly need it.”  

Dr Sara Hedderwick, a consultant in infectious diseases in Belfast, agreed. “During the Ebola outbreak in 2015 it became clear to medics working on this issue that collaboration on an all-Ireland basis made most sense. For example, we faced difficulty in transporting potentially infectious samples by air to Great Britain. It proved much easier to send the samples by road to Dublin where our colleagues provided a critical rapid diagnostic service.

“If we were going to be in the position of dealing with an outbreak of Ebola, we needed to address it right across the country, in terms of setting up isolation units and diagnostic laboratories, and sharing information.”

Dr Mark Porter, BMA council chair, said: 

“As separate health services in Northern Ireland and the Republic often do not have sufficient demand to provide cost-effective, highly specialist medical services, such as the all-island children’s cardiac service, the only viable way to provide these services to patients is to deliver them across both countries.

“Over the last two decades, a significant growth in the provision of all-island healthcare has improved care for patients and allowed both Northern Ireland and the Republic to retain highly trained doctors, who otherwise may not have had the patient demand necessary to warrant their full-time expertise.   

“If border restrictions are introduced following Brexit we risk reversing this progress and damaging patient care. The next government must maintain a soft border after Brexit to help ensure that cross-border health services and patient access to healthcare are not affected by leaving the EU.”

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