What Does Brexit Mean For The UK's NHS And Healthcare In Europe?

What Does Brexit Mean For The UK's NHS And Healthcare In Europe?

Reenita Das


The United Kingdom’s decision to leave the European Union has sent shock waves across the world. The economic fallout is widely expected to result in a recession in the UK along with reduced GDP growth across several European countries. The United Kingdom Independent Party (UKIP), which has championed the cause for “Brexit,” has indicated that funds sent to the EU can be recovered and used to invest in the NHS, thereby improving quality of care provision; the facts, however, say otherwise.

By 2020, UK’s National Health Service (NHS) is expected to face a shortage of around 16,000 primary care physicians. By 2022, nurse shortages are expected to be in the vicinity of 100,000. The UK has traditionally tried to fill the gap by recruiting both doctors and nurses from foreign countries, especially other EU countries. The guarantee of stable, long-term contracts is a huge draw for a broad range of care providers across different EU countries. With the UK voting to leave the European Union, citing immigration as one of the key reasons, the NHS will struggle in recruiting manpower from these countries.

The biggest impact on manpower is expected to be in social care provision. The NHS has sought to recruit 100,000 social care workers to help manage chronically ill and elderly patients outside hospital settings. This is considered a critical aspect of healthcare transition as the UK seeks to reduce the spending on secondary care, which accounts for 78% of the total health budget, and place greater emphasis on primary and long term care, which currently account for around 22% of the total health budget. Most of these social workers are recruited from the EU, and the Brexit is set to guarantee continued vacancies for social care jobs. Some experts predict an exodus on existing social care workers back to their native countries, thereby making a bad situation worse.

The NHS also seeks to bring about efficiency savings of £22 billion over the next few years. These savings are contingent upon transition of care away from hospital-based episodic care models to primary and long-term care based managed care models. Creation of integrated care solutions, linking the entire spectrum of care providers, is also necessary to improve efficiency of care provision. The lack of trained manpower will pose severe challenges to this transition. A key campaign promise made by the UKIP was the reallocation of £350 million sent to the EU by the UK every week towards NHS funding. With senior party leadership now backtracking away from this commitment, the NHS continues to remain as vulnerable as ever. The Economic Intelligence Unit predicts that by 2020, the UK NHS will spend £135 less per head if the UK leaves the EU. With rising healthcare costs, this will most certainly result in lower quality of care provision.


Broader Impact of Brexit on European Healthcare

The UK is also set to lose indirectly in terms of improving healthcare quality and innovation in a post-Brexit environment. For example companies seeking to conduct clinical trials for new drugs across the EU can run multi-country studies by registering on a single EU clinical trial database. In a post-Brexit environment, companies in the UK seeking to conduct multi-country clinical trials will be forced to apply individually to each country, resulting in a huge administrative and cost burden. From a regulatory standpoint, the UK would lose influence over the European Medicines Agency, the organization that approves drugs for use within the EU. This would mean that the UK and the EU would be required to maintain separate databases on pharmaceutical products in the market. As a result, this would entail more spending by the UK, contributing to the NHS’s budgetary woes. The UK, which also currently gains disproportionately from current funding streams for medical research, will incur significant losses.

A major challenge would be future coordination between the UK and the EU in dealing with pandemics, as well as other health threats. Close coordination with the EU is critical in reducing spread of potential new outbreaks. Going forward, the UK will need to coordinate with individual countries within in the EU, which will be a huge administrative burden. While frameworks could eventually be put in place for the creation of a new EU-UK joint coordination mechanism, this process could take a few years.