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Friday, 23 March 2018

Brexit and the NHS (The Lancet)



From The Lancet

"The serious challenges to the National Health Service (NHS) posed by Brexit were outlined last week by think tank The UK in a Changing Europe. Staffing levels are a major concern now and will worsen when immigration rules become more restrictive. Skill shortages are highly likely, especially in nursing, midwifery, and social care, with resultant loss of access to high-quality treatment and care. Removal or restriction of the reciprocal rights of patients within the EU threatens access to treatment across borders, including between Northern Ireland and Ireland, where many services are integrated. Public health measures are threatened, with blood, organ, and tissue safety standards to be agreed, as is communicable disease control across borders. Rare diseases research is likely to suffer. The withdrawal of EU funds and restrictions on shared services and staffing will adversely affect all four countries in the UK. The UK Government is running out of time. In principle, terms for the Brexit transition period were agreed on March 19, but the detail, especially on Northern Ireland, has yet to be ironed out. The NHS was a major battleground in the lead up to the referendum, but the consequences of a soft, hard, or failed Brexit for the nation's health must now take centre stage. Rising child mortality rates should be the final alert. When will the UK Government wake up to the timebomb that Brexit is for the NHS and the nation's health?"


How will Brexit affect health and health services in the UK? Evaluating three possible scenarios


"The process of leaving the European Union (EU) will have profound consequences for health and the National Health Service (NHS) in the UK. In this paper, we use the WHO health system building blocks framework to assess the likely effects of three scenarios we term soft Brexit, hard Brexit, and failed Brexit. We conclude that each scenario poses substantial threats. The workforce of the NHS is heavily reliant on EU staff. Financing of health care for UK citizens in the EU and vice versa is threatened, as is access to some capital funds, while Brexit threatens overall economic performance. Access to pharmaceuticals, technology, blood, and organs for transplant is jeopardised. Information used for international comparisons is threatened, as is service delivery, especially in Northern Ireland. Governance concerns relate to public health, competition and trade law, and research. However, we identified a few potential opportunities for improvement in areas such as competition law and flexibility of training, should the UK Government take them. Overall, a soft version of Brexit would minimise health threats whereas failed Brexit would be the riskiest outcome. Effective parliamentary scrutiny of policy and legal changes will be essential, but the scale of the task risks overwhelming parliament and the civil service".


The UK in a Changing Europe - new report (pdf) on the NHS

"Brexit will pose serious challenges to the NHS and healthcare in the UK including: longer waiting times, increased pressure on staffing levels, a reduction in rights when travelling and delays in the approvals of medicines, a new report by academic think tank The UK in a Changing Europe finds".


U.K., Land of ‘Brexit,’ Quietly Outsources Some Surgeries to France, New York Times


"After years of austerity, Britain’s lumbering National Health Service is under enormous strain, with severe shortages of beds and medical staff, all of which is producing waiting times for nonemergency procedures to stretch over months, and sometimes beyond a year. To cope, the N.H.S. has been quietly outsourcing some surgeries to three hospitals in France for the last year or so. It is a little-known partnership, because the N.H.S. is not eager to advertise the measures it is being forced to take"...Hospitals in Britain “are so old they should be museums,” he said. “It’s shocking what’s going on.” "N.H.S. England’s outsourcing deal has technically little to do with Britain’s decision nearly two years ago to leave the European Union, a process known as Brexit. Rather, it has more to do with the myriad ways that countries across Europe are tied together, but that are often ignored in public discussions about Britain’s relationship with Europe".


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