Brexit

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EU specific with main healthcare impact on UK

Brexit refers to the idea of the UK leaving the European Union.

The word is a portmanteau word, made up of "Britain" and "Exit". It is a misnomer, as Britain comprises only England, Scotland and Wales; whereas the idea refers to the whole of the European Union.

The government has been unclear about whether or not it has conducted any impact assessments (and whether they are in "excruciating detail or at the level of a school student's politics essay), and has refused to make public such assessments as it may have undertaken.

Some believe that the government is driven by ideology, and would prefer not to know the impact, as it might affect their ideologically driven decision-making if they know that Brexit is likely to harm both the UK population and, in the longer term, themselves.

Nevertheless, others have published extensively on the impact of Brexit. See for example:

Contents

Impact

  • In the EU healthcare is devolved to individual nations. However in areas such as medicines regulation, medicines and medical devices supply chain, health care worker employment and commercial law there is a large centralised component.
  • The impact on UK healthcare is unknown in detail but could be substantial. It is subject to political negotiation which might not result in optimal solutions for healthcare possibly due to unintended consequences in an area of complex political and social change. In general periods of social change have an impact on population healthcare and if Brexit is destructive to social cohesion, equality and access to care, multiple examples exist to suggest that population healthcare will be adversely affected. However it is unlikely the effects will be as great as those seen in recent history upon the disintegration of the Soviet Union at one extreme or the economic modernisation of China at the other. Examples of areas where there is likely to be impact are[1]:
    • Trained healthcare staff
      • Access to EU healthcare staff will (has) decreased
      • Almost certainly greater problems with settlement as negotiated up to early 2018
      • Total impact unclear with settlement negotiated up to early 2018
    • Medicines and medical devices supply chain[18][19]
      • Impact seen already in prices due to exchange rate changes
      • 738 of the total 1,165 drug products for human use marketed across the EU – known as centrally authorized products (CAP) have non-UK-based marketing authorization holders[20].
      • As there is no standard collection of individual EU country supply chain data impact unlikely to be quantified post hoc
      • Total impact unclear with settlement negotiated up to early 2018
    • Money/capita available for healthcare and social care investment
      • Unclear with settlement negotiated up to early 2018
    • Healthcare research
      • Access to EU research grants and researchers will decrease
      • Unclear with settlement negotiated up to early 2018
    • Regulation
      • EU medicines regulation will move from London to Amsterdam
      • Unclear with settlement negotiated up to early 2018
    • Travel insurance
      • Mainly priced on healthcare costs of illness during travel so will increase if reciprocal arrangement end
      • Unclear with settlement negotiated up to early 2018

Resources, links, forums and websites for doctors (and others) affected by Brexit

A high proportion of doctors and other health and social care workers are EU citizens; and many more are related to EU citizens.

There are a wealth of support networks, forums, and of information for them - some of them are listed here. Ganfyd hopes that if doctors know of other resources, they will sign up as editors, and add information about them here. In the meantime, here are [links to] some of the resources known to ganfyd editors.

Supportive Facebook groups

NB - some of these groups are "closed" and moderated, meaning that you may have to contact the group owner to ask to join the group, and to comply with the group rules if you do join.

Guidance on acquiring settled status, citizenship, etc.

References

  1. a b Fahy N, Hervey T, Greer S, Jarman H, Stuckler D, Galsworthy M, et al. How will Brexit affect health and health services in the UK? Evaluating three possible scenarios. Lancet 2017, DOI: 10.1016/S0140-6736(17)31926-8
  2. Stuckler D, Reeves A, Loopstra R, Karanikolos M, McKee M. Austerity and health: the impact in the UK and Europe. Eur J Public Health 2017;27(suppl_4):18-21, DOI: 10.1093/eurpub/ckx167
  3. McKee M, Karanikolos M, Belcher P, Stuckler D. Austerity: a failed experiment on the people of Europe. Clinical Medicine 2012;12, DOI: 10.7861/clinmedicine.12-4-346
  4. McKee M, Galsworthy MJ. Brexit: a confused concept that threatens public health. J Public Health 2016;38(1):3-5 PMID: 26869720, DOI: 10.1093/pubmed/fdv205
  5. Maignen F, Berdud M, Hampson G, Lorgelly P. Public Health and Economic Implications of the United Kingdom Exiting the EU and the Single Market. London: Office of Health Economics Consulting, 2017(November); 1-42
  6. Sampson T, Dhingra S, Ottaviano G, Van Reenen J. Economists for Brexit: A Critique. London: Centre for Economic Performance, Londo School of Economics and Political Science, 2017 CEPBREXIT06 (November); 1-15
  7. Office for Budget Responsibility. Economic and fiscal outlook – November 2017. London: Office for Budget Responsibility, 2017
  8. Economic and Development Review Committee (EDRC) of the OECD. OECD Economic Surveys: United Kingdom: Organisation for Economic Co-operation and Development, 2017(October).
  9. Born B, Müller G, Schularick M, Sedláček P. £300 million a week: The output cost of the Brexit vote. VOX CEPR's Policy Portal 2017; Updated 28 November 2017; Accessed: 2018 (24 January)
  10. Office for National Statistics. Consumer price inflation. 2018; Updated; Accessed: 2018 (24 January)
  11. Breinlich H, Leromain E, Novy D, Sampson T. Brexit and the Impact of Immigration on the UK. London: Centre for Economic Performance, London School of Economics and Political Science, 2017 CEPBREXIT11 (November); 1-22
  12. Nursing and Midwifery Council. The NMC register: Nursing and Midwifery Council, 2017(30 September)
  13. Clark N. COUGH UP CASH NHS must get the £350m a week promised by Brexit campaigners, says head of health service. 2017; Updated 8th November 2017; Accessed: 2018 (24 January)
  14. May T. PM Commons statement on European Council: 18 December 2017. 2017; Updated; Accessed: 2018 (24 January)
  15. Hammond P. Autumn Budget 2017: Philip Hammond's speech. Oral statement to Parliament 2017; Updated 22 November 2017; Accessed: 2018 (24 January)
  16. The Comptroller and Auditor General. People and skills: The role of the centre of government. London: National Audit Office, 2017 (1 December)
  17. Blair T. Brexit - What We Now Know. 2018; Updated 3 January 2018; Accessed: 2018 (8 January): Briefing paper
  18. Healthcare Distribution Association (HDA UK) submission to Health Select Committee 31st October 2017 Accessed 4 Feb 2018
  19. The Pharmaceutical Journal, PJ January 2018 online, online DOI: 10.1211/PJ.2018.20204295 Accessed 4 Feb 2018
  20. EMA surveys pharma companies on their preparedness for Brexit
  21. Remigi E, Martin V, Sykes T, Szirtes G. In Limbo: Brexit testimonies from EU citizens in the UK: CreateSpace Independent Publishing Platform, 2017 (https://www.amazon.co.uk/Limbo-Brexit-testimonies-EU-citizens-ebook/dp/B073K1SQ2K/ or https://www.byline.com/project/78).
  22. Remigi E, Williams D, Helen De Cruz H, Pybus S, Killwick C, Blackburn P, et al. In Limbo Too: Brexit testimonies from UK citizens in the EU: Volume 2: CreateSpace Independent Publishing Platform, 2017(https://www.amazon.co.uk/Limbo-Too-Brexit-testimonies-citizens/dp/1721674241/).
  23. Gbikpi N. How to apply for “settled status” for EU citizens. Free Movement, 2018; Updated Nov 2018; Accessed: 2018 (23 Nov): (https://www.freemovement.org.uk/how-to-apply-for-settled-status-temporary-status-brexit/)
  24. Home Office. Using the ‘EU Exit: ID Document Check’ app. Home Office, 2018; Updated 15 Nov 2018; Accessed: 2018 (23 Nov): (https://www.gov.uk/guidance/using-the-eu-exit-id-document-check-app).