After publishing the most up-to-date study on the impact of Brexit on health and care in the UK, health sector think tank, the Nuffield Trust, warns that the UK’s departure from the EU has only intensified the challenge facing the industry.
This, the think tank says, has contributed to making people less healthy and widening health inequalities.
The ongoing monitoring work, funded by the Health Foundation, covers the impact on the NHS and social care workforce, medicine and medical devices supply and the economic cost, and reveals negative effects across all these areas.
Brexit’s shutting off the ‘relief valve’ of EU migration has put additional pressure on staffing issues, in a health and care system which has relied heavily on EU and international recruitment in the past. With the lack of an effective domestic training and retention plan, it has proven immensely difficult to recruit care workers, dentists, and specialist doctors.
Meanwhile, pressures on the supply of medicines and medical devices have steadily increased since the UK left the trading bloc. While other countries have also seen shortages, this seems to be especially prolonged in the UK, likely because of the currency depreciation and trade barriers associated with Brexit.
Recruitment of dentists and social care workers from the EU has been left ‘uncompensated’ by increased recruitment drives from the rest of the world. The number of dentists joining the UK register has halved since the EU referendum vote and since the introduction of more stringent English language testing, it has not regained ground. There has been no marked uptick in care worker recruitment with international recruitment of care workers virtually stopping in Spring 2020.
The study finds that Brexit has also exacerbated longstanding recruitment challenges for specialist doctors, including anaesthetists and heart and lung specialists. It also shows that the UK saw a 100 per cent increase in cardiothoracic surgeons across the five years leading up to the EU referendum, a yearly increase which has now fallen to a meagre five per cent. Meanwhile, the rise in anaesthetists is down to five per cent annually compared to 20 per cent before the pandemic.
The report’s conclusions judge that the rapid increase in recruitment of doctors and nurses from the rest of the world is not sufficient to address ongoing shortages and should not be seen as a replacement for proper workforce planning and efforts to recruit and retain staff domestically.
A matter of concern is that since the end of the transitional period, recruitment of healthcare staff from World Health Organisation designated ‘red list’ countries has expanded rapidly. Between October 2019 and March 2022 there were sharp increases in staff from these nations, including Nigeria, Ghana and Pakistan. This suggests an increase in active recruitment drives, which both raises ethical questions and opens the system to abuses.
On the supply of medicines, while the government was able to stave off any immediate disruption, there have been more shortages of supplies across the board since EU withdrawal took place. Ministers have also been forced to accept more price hikes on medicines, and the complexities of the Northern Ireland Protocol have created a situation where some medicines are only approved for use in Northern Ireland or the rest of the UK, isolating the Northern Irish medicines market from Great Britain.
Despite the difficulties of the current health and care situation, the Nuffield Trust insists that the government can address the challenge by increasing domestic training and supply of health and care workers, and making the most of narrow opportunities for competitive advantage to counter fluctuations in availability of medical devices and medicines.
Mark Dayan, the Nuffield Trust’s Brexit programme lead, commented: “It is undeniable that the NHS has faced three of the most difficult years in its history. The health and care sector is still reeling from the effects of a global pandemic and is now grappling with rising cost pressures. The effects of Brexit appear to have added to the severe challenges and problems the NHS currently faces.
“The economic hit of Brexit combined with the worst cost of living crisis for a generation is reducing living standards creating additional need for health and care. Meanwhile a slowdown in EU and EFTA recruitment is making shortages of urgently needed care workers, dentists, and specialist doctors even worse.
“The UK has also apparently taken the worst of a period of medicines shortages which has swept across Europe. The fall in the value of sterling around the EU referendum, and the trade barriers erected since, are probably major factors in our unusually consistent and longstanding problems supplying vital products.”
Professor Tamara Hervey, the Jean Monnet professor of EU Law at City University of London, added: “We urgently need an honest national conversation about the post-Brexit context for medicines, equipment and devices supply and NHS staffing.
“The health sector, generally speaking, would like a closer relationship with the EU’s standards. There are potential benefits from a looser relationship with the EU but capitalising on them would involve courageous political decisions. Instead, we have drift and fantasies.
“The position in Northern Ireland is particularly worrying, where political game-playing seems to be put ahead of the health of the population.”
Photo by Matthew Waring on Unsplash
