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A no-deal Brexit threatens the very existence of the NHS

Dr Kailash Chand

Dr Kailash Chand

The UK will cease to be a member of the EU on 29 March 2019. Forty years of accumulated legislation and regulations will no longer apply.

It is increasingly clear that failure to reach a deal with the EU on the terms of Brexit would be a disaster for the NHS. The repercussions of a no-deal Brexit could be so catastrophic as to destabilise the NHS to the point of disintegration.

A leaked letter between NHS chiefs accuses government of ‘radio silence’ and ‘mixed messages’ on Brexit planning, and warns that current plans threaten pharmaceutical supply chains, disease control and the NHS’s EEA workforce. The threat of medicines and related shortages has provoked online concern among patients, especially those requiring specialised equipment manufactured abroad. Diabetes UK is rightly concerned about securing supplies of insulin for diabetic patients.

Patients with rare diseases could lose access to European Reference Networks. Elderly British residents in countries such as Spain may decide to return, placing demands on an already over-burdened general practice and social care system. There would be no basis for recognition of medical qualifications obtained in the EU. Pharmaceutical companies would have to seek separate authorisation to market their products in the UK and EU.

 A vacuum of political oversight following a no-deal Brexit could lead to further moves to reduce access, safety and quality

Leaving the EU with no deal has far-reaching implications for general practice too. A large percentage of the workforce consists of non-UK qualified GPs – over a fifth of the workforce of the GP workforce is from the EEA and elsewhere – and research has shown these GPs tend to work longer hours, are older and serve more deprived areas than their UK counterparts. Brexit with no deal, or indeed a hard Brexit, would exaggerate the recruitment and retention crisis and threaten delivery of care, particularly in deprived areas.  

Furthermore, faced with a collapsing economy and an NHS struggling to control increasing demands, the treasury may lose patience and take an even firmer grip on the services’ finances. If the economy nose dives as predicted with no-deal Brexit, the chancellor of a new administration could even seek to end the service’s (already leaking) funding ‘ring-fence’.

More importantly, a vacuum of political oversight following a no-deal Brexit could lead to further moves to reduce access, safety and quality of patient care. Most of the CCGs in England are already quietly outlining plans to close and downscale local services across the country, and withdraw a wide range of treatments from the NHS, from hearing aids to IVF treatment and hip replacements.

The repercussions of Brexit with leadership of the likes of Boris Johnson and Michael Gove could be so catastrophic as to reduce the NHS to a skeleton service offering poor quality ‘emergency services’ only. Michael Gove was one of the co-authors of an infamous book that claimed the NHS was ‘no longer relevant for the 21st century’ and called for it to be replaced by a system of personal health budgets. Boris Johnson has told us that ‘if people have to pay for NHS services, they will value them more’.

My real worry is a more right-wing government would use a workforce crisis following Brexit with no deal, compounded by the NHS funding crisis, to tell the British public that a free universal health care is not affordable, and wash its hands of the NHS.

Dr Kailash Chand is a retired GP in Tameside

 

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Readers' comments (14)

  • It is increasingly clear that failure to reach a deal with the EU on the terms of Brexit would be a disaster for the NHS. The repercussions of a no-deal Brexit could be so catastrophic as to destabilise the NHS to the point of disintegration.

    - all I see is a whole load of BS assertions with no basis or evidence. bilateral agreements/cooperation can be had without the need for political union. Recruitment can be specifically catered for when we have the SOVEREIGNTY to decide what specific immigration policy we would like to supplement the NHS staffing. Pharma already seek separate authorisation to market their products for countries outside the EU, e.g. the USA! Economy nose dives? There's only 1 thing that's been proven time and time again in history to boost the economy - less government spending/intervention/socialism, and conversely more free market capitalism. Its time to let go of your 'religion' that is the NHS, and to consider what's best for the country as a whole.

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  • Brexit could destroy the NHS? So not all bad then, the demise of a second rate service and a first class abusive employer.

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  • Christopher ,
    how did the Americans deal with the recession of the late 1920's? "Less government spending.. etc etc"???
    Or possibly a massive investment in public works which got the country back to work and saved the economy??
    All I see is a load of BS assertions with no basis or evidence!

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  • I don't care. People still get sick and I'm still a Dr. It's way out of my sphere of influence. Our service is cheap and I suspect will only become more valued. win:win :)

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  • No NHS eh? "People will alwats be sick" but if I was earning less than 27.5k (average UK wage) I wouldn't bother with preventive medicine or dentistry. On that basis which 25pc of UK doctors do you think should be fired if we privatise?

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  • The demise of the NHS has nothing whatsoever to do with Brexit.
    It is pre-planned anyway.

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  • Well DrDeath, if you want to get specific, government spending in infrastructure is perfectly fine. Certainly not government spending in socialist policies or bureaucracy. No evidence? Look around you, look at history with what has happened and what is happening with socialist countries or socialist policies in countries. You don't see BS, your head is in the sand with denial.

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  • Agreed on that! All the professions are suffocating with stultifying bureaucracy. The direct consequence of our comfortable "meeting" culture". Reckon that we can count on that continuing after Brexit sadly. The civil service mindset.

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  • I have to add, DrDeath did not take on any of my points at all. No evidence for my assertions? Nations sign trade deals/cooperate on all sorts of things with no need for political union. Look at what Trump and Juncker have agreed to. Also, 90% of the rest of the world have their own immigration policy and can cater it to their workforce requirements. Of my understanding of the Great Recession, it was exacerbated by the Federal Reserve's policies anyways. Its almost as if, DrDeath, you don't bother to do any research before posting. No wonder you don't have the balls to post your name.

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  • Great Depression - oops lol

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