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Brexit could set NHS back half a billion a year if pensioners are forced to return

The UK’s exit from the EU may end up costing the NHS an extra half a billion a year, the Nuffield Trust health think-tank has warned.

In a new report analysing the financial impact on the health service of potential Brexit agreements between the UK Government and the EU, Nuffield Trust said ‘Brexit will have a lasting impact on health and social care in the UK’ and that ‘getting it wrong risks leaving already strained services with an impossible task’.

The main extra cost would occur if 190,000 British elderly people who currently live in other EU countries receiving healthcare under the reciprocal S1 scheme would be forced to return, it said.

The report said: ‘If all the British pensioners who currently receive health care in other countries through EU agreements had to return, caring for them would require the NHS to spend an extra £1 billion a year.

‘This is twice as much as we pay for them to receive care abroad, and there would also be a need for extra beds equivalent to two new hospitals. Every step should be taken to try to secure a deal that allows them to keep receiving care where they now live.’

Since the UK already pays £500m annually for their current healthcare through the S1 scheme, the Nuffield Trust said that the total ‘additional cost of caring for British pensioners if they return to the UK is just under £500m net’.

The report also calculated that ‘around 900 extra beds’ would be required if EU-based British pensioners returned, while the UK could also end up having to pay an extra £100m a year if the UK leaves the EU’s medicine licensing system.

It concedes that although the £350m a week pledged for the NHS during the referendum campaign was ‘a myth‘, the NHS could see some funding come from stopping to pay EU levies. But it said economic disruption would likely to lead to financial losses exceeding this.

As for EU citizens working for the NHS, the report concluded there must be ‘a commitment either to continue to allow substantial nurse migration after Brexit, or to step up domestic training, even if this proves more difficult and more expensive than current policies anticipate’.

Report author Mark Dayan, Nuffield Trust policy and public affairs analyst, said about the Brexit negotiations: ‘[I]f we handle it badly, leaving the EU could make [existing] problems even worse, given the potential impact on both the strength of the UK economy and the supply of overseas staff to both health and social care services.

‘It is possible that extra funds could be found for the NHS from any cancellation of Britain’s EU membership fees – but whether or not these benefits will outweigh the significant staffing and financial costs Brexit may impose on already stretched services remains to be seen.

‘That depends largely on the NHS being recognised as a significant priority as we enter some of the most important negotiations in Britain’s history.’

BMA chair Dr Mark Porter said: ‘These figures are a stark reminder that with the NHS at breaking point, politicians must keep the health service and its patients at the forefront during Brexit negotiations and reduce the impact that leaving the EU will have on health and social care across the UK.

‘Not only might NHS resources fall, but existing chronic staff shortages could be worsened as half of the 10,000 EEA doctors working in the NHS are considering leaving the UK. This would seriously impact patient care across the country and increase what are often already unacceptable delays for treatment.’

He added it was therefore ‘vital that the next government ensures long-term stability for the NHS by granting permanent residence to EEA doctors working in the UK; maintains the current working time regulations; protects life-changing medical research which benefits from European funding; and ensures that leaving the EU will not delay the UK’s access to vital pharmaceuticals’.