Commenting on the news of a trade deal between the UK and the EU [1], Nuffield Trust Brexit programme lead Mark Dayan said:
"This deal finally reduces, just a few days out, the considerable uncertainty around what will happen on January 1st. But relief will be muted in health and social care, because today's agreement was never going to remove the two major sources of difficulty caused by leaving the EU single market: the flow of vital supplies into the UK; and the impact of new migration rules on health and social care workers.
"While we await the full details of the trade deal agreed today, it seems that negotiators should be congratulated for apparently agreeing mutual recognition of inspections for medicine factories, and some cooperation at customs. But the red tape required to get vital products in and out of the UK is still going to be multiplied next Friday, making it more difficult and more expensive to get supplies to the NHS or to sell them competitively into Europe. We still do not know whether there will be mutual recognition of testing batches of medicines, or of the devices, like ventilators and masks, that have been proven to be so essential this year.
"Long before these discussions started, it was clear that the free movement of labour, on which the NHS and social care have relied try to plug gaping staff shortages for the past decade, would end. The new rules previously announced for January 1st will hit social care especially hard. Ultimately the migration system is now a free choice for Britain: if we want the functioning, protective social care system the Prime Minister has promised, we may need to choose differently.
"There are more positive provisions on specific points. British scientists will still be able to be included in flagship Horizon Europe funding programmes. Travellers back and forth will still be able to access care like locals do. While we await details, this seems to be a victory for common sense over precedent, and a great relief to people who faced prohibitive bills to travel with needs like dialysis. There will be some scope for the UK to keep accessing the Early Warning and Response System for updates on the pandemic, though it sounds far less secure than currently.
"The focus will now shift to how the NHS can manage these impacts operationally as coronavirus continues to surge and the usual winter period of highest pressure approaches [2]."
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