This briefing lays out what the Brexit withdrawal agreement and the political declaration mean for the NHS and social care. It also looks at the implications of two possible alternatives: a no deal Brexit, and arrangements where the UK stays in the single market. Read the key points below, or download the full briefing document as a PDF using the link above.
Key points
- The transition period and basic customs union included in the withdrawal agreement would reduce the risks of medicine and device shortages posed by a no deal Brexit.
- The longer term arrangements envisioned in the agreement and political declaration generally entail leaving the single market. Unless negotiating positions fundamentally change, this will produce extra costs for medicines and other supplies. It will incentivise companies to introduce new drugs later in the UK. Under the political declaration it will be difficult to negotiate access to reciprocal healthcare schemes such as the European Health Insurance Card for future generations.
- However, it should be possible to negotiate good continued access to the European market in medical devices, and continued participation in the EU’s flagship science funding programmes.
- Some see opportunities for the NHS from Brexit in the ability to change rules on procurement and working time. The Northern Ireland protocol in this agreement would allow changes to procurement rules, but not working time regulations. These would be live issues in negotiations for the future relationship.
- Although the rights of existing migrants would be secured, the agreement and declaration envisage the end of the free movement of labour for the future. This poses problems for the NHS and social care, which have relied on European workers to manage staffing shortfalls. The UK could avoid these issues by unilaterally retaining an open system for these workers.