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Brexit: The effects on the UK medical field

One certain aspect of Brexit is that it will affect every sector in the UK. The uncertainty surrounding Britain’s exit from the EU has slowed business decisions, and fears of a no deal Brexit have raised concerns over the medical industry in particular.

Moreover, the UK’s medical industry is supported by overseas workers and supplies. 135,000 NHS staff in England are nationals of a country outside the UK, and the NHS has confirmed that there are plans in place to build stockpiles of medicine in case of transport issues after Brexit. For imported drugs such as insulin, this could prove to be a difficult situation indeed.

Sadly for us, the prognosis doesn’t look promising — in the short-term, at least. Even by the government’s own admission in leaked Operation Yellowhammer documents at the start of 2019, healthcare services were marked as one of 12 “high-risk areas” if the UK leaves without a deal. Further to this, England’s chief medical office warned that people’s lives could be at risk in the event of a no-deal Brexit.

As quoted in The Independent Dame Sally Davies claims: “We cannot guarantee that there will not be shortages. Not only in medicines but technology and gadgets and things. They [patients’ lives] are at risk.”

Dame Sally Davies then criticised Jacob Rees-Mogg’s recent comments regarding consultant neurologist Dr David Nicholl’s input into the government’s no-deal medical plans. After Dr Nicholl’s stark warnings, Rees-Mogg compared Dr Nicholl to Andrew Wakefield. Wakefield is a discredited former doctor who was struck off the medical register as a result of suggesting a link between the MMR vaccine and autism. Wakefield’s study was later redacted, citing inaccurate data and potential conflict of interest. Rees-Mogg drew parallels between the public response and damaging anti-vaxx movement caused by Wakefield’s work and the warnings Dr Nicholl gave in regard to epilepsy and neurology drug access after Brexit.

But the question still remains: will Brexit change the face of the UK medical field for the worse, or will we see progression and growth after an initial adjustment period?

Funding for Our Medical Sector

The UK sends £350 million to the EU every week, according to the now-famous red bus. This payment, which referred to the dividend or ‘membership fee’ the UK sent to the EU, was one of the main points upon which the Leave Campaign built its argument. This money, it said, would be better spent in the NHS.

Although this figure was proven to be incorrect due to UK’s budget rebate, it is true that the UK sends money to the EU every week. The figure is closer to £250 million per week after the aforementioned rebate. But leaving the EU would mean the nation would not have to pay this dividend. If this went into the NHS instead, would Brexit have a positive effect upon the medical industry through this new funding?

Let’s consider the full fee of £350 million for argument’s sake, prior to the rebate. If the UK pays this figure every week for a year, it would be sending £18.2 billion to the EU every year. That certainly sounds like a hefty sum to pour into funding our healthcare and medical fields…at least until one steps back and considers the bigger picture.

In 2017/18, the government budgeted £124.7 billion for NHS spending. This is set to increase to £128 billion by 2020/21. Spending increases have increased around four per cent per year since the NHS was established.

So, even with the hypothetical £350 million a week, (or £18.2 billion per year), coming back from the EU and going into the NHS after Brexit, this extra money would barely be a drop in the ocean that is the projected £128 billion spend of 2020. It would only cover 14 per cent of the NHS’s spending in that year alone. Given the amount we spend on the NHS increases every year as well, that £18.2 billion becomes smaller and smaller as the years go on. This is regardless of whether or not we even send a full £350 million to the EU every week in the first place.

Moreover, The King’s Fund reported that the Office for Budget Responsibility estimated that a medium-disruption no-deal Brexit would actually cost the UK £30 billion per year. The Institute of Fiscal Studies’ estimate was even more dire, positing that the UK government would need to double its borrowing to around £100 billion a year.

With all things considered , it certainly doesn’t seem like Brexit will bring more funding the medical field or the NHS at all. Even if the £350 million-per-week claims were true, it simply wouldn’t make a noticeable impact at all.

A Possible Professional Loss

Brexit has undeniably impacted the medical field’s professional level. According to the Financial Times, by the start of 2019 more than 7,000 nurses from the European Economic Area (EEA) had left the UK since the referendum. With 41,000 nursing vacancies in England alone, and the NHS relying on over 5 per cent of nurses to come from the EEA, hearing that there has been an 87 per cent drop in the number of EEA nurses coming to the UK is worrying. It is predicted that by 2021, England will be short 51,000 nurses.

This is in fact, not unique to nursing. From psychology to technology, the prospect of a ‘brain drain’ as EU nationals leave the UK is a frightening thought. Experts from all across the EU came to the UK for so many reasons — but few of those reasons would withstand the recorded increase in racism and hate crimes as a result of Brexit’s influence. In just one snapshot, the Financial Times reported how a Polish nurse recounted that she has not only been told to “go home” by patients she is employed to help, but also by her own colleagues. Between this and dropping employment conditions, the nurse stated she is waiting for the Brexit deal to be finalised. Then, she will choose whether to stay or leave.

For those medical science and research academics in the field, securing funding for research is difficult enough. Leaving the EU means Britain loses its research funding from the EU, which makes up around 14 per cent of its total research funding pool.

However, not everyone believes Brexit will cripple the UK. Dr Thomas Fink, Director of the London Institute for Mathematical Sciences, believes that the UK has a strong enough history of being a leader across many scientific fields, including medical. The doctor argues that, with Britain’s enviable university world rankings, the nation will still be a top pick for professionals.

The impact of Brexit on the medical field has already been a talking point among professionals at medical conferences in the last few years, and it will continue to be so for medical conferences in 2020. In October 2019, the BMA council chair Chaand Nagpaul spoke at the European Union of Medical Specialists conference to share a similar optimism as Dr Fink’s regarding the effect of leaving the EU upon the medical sector. Dr Nagpaul commented that, regardless of being in or out of the EU, doctors would remain cooperative and united in their share interest and care for patients above all else.

Overall, it is difficult to predict how the UK’s medical sector will be impacted once Brexit truly finalises. But it is clear that the elongated process has already made significant shifts within the industry. These changes will only amplify once the nation actually leaves the EU, but if the preliminary changes caused by the prospect of leaving are anything to go by, the sector faces challenging times ahead.

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