UK has failed to resolve post-Brexit health issues, report warns
The UK government has failed to resolve key post-Brexit issues affecting health and social care nearly a year after the country left the EU, according to a think-tank report that accuses ministers of delaying decisions and negotiating “brinkmanship”.
A report from the Nuffield Trust, published on Monday, suggested that pledges to keep the NHS and medicine prices “off the table” in new trade discussions were largely meaningless without specific commitments to ensure the health service would not have to pay more for drugs.
Restricted access to EU science funding, and staffing pressures worsened by immigration constraints, are among other elements that have yet to be satisfactorily addressed, it warned.
Mark Dayan, the trust’s senior policy analyst, said the protracted struggle of negotiating a Brexit deal was supposed to provide “clarity and some certainty to the UK health and care sector”. But nearly a year on from the UK’s departure from the bloc, the effects were only beginning to filter through, at times masked by the severe shocks to the health service and economy caused by the Covid-19 pandemic.
“The government’s approach to the effects of Brexit on health and care has fuelled uncertainty with the UK health sector. The lack of answers to key decisions, ongoing brinkmanship between the UK and EU and a secretive process lacking in engagement with health and care has already had direct impacts …” Dayan said.
The report focused on the potential outcomes of future trade deals, suggesting discussions with prospective partners did not appear to include any plan to bring benefits to the UK health sector. If deals were struck that included protections for investment and the provision of cross-border services, it could be difficult for a future government to remove the current right of foreign private firms to tender for contracts in the English NHS, it said.
Nuffield also raised concerns that under these deals the NHS could wind up paying more for medicines. For example, if companies were allowed to hold exclusive rights over their drugs for longer, the NHS could be prevented from switching to cheaper generic versions, it suggested.
The obvious way to demonstrate the NHS “not being on the table” was for it to be entirely excluded from chapters in trade deals covering services or investment, the report argued. “However . . . officials we spoke to were less than fully confident that there was an absolute commitment to this,” it added.
Another key area still to be fully resolved concerns access to medicines and medical devices for patients in Northern Ireland.
Under proposals from the European Commission announced on Friday, and welcomed by the pharmaceutical industry, Brussels will legislate to permit UK-approved medicines to enter the region.
However, Nuffield argued that “unilateral provisions to accept incoming goods from Great Britain will not, by themselves, suffice” to ensure frictionless export and import. It pointed to the continuing existence of a GB-NI customs border.
Tamara Hervey, a professor of EU law at City, University of London, said the position of the NHS in Northern Ireland had become critical. “The supply of products to the comparatively small Northern Irish NHS is in jeopardy, as market actors take rational decisions about whether to supply that market, looking at the costs associated with different possible trade routes,” she added.
The government said the EU’s proposals followed on from discussions between the UK and EU teams. “They could constitute a constructive way forward, and we are willing to look at them positively, but as we have not been able to scrutinise the texts in the necessary detail we are not yet able to make that judgment with full confidence,” it added.