Will Brexit harm the NHS ?

Patients lack answers to too many questions about their healthcare after Brexit

Predictions of a smaller UK economy, at least in the short term, and fewer EU healthcare staff present challenges for the NHS after 29 March 2019, argues Anand Menon.

But Graham Gudgin is unconvinced by what he believes are biased estimates promoted by a government pushing for a soft Brexit.

Read Could Brexit harm the NHS? on The BMJ, 26 September 2018.

Brexit and The Future of Chemicals Regulation

Will Brexit risk our health and our environment?

The Environmental Audit Committee is launching a second inquiry into the future of environmental law and policy following the result of the EU Referendum. It will focus on the future of the European Regulation on Registration, Evaluation, Authorisation and Restriction of Chemicals (REACH). Please send written submissions using this form.

The EU has adopted several pieces of legislation on chemicals, which are primarily ‘trade regulations’ harmonising the conditions under which chemicals can be placed on the market. The aim of REACH is to protect human health and the environment. REACH shifts the responsibility from public authorities to industry with regards to assessing and managing the risks posed by chemicals and providing appropriate safety information for their users. REACH is constantly evolving, having been amended 38 times since it was enacted in 2006. REACH is enforced by the European Chemicals Agency (ECHA) and relatively little of its regulation has been transposed into UK law.

The Future of Chemicals Regulation after the EU Referendum, parliament uk, 21 December 2016.

Will Brexit risk our health? UK MPs start inquiry into chemicals regulation after the EU referendum, chem trust, JANUARY 11, 2017.

Image credit Javier Díaz Barrera.

It has been estimated that the chemicals industry is the UK’s largest manufacturing exporter. The industry produces products which are fundamental to many other sectors of the economy – from energy to clothing, motor manufacturing to agriculture, food standards to children’s toys.

The Prime Minister has said that leaving the EU will involve converting the body of EU law into British law (via a “Great Repeal Bill”). However, the Government has said that up to a third of EU environmental law cannot be simply ‘copy pasted’ into UK law and will require additional work to ensure that the UK maintains the current level of environmental protection. REACH was cited in the evidence to our Future of the Natural Environment inquiry as one of these challenging areas.

This inquiry will examine the future of chemicals regulation in the UK after the Referendum result, with a particular focus on the possible impacts on environmental protection, public safety and the UK chemicals industry.

The Committee invites submissions on some or all of the questions below:

Transposition

  • What particular challenges will the UK Government face when it seeks to transpose REACH into UK law through the “Great Repeal Bill”?
  • How far will the UK’s ability to effectively transpose REACH depend on negotiations with other Member States and the nature of the UK’s future relationship with the EU (e.g. Single Market membership)?
  • What role should the devolved administrations play in setting the regulatory environment in this area? How should any divergences in policy be managed?

Administrative, Policy and Regulatory Implications

  • How should administrative and enforcement responsibilities, which are currently being carried out by the European Commission or EU Agencies (such as ECHA), be transferred to domestic bodies?
  • What are the likely implications for industry in terms of regulation, environmental and safety standards?
  • Does the UK Government have the requisite expertise and resources to take on these tasks?

Future of Chemical Industry

  • What scope is there for the UK to pursue a divergent approach to chemicals regulation from the EU once the process of leaving has been completed?
  • What principles should a UK chemicals regulation regime follow?
  • What are the likely practical implications of having a UK-only chemicals regulatory policy for:
    1. The Environment?
    2. Public Safety?
    3. UK Industry
  • What key features should any new regime have to ensure these are not compromised?

CHEM Trust will be submitting its views on this important issue, emphasising :

  • the importance for public health & the environment of having effective regulation of chemicals;
  • the role of REACH as a world-leading regulation system, even though it is not perfect;
  • potential risks from the UK becoming detached from REACH, and the challenges of creating a new regulatory system.

Brexit, UK Healthcare and The NHS

Where does the Brexit vote leave the NHS, the health workforce, science, and research?

Where does the vote for the United Kingdom to exit the European Union leave the NHS, the health workforce, science, and research?
The BMJ asked a range of people for their thoughts.

This post content was originally published by The BMJ :

advancing healthcare worldwide by sharing knowledge and expertise to improve experiences, outcomes and value.

Image via Gareth Iacobucci.

On 23 June 2016 the UK government held a referendum on EU membership. Vote Leave won with 52% of the votes.

In the immediate aftermath of the vote, we set up a live blog to track reactions from health experts and scientists, and in the week that followed asked a range of people for their thoughts.

Journalist Anne Gulland followed this with a deeper assessment of the outlook for UK science and health outside the EU, considering how Brexit will affect NHS finances, the pharmaceutical sector, key public health legislation, and other sectors.

In related news stories, scientists and researchers ask what next after the vote, and BMJ journalists Tom Moberly and Gareth Iacobucci report, respectively, on how Brexit threatens the stability of the medical science workforce and NHS staffing.

Martin McKee has written two blogs: one looking at the impact that this vote might have on health, and a second blog discussing the growing confusion as Britain has been thrown into political turmoil. US doctor Bill Cayley says this sends out a warning signal to the US for their forthcoming presidential elections. Margaret McCartney discusses our messy divorce from the EU.

The Brexit Debate

The articles listed below are a collection of free articles and other resources published in the run up to the referendum from The BMJ about the pros and cons of “Brexit” in relation to medicine, pharma, research, the law, the NHS, and global trade agreements.

The BMJ’s editors believe the UK should stay in Europe. Their article arguing for Remain was published on 14 June. A second article was published at the same time by Conservative MP and former GP Sarah Wollaston. Wollaston, chair of the UK Parliament’s health select committee, explained why she had switched from supporting Brexit to supporting the Remain campaign.

The journal’s regular columnist Margaret McCartney also joins the debate, concluding:

“I wouldn’t wish to leave a union where the NHS and research community benefit from close ties with colleagues across the EU. We should not want to be Little Britain.”

What Brexit could mean for . . . The NHS?

David OwenThe launch of the Vote Leave group’s Save Our NHS campaign in April 2016 warned of the growing control and influence the European Union would have over the NHS if the country voted to remain in the EU. Pro-EU campaigners accused the group of “scaremongering” and said that the NHS would be protected from trade deals.

In a letter to The Times newspaper published on 14 June, 60 former presidents and chairs of medical royal colleges and the BMA set out why the UK should remain in the EU.

This article examines what the leave campaign said about the NHS, and how the experts answered. Stephen Dorrell, a former Conservative health secretary, and now chair of the NHS Confederation, told the Confederation’s annual conference on 15 June:

“We need a strong economy to guarantee the growth in funding that the health and care service requires and evidence suggests leaving the EU would undermine this.”

Not all prominent doctors share their views. David Owen, the former Labour foreign secretary who was health minister at the time of the last European referendum in 1975, said:

“We in the cross-party Vote Leave campaign, however, share a common democratic commitment. We will restore legal powers and democratic control of the NHS to voters in the UK. If we vote to leave, we will be able to protect our NHS from EU interference.”

But would a post-Brexit NHS look any different? Anne Gulland investigates.

Public health

EU legislation covers everything from food labelling to disease control, so how might a Brexit affect policies and activities that promote the UK’s health? Anne Gulland assesses the effects of leaving in key public health battlegrounds, including marketing and pricing of alcohol and tobacco, food standards and legislation, and environmental health. Retired civil servant Bernard Merkel offers a personal perspective, based on his experience of working with the European Commission on its public health programmes.

Pharma

Big UK based drug companies have said they want the country to remain in the EU. Would a Brexit affect access to medicines? Anne Gulland investigates.

Finance

John Appleby

Economist John Appleby’s analysis concludes that after 43 years of membership of the EU, unwinding agreements, obligations, and laws, and then renegotiating trade, security, legal, and other relationships with the EU is unlikely to be a snappy or straightforward process. He adds:

“The problem for referendum voters keen on evidence is that there is no comprehensive and reliable cost-benefit analysis that weighs up the facts, the positives and negatives, over the short, medium, and long term and across different groups in society of exiting or remaining in the EU.”

Trade

Martin McKee Martin McKee, professor of European public health at the London School of Hygiene and Tropical Medicine, asks if the survival of the NHS is threatened by continued British membership of the European Union, with a particular focus on the Transatlantic Trade and Investment Partnership (TTIP), which if agreed would ease trade between the EU and the United States.

Employment law

Chris CoxWhat would a Brexit mean for employment law in the UK? Christopher Cox, director of membership relations at the UK Royal College of Nursing, says the EU has been the source of many employment rights, including working time, work-life balance, key areas of equality including equal pay for work of equal value, and the treatment of part time, fixed-term contract, and temporary agency workers. He concludes:

“If there was a vote in favour of leaving, many complex issues would have to be resolved. It would take at least two years, if not longer, to serve notice of withdrawal and agree terms with the remaining Member States.”

Looking specifically at doctors, Anne Gulland assesses how leaving the EU would affect working conditions, and in a separate article, asks if Brexit would stop the flow of doctors and patients between EU countries.

Science and research

Paul NurseIn April 2016 a report by the House of Lords Science and Technology Committee warned that leaving the European Union would cost UK scientists money and influence. Research funding is one of the few areas where the United Kingdom gains more money than it spends, said Nigel Hawkes in his news article, adding:

“Of the country’s gross contribution to the EU, £5.4bn (€6.84bn; $7.77bn) can be attributed to the community’s research, development, and innovation activities. But the UK gets back £8.8bn in research grants, so exiting the EU would in theory leave a gap of £3.4bn to be filled.”

Paul Nurse, director of the Francis Crick Institute and former president of the Royal Society, had earlier said that anyone in the UK science and research disciplines who supported the so called “Brexit” was displaying “naivety” and “intellectual laziness.” A letter published in The Sunday Times, signed by more than 100 university leaders, claimed an exit would harm UK research and damage universities’ education alliances.

External links