In line with the terms of reference for the inquiry, our response focuses on the issues to which attention will need to be paid in the withdrawal negotiations in relation to health and social care and, where applicable, the outcomes that should be sought. Our response is largely based on our briefing Five big issues for health and social care after the Brexit vote that we published in June 2016 shortly after the UK’s vote to leave the EU (McKenna 2016).
- The impact of the UK’s vote to leave the EU could have major implications for health and social care, not least because it has ushered in a period of significant economic and political uncertainty at a time when the health and care system is facing huge operational and financial pressures.
- With little clarity as yet over the nature of the UK’s exit deal, a number of important issues will need to be resolved during the negotiations on the UK’s withdrawal from the EU. The key priorities are: the recruitment and retention of EU nationals in the health and social care workforce; arrangements for accessing treatment here and abroad; regulation; cross-border co-operation; and the impact on funding and finances.
- Health and social care has long relied on EU and other foreign nationals in all parts of the workforce. Without them quality of care and the sustainability of some services would inevitably suffer.
- An immediate priority is for the government to clarify its position on the status of EU nationals currently working in health and social care roles in the UK. We recommend they are granted the right to remain in the UK. In the longer term, providers of NHS and social care services should retain the ability to recruit staff from the EU.
- The rules governing UK citizens’ access to health and care in the EU, and EU citizens’ access to UK services will need to form part of withdrawal negotiations. The most straightforward approach would be to continue existing arrangements.
- In many important areas, the government will need to clarify whether its intention is to repeal EU regulations and replace them with UK-drafted alternatives or to continue to abide by them. These include: the Working Time Directive; procurement and competition law; regulation of medicines and medical devices; and regulation to enable common professional standards and medical education between European Economic Area (EEA) countries.
- As well as playing an important role in a range of public health issues, the EU operates systems for the surveillance and early warning of communicable diseases. Collaboration across the EU has also enabled the UK to further its scientific research agenda. We would argue that both issues should be priorities in forthcoming negotiations.
- The economic impact of the vote to leave will have significant implications for health and social care, with the fall in the value of sterling feeding through into higher prices for some drugs, for example. In the long term, the performance of the economy will be a key determinant of health and social care funding.