Leaving the European Union could be “potentially catastrophic” for the NHS, the authors of a hard-hitting report have warned.
Even a “soft” Brexit that retains access to the single market while restricting the free movement of people is likely to have a big impact on healthcare in the UK, they claim.
A total break with Brussels was expected to have far worse consequences.
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Professor Martin McKee, a member of the team from the London School of Hygiene & Tropical Medicine, said: “Our analysis of how Brexit will affect the NHS, although the UK’s desired outcome remains unclear, is that Brexit in any form poses major risks to almost every part of the NHS, with a ‘no deal’ scenario potentially catastrophic.
“The EU has shown that it recognises many of these threats, and we hope that our paper encourages the UK negotiating team to make health issues a priority.”
Writing in The Lancet medical journal, the seven authors examined the effects on the NHS of three possible Brexit scenarios: a “soft” departure that allows the UK to remain a member of the EU single market, a “hard” Brexit providing a free trade agreement between the UK and EU, and a “failed” Brexit that results in the UK falling back on World Trade Organisation rules.
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Even the soft option raised serious issues for policymakers, including workforce recruitment and retention, NHS financing, public health legislation, and the licencing of medical products, the report said.
After Brexit it will be increasingly difficult for the UK to recruit sufficient NHS and social care staff, according to the research.
Estimates for 2017 suggest that 60,000 people from the EU work in the NHS and 90,000 are employed in adult social care, with a concentration of staff in London and the South East. These regions would be especially vulnerable to labour shortages, said the authors.
Another risk highlighted in the report was the loss of funding to the NHS, both as a direct result of the European money stream being cut off, and indirectly from impacts on the UK economy.
The NHS was said to have received 3.5 billion euros (£3 billion) from the European Investment Bank since 2001, which helped fund various public-private partnerships.
In addition the NHS soaked up so much public expenditure it was likely to be especially sensitive to any damaging impact of Brexit on the UK economy.
UK science was likely to suffer post-Brexit since EU direct funding accounted for 17% of research contracts held by British universities, the report said.
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Lead author Nick Fahy, from Oxford University, said: “Health is often thought to be a purely national matter, relatively insulated from the consequences of Brexit.
“That is not the case; as this analysis shows, leaving the EU will have wide-ranging impacts on health and the national health service. These must be addressed now if the consequences of Brexit are not to be borne by the sick and the vulnerable.”
A Government spokesman said: “We are committed to a world-class NHS, which is why we’re backing it with an extra £8 billion investment by 2022 and are focused on getting a Brexit deal that is in the best interests of business, citizens and patients.
“We’ve made clear that the future of EU nationals should be a priority in Brexit negotiations so their valued contribution to the NHS can continue, but the NHS also needs more home-grown staff, so we’ll be training an extra 1,500 doctors and 10,000 nurses, midwives and allied health professionals a year by 2020.”