Brexit poses “substantial threats” to NHS staff levels, funding and drug treatment, according to a new study in the respected health journal The Lancet.
The research paper, published on Friday, warns that “almost every part” of the health service, from organ transplants to curbs on tobacco, would be hit hard when the UK quits the EU.
Academics from Oxford University and the London School of Hygiene and Tropical Medicine calculated the impact of “hard Brexit”, “soft Brexit”, and “failed Brexit” and found that each would be “profound”.
Using World Health Organisation (WHO) models, the researchers predict that new drugs could be less available, EU science cash may dry up and tens of 150,000 doctors, nurses and care workers could be forced out of the service.
They also warn that the NHS could be opened up to privatisation from foreign firms without any fresh safeguards to replicate EU competition law.
The research paper concludes that the scale of the task “risks overwhelming Parliament and the civil service” and urged ministers to ensure the challenge was a centrepiece of talks with Brussels.
The Lancet study, which carries the authority of one of the country’s oldest scientific journals, was seized on by Labour as further proof that Theresa May was heading for a “chaotic Brexit”.
But the Department of Health said it was focused on getting the best Brexit deal in the interests of patients, business and citizens.
In stark contrast to Boris Johnson’s infamous claim that quitting the EU would free up £350m a week to spend on the health service, the research warns that the NHS could end up with less money as the economy is rocked by a downturn.
The researchers modelled the likely impact of three possible Brexit outcomes: soft Brexit (a similar agreement to countries in the European Economic Area, with access to single market but restrictions on free movement of people), hard Brexit (a free trade agreement between the UK and EU) and failed Brexit (falling back on World Trade Organisation rules).
“We conclude that each scenario poses substantial threats. The workforce of the NHS is heavily reliant on EU staff . Financing of health care for UK citizens in the EU and vice versa is threatened, as is access to some capital funds, while Brexit threatens overall economic performance. Access to pharmaceuticals, technology, blood, and organs for transplant is jeopardised. Information used for international comparisons is threatened, as is service delivery, especially in Northern Ireland.
Even under the scenario of a soft Brexit, it warns there would be problems with “workforce recruitment and retention, NHS financing” and potentially weaker protections on tobacco, air quality and medicinal products.
Professor Martin McKee, one of the authors 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.”
The study points out that the NHS has benefited from €3.5 billion in funds from the European Investment Bank since 2001, helping to fund various public-private partnerships.
“The overwhelming consensus of economic forecasts, including that of the Office for Budget Responsibility, is that Brexit will have a substantial long-term negative impact on the UK economy, and thus can be expected to put additional pressure on NHS financing.”
The authors note potential opportunities with the hard and failed Brexit scenarios, such as adapting competition laws, but say this will only benefit the NHS if the government chooses to take them on board.
The study says that on tobacco imports, the UK has been ahead of many other countries in looking to EU law in interpreting regulations. “There is, however, a risk that the UK could become a prime target for the tobacco industry post Brexit, as is the case in Switzerland,” it says.
Shadow Health Secretary Jonathan Ashworth told HuffPost UK: “The Government’s chaotic approach to Brexit is already a threat to our NHS. As a result of the Government’s failure to prioritise the NHS, recruitment from the EU into the UK health service has collapsed and the European Medicines Agency has been lost along with hundreds of jobs.
“Hugely important questions remain unanswered about reciprocal health arrangements, and our future access to medicines. The Government urgently need to get a grip and make sure that the NHS is given the priority it needs in the Brexit negotiations.”
A spokesman for the Department of Health said: “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”.
Lead author Nick Fahy, of the University of Oxford, 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.”
The authors of the paper made declarations of interests, revealing that Prof McKee was on the board of “Healthier In”, a group which campaigned to remain in the EU, and Fahy was a former European Commission official.
The Lancet stressed that the study was “peer reviewed” - subjected to scrutiny by other academics - in line with its high standards, but pointed out that it was a health policy review rather than a scientific paper.