A no-deal Brexit will cause “significant harm” to the NHS, top health academics have warned in a new paper.
The medical journal The Lancet says that any form of leaving the EU will harm the health service, but that quitting without a withdrawal agreement will be “by far the worst option”.
The medical journal outlines how NHS staffing numbers, finances and medicine will be impacted under four Brexit scenarios, and concludes that the only way to avoid damaging healthcare is to remain a member of the bloc.
The authors warn “little evidence exists that the UK is prepared for any of the eventualities set out in their analysis”.
Professor Martin McKee, a co-author of the paper, who is from the London School of Hygiene and Tropical Medicine, warned against dismissing the analysis as ‘Project Fear’.
He continued: “With just over a month to go to Brexit, we need to move beyond slogans.
“We have set out the problems in detail, based on the best available evidence. If others disagree, then they owe it to the British people to say why.
“It just isn’t good enough to keep saying that “something will work out” without any details of exactly how.”
The four scenarios examined by the health policy review include a no-deal and Theresa May’s withdrawal agreement, that includes a two-year transition.
It warns that even if the Irish ‘backstop’ is enacted to avoid a north-south hard border it is only “slightly less harmful” than the no-deal scenario.
Underlining how ill-prepared the UK is for Brexit, the authors cite the recently published NHS ten-year plan that ran to 136 pages, but only had two mentions of Brexit.
Recruitment and retention of staff is among their many concerns, and they warn a proposed minimum salary threshold of £30,000 per year post-Brexit could seriously limit immigration of many health workers to the UK.
It also refers to how public healthcare cover for UK visitors to the EU, and vice versa, would cease this year under a no-deal scenario, and potentially lead to a sharp rise in the cost of private health insurance.
Under any form of Brexit, they fear a delay to accessing new medicines because of no longer being part of cross-EU agencies.
Co-author Professor Tamara Hervey, from the school of law at the University of Sheffield, said: “It’s critical to be clear about the practical effects of disentangling over 40 years of legal integration.
“This is not something that can be done hastily without potentially jeopardising people’s health.
“Future legal relations will have quite different effects on the NHS: these should be taken into account when the UK government, advised by parliament, makes its post-Brexit choices.”
Another co-author, Dr Nick Fahy, from the department of primary care at the University of Oxford, said: “The NHS is at the heart of our national life; it is vital to understand the impact Brexit will have on it.
“Patients and the people who care for them are facing ever-growing uncertainty and potential disruption to healthcare.
“The NHS urgently needs clarity and certainty about Brexit.”
A spokesperson from NHS for a People’s Vote said: “This analysis shows that the choice between No Deal and Theresa May’s deal is no real choice at all, as any form of Brexit will be damaging to the NHS.
“Leaving the EU hurts NHS staffing numbers, finances, UK pharma, and public health policy.
“That reality is very different from the infamous red bus promises, and that’s why we need a People’s Vote on the Brexit deal.”
Health minister Stephen Hammond said the Department of Health and Social Care had analysed the supply chains of 12,300 medicines.
“While we never give guarantees, we are confident that, if everyone - including suppliers, freight companies, international partners and the health and care system - does what they need to do, the supply of medicines and medical products should be uninterrupted in the event of exiting the EU without a deal,” he said.
Shadow health secretary Jonathan Ashworth said the research “devastatingly reveals the dangers to the NHS of a no deal Brexit”.
He added: “From delays in accessing lifesaving drugs, to the desperate staffing implications that our already understaffed and overstretched NHS faces, this report makes crystal clear the sheer irresponsibility of refusing to rule out no deal.”