At this stage, it may seem fruitless to continue pondering over the what ifs and maybes of the various endgame scenarios, however it’s a question that big businesses Europe-wide will have to keep at the forefront of their minds.
One of the bigger points of concern for the UK surrounds its proudest institution: the NHS. A critical part of British infrastructure, what’s the prognosis for our health service in the wake of continued Brexit uncertainty?
The NHS has long been known as an organisation both reliant on foreign labour and proud of its culturally diverse workforce. Indeed, a significant portion of our best doctors, nurses and general staff have come from abroad. With that in mind, the implications of new immigration policies and the as yet unclear status of EU nationals in post-Brexit Britain have the potential to have a major impact on the NHS.
According to The King’s Fund, EU nationals make up just over 5% of the 1.2 million strong NHS workforce, with NHS trusts collectively experiencing a shortage of over 100,000 staff – meaning 1 in 11 posts are currently unfilled.
The political quagmire around immigration law, European Economic Area (EEA) migrants and the EU Settlement Scheme is set to exaggerate an already significant staffing issue in an NHS that is trending to becoming even more dependent on foreign labour in the future.
Access of Treatment
As it stands, EU rules dictate mutual access to healthcare abroad, both for UK citizens living in the EU and EU nationals living here in the UK, via the European Health Insurance Card (EHIC). The EHIC gives its holders access to medically necessary, state-provided health treatment, with costs of such treatment recovered by these reciprocal health agreements.
An advantageous arrangement, but one that could be negatively affected by Brexit. Whilst the UK would look to retain the current scenario after Brexit by installing a series of bilateral agreements with EU member states, there is no guarantee this will be successful.
A failure to retain these agreements could mean 3 million EU nationals denied access to NHS care, with 1 million UK ex-pats also refused help abroad. Should those UK nationals decide to return home, the NHS will then face extra strain in dealing with the healthcare requirements of this returning, typically older, demographic.
Like many key areas of UK infrastructure, the NHS has some level of vulnerability to Brexit’s wider effects on the UK economy, whatever they may turn out to be.
While economic uncertainly continues, there are suggestions that many goods and services in the NHS may be subject to increased costs in the wake of lower public spending growth, though this is simply conjecture at this stage. In such circumstances, systems around the likes of prescription administration, patient prognosis and bed management would have to be more efficient than ever.
The good news for the NHS specifically, however, is the 2018 NHS Funding Settlement, which committed £100bn of funding (inflation adjusted) to the health service over the next 5 years, meaning the NHS has been somewhat future-proofed against the economic fallout of Brexit.
Of course, we don’t really know what’s to come from a post-Brexit UK economy, but it should at least be reassuring to know that measures have been taken to protect the short-term financial stability of one of our most important services.
Overall, the question of Brexit and its effect on the NHS is an extremely complex and detailed problem which will only become clearer once there is more certainty around the country’s wider approach to its exit from the EU.
In a scenario where freedom of movement and membership of the single market and customs union end, the NHS faces a number of serious threats including an impact on its workforce, trading relationships and future funding. A no-deal Brexit would only compound these issues further, meaning it could be a turbulent road ahead for one of our most treasured establishments.