As the UK marks a decade since its EU referendum, the NHS finds itself at a critical juncture, facing a multitude of challenges that were once touted as benefits of Brexit.
The issue of staffing has been one of the most pressing concerns. In the years leading up to the vote, many nurses and doctors came from other EU countries, attracted by the UK's well-funded healthcare system. However, with changes to immigration rules and a perceived shift in public opinion, these workers began to dwindle. While official figures show that 61,000 EU nationals were still working in the NHS in March 2023 – albeit slightly fewer than pre-Brexit peaks – international recruitment has become more complex. The NHS now relies on hiring from both within and outside the EU, which requires new strategies to attract and retain staff.
The regulation of medicines was another area where concerns were raised. With the UK's departure from the European Medicines Agency (EMA), the country had to establish its own body, the Medicines and Healthcare products Regulatory Agency (MHRA), to approve new drugs. While the MHRA aims to mirror EMA's swift approval times, there have been worries about potential delays in accessing treatments approved by EMA and the added administrative burden on pharmaceutical companies.
The availability of certain medications has also been affected by changes in customs procedures and supply chains. Although contingency plans have been put in place to mitigate disruptions, some shortages have still occurred. This situation highlights the importance of maintaining smooth relations with European regulatory bodies for a stable supply of life-saving treatments.
Research collaborations are another area where Brexit has had an impact. The UK's participation in Horizon Europe, the EU's flagship research programme, was a contentious issue until a deal was reached in September 2023. Although the hiatus is over, it still took several months for UK researchers to rejoin, which may have slowed the pace of medical breakthroughs and reduced access to shared European expertise.
The economic implications of Brexit are also beginning to affect the NHS. Changes in trade relationships, economic downturns, and inflation can all impact government tax revenues, which in turn dictate NHS funding. The increased cost of imported goods, including medical equipment and supplies, is just one example of how a weaker economy could further strain the NHS.