The European Union has never experienced the withdrawal of one of its member states and the EU Treaty does not provide much detail on the process to be followed in this type of event. Here we take a look at what we know about the process and clarify what it means for the NHS.
What is Article 50 of the EU Treaty?
Article 50 of the EU Treaty says that if a member decides to leave the EU, there will be a period of two years for the leave agreement to be conducted, starting from the moment a formal notification is submitted from the government of the member state to the EU. If required, this period of time can be extended.
Michel Barnier, in his first statement on the negotiations, suggested a deadline of October 2018 for a deal to be agreed, giving the European Parliament, European Council and UK Parliament five months to ratify the agreement before the end of the two year period.
Negotiations will be long and complex and the EU has made clear that the UK cannot ‘cherry-pick’ the terms of its new relationship with the EU after Brexit, stressing that the EU's four principles – free movement of goods, services, people and capital – cannot be split up.
Now Article 50 has been triggered, what is the process and timescale for the UK withdrawing from the European Union?
On 29 March 2017, Theresa May, the Prime Minister of the UK, sent a letter to President of the Council of the European Union to inform him of the UK’s intention to leave the EU, and to invoke Article 50.
Until the moment the UK formally leaves the EU, it remains a full member and all EU policy and law will continue to apply. On the morning of the 24 June 2016, the President of the Council of the EU issued a statement saying “I would also like to reassure you that there will be no legal vacuum. Until the United Kingdom formally leaves the European Union, EU law will continue to apply to and within the UK. And by this I mean rights and obligations”.
The rights of EU citizens working in the NHS will be unaffected during this period and NHS employers can continue as before to recruit staff from EU countries. The UK will continue to receive EU funding and be able to participate as partners in the different EU funding programmes.
The UK government has set out plans for a (Great) Repeal Bill to ensure legal continuity on the day the UK leaves the European Union (EU), by incorporating pre-Brexit EU law into UK domestic law. See our briefing for more on the (Great) Repeal Bill.
This European Commission fact sheet on the Article 50 process gives an indication of timescales and key milestones in the process. We have also produced an infographic on key decisions for the NHS during the exit negotiations.
Listen to episode two of our Brexit podcasts which includes an interview with Fabian Zuleeg from the European Policy Centre on the exit negotiation process.
Conduct of negotiations
On 19 June, both the European Commission and the UK Government agreed the terms of reference, which set out the guiding principles for the conduct of the Brexit negotiations.
Negotiations will follow the sequence set out by the EU 27, with terms of the divorce being addressed first - namely citizens rights, agreement on the financial settlement and the border separating Northern Ireland and the Irish Republic - followed by negotiations on the UK's future relationship with the EU, and only when enough progress has been made on the divorce issues.
Each month will see one week of discussions take place, with the time in between being used to exchange and work on proposals. The first full round of talks took place on 17 July.
You can keep up to date with the negotiations via the European Commission's dedicated Article 50 Task Force webpage.
What sort of future relationship is the UK government seeking with the EU post-Brexit and what are the main priorities for the EU?
The Prime Minister set out the 12 principles which will guide the UK Government during its negotiations with the EU on leaving the union. This announcement was followed up by a Government White Paper. Later, in response to the proposal by the European Commission, the UK government has also put forward its proposal on safeguarding the rights of EU citizens. Read our article on potential implications to the NHS.
The EU's main priorities EU are revealed in the negotiating directives. Priorities include; reciprocal rights for EU citizens living in the UK, and UK citizens living in the EU; finding an appropriate financial settlement; prevention of a legal vacuum for businesses; and maintaining the Northern Ireland peace process and resolving the issues of the land border with the EU. There are further EU position papers on the issue of citizen’s rights and the financial settlement available here.
What will be the impact of the UK’s plans to leave the EU on the NHS?
The NHS played a central part in the Remain and Leave campaigns before the EU Referendum. In this blog article, the director of the NHS European Office has considered what lies ahead for the NHS as the UK plans to exit the EU; there is also an article by Elisabetta Zanon published in the Health Service Journal.
We have produced an infographic on the top issues for the NHS related to Brexit and one on the key decisions for the NHS in the Brexit negotiations.
In October 2016, the NHS Confederation issued a response to the Health Select Committee (Commons) inquiry on Brexit and health and social care, where we discuss the key potential impacts and make some recommendations on how to mitigate risks and take advantage of opportunities.
Take a look at some of our other blogs and articles on the potential impact for the NHS:
In July 2017, the Brexit Health Alliance was formed to ensure that patients and the healthcare sector that supports them are in the strongest possible position once the UK leaves the EU. More information on the work and members of the Alliance
What will be the impact on the NHS EU workforce and on recruiting and retaining staff from outside the UK?
Kate Ling from the European Office has produced a blog article on immediate implications for the workforce and what may happen next. There is a highlight on issues such as education, training and on employment regulation, and the Working Time Directive.
The NHS European Office is a member of a coalition of 29 health and social care organisations created to ensure that standards of care are maintained as Britain prepares to withdraw from the EU.
What will be the impact on EU grants for NHS organisations currently involved in EU funding bids?
On 13 August 2016, the Treasury announced guaranteed funding for certain EU funded projects, including Horizon 2020 and the EU Health Programme research projects that continue beyond the point where the UK leaves the EU.
On 18 July 2017, Jo Johnson, UK Minister for Universities, Science, Research and Innovation highlighted the importance of collaboration with European and international partners on major science, research and technology initiatives. He also reaffirmed the parameters of the UK Government’s underwrite of Horizon 2020 funding, in which the Government has committed to underwrite the funding for all successful bids for competitive EU funding made by UK participants that are submitted before the UK leaves the EU. A full transcript of the speech is available on the UK Government’s website.
In terms of charting the future collaboration between the UK and the EU on science and research, this will be part of the negotiations process on the UK’s withdrawal from the EU. Our office responded in writing to the House of Commons Science and Technology Committee on the opportunities and challenges of Brexit.
Will I still be able to use my European Health Insurance Card (EHIC) to access healthcare in the EU?
Until the UK formally leaves the EU, EU law will continue to apply to and within the UK – both in terms of rights and obligations. So there is no immediate impact on UK citizens travelling and living abroad and using the EHIC or for European citizens living in the UK.
What will happen to the European Medicines Agency (EMA) which is based in London?
In February 2017, Secretary of State, Jeremy Hunt, made it clear to the Commons Health Select Committee that an important consequence of leaving the EU single market will be that the UK will no longer be part of the European Medicines Agency (EMA) system.
For two decades, the EMA has overseen medicines regulation across the EU and has granted pharmaceutical companies a single marketing authorisation that provides access across the whole of the EU market. Mr Hunt indicated that while leaving the centralised licensing system for medicines, the UK will seek strong partnership with the EMA, ideally through a form of regulatory equivalence, such as mutual recognition of licences - which he reiterated in a joint letter with Greg Clark, the Business Secretary, to the Times newspaper in July 2017. He was however very clear that this will depend on the outcome of the UK-EU negotiations.
More generally, the relocation process of the EMA has begun. 23 cities have put in bids to host the EMA and the European Council will take a decision on the winning bid in November 2017 in order to give time for an orderly withdrawal.
The EMA has developed a business continuity plan prioritising the Agency’s activities in order ensure that the assessment of medicines is not disrupted and that patients in Europe continue to have access to high quality, safe and effective medicines in the coming months and after the UK’s withdrawal from the EU. It has also produced a ‘Questions and Answers’ document related to the United Kingdom's withdrawal from the European Union with regard to the medicinal products for human and veterinary use. Both documents can be found on the EMA’s dedicated Article 50 page.
Read the statement from the EMA which clarifies that there will be no immediate impact on its work following the UK’s vote to leave the EU.