The Brexit point of no return: what does this mean for health?

The UK’s transition period will come to an end on 31 December 2020 and from 2021, we will cooperate with the EU on the basis of a future relationship agreement. The deadline for extension came and went on 30 June and there are no more official opportunities to change the timeline.

On what the current Brexit status means for health, the negotiations have not yet provided many answers. However, a group of prominent academics working in this area recently provided a useful assessment of the potential impact on health of the UK’s future relationship agreement with the EU based on each side’s stated negotiating positions. In addition, this week the government published the UK Research and Development Roadmap, confirming the ambition to maintain a ‘close and friendly relationship’ with European partners and to participate in the next generation of European research and innovation programmes starting in 2021, such as Horizon. The terms of the UK’s participation will depend on success of the ongoing negotiations.

The good news is that the UK-EU talks have recently seen renewed intensity. On 15 June the PM held high-level talks with EU leaders to take stock of progress and in a joint statement, both sides agreed new momentum was required to speed up agreements. They set out plans for weekly negotiating rounds throughout July and August, with the aim of establishing a set of principles which will underpin any agreement that need to be in place before October this year. These started this week.

Following the call for new momentum in future relationship talks amid the ongoing global COVID-19 pandemic, the Brexit Health Alliance has published a briefing and infographic exploring how the outcome of those negotiations could affect the UK’s ability to manage another pandemic. The briefing states that COVID-19 has provided sharp focus on the implications of the UK’s exit from the EU for protecting the British and European public from cross-border health threats such as infectious diseases.

The briefing says that any agreement would need to provide minimum customs and tariff barriers on importing and exporting medicines and medical equipment, mutual recognition of regulatory standards on items such as PPE and ventilators and continued participation in key EU data-sharing platforms and alert systems to provide maximum preparedness to health threats. It also argues that ultimately the best way to prevent and tackle health threats is to understand them and so continued participation in a Europe-wide medical research system that encourages cooperation and innovation is vital to retain Europe’s reputation as an attractive destination for cutting-edge research.

In an opinion piece published this week, I highlighted how coronavirus has shone an unwelcome spotlight on how health systems will be affected by exiting the EU, but that there is still time to aim for the sort of outcome from the negotiations that lightens our burdens. Victoria Hage, from the Welsh NHS Confederation, also adds a valuable view from the devolved nations’ perspective in her recent blog.

In parallel to talks with the EU, the UK is on a journey to redefine its relationship with rest of the world too. This month saw negotiations on a UK-Japan Free Trade Agreement start and negotiating objectives published for agreements between the UK and Australia and New Zealand. The relationship that has attracted the most attention is a potential UK-US deal, with an essay in the BMJ this month highlighting the implications that trade deals negotiated as the next part of the Brexit process will have for healthcare.

So, what is next? Following the decision not to extend the Brexit transition period deadline, the NHS now has six months to prepare for the impact of the new deal, or no deal. This may seem ample time to reach an agreement but for the NHS it will be a period of unprecedented challenge and recovery from COVID-19 as it navigates a tightrope of pressures on capacity, rehabilitation, workforce and public expectations, to name a few. The NHS Confederation will continue to monitor progress and analyse the implications for patients, staff and the public, and helping ensure these key issues are properly discussed.

Dr Layla McCay is director of international relations at the NHS Confederation. Follow Layla and the Confederation’s European office on Twitter @LaylaMcCay and @NHSConfed_EU