Protecting the Welsh NHS in a post-Brexit world

Health Impact Assessments (HIAs) have been carried out in Wales for over two decades. In 2017, Wales was the first country in the world to place a statutory requirement on public bodies to conduct them.

HIAs act as a pre-decision assessment tool of taking health into account as part of decision making and planning processes. Any policy that has a national or major significance, or which have a significant effect at the local level on public health, is examined through the lens of an HIA. They act as an opportunity to integrate health and wellbeing by ensuring policies, programmes and services maximise health benefits, minimise harm and reduce health inequalities. 

In 2019 Public Health Wales NHS Trust (PHW) published two HIAs examining one of the key political debates in a generation: Brexit. The reports were aimed to inform key decision makers in Wales to prepare for the potential population health and wellbeing impacts that may occur from the UK leaving the European Union (EU). They examined both positive or negative impacts as well as the likelihood, severity of the impact and what mitigation measures needed to be in place.

Brexit has presented a significant challenge due to the complexity of untangling nearly 50 years of laws that have shaped the standards of public and environmental health.  And its path so far has not been easy. Since the referendum in June 2016, there have been three Prime Ministers, turbulence in the negotiation process which has resulted in three delays of the UK exiting the EU, not to mention a pandemic that has required a global response.

Despite all that has happened since the referendum, the UK Government has confirmed the Transition Period will come to an end on 31 December 2020.  The health and care system in Wales and across the UK, is now juggling preparing for the end of the Transition Period, responding to COVID-19 during winter, an upcoming Senedd election in May 2021, and many other issues that were present before anyone even heard of Brexit or COVID-19.

The Welsh NHS, both in terms of its services and the people who work in health and care that make everything possible, is under significant pressure. But what is carrying the system through this storm is the fundamental drive to utterly embed the protection and enhancement of health and wellbeing for the people of Wales. Whatever the outcome is when we ring in 2021, the Welsh NHS will use its world-leading expertise in health in all policies approach to protect patients and the service. As members of the Brexit Health Alliance and the Cavendish Coalition, we at the Welsh NHS Confederation will continue to ensure our member’s views are heard at a UK level and press the case for an EU Transition deal that will ensure health and wellbeing are considered at every step along the way.

Brexit and COVID-19 have combined to be the biggest challenge the NHS has faced. But through our ability and commitment to protect health and wellbeing through everything we do, the health and care system in Wales will embrace any positives and mitigate any negatives to protect a service which is central to the identity of Wales and the UK.