'Mini-deals' are needed to keep both UK and EU patients safe | Layla McCay

Layla McCay

The Operation Yellowhammer report makes for worrying reading and, despite all the planning for Brexit, we remain concerned that a no-deal Brexit will affect people’s health. Layla McCay, director of international relations at the NHS Confederation, reports on the situation.

While our analysis has long pointed to these risks to health and care, we were concerned to see the Yellowhammer report of 2 August identifying the scale of these risks.

The government assesses that Brexit-related medicines and medical supply will be affected for months due to severe delays at ports. I have been reassured by the extensive contingency plans the government has developed to ensure medicines get to the patients who need them, when they need them. The Yellowhammer report underlines the scale of the challenge and some key variables.

It’s also no surprise to see the uncertainty around healthcare arrangements for UK citizens living in EU countries, with a note that some patients could face ‘substantial costs’. As of right now, there are still no reciprocal healthcare deals between the UK and other EU countries post-Brexit in the case of no deal. 

It is particularly concerning to see the government’s clearly articulated projections of public health risks: reduced availability of fresh foods (especially for low income groups); shortages of animal medicines possibly leading to diseases that impact human health; job losses; and public disorder and community and trader tensions.

And the many NHS leaders already raising concerns about the impact of no-deal Brexit on social care will nevertheless be disturbed to see that as of 2 August the government anticipates the likely increase in inflation could lead to social care provider failure as early as two to three months after Brexit day.

Furthermore, as many NHS leaders have been anticipating, the ability to deliver health and care may be further impeded by fuel distribution problems that could affect patients and staff getting to healthcare facilities, especially in London and the South East, and by an increased demand for care due to seasonal flu.

The report makes for worrying reading. We can only hope that in the weeks since Operation Yellowhammer was written, further contingency plans have been established. My own interactions with the Department of Health and Social Care have seen some improvements in contingencies since then, especially around medicines and medical goods supplies.

However, managing many of the risks identified in the Yellowhammer report depends on both the UK and the EU. As such, we suggest that even in the absence of a deal, agreements can be made to keep both UK and EU patients safe. While the EU has been clear it does not want to enter into ‘mini-deals’, they have already announced technical adjustments of contingency measures for transport (to maintain road and air connectivity) and fishing authorisations. A technical adjustment for health would demonstrate the EU’s commitment to doing everything possible to protect the lives and wellbeing of citizens both in the UK and the rest of Europe. This should include: prioritising the import of medicines, recognising the authorisations of medicines and medical goods, enabling citizens to access healthcare across the UK and EU during the transition, and continued UK participation in key data sharing platforms that protect the public from health threats such as pandemics, unsafe medicines and products, and unsafe practitioners.

In the meantime, it would be helpful to see the most recent version of the report so we can understand where we are now and be reassured that plans are in place to protect patients.

Layla McCay is director of international relations at the NHS Confederation. Follow her on Twitter @LaylaMcCay

This blog first appeared in the HSJ

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