On 25 November, leaders of the EU27 approved the texts of the Withdrawal Agreement setting out the terms of the divorce deal, and the political declaration setting out the framework for the future relationship between the EU and the UK. The UK Parliament was expected to vote on the deal on 11 December, but the Government has now postponed the vote until later date, yet to be confirmed.
Many of the key issues which the Brexit Health Alliance has raised are addressed at least to a degree in the Withdrawal Agreement, and this is welcome. The headline messages for the health and social care sector are as follows:
- The agreement avoids a no-deal cliff-edge, confirming that a transition period will be in place until the end of 2020, during which time the details of the future relationship will be finalised.
- It guarantees the rights of UK citizens (including reciprocal and cross-border healthcare) in the EU and vice-versa during transition, but without guarantees as to what will happen after the transition period ends.
- Free movement will end, the UK government has stated that the future immigration system will based on skills, not on where the person comes from.
- There will be appropriate arrangements in the future relationship for reciprocal professional qualifications.
- In terms of supply chains of medicines and medical equipment, there will be a single customs territory between the EU and UK, no tariffs on goods, and deep regulatory co-operation during the transition period. This should avoid Brexit-related shortages and supply chain difficulties after 29 March 2019.
- Goods licensed / authorised before the transition period can continue to be circulated in the EU.
- Data sharing will continue during the transition, with an intention to have a future agreement in place by the end of the transition period.
- The political declaration talks about continued co-operation on health security and participation in programmes such as science and innovation.
- The backstop of the UK and Northern Ireland remaining in a single customs territory will persist until an alternative arrangement, agreed by an independent panel from both the UK and EU, is in place.
Once approved by both the UK and EU Parliaments, the Withdrawal Agreement would then allow negotiations to begin in earnest on the details of the future relationship. Until then, the possibility of a no-deal remains, with concerning consequences for patients.
Following agreement between the EU and the UK on the terms of the Withdrawal Agreement (WA) - which remains to be ratified by both parties - the European Commission has published a Question and Answer text on the rights of EU and UK citizens as they are outlined in the WA.
The text includes information on:
- who will be covered by the Agreement, with real-life examples
- what residency conditions must be met to be covered by the Withdrawal Agreement
- how will family members be treated
- how will citizens' rights contained within the Withdrawal Agreement be monitored post-Brexit - will the European Court of Justice have competence
- how will freedom of movement be handled during the transition period
- will the mutual recognition of professional qualifications continue under the Withdrawal Agreement
- how will social security rules be handled under the Withdrawal Agreement and what will be the status of the European Health Insurance Card (EHIC)
Technical notices from UK government
The government has published several in a series of papers setting out how the UK plans to deal with a range of issues, including health, in the event that we leave the EU in March 2019 without an agreement.
The papers stress that both the UK and EU are working hard to negotiate a positive deal and that no-deal is unlikely. However they recognise that until they can be certain of the outcome of negotiations, they have a duty to prepare for all eventualities, however unlikely, to ensure business continuity.
Here we examine at the papers in more detail. Responding to the guidance, Niall Dickson, co-chair of the Brexit Health Alliance, said:
"What we need is a categorical assurance that patients will continue to get the medicines and treatment they need, no matter what happens in the negotiations. This guidance is a first step, but only a first step, towards that". Read the full response from the Brexit Health Alliance.
Government publishes its white paper on future relationship
The government has published its long-awaited white paper on how it sees the future relationship between the UK and the EU post-Brexit. Read our analysis of the white paper.
In response, Niall Dickson, co-chair of the Brexit Health Alliance, welcomed the government's commitment to maintaining the highest standards of health protection after the UK leaves the EU, but pointed out that "we should be under no illusions of the consequences for patients if we fail to plan properly and do not reach a good agreement". Read the full response from the Brexit Health Alliance.