All forms of Brexit will negatively impact the NHS, with a no-deal Brexit presenting the worst scenario, according to a new health policy review published in the Lancet.
In the analysis, experts in public health and law have reviewed available legal and political texts on four Brexit scenarios to assess the likely impact on 15 specific aspects of the NHS.
The four scenarios are: a no-deal Brexit; the Withdrawal Agreement including a transition agreement until the end of 2020; the Northern Ireland Protocol's Backstop; and the Political Declaration on the Future Relationship between the UK and EU.
Recruitment and retention of healthcare workers represents a major challenge post-Brexit, the authors say. The Withdrawal Agreement provides reciprocal arrangements and mutual recognition of professional qualifications up to 2020. But, no provisions for healthcare workers have been made in the Backstop or Political Declaration. And, under a no-deal Brexit, the Immigration White Paper proposes a minimum salary threshold of £30,000 per year, which could seriously limit immigration, they say.
Access to capital financing for NHS infrastructure via the European Investment Bank would be negatively impacted in all scenarios. The authors point out that the UK has already seen a slower rate of economic growth than if it had remained in the EU.
Co-author, Professor Martin Mc Kee from the London School of Hygiene & Tropical Medicine said: "Some people will dismiss our analysis as ‘Project Fear’. But with just over a month to go to Brexit, we need to move beyond slogans. We have set out the problems in detail, based on the best available evidence. If others disagree, then they owe it to the British people to say why. It just isn't good enough to keep saying that something will work out without any details of exactly how."