The Vote Leave campaign promised UK citizens that leaving the EU would free up millions of pounds to invest in the NHS – even though many experts warned that this was not true. So, how did Brexit really impact the NHS?
Four years ago, the UK formally left the European Union. Leading up to the Brexit referendum, the Vote Leave campaign heavily focused on the NHS and the benefit leaving the EU would have on it. One of their slogans was “We send the EU £350 million a week. Let’s fund our NHS instead” even though many experts – including the Chair of the UK Statistics Analysis – declared this number to be false. And the strategy of the campaign was effective: It won the referendum and among the people with the worst access to healthcare and worst health, a majority voted to leave. So now, four years later, how has Brexit affected the NHS?
A new comment published in The Lancet examined this question. The authors write that there are two answers, one easy, one difficult. The easy answer is that there is no evidence of the NHS improving since leaving the EU. But the absence of improvement does not automatically mean that Brexit has harmed the NHS. And to answer the question about harm is difficult because one cannot simply compare the state of the NHS before and after Brexit. There have been a lot of factors impacting the health care system that had nothing to do with Brexit: The corona-pandemic, Russia’s invasion into Ukraine and intensifying conflicts in other parts of the world, resulting in a global disruption of supply chains.
It is a fact that life expectancy is dropping in the UK. However, this trend has begun in the early 2010s and has been associated with the imposition of austerity and the additional impact of Brexit is not clear. It is also true that the number of people waiting for NHS hospital treatment has doubled between the referendum in 2016 and October 2023. Furthermore, Doctors are striking, which the authors write is a “marker of deep system failure.” But again, it is difficult to exactly contribute that to role of Brexit.
The relationship is a bit clearer when looking at the funds: The money that came from EU funds, for example to invest in life sciences or to address regional inequalities, have been replaced with much smaller amounts of domestic fundings. As a result, funding remains inadequate to improve health care facilities and equipment and to afford competitive salaries to recruit new professionals.
One impact of Brexit is quite straight-forward: Recruitment of health care workers out of Europe has dropped significantly. Between September 2016 and September 2021, the number of nurses who trained in the EEA and were registered to work in the UK fell by 28 %. However, there was also an increase of health care workers coming from other parts of the world, which more or less balanced out the loss of EEA-workers. But the authors note that this trend is endangered by the government’s plan to reduce net migration. While health care workers will still have it easier to migrate, the constant changes in regulation cause great uncertainty and reduce willingness to move to or stay in the UK.
Besides health care workers, it is also harder for European researchers and students to come to the UK, because of its choice to not join the Erasmus+ programme and the delayed re-entering of the Horizon programme, where the UK will only have limited input. Additionally, not being part of the EU means exclusion of the emergency programmes to combat the supply shortage felt across the world. Indeed, it has been shown that the UK suffered more severely from drug shortage than the EU.
The authors come to a clear conclusion: “Ultimately, Brexit has been a failure from a health perspective.” They advise that the health care crisis will be best solved if the UK moves closer to the EU again. For domestic solutions, they recommend taxing the super-rich to increase NHS-funding, tackling inverse care laws, listening to communities that feel left behind and to implement regulations to better protect people’s health.
Image source: Cosmin Gurau, Unsplash
