UK: Health and Brexit: six years on, 2023, McCarey et al

[CRG]

Nuffield Trust

Health and Brexit: six years on

Martha McCarey, Mark Dayan, Holly Jarman, Professor Tamara Hervey, Nick Fahy, Dan Bristow, Prof Scott L Greer

The referendum vote for the UK to leave the European Union in June 2016 marked a watershed in the country’s relations to its neighbours, changing relationships, rules, and the flow of goods and people.

This project, supported by the Health Foundation, monitors the ongoing effects of that EU exit on the health care system in the UK and the people, goods and resources that it relies on. Having previously looked at the issues following the UK’s fitful negotiation of exit and trade agreements with the European Union, this major 2022 update looks back to consider the impact of Brexit on health to date in total across three major areas: workforce, medicines, and the economy.

https://www.nuffieldtrust.org.uk/research/health-and-brexit-six-years-on

Full report pdf: https://www.nuffieldtrust.org.uk/files/2022-12/1671199514-health-and-brexit-web.pdf

 

[CRG]

 

[Shadrach Loom]

It’s going to be very difficult to discuss this without infringing on rule 12, but a) everything here was foreseeable in 2016 and b) very little of it is reversible without FOM.

 

[Trish]

FOM.

Freedom of movement?

 

[Shadrach Loom]

Freedom of movement?

Yes.

There are all sorts of fudge which could allow us to work well with the massive labour pool on our doorstep, from EFTA to something bespoke, but they all require that pillar of the single market which focus groups tell politicians would “play badly in the red wall”.

And this is all directly relevant to the NHS staffing crisis, as it hardly takes Nuffield to point out.

 

[CRG]

It’s going to be very difficult to discuss this without infringing on rule 12, but a) everything here was foreseeable in 2016 and b) very little of it is reversible without FOM.

I thought it was important as background detail - similar to the issue if health funding - even if the political aspects are off limits, we can't sensibly discuss better outcomes for ME/CFS in the UK without acknowledging the problems affecting the whole health sector i.e lack of money, lack of facilities and lack of staff, and having some sense about why all that is happening.

 

[Kitty]

There are all sorts of fudge which could allow us to work well with the massive labour pool on our doorstep, from EFTA to something bespoke, but they all require that pillar of the single market which focus groups tell politicians would “play badly in the red wall”.

True, but there are also the options of making care a more attractive option by offering workers formal training and career progression, and establishing an NHS-like pay framework that recognises their skills; and by making it feasible for family members to choose to provide care themselves if they want, by offering a more workable care allowance.

I don't think for a moment either will happen in the near future, whoever is in government, but arguably it's a better solution than importing and exploiting cheap labour. I've no problem at all with FOM, I just worry about using it as a short term sticking plaster for structural issues that need to be addressed if we're going to have a functioning health and care system for the longer term.

 

[Shadrach Loom]

True, but there are also the options of making care a more attractive option by offering workers formal training and career progression, and establishing an NHS-like pay framework that recognises their skills; and by making it feasible for family members to choose to provide care themselves if they want, by offering a more workable care allowance.

I don't think for a moment either will happen in the near future, whoever is in government, but arguably it's a better solution than importing and exploiting cheap labour. I've no problem at all with FOM, I just worry about using it as a short term sticking plaster for structural issues that need to be addressed if we're going to have a functioning health and care system for the longer term.

Everything in the first para sounds good, and I agree that labour arbitrage isn’t a panacea, but it’s not necessarily a short term or exploitative solution. Other countries (including some EU member states) have demographic cohort bulges that complement (as opposed to mirroring) ours, and I don’t see how we can simultaneously generate wealth and care for the retired without flexible, low-friction immigration.