Public Health Planning for Brexit
Friday, 29 March 2019, the official date for the United Kingdom withdrawal from the European Union is fast approaching. If a deal is reached, there will be a transition period until the end of 2020 with post-Brexit rules taking effect in January 2021. However, with less than 6 months to go, negotiations between Theresa May’s government and the EU are still ongoing raising the spectre of a no-deal Brexit. The Brexit deadline could be extended, but it would require agreement from all 28 EU member states
Breakdown in cooperation between the UK and EU will surely weaken the ability to confront public health challenges on both sides of the channel. Moreover, if predictions prove true, Brexit may trigger several public health crises. Questions remain as to the supply of essential medicines for the UK and the EU if there are disruptions in trade and shipping and with the UK holding EU marketing rights for nearly 700 medicines. Food supply and safety is also a concern with 31% of UK food by value coming from the EU and it is unclear if the UK will be able to access or contribute to EU entities such as the European Food Safety Authority and the European Rapid Alert System for Food and Feed. Meanwhile, within the UK’s National Health Service (NHS), 10% of doctors and 7% of nurses are EU nationals with the largest cities being most dependent on EU staffing. Not least of all, infectious diseases do not acknowledge borders making the UK’s participation and financial investment in the European Centre for Disease Prevention and Control (ECDC) essential for exchanging intelligence and early warning signs on emerging strains of disease, epidemics and other health emergencies.
From an education and research perspective, international students, researchers, academic staff and funding will also be impacted. The UK Government has committed to unchanged tuition and financial support for EU students entering UK schools in 2019 and to underwrite successful bids for some EU programmes such as ERASMUS+ that are submitted before UK withdrawal. However, no such assurances have been made for UK students attending EU universities.
With these and other daunting realities in mind, many public health and healthcare entities are working on their own post-Brexit plans to maintain the best possible health conditions for the European and UK populations. Importantly, the UK Faculty of Public Health (FPH) has released a Blueprint for a post-Brexit relationship between the UK and the ECDC with options for going forward under different Brexit scenarios. The Brexit Health Alliance has been formed bringing together multiple entities including the NHS and public health organizations to safeguard the interests of patients, healthcare and research during Brexit negotiations. The European Medicines Agency, which will be leaving London to relocate to the Netherlands, has issued its own Business Continuity Plan and Brexit-related guidance for companies.
An emergency Brexit Summit is expected in November, which may leave enough time to ratify a deal by March if an agreement is reached. Let the commitment enshrined in Article 168 of the Lisbon Treaty to ensure “a high level of human health protection” help guide negotiations and public health planning in the face of Brexit.
**UPDATE**
5 November 2018
The UK Faculty of Health has recently published their "Response to the Department for International Trade’s Four Consultations on Post-Brexit Trade." The statement was developed as the result of a rapid response on health and trade workshop held 17 October 2018, bringing together 20 leaders from across third sector health organisations including the Brexit Health Alliance, Cancer Research UK, the European Public Health Association, EU legal experts, and Public Health England and Public Health Wales. The document includes a "short list" of prevention areas for investment, ranked in the order by stakeholders:
- A ‘seat at the table’ for the public health sector
- The duty to regulate
- 'Do No Harm'
- The right to health
- A transparent comsultation process
- Health in All Policies
ASPHER has supported the statement along with APHEA and EPHA as well as many UK based health organizations.