General debate on the effect of leaving the European Union on the UK’s health and social care sector

This reading list has been prepared by the House of Commons Library for the debate on the effect of leaving the EU on the UK's health and social care sector. This debate will take place in Westminster Hall on Tuesday 19th March 2019 at 9.30am. This subject was determined by the Backbench Business Committee and the debate will be opened by Brendan O'Hara MP.

Library publications

What if there's no Brexit deal?, House of Commons Library Briefing Paper, 8 February 2019

• Section 9 looks at the free movement of people, healthcare, social security and pensions.

Healthcare (International Arrangements) Bill, House of Commons Library Briefing Paper 17 January 2019

• Section 5 covers potential impact on NHS of changes to reciprocal healthcare arrangements.

NHS staff from overseas: statistics, House of Commons Library Briefing Paper, 10 October 2018

Effect on the NHS of the UK leaving the EU, House of Commons Library Debate Pack, 21 March 2018,

• This debate pack outlines background to the issue and has a small further reading selection.

Brexit and medicines regulation, House of Commons Library Briefing Paper, 20 November 2017

Safety of medicines and medicinal devices, House of Lords Library Briefing Paper, 21 February 2019

NHS and Social Care Workforce: Implications of Leaving the European Union, House of Lords Library Briefing Paper, 15 July 2016

Health and Social Care Committee

During the 2015-17 Parliament, the Health and Social Care Committee launched a Brexit and health and social care inquiry. Due to the 2017 election the inquiry was closed but he Committee subsequently published a report on Brexit and health and social care: people & process (HC 640, 28 April 2017). The Government responded in December 2017 and oral and written evidence can be read on the Committee’s website.

The Committee also reported on Brexit: medicines, medical devices and substances of human origin (HC392, 21 March 2018), with the Government responding in May 2018.

The Committee held a one-off evidence session on the impact of a no-deal Brexit on health and social care on 23 October 2018, and received written evidence on the subject.

Brexit was also considered in Health and Social Care Committee evidence sessions on the Budget and the NHS Long Term Plan in January 2019.

Official Publications

Planning for a possible no-deal EU Exit: information for the health and care sector, Department of Health and Social Care, updated 14 March 2019

• Guidance for industry and organisations involved in health and care about contingency plans for a no-deal Brexit, including advice regarding continuity of supply of medicines and medical devices.

Brexit operational readiness guidance for the health and care system in England, Department of Health and Social Care, 21 December 2018. (The guidance was published alongside 2 letters to commissioners and providers of adult social care. The Brexit Health Alliance, which brings together NHS, medical research, industry, patients and public health organisations, also issued a statement on the guidance).

Preparing for EU Exit, NHS England, accessed 15 March 2019

Medicines, NHS England, accessed 15 March 2019

Migration Advisory Committee (MAC) report: EEA migration, 18 September 2018, Migration Advisory Committee

• Chapter five looks at the Public Service impact of migration from the European Economic Area.

Further reading

Brexit: the implications for health and social care, King’s Fund, 22 February 2019

Nick Fahy et al. How will Brexit affect health services in the UK? An updated evaluation, Lancet, Volume 393, Issue 10174, 2–8 March 2019, Pages 949-958

• An article looking at several different scenarios and their potential impact.
• The earlier version was published in September 2017.

Mark Dyan, Hard facts about a soft Brexit and the NHS, [Blog post] Nuffield Trust, February 2019

Kitty Stewart, Kerris Cooper and Isabel Shutes, What does Brexit mean for social policy in the UK? London School of Economics and Political Science, February 2019

What the Brexit withdrawal agreement means for the NHS, Nuffield Trust, December 2018

Patient access to medical research, Brexit Health Alliance, December 2018

Brexit and the Health & Social Care Workforce in the UK, National Institute of Economic and Social Research, November 2018

• This was prepared for the Cavendish Coalition. This is a group of 36 health and social care organisations. More information about this group can be found here.

John Appleby, Mark Dyan, Causes of concern for the NHS after Brexit, BMJ, 14 November 2018

Nigel Hawkes et al. Braced for Brexit, BMJ, 14 November 2018

• An article about access to drugs and treatment for rare diseases.

Brexit implications for health and care, NHS European Office/NHS Confederation, 6 November 2018

Brexit risks putting social care on the critical list [Blog post], National Institute of Economic and Social Research, 6 November 2018

NHS Trust contingency planning in the event of a no deal Brexit, NHS Providers, November 2018

Fair care: A workforce strategy for social care, IPPR, November 2018

Gemma Tetlow and Alex Stojanovic, Understanding the economic impact of Brexit, Institute for Government, October 2018

• The authors of this report talk about the impact on the services sector, including health and care services, on pages 52-3.

The state of the adult social care sector and workforce in England, Skills for Care, September 2018

BREXIT BRIEFING: A health service under threat: the dangers of a ‘no deal’ Brexit, BMA, 2018

Brexit: RCN priorities overview, Royal College of Nursing, 7 March 2019

Professor Amelia Hadfield and Professor Mark Hammond, Kent and Medway: Health And Social Care: A Brexit Impact Assessment, Centre for European Studies/Canterbury Christ Church University, March 2018

• An in-depth case study in a particular region.

Brexit and the NHS, The UK in a Changing Europe, March 2018

The Impact of Brexit on the NHS: Cure or Disease? [Blog post], University of Aberdeen, 21 February 2018

Brexit and the impact on patient access to medicines and medical technologies, Brexit Health Alliance, January 2018

Policies for healthy lives: a look beyond Brexit, Health Foundation, January 2018

Moriarty, J., Manthorpe, J., & Harris, J. (2018). Recruitment and retention in adult social care services. Social Care Workforce Research Unit, King's College London.

• As well as looking at general issues, pages 23-26 consider the impact of EU withdrawal.

The Brexit effect, Nursing in Practice, 24 July 2017

• An article about the impact of the Brexit vote on the number of EU nurses joining the register.

Mark Dayan, Getting a Brexit deal that works for the NHS, Nuffield Trust, 31 May 2017

McIntosh B and West S (2017) Brexit: the consequences and impact on the health sector. British journal of healthcare management. 23(4) 154-157.

Nick Fahy and Tamara Hervey, What does Brexit mean for health in the UK? Eurohealth incorporating Euro Observer — Vol.23 | No.1 | 2017, pp.24-26

Care in a post-Brexit climate, IPPR, February 2017

• The authors of this report talk particularly about the challenges faced by the care workforce, given a reliance on migrant labour.

Victoria L. Simpkin and Elias Mossialos, Brexit and the NHS: challenges, uncertainties and opportunities, Health Policy, 2017

Devolved administrations

Jean V. McHale et al., The NHS and Health Law Post Brexit: Views from Stakeholders and the Devolved Jurisdictions, University of Birmingham, 2018

Scotland

Preparing for Brexit, Scottish Government, 18 December 2018

The Scottish Parliament launched an inquiry in 2017 on the Impact of leaving the European Union on health and social care in Scotland. You can read evidence taken so far on the Health and Sport Committee’s website. Its report, The impact of leaving the European Union on health and social care in Scotland (SP Paper 314) was published in May 2018.

The Scottish Parliament Information Centre (SPICe) also published, in January 2018, a briefing paper on Leaving the EU - Implications for Health and Social Care.

Contingency Planning for Health and Social Care in the event of a ‘No-deal’ Brexit, The Scottish Parliament Information Centre (SPICe) ‘Insight’ [Blog post] 5 December 2018

‘No-deal’ EU exit preparations – The regulation of medicines, clinical trials and medical devices, The Scottish Parliament Information Centre (SPICe) ‘Insight’ [Blog post] 5 December 2018

Wales

Preparing Wales: Health and social services, Welsh Government, accessed 15 March 2019

Managing Brexit / EU withdrawal in health and social care in Wales: Frequently asked questions, Welsh NHS Confederation, last updated 27 February 2019

Briefing for Assembly Members for the debate on the External Affairs and Additional Legislation Committee reports on Brexit Preparedness, Welsh NHS Confederation, 25 January 2019

The Public Health Implications of Brexit in Wales: A Health Impact Assessment Approach, Public Health Wales, January 2019

Preparing for Brexit - Report on the preparedness of the healthcare and medicines sector in Wales, National Assembly for Wales External Affairs and Additional Legislation Committee, November 2018

Brexit. The impact on health and healthcare in Wales, Academy of Medical Royal Colleges Wales, 13 September 2018

The key issues for health and social care organisations as the UK prepares to leave the European Union, Welsh NHS Confederation, June 2018

Northern Ireland

The Department of Health has a website dedicated to EU Exit. The Northern Ireland Assembly Research and Information Service (RaISe) has a website which collates Brexit related publications. This includes a recently updated reading list on Brexit and Northern Ireland, some of which convers Health and Social Care.

How Brexit could affect the health service in Northern Ireland [Blog post], Nuffield Trust, 6 February 2018