ANN ARBOR—A no-deal Brexit would make it harder for the United Kingdom to recruit health workers into their system, would jeopardize continuing care for British citizens with pre-existing conditions living outside the U.K., and could even lead to an increase in cardiovascular disease-related deaths, say researchers.

Researchers from the University of Michigan and Oxford University looked at what effects four different Brexit scenarios would have on health services in the U.K.

Holly Jarman.

“Under all of the scenarios we examined, Brexit has significant, negative consequences for Britain’s health,” said Holly Jarman, assistant professor at the U-M School of Public Health. “Remaining in the EU is still the best option in terms of health outcomes.”

But of all four Brexit scenarios, a no-deal Brexit would have the greatest negative impact on health, Jarman said.

“We predict that the political and economic disruption from a no-deal Brexit would be detrimental to the U.K. National Health Service and the health of people who depend on the NHS for care and support,” she said.

The four scenarios the researchers looked at include:

• No-deal Brexit: If there is no withdrawal agreement by March 29, European Union law and agreements stop working immediately.
• Withdrawal Agreement: A legal agreement for a transitional period lasting until December 2020 during which EU law continues to apply in the U.K. until the end of this transition.
• Northern Ireland Protocol’s “Backstop”: A binding part of the agreement focusing on all trade in products between the U.K. and EU
• Political Declaration on the Future Relationship between U.K. and EU: A political text that points to a free trade agreement similar to the EU-Canada agreement but lacks details on how the changes would be implemented.

Figure: Impact of four different Brexit scenarios. Courtesy: The Lancet

Jarman said that yesterday’s opinion by U.K. Attorney General Geoffrey Cox shows that Prime Minister Theresa May’s new withdrawal agreement is little different than the original. The withdrawal agreement would provide the legal continuity needed to ensure supplies of medicines and medical devices.

Brexit is being treated as a political game by those in positions of power.

Holly Jarman

NHS Trusts would still have the option of sending patients for treatment in the EU to cope with long waiting times. But the U.K. would also become a “rule-taker” in Europe, meaning that British officials would lose almost all influence over future EU decisions affecting health.

“Brexit is being treated as a political game by those in positions of power,” Jarman said. “But the consequences of crashing out of the EU without a deal would fall on ordinary people whose lives depend on a consistent supply of medicines or properly staffed NHS care. In the longer term, the impact of Brexit on the U.K. food supply or levels of air pollution could lead us to live less healthy lives.”

The study is published in The Lancet.

More information:

• Study: How will Brexit affect health services in the UK? An updated evaluation
• Holly Jarman