In a report analysing the impact of Britain leaving the EU on the NHS, the Nuffield Trust said the main increase in costs would come from British pensioners currently living in other EU countries returning to the UK if their right to healthcare in those countries was withdrawn.
The report also warns that social care is facing a shortfall of up to 70,000 staff by 2025/26 if migration of unskilled EU workers is stopped after Brexit, while the NHS could face a serious shortage of nurses.
If the UK leaves the EU’s medicine licensing system, the NHS could incur extra costs of over £100m if it was unable to secure medicines at similar low prices.
The Nuffield Trust does concede that there could be some upsides to Brexit for the NHS. ‘While the £350m figure used during the EU referendum is a myth, there is the scope for a significant funding boost when the UK stops paying its EU membership fees, which could give the NHS enough additional money for one or two years,’ the report says.
There are around 190,000 British pensioners living in other EU countries who receive healthcare under the EU reciprocal S1 scheme. The UK currently pays around £500m into the scheme, however the Nuffield Trust estimated that the actual cost to the NHS of treating these people if they returned to the UK would be around £979m. The NHS would also need around 900 extra hospital beds to meet this demand.
‘Every step should be taken to try to secure a deal that allows them to keep receiving care where they now live,’ the report said.
To avoid a staffing crisis in social care, either substantial migration of staff from the EU will have to continue post-Brexit, or wages in UK care homes and agencies may need to rise to attract more people from the UK to work in the sector, the Nuffield Trust said.
Almost a third of nurses who registered in the UK last year had trained in the EEA, the report notes. If the NHS is to avoid a serious shortage of nurses ‘there must be a commitment either to continue to allow substantial nurse migration after Brexit, or to step up domestic training, even if this proves more difficult and more expensive than current policies anticipate’.
Mark Dayan, Nuffield Trust policy and public affairs analyst, said: ‘If we handle it badly, leaving the EU could make [funding and staffing] problems even worse, given the potential impact on both the strength of the UK economy and the supply of overseas staff to both health and social care services.
‘It is possible that extra funds could be found for the NHS from any cancellation of Britain’s EU membership fees – but whether or not these benefits will outweigh the significant staffing and financial costs Brexit may impose on already stretched services remains to be seen.
‘That depends largely on the NHS being recognised as a significant priority as we enter some of the most important negotiations in Britain’s history.’
BMA chair Dr Mark Porter said: ‘These figures are a stark reminder that with the NHS at breaking point, politicians must keep the health service and its patients at the forefront during Brexit negotiations and reduce the impact that leaving the EU will have on health and social care across the UK.’