A no-deal Brexit could magnify the workforce crisis in social care, drive up demand for hard-pressed services and worsen funding shortfalls in the sector, three health think tanks have warned.
In an open letter to MPs, the Health Foundation, The King’s Fund and the Nuffield Trust gave evidence that a no-deal Brexit could cause “significant harm” to health and social care services and people who rely on them.
They outlined four major areas where the impact could be felt most sharply.
Firstly, there is a “very real risk” that leaving the EU without an agreement could exacerbate the workforce crisis in health and care.
“With 116,000 EU nationals working in health care and 104,000 in social care, even a small trend towards European migrants leaving the UK due to a fall in the pound or uncertainty around being granted settled status will worsen this situation,” the letter says.
The think tanks’ calculations show that 90% of social care staff would not qualify for a permanent work visa under immigration reforms put forward by the last government, as they earn less than the proposed £30,000 salary threshold.
“The risk is magnified because many of the small and medium sized businesses which make up the majority of the sector are already in a perilous financial state,” the letter warns.
The health experts also suggested that a no-deal Brexit will mean UK emigrants to the EU do not have guaranteed rights and they may have to return to the UK to live and receive treatment if they become ill.
Meanwhile, the supply of medicines and medical devices is also expected to be affected by a no-deal Brexit.
“Despite plans for stockpiling and creating new supply routes, the large amount of new paperwork and regulatory hurdles that a no-deal Brexit would create for imports is likely to increase shortages of medicines and medical devices,” the letter says.
Although it is difficult to judge the magnitude of the problem, the think tanks said the leaked Operation Yellowhammer document emphasised the vulnerability of supply chains in the sector.
“We can be certain that these additional burdens will mean companies face higher costs to get their products into the UK – costs that will ultimately be passed on to the NHS,” they warned.
A no-deal Brexit is also likely stretch the public finances which pay for health and social care, the letter warns.
The think tanks cited the Office for Budget Responsibility’s assessment of the UK’s public finances, which says they would be around £30bn worse off each year in a no-deal scenario of medium disruptiveness.
This sum is more than the total spent on adult social care, plus investment in NHS buildings and equipment across the whole of the UK in 2017/18.
“Health and care services are already struggling to meet rising demand for services and maintain standards of care, not least in advance of an expected difficult winter,” the think tanks said.
“The potential consequences of a no-deal Brexit could significantly impede services’ ability to meet the needs of the individual patients and service users who rely on them.”