Brexit could cost NHS millions of pounds, says think-tank

31 May 17

The NHS could face a bill of £500m and staff shortfalls of 70,000 thanks to Brexit, The Nuffield Trust has warned.

The health think-tank made the calculations based on the prospect of retired British expats living in the EU returning to the UK in the event their healthcare was withdrawn because of Brexit.

More than 190,000 British pensioners live in other EU countries and receive healthcare under the EU reciprocal S1 scheme.

If they decide to return to the UK, in the event that this benefit is withdrawn after Brexit, then the cost to the NHS is likely to be around £979m.

Currently the UK pays £500m into the EU S1 scheme, to help cover care costs, meaning the NHS will have to find another £500m to cover the total costs if the expats returned.

The UK benefits more from S1 scheme than some other countries because EU migrants who settle here are usually of working age and pay taxes.

This figure could be substantially higher if the NHS has to pay to replace staff if EU migration is reduced, or if it faces a rise in the cost of medicines.

A shortfall of 70,000 staff in care home and home-care agencies could emerge by 2025/26 if migration of unskilled workers is prohibited, the Nuffield Trust calculated. 

Health secretary Jeremy Hunt told the i newspaper on Monday his plans for increased NHS investment and staffing depended on securing a good Brexit deal for the UK.

Speaking in his South West Surrey constituency, Hunt said: “Everyone cares passionately about the NHS.

"They also know there’s not a magic money tree and in the end the Brexit negotiations will determine whether our economy stays strong and we can carry on putting more money into the NHS, which is what people want.”

Hunt said he had drafted in around 200 new officials to work on Brexit negotiations for the Department of Health, including on the future of the European Health Insurance Card.

Today’s Nuffield Trust report follows the release of Office for National Statistics figures, which showed that net migration fell by 84,000 last year to 248,000, fuelled by the “statistically significant” departure of EU citizens.

Of the 339,000 people who left the UK in 2016 117,000 were from the EU, up 31,000 from 2015.

Mark Dayan, Nuffield Trust policy and public affairs analyst, said: “The NHS and social care were already under pressure from tight funding settlements and growing staffing problems well before the EU referendum last year. 

“But if we handle it badly, leaving the EU could make these 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.”

Today’s report argues that either substantial migration care home staff from the EU will have to continue after Brexit, or wages in UK care homes and homecare agencies may need to rise – to compete with pay in the retail sector -  to attract more home-grown staff.

Currently there are 22,000 EU-born nurses in the NHS and last year a third of newly-registered nurses in the UK had trained in the European Economic Area.

Dayan said it was possible for extra funding to be directed to the health service from any cancellation of Britain’s EU membership fees but he questioned whether these benefits would outweigh the significant staffing and financial costs Brexit may impose on already stretched services remains.

During the referendum on EU membership, leave campaigners argued that up to £350m a week, which is currently spent by the government on EU membership, could be redirected to the NHS.

He called on whichever government is negotiating the Brexit deal to make the NHS a “significant priority”.

Responding to today’s report, Liberal Democrat Leader Tim Farron, said it showed the government’s approach would be a “disaster” for the health service.

"Crashing out of the EU without a deal would mean the loss of healthcare rights for British pensioners in Europe, putting huge pressure on our hospitals,” he said.

Adding: "We risk seeing nurses and social care workers from the EU leaving in their droves because Theresa May won't do the right thing and guarantee their right to stay.”

Find here a special collection of articles for PF from experts on the far-reaching implications of Brexit for central and local government and across the public sector.

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