An article in the Lancet starts "All forms of Brexit are bad for health, but some are worse than others" It looks a four different scenarios . " ... a No-Deal Brexit under which the UK leaves the EU on March 29, 2019, without any formal agreement on the terms of withdrawal; a Withdrawal Agreement, as negotiated between the UK and EU and awaiting (possible) formal agreement, which provides a transition period until the end of December, 2020; the Northern Ireland Protocol's backstop coming into effect after the end of that period; or the Political Declaration on the Future Relationship between the UK and EU."
It tells us that they have found that, although all forms involve negative consequences for the UK's leadership and governance of health, in both Europe and globally, with questions about the ability of parliament and other stakeholders to scrutinise and oversee government actions a No-Deal Brexit is substantially worse for the NHS than a future involving the Withdrawal Agreement.
It discusses difficulties in recruiting medical staff which they see as the most challenging area. It goes on to illuminate the issues with financing health care, saying "The only aspect of NHS financing after Brexit in which we can expect no change is for reciprocal health care under the Withdrawal Agreement. Obviously even this goes if we are unable to reach a deal and just drop out. It then looks at all other aspects of NHS where, they say, financing is negatively affected under all Leave outcomes.
"Ceasing of this system will have major consequences for older UK residents, especially if they have pre-existing conditions, because insurance cover, which might not be available for those with the most severe conditions, could be extremely expensive." Some other groups will be particularly affected, such as patients on dialysis who benefit from provisions that allow them to receive it in centres in other member states."
They looked at the consensus of economic reports and noted that the outcomes suggested in those reports - of a negative impact on the economy - have been borne out. They point out that forecasting is always difficult but in the case of Brexit is it more so.
"As one of the largest areas of public expenditure, any negative impact on the UK economy will put additional pressure on NHS financing ..."
The paper also looks at other areas which will have an effect on health. Food supply (there was an interview about this on "Today, R4, this morning) because of our overwhelming importing of fresh fruit and vegetables.
"... a modelling study estimated that a No-Deal Brexit could lead to between 6000 and 23 000 excess deaths from cardiovascular disease between 2021 and 2030."
There was a great deal more of course. You can read the article (if you register) here: www.thelancet.com/journals/lancet/article/PIIS0140-6736(19)30425-8/fulltext?fbclid=IwAR3NrFJwWrGUD-P0BZcq51fo9KApsEJdToJvvYI2kPOBkC5n38JzpT0BXJ4
