How will Brexit affect the healthcare workforce? (BMJ)

Dhillon Hirani
January 5, 2021

It is estimated that around 5.5% of staff in the NHS are from the EU, and this figure has remained fairly constant in recent years. If we split this data up, the percentage of doctors from the EU has increased (albeit it at a lower rate compared to overseas doctors) whereas the percentage of EU nurses and health visitors in NHS England has actually decreased over the last couple of years.

Despite the detailed negotiations regarding how we leave the EU, any form of Brexit would discourage professionals from emigrating from the EU to the UK due to the uncertainty over Brexit’s impact on taxation, pensions and long-term residency for migrants.

Food for Thought

The key effects of Brexit on the NHS workforce include:

A points-based system – This means that immigrants will have to meet certain entry criteria (such as ability to speak English and additional qualifications) to qualify to enter the UK. This is an idea that has been adopted from other nations such as Australia. This may not affect healthcare workers but could drastically impact care workers. If it becomes more difficult for care workers from the EU to work for the NHS, what impact may this have on patients? What is the relationship between social care and health care in the UK? 

A hostile environment - There is a good chance that potential migrants from the EU may consider moving to the UK to be too expensive and difficult. The UK has not been the most welcoming place to migrants, and the Brexit changes may mean incoming doctors have to pay significant fees to work for the NHS. Beyond that, it may be difficult for migrants to secure entry into the country for their families - and even then, their partners and children may have difficulty obtaining work and accessing healthcare and education. For many potential migrants, these factors may be enough to turn them away from the UK.

Unrecognition of qualifications
– The UK will continue to automatically recognise European (EEA) qualifications for up to two years after Brexit begins, but there is no guarantee beyond this. There is a possibility that after the two years, it will be treated the same as other international qualifications.

Practice Interview QUestions

1.    How could a points-based system affect the quality and size of the future NHS workforce?

2.    What impact do you think Brexit may have on the standard of patient care in the NHS?

3.    How could we encourage more skilled EU healthcare workers to work in a post-Brexit NHS?

Extra Reading (optional)

Brexit is a complex issue and will have many implications on the NHS and how it is run. This article only focuses on how Brexit affects the workforce of the NHS. There are also other similar articles from the BMJ on how Brexit will impact:

- Medicine supplies: https://www.bmj.com/content/371/bmj.m4303

- Patient care and medical research: https://www.bmj.com/content/371/bmj.m4380