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• Read the conclusions and recommendation
• Read the full report: Brexit and health and social care—people & process

Background

The UK's withdrawal from the European Union—"Brexit"—will affect many aspects of the provision of health and social care in the United Kingdom. Given the range and complexity of the questions involved, we took evidence in advance of the triggering of Article 50 of the Treaty on European Union (TEU). This report was intended to be the first phase of our inquiry, addressing the immediate. Further phases of our inquiry have necessarily been cut short by the general election but we hope that our successor committee will return to this issue. 

Preparations and departmental resource

We have also considered the process and preparations being made by the Department of Health in advance of the Brexit negotiations. We urge the Department of Health to produce a comprehensive list of those issues that will require contingency planning.

Our concerns extend to the resource dedicated by the Department of Health to preparation and negotiation and we would urge the Department to ensure that it has sufficient staff working on the process of Brexit. Furthermore, we also believe the Government should consult more widely with external stakeholders and the devolved administrations.

Many of the issues relevant to health and social care that will require negotiation do not fit neatly into the EU’s legal definition of ‘health’ policy. We urge the government to put fundamental health concerns front and centre of the British negotiating priorities. The Government should clarify the expertise of the negotiating team and, whenever health issues are being discussed, it is vital that ministers or officials from the Department of Health should form part of the UK representation in negotiations with the EU.

Workforce

Over sixty thousand people from EU countries outside the UK work in the English NHS and around ninety thousand in adult social care. Post-Brexit we will continue to need, and benefit from the presence of EU staff in health and social care.

The impact of Brexit on the morale of R-EU (the remaining 27 members of the European Union) staff is concerning and the uncertainty they face is unwelcome. Difficulties in negotiating the process of applying for permanent residency in the UK and bureaucratic hurdles such as the requirement for Comprehensive Sickness Insurance all add to the concerns of EU workers and their families.

The Government's plan for our post-Brexit future should both ensure that health and social care providers can retain and recruit the brightest and best from all parts of the globe and that the value of the contribution of lower paid health and social workers is recognised.

We wish to make clear the value that we as a Committee place on the health and social care workforce from R-EU nations.

We welcome the opportunity for the UK to negotiate a more pragmatic approach to the mutual recognition of professional qualifications directive within the British regulatory model and we make recommendations about how that might be achieved.

Reciprocal healthcare

The impact Brexit will have on people who rely on the EU's reciprocal healthcare arrangements should not be underestimated. Not only would travellers and holiday makers potentially lose cheap and easily accessible care provided under the European Health Insurance Card, we heard in evidence that retired British citizens in the EU, disabled people, and people with multiple conditions could face particular challenges.

The Government wishes to maintain the arrangements largely as they operate at present but no guarantee can be provided that this will happen. Consequently people both here and in the EU face uncertainty about their future healthcare arrangements.

We welcome the Government's signal that they wish to prioritise and resolve the existing rights of all R-EU nationals resident in the UK and UK nationals resident in the R-EU. We call on both sides of the negotiation to prioritise and resolve this matter at the earliest opportunity.