Intended for healthcare professionals


Brexit and health in Ireland: Doctors’ concerns about crossborder care

BMJ 2018; 362 doi: (Published 21 September 2018) Cite this as: BMJ 2018;362:k3941
  1. Niamh Griffin, journalist
  1. Dublin, Republic of Ireland
  1. niamh.griffin21{at}

As the Irish border problem continues to hamper EU negotiations, GPs, hospitals, and medical educators are trying to work out what will happen to patients and doctors where Northern Ireland meets the neighbouring Republic. Niamh Griffin reports

A GP in Northern Ireland (NI) turns to a map in his surgery to explain how Brexit could impact on his patients. To reach his practice they travel in and out of the neighbouring Republic of Ireland (ROI)—easily done now, but no one is sure what next year holds.

On 29 March the UK leaves the European Union and, with just six months to go, doctors working in Northern Ireland and along the border say they are not sure what this means for their work or their patients. Endless discussions about hard versus soft Brexit have an increased urgency when a land border with the EU is, sometimes literally, on your doorstep.

The border runs, in a looping movement, from east to west across the island of Ireland, dividing towns, streets, and even diving into the River Foyle.

A drive along the border is soundtracked by the ping of mobile phones as the connection moves between two systems. The satellite navigation system gives directions in kilometres while driving past signs marked in miles. Locals carry both euros and sterling, and some petrol stations offer currency exchange. In Strabane town, Ulster Bank offers two ATMs—one for euros and one for sterling.

In the midst of this, cardiologists in Belfast send children to Dublin through the All-Island network, and oncologists in Donegal (ROI) send patients to Altnagelvin (NI) for radiology imaging. Patients on public waiting lists on both sides of the border benefit from EU rules allowing them to receive their treatment in a foreign, private hospital that may be minutes from home.

Along the …

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