Intended for healthcare professionals

Head To Head

Could Brexit harm the NHS?

BMJ 2018; 362 doi: (Published 26 September 2018) Cite this as: BMJ 2018;362:k4014

Linked commentary

Patients shouldn’t have to worry about an unhealthy Brexit

  1. Anand Menon, director, UK in a Changing Europe1,
  2. Graham Gudgin, honorary research associate2
  1. 1King’s College, London, UK
  2. 2Centre for Business Research, Judge Business School, University of Cambridge, Cambridge, UK
  1. Correspondence to: A Menon anand.menon{at}, G Gudgin gg14{at}
    Follow Anand Menon on Twitter @anandmenon1

Predictions of a smaller UK economy, at least in the short term, and fewer EU healthcare staff present challenges for the NHS after 29 March 2019, argues Anand Menon. But Graham Gudgin is unconvinced by what he believes are biased estimates promoted by a government pushing for a soft Brexit

Yes—Anand Menon

No one knows what Brexit will mean for the UK. And for several reasons. We don’t know what Brexit will look like—will our relations with the EU be like those of Norway, Canada, Switzerland, or none of the above? And no one—not even, apparently, the government—knows how we will adapt as a country to leaving the EU. What is the plan for health, for education, or for immigration?

The EU has limited direct competence over health policy. Consequently, the effect of Brexit on the NHS will be mostly indirect. Nevertheless, there are at least two good reasons to think that, in the short to medium term, Brexit’s effect on the NHS will be negative.

Smaller economy means less money

The first is Brexit’s wider economic implications. Based on an analysis of the likely effect of, among other things, barriers to trade and falling migration,1 government forecasts most independent economists suggest that the domestic economy will be around 5% smaller than it otherwise would have been if the UK and EU sign a free-trade agreement, which remains the government’s preferred option. Remember that gross domestic product (GDP) would need to be just 0.8% smaller2 than …

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