Intended for healthcare professionals

  1. May C I van Schalkwyk, research fellow1,
  2. Pepita Barlow, assistant professor3,
  3. David Stuckler, professor of policy analysis and public management4,
  4. Maggie Rae, president5,
  5. Tim Lang, professor of food policy6,
  6. Tamara Hervey, Jean Monnet professor of European Union law7,
  7. Martin McKee, professor of European public health1
  1. 1Faculty of Public Health and Policy, London School of Hygiene and Tropical Medicine, London, UK
  2. 2Department of Health Policy, London School of Economics, London, UK
  3. 3Bennett Institute for Public Policy, University of Cambridge, Cambridge, UK
  4. 4Department of Policy Analysis and Public Management and Dondena Research Centre, University of Bocconi, Milan, Italy
  5. 5Faculty of Public Health, London, UK
  6. 6Centre for Food Policy, School of Health Sciences, City University of London, London, UK
  7. 7School of Law, University of Sheffield, Sheffield, UK
  1. Correspondence to: M C I van Schalkwyk may.vanschalkwyk{at}

Leaving the EU without a deal is a leap in the dark. May van Schalkwyk and colleagues call for a full evaluation of the health effects and suggest what it should cover

Key messages

  • Leaving the EU without a deal threatens health and the NHS in many ways, but the scale of the threat remains unclear

  • We propose a framework that could be the basis for the comprehensive health impact assessment to inform politicians and the public

  • The government’s claims that it is prepared for no deal are implausible and, at best, might mitigate some of the worst consequences

Boris Johnson says that the UK will leave the EU on the 31 October 2019, “do or die.” Assuming he succeeds in this goal, the UK seems set to leave without a withdrawal agreement—a “no deal” scenario.

Health is central to Brexit. The Leave campaign claimed that Brexit would provide £350m ($390m; $430m) a week for the NHS and Johnson, on becoming prime minister, announced what he misleadingly described as “new” spending on the NHS. Thus, many people may think that a no deal Brexit will do no harm and could even be good for health and the NHS.

But will it? Two previous analyses have set out, in detail, why any form of Brexit will be damaging,12 and a leaked government document, written in early August 2019, paints an even more alarming picture.3 This contrasts starkly with the prime minister’s reassurances that the UK will “cope easily.”

Countering misinformation

It is important to clarify common but misleading statements about no deal. The often mentioned “managed no deal” does not exist. New, time limited EU laws on aviation and road freight are not side deals, but unilateral measures by the EU27 to safeguard their interests. Suggestions that authorities might ignore actions lacking …

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