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Feature Brexit

The Brexit predictions that came true, those that didn’t—and what we didn’t see coming

BMJ 2022; 378 doi: (Published 03 August 2022) Cite this as: BMJ 2022;378:o1870
  1. Richard Vize, journalist
  1. London
  1. richard.vize{at}

Six years after the referendum we can disentangle the evidence and judge the effects on health and care, says Richard Vize

The battle over Brexit triggered extreme claims about its likely impact on UK healthcare, ranging from a collapse in staffing and drug supplies to a big funding increase and a bonfire of red tape. Then came the covid pandemic, which all but obscured any Brexit effect.

But, six years after the vote and 19 months after the UK finally separated from the EU, it’s possible to judge which predictions were accurate, which ones were not—and the things we didn’t see coming.

Predictions that came true

Nurse recruitment from Europe collapsed, although medical recruitment didn’t

The European supply of nurses plummeted, but it’s been made up by immigration from outside the European Economic Area (EEA). Mark Dayan, policy analyst and head of public affairs at the Nuffield Trust, says, “Before the vote to leave, there was heavy recruitment of nurses from the EEA—more than 10 000 a year at one point—and that was a fairly crucial way in which the health service was trying to fill the shortage of nurses.”

The migration of nurses from Europe “fell off a cliff in 2016, partly as a result of Brexit and partly as a result of a new language test that the Nursing and Midwifery Council imposed,” says Dayan. “Since then you see quite a rapid pick-up in non-EU nursing migration, especially after the liberalisation of migration rules in 2019. That’s gone back to delivering several thousand additional nurses recruited abroad every year.”

Layla McCay, director of policy at the NHS Confederation, says that the points based immigration system introduced since Brexit “has had the biggest impact because it allows doctors, nurses, and various allied health professionals to immigrate to the UK, but low paid health and social care workers cannot meet the salary threshold, and …

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