The implications of Brexit for the Irish health system
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BRIEF REPORT
The implications of Brexit for the Irish health system Brian Turner 1 Received: 26 June 2020 / Accepted: 31 August 2020 # Royal Academy of Medicine in Ireland 2020
While COVID-19 has rightly been the focus of attention in recent times, the previous issue of concern in Ireland— Brexit—has not gone away. Although the UK signed up to a transitional arrangement, if a trade deal is not concluded by the end of 2020, then it will essentially mean a hard Brexit by another name. This will have significant effects on the Irish health system, which will be manifested in several ways.
Effect Some measures have been put in place to avoid shortages, although it remains to be seen how effective these would be in practice [1]. Cross-border care Assurances have been given regarding the continued right of Irish and UK citizens to receive treatment in the other jurisdiction and to cross-border healthcare services, which are covered by service level agreements [1]. Recognition of There may be delays to the recognition of UK qualifications qualifications in Ireland (for those whose qualifications are not already recognised here), as these would have to be applied for as would any qualifications from outside the EU [1]. Economic impact Brexit will further weaken the Irish economy, in addition to the COVID-related shock. This will impact both the Government, through lower tax revenue, and individuals, through higher unemployment and lower disposable income [2] as well as higher prices for some imported goods [3], which will have knock-on implications on a number of areas of the health system, as discussed below. Health service funding The additional negative shock to the Irish economy of Brexit will further reduce Government revenue, through lower taxes, and increase Government spending,
(continued)
Recruitment and retention of staff
Issue Medicines
Implementation of Sláintecare
Private health insurance
Access to care * Brian Turner [email protected] 1
Department of Economics, Cork University Business School, University College Cork, Cork, Ireland
particularly on those sectors that are most adversely affected by Brexit, such as agri-food. This may have implications on the available funding for spending on areas such as health. The anticipated exit of some medical personnel from the UK due to Brexit [4] might help with the recruitment of additional staff envisaged under Sláintecare [5], which calls for an additional 593 public hospital consultants, and the Health Service Capacity Review [6], which calls for a 48% increase in the primary care workforce. However, Ireland is competing internationally for medical workforce, with anticipated shortages of doctors and nurses at an OECD level in 2030, including in a number of countries to which Irish medical and nursing graduates are attracted to work [7]. Sláintecare envisages an additional €2.9 bn per annum spending on health by the end of the plan, over and above the increases arising from demographic factors and medical inflation, for which the report allows three percen
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