Opinion: Brexit and its impact on healthcare - What is happening now?

Dr Layla McCay, director of international relations at the NHS Confederation, warns that Brexit “should not hinder” the collaboration between the UK and other European countries in the field of health research.
07:13 AM

After several decades of EU membership, UK and EU co-operation in many mutually beneficial areas is strong, underpinned by European legislation and infrastructure such as shared regulatory standards, databases and networks. We therefore need to keep a watchful eye on the unfolding Brexit process, which aims to move us further apart from alignment with the EU, in order to understand its impact and find ways to continue to achieve our shared priorities. A key question from a health perspective is how we can maintain the common benefits of continued collaboration in pan-European medical research.

We have a strong partnership, particularly in health research

There is a strong partnership between the UK and Europe in ensuring access to affordable and high-quality healthcare and protection against epidemics and diseases. The fact that our societies are becoming older and need more complex and expensive treatments, highlights further the need to collaborate to find new ways of delivering on our priorities by investing in technology and cooperating more effectively with international partners. This is particularly true in health research, which is increasingly international and intrinsically collaborative as scientific breakthroughs are rarely developed in isolation. Patients across the EU, including the UK, have benefited from pan-European collaboration on medical research that investigates, develops and tests new treatments on a scale only achieved on an EU-wide basis.

An example is the pan-European work to understand the human genome, and the UK’s role at the centre. The UK’s ambition to sequence five million genomes, by 2023-2024, goes well beyond the European collective target, and makes the UK a key partner for this collective effort. While the first genome sequencing took 13 years to complete and cost just short of £1bn, sequencing can now be completed on the National Health Service in two days for under £1,000.

Although the UK has an important role to play here, the next steps in leveraging this and other research will only be achieved through collective work, because many of the challenges around genomic medicine are shared challenges. This has been started through the Million European Genomes Alliance, formed of a number of EU member states, including the UK, who came together last year to build understanding of the human genome to more effectively diagnose, treat and prevent illness.

Further opportunities to collaborate are emerging

Taking the lead of the new European Commission president, new opportunities are emerging for the UK and EU to create even greater benefits through collaboration. In her letter to the newly appointed Commissioner-designate for Health, Ursula von der Leyen, President-elect, has proposed work on the creation of a ‘European Health Data Space to promote health-data exchange and support research on new preventive strategies, as well as on treatments, medicines, medical devices and outcomes.’

The European Health Data Space is centred on allowing data sharing to become easier and represents a boost to the work of the Million European Genomes Alliance, which relies on being able to share data safely across borders. Working across international borders will allow the group to accelerate progress and improve the prevention, diagnosis and treatment of diseases by providing a sufficient scale for accessing genomic data to the benefit of citizens’ health. Given the UK’s prominence in the field of genomics, it is crucial that it remains a strong collaborator in this area.

Brexit should not hinder collaboration

With clear benefits from partnering on health research, as highlighted by the collective work on genomics, it would be regrettable if this collaboration and the many more like it, were to be set back as a result of Brexit. As it currently stands, after exit from the EU, the UK will see divergence from EU research infrastructure, losing access to EU funding and European Reference Groups.

Therefore the Brexit Health Alliance is calling for the negotiations for the future relationship to focus on limiting that divergence and establishing a positive future cooperation model for research and innovation between the UK and the EU, which includes UK involvement in EU-funding programmes and which supports health research, innovation networks and clinical trials.

Although we stand ready to argue in favour of close future cooperation, the actual path to Brexit is uncertain. The legislation required to pass it into UK law has been paused and we await the contest and outcome of a UK general election due on 12 December. In the case that the current UK government wins a majority and we proceed with the current terms of exit, there is likely to be a substantial amount of work to be done before the end of the transition period in December 2020 to get to the positive future relationship on health research described above.

In the case that a different administration is elected, the potential outcomes are much more varied. This could include revoking Article 50 to cancel the exit process, a further extension to delay exit, or a renegotiation of the withdrawal agreement. All with very different implications for the future of health research between the UK and the EU.

Dr Layla McKay is the director of international relations at the NHS Confederation.