World economy

2.How will Brexit affect the UK’s response to coronavirus?

Coronavirus has demanded exceptional things of the NHS, and of health services across Europe. Now, the UK is scheduled on 31 December to make the biggest changes to its domestic and international legal system in 50 years during what may be a period of difficult containment – or of an ongoing and resurgent second wave.

Key points

• Leaving the single market will create new and wide-ranging problems for the majority of NHS medicines and medical devices which come from or via the EU. Measures such as stockpiling and planned delays in bringing in full controls will help, but data since the EU referendum shows medicines shortages have become more common and seem to fluctuate easily. The coronavirus wave and Brexit stockpiling both created spikes in imported supplies, and filling both requirements at once may be very difficult.

• Export blocks on medically vital supplies by the EU were used during the first wave of coronavirus and could cover the UK after 31 December.

• The UK will no longer have access to the European Centre for Disease Prevention and Control (ECDC), which collects and shares intelligence on pandemics and other infectious disease outbreaks. The UK is trying to negotiate access to the Early Warning and Response System, which shares information between ECDC and member states during pandemics, but this will depend on whether a deal is reached and whether this provision is secured.

• Based on negotiating documents, draft treaties, and briefing to date, the majority of the crucial issues for health which could have been secured in an agreement are not agreed upon by the two sides, or the outcome is uncertain. These should be given a higher priority in the context of the ongoing pandemic.

• Several important areas for responding to coronavirus depend on cooperative practices and favourable decisions across the EU and UK, beyond simply the presence or absence of a deal. These include allowances at customs on the EU side; the exchange of data and intelligence; and the UK being subject to blocks on exports. Bad relations will magnify the issues the NHS faces in trying to tackle coronavirus next year.

• Poor funding for public health and social care contributed to limitations in the UK’s capacity to address coronavirus during the first wave. Leaving the single market will mean slower growth, making addressing these more difficult though the case to do so remains very strong.