Statement by the Irish Medical Organisation [IMO]

Special seminar on Brexit challenges for health services hears of challenges posed for health services

Thursday 18^th January 2018.  A special seminar on the challenges posed by Brexit to health services has heard that the UK’s exit from the EU poses a number of significant challenges for healthcare collaboration between the Republic and the United Kingdom.

The IMO seminar was hosted by the Irish Medical Organisation (IMO) tonight in Dublin.  Speakers included MEP Ms Mairéad McGuinness (Vice-President of the European Parliament), Dr Denis McCauley (GP and Donegal Coroner), Mr Leo Kearns (CEO of the Royal College of Physicians in Ireland) and Ms Rita Purcell (Deputy CEO of the Health Products Regulatory Authority (HPRA)).

Brexit Risks:

• Brexit poses an immediate challenge to how patients from the Republic can access health services in Northern Ireland and the UK and vice versa. 

In 2016, 574 patients received high tech treatment in the UK under the treatment abroad scheme and 700 patients accessed care in Northern Ireland last year under the patients’ right in cross border care directive.  The basis under which these patients received treatment in the UK is based on shared membership of the European Union and will need to be re-established when the UK leaves the EU.

• A new basis will have to be agreed to support ongoing and future collaboration in health services and ensuring timely and seamless access to care for patients in the border areas.  

The Cooperation and Working Together (CAWT) partnership between health and social care services in Ireland and Northern Ireland which has facilitated a number of successful collaborative projects in healthcare in the border regions managing funding from the EU INTERREG Programme and the Special EU Programmes Body. 

Many of these projects have resulted in longer-term service level agreements including agreements for the provision of GP out-of-hour services, shared dermatology clinics, ENT Services and Renal services in the border areas. New funding arrangements will be need to support future collaboration after 2020.

Other cross-border service level agreements exist as a result of collaboration and capital investment from both sides of the border including Radiation Oncology services and Emergency Cardiology Services at Altnagelvin Hospital, as well as the provision of all-island paediatric cardiac surgery services for children with congenital heart disease at Our Lady’s Children’s Hospital Crumlin, Dublin.

Cross-border cooperation also exists in the area of public health, particularly in the area of health protection.  Future cooperation in data sharing and emergency planning will need to be teased out. 

• Brexit will also change the current basis for the mutual recognition of qualifications between the Republic of Ireland and the UK. Currently there are 3,196 doctors registered with the General Medical Council in the UK who received their primary medical degree in Ireland and 742 doctors registered with the Medical Council in Ireland who received their primary medical degree in the UK.

Many Irish graduates complete their post graduate training and/or spend a period of time in the UK before returning to Ireland. A bi-lateral agreement will be required between Ireland and the UK.  

Ireland will need to become more competitive in attracting and retaining medical professionals as the NHS will have a smaller pool of countries from which to recruit from.

• An additional challenge centres on access to and the cost of certain medicines where the market is shared with the UK or medicines that are imported through the UK . Differing regulatory requirements in each jurisdiction may impact on the cost of medicines or may deter manufacturers from supplying the Irish market if they consider it too small.

Speaking at the seminar, Ms. Mairead McGuinness, MEP and Vice President of the EU Parliament said; “Brexit poses significant risks to patients in Ireland and across the EU. It is positive that both Ministers for Health in Ireland and Northern Ireland (previously) have expressed their wish to extend and further develop patient access to quality services on a cross border / all-island basis. And I have met many UK officials who want collaboration on healthcare to continue. But that willingness to continue as we are, will be challenged by the reality of the UK leaving the EU and the follow on consequences.  There are risks to both formal and informal working relationships and arrangements which characterise cross border health and social care activity in Ireland and Northern Ireland. Issues like diverging regulations could lead to shortages of medicines, and confusion over recognition of qualifications could hinder the continued free movement of doctors and other medical professionals. Overall there is still considerable uncertainty over the shape of the future EU/UK relationship, which makes preparing for these challenges difficult. Now is the time to outline the challenges, inform the negotiators and put patient safety at the heart of our negotiations.”

Dr. Denis McCauley, IMO GP Committee member and Donegal Coroner said;  “There has been increased sophistication in our cross border health collaboration. It is vitally important that we remain vigilant during the Brexit negotiations and that this collaboration is not threatened.”