At the time of writing, members of parliament are debating the UK’s future relationship with the EU. As the nation is poised to find out whether the prime minister Theresa May’s deal will pass through the House of Commons, these discussions will doubtlessly continue.
Out in the real world — whether ‘Brexiteer’ or ‘Remainer’ — pharmacists could be forgiven for a sense of ennui over the whole enterprise. But that would be a mistake. May’s favourite phrase may be the spectacularly vacuous “Brexit means Brexit”, but parliamentary decisions now will have consequences for medicines supply and drug development in the UK for years to come.
Even the softest of Brexits could mean significant changes to the provision of healthcare in the UK
Of course, stockpiling and the potential role of pharmacists in substituting drugs to manage shortages of medicines after a ‘no deal’ departure is the worst-case scenario and this has received the most attention thus far. But even the softest of Brexits could mean significant changes to the provision of healthcare in the UK. Indeed, it started happening some time ago, with the European Medicines Agency (EMA) headquarters moving from London to Amsterdam following the Brexit vote. The EMA has already rolled back its day-to-day work to enable the relocation, and the UK’s Medicines and Healthcare products Regulatory Agency has had its evaluation work for new drugs shifted to other EU countries.
May did promise earlier in 2018 that the UK would be prepared to pay for access to the EMA and similar EU bodies, but the deal on which the House of Commons will vote says simply that “cooperation will be explored”.
And it’s not just regulatory bodies that will be affected. As the Brexit debate rumbles on, it has become increasingly apparent how intertwined healthcare provision in the UK is with the rest of the continent — from clinical trials to mutual recognition of qualifications; from healthcare staff, including pharmacists, to ‘just-in-time’ delivery mechanisms for medicines. The Association of the British Pharmaceutical Industry points out that 37 million packs of medicines are imported into the UK from the EU each month, and 45 million packs move the other way. Regulatory divergence could add £45,000 to the cost of each new medicine released in the UK, potentially making it an unattractive market for specialised medicines, according to the House of Commons business, energy and industrial strategy committee.
The risks to health could be so grave that the British Medical Association (BMA) and the Royal College of Nursing have both backed calls for a second referendum, following the government’s proposed Brexit deal. In pharmacy, the Royal Pharmaceutical Society (RPS) has chosen not to back this particular call, but its president has been front and centre on news bulletins, talking about the risks that Brexit could pose to patients.
The Pharmaceutical Services Negotiating Committee has created a Brexit Forum, which includes the RPS, the Company Chemists’ Association, the National Pharmacy Association, the Pharmacists’ Defence Association and others. However, it only held its first meeting in September 2018, less than six months before Brexit is due to happen.
It is essential that pharmacy’s voice is heard in these discussions. Perhaps taking a position similar to the BMA’s would be too political, but it is also abundantly clear that the profession must continue to speak out about the effect that Brexit could have. It is extremely difficult to cut through the din surrounding Brexit, but scrutiny and campaigning from pharmacists, pharmacy bodies and their colleagues across healthcare in the UK is needed if the most vital group of people — patients — are to be placed as centrally as possible in considerations of the UK’s future relationship with the EU.