Patient care in Northern Ireland and the Republic of Ireland will be put at risk if the next government fails to maintain a ‘soft border’ following Brexit, warns BMA

Ahead of next week’s general election, the British Medical Association is calling on politicians to protect the future of patient care in Northern Ireland and the Republic of Ireland following Brexit, by ensuring that a ‘soft border’ is maintained.

The existing open border arrangements, alongside an expansion in the provision of all island healthcare, provide a number of benefits for patients1, including access to both specialist medical services and to highly trained clinicians. This access risks being lost if border restrictions are introduced following the UK’s withdrawal from the EU.

The BMA is warning that cross border health services and patient access to healthcare, including the cooperation of emergency services and other organisations in response to major emergencies and public health risks, must not be impeded following Brexit.

Dr John D Woods, BMA Northern Ireland council chair, said:

“Northern Ireland is too small a health economy to efficiently provide some smaller specialist services; the Republic of Ireland is our natural partner for many of these services allowing both countries to work at a scale to provide benefits to patients on both sides of the border.

“We have seen several large scale success projects here such as the cancer centre in Derry and the all-island children’s cardiac service. Such projects mean that on a day-to-day basis doctors across Northern Ireland and the Republic of Ireland will be in contact with each other; getting professional advice, sharing knowledge and collaborating on patient care.

“Any border restrictions imposed after Brexit would risk reversing this progress and would damage patient care. We must maintain a soft border after Brexit to help ensure that cross border health services and patient access to healthcare are not affected by leaving the EU.”

The BMA is also asking that doctors in Northern Ireland and the Republic of Ireland maintain the ability to move freely between both countries, and that the mutual recognition of medical qualifications between Northern Ireland and the Republic of Ireland continues.

Dr Peter Maguire, a consultant anaesthetist who lives and works in Newry in Northern Ireland but also works across the border in Monaghan in the Republic of Ireland, said:

“I am one of a number of Northern Ireland doctors who regularly travels south of the border to care for patients. If a hard border is introduced following Brexit, it will present a number of difficulties for the health service, and will leave me with no choice but to leave the NHS and move to the Republic of Ireland.

“It’s not just cross-border movement that will be an issue for patients. 54 per cent of the exports from Ireland are pharmaceuticals and huge amounts of medical equipment are made and come from Ireland. What will happen if there are tariffs? What will happen to the cost of drugs with the change in the Euro?

“Medication that I already have to make a business case for to access in Northern Ireland will potentially become even less available to patients who truly need it.”

Dr Sara Hedderwick, a consultant in infectious diseases; “During the Ebola outbreak in 2015 it became clear to medics working on this issue that collaboration on an all-Ireland basis made most sense. For example, we faced difficulty in transporting potentially infectious samples by air to Great Britain. It proved much easier to send the samples by road to Dublin where our colleagues provided a critical rapid diagnostic service.

“If we were going to be in the position of dealing with an outbreak of Ebola, we needed to address it right across the country, in terms of setting up isolation units and diagnostic laboratories, and sharing information.”

Dr Tom Black, chair of BMA NI’s GP committee added, “The European Union of General Practitioners [UEMO] agrees that Brexit is a key issue for primary care, particularly in relation to the provision of cross border patient services and the free movement of patients and health professionals. We also need clarification on funding for joint medical research initiatives.”