Health

Ministers still do not know if NHS can cope with no deal, says watchdog


Ministers will not know whether there are enough medicines, medical supplies or freight capacity to support the NHS if the UK leaves the EU without a deal next month, Whitehall’s spending watchdog has found.

With just five weeks to Britain’s scheduled withdrawal on 31 October, the National Audit Office (NAO) said there were still risks, with the Department of Health and Social Care (DHSC) still to do a “significant amount” of work .

In a critical report, the government’s “reasonable worst case” assumption is that the flow of goods across the Channel could be reduced to 40-60% of current levels on day one. Auditors said the data available did not show that the department was ready, or would be ready, if the UK were to leave the EU on the planned date.

Meg Hillier, the chair of the public accounts committee, said the report was deeply concerning and could result in the “gravest of consequences”.

“The Department of Health and Social Care still doesn’t know whether all stockpiles are in place, it has no idea whether social care providers are ready and it is still not certain whether all the freight capacity government needs will be in place on time. If government gets this wrong, it could have the gravest of consequences,” the Labour MP said.

Auditors examined the supply and transport of 7,000 medicines that come to the UK either from or via the EU as well as at least 450,000 different medical devices available on the NHS, most of which come to the UK through ports on the Channel.

The report said additional freight capacity chartered by the government for shipping priority goods across the Channel may not be fully available until the end of November, a month after the UK is scheduled to leave.

Auditors expressed concern that the DHSC did not know how many of the UK’s 24,000 nursing homes and other social care providers, many of which are small businesses, had followed its advice on “robust” contingency planning for a no-deal Brexit.

“The department has done a great deal of work to prepare for a no-deal exit. However, there remains a significant amount to do before 31 October,” the report said. “In the event of a no-deal exit, the department would be working in a highly uncertain environment and operating all the elements of its plan would be a hugely demanding task.”

The department estimates that by the end of March 2020 it will have spent more than £87m securing continued supplies, while the Department for Transport (DfT) has been allocated £150m to procure additional freight capacity, mainly for health and social care needs.

But while the DHSC has said it needs the equivalent of 2,326 additional HGV spaces a week, the NAO said the time left was “extremely limited” if the shipping contingency was to be fully ready by 31 October.

The health ministry is setting up its own courier service for transporting particularly urgent goods. This system will not be tested until 24 October, although the department has said it is expected to be ready for service from 1 November.

Warehouse space has been rented for manufacturers to stockpile medicines and materials for clinical suppliers, with capacity for 48,000 pallets, the report said. Pharmaceutical suppliers have been advised to build up six weeks of supplies of medicines that come from the EU, but auditors said it had “incomplete information” about the levels of stockpiling.

Prof Alan Boyd, the Brexit spokesperson for the Academy of Medical Royal Colleges, said the report was “really worrying”.

“Very little thought has been given to securing basic medical supplies such as bedpans and incontinence pads for people in social care in nursing homes. Bluntly, that means the frail, the elderly and most vulnerable could be hit the hardest,” he said.

A spokesperson for the DHSC said “substantial” stockpiles of medicines had been built up and were “increasing by the day”.

“We want to reassure patients we are doing everything necessary to make sure they can access the medicines they need after Brexit on 31 October,” they said.



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