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Brexit: what happens next?

Boris Johnson entered December’s general election promising to ‘get Brexit done’. The electorate gave him the opportunity to do so. Adrian Houghton, our Policy Officer, examines the current key issues still at stake for our community.

Why was the general election result significant?

Theresa May’s ill-fated decision to call a general election in 2017 resulted in a hung parliament, meaning the Conservatives were reliant on ten MPs from the Democratic Unionist Party (DUP) to govern. But when it came to Brexit, the then-Prime Minister encountered a sceptical opposition and rebels from her own benches, meaning her EU withdrawal agreement was rejected three times by Parliament.

But Boris Johnson should have no such problems. As well as having a majority in the House of Commons of 80, he proclaimed during the election campaign that each Conservative candidate had pledged to support his Brexit deal.

Have there been any developments since?

In the week after the election, the second reading of Mr Johnson’s Brexit bill was comfortably backed by Parliament. Although the bill must pass through various stages in the Commons and House of Lords before becoming law, as well as be ratified by the European Parliament, it is highly likely that the UK will leave the EU by the end of January.

What will the next step be?

There will be a transition period, lasting until 31 December 2020, during which time the UK will continue to pay in to the EU’s budget and adhere to EU law, without being a member state. The purpose of the transition period is for the UK and the EU to negotiate the terms of their future relationship (including a trade deal).

Can the transition period be extended?

The UK could request an extension if it feels that it needs more time for the negotiations, provided it does so before 1 July. However, this could now be a moot point – a new clause has been added to the withdrawal agreement by the Government that prevents any extension. This means a no-deal Brexit could still happen, particularly since the EU consider the timeframe to be ‘extremely challenging’.

What are the implications for our community?

Medicines supply

In August, a dossier on planning for a no-deal Brexit (known as Operation Yellowhammer) containing reasonable worst-case scenarios was leaked. It mentioned that there could be ‘significant disruption lasting up to six months’ at Channel ports, with medicines being ‘particularly vulnerable’ since 75% of supplies arrive in the UK via this route.

While the Government had requested the stockpiling of medicines for an additional six weeks as a contingency, the Yellowhammer leak revealed that this was not possible for those drugs with ‘short shelf lives’, while stockpiling for six months to cover such delays would ‘not be practical’. This is why it is important that the UK leaves the EU with a deal.

Medicines regulation

Evaluation and monitoring of medicines across EU states is the responsibility of the European Medicines Agency (EMA). Pharmaceutical companies can obtain approval for new medicines throughout the EU by applying to the EMA, while the UK, as an EMA member, is a priority market. The Government’s Political Declaration on the future UK-EU relationship seeks to ‘explore the possibility of cooperation’ between the EMA and authorities such as the UK’s own regulatory body, the Medicines and Healthcare products Regulatory Agency (MHRA).

With the future relationship between the UK and EMA not yet determined, the MHRA’s former chair, Sir Alasdair Breckenridge, has previously expressed concern that the UK will face delays in getting new drugs by withdrawing from the EMA.


Our Chief Scientific Officer, Dr David Jenkinson, has previously spoken about the need for continued access to EU research grants, which otherwise would lead to a loss in funding and collaborative opportunities. Consequently, according to their manifesto, the Conservatives will ‘collaborate internationally and with the EU on scientific research, including Horizon’ (indeed, Horizon 2020 is an €80-billion funding programme).

However, the details of how this will work, as well as subsequent arrangements (such as involvement in the successor Horizon Europe programme, which is due to begin in 2021), need to be ironed out. Furthermore, the proposed ‘Australian-style, points-based system’ for immigration must ensure that EU researchers will still be able to work in the UK.

Clinical trials

Replying last June to a letter co-signed by The Brain Tumour Charity, the Department of Health and Social Care stated that the UK will continue to take part in multinational EU clinical trials after Brexit, with British organisations being able to sponsor such trials. In addition, the EU is set to implement a new Clinical Trials Regulation (CTR) that aims to improve efficiency by harmonising processes and providing more transparency in clinical trial data.

This will not be enacted before 31 January, but the Government has said that it will align ‘where possible’ with the CTR. However, failure to do so appropriately could affect UK participants in multinational EU trials and recruitment for future trials.

NHS workforce

The health service is facing a staffing crisis. For example, data from NHS Digital reveals that there are currently more than 43,000 nursing vacancies in England alone. As it stands, EU nationals make up 6% of the nursing and health visitor workforce; yet of those nurses leaving the service, almost 11% are from the European Union (with the respective statistic for those joining being only 6%). It is estimated that the NHS must recruit 5,000 nurses from abroad each year to prevent the situation from deteriorating further. 

In an attempt to attract trained staff from overseas, the Conservatives wish to introduce an NHS Visa, with healthcare professionals offered ‘fast-track entry, reduced visa fees and dedicated support’ (as pledged in their manifesto); yet, whether this will meet the staffing shortfall is unclear.

It is imperative that the Government resolves each of these issues to ensure that brain tumour patients receive the best treatment and care.

As a result, The Brain Tumour Charity will continue to monitor Brexit closely, both before and after 31 January, and update our community with the latest news.

Moreover, we will lobby the Government with the aim to arrange meetings, as well as encourage other MPs to raise these matters in the House of Commons. Given our passion for the needs of our community to be met, we must ensure that patients do not see the quality of their treatment and care fall following the decision to leave the European Union.

(For more information on the implications, please see the King’s Fund’s Brexit analysis).