If you live in Northern Ireland and suffer from a serious illness, there is a very real possibility that in six months’ time, you won’t be able to access the medicines you need.
This may sound alarmist, but since Brexit, Northern Ireland has become a “political football” between the UK and EU. Under the Northern Ireland Protocol, which was part of the withdrawal agreement negotiated on the UK’s exit from the EU, the province is in the peculiar position of remaining in the UK Customs Territory, but is in effect still in the EU’s single market.
This was agreed so that there would be no need for a “hard border” between Northern Ireland and the Republic of Ireland, which is an EU member state. But in order to ensure that goods crossing from north to south on the island of Ireland meet EU standards and comply with all the relevant rules, checks instead need to occur when goods cross the Irish Sea east to west from mainland Britain to Northern Ireland.
Media coverage has already cast a spotlight on the disruption to truckers at Northern Irish ports, as well as complaints about goods not reaching supermarket shelves. The so-called “sausage war” has been kept at bay by an extension until October of the “grace period” before checks need to be applied to chilled meats entering Northern Ireland from Britain.
But what if, in place of sausages, this disruption affected supplies of vital medicines, such as those needed to treat cancer?
At midnight on 31 December this year, the “grace period” whereby EU rules don’t apply to medicines will run out. After that, medicines imported to Northern Ireland from mainland Britain will have to satisfy EU rules, such as manufacture and import authorisation, batch testing and certification carried out in an EEA state. Pharmaceutical companies are doing everything in their power to prepare for operating according to the new rules after the end of this year, but they are running out of time to make substantive changes to supply chains if needed.
The majority of patients will still be able to obtain the medication they need. But it is likely there will be some who will find that suppliers, whether in the UK or otherwise, are no longer prepared to import small quantities of medicines for specific conditions to the Northern Irish market. Even if only a handful of patients are affected, that is too great a risk.
The UK and EU must come to a swift agreement on how the protocol will work and provide companies with the time, support, and assurances they need to get ready. After all, the core purpose of the NHS is to care for the people of the UK, whatever part they may be in. It cannot do so if medicines and treatments cannot be supplied unhindered.
In addition, new medicines approved only by the UK’s medicines regulator, the MHRA, and not the EU regulator, the EMA, will not routinely be available to Northern Irish patients in future.
The UK has put forward proposals aimed at breaking the deadlock on the protocol, even suggesting that medicines be treated as a special case and that they might be removed entirely from its scope. Within hours, the EU rejected the proposals and said they would not countenance reopening negotiations on the protocol, although they were prepared to “continue to seek creative solutions … within the framework of the protocol”.
Although the EU has paused legal action against the UK while discussions on the protocol continue, this merely underlines the urgency of engaging constructively to find a mutually acceptable solution.
We must not allow Northern Irish patients to go to the back of the queue for medicines, or even worse, to become collateral damage in the political haggling between the UK and the EU. It’s unacceptable that people could find themselves without essential medication next year if the UK and the EU cannot come up with a solution.
The NHS Confederation has been calling urgently for patients to be taken out of the firing line. This latest setback raises the stakes even higher.
Dr Layla McCay is director of policy for NHS Confederation
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