Get the biggest stories sent straight to your inbox Sign up for regular updates and breaking news from WalesOnline Thank you for subscribing We have more newsletters Show me See our privacy notice Invalid Email

Brexit will create serious and lasting problems in recruiting and retaining doctors, nurses, vets and social workers within Wales, and will have a major detrimental impact on the nation's ability to access cutting-edge medical research, a report by Wales' national public health agency has warned.

A health impact assessment conducted by Public Health Wales found four areas where any form of exit from the European Union was likely to have a major negative effect.

Wales already struggles to recruit enough healthcare staff, particularly for GPs and specialist posts such as paediatrics, but Brexit will make that worse, the report found.

And the impact will not be limited to the Welsh NHS, with further staffing problems expected to hit the veterinary, pharmaceutical, social services and life sciences sectors, which are all equally reliant on recruiting staff from the European Economic Area (EEA).

The report also warned that the stress and uncertainty caused to the agricultural sector by the potential loss of £680m of annual EU funding could have a highly damaging effect on mental health among workers in the industry.

Public Health Wales was tasked with carrying out a health impact assessment to understand the impact of Brexit on different aspect of Welsh life.

And while the report accepts that many of the impacts of Brexit will be dependent on the exact form Britain's departure from the EU takes, it found four areas where it believed direct, negative impacts, were inevitable.

They were:

Recruiting and retaining healthcare staff

Workforce challenges in sectors linked to health and well-being

Agricultural policy and funding

Funding for research and development

(Image: Stefan Rousseau/PA Wire)

Healthcare staffing

Public Health Wales warns that Brexit will make it harder to recruit health and social care staff, leading to slower access to care and more disease and death.

Wales already struggles to recruit enough healthcare staff, particularly for GPs and specialist posts such as paediatrics, but Brexit will make that worse, the report found.

Losing significant staffing "would have severe impacts on the ability to deliver already over-stretched health care services".

And it's not just in healthcare. The Welsh NHS Confederation found the number of EU nationals working in social care is far greater than those working in the NHS.

The numbers of people from the EEA working in social care in Wales has grown by 56% since 2011.

There are already recruitment and capacity challenges in social care in Wales along with a growing demand.

"The UK’s withdrawal from the EU will have the potential to impact the current system of recognition of medical qualifications that allows doctors who qualified in other EU countries to readily work in the UK," the report says.

The report found there is a confirmed major negative impact on staffing and recruitment in health care and social care in the short to medium term.

The issues could limit public access to health and social care , and even contribute to a higher death rate.

It also found a potential positive long term result would be training more UK nationals to work in health care.

(Image: Public Health Wales)

Fewer vets, nurses and manufacturing jobs

As well as the NHS, there are warnings of an impact on the availability of skilled workers in sectors linked to health and well-being as a result of the UK withdrawing from the EU.

In Wales, sectors dependant on staffing from the EEA include the veterinary sector and the food and drink manufacturing industry.

The life sciences sector and the pharmaceutical industry are also significantly dependent on EU citizens.

Ending freedom of movement and changes to immigration policies would mean a "major negative impact" on staffing in key sectors linked to health and outcomes including worse access to health and social care and more food-borne illness, the study found.

There is a major, potential impact of food related workforce shortages and gaps.

Brexit could lead to workforce gaps and thereby delays in certification and delivery that could subsequently lead to increased perishability and food wastage.

Within meat hygiene services, for example, it is estimated that more than 80% of the veterinary workforce is made up of non-British EU citizens.

How else could you be affected if we leave without a deal? This video explains five potential impacts

Video Loading Video Unavailable Click to play Tap to play The video will start in 8 Cancel Play now

Agricultural funding

Wales currently receives about £680m in EU funding each year, from a number of different funds.

While the UK Government has announced a UK wide Shared Prosperity Fund to replace EU structural funding but details of how the fund will operate are currently unclear.

The Government's white paper makes no reference to structural funding but in technical notes has said it will guarantee EU funding which has already been awarded to organisations until 2020 if there is "no deal".

However, the Welsh Government objects to a shared fund.

It has been estimated that EU subsidies make up 80% of farm income in Wales, although the figure differs between dairy and sheep farmers.

Many farmers rely on the Common Agricultural Policy (CAP) funding to keep their businesses viable, and any substantial reductions in the level of support will have a major impact on both the agriculture sector and the wider rural economy.

There will be a major impact on agriculture policy and payments in the short to medium term affecting farmers, landowners and rural communities - based on the impact of uncertainty, transition and scale of change affecting the foundation of people’s income and livelihoods.

Contributors to the report also recognised uncertainty and transition to future agricultural payments stemming from Brexit potentially having health and well-being impacts on farmers and rural communities.

Brexit could make it harder to obtain labour or export goods.

The combined impact on an industry that is dependent on EU funding and susceptible to issues relating to rural isolation is expected to be a greater incidence of stress and depression.

Longer term there could be new opportunities for Welsh land management policy and environmental protections and benefits from EU withdrawal, including freedom from the CAP and its restrictions.

Funding for research and development

At Welsh universities, 4% of students are from the EU, as well as 1,360 academic staff (as of December 2014).

Any restrictions to the free movement of workers or access to Europe-wide research programmes would "severely impact Wales’ ability to access academic talent and to engage in cross-border collaboration".

It will mean reduced access to EU Research and Development funding streams and loss of collaboration opportunities.

When it comes to funding, the UK is a net beneficiary for EU research funding and EU money is an important source of research funding in Wales.

The report found a major impact on research funding which could in turn reduce quick access to new treatments and technologies and health-evidenced based policy and care.

What does the report mean?

Professor Mark Bellis, Director of Policy, Research and International Development for Public Health Wales, said: “As the final decisions are made on our relationship with Europe it is paramount that we consider how they will affect the health of our people and especially the health of those who are vulnerable to ill health through their reliance of health care, low levels of income or employment in sectors at risk through the Brexit process.

"Changes in the prosperity of Wales will fall hardest on such individuals and communities.

"This Health Impact Assessment is not a road map through Brexit but a check list for those navigating the process to ensure that the health and well-being of the people of Wales is considered at every juncture.”

Liz Green, principal health impact assessment development officer at Public Health Wales said: “Predicting health outcomes is complex and difficult, even more so in the context of the shifting sands of the Brexit process.

"The Health Impact Assessment is not an analysis of the type of Brexit position the UK should adopt. It is about informing decisions so that once a destination has been chosen it can be reached with the least harms and most benefits to health.

"Nevertheless, this report will provide plenty to think about for organisations in Wales. It highlights the need for action to maximise any potential opportunities for improving health and well-being in Wales following Brexit, as well as mitigating or preventing any possible negative impacts or unintended consequences.”

Health minister Vaughan Gething said: “I am grateful to Public Health Wales for this thorough and considered analysis of how all aspects of Brexit may impact on health and well-being in Wales over the short, medium and long term.

"The report focuses on the unique political, social, cultural and economic challenges Brexit poses to Wales and will provide an invaluable aide memoire for service and community leaders as we move forward into uncertain times.”