Zoltán Massay-Kosubek

Genval, 28th March 2017.Triggering article 50 tomorrow is one of the known knowns. The exact content of the future EU-UK trade deal is one of the known unknowns, while the in-depth health consequences of Brexit are still unknown unknowns.

Brexit means Brexit

brexit means brexit

(On the photo – Infographic from the NHS European Office explaining some of the possible implications of Brexit on the NHS.)

A dedicated discussion took place on Brexit, Trade and Health on 22nd March in Brussels. It was said during the event that never before in the history of the EU has a state decided to leave the Union. When Article 50 was drafted as part of the new European Constitution – which eventually morphed into the Treaty of Lisbon – Valéry Giscard d’Estaing, the President of the Convention, said that the Union is based on a democratic decision: if the basis of that decision is not there anymore, the EU should respect it and give the any country the opportunity to leave. However, no one thought that these legal provisions would be put to the test so soon.

If everybody with us, who is against us?

The discussion gathered a range variety of participants including public health NGOs, representatives of the business community, attendees from the health industry, not-for profit associations representing private interests, member state and European Parliament representatives, journalists, academics as well as those working in think thanks.

I have argued in my earlier post on Brexit that all the major stakeholders both in the EU ad the UK are not interested in Brexit (and therefore may have campaigned for ‘remain’).

Known Knowns, Known Unknowns, Unknown Unknowns

And if there is one thing that is clear about Brexit, is it that its full consequences are as of yet very uncertain. When we talk about it, we are definitely discussing a moving target. There are discussions about its various impacts on many areas of our life, both in the UK and the EU. This involves some things which we know (known knowns e.g. once article 50 is triggered, formal exit negotiations will begin), but also others which we do not (known unknowns, will there be an interim deal to prevent a cliff-edge Brexit?) including even matters which are as of yet unforeseeable (the wider public health impacts of the negotiations both in the UK and in the EU – unknown unknowns).

Brexit and Trade

There is an interplay between the EU trade and public health policy. The withdrawal of the UK would affect the EU’s negotiating leverage with regard to third countries and it will also impact the negotiating position of the UK both for future EU 27 trade agreement and individual trade agreements the UK wants to conclude with third states in the future.

Brexit and Health

Brexit, which is one of the priority issues for the EU at present, will have crucial implications for both Europe and the UK in a number of areas of public health, including: health research, free movement of healthcare professionals, cross-border healthcare, the role of regulatory agencies (including the European Medicines Agency (EMA), health policies and standards, UK-EU trade relations and trade agreements between the EU and third countries to name just a few.

When talking about Brexit and trade, a proper discussion cannot be conducted without soon or later addressing the impacts for healthcare and the wider question of public health. And this is ultimately what public health advocates should focus on.

Article 50 – Treaty on European Union (TEU)

1. Any Member State may decide to withdraw from the Union in accordance with its own constitutional requirements.

2. A Member State which decides to withdraw shall notify the European Council of its intention. In the light of the guidelines provided by the European Council, the Union shall negotiate and conclude an agreement with that State, setting out the arrangements for its withdrawal, taking account of the framework for its future relationship with the Union. That agreement shall be negotiated in accordance with Article 218(3) of the Treaty on the Functioning of the European Union. It shall be concluded on behalf of the Union by the Council, acting by a qualified majority, after obtaining the consent of the European Parliament.

3. The Treaties shall cease to apply to the State in question from the date of entry into force of the withdrawal agreement or, failing that, two years after the notification referred to in paragraph 2, unless the European Council, in agreement with the Member State concerned, unanimously decides to extend this period.

4. For the purposes of paragraphs 2 and 3, the member of the European Council or of the Council representing the withdrawing Member State shall not participate in the discussions of the European Council or Council or in decisions concerning it.

A qualified majority shall be defined in accordance with Article 238(3)(b) of the Treaty on the Functioning of the European Union.

5. If a State which has withdrawn from the Union asks to rejoin, its request shall be subject to the procedure referred to in Article 49.

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