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Many people were caught off guard by the Leave outcome in the EU Referendum on June 23rd-24th, including politicians, economists, bookmakers and members of the public too.

The slender victory should now mean Article 50 is put into action, eventually taking the UK out of the EU completely, although there are still several possible eventualities.

First of all, the result is not legally binding – the government could choose just to ignore it – although David Cameron’s resignation speech following the result suggests that he believes the public’s wishes should be respected, but does not want to be the one to sign the papers.

There is a clause that could trigger a rerun of the Referendum, because turnout was less than 75% and the result was a narrower margin than 60/40, and this has already gained the tens of thousands of votes needed in a petition to demand attention from Parliament.

Meanwhile however, the EU Council is calling for the UK to depart as soon as is reasonably possible, which would mean filing the Article 50 immediately.

Assuming nothing overturns the current Leave majority, it seems likely the Article 50 filing will come in October or soon after, when Cameron’s successor takes over as Prime Minister.

From there, a minimum two-year negotiation period will see the terms of the UK’s exit, or Brexit, hammered out with the 27 remaining EU member states.

So what will change in UK healthcare careers? One item of legislation that might not be transposed into UK law is the Working Time Directive, which limits the maximum working week to 48 hours.

The UK has always allowed an opt-out from this anyway, and junior doctors are often expected to opt out to allow extra time in their week for more training.

However, it is worth recognising that failing to copy its terms into the prevailing UK law would effectively remove one form of protection once the Brexit process is complete.

Research published in the BMJ ahead of the poll showed healthcare high on the agenda for voters as a whole, with a Remain vote more likely if visitors to the UK from elsewhere in the EU were given only restricted access to the NHS, as well as more limited rights to work in the UK.

Interestingly, that survey found removing the maximum working hours limit would lead to a swing towards Remain – and any such swing could have proved pivotal in light of how close the final tally was.

The fact is that the road is far from over – we likely have three months before David Cameron steps down and the Article 50 can be filed, followed by at least 24 months before Brexit can finally occur.

In the meantime, the final impact on the UK healthcare sector and its employees will depend on the Brexit deal that can be negotiated, or on any turnaround in the vote due to a forced second referendum, or due to Parliament simply refusing to enforce Article 50.

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