Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK.
The City Law School, City University, London, London, UK.
Health Econ Policy Law. 2022 Oct;17(4):471-496. doi: 10.1017/S1744133122000044. Epub 2022 Jun 28.
The UK's relationship with the European Union (EU) is now embodied in two principal legal instruments: the EU-UK Trade and Cooperation Agreement, which formally entered into force on 1 May 2021; and the Withdrawal Agreement, with its Protocol on Ireland/Northern Ireland, which continues to apply. Using a 'building blocks' framework for analysis of national health systems derived from the World Health Organisation, this article examines the likely impacts in the UK of this legal settlement on the National Health Service (NHS), health and social care. Specifically, we determine the extent to which the trade, cooperation and regulatory aspects of those legal measures support positive impacts for the NHS and social care. We show that, as there is clear support for positive health and care outcomes in only one of the 17 NHS 'building blocks', unless mitigating action is taken, the likely outcomes will be detrimental. However, as the legal settlement gives the UK a great deal of regulatory freedom, especially in Great Britain, we argue that it is crucial to track the effects of proposed new health and social care-related policy choices in the months and years ahead.
英国与欧盟（EU）的关系现在体现在两个主要的法律文书中：《欧盟-英国贸易与合作协定》，该协定于 2021 年 5 月 1 日正式生效；以及《退出协议》及其关于爱尔兰/北爱尔兰的议定书，该协议仍在适用。本文采用世界卫生组织（WHO）提出的国家卫生系统“积木”分析框架，研究这一法律解决方案对英国国民保健制度（NHS）、卫生和社会保健的可能影响。具体来说，我们确定这些法律措施的贸易、合作和监管方面在多大程度上支持 NHS 和社会保健的积极影响。我们表明，由于在 NHS 的 17 个“积木”中只有一个明确支持积极的健康和护理结果，除非采取缓解措施，否则可能的结果将是不利的。然而，由于法律解决方案赋予英国在大不列颠地区极大的监管自由，我们认为，在未来几个月和几年内，跟踪新的卫生和社会保健相关政策选择的影响至关重要。
