Last reviewed: 16 October 2026
The NHS was one of the Brexit campaign’s most powerful symbols.
The red bus and its claim that it would send £350 million a week to the European Union became a defining image of the 2016 referendum. But the relationship between Brexit and the NHS is much wider than one funding slogan.
Leaving the EU affected how the UK recruits health workers, regulates medicines, participates in European research, manages cross-border healthcare and cooperates with neighbouring countries on health threats.
So the question is broader than whether the NHS budget rose after Brexit.
Did leaving the EU actually strengthen the health service?
The evidence points to a complicated answer. Britain gained more national control in several areas. NHS funding also increased substantially. But the health service remains heavily dependent on international staff, European medicines supply chains and cross-border scientific cooperation, while many of its biggest pressures have little or nothing to do with Brexit.
A fair assessment therefore has to separate what Brexit genuinely changed from problems that would be misleading to blame on Brexit alone.
A note on the figures: Healthcare is devolved across the UK. Some of the most detailed workforce and spending data used below relates specifically to NHS England. Where that is the case, it is identified rather than presented as a UK-wide figure.
Brexit and the NHS at a Glance
- After leaving the EU, the UK gained greater control over immigration rules, medicines regulation, and parts of health policy.
- NHS spending rose substantially after the referendum, but the increase cannot be treated as a simple pot of money released by Brexit.
- Around 21% of NHS staff in England reported a non-British nationality in June 2025, including more than 70,000 EU nationals.
- The share of staff reporting an EU nationality peaked at 5.6% in 2017 and was 5.2% in June 2025; the NHS increasingly relies on workers from outside Europe.
- NHS England still had around 100,000 full-time-equivalent vacancies in December 2025.
- The UK now operates its own medicines approval system through the MHRA, although it also uses international recognition routes and remains closely connected to European pharmaceutical supply chains.
- The UK imported around £16.6 billion of pharmaceutical products from the EU in 2024.
- The UK fully re-associated with Horizon Europe from 2024, restoring access to major European research collaboration after a period of uncertainty and reduced participation.
- UK residents continue to have access to reciprocal healthcare in the EU through arrangements including the GHIC and, for some people, the EHIC.
The central point is this: Brexit gave Britain more control over some healthcare systems. It did not remove the NHS’s dependence on international people, products and cooperation.
Sources: House of Commons Library – NHS staff from overseas | House of Commons Library – international recruitment in the NHS | UK Government – medicines supply resilience
The NHS Was at the Heart of the Brexit Argument
Few public services featured as prominently in the referendum campaign as the NHS.
Vote Leave’s claim that the UK sent the EU £350 million a week and could instead fund the NHS became one of the campaign’s best-known political messages.
We examine that specific claim separately in The £350 Million NHS Claim: What Was Promised and What Actually Happened?
For this article, the more useful question is what happened to the NHS after Britain actually left the EU.
That requires looking beyond a single number.
Healthcare depends on:
- Public funding
- Doctors, nurses and other staff
- Medicines and medical devices
- Research networks
- Regulation
- Public-health cooperation
- The movement of patients and professionals across borders
Brexit touched all of them.
Did the NHS Receive More Money After Brexit?
Yes. NHS spending increased substantially after the referendum and has continued to increase.
In 2018, Theresa May’s government announced a five-year funding settlement for NHS England and explicitly linked part of the increase to what it called a “Brexit dividend.”
By 2026–27, the published financial directions for NHS England set a revenue resource limit above £205 billion, while the 2025 Spending Review planned further real-terms growth in NHS England funding through 2028–29.
Those are genuine increases in health spending.
But that does not mean the additional funding can simply be identified as money that previously went to Brussels and was redirected to hospitals.
Public finances do not work like separate household envelopes.
The UK did cease making normal Member State contributions to the EU budget, although it continued to make payments under the withdrawal settlement and participates financially in selected European programmes.
At the same time, Brexit affected economic growth, tax receipts, government spending obligations and replacement programmes previously funded through the EU.
The Office for Budget Responsibility and the Institute for Fiscal Studies both challenged the idea that a clearly identifiable fiscal “Brexit dividend” could finance the NHS increase on its own.
The OBR said in 2018 that Brexit was more likely to weaken than strengthen the public finances overall, even though leaving the EU created direct savings from contributions that would otherwise have been made.
So two statements can both be true:
- The NHS received substantially more money after the referendum.
- That does not prove Brexit generated an equivalent financial windfall for the NHS.
Sources: UK Government – 2018 NHS funding plan | Office for Budget Responsibility – Fiscal Sustainability Report 2018 | UK Government – NHS England financial directions 2026–27 | HM Treasury – Spending Review 2025
Did Brexit Solve NHS Staffing Problems?
No.
The NHS remains heavily dependent on international recruitment.
According to the House of Commons Library, around 325,000 of 1.5 million NHS staff in England reported a non-British nationality in June 2025—about one in five staff whose nationality was known.
The reliance is even greater in some professions.
Around 36% of doctors and 30% of nurses reported a non-UK nationality.
And despite substantial workforce growth, NHS England still had around 100,000 full-time-equivalent vacancies in December 2025, equivalent to about 6.7% of roles.
This matters because one argument for Brexit was that the UK could replace EU free movement with a system under greater national control.
That happened.
But greater control over migration did not remove the NHS’s need for overseas workers.
Instead, recruitment became more global.
Source: House of Commons Library – international recruitment in the NHS workforce
What Happened to EU Staff in the NHS?
The story is more nuanced than either side of the Brexit debate sometimes suggests.
It would be wrong to say that EU staff disappeared from the NHS after the referendum.
In June 2025, more than 70,000 NHS staff in England reported an EU nationality, representing about 5.2% of staff whose nationality was known.
The proportion had risen from 2.9% in 2009 to a peak of 5.6% in 2017, before gradually falling to 5.2%.
The recorded number of EU staff was higher in 2025 than in 2016.
However, the House of Commons Library strongly warns against a simple before-and-after comparison because NHS nationality records improved considerably during the period. Tens of thousands fewer staff now have an unknown nationality than in 2016.
The safest conclusion is therefore:
EU nationals remain an important part of the NHS workforce, but their share has not grown in the way recruitment from some non-EU regions has.
Since 2016, the proportion of NHS staff reporting Asian and African nationalities has risen much more sharply.
That suggests Brexit did not end international dependence. It changed its composition.
Source: House of Commons Library – NHS staff from overseas: statistics
Did Britain Gain More Control Over Health-Worker Immigration?
Yes.
Ending free movement gave the UK Government greater control over immigration rules for most European workers.
Healthcare professionals from the EU are now generally subject to the UK’s immigration system rather than an automatic right of free movement.
At the same time, the government created and adapted visa routes designed to make it easier for health professionals to work in Britain.
The regulatory position is also more pragmatic than a complete break might suggest. UK rules still provide for recognition of relevant European healthcare qualifications in important circumstances, and regulators continue to recruit internationally.
So Brexit produced greater legal control over entry.
But in practice the NHS has continued to use international recruitment because domestic training and retention have not supplied enough staff to meet demand.
This illustrates a recurring distinction in Brexit policy:
greater control over a system does not necessarily reduce dependence on the people moving through that system.
Source: House of Commons Library – international recruitment in the NHS workforce
What Changed With Medicines Regulation?
Brexit gave the UK more regulatory autonomy over medicines.
The Medicines and Healthcare products Regulatory Agency — the MHRA — now has responsibility for authorising medicines across the UK under the arrangements introduced following the Windsor Framework.
From 1 January 2025, new medicines for the UK market can be licensed on a UK-wide basis by the MHRA, including in Northern Ireland.
The UK has also created an International Recognition Procedure, allowing the MHRA to use approvals from specified trusted overseas regulators as part of the UK authorisation process.
This creates potential advantages.
Britain can design its own regulatory pathways and, in principle, move more quickly where it believes a different approach is appropriate.
But independence also creates trade-offs.
The UK is a smaller medicines market than the EU as a whole. Separate regulatory requirements can create additional costs for manufacturers, while the NHS still depends on international supply chains.
The UK Government itself recognises the importance of cooperation and regulatory alignment with international partners.
Sources: MHRA – International Recognition Procedure | UK Government – Windsor Framework medicines arrangements
How Dependent Is Britain on European Medicines?
Very.
The Department of Health and Social Care says the EU remains the UK’s largest trading partner for pharmaceuticals.
In 2024, Britain imported approximately £16.6 billion of pharmaceutical products from the EU and exported around £9.7 billion to the EU.
That does not mean Brexit prevents medicines from crossing the Channel.
It means that the NHS and the wider UK health system remain closely connected to European manufacturing and distribution even though the regulatory relationship has changed.
This is important because health security increasingly depends on resilient international supply chains rather than national self-sufficiency.
The UK Government joined the EU’s Critical Medicines Alliance in 2024 and has continued to seek cooperation with European and other international partners on supply-chain resilience.
Source: Department of Health and Social Care – Managing a robust and resilient supply of medicines
Can Medicine Shortages Be Blamed on Brexit?
Not responsibly.
Medicine shortages are real, and the UK has experienced significant supply problems.
But the causes are international and complex.
The Department of Health and Social Care says shortages are being experienced across many countries and identifies manufacturing disruption, raw-material shortages, demand surges, production problems and logistics as important causes.
In 2024, manufacturing problems accounted for roughly 60% of UK medicine supply notifications.
The department also says no single reliable measure can comprehensively show whether UK shortages have risen or fallen in recent years.
Brexit-related regulation and border friction can form part of the environment in which pharmaceutical companies operate, but it would be misleading to present Brexit as the sole — or even necessarily the dominant — cause of UK medicine shortages.
The evidence does not support that conclusion.
Source: Department of Health and Social Care – Managing a robust and resilient supply of medicines
What Happened to Medical and Scientific Research?
This is one of the clearest examples of disruption followed by partial repair.
Before Brexit, British universities, hospitals and research institutes were deeply integrated into EU research programmes.
After the referendum, uncertainty about the UK’s future participation affected European research collaboration.
Britain did not initially participate in Horizon Europe on the same full basis as EU Member States and associated countries.
The UK eventually reached an agreement and became fully associated with Horizon Europe from the 2024 work programmes onward.
That restored the ability of UK researchers to participate in and lead eligible consortia on broadly the same basis as other associated countries.
Official UK analysis published in 2026 shows signs of recovery.
The UK’s share of Horizon Europe funding rose from 5.8% in 2023 to 9.3% in 2024, while its share of eligible proposals also increased.
But the same government analysis says participation remains below the earlier peaks seen before and around the referendum period.
So the research story is not simply “Brexit ended European science cooperation.”
Nor is it accurate to say nothing changed.
There was a period of disruption and lower participation, followed by a negotiated return to one of Europe’s most important research programmes.
Sources: UK Government – UK association to Horizon Europe | Department for Science, Innovation and Technology – UK participation in EU Framework Programmes
Did British Travellers Lose Access to European Healthcare?
Not entirely.
One concern during the Brexit process was whether UK citizens would lose the healthcare protections associated with the European Health Insurance Card.
New arrangements preserved much of the practical protection.
Eligible UK residents can use a UK Global Health Insurance Card (GHIC) — or, for some people, a valid UK-issued EHIC — to receive medically necessary state healthcare during temporary visits to EU countries.
There are also continuing arrangements involving S1 forms and other reciprocal healthcare mechanisms for eligible residents, pensioners and workers.
The system is not identical to EU membership, and travellers are still advised to carry appropriate travel insurance because reciprocal arrangements do not cover every cost.
But it would be incorrect to say Brexit ended reciprocal healthcare between Britain and Europe.
Sources: UK Government – healthcare and insurance in the EU | UK Government – reciprocal healthcare and the GHIC
What About Health Security and Future Pandemics?
Disease does not stop at national borders.
The COVID-19 pandemic demonstrated the importance of fast international information sharing, surveillance, scientific collaboration and coordinated responses to health emergencies.
The UK–EU Trade and Cooperation Agreement already contains health-security provisions, including mechanisms for cooperation on serious cross-border threats.
In 2025, Britain and the EU agreed to explore deeper cooperation on detecting, preparing for, and responding to emerging health threats.
By February 2026, the two sides reported that a joint action plan had been established between the European Centre for Disease Prevention and Control and its UK counterpart to support cooperation on communicable diseases.
This is another example of the post-Brexit relationship evolving towards selective cooperation where both sides see a practical benefit.
Sources: UK–EU Summit 2025 – Common Understanding | UK–EU Partnership Council minutes, February 2026
Has Brexit Made the NHS Better or Worse?
This is where caution matters most.
The NHS faces severe pressures, including waiting lists, workforce shortages, an ageing population, rising demand, the long-term effects of the pandemic, productivity challenges, social-care constraints and the cost of new treatments.
Some of those pressures existed long before Brexit.
Others were transformed by COVID-19.
Government decisions on NHS funding, pay, training, capital investment, social care and management have also had major consequences.
It would therefore be poor analysis to look at the NHS’s overall performance today and assign the result entirely to Brexit.
Brexit is one factor among many.
The more defensible question is whether the specific changes caused by leaving the EU have strengthened or weakened particular parts of the health system.
On that basis, the picture is mixed.
The Strongest Case That Brexit Helped the NHS
Supporters of Brexit can point to several real changes.
Britain now has greater control over:
- Immigration policy
- Medicines regulation
- International trade policy
- The design of some professional-recognition rules
- How it chooses to cooperate with European institutions
The MHRA can develop UK-specific approval pathways and use international recognition arrangements designed around British priorities.
The government can design health-worker visa rules without having to apply EU free-movement law.
NHS spending has risen substantially since the referendum.
And Britain has retained the ability to negotiate participation in major international programmes where cooperation remains useful, as happened with Horizon Europe.
The sovereignty gain is therefore real.
The strongest pro-Brexit argument is that Britain now has more freedom to design health-related rules for itself while choosing cooperation on a case-by-case basis.
The Strongest Case That Brexit Did Not Strengthen the NHS
The counterargument is that control is only valuable if it produces better outcomes.
The NHS still relies heavily on overseas workers.
It still faces approximately 100,000 full-time-equivalent vacancies in England.
European nationals remain an important part of its workforce, while the system has become increasingly dependent on recruitment from countries farther afield.
Britain remains closely integrated with EU pharmaceutical supply chains.
The UK ultimately negotiated its way back into Horizon Europe after a period of uncertainty and reduced participation.
And the UK and EU are now seeking closer cooperation again in areas such as health security.
None of those facts proves Brexit caused the NHS’s present difficulties.
But they do challenge the idea that leaving the EU would allow Britain to solve major health-service problems simply by reclaiming money and control from Brussels.
So, Did Leaving the EU Make the Health Service Stronger?
Did NHS funding increase after the referendum?
Yes.
The NHS received substantial additional funding.
But the increase should not be treated as proof that Brexit produced an equivalent fiscal windfall.
Did Britain gain more control over health-related policy?
Yes.
The UK has greater autonomy over immigration, medicines regulation and some other policy areas.
Did Brexit end the NHS’s dependence on overseas workers?
No.
International recruitment remains central to NHS staffing.
Did EU health workers disappear from the NHS?
No.
Tens of thousands of EU nationals still work in NHS England, although their share of the workforce has edged down from its 2017 peak while recruitment from other regions has grown.
Did Britain leave European medical research behind?
Temporarily and partially — but not permanently.
After a period of uncertainty and weaker participation, the UK re-associated with Horizon Europe from 2024.
Did Brexit cause Britain’s medicine shortages?
The evidence does not justify that claim.
Supply problems have multiple global causes, although Brexit changed the regulatory and trading environment in which medicines reach the UK.
The Brexit Files Verdict
Brexit gave Britain greater control over several systems that affect the NHS. It did not, however, provide a simple solution to the health service’s deeper problems.
The NHS received more funding, but public-finance evidence does not support the idea of a neatly identifiable Brexit dividend.
Britain gained immigration control, but the NHS remains dependent on international recruitment.
Britain gained medicines-regulation autonomy, but the health service remains deeply connected to European pharmaceutical supply chains.
Britain left the EU research framework, then negotiated its way back into Horizon Europe.
And Britain has increasingly sought practical cooperation with the EU again in areas such as health security.
The evidence therefore supports a distinction that appears repeatedly across the Brexit debate:
Brexit increased Britain’s freedom to make its own choices. Whether those choices have made the NHS stronger is much harder to demonstrate.