Northern Ireland’s health system in decline

Patients suffer as Brexit affects the transport of medication from Great Britain to Northern Ireland. 

Certain brands of medication are in great demand as the Northern Ireland protocol which came into effect on the January 1st, 2021 as a result of Brexit, causes a shortage due to various regulations.

The protocol created a trade border across the Irish sea and as a result medicines in the Great Britain must now be licensed separately than those in Northern Ireland. All medications moving from the GB to NI are required to have custom declarations as they are at risk goods, 98 per cent of NI’s medication comes from GB.

All these new regulations for goods travelling from GB to NI has resulted in patients receiving the same medication but by an alternative brand name or produced by different manufacturers where the compound, look or indeed taste of the medication has changed.

The impact on the patients receiving these medicines due to a change in brand has been both physical and mental effects. These changes have affected patients across Northern Ireland from private hospitals to nursing homes not to mention everyday individuals.

Sister Oana Tache a nurse in Cookstown’s Fairfields Care Centre which houses over 75 residents and receives medication through the NHS stated that ‘many of our core medicines have been changed to cheaper alternatives, many of these are causing minor side effects such as headaches or nausea. We also have had various supply issues, so some medicines are being missed for two to three days’.

The shortage of medication meaning elderly and vulnerable residents are not receiving their essential medicine for two to three days at a time is dangerous and lessens the effectiveness of the treatment. The change for a cheaper medicine has negatively impacted on the residents at the home as they are experiencing various side effects.

Mr Mark Hamilton a resident in Fairfields care centre has expressed his anxiety at his normal epilepsy medicine Epilum being changed to an EU brand named Valproate. Mr Hamilton states ‘the taste is making me nauseous, now I have to take more drugs to stop it as well. It’s just not right or fair, I was used to the medication I was taking before this’.

Brexit has resulted in these regulations on medication to be put in place, the NI protocol is what has created the trade market separation between GB and NI. This is making many of the Northern Irish people miserable especially the elderly who rely strongly on medication.

Rosalyn Craig a nurse manager in Kingsbridge private hospital in Ballykelly which treats patients through private healthcare stated that ‘some less commonly used drugs are now not available as it isn’t economically feasible to apply for a NI licence due to the small market. Our consultants are having to research what is available to undertake certain procedures.’

Kingsbridge private hospital gets its medication from Phoenix Healthcare distribution limited who stated that Brexit has ‘led to additional costs and bureaucracy across the health sector’.

This has not only impacted the patients who receive private healthcare but also those who receive healthcare via the NHS. As the Kingsbridge private hospital performs procedures on patients from the NHS who are on waiting lists for certain surgeries, these patients could be waiting for years on these lists. Therefore, the inability of the private hospitals to receive certain medications for procedures pushes those on waiting lists surgeries back even longer.

Those suffering from long term disease are also being impacted by the regulations for medication between NI and GB. Phillip McGowan who suffers with Crohn’s disease has had the same medication for eight years and due to Brexit and the regulations in place via the NI protocol he now had to change the brand of his medication. He stated ‘the new brand of medication I was given caused severe nausea, due to this the NHS gave me a different medication again which is much more expensive than my original one. I just can’t help but wonder how much money the health service is losing on issues like this.’

This displays clearly the impact these regulations are not only having on those who are ill and need of medication, but the economy is also taking a hit. As a nation NI cannot afford to take another hit on its economy especially in sectors such as healthcare during the cost-of-living crisis.

The trade issues between the Great Britain and Northern Ireland regarding medication originate in the fact that NI is part of the European single market for these products, the single market is a bloc which most trade barriers have been removed for goods.

Safety inspections and other checks on medication coming from the UK must take place before Northern Irish patients can receive them.

These checks are done to ensure the medications follow the appropriate regulations. The checks are however another new expense the UK must accommodate, these checks include such things as having to deactivate and reactivate the security tags that must go on medicine bottles.

This is in accordance with the Falsified Medicines Directive. Not to mention the whole escapade being extremely time consuming.

Another issue then arises as to whether the medications approved by the UK regulator MHRA are also regulated by the European Union regulator the EMA, and if not MHRA approved medications cannot be used by the Northern Irish citizens.

These new importation regulation requirements and compliance with the Falsified Medicines Directive checks were phased in to allow time for the healthcare industry to prepare as agreed by the UK and EU. The phased return ended on December 31st, 2021.

Despite this many of the declared issues still remain even though the EU says they will form a creative solution to solve this issue in 2021.

Northern Irish citizens are receiving their medication from Great Britain but a cheaper version or several days later than they were supposed to which is greatly impacting the health of individuals across NI, this is a result of Brexit.