Caroline Bovey1
Chair, British Dietetic Association
With the government’s defeat on its proposed Brexit deal, the UK finds itself stepping closer to a situation where it leaves the European Union with no deal in place at all. Here, Caroline Bovey offers a view a view on what this might mean for our profession.
It is very clear that a ‘No Deal’ Brexit could have a significantly negative impact on food and nutrition – the government needs to act quickly to mitigate that risk if a deal with the EU is not possible. Our food and healthcare systems are strongly intertwined with our European neighbours, so there are a number of areas of concern.
Specialist products
Many of the specialist nutrition products used by patients to manage serious conditions or recover from surgery or illness are manufactured in the EU or further afield. Government contingency planning has made it clear that they anticipate significant delays at ports. Not only that, but even if products do get through, there is a risk that tariffs either on the products themselves or the ingredients used to produce them will push up prices significantly.
Specialist products are often only produced in relatively small quantities by a small number of manufacturers, so are particularly vulnerable to disruption in the supply chain. These worries were well illustrated by dietitian Suzanne Ford from NSPKU, who recently appeared on BBC Newsnight to highlight the potential challenges facing patients with phenylketonuria, to whom specialist metabolic products are vital.
Stockpiling products or food more generally may help, but this depends on how long disruption caused by “no deal” lasts. The Food and Drink Federation have already said that said that existing storage capacity is pretty much full, so there is a limit to this contingency.
Food supply
Furthermore, as a net importer of food, the UK is reliant upon supply chains from Europe to provide for the nutrition needs of the public as a whole. Our retailers often operate on “Just in Time” models which mean that fresh products in particular may become more difficult to source if Dover and other ports become blocked.
This may make healthy food harder to access or more expensive, with a reduction in variety and choice. It would be the poorest and most vulnerable in our society who would hit the hardest, against a background of already growing food inequality and food poverty.
Hospital catering
Hospital caterers may find themselves particularly badly effected by shortages in supply or sudden price increases. Anything up to 40% of the food provided to patients in hospitals is sources from the EU. Competing against large supermarket chains for more limited or expensive suppliers will be difficult when they are expected to deliver against fixed contracts.
Again, contingency plans are in place but they may involve restricting or changing. It is important that our hospitals cater to a wide range of dietary needs and preferences, from Kosher and Halal to vegetarian or gluten-free. Managing this with fewer and more expensive ingredients, particularly beyond the short term, might be difficult.
Workforce
No Deal also creates uncertainty for the many millions of EU residents who form an important part of our workforce and economy. The NHS and social care are reliant upon skilled European doctors, nurses, carers and AHPs. Dietetics is no exception.
Up to 10% of UK registered dietitians have EU citizenship (mostly Irish), with a further 10% from further afield. They form a hugely important part of our dietetic workforce and it is critical that the government acts, in the event of No Deal, to ensure they can and want to remain in the UK.
What are we doing?
So, to come back to the question posed in the title, the simple, but concerning answer is, we don’t know what the future holds, however, the BDA is working with the Department of Health and NHS Improvement to ensure that they are aware of the wide range of products that might be at risk from a no deal. Lord Balfe, our honorary president, has written to the Secretary of State for Health, Matt Hancock, on our behalf to raise our concerns about the supply of specialist products.
This all paints a rather dark image of the future. It should be possible to mitigate these risks, and it may be that a deal can be reached. But it is important that we are prepared and the BDA will continue to influence through a wide range of avenues.