Brexit has claimed an unexpected victim: patient care in England’s National Health Service (NHS) hospitals. According to a new IZA discussion paper by Henrique Castro-Pires, Kai Fischer, Marco Mello, and Giuseppe Moscelli, hospitals previously reliant on European Union nurses experienced significant declines in care quality following Brexit, leading to approximately 4,454 additional deaths and 8,777 extra unplanned readmissions across England.
The study employs a difference-in-differences approach, comparing hospitals with varying levels of pre-Brexit dependence on EU nurses. This methodology isolates Brexit’s specific impact from other potential factors affecting healthcare quality.
The researchers estimate that Brexit’s immigration restrictions resulted in roughly 1,485 additional patient deaths annually. This alarming increase in mortality appears directly linked to staffing changes forced by the sudden reduction in EU nurse recruitment.
Hospitals responded to the nurse shortage by hiring less-skilled replacements, the authors note. Evidence for this skills downgrade appears in the lower pay grades assigned to new nursing hires in the post-Brexit period.
The research team developed a theoretical framework predicting that Brexit would force hospitals previously dependent on EU nurses to lower their hiring standards, subsequently reducing care quality. This effect would occur regardless of whether overall nurse numbers were maintained.
Importantly, the negative impact varied based on pre-Brexit staffing patterns. Hospitals with higher reliance on EU nurses before the referendum experienced more severe quality declines than those less dependent on European staff.
The researchers took extensive measures to ensure their findings weren’t influenced by confounding variables, controlling for pre-Brexit changes in hospital finances, patient volumes, bed occupancy, and workforce composition.
While nursing was particularly affected, the study suggests higher-paying medical positions faced less severe consequences, as the relative wage advantage of UK employment continued to attract qualified candidates even after Brexit.
This research carries profound policy implications, highlighting how immigration restrictions can severely impact essential services like healthcare. As countries worldwide debate immigration policies, this cautionary tale demonstrates how limiting skilled worker mobility can produce unintended—and potentially deadly—consequences.