Brexit’s Aftershocks: Migration, Health, and Territorial Strains in the UK

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Migration and Labour

The Brexit era reshaped not only the economy but also the flow of people into and out of the United Kingdom. Net migration from EU countries peaked just before the referendum, reaching 322,000 arrivals, according to the National Statistics Office. Since then, numbers have declined year after year, turning negative by December 2021 and remaining low. The loss of European workers has been offset by new arrivals from non EU countries, pushing net migration to historically high levels at the start of the previous year.

The surge of foreign workers has strained the governing parties, who promised to curb immigration but have struggled to deliver. The previous administration under a former prime minister introduced measures that eased visa requirements in critical sectors like health and social care, mindful of the need to fill essential roles. In sectors such as care and agriculture there has been some substitution of workers from Europe, yet shortages persist in services including hospitality and certain manual jobs, according to researchers from Oxford University’s Migration Observatory.
Officials from sectors like agriculture and transport have pressed the government to facilitate a steady flow of workers who previously came from Eastern Europe before Brexit.

The prime minister has launched plans to re-engage millions of Britons who are inactive in the labour market. The aim is twofold: reduce welfare spending and address labour shortages in certain industries. Still, questions remain about the capacity to attract workers to roles with lower pay and tougher conditions. Local residents and existing migrants alike often pursue higher paid positions, leaving vacancies in lower paid service roles, notes a senior researcher from Oxford. Many migrants enter the care sector to gain access to the job market and move on when better opportunities arise.

Public Health System Strain

Despite foreign workers counting for a substantial portion of staff in the National Health Service, the Sunak government has introduced tighter rules for immigration, including higher wages required for visa eligibility and restrictions on dependent family members. These limits also affect student visas, which are likely to lead to fewer applications to British universities and lower income from international students.

Staff shortages in the NHS rank among the biggest challenges facing the public health system. The share of healthcare workers from Asia and Africa has risen since 2016 as the NHS seeks to compensate for the reduced inflow of European doctors and nurses and the wave of burnout following the pandemic. In certain specialties such as cardiology, anesthesiology, and psychiatry, there are still no ready replacements for trained professionals from the EU. NHS England reports that about 7.5 percent of NHS posts were unfilled in March 2024.

The recruitment gaps have contributed to longer waiting lists. By April 2024, more than 7.5 million people in England were awaiting treatment, about 300,000 more than a year earlier. The government attributes the rise to the pandemic and to strikes by doctors and nurses demanding better pay and working conditions. Although some disputes have been resolved, talks with junior doctors have continued to unfold with discussions scheduled around the time of elections.

Territorial Tensions

Brexit also catalyzed greater regional fragmentation within the United Kingdom. Negotiations over the Northern Ireland Protocol, which seeks to manage checks on goods moving between the UK and the EU across the Irish border, sharpened tensions with Northern Ireland unionists and hardline Tory factions. The Windsor Framework was ultimately signed to avoid a hard border in Ireland while keeping the Northern Ireland flow aligned with the UK market. Critics still argue that Northern Ireland remains tethered to European law in many respects, raising doubts about its full integration into the UK internal market.

The political implications of the protocol have influenced electoral dynamics in Northern Ireland, benefiting Sinn Féin, historically tied to the Irish republican movement. In a regional election, Sinn Féin achieved a historic victory, underscoring the broader shifts in the unionist camp. Surveys indicate a significant portion of Northern Ireland residents foresee a future reunification with the Republic, while a large share believes Brexit has intensified the possibility. Experts highlight that the next steps depend on broader political developments in both the UK and the Republic of Ireland, as the question of a referendum remains a decision for the British government rather than the Irish administration.

While a full reunification remains a distant prospect in the medium term, Brexit has nonetheless driven a clear distancing between Northern Ireland and the rest of the UK. At the same time, calls for increased autonomy in Scotland and, to a lesser degree, in Wales persist, with nationalist movements pushing for referendums on future status and potential re-entry into the European Union.

In sum, the Brexit era has spurred a rethinking of migration, labour supply, public services, and regional balance within the United Kingdom. The path forward will likely hinge on political stability, economic performance, and how policymakers address both labor market needs and regional tensions as the country navigates post Brexit reality [Citation].

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