Intended for healthcare professionals


The dispute over the Northern Ireland Protocol may benefit some politicians, but is very bad for science and health

BMJ 2022; 377 doi: (Published 18 May 2022) Cite this as: BMJ 2022;377:o1243
  1. Martin McKee, professor of European public health
  1. London School of Hygiene and Tropical Medicine

The 98 UK-based researchers who were awarded £145 million in the latest round of European Research Council grants are justifiably angry. The European Research Council (ERC) has written to them to say that if the UK’s associate membership of the €80bn Horizon Europe programme is not ratified then they will not be eligible for the funding. As one researcher commented, “We all had reason to believe that the UK association was just a matter of the UK implementing the free trade agreement. Now we are waking up to the reality. It is very devastating.”1

That belief was understandable if one listened to British politicians, such as those who argued that a deal with the EU would be “the easiest in history.” Those who understood how the EU worked, a group widely dismissed as promoting “Project Fear,” knew better. They pointed to what happened when Switzerland held a referendum that excluded Croatian citizens, whose country had just joined the EU, from free movement, a right agreed with all the other EU citizens.2 The EU halted Swiss participation in EU research programmes and the Swiss held a second referendum, reversing the first decision. The matter was then resolved. The message was simple. Being a member of the EU, or its programmes, has many benefits, but also brings obligations. As was pointed out during the Brexit negotiations, you cannot have your cake and eat it.

There are several reasons why the UK cannot now participate in the EU’s research programmes but, as the EU’s Research Commissioner has made clear, resolving the dispute over the Northern Ireland Protocol is key.3 Yet repeatedly Boris Johnson, the British prime minister, has said that he has “got Brexit done.” But has he?

Johnson’s predecessor, Theresa May’s approach to Brexit gave rise to what has been termed a trilemma, with mutually incompatible requirements.4 Taking the whole UK out of the Single Market and Customs Union, would require a border on the island of Ireland to protect the Single Market from what may, in time, be food and other products that did not meet its standards. This was a real fear given the support among British politicians for reducing those standards, especially given how many of those standards were introduced after British policies led to bovine spongiform encephalopathy (BSE). But such a border was inconsistent with the principles in the Good Friday Agreement that had brought peace to Northern Ireland. This could be resolved by a border between Great Britain and the island of Ireland, but that was unacceptable to Unionists in Northern Ireland. There was an obvious solution. The UK could continue to apply EU standards, just like Norway. As long as it did, there was no need for checks either on the island of Ireland or in the Irish Sea. This was the so-called backstop, but it was unacceptable to Conservative backbenchers.

The EU had prioritized this issue given its concerns about the peace process in Northern Ireland and insisted that negotiations on a future trade agreement with the UK could only start once it was resolved. The solution adopted by both parties, and lauded by the UK government as a great success, was the Northern Ireland Protocol. This did place the border in the Irish Sea but sought ways to minimize the necessary checks. However, as long as the UK refused to maintain EU standards, they could not be removed without compromising the free movement across the Irish border or between Ireland and the rest of the EU.

It is working. Northern Ireland’s economy is growing faster than the rest of the UK, taking advantage of its links to both Great Britain and the EU.5 The Protocol is supported by a clear majority of the people of Northern Ireland and a large majority of their elected representatives in the Northern Ireland Assembly.6 Where genuine problems have arisen, such as the supply of medicines, the EU has shown an ability to find creative practical solutions.7 It is true that some British supermarket chains face problems moving goods to their Northern Irish outlets, but other chains, such as Lidl, simply source their products locally or from the EU.8 So why are some of the UK’s leading scientists now asking whether they must relocate to the EU?

To answer this question, it is necessary to understand Northern Irish politics. Since its creation a century ago, Unionists parties have been dominant, but are now losing ground, mainly to the non-sectarian Alliance Party. Before the recent election to the Northern Ireland Assembly it was clear that Sinn Fein, which draws its support from the nationalist community and favours Irish unification, could become the largest party. This would allow them to nominate the First Minister while the Unionists would nominate the Deputy First Minister. In reality, the two posts are equal, but the words are symbolic. The Northern Ireland Protocol offered an ideal excuse to reject the decision of the electorate. It stretches credulity to argue that large numbers of people in Northern Ireland are exercised about the role of the European Court of Justice in interpreting EU law as they, like people across the UK, are struggling with the rising cost of living.

The dispute over the Protocol brings benefits for others too. Those who see themselves as candidates to succeed Boris Johnson can use it to display their anti-EU credentials. However, they can only do so by creating an alternative version of reality.9 The Protocol was not intended to be temporary. Any problems now occurring were foreseen in the government’s own impact assessments.10 The suggestion by Liz Truss that Northern Ireland, with over 700 000 pigs, will suffer because it is difficult to import Brazilian pork is ludicrous.11 And the Attorney General’s claim that disapplying the protocol seems to be based on a concept of “primordial significance,” implies a hierarchy of treaties that simply does not exist in law.12

Meanwhile, this dispute has prevented the Northern Ireland Assembly from convening. This is at a time when its health service desperately needs action. Waiting lists are the longest in the UK.13 The BMA and other organisations representing NHS staff have called for Assembly Members to do what they were elected to do but, inevitably, they have been attacked by some Unionists for saying this.14

Edward Carson, a hero of Unionism whose statue stands in front of the Parliament Buildings in Belfast, famously said “What a fool I was. I was only a puppet, and so was Ulster, and so was Ireland, in the political game that was to get the Conservative Party into power.”15 Some might think that little has changed.


  • Competing interests: MM was born in Northern Ireland. He was an adviser to Scientists for EU, which campaigned against Brexit. He is President Elect of the BMA and is a Past President of the European Public Health Association. He writes in a personal capacity.


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