Parkinson's UK in Scotland has told the Scottish Parliament that the Brexit process is causing concern for people with Parkinson's around their ability to access essential medication.
The charity also highlighted the potential for further pressures on the health and social care workforce, and the threat to continued collaborative Parkinson's research.
This was in response to an inquiry by the Scottish Parliament's Health and Sport Committee, into the impact of leaving the European Union on health and social care in Scotland.
Medication is the main method used to control the symptoms of Parkinson's. Without it, people can be left unable to move, speak or swallow, and can experience severe mental health symptoms.
Annie Macleod, Director of Parkinson's UK in Scotland, says:
"We have 2 major concerns around access to medication. Firstly there is a potential that any disruption to the supply chain would lead to medication shortages and people with Parkinson's being forced to switch between preparations. We also want to see action to avoid any delays in making new drugs and treatments available
"Parkinson's medications are often available in branded and generic versions. The medicines are currently manufactured in several EU countries, and can have lengthy international supply chains. The medicines can often be substituted, but for many people changes in supply of Parkinson's medication or switching between generics and brands leads to sudden treatment failure with subsequent risk of serious complications such as infections and falls.
"We are seriously concerned that there will be major problems if people with Parkinson's cannot access a continuous supply of the specific preparations that work for them."
On the issue of delays in accessing new medications Annie Macleod adds:
"Withdrawal from the European Medicines Agency must not lead to delays in new medicines being available in the UK. The EU accounts for 26% of the world's medicines market, compared to the UK's 3%. Other countries, such as Canada and Australia, are typically 6-12 months behind the EU in terms of licensing new medicines."
Parkinson's UK in Scotland is also concerned that increased pressure on the health and social care workforce in Scotland should be avoided.
Audit Scotland has identified "urgent workforce challenges" for the NHS in Scotland - 5-6% of NHS Scotland doctors and 4% of trainee nurses are EU nationals. And Scottish Care reports that 8% of nurses based in care homes are EU nationals, and 6% of the care home workforce are from the EU.
People with Parkinson's need ongoing support from a multi-disciplinary team of health professionals, and typically require increasing amounts of social care as their condition progresses.
Annie Macleod adds:
"There's a lack of clarity about the terms under which EU nationals will be able to work in Scotland after Brexit. It is vital that any solution does not overlook care workers who could well fall below any earnings threshold attached to the right to remain and work."
When it comes to Parkinson's research, Parkinson's UK is Europe's largest non-commercial funder of Parkinson's research. And despite huge scientific progress, none of the available Parkinson's treatments can reverse or slow down the progress of Parkinson's.
A number of Parkinson's researchers currently working in Scotland are EU nationals. It is essential that Scotland and the UK continue to be attractive places for the best researchers to live and work after Brexit, both to avoid losing their contribution and to encourage others to work here in the future.
Annie Macleod continues:
"People with Parkinson's tell us that they want to participate in clinical trials but that opportunities are already limited. We want to make sure that people living in Scotland and the rest of the UK retain the ability to take part in EU-wide clinical trials for new treatment, and that clinical trials originating here are able to recruit from the widest possible pool of participants, including those living in the EU.
"While Parkinson's UK does not currently receive any funding from the EU, some of our partners and Parkinson's research centres in the UK do. If this funding is lost, it is not likely to be replaced by UK or Scottish Government funding streams.
"This could have a chilling impact on the research sector. It is imperative that researchers based in Scotland and the rest of the UK continue to be able to access EU funding programmes and collaborations."
Parkinson's UK supports calls from the Health and Social Care Alliance and others to implement an independent evaluation of the impact of Brexit on the health and social care sectors across the UK.