# No deal brexit and insulin



## Jamiesamp (Dec 10, 2020)

Is anyone else worried about the consequences of no brexit on our insulin supply and food


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## trophywench (Dec 10, 2020)

Concerned, yes of course.  Not actually worried though - yet!


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## pm133 (Dec 10, 2020)

Jamiesamp said:


> Is anyone else worried about the consequences of no brexit on our insulin supply and food


Not worried, no.
There won't be an existential threat to the country's supply of insulin but it might be sensible to make sure you are well stocked for a couple of months.
Just picked up my new bolus today and that will see me through to probably March.


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## Sally71 (Dec 10, 2020)

Yes a little bit but there isn’t much we can do about it.  I very much doubt that even our incompetent government would allow lots of people to die because of Brexit.  I have gradually built up a good stock of everything though just in case!


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## nonethewiser (Dec 11, 2020)

No worries here, all will work out alright.


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## SaraKaya (Dec 11, 2020)

I am so glad someone has raised this as it is something that has been on my mind! I have only been diagnosed a few months so haven’t been able to ‘stockpile’ anything and have been wondering if my Insulin would be difficult to obtain after the new year (is it imported?) 
Will there be a toilet roll style rush to get Insulin do you think!!??


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## Robin (Dec 11, 2020)

SaraKaya said:


> I am so glad someone has raised this as it is something that has been on my mind! I have only been diagnosed a few months so haven’t been able to ‘stockpile’ anything and have been wondering if my Insulin would be difficult to obtain after the new year (is it imported?)
> Will there be a toilet roll style rush to get Insulin do you think!!??


Insulin suppliers have been asked to keep six weeks extra stock in the U.K. just in case of delays, see here.





						Brexit and diabetes
					

If you’re living with or affected by diabetes, we know you might be worried about how Brexit and leaving the EU may affect things like your diabetes medicines, particularly insulin supplies. How could Brexit affect diabetes? The UK is no longer a member of the European Union (EU) and the...




					www.diabetes.org.uk


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## Bruce Stephens (Dec 11, 2020)

Almost all our insulin is imported. I'm perhaps being overoptimistic but I think the government will work really hard for this  kind of thing to go OK. The official advice is *not* to stockpile.


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## SaraKaya (Dec 11, 2020)

Thank you that’s really helpful.


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## Sally71 (Dec 11, 2020)

There can’t be a toilet roll style rush, you can only get insulin on prescription and your doctor will only allow you to order so much.  If I put in a request for some, I’m not allowed to order it again for 3 weeks, and trying to get the quantity per prescription increased was a right palaver when my daughter was growing all the time and the two bottles per month we had was not lasting long enough!


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## helli (Dec 11, 2020)

My doctor only allows me to order three vials at a time but they do not not limit how often I order.
I will not be massively stock piling because I believe that is selfish but, given it is also Christmas, I will make sure I have some spare for the new year.


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## rebrascora (Dec 11, 2020)

I know it will be a controversial comment but....
Maybe a good time to start eating lower carb and therefore needing less insulin perhaps? 
A prescription of 5 cartridges might last 6 months for me if I am extra careful. Rather than stockpile, does it not make sense to try to use less? 
.... Just my thoughts.


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## trophywench (Dec 12, 2020)

Good God Barbara - that really is a tiny amount!  But of course my eating less carb wouldn't have made very much difference to that.  I've never needed massive doses but on MDI I was using 30+u a day.  18-20u basal and the rest bolus and corrections.   With all the airshots and general wastage I'd easily get through 7 x 3ml cartridges per calendar month.

But you just need however much your body needs - so shouldn't really compare since it doesn't help anyone really.


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## pm133 (Dec 12, 2020)

Sally71 said:


> There can’t be a toilet roll style rush, you can only get insulin on prescription and your doctor will only allow you to order so much.  If I put in a request for some, I’m not allowed to order it again for 3 weeks, and trying to get the quantity per prescription increased was a right palaver when my daughter was growing all the time and the two bottles per month we had was not lasting long enough!


I take it you are on vials and not on insulin pens?
My pens come in packs of 5 which will end up lasting me for over 2 months and I re-order when I am down to my last 2 to avoid possible problems with a dodgy or broken pen.


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## pm133 (Dec 12, 2020)

rebrascora said:


> I know it will be a controversial comment but....
> Maybe a good time to start eating lower carb and therefore needing less insulin perhaps?
> A prescription of 5 cartridges might last 6 months for me if I am extra careful. Rather than stockpile, does it not make sense to try to use less?
> .... Just my thoughts.


As an emergency, this is obviously something which could be done but there is no solid evidence in the scientific literature that I am aware of for any benefit to Type 1s in deliberately adopting a low carb diet as a matter of course either in terms of avoiding diabetes complications or in controlling blood glucose levels. I suspect that a low carb diet might actually make blood glucose control much more difficult for a type 1 because of inevitable large glucose dumps during the day and large glucose reclamation at night by the liver but I have no proof of that.

Of course, if someone who was type 1 made a low carb diet a lifestyle choice then that's a matter for them personally but the idea that you can control type 1 largely by diet is not supported by the science.


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## Sally71 (Dec 12, 2020)

pm133 said:


> I take it you are on vials and not on insulin pens?
> My pens come in packs of 5 which will end up lasting me for over 2 months and I re-order when I am down to my last 2 to avoid possible problems with a dodgy or broken pen.


Yes we are pumping, one 10ml vial is 3 1/3 pump refills, each refill lasts 3-4 days (because it's doing basal as well as bolus)


pm133 said:


> As an emergency, this is obviously something which could be done but there is no solid evidence in the scientific literature that I am aware of for any benefit to Type 1s in deliberately adopting a low carb diet as a matter of course either in terms of avoiding diabetes complications or in controlling blood glucose levels. I suspect that a low carb diet might actually make blood glucose control much more difficult for a type 1 because of inevitable large glucose dumps during the day and large glucose reclamation at night by the liver but I have no proof of that.
> 
> Of course, if someone who was type 1 made a low carb diet a lifestyle choice then that's a matter for them personally but the idea that you can control type 1 largely by diet is not supported by the science.


To some extent it would, meal boluses are smaller if you eat less carbs and you’d probably get less or smaller spikes between meals.  My daughter's blood sugars are much more likely to go crazy if she's eaten a particularly carb heavy meal, which means more likelihood of needing correction doses as well.  I agree it wouldn’t work 100% though, you always get those days when it all goes wrong and you can’t work out why, female hormones are wonderful too...


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## pm133 (Dec 12, 2020)

Sally71 said:


> Yes we are pumping, one 10ml vial is 3 1/3 pump refills, each refill lasts 3-4 days (because it's doing basal as well as bolus)
> 
> To some extent it would, meal boluses are smaller if you eat less carbs and you’d probably get less or smaller spikes between meals.  My daughter's blood sugars are much more likely to go crazy if she's eaten a particularly carb heavy meal, which means more likelihood of needing correction doses as well.  I agree it wouldn’t work 100% though, you always get those days when it all goes wrong and you can’t work out why, female hormones are wonderful too...


Spikes in type 1s don't happen because of "high carbs" though. They happen because of the type of carb and how it reacts with your body. That is person-specific.
The carb heavy thing is more to do with the fact that the bolus has ran out but there's still food to metabolise. That's when a correction is needed. If your daughter is spiking I would check the nature of the carbs causing it.

We have posters on this site on ultra low carb diets and still experiencing wild an unpredictable blood sugar swings.


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## Kaylz (Dec 12, 2020)

pm133 said:


> Spikes in type 1s don't happen because of "high carbs" though. They happen because of the type of carb and how it reacts with your body. That is person-specific.
> The carb heavy thing is more to do with the fact that the bolus has ran out but there's still food to metabolise. That's when a correction is needed. If your daughter is spiking I would check the nature of the carbs causing it.
> 
> We have posters on this site on ultra low carb diets and still experiencing wild an unpredictable blood sugar swings.


Please remember,  Sally is  experienced in caring for her daughter's Type 1, she's been at it for years.  Her daughter is still growing which throws spanners in the works and you have to take females hormones into account as well!


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## Docb (Dec 12, 2020)

Puts moderators hat on.....

Everybody's views have merit and everybody is entitled to suggest an alternative way of looking at things but getting personal when disagreeing helps nobody, especially the original poster or anybody else seeking help from the thread.  So, come on people, bury the hatchet and get on with what you do best which is to use your varied experiences to suggest ways forward for members who are confused or struggling.

Takes moderators hat off..... 

Good to see you posting again @Kaylz.  I have found your contributions really valuable when it comes to my trying to understand what living with type 1 is all about.  Not only that, because of your openness about your life they always remind me that there is a person behind the words and that is something I must not forget when I respond to posts.


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## AJLang (Dec 12, 2020)

Interesting to see how we vary in our insulin needs. If I don’t eat any carbs I still need 35 units for basal in my pump and that hasn’t changed too much over the years.


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## rebrascora (Dec 12, 2020)

pm133 said:


> As an emergency, this is obviously something which could be done


That was why I was posting it here.... for people to give thought to, in case they get into the situation where they are struggling to get insulin. Having a plan B is always a good idea, but difficult to implement at short notice if you haven't tried low carb or planned for it. 
For me, knowing that I can get by on minimal insulin is a bit of a comfort as we approach No Deal Brexit. I do also have faith in the manufacturers to have stockpiled enough in the UK to tide us over the initial chaos which may well ensue.

The problem with any dietary studies is that you have no idea if people are following a particular diet unless they are incarcerated with no other access to food which I believe was done in the 50s in a mental institution to test some research on fat in the diet, if I remember rightly..... shockingly unethical! 

For me my low carb choice is because I don't trust myself not to revert back to the sugar habit I had before diagnosis. It is no different to a recovering alcoholic except that occasionally I have to give myself the odd sugar fix to recover from a hypo, whereas alcoholics can totally abstain. As long as I keep the carbs low though, I don't have the cravings and I feel fitter and healthier than I have for many years.... so there are other mental and physical health reasons for my low carb way of life.... what I would say is ..... don't knock it if you haven't tried it....  and just because it is not "the norm" diet wise, in our current times and unproven as being beneficial doesn't mean that your  "normal carb diet" is any more proven to be good for us.


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## rebrascora (Dec 12, 2020)

AJLang said:


> Interesting to see how we vary in our insulin needs. If I don’t eat any carbs I still need 35 units for basal in my pump and that hasn’t changed too much over the years.


It will make a difference to your bolus needs though.... 

I will confess that my basal needs have reduced significantly since I started doing a lot more exercise.... so... maybe I should also mention increased exercise as another angle/strategy to look at if insulin is running short. 

I appreciate that some people cannot make these changes for various reasons, but maybe those of us who can should consider doing so, so that there is less strain on limited resources for others who can't.


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## Robin (Dec 12, 2020)

rebrascora said:


> I will confess that my basal needs have reduced significantly since I started doing a lot more exercise.... so... maybe I should also mention increased exercise as another angle/strategy to look at if insulin is running short.


Doesn’t always play ball like that, though. Last week I was looking after and exercising a horse for two mornings, so a lot of increased activity. Day one, I had 2 units of bolus for my Dawn effect, and scrambled egg for breakfast. By the time I'd finished just before lunch, I’d shot up to 15. Next day, I had 5 units of insulin for a breakfast of muesli  (30g carb). My BG never went above 7 the whole morning. I suspect Mr. Liver at work on day one.


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## AJLang (Dec 12, 2020)

rebrascora said:


> It will make a difference to your bolus needs though....
> 
> I will confess that my basal needs have reduced significantly since I started doing a lot more exercise.... so... maybe I should also mention increased exercise as another angle/strategy to look at if insulin is running short.
> 
> I appreciate that some people cannot make these changes for various reasons, but maybe those of us who can should consider doing so, so that there is less strain on limited resources for others who can't.


The point I was trying to make was that even if I went zero carb I would still not be able to reduce my insulin need significantly if there was an insulin shortage due to my basal needs.
Not trying to be awkward but some of us are not able to/no longer able to do sufficient exercise to reduce basal rates - and for me that’s despite being a former gym bunny/dog walker/swimmer.
im not a low carb advocate but as it happens I average a maximum of 60-80 carbs a day.


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## trophywench (Dec 12, 2020)

You see - it is all absolutely different for each and every one of us!!  Sally's daughter obviously needs SHEDLOADS more insulin generally than I ever do or even would in a month of Sundays - (so does Amanda) goodness knows how much I might have needed had I been diagnosed when a child - there absolutely is no point whatsoever in trying to compare either physical amounts of insulin or carbs eaten!

I'm currently getting cross because it really is puzzling to me after years and years - decades! - of having practically the same lunch every day - ie one sandwich & nowt else (well sometimes plus about 3 crisps nicked from Pierre's packet) - why the heck my BG suddenly stays above 10 all afternoon and doesn't slide gracefully downwards again after a couple of hours like what it always reliably did.  I didn't really notice this too much till I got the Libre of course, although I did know BG dropped often too much before dinner in the evening, so at least I've been able to fiddle with a few hours basal rates at times - but this lunchtime thing is odd.  I could change the carb ratio for it - but I'd have to add such a lot - approx 30% - it seems weird to me - I've only every had to change things by the very minimum (less than 5%) at a time in the past.


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## rebrascora (Dec 12, 2020)

Robin said:


> Doesn’t always play ball like that, though. Last week I was looking after and exercising a horse for two mornings, so a lot of increased activity. Day one, I had 2 units of bolus for my Dawn effect, and scrambled egg for breakfast. By the time I'd finished just before lunch, I’d shot up to 15. Next day, I had 5 units of insulin for a breakfast of muesli  (30g carb). My BG never went above 7 the whole morning. I suspect Mr. Liver at work on day one.


I understand that but over the longer period it does seem to settle down and reduce with consistent increased daily exercise. 
I am still using 1 unit of Fiasp for DP whereas normally it would be 1.5-2 but since the increase in exercise, my overnight basal needs have vanished. I was needing 7-8 units at night this time last year and none now. I don't need bolus for my evening meal either, so I can almost pretend I am only part time diabetic.... insulin in the morning and then just some exercise and low carb to see me through the rest of the day. I might need a little correction in the afternoon if I am naughty and have a few too many peanuts at lunchtime. For me it takes a bit of the relentlessness of it away by not having to think about injections on an evening.


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## rebrascora (Dec 12, 2020)

AJLang said:


> Not trying to be awkward but some of us are not able to/no longer able to do sufficient exercise to reduce basal rates - and for me that’s despite being a former gym bunny/dog walker/swimmer.


I totally appreciate that which is why I put the caveat sentence at the bottom of my post....

"I appreciate that some people cannot make these changes for various reasons, but maybe those of us who can should consider doing so, so that there is less strain on limited resources for others who can't."


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## Sally71 (Dec 12, 2020)

trophywench said:


> You see - it is all absolutely different for each and every one of us!!  Sally's daughter obviously needs SHEDLOADS more insulin generally than I ever do or even would in a month of Sundays - (so does Amanda) goodness knows how much I might have needed had I been diagnosed when a child - there absolutely is no point whatsoever in trying to compare either physical amounts of insulin or carbs eaten!
> 
> I'm currently getting cross because it really is puzzling to me after years and years - decades! - of having practically the same lunch every day - ie one sandwich & nowt else (well sometimes plus about 3 crisps nicked from Pierre's packet) - why the heck my BG suddenly stays above 10 all afternoon and doesn't slide gracefully downwards again after a couple of hours like what it always reliably did.  I didn't really notice this too much till I got the Libre of course, although I did know BG dropped often too much before dinner in the evening, so at least I've been able to fiddle with a few hours basal rates at times - but this lunchtime thing is odd.  I could change the carb ratio for it - but I'd have to add such a lot - approx 30% - it seems weird to me - I've only every had to change things by the very minimum (less than 5%) at a time in the past.


LOL - and here is another little conundrum for you - daughter goes to dance classes for 2 hours on Saturday mornings, leaves pump at home all that time, walks home, faffs about for some considerable time before getting in the shower and then takes ages before getting out again.  Then eventually puts her pump back on after about 5 hours.  By which time she usually needs a large correction (I have nagged her about doing a correction BEFORE going in the shower but the message doesn’t seem to be getting across, and she isn’t always high by then). 
Today - she has had no pump on for nearly 5 hours and has been hypo for the last two - we haven’t bothered treating because we have been expecting a rise any minute now (after all no basal is what Control IQ/Medtronic pumps do to correct lows.)  Ummmm...   Sensor is working correctly!


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## rebrascora (Dec 12, 2020)

@Sally71 
I have tried that with my night time hypos where I have no active insulin in my system and still go low and I expect that it will come back up itself but I get a nasty liver dump if I leave it too long, so now I just have 1 jelly baby or 2 if I am below 3.5 but don't have the full 3 JBs that I would normally treat a hypo with.


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## trophywench (Dec 12, 2020)

We-e-ell - whilst it is true that yes even though we're pumping and have no 'basal' insulin hanging about - we still have so called fast acting insulin at work for a certain number of hours from what dripped in prior to removing our pump - it would concern me doing that as often as once a week - because it is 100% true that the body needs both insulin and glucose to function - the body will still make glucose from food we ate whenever previously, or operate on stored fat/ketones in the absence of actual food - but not for ever so long, when there is NO insulin.  No use to the body when the glucose can't get into the cells, surely?

So-o-o - what future glitches in health are you, however accidentally, instigating, by such actions?

Clearly - I don't know.  Or know whether anyone does.


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## nonethewiser (Dec 12, 2020)

rebrascora said:


> It will make a difference to your bolus needs though....



Well not in everyone my friend. 

Tried going low carb for 2 months, 60g daily & didn't cheat.  Found initial bolus dose for meal was low but then needed top up 2 & 4 hours after eating, so instead of injecting once each meal would need 2 sometimes 3 doses, in total dose would be same as before eating this way. Saw no increase decrease in basal.

Still eat odd low carb meal, omelette being one, cope better now on pump as bolus dose gets split, 40% before meal then rest trickled  in over few hours.


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## pm133 (Dec 13, 2020)

rebrascora said:


> That was why I was posting it here.... for people to give thought to, in case they get into the situation where they are struggling to get insulin. Having a plan B is always a good idea, but difficult to implement at short notice if you haven't tried low carb or planned for it.
> For me, knowing that I can get by on minimal insulin is a bit of a comfort as we approach No Deal Brexit. I do also have faith in the manufacturers to have stockpiled enough in the UK to tide us over the initial chaos which may well ensue.
> 
> The problem with any dietary studies is that you have no idea if people are following a particular diet unless they are incarcerated with no other access to food which I believe was done in the 50s in a mental institution to test some research on fat in the diet, if I remember rightly..... shockingly unethical!
> ...


I should clarify that I am not knocking your personal choice to follow a low carb diet. I don't understand it but that's a different thing and none of my business. I wouldn't normally have commented at all but it was when you were advocating it to another poster that I wanted to say something from the opposite side of the argument.

You make a perfectly reasonable point about the "normal carb diet" not necessarily being more proven to be good for us. None of us have the answers here and people will rightly follow whatever path they feel works for them, perhaps taking others thoughts and opinions into account in doing so, but ultimately making their own minds up.


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## pm133 (Dec 13, 2020)

Members are perfectly capable of assessing the value and credibility of my advice for themselves.

Alternatively, if someone wants to challenge the specific details of my post and show me where my advice is wrong, then I welcome that.


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## pm133 (Dec 13, 2020)

Anyway, dragging the discussion back to the original post, it really is staggerring that a bit of common sense has not kicked in with the government over Brexit. Surely, in the teeth of this pandemic, a short delay to Brexit until the pandemic was under a bit of control would have been sensible?


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## trophywench (Dec 13, 2020)

Whyever would you imagine anything much about UK Government in recent years, could be accused of being sensible?

Been a long time since I've ever thought that of one collectively,  whatever colour rosette they happen to be wearing.


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## Eddy Edson (Dec 13, 2020)

According to the Guardian live blog this morning:

_Asked about the flow of medical supplies if no deal is struck, Raab has told the BBC:_



> Well, of course, with things like vaccines and more generally medical supplies the NHS and DHSC (The Department of Health and Social Care) already have a widespread programme of stockpiling and security of supply.
> So I actually think – you know, there may be shifts – but we’ve got enough diversity of supply.



So that's all sorted then


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## grovesy (Dec 13, 2020)

Eddy Edson said:


> According to the Guardian live blog this morning:
> 
> _Asked about the flow of medical supplies if no deal is struck, Raab has told the BBC:_
> 
> ...


There were reports a short time ago that Brexit stockpile had been used. I also think for the Covid Vaccines stockpiling is not an option. 
The only hope I have is, after watching a Defensive Committee meeting a couple of weeks ago that the Military had been doing Brexit planning exercises. Though I have reservations of not having enough Military,


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## Eddy Edson (Dec 13, 2020)

grovesy said:


> There were reports a short time ago that Brexit stockpile had been used. I also think for the Covid Vaccines stockpiling is not an option.
> The only hope I have is, after watching a Defensive Committee meeting a couple of weeks ago that the Military had been doing Brexit planning exercises. Though I have reservations of not having enough Military,


As an outsider, the whole thing just seems inexplicably stupid.

And if people don't want to call it "no deal", then instead of "Australian option" I suggest the "choosing to be subject to standards and regulations you have no influence over and to tarrif barriers erected for the benefit of French farmers option'. Then you can join us in getting trade-thrashed by China.


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## grovesy (Dec 13, 2020)

Eddy Edson said:


> As an outsider, the whole thing just seems inexplicably stupid.
> 
> And if people don't want to call it "no deal", then instead of "Australian option" I suggest the "choosing to be subject to standards and regulations you have no influence over and to tarrif barriers erected for the benefit of French farmers option'. Then you can join us in getting trade-thrashed by China.


You ex Prime Minister was our BBC Question Time (poltical) programm on Thursday   and he spelt it out in uncertain terms that the Australian option was not a deal you would want.


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## Bruce Stephens (Dec 13, 2020)

Eddy Edson said:


> As an outsider, the whole thing just seems inexplicably stupid.


And to most insiders.

It seems obvious that at least the level-playing field bit is pretty much OK to anyone sane: as the two sides diverge (we're very much allowed to) the free trade deal might gradually move to WTO terms with those tariffs. And instead of agreeing, we're saying we don't want free trade at all. Utterly stupid, and Johnson only gets away with it by using obfuscatory analogies. And fishing is surely negotiable (we can't practically fish our waters now anyway, and we want to sell most of the fish to the EU).

I can only hope that they understand all that and are just playing around before agreeing some different wording which allows Johnson to pretend that the EU have moved a bit.


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## trophywench (Dec 13, 2020)

Manufacturers of anything and everything simply all want - need - to sell their products.  If the whole of the EU decided to ban the whole of the EU selling anything and everything to the UK I think they could do that - but what earthly good that could possibly do their countries I fail to see, so I reckon as long as we are still prepared to pay for whatever we want to buy - manufacturers will still wish to supply us with them.


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