With Whitehall and Downing Street trying to get to grips with the referendum result, its impossible to get any sense of how the domestic agenda will develop.
In the period of government “purdah” during the campaign, the policy implementation machine had ground to a halt.
It was assumed by those mandarins who had expected a remain vote that normal service would quickly resume – in trays would be emptied in a blizzard of announcements before the summer recess. Now all bets are off.
The biggest impending health policy initiative is the childhood obesity strategy. Originally postponed last autumn and then again when the referendum campaign got underway, public health experts were pinning their hopes on a July launch.
Measures to reduce sugar content of food and drink products, curb price promotions in supermarkets and extend TV and online fast food advertising restrictions were seen as urgently needed in the battle to reduce obesity and the Type 2 diabetes risk.
It’s understood that a little more work on the strategy is needed but the essentials are in place.
In the light of the referendum result there can be no certainty about when the obesity strategy will be published.
David Cameron had been keen to lead the launch of a policy which was seen by Downing Street as a high profile “domestic legacy” initiative similar to the dementia plan under the coalition.
But with the Prime Minister now only in office for a few more months, everything is up in the air.
He may decide he needs to complete his policy agenda and keep the business of government moving by getting the obesity strategy out. Alternatively, ministers and advisers may feel there is no mandate for such a high- profile announcement before a new PM is in place.
Looking further ahead, the question of funding for the NHS is already being raised. There was a much criticised claim that Brexit would save the UK £350m a week in payments to the EU and allow more funding for the NHS.
This did not take account of about £200m of rebates to the UK. Nigel Farage has already said that claim was a mistake.
Leave campaigners talked of an extra £100m a week being freed up for the NHS but that would depend on the government of the day choosing to spend any money saved on health, rather than other areas of the public sector.
Simon Stevens, the head of NHS England, has made clear that the financial stability of the service depends on the state of the economy.
Growth will generate the higher tax revenues which can fund higher public spending.
But plotting the path of the economy in the run-up to the exit in 2018 is anyone’s guess. The prospect of a recession has been raised by the Bank of England. That was dismissed as scaremongering by Leave campaigners.
Nobody is contesting that the NHS needs staff from outside the UK, but how that will be affected by Britain’s new status will not be clear for a while.
The prospect of a new immigration policy may or may not at the margin deter foreign doctors, nurses and care workers from working in the UK.
The actions of pharmaceutical companies will also be studied closely.
There have been warnings that Brexit could lead to drug trials in the UK being reduced with investment shifted to other European countries.
Health organisations have expressed concern about the uncertainty which will inevitably persist after the UK electorate’s momentous decision.
That uncertainty won’t ease any time soon.
Stephen Dalton, chief executive of the NHS Confederation summed up the mood: “The NHS has broadly benefitted from being in the EU and leaving it will undoubtedly have implications which are yet to be clearly understood.”