A man passes in front of the building Berlaymont at the EU headquarters in Brussels. Photograph: Getty Images.
Show Hide image

How the EU is making NHS privatisation permanent

The Transatlantic Trade and Investment Partnership gives the coalition's health reforms international legal backing.

No doubt the launch of Transatlantic Trade and Investment Partnership (TTIP) in June was cause for much celebration in Brussels. The European Parliament is in the process of enabling a historic shift in world economics with countless, far-reaching consequences.

A key part of the TTIP is 'harmonisation' between EU and US regulation, especially for regulation in the process of being formulated. In Britain, the coalition government’s Health and Social Care Act has been prepared in the same vein – to 'harmonise' the UK with the US health system.

This will open the floodgates for private healthcare providers that have made dizzying levels of profits from healthcare in the United States, while lobbying furiously against any attempts by President Obama to provide free care for people living in poverty. With the help of the Conservative government and soon the EU, these companies will soon be let loose, freed to do the same in Britain.

Linda Kaucher is a leading expert on trade agreements. She has written and spoken extensively on the topic, most recently in an article in Chartist. In it, she lays out a disturbing truth about what is going on behind the scenes in Brussels, arguing that while on the surface the EU is a bastion of protections and rights, its true agenda is far more tenebrous.

It is, she says, to "permanently fix corporate-driven neo-liberalism, within the EU and internationally, via trade agreements. Any reassertion of democracy within the EU structure or member states is prevented by legally binding international trade law." She also states that the agenda is "driven and effectively controlled by transnational corporations, especially transnational financial services corporations."

How does this affect the NHS? It’s painfully simple. The agreement will provide a legal heavy hand to the corporations seeking to grind down the health service. It will act as a Transatlantic bridge between the Health and Social Care Act in the UK, which forces the NHS to compete for contracts, and the private companies in the US eager to take it on for their own gain.

Kaucher says: "[The Health and Social Care Act] effectively enforces competitive tendering, and thus privatisation and liberalisation i.e. opening to transnational bidders - a shift to US-style profit-prioritised health provision."

The TTIP ensures that the Health and Social Care Act has influence beyond UK borders. It gives the act international legal backing and sets the whole shift to privatisation in stone because once it is made law, it will be irreversible. Investor State Dispute Settlement (ISDS) laws, fundamentals of the agreement, allow corporations legal protection for their profits regardless of patient care performance, with the power to sue any public sector organisation or government that threatens their interest.

Once these ISDS tools are in place, lucrative contracts will be underwritten, even where a private provider is failing patients and the CCG wants a contract cancelled. In this case, the provider will be able to sue a CCG for future loss of earnings, thanks to the agreement, causing the loss of vast sums of taxpayer money on legal and administrative costs.

Even more worrying is that, once the TTIP is enacted, repealing the Health and Social Care Act in the UK will become almost impossible. As Kaucher explains: "Even if outcomes of the NHS changes are disastrous, ISDS will effectively disallow any attempts by any future UK government to reverse the changes."

'Harmonised' standards favour private companies over public sector providers and the coalition government, the standard bearer of big business, is tirelessly working away to deliver a privatised system to its sponsors. The government claims that in privatising the NHS it will be its 'liberator'. The term even made it into the title of Andrew Lansley’s now infamous report laying out the Conservatives’ plans for the NHS: Liberating the NHS.

This is just more euphemistic language masking sinister intentions. In a 2010 speech Dr Jacky Davis, co-founder of Keep Our NHS Public, said: "Liberating the NHS really means unprecedented cuts, job losses, deniable of accountability and privatisation.

"It means liberating the NHS budget to hand it over to the corporate sector; and among those companies waiting like vultures around a dying animal are the very same companies that spent a million dollars a day in the States lobbying against Obama’s healthcare reforms."

The public need to be aware of this landmark shift and the way it affects them. So why has nothing about the TTIP appeared in the British press and why is the work of the European Parliament and Commission carried out in such a murky, underhand way?

The public has the democratic right to contest the agreement, and fight for a health service that protects them. But how can they when MEPs do nothing to inform opinion or gather support back home? The NHS is in a very precarious position. It seems that soon, with the help of Brussels, its fate will be sealed.

Benedict Cooper is a freelance journalist who covers medical politics and the NHS. He tweets @Ben_JS_Cooper.

GARY WATERS
Show Hide image

In defence of expertise: it’s time to take the heart out of “passionate” politics

What we need is cool logic.

We are living through a bonfire of the experts. During the EU referendum campaign, Michael Gove explained that people had had enough of them. A few weeks later, his fellow Tory MPs took him at his word and chose a relative ingénue to run against Theresa May.

After declaring for Andrea Leadsom in the Tory leadership race, Michael Howard was asked whether it might be a problem that she had never held a position higher than junior minister. Howard, whose long career includes stints as home secretary and opposition leader, demurred: “I don’t think experience is hugely important.”

Even in this jaw-dropping season, that comment caused significant mandibular dislocation. I thought: the next Tory leader will become prime minister at a time of national crisis, faced with some of the UK’s most complex problems since the Second World War. If experience doesn’t matter now, it never does. What does that imply about the job?

Leadsom’s supporters contended that her 25 years in the City were just as valuable as years spent at Westminster. Let’s leave aside the disputed question of whether Leadsom was ever a senior decision-maker (rather than a glorified marketing manager) and ask if success in one field makes it more likely that a person will succeed in another.

Consider Ben Carson, who, despite never having held elected office, contested the Republican presidential nomination. He declared that Obamacare was the worst thing to happen to the United States since slavery and that Hitler may have been stopped if the German public had been armed. Yet Carson is not stupid. He is an admired neurosurgeon who pioneered a method of separating conjoined twins.

Carson is a lesson in the first rule of expertise: it does not transfer from one field to another. This is why, outside their domain, the most brilliant people can be complete dolts. Nevertheless, we – and they – often assume otherwise. People are all too ready to believe that successful generals or entrepreneurs will be good at governing, even though, more often than not, they turn out to be painfully inept.

The psychologist Ellen Langer had her subjects play a betting game. Cards were drawn at random and the players had to bet on whose card was higher. Each played against a well-dressed, self-assured “dapper” and a shabby, awkward “schnook”. The participants knew that it was a game of chance but they took more risks against the schnook. High confidence in one area (“I’m more socially adept than the schnook”) irrationally spilled over into another (“I’ll draw better cards”).

The experiment points us to another reason why we make poor judgements about competence. We place too much faith in social cues – in what we can see. As voters, we assume that because someone is good at giving a speech or taking part in a debate, they will be good at governing. But public performance is an unreliable indicator of how they would cope with running meetings, reading policy briefs and taking decisions in private. Call it the Boris principle.

This overrating of the visible extends beyond politics. Decades of evidence show that the job interview is a poor predictor of how someone will do in the job. Organisations make better decisions when they rely on objective data such as qualifications, track record and test scores. Interviewers are often swayed by qualities that can be performed.

MPs on the Commons education select committee rejected Amanda Spielman, the government’s choice for the next head of Ofsted, after her appearance before them. The committee didn’t reject her because she was deficient in accomplishments or her grasp of education policy, but because she lacked “passion”. Her answers to the committee were thoughtful and evidence-based. Yet a Labour MP told her she wasn’t sufficiently “evangelical” about school improvement; a Tory asked her to stop using the word “data” so often. Apparently, there is little point in being an expert if you cannot emote.

England’s football team is perennially berated in the media for not being passionate enough. But what it lacks is technique. Shortly before Wales played England in the European Championship, the Welsh striker Gareth Bale suggested that England’s players lacked passion. He knew exactly what he was doing. In the tunnel before kick-off, TV cameras caught the English goalkeeper Joe Hart in a vessel-busting frenzy. On the pitch, Hart allowed Bale to score from an absurdly long range because he was incapable of thinking straight.

I wish there were less passion in politics and more cool logic; less evangelism and more data. Unthinking passion has brought the Labour Party to its knees and threatens to do the same to the country. I find myself hungering for dry analyses and thirsting for bloodless lucidity. I admire, more than ever, those with obscure technical knowledge and the hard-won skills needed to make progress, rather than merely promise it.

Political leadership is not brain surgery but it is a rich and deep domain. An effective political leader needs to be an expert in policy, diplomacy, legislative process and how not to screw up an interview. That is why it’s so hard to do the job well when you have spent most of your time in boardrooms or at anti-war rallies.

If democratic politicians display contempt for expertise, including their own, they can hardly complain if those they aspire to govern decide to do without the lot of them. 

Ian Leslie is a writer, author of CURIOUS: The Desire to Know and Why Your Future Depends On It, and writer/presenter of BBC R4's Before They Were Famous.

This article first appeared in the 21 July 2016 issue of the New Statesman, The English Revolt