Andy Burnham: NHS must be exempted from EU-US free trade agreement

Shadow health secretary reveals he will soon travel to Brussels to lobby for the health service to be exempted from international competition law.

Aside from his threat to vote against HS2 (for which he was swiftly rebuked by Labour), the most notable comments by Andy Burnham in my interview with him for this week's NS were on the proposed EU-US free trade agreeement and its implications for the NHS. Many Labour activists and MPs are concerned at how the deal, officially known as the Transatlantic Trade and Investment Partnership (TTIP), could give permanent legal backing to the competition-based regime introduced by the coalition.

As Benedict Cooper wrote recently on The Staggers: "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 ...

... 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."

When I spoke to Burnham, he revealed that he will soon travel to Brussels to lobby the EU Commission to exempt the NHS (and healthcare in general) from the agreeement. He said: 

I’ve not said it before yet, but it means me arguing strongly in these discussions about the EU-US trade treaty. It means being absolutely explicit that we carry over the designation for health in the Treaty of Rome, we need to say that health can be pulled out. 

In my view, the market is not the answer to 21st century healthcare. The demands of 21st century care require integration, markets deliver fragmentation. That’s one intellectual reason why markets are wrong. The second reason is, if you look around the world, market-based systems cost more not less than the NHS. It’s us and New Zealand who both have quite similar planned systems, which sounds a bit old fashioned, but it’s that ability of saying at national level, this goes there, that goes there, we can pay the staff this, we can set these treatment standards, NICE will pay for this but not for this; that brings an inherent efficiency to providing healthcare to an entire population, that N in NHS is its most precious thing. That’s the thing that enables you to control the costs at a national level. And that’s what must be protected at all costs. That’s why I’m really clear that markets are the wrong answer and we’ve got to pull the system out of, to use David Nicholson’s words, 'morass of competition'.

I’m going to go to Brussels soon and I’m seeking meetings with the commission to say that we want, in the EU-US trade treaty, designation for healthcare so that we can exempt it from contract law, from competition law.

Should Labour fail to secure these reassurances from the EU, it would undoubtedly embolden the party's small but significant eurosceptic wing, those who have long denounced the EU as a "capitalist club". 

It's worth remembering, of course, that it was once Labour, not the Conservatives, that was most divided over Europe. The 1975 referendum on EEC membership was called by Harold Wilson after his cabinet proved unable to agree a joint position (Wilson subsequently suspended collective ministerial responsibility and allowed ministers to campaign for either side, an option that David Cameron may well be forced to consider) and Michael Foot's support for withdrawal was one of the main causes of the SDP split in 1981. Those divisions have not entirely been consigned to history. While the Tories are now split between 'inners' and 'outers', in Labour the fundamental europhile-eurosceptic divide persists.  

US and EU flags are pictured on November 11,2013 at the EU headquarters. Photograph: Getty Images.

George Eaton is political editor of the New Statesman.

Paul McMillan
Show Hide image

"We're an easy target": how a Tory manifesto pledge will tear families apart

Under current rules, bringing your foreign spouse to the UK is a luxury reserved for those earning £18,600 a year or more. The Tories want to make it even more exclusive. 

Carolyn Matthew met her partner, George, in South Africa sixteen years ago. She settled down with him, had kids, and lived like a normal family until last year, when they made the fateful decision to move to her hometown in Scotland. Matthew, 55, had elderly parents, and after 30 years away from home she wanted to be close to them. 

But Carolyn nor George - despite consulting a South African immigration lawyer – did not anticipate one huge stumbling block. That is the rule, introduced in 2012, that a British citizen must earn £18,600 a year before a foreign spouse may join them in the UK. 

“It is very dispiriting,” Carolyn said to me on the telephone from Bo’ness, a small town on the Firth of Forth, near Falkirk. “In two weeks, George has got to go back to South Africa.” Carolyn, who worked in corporate complaints, has struggled to find the same kind of work in her hometown. Jobs at the biggest local employer tend to be minimum wage. George, on the other hand, is an engineer – yet cannot work because of his holiday visa. 

To its critics, the minimum income threshold seems nonsensical. It splits up families – including children from parents – and discriminates against those likely to earn lower wages, such as women, ethnic minorities and anyone living outside London and the South East. The Migration Observatory has calculated that roughly half Britain’s working population would not meet the requirement. 

Yet the Conservative party not only wishes to maintain the policy, but hike the threshold. The manifesto stated:  “We will increase the earnings thresholds for people wishing to sponsor migrants for family visas.” 

Initially, the threshold was justified as a means of preventing foreign spouses from relying on the state. But tellingly, the Tory manifesto pledge comes under the heading of “Controlling Immigration”. 

Carolyn points out that because George cannot work while he is visiting her, she must support the two of them for months at a time without turning to state aid. “I don’t claim benefits,” she told me. “That is the last thing I want to do.” If both of them could work “life would be easy”. She believes that if the minimum income threshold is raised any further "it is going to make it a nightmare for everyone".

Stuart McDonald, the SNP MP for Cumbernauld, Kilsyth and Kirkintilloch East, co-sponsored a Westminster Hall debate on the subject earlier this year. While the Tory manifesto pledge is vague, McDonald warns that one option is the highest income threshold suggested in 2012 - £25,700, or more than the median yearly wage in the East Midlands. 

He described the current scheme as “just about the most draconian family visa rules in the world”, and believes a hike could affect more than half of British citizens. 

"Theresa May is forcing people to choose between their families and their homes in the UK - a choice which most people will think utterly unfair and unacceptable,” he said.  

For those a pay rise away from the current threshold, a hike will be demoralising. For Paul McMillan, 25, it is a sign that it’s time to emigrate.

McMillan, a graduate, met his American girlfriend Megan while travelling in 2012 (the couple are pictured above). He could find a job that will allow him to meet the minimum income threshold – if he were not now studying for a medical degree.  Like Matthew, McMillan’s partner has no intention of claiming benefits – in fact, he expects her visa would specifically ban her from doing so. 

Fed up with the hostile attitude to immigrants, and confident of his options elsewhere, McMillan is already planning a career abroad. “I am going to take off in four years,” he told me. 

As for why the Tories want to raise the minimum income threshold, he thinks it’s obvious – to force down immigration numbers. “None of this is about the amount of money we need to earn,” he said. “We’re an easy target for the government.”

Julia Rampen is the digital news editor of the New Statesman (previously editor of The Staggers, The New Statesman's online rolling politics blog). She has also been deputy editor at Mirror Money Online and has worked as a financial journalist for several trade magazines. 

0800 7318496