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13 June 2012updated 21 Jul 2021 12:56pm

We only have the Conservatives’ word that the NHS isn’t up for sale

By Ailbhe Rea

It is 24 hours since Jeremy Corbyn stood in front of the nation’s political journalists brandishing a 451-page dossier of what he called “evidence that the NHS is up for sale”. 

It has since become clear that the dossier doesn’t quite constitute “evidence” that the Conservatives will include parts of the NHS in a UK-US trade deal. All we know from these documents from “scoping talks”, held between civil servants from both countries from July 2017 until recently, is that the US does indeed appear to be demanding access to the NHS (“total market access as the baseline assumption”) and that it wasn’t ruled out in these discussions. 

So, Labour hasn’t caught the Conservatives red-handed selling off our NHS, and there’s a case to be made that it was in bad faith to hold a press conference to frame the documents that way, rather than passing the dossier on to a reputed journalist to sift through the detail independently. 

But it is further proof, if any was needed, that the US does seek that sort of access and a reminder that, as Stephen writes here, “if you want a meaningful US-UK trade deal, the ability for American companies to bid for NHS contracts and British agricultural standards will both have to be on the table”. By extension, if the US sticks to its promises on keeping the NHS and agriculture off-limits, the new trading relationship would remain relatively shallow, and fail to provide the economic boon that the Conservatives are promising. 

We have firm assurances from the Conservatives that no part of the NHS would be on the table in a trade deal with the US. For example, the dossier has raised specific concerns about American access to the UK drugs market: US officials have “pushed hard,” the report says, for longer patents for US drug companies, which would make medicines more expensive in the UK. But this morning, Health Secretary Matt Hancock gave the Today programme specific reassurances on this point, saying with conviction that he didn’t see any sense in making drugs more expensive in the UK when he has worked so hard in the past to secure drugs for the NHS at an affordable price. (He was less firm on chlorinated chicken.) 

“The NHS is not on the table. The price the NHS pays for drugs is not on the table. The services the NHS provides are not on the table.” That is the manifesto pledge from the Conservatives on the principles it will stick to in international trade negotiations. 

But that is all we have: their word.

The important thing to remember as we consider the potential impact of a radically new trade relationship with the United States is that the Conservatives are the only large party proposing such an agreement. Whether by remaining in the EU or negotiating a customs union with Europe, Labour and the Liberal Democrats’ policy on the EU precludes a trade relationship with the US that would be substantially different to the one we already have. 

This is emphasised in the dossier by statements from the US side. “The UK-EU situation would be determinative,” it reads. “There would be all to play for in a No Deal situation, but UK commitment to the Single Market and Customs Union would make a UK-US Free Trade Agreement a non-starter.” 

The possibility of a trade deal that undermines workers’ rights, food safety standards, animal welfare standards, and the integrity of the NHS, is only a prospect under the Conservatives. 

The dossier ultimately tells us nothing about what a Conservative British government would negotiate once we leave the EU. Negotiations can only start properly after Brexit, and those “scoping talks” don’t set anything in stone, only giving us a sense of what the US has demanded. 

As you’ll hear on the New Statesman podcast with Stephen, Anoosh, Patrick and me, our instinct tells us different things, and I am the only one in the group who maintains that there is a reasonable possibility of a fudge from the Conservatives on some of these issues: maybe a fudge on issues unrelated to the NHS, like food safety regulations, or maybe, indeed, an agreement to extend the length of patents on certain drugs. It could be politically toxic, but aren’t politically toxic decisions made all the time? 

It strikes me that, a few years down the line, it wouldn’t necessarily be difficult for the Conservatives to argue that the NHS hasn’t been privatised, if changes only relate to changes in the price of drugs, or new services around the edges of the health service. (If full market access is the “baseline assumption”, then new services will automatically be open to competition from the US.)

Labour may have illegitimately claimed they had hard “evidence” of the NHS being up for sale yesterday, but they are right to raise it as a possibility under the Conservatives. This is a legitimate area for discussion and probing as we contemplate our future trading relationships with other countries, and prepare to vote for the government that will lead us into them. We have a firm, unequivocal pledge from the Conservatives that the NHS isn’t up for grabs. But that is all we have. 

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