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Ministers risk putting money before health, BMA warns

Post-Brexit trade deals could open NHS to further privatisation, limit public health and lower standards

Louise Prime

Tuesday, 11 September 2018

The government’s rush to secure international trade deals following Brexit means ministers risk putting economic benefits ahead of the nation’s health, doctors’ leaders have warned. The British Medical Association (BMA) said the results could include creeping further privatisation of the NHS, limits on public health initiatives and poorer safety standards.

The BMA published its latest briefing paper on the potential risks of Brexit yesterday, ahead of today’s debate in the House of Lords on the Trade Bill. In it, it pointed out that although international trade agreements (ITAs) aim to ensure that countries behave fairly towards one another in a competitive market (by, for example, agreeing safety standards on goods that cross borders, setting quotas to protect sensitive sectors and setting out how disputes should be settled) they are subject to strong commercial interests and there is limited transparency around their negotiation; and, once signed, they are legally binding, and their length and complexity means that they are difficult to change or reverse.

The BMA is concerned that ITAs could:

  • open up the NHS to further creeping privatisation if healthcare service provision is outsourced to private companies based abroad;
  • limit the UK’s future ability to improve public health if private companies are allowed to block policies and initiatives that would negatively affect their investments;
  • weaken current high safety standards, including the animal welfare and environmental safety standards for food items;
  • and restrict lower-income countries’ affordable access to essential medicines through strengthening of intellectual property rights.
Because of these and other concerns, the BMA is urging the government to exclude from any future trade agreements the provision of healthcare services – particularly the NHS – and any clauses that could lock in competitive procurement of publicly funded healthcare services. It said agreements must also exclude: investor protection and dispute resolution mechanisms that could limit the UK’s future ability to regulate in the interest of public health; any weakening of the current high level of safety standards including animal welfare and environmental safety standards for food items; and strengthening of intellectual property right that could limit lower-income countries’ ability to procure generic medicines.

BMA council chair Dr Chaand Nagpaul said: “These new trade deals absolutely must not put money ahead of the nation’s health.

“First and foremost, the NHS must be taken off the table entirely. … If healthcare provision is not excluded from future trade agreements, it would risk sections of the NHS being outsourced to private companies based abroad, further contributing to the worrying increase in publicly-funded care being delivered by the independent sector. Market, rather than health-driven policies, contribute to fragmentation of services and create significant barriers to innovative and cooperative models of care that can have a real positive impact on the health of the country.”

He warned: “While the government has attempted to make some assurances, in its own words ‘nothing is agreed until everything is agreed’, and it is easy to see how promises made could soon be broken to push through lucrative trade agreements. And worryingly, the Trade Bill, if left unamended, would allow such deals to be struck with little transparency and almost no parliamentary scrutiny.

“The BMA has been clear on the major threat Brexit poses to the NHS and the nation’s health, and therefore it is vital the public is given a vote on any final deal with the EU.”

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