The National | 25 June 2020

Why we have to protect the NHS from trade deals

By Stewart Hosie, SNP international trade spokesman

THE UK Government’s Trade Bill is currently undergoing line by line scrutiny in a Bill Committee.

While, at face value, this legislation is merely to enable the roll-over of existing trade agreements the UK benefits from through its membership of the EU.

But there are concerns the approach the UK is taking could allow substantial modifications to existing trade deals or indeed facilitate new ones.

And one of the chief concerns is that our NHS might be put on the table in any trade negotiation.

The SNP has tabled many amendments and new clauses, in particular, new clause 12 which would ensure that the UK Government has a duty to restrict market access to healthcare services, including medicines and medical devices.

And we have tabled this new clause precisely because trade deals do have the potential to negatively impact on health services.

While the Government has repeatedly pledged that the NHS is “not on the table” in trade negotiations, leaked documents detailing conversations between UK and US negotiators revealed that health services had been discussed, including US “probing” on the UK’s “’health insurance’ system”, and the US has made clear its desire for the UK to change its drugs pricing mechanism.

This new clause includes:

A specific carve-out for the NHS, all health-relevant services and regulation, meaning that it would be illegal for the government to conclude a trade agreement which altered the way NHS services are provided, liberalised healthcare further, or opened up parts of the NHS to foreign investment.

No use of negative listing: these clauses require that all industries are liberalised in trade agreements unless there are specific carve-outs. It is not always easy to define what services count as health services: for instance, digital services may seem irrelevant to health, but NHS data management and GP appointments are increasingly digitised. Negative lists therefore make it harder for governments to regulate and provide health services.

No standstill clauses or ratchet clauses: because these provisions mean that, after the trade deal has been signed, parties are not allowed to reduce the level of liberalisation beyond what it was at the point of signature. This can make it difficult to reverse NHS privatisation.

Had such a ratchet clause been in existence, it may not have been possible, for example, for the Scottish Government to have removed private hospital cleaners and return that work to the NHS staff.

And vitally, no ISDS: Investor-State Dispute Settlement (ISDS) clauses in trade agreements which allow private investors to challenge government policy when this affects their profits. Failure to abide by these clauses can result in legal challenge from private investors

There are many examples of this from around the world, not least the Canadian Government being sued for trying to ban a toxic petrol additive on public health grounds.

Without real protection for the NHS in any future trade agreement, we can only see bad news for patients, taxpayers and Health Boards around the country.

Trade deals must not be used to facilitate this.