The medical association which represents UK doctors has recently produced a briefing paper, which focuses on the trade agreements that the UK will be able to negotiate post-Brexit, cautioning that such agreements can change policy ‘in ways that affect health, both within the UK and globally’ – including policies on procurement and provision of public services, regulation to promote public health, food safety standards and intellectual property rights.
In it, the BMA suggests that international trade deals could:
- open the NHS up 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;
- Restrict lower-income countries’ affordable access to essential medicines through strengthening of intellectual property rights (IPR).
Coming at a time when the threat of a no-deal Brexit looms large, the BMA if the UK were to leave the UK on poor terms and be forced to trade under World Trade Organization (WTO) rules, the subsequent cost to the economy could pile pressure on ministers to enter free trade agreements that promote the UK’s economic interests over its health – suggesting the privatisation of care.
On the back of this the BMA is calling on 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.
- 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.
- Strengthening of IPR that could limit the ability of lower-income countries to procure generic medicines.
Dr Chaand Nagpaul, BMA council chair, commented:
“As the clock ticks down to our departure from the EU, the uncertainty surrounding post-Brexit Britain poses an ever more serious risk to the health service, its patients and its workforce.
“With a no-deal scenario looking more probable every day and the UK facing the real possibility of having to trade under WTO rules, there will likely be an appetite from the government to secure new agreements that will go some way to minimise Brexit’s cost to the economy. However, 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. Our public health service cannot be dismantled and auctioned off to the highest bidder bit by bit to plug holes in the country’s finances caused by a poorly-judged political decision. 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.
“We must not allow any future deals to dictate Britain’s ability to improve the health and wellbeing of its citizens, but many agreements include clauses that could do just that. Such clauses mean companies can sue governments for introducing policies or measures that seek to improve models of care and public health, but in doing so hit investors’ profits.
“The current high health and safety standards of products allowed through our borders, including those for food items, are also under threat.
“Furthermore, the government risks undermining Britain’s role as a global leader on health if lower-income countries are no longer able to affordably access essential medicines because of strengthened intellectual property rights.
“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.”