Since 1948, Britain’s National Health Service has provided free medical care with no questions asked to all men, women and children. The institution remains much beloved in the country and rightly so. However, the fact that the NHS is so beloved gives political and media provocateurs an opportunity to employ hyperbole, half-truths and utter lies about the health of the NHS in order to rally public opinion to certain parties and causes that may have very little to do with the NHS itself.
The present wave of hysteria has been caused by the potential that a post-Brexit Britain could sign a substantial free trade deal with the United States. Such a win-win trade deal ought to inspire optimism on both sides but instead it has inspired a few poorly worded statements from the US side and a crazed over-reaction from the British left in particular.
A traditional free trading agreement (FTA) does not impact the regulations governing domestic corporations in the land of either of the parties to such a bilateral deal. Likewise, FTAs do not impact state run or strongly state subsidised institutions in the country of either of the parties to such a bilateral deal. This means that unless a specific agreement is made to do so, a UK-US FTA would no more impact the fiscal governance of Britain’s NHS than it would America’s highly subsidised military-industrial complex. In this sense, if the NHS is socialised medicine, America’s war machine is very much a partly socialised defence sector.
Seeing as the NHS spends 20% of its budget on drugs, an FTA with the US could reduce these costs Apart from that, a traditional FTA would have little if any impact on the rest of the NHS budget. This would be an objectively good thing. Beyond that, one cannot blame the US for wanting to buy the NHS if the UK government puts some or all of it up for sale. It is only up to the UK as to whether or not the NHS is for sale and to whom. Very recent history is a helpful illustration of this reality.
There is in fact a precedent for NHS semi-privatisation and it has nothing to do with any FTAs. Beginning with the Thatcher government in the 1980s, certain elements of the NHS were in fact sold to the private sector. It was however under the Labour government of Tony Blair that vast elements of the NHS were removed from direct public ownership and taken into the hands of corporations. This move was very controversial at the time – so much so that any future privatisation schemes would likely come under heavy scrutiny.
But when it comes to threatening the sanctity of hitherto ring-fenced state owned institutions, it is in fact the European Union which demands that private firms have a co-equal opportunity to tender bids to operate public services under the “competitive tendering of public service contracts” rules. In this sense, it is the EU whose draconian Single Market rules are dictating much of what the NHS can and cannot do in terms of corporate governance whilst an FTA with the US, or China, or India, or Singapore, or Australia, or Canada simply means a free exchange of goods without any tariff barriers.
Speaking of Canada, unlike its neighbour to the south, Canada has a fully socialised health care system. Even when Canada, Mexico and the US formed the North American Free Trade Agreement (NAFTA) in 1994 – an agreement whose scope is far wider than the kind of straightforward bilateral FTAs favoured by Donald Trump, Canada’s socialised health service remained unchanged. There is no reason to think that a UK-US FTA with a narrower scope than NAFTA should have any impact on the NHS other than to possibly reduce the costs of drugs.
But instead of realising that an FTA has nothing to do with privatising state run institution and instead of realising that whilst Brexit makes an FTA with America possible, it is not mandate it – fake news stories are suggesting that a UK-US FTA would require NHS privatisation and that likewise Brexit requires a UK-US FTA. The opposite is in fact the case. In terms of trade, Brexit frees the UK to do free trade deals with whomever it wants. This also means that the UK will at long last have a say in the nature of FTAs that it signs because such deals will be negotiated by Westminster rather than by Brussels.
Perhaps most worryingly, the UK Labour party is using the manufactured hysteria about the NHS to show its true colours which since the 1990s have been wrapped in the EU flag. While Labour claims that Donald Trump cannot be trusted to handle the NHS (the US President has no role in such a matter in any case), the more accurate statement is that Labour cannot be trusted to handle democracy.
Making matters more absurd is the fact that when Trump made his initial statement regarding the NHS, the context in which he made it has been completely ignored. During his press conference with outgoing UK Prime Minister Theresa May, a British reporter asked Trump if the NHS would be “on the table” in a UK-US FTA.
Trump clearly did not know what NHS stood for (as most who have never lived in Britain likely do not). May then tried to quickly whisper in Trump’s ear in order to clarify the issues. Trump then gave a bog-standard answer that “everything is on the table in a trade deal”, which is to say ‘we’ll know what’s on the table once actual negotiations begin’. To add further clarity, after clearly being consulted about how the NHS is a red line for most in the UK, Trump said later in the day during an interview with Piers Morgan that the NHS in fact does not need to be on the table in this sense.
Finally, the fact that much of the UK media and the Labour party (as well as elements of the Conservative party) have gone out of their way to mislead the public is a symptom not only of the honesty deficit in today’s UK politics but it also shows the extent to which people will lie in order to overturn the democratic will of the British public who voted to leave the European Union.
–A traditional free trading agreement between the UK and any other nation has nothing to do with the voluntary decision a government makes to privatise a hitherto state run institution. Tony Blair privatised much of the NHS whilst in the EU and not having an FTA with America.
–Donald Trump did not even know what the acronym NHS stood for when he made his initial “on the table remarks” and hours later clarified that the NHS does not need to be on the table in any sense
–Canada has traded freely with the US for decades and its health service remains socialised
–The EU’s “competitive tendering of public service contracts” rules are a bigger threat to a publicly owned NHS than any bilateral FTA
–An FTA between the US and UK wouldn’t give the US the right to take over the NHS any more than it would give the UK the right to take over America’s highly subsidised military-industrial complex. All such matters are subject to bilateral talks between the two interested parties