Trade Deals and the NHS

Catherine West Excerpts

Monday 16th November 2020 Westminster Hall

[Catherine West (Hornsey and Wood Green) (Lab)]

It is a pleasure to serve under your chairmanship, Mr Stringer. I am unsurprised that my constituents have signed this petition in droves, because they have been contacting me with their concerns about the NHS and Brexit for many years.

We now have some concerning facts to go on. Following the Brexit vote, the Government had three fundamental jobs on trade. First, they had to get a deal to secure the half of our trade that depends on Europe. Secondly, they had to negotiate roll-over deals with the 40 countries and trade blocs with which we currently trade freely thanks to our membership of the EU. Thirdly, they had to negotiate entirely new trade deals with other parts of the world.

After more than four years, and with just weeks until the end of the Brexit transition period, the Government have failed dismally on all three counts. There is no deal in place with the EU, roll-over deals have still not been agreed with the likes of Canada, Turkey, Singapore and Mexico, and not a single genuinely new trade deal has been agreed with any other country in the world. The International Trade Secretary recently trumpeted her roll-over trade deal with Japan, but she failed to mention that 83% of the export growth resulting from the deal will go to Japanese exporters, and only 17% to British firms. What will that do to our current trade deficit of £3 billion with Japan?

With a potential trade deal with the US now on the back burner because of the election result, the Government’s trade strategy is in tatters. They said their objective after Brexit was that 80% of global trade would be covered by free trade deals, but as things now stand we will go into 2021 with little over 10% of our global trade agreed.

Turning to the question of the national health service, many civil society organisations—particularly trade unions and health organisations—have long warned about the inclusion of public services, including health, in trade agreements. The concerns are four-fold. Negative lists are clauses requiring that all industries can be included in trade agreements, unless there are specific carve-outs. It is not always easy to define which services count as health services. For instance, digital services may seem pretty irrelevant to health, but NHS data management is increasingly digitised, and apps for such things as GP appointments are increasingly prevalent. Negative lists have a broad scope, covering existing and future services, and therefore make it harder for Governments to regulate and to provide health services, let alone to reassure our worried constituents.

There are also stand still clauses. After the trade deal is signed parties are not allowed to reduce the level of liberalisation beyond what it was at the point of signature. Under ratchet clauses parties are not allowed to reverse certain measures brought in after the point of signature. Furthermore, failure to abide by those clauses can result in legal challenge from the trade partner or, if there is a separate ISDS clause, challenge from private investors. The hon. Member for Linlithgow and East Falkirk (Martyn Day) covered that very well in his speech, so I shall not repeat what he said.

The US Administration have stated publicly that they wish to use a trade deal to challenge the purchasing model. That could be done through specific market access provisions, or other clauses aimed at the pharmaceutical industry. That has the potential to increase greatly the cost of medicines, making some vital treatments unaffordable for the NHS. The benefit of our unitary model in the NHS is that it is a cover-all. However, should there be an infiltration into that unified system, that could be a slam-dunk for a “hostile takeover”, almost.

Another good example, in relation to digital trade, is cross-border data flows. Digital trade rules are aimed at limiting the ability of Governments to introduce localisation measures or stop data leaving the country. There are potential privacy and security implications—for example, if sensitive NHS patient data are held by private firms outside the UK. There are further points on technology transfer and the monetisation of patient data.

The other great point about the unified NHS system, of course, is that we have probably the best block of data in the world to understand health. The NHS, being a unified system, has information about every one of us. If we see NHS data in that way, it provides a wonderful trading tool. However, those of us who are concerned about the way data can be used—that includes every Member of the House, I am sure—have to ask the Government a lot of questions.

That brings me to my final point, on the lack of scrutiny of the principles behind the way the trade operation is working at the moment, and in relation to specific trade deals and the way they will come to the House of Commons. I worry a lot about the fact that we do not bring people, groups or our constituents with us when we do things in the Commons. We know that from the times we get to the end of a vote, and people ask what we were voting on—we are explaining backwards. The thing about trade is that we need to bring people with us. The wonderful, now deceased, Congressman John Lewis, whom I met when I, like my hon. Friend the Member for Birkenhead (Mick Whitley), was on the International Trade Committee, said that he felt the transatlantic trade and investment partnership failed because it failed to bring working people and trade unions with it. I think it failed for other reasons—it was quite complex—but he made a valuable contribution. The Government are trying to cut corners now, because time is running out and because they think that they will be in government forever, which many of us hope they will not.

However, we have to see this issue less in a party political way, because it can affect trade for a long period—for 10 to 15 years—and over a series of different Governments. We now have the opportunity to put in place the building blocks of scrutiny so that, in the words of John Lewis, we can bring people with us and ensure that, at the last hurdle, these things are genuinely in the interests of our communities and the people we serve.