NHS and Future Trade Deals

Judith Cummins Excerpts

Monday 22nd July 2019 Westminster Hall

[Judith Cummins (Bradford South) (Lab)]

It is a pleasure to serve under your chairmanship, Sir Roger. I congratulate my hon. Friend the Member for Hartlepool (Mike Hill) on opening this important debate and speaking so eloquently on behalf of the Petitions Committee. I thank hon. Members who contributed to the debate, including my hon. Friends the Members for York Central (Rachael Maskell), for Coventry South (Mr Cunningham), for Hornsey and Wood Green (Catherine West), for Sheffield Central (Paul Blomfield), for Weaver Vale (Mike Amesbury), for Warwick and Leamington (Matt Western), for Blaydon (Liz Twist) and for Warrington South (Faisal Rashid), as well as the hon. Member for South Thanet (Craig Mackinlay).

The petition calls on the Government to categorically rule out including the NHS in future trade deals. It has been signed by more than 166,000 people, while another petition organised by Keep Our NHS Public has been signed by more than half a million people. Last week the Government published a summary of responses to their consultation on trade negotiations with the US, Australia and New Zealand, as well as potential accession to the comprehensive and progressive agreement for trans-Pacific partnership. Over 600,000 people responded, with an overwhelming number of those responses calling explicitly for protections for the NHS in trade deals.

The British public are absolutely clear: they do not want the NHS to be bargained away as part of a trade deal, they do not want companies to have the right to sue our Government for decisions taken in the interests of public health, and they do not want drug prices to be pushed up by American pharmaceutical giants. We on the Labour Benches firmly agree with that. We are extremely proud of the Labour-created NHS and we know how important it is to the people of the United Kingdom. We will always defend the principles of universality and the NHS being free at the point of use.

A number of hon. Members, including my hon. Friends the Members for Hartlepool, for Coventry South, for Blaydon, for Warrington South and for Hornsey and Wood Green, mentioned the comment made by the President of the United States when he said the NHS would be “on the table” in any US-UK trade deal. A few hours later, perhaps after some encouragement from the current Prime Minister, he appeared to row back somewhat. On Wednesday we are entering a brave new world, with a new Prime Minister. The person almost certain to be that new Prime Minister, the right hon. Member for Uxbridge and South Ruislip (Boris Johnson), has repeatedly stated that he regards concluding a quick trade deal with the US as an absolute priority. So this is a timely debate and one that will no doubt continue in the coming months and years.

My hon. Friend the Member for Blaydon made the point that the NHS cannot be part of trade deal; that is her red line. My hon. Friend the Member for Warrington South spoke about our moral duty. In my remaining time, I want to mention a number of areas where aspects of trade deals could threaten the NHS if proper safeguards and guarantees are not put in place. I will then turn to the importance of the proper scrutiny of trade deals, both in Parliament and more generally, to ensure that no Government can put our NHS in danger.

First is the risk that trade deals could increase and consolidate privatisation of the NHS. Services chapters in free trade agreements typically include provisions that lock in liberalisation measures, such as privatisation. There is genuine concern that trade agreements could force us to lock in market liberalisation of the NHS, so that future Governments are unable to bring these services back in house. The move from positive lists, where only listed services are subject to liberalisation, to negative lists, where all services are deemed open to liberalisation, unless explicitly excluded, makes that significantly more likely.

Under the negative list system, the UK would have to explicitly opt out all healthcare and related services. If we did not, it could be difficult to ever bring privatised services back in house. In my area of Bradford, I am fighting alongside Unison to stop the creation of a wholly owned company for NHS staff such as cleaners and porters. If this goes ahead, and we agree a trade deal without the correct exceptions, bringing those services back into the NHS will be even more difficult and complex.

There are similar concerns about the inclusion of ISDS procedures in trade agreements. The threat of Government or NHS bodies being sued under ISDS, for example for bringing a service back in house, can have a major chilling effect on public policy decisions. There are numerous examples of this around the world. The Labour party has taken a clear position on ISDS. We do not think it is necessary and we do not think it is right. We believe there are many alternatives that balance the need for investor protection with proper guarantees, so that Governments can make public policy decisions without fear of corporate legal action.

A potential deal with the US is of major concern in respect of drug pricing. Last year, President Trump accused the rest of the world of freeloading on the US, resulting in high drug prices in the US. He claimed that:

“When foreign governments extort unreasonably low prices from U.S. drug makers, Americans have to pay more to subsidize the enormous cost of research and development”.

In particular, he blamed countries that

“use socialized healthcare to command unfairly low prices from U.S. drug makers”.

The NHS purchases drugs in significant volumes and therefore uses its bargaining power to set the price at the lowest possible levels. When the Office of the US Trade Representative published an outline of negotiating priorities for a US-UK trade deal in February, it included in a section entitled “Procedural Fairness for Pharmaceuticals and Medical Devices” a statement that the US would

“seek standards to ensure that government regulatory reimbursement regimes are transparent, provide procedural fairness, are non-discriminatory, and provide full market access for U.S. products”.

The threat here should be evident. The US Secretary of Health and Human Services put it even more starkly when he said that the US would “pressure” other countries through trade negotiations,

“so we pay less, they pay more.”

The Government may say that that is not what they intend, but we must recognise the very real risk that, in the rush to complete a trade deal with the US, it will happen—a case of marrying in haste and repenting at leisure. In negotiations with Australia and New Zealand, the US has already tried to force changes to their medicines pricing policies. In those cases, the US backed down to achieve other trade objectives, but that is highly unlikely to be the case with the UK, given the size and scope of the NHS’s purchasing power. That could lead to higher prices and less choice for the drugs the NHS needs. The effect on the NHS would be significant and potentially devastating for patients.

As many hon. Members have made clear, there are numerous and credible threats to our NHS in potential future trade agreements. That is why parliamentary scrutiny of trade agreements is critical. We in the Labour party have repeatedly pushed for the Government to bring forward an inclusive, transparent and meaningful system of scrutiny and accountability. We tabled amendments to the Trade Bill and the Lords passed amendment 12 to the Bill, which secured Parliament’s right to vote on the mandate and to have a meaningful debate on any signed deal before ratification. Alas, it seems that the Trade Bill has disappeared. Can the Minister confirm today whether it will ever see the light of day again? It must be this Parliament’s right to scrutinise and approve trade deals and it is our duty to protect the NHS in trade agreements.

To finish, I thank all my hon. Friends who have made it clear that we in the Labour party will not allow our NHS to be sold off as the price of a quick trade deal. The NHS is more than a service; it is one of our proudest national institutions, and we must defend it with all we have.