Trade Deals and the NHS

Rachel Hopkins Excerpts

Monday 16th November 2020 Westminster Hall

[Rachel Hopkins (Luton South) (Lab)]

It is a pleasure to serve under your chairmanship, Mr Stringer. I fully support the e-petition relating to trade deals and the NHS, which has been signed by more than 110,000 people, including a number of my constituents. I, too, pay tribute to and thank our superb NHS staff for their public service. I also thank Unite, Unison, We Own It, Keep Our NHS Public, Global Justice Now and other organisations for their campaigning to protect our NHS.

Our NHS was founded on a set of collectivist principles that bind our communities together. Those principles represent a commitment to a comprehensive free healthcare service that delivers excellent and professional care to all who need it in the UK. They are also an obligation to provide the best value for taxpayers’ money and ensure that services remain accountable to the public.

That seems to be at odds with the Government’s current trade strategy, however, which does not omit the NHS from future trade deals, but exposes it to competition and the market. That runs the risk of damaging standards of care and diluting the transparency of decision making. The threat posed to our healthcare system is clear for all of us to see. US officials have repeatedly stated that they regard the NHS as being on the table and that they specifically want to ensure that big US healthcare and drug companies can compete fairly to provide medical services, sell drugs and access NHS patient data.

We should not just be looking across the pond. The Secretary of State for International Trade has close relationships with right-wing think-tanks that want the NHS to be opened up to private competition, notably Daniel Hannan. In 2018, Hannan and his Initiative for Free Trade joined forces with the US Cato Institute and 10 other UK and US right-wing think-tanks to promote their ideal US-UK free trade agreement, which called for the opening up of all services in both countries to competition. Its co-editor, Daniel Ikenson, said of the report:

“Healthcare is a service, we call for opening services to competition. And I know some people are worried about what happens to the NHS…We think competition is a good thing and it would lead to better quality healthcare.”

When the Minister responds to the debate, will he explain why the other co-editor of that report, Daniel Hannan, is now a lead adviser on his Department’s Board of Trade? Is it any wonder that we do not feel inclined to trust the Secretary of State when she says publicly that the NHS is not for sale but then surrounds herself in private with advisers from the Institute of Economic Affairs, the Cato Institute and other right-wing think-tanks who argue the exact opposite?

We must remember that even if the US healthcare industry is prevented from directly competing with the NHS for Government-funded services, the Government’s trade agreement may open up access to NHS procurement contracts for buying medicines, delivering medical treatments and providing patient accommodation. US healthcare would then have the power to drive up the price charged for those services in future contract rounds. It is not accurate for the Government to state that the NHS is not for sale when we have already seen them privatise our covid-19 response, handing out huge contracts to companies such as Deloitte, Serco and KPMG, which have put profits and cost-cutting before care and wasted millions of pounds of taxpayers’ money.

The UK-US trade situation is likely to change as the incoming US Administration takes office in January. However, we must also monitor discussions regarding the UK joining the Comprehensive and Progressive Trans-Pacific Partnership, which demands a very open approach to competition in services, potentially including healthcare. I hope the Minister will address that point and say specifically whether membership of the CPTPP will oblige the UK to accept a “list it or lose it” approach to private competition in the public sector. If so, will the Government guarantee to negotiate a carve-out for the UK from those provisions when it comes to our NHS and other essential public services?

I agree with campaigners that we must oppose the gradual marketisation and outsourcing of NHS care at all costs. Our ethical and communitarian-focused NHS is not compatible with private greed. The Labour party’s stance on this issue is simple and clear: the best way to remove the threat to the NHS, from whatever direction it comes, now or in the future, is to legislate in the Trade Bill that the NHS should be outside the scope of any future trade agreements. However, it speaks volumes that the Government refuse to do that. The NHS is more than a logo.

[Dean Russell (Watford) (Con)]

It is a pleasure to serve under your chairmanship, Mr Stringer.

First, I say thank you to those who organised the petition and to those who signed it. It is great to be able to stand here to clarify matters and reassure those people regarding the concerns they may have had about the privatisation of the NHS or any act towards that under the trade deal. The reality is that the Trade Bill has nothing to do with that; it is an extension of the existing agreement, which does not cover US activities. More importantly, this Government have not engaged in any activities to privatise the NHS.

In fact, the fearmongering that happens around this issue, as I wrote in an article earlier this year, actually causes many people anxiety. It causes fear and concern among the very people who need to be reassured that they can always access their NHS services at the point of need and for free. The reality is that nuanced debate is stifled, ironically, by the Opposition.

I do not wish to score points on this issue, because I really do not like political point-scoring, but it was the Opposition that brought in the private finance initiative. The Labour Government brought in the privatised Hinchingbrooke Hospital, and they introduced prescription charges for spectacles and dentistry. This Government have undone much of that work. We bought back Hinchingbrooke. We have invested millions, if not billions, in the NHS over the past year.

As a member of the Health and Social Care Committee, I have seen at first hand the good, but also the challenges the NHS faces. When we look at those challenges, one of the biggest problems I have seen over the past few decades, and particularly over the past few years, is that the rhetoric and fearmongering around privatisation of the NHS have built and built. Yes, it helps people to put leaflets through doors; yes, it helps them to make political points; and, yes, it helps to create coverage and news headlines. However, what it also does is make the people at the very heart of the NHS, who need support, worry about their futures.

[Rachel Hopkins]

The hon. Gentleman’s point about fearmongering is interesting. Has he, like me, had many NHS employees contact him with their concerns about privatisation of the NHS? They are fearful not for their jobs, but for the future of the NHS.

[Dean Russell]

I thank the hon. Lady for her question. Yes, they have, and where have they got that from? From leaflets and newspapers. In fact, I was about to make the point that in my volunteering at Watford General Hospital, I have spoken to staff who are anxious about what the future looks like. I was anxious to speak to them because I want to understand what their fears are. Often the fears are based on rhetoric, not on fact, and what there might be in the future, which is based on past Governments, not the current Government.

The anxiety goes deeper. Recently, while volunteering at the hospital, I held an iPad for a gentleman who had had a stroke. It was quite a moving moment. I explained to him that he had time to speak to his daughter and, as I sat there on my knees holding the iPad for him, he reached his hand over to hold my wrist and said, “Just a few minutes longer,” because he wanted to speak to his daughter for a little longer. In that moment, I realised the fear and vulnerability of the patients who are in the hospital beds, and how they, the staff and the families worry about what support they will get. In that moment, I realised also that the issue is not only about medicine, pharmaceuticals and trade deals, but about real people who are suffering and need support. What they also need is the continued reassurance that we are not privatising the NHS, even though the Government have never—not once—opted to do so, and neither will they.

We heard an excellent contribution earlier about data, which is something I am passionate about. Digital and data are the future of the NHS. We want the ability to cure cancer and diseases by looking at data in a much fairer way, and by making sure that people feel comfortable sharing their data online and with the NHS and organisations to help them solve the biggest issues in the world. Why would they not do that? Because of the fear around where the data would go. Yet every single day, people share where they are, what they eat and who their friends are with Facebook, Google and all the big corporate organisations without a second thought. However, because of the rhetoric—I will not blame it fully, to be fair—they are fearful of giving data and important information to the Government and the NHS to help them solve the big issues.

We have seen with the test and trace app that when the safety and security are created and people are reassured, they use it. Being able to use the app saves countless lives, and people can look to see whether other people need support or need to be isolated. That is about people feeling secure and safe, but the constant rhetoric—this drumbeat—just to get leaflets through doors to make the constant argument about privatisation is fearmongering at its worst. In fact, it scares the most vulnerable.

As a member of the Health and Social Care Committee, I hear the good and the concerning from the NHS and social care. I am not saying that it is an amazing organisation—I am not even saying the Government are perfect in every possible way— but there is scrutiny there. There are opportunities to delve into it and to have a much-needed calm and nuanced debate about what it will look like in future. What does the NHS need in the next five, 10, 20, 30 years? We must not constantly look at the next election cycle. We need to take the rhetoric out so that we can have calm, consistent and thoughtful debate about what it will look like. I am pleased to see colleagues here from the Committee. I am sure they will agree that we work closely and very well together on the Committee to be able to have debate and discussion around this. When we cannot do that in the public realm, it stifles our ability to continually improve the NHS.

The Trade Bill is about existing trade. I will not go into the details because I am sure the Minister will go into it in much more detail, but let us move forward. I urge those watching and listening to this debate and who signed the petition to please look at the facts and be reassured by what the Government have done and what we say about the NHS not being on the table. I urge colleagues to come together and have a calm debate about what this will look like in the future, because if we do not, the people who need the most support, who are the most anxious and fearful, will be harmed the most simply by words.