While Dr No has been away frying other fish, it seems the Tories have been sneaking a few of their own right old brown trouts through the S bends and P traps of US/EU trade negotiations. Like those in the wild, these fish are well camouflaged. Against a backdrop of general do-goodery – free trade, liberalisation of markets, and boosting of GDPs – there is some serious mumbo-jumbo about the steps needed to break down barriers to trade not just in goods, but services. The scope is grand: all sectors are covered unless specifically excluded. No longer will Detroit be able to give das auto da boot; nor will M. ’Ollandaise be able to stop Hollywood setting up Frollywood on the French Riviera – unless exclusions are granted. But here’s the thing: while other governments are geeing up to protect their important sectors, our Tory led government is eerily silent on excluding what is arguably today our biggest and most defining sector: the NHS.
Together, the Health and Social Care Act and the arrival of a free trade agreement – something Cappers has publicly committed Britain to during its chairmanship of the G8 – are the lock and key that will open the NHS to the full force of international – read American – competition. The Act and its regulations establish an obligation on CCGs to put services out to tender, but a free trade agreement, without specific NHS exclusions, goes much further: it will drive a bulldozer through the existing wicker-work of informal local protection, allowing American corporate giants to invade the English national health service. Not, one might say, so much a case of bend over for the doctor, as bend over for Corporate America.
Earlier this year, the US/EU High Level Working Group on Jobs and Growth produced a brief ‘final report’ on the direction in which it wants to see talks move. Much of the thrust is on ‘regulatory harmonisation’ – cutting red tape – but delve a bit deeper and we find the knives and spikes that will not only cut the red tape, but give pokey effect to the agreements. The group was charged among other things to consider options to achieve the ‘elimination, reduction, or prevention of barriers to trade in goods, services, and investment’ and furthermore on a level greater than anything achieved in previous agreements. The group lists seven areas where agreement will foster free trade, and at least three are direct threats – the knives and spikes – to the NHS:
•Beefing up competition policy (make it easier for American Corporates to fry CCGs whose decisions they dislike)
•Removing protection for ‘state-owned enterprises and other enterprises that benefit from special government-granted rights’ (inter alia, the NHS)
•Elimination of local barriers to trade ‘designed to protect, favor (sic), or stimulate domestic industries, services [and] providers at the expense of imported goods [and] services’ (again, inter alia, the NHS).
Although it is fair to say that these are at present only aspirations for trade agreements – if any – that are achieved, make no mistake: if they are achieved, and the health service remains un-excluded, then it won’t be so much a poke in the eye with a sharp stick for the NHS as a green light for not the trout nor the otters but the Dreadnoughts of corporate American healthcare to steam right up the NHS’s backside, with consequences that Dr No predicts will be painful, messy, and very very expensive, for many years to come.