Image: The Prime Minister's Office
When we say that the NHS is being denationalised and privatised, it means several things are happening. At the top, the Health Secretary no longer has a legal duty to provide a universal healthcare system. Regionally, there will be Clinical Commissioning Groups (CCGs), which will have to offer contracts to any willing provider, namely private companies. And every hospital trust will need to attain Foundation Trust status, making it an independent organisation responsible for its own financial wellbeing.
All this had been happening only at snail’s pace until a Conservative-led government, and the Health & Social Care Act, came along. The reason for a Tory Bill giving contracts to private companies seemed fairly obvious: over one hundred Conservative MPs and Lords have pecuniary interests in private healthcare. The then-Health Secretary, Andrew Lansley, even had his office bankrolled by private provider Care UK.
Thanks to researcher Linda Kaucher’s recent article, we can see how far the rabbit hole goes. A US/EU Free Trade Agreement, as publicly announced last month, will “dismantle hurdles to trade in goods, services and investment” and “make regulations and standards compatible on both sides”. The EU has already stated that “certain ‘sensitive’ sectors will require more negotiation” but that “no sectors would be excluded from the deal completely”. David Cameron has stated such an agreement is one of his key aims during the UK’s leadership of the G8 group this year.
The agreement is meant to give transnational corporations a level playing field, both in the trade of goods and in the provision of services. Rules must be the same for everyone, to avoid any extra cost or “import tax” for foreign providers. If a corporation thinks that a government or body is limiting their ability to profit, it can take legal action against them.
According to Kaucher, the Health & Social Care Act’s Section 75 is an example of legislation guided by the principles of this overarching trade agreement. It breaks the NHS up into little parcels (the CCGs) that must offer their contracts to any willing provider. If a private provider feels they have been unfairly excluded from a contract, they can use Section 75 to take legal action[8,9]. Kaucher points out that this legislation may have been written specifically to pave the way for international free trade involving the NHS.
The idea that the Health & Social Care Act was developed to allow foreign transnational corporations to profit from NHS privatisation is pretty chilling. Even worse is the idea that, once passed, an international trade agreement will leave us irreversibly committed to privatising the NHS. Even with a change of government and the repeal of the Act, we’d be facing the insurmountable obstacle of international competition laws. The government must be clear with the public - will our health service be opened to multinational business as part of this trade agreement?
We should continue to oppose NHS privatisation at every level - locally with the CCGs and nationally with opposition to the competition regulations, but with the recognition that unless we combat the threat from international legislation, we will likely fail with the rest.
I’d therefore ask that you sign this petition calling for the NHS to be exempt from the US/EU Free Trade Agreement and share it with like-minded friends and colleagues. Thank you.
Statement of interests: Dr Alex Ashman works within the NHS and is a member of the National Health Action Party.
 Peedell C, Cook J. Further privatisation is inevitable under the proposed NHS reforms (BMJ 2011;342:d2996)
 Over 60 MPs Connected to Companies Involved in Private Healthcare (Social Investigations)
 Andrew Lansley bankrolled by private healthcare provider (Daily Telegraph)
 The real force behind the NHS Act - the EU/US trade agreement (Open Democracy)
 US and EU governments aiming to agree transatlantic free trade pact (The Guardian)
 EU and US free-trade talks launched (BBC News website)
 David Cameron sets free trade agreement as his G8 priority (The Guardian)
 Revised Section 75 regs mire CCGs in a legal minefield (CCG watch)
 In the new NHS lawyers, not GPs, will be in the driving seat (The Guardian)
 ‘Save Your Local NHS’ - 38 Degrees campaign
 Doctors’ concerns over NHS contracts being put up for sale (Daily Telegraph)