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NHS is not safe from TTIP despite headlines to the contrary

On the 8th July Ignacio Garcia Bercero, Chief EU negotiator on the TTIP wrote a letter to John Healey MP, Chair of the UK's All Party Parliamentary Group on TTIP. The purpose of this letter was to respond to John Healey's enquiry in March about how the TTIP could affect the NHS.

This generated an extraordinary piece in the FT on Thursday 10th "EU vows to protect NHS in US trade talks" and the Guardian on Friday 11th entitled 'European official commits to safeguarding NHS in EU-US trade deal'. These assurances were based on the claim that the Commission's negotiator had said that the NHS would be 'fully safeguarded'. The Guardian article went on to quote the specific text from the letter:

"Although health services are in principle within the scope of of these agreements and ongoing negotiations, we are confident that the rights of EU member states to manage their health systems according to their various needs can be fully safeguarded."

According to John Hilary of War on Want, "the first thing to note is (Bercero's) statement that health services are "in principle" within the scope of TTIP and the other service agreements. This is dissimulation. Health services ARE included in TTIP, not just "in principle".

Earlier this year, on February 25th there was a Commons debate on the TTIP. During this debate it was stated - correctly - that the French government had secured the exclusion of culture and audiovisual services from the mandate.

But on the question of the NHS exclusion raised by Katy Clark, MP, Ken Clarke, the Minister without Portfolio, responded:

"...I can assure the hon.Lady that nothing in the agreement would open up access to the national health service beyond what is already permitted, and what was permitted under the previous Government. Overseas suppliers are already able to offer hospital services and health-related hospital services through a commercial presence here. The important thing for anyone who engages in the provision of professional health services and health care companies in this country is that they have to comply with UK standards and regulations in just the same way as British health providers, and, as I say, those standards will remain under the sovereignty of this country."

In the context of the TTIP it is disingenuous to talk of standards remaining under the sovereignty of this country, The purpose of TTIP is to harmonise regulatory frameworks and remove - as far as possible - "barriers to trade", such as Ken Clarke is referring to. Since health services are included it is precisely the regulations affecting them - including market access - that will be on the table for discussion.

Notwithstanding this failure to apply for an exclusion, Bercero says in the letter that it is still possible for individual EU member states to record their own limitations to both market access and national treatment commitments within the Agreement. However in the chapter in TTIP on health and social services (chapter 13) the UK has done this only for ambulance services. He also quotes from existing trade agreements such as GATS 1:3b on safeguards for services supplied "in the exercise of governmental authority". But this is a worthless safeguard, as the definition of such services requires them to be both non-commercial and not in competition with other service suppliers. Bercero alludes to this with a mention of the current framework of the NHS (the "purchaser-provider split") and an oblique reference to the choices the UK government makes already being subject to existing trade treaties.

Clive Peedell, co-leader of the NHA, says the language throughout the letter is open to interpretation, allowing for claims to be made about the safety of the NHS which are belied by the facts. He stated:

"The NHS is now an external market system. The Secretary of State for Health severed his duty to provide the health service with the Health & Social Care Act. The Coalition Government have not negotiated an exclusion for the health service in TTIP and clearly have no intention of doing so. The chief negotiator has stated what is possible for member states to do in certain situations, but has made no clear statements about exemption. On the contrary he confirms that US companies could indeed bring a successful ISDS case, but considers it "unlikely". Such assurances hold no comfort at all. We are most concerned that there appears to be only one aspect of the NHS' founding principles which is held to be of any importance by this Government: free at the point of need. They have failed to grasp that a publicly owned, publicly provided service is the only way to ensure the other principles: universality, equality, access and consistent standards. TTIP provides the lock-in for privatisation and the destruction of the NHS. We are in no doubt that this letter and the headlines that followed its publication are pure spin intended to de-toxify TTIP in the face of strong opposition throughout the country."

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