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Selling Off the NHS: The “Great Prize” of No Deal Brexit

Leaked ‘sensitive’ documents from trade talks with the Trump Administration suggest the Holy Grail of Hard Brexiters is carving up Britain’s efficient, free universal healthcare.

Leaked ‘sensitive’ documents from trade talks with the Trump Administration suggest that the Holy Grail of Hard Brexiters is carving up Britain’s efficient, free universal healthcare.


Boris Johnson’s previously inexplicable drive towards a catastrophic and disruptive ‘hard Brexit’ has come into sharp focus thanks to leaked documents from the Department for International Trade’s secret talks with the UK-US Trade & Investment Working Group.

The DIT documents, marked “sensitive”, reveal that extensive secret trade talks with Donald Trump’s Administration in the US have been on the “baseline” assumption of “total market access” to the UK. A major brake on that, from America’s perspective, is Britain’s “regulatory alignment” with the EU post-Brexit.

Trump himself has often pushed for a catastrophic ‘hard Brexit’ and the documents make clear the interests from the US side: “There would be all to play for in a ‘no deal’ situation”.

With an annual budget of £140 billion for NHS England alone, Britain’s health service provides rich pickings for any Brexit deregulation.

Trump himself has often pushed for a catastrophic ‘hard Brexit’ and the documents make clear the interests from the US side: “There would be all to play for in a ‘no deal’ situation”

One of the key targets is the £20 billion medicines budget, which is rising faster than other healthcare costs at 5% a year. The leaked documents explain that “NHS access to generic drugs… will be a key consideration going forward”. It has also been reported that the UK Trade Minister, George Hollingbery, held a meeting with a US drugs giant last year, at which “future trade” deals post-Brexit were discussed.

Britain’s NHS has long been a focus of hard Brexiters associated with the Conservative European Research Group (ERG) and allied think tanks – many of which receive opaque US funding.

Leading Brexiters such as the MEP Daniel Hannan have called the NHS a “mistake”. Nigel Farage has openly called for an insurance-based system, and his Leave.EU campaign communications director has invested in private healthcare solutions.


The NHS – Highly Trusted and Cost-Effective

Since Labour Leader Jeremy Corbyn brandished the documents at a General Election press conference, the Prime Minister has denied any intention to sell off the NHS.

Though Boris Johnson’s track record for honesty leaves much to be desired, the Conservative Party knows that the health service is top of voters’ concerns in this (even above Brexit) and the issue is a touchstone for the British public. It is the last great British Institution, since the BBC lost its lustre and Prince Andrew wounded the monarchy. Selling off the world’s largest unified, universal healthcare system would risk losing an election.

But, it is not just that the NHS is held in such high regard by the British public, it is also very cost-effective. In 2016, according to the World Health Organisation, the UK spent 9.7% of its GDP on healthcare, versus 17.07% of GDP in the US. This huge variation is even more concerning when you consider that 44 million people in the US are uninsured and another 38 million have inadequate insurance – which means that one-third of US citizens are not protected in terms of proper healthcare. Nor is all the extra US expenditure necessarily leading to better outcomes in comparison with the UK.

When it comes to medicines and Big Pharma, which is predominantly US-owned, there is a double red flag because the NHS spends much less than the US on medicines.

Some of this is due to its use of generic medicines that are a fraction of the price of branded medicines that have come off patent, and also better negotiation with Big Pharma with the help of NICE which measures the cost and benefit of all medicines. This has resulted in a per person cost of medicines in the UK of £365, versus £946 in the US in 2017, according to the OECD.

US Big Pharma is continually trying to drive up the costs of drugs by wanting to extend patent periods, push prices on new medicines and stop generics.


An Ideological Alliance

Most of Britain’s leading Brexiter think tanks supporting Boris Johnson – the Institute of Economic Affairs, the Adam Smith Institute, Policy Exchange and the Legatum Institute – have received financial support from US backers in the past 10 years and have been at the forefront of free trade talks with the Trump Administration.

The Legatum Institute’s Shanker Singham, supported by a three year £1.1 million grant from the US right-wing evangelical Templeton Foundation, authored a report stating that the UK could “deliver the Brexit prize” by negotiating radical free trade agreements with the US and scrapping the EU regulations on food safety and pharmaceuticals.

The Adam Smith Institute, which has raised $1.4 million from American donors since 2008, partnered with American US libertarian think tanks to launch a blueprint for a free trade deal which would open up the NHS to competition from US healthcare companies.

The economic and ideological alliance between the Hard Brexiters and US commercial interests is out in the open – and the world’s largest unified and universal healthcare is the ultimate prize on the Brexit/Trump axis.



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