TTIP and the NHS: a reason for Brexit?

Author: Christopher Grey


Great photo opportunity but what are the facts?
Great photo opportunity but what are the facts?

Amongst the various arguments for Brexit, one in particular has growing traction with those on the political left. It is that by remaining in the EU Britain will be subject to the terms of the Transatlantic Trade and Investment Partnership (TTIP) between the EU and the US. In particular, it has been argued by David Owen amongst others that TTIP would lead to the privatization of the NHS and/or make any such privatization irreversible. Owen is by no means a traditional Eurosceptic, and his longstanding commitment to the NHS means that his views should be taken seriously.

TTIP isn’t finalised yet, so we don’t know its exact terms and the discussions have been held in secret. This, by the way, isn’t unique to TTIP or especially sinister: it’s the norm in international trade negotiations. Even so, there are clear indications that the fears of David Owen and others are misplaced. On March 20 2015 the EU and US negotiators issued this unequivocal statement:

“US and EU trade agreements do not prevent governments, at any level, from providing or supporting services in areas such as water, education, health, and social services. Furthermore, no EU or US trade agreement requires governments to privatise any service, or prevents governments from expanding the range of services they supply to the public. Moreover, these agreements do not prevent governments from providing public services previously supplied by private service suppliers; contracting a public service to private providers does not mean that it becomes irreversibly part of the commercial sector …. The United States and the European Union are following this same approach in TTIP …”

This led the NHS Confederation’s European Office to say that subject to the agreement being worded as promised by the negotiators then the NHS would not be forced to privatize, nor would any privatization that occurred be irreversible.

Alongside the general statement from the negotiators, EU Trade Commissioner Cecilia Malmström wrote the British government a letter, published on January 28 2015, which addressed the specifically UK issue of the NHS, saying:

“To be clear, the effects of the EU’s approach to public health services in trade agreements such as TTIP are that:

·       member states do not have to open public health services to competition from private providers, nor do they have to outsource services to private providers

·       member states are free to change their policies and bring back outsourced services back into the public sector whenever they choose to do so, in a manner respecting property rights (which in any event are protected under UK law)

·       it makes no difference whether a member state already allows some services to be outsourced to private providers, or not”

This is again an unequivocal statement and, short of a complete volte-face, it seems absolutely clear that TTIP does not mean privatization of the NHS or the entrenchment of any privatization that did occur.

It is of course perfectly possible that a British government could seek as a matter of its own policy to privatise the NHS – but that is so whether or not TTIP exists and whether or not Britain is in the EU. It might be argued that were such a policy pursued under TTIP it would at least mean a more competitive tendering process than has often been the case with British public sector outsourcings where a small number of companies repeatedly get awarded contracts despite a history of failures. Be that as it may, TTIP does not require NHS privatization and nor would it prevent the reversal of such a policy.

The other side of the coin is to consider what would happen under Brexit. Campaigners to leave speak of being free to sign international free trade agreements, and often cite the EU-Canada Comprehensive Economic and Trade (CETA) deal as a model. Interestingly this, like the Trans-Pacific Partnership (TPP), is one of the models for TTIP itself in terms of the approach to public services. Thus, suppose it were indeed true that TTIP meant NHS privatization then so too would the envisaged post-Brexit scenario. But it isn’t true and, ironically, the Brexiteers’ claims about TTIP were debunked by the most high-profile of their number, Boris Johnson. Writing in the Daily Telegraph on October 19 2014 he said:

“There is absolutely nothing not to like about the TTIP … it will certainly not mean the privatization of the NHS … [it is] a massive potential win for humanity … if the EU can’t pull it off we in Britain should offer to go first and do it ourselves.”

A final thought. David Owen’s intervention was undoubtedly motivated by genuine concern about the NHS, but this cannot be said of the Brexiters in general, who are raising the issue quite opportunistically. Many of them are ideologically committed to the privatization of the NHS anyway, Nigel Farage being one prominent example, even as they peddle the myth about TTIP in the hope of gaining support for leaving the EU. The same is undoubtedly true of many Conservative Eurosceptics. In a post-Brexit Britain it is these politicians who would be in the ascendant.

So anyone voting to leave the EU on the grounds that TTIP will mean privatization of the NHS will be making a double error. First and foremost, by voting on the basis of a fear that has no foundation; second by voting for an outcome that will make what they fear more likely to occur.


Christopher Grey

About the Author

Christopher Grey

Christopher Grey FAcSS is Professor of Organization Studies at Royal Holloway, University of London.

Before that he held Professorships at the Universities of Warwick and Cambridge, where he was also a Fellow of Wolfson College. Publications include Decoding Organization: Bletchley Park, Codebreaking and Organization Studies (Cambridge University Press, 2012) and Secrecy at Work: The Hidden Architecture of Organizational Life (Stanford University Press, 2016).

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Christopher Grey

About the Author

Christopher Grey

Christopher Grey FAcSS is Professor of Organization Studies at Royal Holloway, University of London.

Before that he held Professorships at the Universities of Warwick and Cambridge, where he was also a Fellow of Wolfson College. Publications include Decoding Organization: Bletchley Park, Codebreaking and Organization Studies (Cambridge University Press, 2012) and Secrecy at Work: The Hidden Architecture of Organizational Life (Stanford University Press, 2016).

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