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Doctors leaders reassured over transatlantic healthcare market

The BMA has been given further assurances that a free-trade agreement between the EU and the USA will not affect healthcare in the UK.

USA and EU flagsTalks to develop the TTIP (transatlantic trade and investment partnership) started last July, with a fourth round of negotiations scheduled for next month.

Letters to the BMA from the European Commission’s director general for trade and UK minister for trade and investment respond to its concerns about healthcare being opened up to greater market forces.

Lobbying by the BMA has already won assurances from key UK and EU players that healthcare provision would not be part of the talks.

BMA EU policy manager Paul Laffin said the recent correspondence was ‘good news’, as it reiterated what the organisation has been told to date.

He said: ‘No matter what is eventually agreed for the final text of the TTIP, the European Parliament can vote to reject the treaty, just as it did — overwhelmingly — with the anti-counterfeiting trade agreement, back in 2012.’

Local commissioning decisions

This month, UK trade and investment minister Lord Livingston wrote to BMA council chair Mark Porter (pictured below) to reassure him that the position on health services in the TTIP had not changed.

He emphasises it is ‘for NHS commissioners’ to take decisions about which providers to contract with and the TTIP would not affect this policy. 

Lord Livingston also attempts to alleviate concerns raised about the potential for so-called IP (investor protection) and ISDS (investor to state dispute settlement) mechanisms to be used by corporations to attack public services.

These are contentious because they give foreign corporations the right to sue the countries in which they are investing if they believe a government decision, such as standardised tobacco packaging, has unfairly impacted on their investment.

Investor claims rare

He says: ‘ISDS has been a feature in the vast majority of the UK’s 94 bilateral investment treaties.

‘These treaties date back as far as 1975 and protect UK investors from unfair treatment, such as expropriation without compensation.

‘If the standards of protection provided in these treaties are breached, investors are typically entitled to claim for compensation.

‘However, the UK has not been subject to many claims, with only two, unsuccessful, claims brought against the UK to date.’

Lord Livingston adds it is essential to strike ‘an appropriate balance’ between protection for UK investors abroad, while ensuring the UK government was not prevented from acting in the public interest in areas such as public health.

Public policy protection

Similar sentiments came from the European Commission this month, in a response to a letter Dr Porter wrote to the director general for trade in early December.

Mark-Porter-QA-196x148It says: ‘The European Commission has, since 2010, been developing a new EU policy on investment protection and ISDS that builds on the lessons learnt from the way the system has operated so far.

‘Indeed, the commission has been very mindful to ensure that legitimate public-policy decisions cannot be successfully challenged.

‘Neither the EU nor the US government has an interest in seeing their public policies successfully challenged by investors.’

A consultation on the investment protection provisions proposed by the European Commission for the TTIP will shortly open and public comment is invited. 

NHS dangers quashed

Mr Laffin added: ‘This public consultation will be key, as it gives the BMA the opportunity — alongside experts — to close any ISDS or IP loopholes to ensure that they cannot be abused by corporate interests.’

In a speech on the TTIP in London last week, European commissioner for trade Karel De Gucht offered further reassurances about the health service. He said he wanted to make sure everybody understood that the TTIP ‘does not endanger the NHS in any way’.

He said trade agreements were used to create opportunities for service companies — but not for public services such as health because of their social role. 

He insisted: ‘The UK government’s approach to providing health services will therefore not be affected by the TTIP negotiations on services.’

 Read about the BMA's work on European issues

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