Scotland Wants NHS Protected From Post-Brexit Trade Deals
Election Manifesto Backs Scottish Independence & EU Membership
Executive Summary
The Scottish National Party has put the NHS, EU membership and Scottish independence at the heart of its campaign as the UK prepares to vote in the 12 December general election.
The Scottish National Party has called for more funding for the National Health Service and urged the future UK government to pass legislation guaranteeing that the principles of the NHS are not undermined by any trade deals negotiated by the UK after Brexit.
In any post-election talks, the SNP would "demand that Scotland's NHS be protected from trade deals, said First Minister Nicola Sturgeon, who launched the SNP's general election manifesto on 27 November. The SNP is worried over the possibility of a trade deal with the US opening up the NHS to US health care companies and leading to higher drug prices.
Sturgeon said her government was currently spending £136 more per head on frontline health services than in England. “This amounts to over £740 million more spending in Scotland, compared to the UK,” she observed.
Health is a devolved responsibility in the UK, which means Scotland makes its own policy and spending decisions in this area, although the overall amount of money it has available is determined by the Barnett formula, under which the devolved administrations receive a proportionate share of new funding.
Sturgeon suggested more money needed to be made available to the NHS overall in order to boost Scottish health spending. If the next UK government were to raise per capita health spending per head to the current Scottish level, she said, “it would not only substantially increase health investment in England, it would mean that by 2024/25 frontline investment in NHS Scotland would be £4 billion higher than it is today."
'NHS Protection Act'
The SNP manifesto, entitled “Stronger for Scotland,” says that the party would press a future UK government to pass legislation that would “enshrine in law that our NHS must be protected as publicly owned, publicly operated, and its services publicly commissioned."
Sturgeon said: "We will introduce an NHS Protection Bill. This will guarantee that trade deals will not undermine the founding principles of the NHS, nor open it to profit driven exploitation. And as a double-lock, it will stipulate that no trade deal could come into force without the consent of the Scottish Parliament.”
The legislation would stipulate that “any goods or services that are procured by the NHS must be explicitly prevented from being subject to any future ‘investment protection mechanisms’ or ‘investor-state dispute resolution mechanisms’,” the manifesto says. It would also require all the devolved administrations (in Scotland, Wales and Northern Ireland) to give “explicit consent” to ratification of any trade deals.
Price Increases On The Trade Talks Table?
The SNP is specifically concerned about the possibility that greater access to the NHS by US health care firms and higher medicine prices could be part of the negotiations on a future UK-US free trade deal. “Now Scotland faces the real risk that Tory Brexit trade deals with Donald Trump’s United States will open the NHS to multinational US health companies,” the manifesto declares.
Matters relating to drug pricing, as well as intellectual property protections, have indeed been formally raised by the US in this context. One of the negotiating objectives released earlier this year by the US Trade Representative is to ensure that UK drug reimbursement procedures are “transparent” and “fair” and provide “full access for US products."
The objectives also include seeking provisions on IP rights that “reflect a standard of protection similar to that found in US law." Brian Toohey of the US industry body, PhRMA, said at the time that the US “should seek IP protections that meet the highest global standards, including at least 12 years of regulatory data protection for biologics.”
(Also see "UK Drug Pricing & IP Targeted As US Gears Up For Post-Brexit Trade Deal Talks " - Pink Sheet, 4 Mar, 2019.) The UK currently offers 10 years of RDP (eight years of data exclusivity plus two years of market protection) for all pharmaceutical products including biologics.
The issues were brought to the fore last month in a Channel 4 TV documentary that claimed senior UK civil servants had discussed the possibility of higher drug prices at "secret" meetings with US pharmaceutical companies, although the claim was denied by the health secretary, Matt Hancock. (Also see "UK Gov't Disowns ‘Secret’ Meetings With US On Post-Brexit Drug Pricing" - Pink Sheet, 30 Oct, 2019.)
The American Pharmaceutical Group, representing 11 research-based companies with a presence in the UK, subsequently stated that there had been “no meetings between the APG and government officials on the topic of a future US/UK trade deal.” (Also see "US Pharma Firms Not In Post-Brexit Trade Talks " - Scrip, 4 Nov, 2019.)
But the issue is back in the headlines again after Jeremy Corbyn, leader of the UK opposition Labour Party, produced a dossier that he said proved that the NHS, higher prices and longer patent protection had in fact been discussed by UK and US officials in “secret talks for a deal with Donald Trump after Brexit.”
He claimed the documents showed “US corporations want to force up the price our NHS pays for drugs” and that the two sides had already completed “initial discussion on lengthening patents for medicines” – a move that could indirectly lead to higher drug prices. Johnson dismissed the claims as “total nonsense” and insisted the NHS would not be “on the table” in the trade talks.
These are of course just initial negotiating positions and it will be up to the UK negotiators to decide whether to accept any of the US demands.
But some have suggested that once it has left the EU, the UK will be in a weaker negotiating position and may come under strong pressure from the powerful US trade lobby to accept certain terms in return for agreement on a trade deal.
The question of whether the US could have any direct influence on UK drug pricing had been addressed in August by the Association of the British Pharmaceutical Industry, which said the UK had “very strict rules which control medicine spend.”
Its executive director of commercial policy, Richard Torbett, said pharmaceutical companies in the UK had “voluntarily signed up to a five-year agreement which controls how much the NHS can spend on medicines; this will not change.” He added that the “strict processes the UK has in place to ensure value for money mean we have some of the lowest prices for medicines in Europe and this is good for NHS patients.”
Brexit
The SNP manifesto also deals with Brexit in general – including the possiblity of another "no-deal" exit – and the SNP’s desire for a second referendum on Scottish independence.
It says that the deal negotiated by Johnson would not “get Brexit done” and would instead open the door to “many more years of negotiations on the UK’s future relationship with the EU.” Talks on a future trade deal with the EU have not even started and “there is a high chance they could break down next year, meaning ‘no deal’ will be back on the table,” it adds.
Sturgeon said Johnson’s “dream deal” would be “a nightmare for Scotland.” It would “take Scotland out of the Single Market – which is eight times the size of the UK alone – and out of the Customs Union, the world’s biggest trading block.”
She said the SNP backed a new UK-wide referendum on EU membership, and that “if it is the only alternative to a ‘no-deal’ Brexit, we will support the revocation of Article 50” (the process that the UK triggered in order to leave the EU).
The SNP also believes “the best future for Scotland is to become an independent member of the EU,” but whatever Scotland’s constitutional status “it is in our interests for the UK to remain as close to the EU as possible,” Sturgeon continued.
The party would like a second independence referendum by the end of 2020. The UK government has to give permission for Scotland to hold a referendum if it is to be “beyond legal challenge," but Johnson has said he will not acquiesce to any such request. Sturgeon has told Corbyn that the SNP would back a minority Labour government – if one emerges from the election – but only if he agrees in return to support a referendum. Corbyn has said he would not agree to a referendum in the first term of a Labour government.
The SNP currently has 35 seats in the UK House of Commons, but this number is widely expected to rise after the December election.