The article in The National under the headline Corbyn reveals unredacted document showing ‘NHS is on the table in trade talks’ refers throughout to “the NHS”, implying a single entity. This is misleading. There are, in fact four quite separate and distinct public health services in the UK.
- NHS Scotland
- NHS England
- NHS Wales
- Department of Health, Social Services and Public Safety for Northern Ireland
We may, however, assume that the US corporations seeking access to and control of “the NHS” think of it as a single entity even if, as we should expect, they are sufficiently well informed to be aware of the reality. What is certain is that they will want the same access to and control of all four health systems. And, with the support of the US Government, they will demand that the UK Government facilitate this as a condition of any trade deal.
We know also that, post-Brexit, the UK Government will be so desperate to conclude a trade deal with the US which can be spun as an example of the benefits of leaving the EU that they will agree to pretty much any and all conditions set by the US negotiators. We must ask ourselves, therefore, how the UK Government might go about facilitating this ‘sell-off’ of all four health services as part of a single deal given that there are significant differences in the way they are structured, funded and managed. We should also ask ourselves what demands the US negotiators might make in this regard.
It seems extremely likely that the US negotiators will want the four health services combined under a common UK-wide framework. Which is handy, because the UK Government has prepared for just such an eventuality. Readers may recall discarded Scottish Secretary David Mundell referring to these “UK-wide common frameworks” on numerous occasions – and with great relish as he at the time supposed he would be in charge of the Scottish bit of these common frameworks through the shadow administration called ‘UK Government in Scotland’. We may also note that these “UK-wide common frameworks” are openly being discussed in relation to agriculture, agricultural support, fisheries etc.
While there has been no mention of a “UK-wide common framework” for health services we would anticipate that any proposals of this nature would be kept under very tight wraps. Tighter even than those that secured – or failed to secure – the document Jeremy Corbyn now claims to have in his possession. Even if no specific proposals exist, which seems highly unlikely given the language of the aforementioned document, the UK Government has seized powers which could provide the means to ‘surreptitiously’ force the four health services into adopting common practices in various areas – notably, powers over public procurement.
Additionally, the UK Government has seized powers over elements of reciprocal healthcare, which would allow them to claim some kind of precedent for the imposition of a common framework in other aspects of health services. We know how that argument goes – there is already a “common UK-wide framework” in respect of that, and this is closely associated with that, so obviously there should also be a “UK-wide common frameworks” for this.
And let us not forget the provisions of Section 30 of the Scotland Act (1998), which gives the British Prime Minister sweeping authority to unilaterally alter which powers are devolved and which reserved. Read with due trepidation.
“Her Majesty may by Order in Council make any modifications of Schedule 4 or 5 which She considers necessary or expedient.”
Taken altogether, we may safely conclude that the intention of the UK Government is to effectively abolish the separate health services by absorbing them into NHS England in order to present a more tempting prey for America’s corporate hyenas. We can be sure that NHS Scotland will be particularly targeted due to the fact that those predators find distinctly unpalatable the Scottish Government’s commitment to preserving a genuine public health service founded on a principle of universality that is alien and anathema to them.
Some will protest that this is overstating the threat to NHS Scotland. Can we afford to take the chance?
PS – How could I have forgotten this? ‘Boris Johnson warns SNP will ‘forfeit all right’ to manage NHS‘?
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