The December 2019 UK general election has returned a landslide majority for the Conservative Party on the single-minded promise to ‘Get Brexit done’. Leaving the European Union as soon as possible will require the Government to secure new trade deals with other countries just as quickly, which now raises urgent questions about exactly what this means for the NHS and its patients.
The Labour Party centred its doomed campaign on the warning that the Conservatives were prepared to sell the NHS to predatory corporate interests to secure a free-trade deal with the US. Labour leader Jeremy Corbyn based this claim on documents that showed US negotiators had requested ‘total market access’ to the NHS, and that their UK counterparts had suggested that this was on the table for future negotiations (Perraudin, 2019). To spell out what this could mean for NHS patients, Corbyn pointed to average drug prices in the US being two-and-a-half times what they are in the UK. He illustrated this with the example of Humira (adalimumab), which is used to treat Crohn's disease, pointing out that it costs £1409 for the NHS and £8115 under the US private system—a 576% increase.
This was not enough to sway voters, who either had other priorities or did not believe any UK government would have the nerve to undermine an institution as overwhelmingly popular as the NHS. Full privatisation may be politically untenable, especially in the face of horror stories of Americans refusing ambulances (Parry, 2018), taking antibiotics designed for fish (Gander, 2019) or leaving a suicide note citing medical debt (O'Kane, 2019). However, it is not so hard to imagine an unassuming regulatory adjustment with a profound public cost, such as an extension on the patent period before the NHS can switch to a generic drug.
US companies stand to make a fortune off the NHS, and the UK's rush for a trade deal will hand the US negotiating team all the cards. It remains to be seen how hard the Americans will push, as well as how much resistance they will face from a party that has spent the past four decades enthusiastically privatising as much of the welfare state as it can.
It will be up to healthcare professionals to scrutinise any proposed deal and sound the alarm on anything suspect. The Brexit culture war has scrambled British politics, with the Conservatives, perhaps surprisingly, emerging as its only clear beneficiaries. Leaving the EU is now a certainty, but, as this issue fades in the rear-view mirror, there will be new opportunities to redraw the lines of public debate. It is in the interests of nurses, patients and other public sector workers to refocus the national discussion on protecting public services and defending the sovereignty of the NHS.
‘It will be up to healthcare professionals to scrutinise any proposed deal and sound the alarm on anything suspect.’