EXTRACT FROM THE BRITISH MEDICAL JOURNAL

"A forthcoming trade treaty between Europe and the United States could have far-reaching implications for the NHS. Some observers believe the Health and Social Care Act was designed with this deal in mind. Will it add a new dimension to competition in the health service? Peter Davies reports.

The European Union and the United States are about to agree terms for negotiating a free trade treaty. Prime minister David Cameron has made reaching agreement a priority for the meeting of the G8 countries on 17-18 June, which he is chairing. It is hoped the treaty will be signed by the end of 2014. The European Commission says it will be “the biggest bilateral trade deal ever negotiated,”1 adding £73bn (€85bn; $110bn) a year to the EU’s economy.

Officially titled the transatlantic trade and investment partnership (TTIP), this is the latest in a series of agreements to “liberalise” trade between wealthy nations. The EU has been negotiating a similar deal with Canada, the comprehensive economic and trade agreement (CETA), since 2009. These agreements focus on “harmonising” regulation and opening up markets: often this involves privatising public services. Though governments negotiate the agreements, they are designed to benefit large transnational corporations and protect foreign investors.

Cameron said of the TTIP talks: “Too often in trade, the voices defending special interests shout loudest. But it makes no sense to exclude vital parts of the economy. Everything is on the table with no exception. ”.

Some health policy analysts have deduced that the NHS will be one of the markets the government opens to US interest. Since the Health and Social Care Act 2012 it has been primed to make ever more use of competition, in England at least. The result could be many more NHS services contracted out to private providers...."

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