Report from NHS/TTIP [Transatlantic Trade and Investment] meeting 3rd Feb 2014 at Unite building organised by StopTTIP [Notes compiled by Linda Kaucher]
A meeting attended by about 80 people and Chaired by Melanie Strickland was convened to highlight what the new trade partnership rules would mean for the UK Health Service

Rachael Maskell (UNITE national officer for health)

The NHS is actually 4 health services – those of Scotland, Wales, Northern Ireland are exempt from much of what is now in the English NHS, so essentially we are talking about the English NHS.
NHS privatisation started with Thatcher, at first catering, cleaning, then non-clinical health provision e.g. labs, then PFIs [Private Finance Initiative], and contracting with large corporations not associated with health.
The Health and Social Care Act covers all NHS services including clinical ones.
Regulation 75 opened everything to the private sector.
Anyone can get a license via Monitor, the overseeing mechanism, so now there is a market within the NHS.
Now there are hospital takeovers. One third of hospitals will be in financial difficulties by the end of the year, which opens the door to privatisation.
York clinical commissioning goes out to a private hospital.
Effects: loss of services, the cost to us as taxpayers and working conditions in the NHS are deteriorating.
With the TTIP, where there is any privatisation, the private sector can challenge governments.
UNITE is concerned for privatisation but especially labour rights.

Lucy Reynolds (London School of Tropical Medicine)

The overall plan is rolling back the state – seen in the debt crisis of the eighties, in the collapse of communism, and in ‘austerity’ now.
Big Society (also in Australia) means a takeover of the public sector by the private sector,
What’s left, or what the private sector doesn’t want, is for philanthropy and charities to provide (nb use of volunteer workers).
Since Thatcher, in fact since the 1970s, there have been waves of aggression against the NHS
First the easy bits like catering, then into the plan. NB Oliver Letwins book ‘Privatising the World’ in the 1980’s.
Primary care is meant for the insurance industry, secondary care for private health care
The Health and Social Care Act is an insurance industry takeover – so health care in the UK becomes a clone of the US healthcare industry by 2020.
According to the Adam Smith institute, Clinical Commissioning Groups (CCGs) in the Act were the creation of MP John Redwood, transitional to the invisible insurance takeover.
When Dutch health care professionals challenged the fact that with privatisation changes taking place there, there was no longer any rural health care provision, the Dutch state had to pay out 7.7m euros, because of EU competition law.
With the ‘autonomy clause’, whatever is not specified in contracts (and there are questions about the capabilities of the staff preparing contracts) the providers can do as they please.
The Act allows for a fire sale of NHS land and buildings.
From Thatcher to TTIP – governments do the dirty work, and then Washington can take over.

Linda Kaucher (researcher on international trade and from StopTTIP campaign)

General remarks about international trade agreements, then 4 aspects of the trade agreements affecting the NHS (2 in all free trade deals, 2 specifically in TTIP):

International trade agreements are the means for setting neoliberalism in stone – regardless of the nature of future governments.
They are promoted by transnational corporations, for their benefit, and particularly transnational financial service corporations – so the City of London, representing these transnational financial service corps, is a big voice in EU free trade agreements.
Through international trade agreements we’re locked into international trade law, which
is above national and EU law
is only judged on values of free trade (not taking into account social wellbeing, human rights, environmental protection etc)
‘Locked in’ means no reversals, whatever government, so ‘corporate security’.

4 aspects of trade deals affecting the NHS:

The global public procurement grab – Transnational corps seeking rights to access all government spending, getting in on all government spending investment opportunities.
When they have that right, with their economies of scale, access to cheap labour, and access to credit, they suck up all the investment opportunities, squashing out SMEs and charities, despite the spin about trade agreements benefitting SMES.

Liberalisation – often said, rarely explained
Simply it means opening investment opportunities to transnational and foreign corps.
UK is a most liberalised country so everything in the UK is liberalised (unilaterally, even without trade deals trade-offs, because we have the City of London, which pressures for liberalisation, so we are the model, domestically, for the global ambitions).
The result in the private sector is that everything in the UK is foreign owned.
In the privatised public sector, transnational firms have access for PFI, contracts and takeovers – so Thames Water is owned by Canadian pension funds, South African companies are big in UK PFI, and big US health investors are coming into the NHS.
When liberalised services (investment opportunities) are committed to trade agreements like TTIP, the commitment is to keep them open to transnational investors – permanently.
In this process, privatisations underpinning the liberalisation also become irreversible. So currently the H&SC [Health and Social Care] Act is national legislation – it can be repealed, but in the TTIP, it will be subject to liberalisation commitments.
‘Regulatory harmonisation’ in TTIP– harmonising regulation between the US and the EU – but downwards, because this is a corporate agenda.
The NHS has already been harmonised – health was identified as the primary target in a Trade Commission meeting in Brussels a few years before the Act.
But at this point this is national legislation and it is reversible.
Investor–state dispute settlement (ISDS) in TTIP – allows corporations to sue governments for the loss of expected future profits resulting from any regulatory changes or backtracking.
So all will be kept in place by this mechanism, preventing any reversals (as the Labour Party is promising) with the threat of big pay-outs from the public purse.
There is a wide campaign against TTIP, with groups in the EU and US opposing TTIP or wanting elements changed, particularly ISDS.
In some ways, the Trade Commissioner, De Gucht, is cracking, as seen in a recent German TV interview, but he is not the power behind it, corporations are.
Recently the Commission announced a hold on ISDS negotiations, with a public consultation, but with a drawn-out timeframe and only on ISDS ‘loopholes’, not about getting rid of ISDS, and negotiations on all the rest of the agreement continue in the meantime.

Question and answer session: further information that emerged in response to questions

The NHS is worth £100b a year for investors.
If a government was sued and didn’t pay – likely to become a public enemy, outcast, rogue state.
Exemptions from trade deals – hard to get, France did NOT get an exemption for audio visual services.
KONP [Keep our NHS Public] wants an exemption for health and for social care.
Re: a possible definition issue with ‘public services’? Big, geographical, natural monopolies are a sound basis.
Does Canada have a health services exemption in CETA? [Comprehensive economic trade agreement, Canada/EU free trade agreement] The Canadian government is telling Canadians it has – but in a spin document, negotiations are still going on and the actual text is still secret. Certainly a big EU push to get access to Canadian provincial government procurement.
Many in audience not convinced the TUC [Trade Union Congress] is really pushing on this issue.
Who represents us in the EU? We have to represent ourselves. EU is corporate dominated.
Should we be aiming higher than an exemption for the NHS – re: the Agreement, re: other renationalising? Or is the broad public consciousness about the NHS the way in, and an exemption is a safeguard. Calling for an NHS exemption strikes at the heart of both the public procurement grab and the TTIP.
The public is ready to react against unpopular big companies like Serco, G4S.
Where is policy made? On trade, in the City of London’s LOTIS (Liberalisation of Trade in Services committee) where banks and other financial services dictate to trade bureaucrats the demands they are to take to Brussels.
Although the European Parliament has the right of assent (only) on the TTIP, a demand for an exemption would have to come from the UK, from Cameron, so difficult though a Tory Prime Minister is as target, that has to be the target, and we need an Opposition to be calling for this.
Will support for the National Health Action Party help turn Labour?
Is calling for an exemption of the NHS from the TTIP a simple enough message for the public?
Milburn the privatiser is back in the Labour party policy team

The last part of the meeting was about ideas for campaigning.

Identifying general support for a call for an exemption in the meeting, proposal for either ongoing public meetings on NHS/TTIP and/or a committee of representatives of organisations committed to an exemption for the NHS from TTIP.
There is a dearth of information on TTIP to address
Journalists don’t even know about it, are not talking about it.
Need for posters and adverts in press – will unions fund these?
Trade Commission consultation – is it worth engaging with?
The NHAP [National Health Action Party], as a political party will not be affected by the gagging law.
Need for a big public demonstration.
Lewisham [Hospital] success – a simple message.
Save Lewisham Hospital offering a campaign workshop, about getting local support?
The NHS is our particular UK part of EU and US resistance to TTIP

Information distributed at the meeting:
point form one pager on the trade agreement (the first 2 pages of information kit)
template letter for MEPS with London MEPs contact details
UNITE briefing on the TTIP and health.

Thanks to UNITE [Trade Union] for the meeting space.