Uneasy partnership

The Transatlantic Trade and Investment Partnership, a trade agreement currently being negotiated by the United States and the European Union, is set to remove barriers to the buying and selling of goods and services between the two trading giants.

Anti-TIPP campaigners fear the NHS and its staff will be a target for big business if the agreement proceeds

Picture credit: Press Association

Advocates of free trade, including the UK, have been eager to finalise a deal. Yet the public remains largely unaware of the implications of the TTIP agreement, and the effect it could have on NHS patients and staff.

So how might it work in reality? Suppose a clinical commissioning group (CCG) puts out a tender for organisations to provide community health services. Any service provider that meets NHS standards and costs – for example, hospitals, social enterprises, voluntary organisations or public sector providers – can offer to deliver these services. This includes organisations in the US and EU.

Let’s say that applications are received from a major care provider in Philadelphia, along with a couple of social enterprises and a private sector provider in the UK. The CCG examines each application, then makes a decision.

In scenario one, they award the contract to a UK social care provider with a good track record. But what if the organisation in Philadelphia disputes this decision? Under a mechanism embedded in TTIP, they can do this. These dispute settlements are secret tribunals, with corporate lawyers appointed on an ad hoc basis as arbitrators.

If we continue this scenario, the Philadelphia organisation could then decide to sue the hapless CCG for damages for loss of earnings, heaping an enormous burden on the commissioning group and the local area.

In scenario two, the CCG, dazzled by corporate literature and rows of smiling, satisfied patients, awards the contract to the Philadelphia provider. This is where NHS staff will learn the hard way that the bottom line under TTIP is profit. Jobs may be lost and workers’ rights undermined as services are ‘streamlined’ according to the needs of the organisation, not the patients.

To date, there have been no cast-iron assurances that the publicly funded NHS will be exempt from the trade deal. Indeed, the rate of privatisation that already exists and that continues apace, could remove it from the scope of a public service.

The RCN has consistently expressed apprehension, consternation and dismay at the implications of TTIP and its stated economic focus. RCN EU/international adviser Matthew Hamilton has spoken about the damaging impact it is likely to have on the terms and conditions of employment for healthcare staff and ultimately on standards of patient care.

At RCN congress 2014, a resolution urging council to lobby against the inclusion of health services in TTIP was passed with a 97% majority. Nurse Gay Lee, who proposed the resolution, said TTIP poses ‘a real threat to public and environmental health, drug quality and prices, health and safety, health workers’ pay and training standards’.

Be under no illusion: the NHS, bruised and battered as it is, remains an attractive acquisition for the private sector, even more so for organisations in the US and EU eyeing up TTIP.

The message is clear. If we are to safeguard the NHS, we have to oppose TTIP. There is no other way.

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