Click to listen highlighted text! Powered By GSpeech

Home » Posts tagged 'TTIP'

Tag Archives: TTIP

Trust has become totemic for the NHS, so a promise to preserve it would pay dividends



David-Nicholson-FOR-EXTERNAL-USE-approved

 

The CEO of the English National Health Service, Sir David Nicholson, sent out a stark warning in the Guardian today:

“Public support in this country for our healthcare system is greater than in almost any other country in Europe, and that’s so important for a taxpayer-funded system. My worry is that if it gets worse, before you know it you get to a place where a minority of the people support it and then people who can afford to [do so] will go elsewhere for their healthcare. In those circumstances the question of how sustainable the NHS is becomes a much more difficult one to deal with. That’s my worry.”

Various aspects of what Nicholson has said have in the past made me conclude Nicholson is definitely a Socialist, and not merely a Social Democrat.

At the end of a recent interview with Jeremy Paxman, Nicholson referred to how a private insurance system based on complicated genetic diagnoses would simply not work for the healthcare system, referring to imminent issues such as the growth in prevalence of the dementias.

Some even say that the private healthcare companies do not wish themselves a private insurance system; in that, they currently benefit from having some of the work outsourced to them in a controlled manageable way.

Ed Miliband said two highly significant things yesterday.

One was that he would take NHS policy out of the claws of EU competition law.

That is going to be essential if Labour is to have a manageable approach to ‘whole peson care’ or integration.

The Sir John Oldham Commission Report “One Person, One Team, One System” recently made a very noteworthy recommendation.

“We recommend that the benefits are considered of a single regulator covering issues of both care and economics, whilst recognising that is not feasible at present. We believe that the Office for Fair Trading’s role in reviewing competition decisions should be withdrawn.”

And we can see why with the Office for Fair Trading (OFT) due to report this month the results of its ‘market survey’ for ICT according to the ‘prime contractor model’.

The OFT are due to report on whether there has been ‘cartel’ like activity in awarding of contracts, where the award of subcontracts from lead contracts can be ‘opaque’.

With an eye-watering contract having been put out to tender only this week, it is going to be essential that the Government tightens up the law in this area, as integration might offend EU competition law.

The second thing which Miliband said, about electoral priorities in 2015, was equally interesting.

Miliband said he wanted the 2015 election to be about ‘the cost of living crisis’ and the NHS, and not whether he would hold a referendum on EU membership.

Whether or not the media will allow this to happen is another matter, but there has been considerable concern over NHS issues during the course of the parliament.

Firstly, Andrew Lansley against all the odds enacted his vanity project, now known as the Health and Social Care Act (2012); only this week, Jeremy Hunt managed to bring in his ‘fast track to hospital closure’ mechanism in the Care Bill.

As long as contracts continue to go out to the private sector, Miliband will be unable to pledge no further privatisation of the NHS. Labour can pledge to repeal the Health and Social Care Act and Clause 119, but this is different.

If the Labour government wishes to pursue ten-year contracts using the ‘prime contractor’ model, it is likely that many of these contracts will subcontract to the private sector.

The NHS ‘preferred provider’ plan, which Andy Burnham has been advocated, may indeed have limited scope if the TTIP (EU-US free trade mechanisms) are negotiated in the favour of the multinational corporations.

The bungle over #caredata has further demonstrated the need for politicians to be transparent with the public.

Angela Eagle may wish to talk up the progress she is making in overcoming the ‘democratic deficit’, the millions of lost votes and so forth, but essentially Ed Miliband’s Labour will rightly come under some scrutiny in the election leading up to May 7th 2015 regarding the NHS.

David Nicholson is a true socialist. He has spoken his mind about the public’s affection for the NHS. Hunt never talks about the Lansley legislation.

If Labour is unable to pledge much on this, it might at least pledge a term of government where the NHS is free at the point of need and paid for entirely through general taxation.

TTIP presents as a crucial test for Labour’s future direction on the NHS



The EU-US (TTIP) trade deal could be worth £67 billion to the EU, and could bring 2 million new jobs to the EU. Here in the UK, it is expected to add between £4 billion and £10 billion a year to our economy. That could mean new jobs for British workers, and stronger, sustainable growth for the British economy. The car industry keeps on bringing up as the poster body for TTIP, but everyone knows there are clear differences.

In Peter Mandelson’s “The Third Man”, Mandelson talks about how his aim was to seek a post-Blair era in leaving a legacy of New Labour. However, he also describes the personal tensions between Blair and Brown. Mandelson felt that there was an inevitability about Labour losing the election in May 2010, but how the mantra “it’s the global economy stupid” might work for Gordon Brown. It didn’t.

The next General Election is due to occur on May 7th 2015. It will be first which Ed Miliband fights. It could also possibly be his last. Miliband is still not ubiquitously popular within his party. If he loses the election, he almost certainly will be ditched by the Party. It would be inconceivable for Ed Miliband to wish to bang on about ‘One Nation’ should the electorate deliver a defeat for his party.

If Ed Miliband loses, there will be a leadership election. Clearly activists, even those who are ambivalent about Ed’s leadership will not wish for anything other than a Labour victory. The chances of a leadership fight, given how time consuming the last one was for Labour, are virtually non-existent. It seems we are ‘nearly there’ with the Labour Policy Review and the Sir John Oldham Commission on ‘whole person care’. It’s unlikely to be as bad as 1983, but who knows. Under Michael Foot, in the 1983 general election Labour had their worst post-war election result.

Not waving but drowning

It is intriguing how much both will have Andy Burnham’s personal stamp on it. Ed Miliband doesn’t wish to commit to the members of his Cabinet, if he were to be elected as Prime Minister. Likewise, there’s a growing feeling that some of the leading candidates, were he to fall on his sword, don’t particularly need his backing. Whether or not Labour can commit to Andy’s hopes would then become irrelevant, unless Andy Burnham becomes a central figure in health after the election. If somebody like Chuka Umunna takes over,  what Burnham says now might not matter to an extent.

What Burnham says now can act as a ‘weather vane’ as to the opinions of grasssroots membership of Labour. There has been a growing feeling in this parliament that Labour has acted as a frontman for the corporate establishment. As criticism of monolithic unresponsive outsourcing private providers continues, Ed Miliband may wish to capture on certain elements of left populism, as indeed he did at the Hugo Young Lecture. Miliband has offered to repeal the Health and Social Care Act (2012), and has overall made pro-NHS noises.

There’s no doubt that the Tories are scared of Burnham as a potential returning Secretary of State for Health. When David Cameron first addressed Parliament on the Francis Report, he told MPs that he didn’t wish to seek scapegoats. Despite numerous parts of a ‘smear campaign’ from Jeremy Hunt, with one even culminating in a legal threat from Burnham, Burnham has appeared surprisingly resilient. The only explanation of this is that he still carries with him considerable clout within the Labour Party.

The most notable comments by Andy Burnham in George Eaton’s New Statesman interview were on the proposed EU-US free trade agreeement and its implications for the NHS. Many Labour activists and MPs are concerned at how the deal, officially known as the Transatlantic Trade and Investment Partnership (TTIP), could give permanent legal backing to the competition-based regime introduced by the coalition.

A key part of the TTIP is ‘harmonisation‘ between EU and US regulation, especially for regulation in the process of being formulated. In Britain, the coalition government’s Health and Social Care Act has been prepared in the same vein – to ‘harmonise’ the UK with the US health system. This would open the floodgates for private healthcare providers  well known in the US already. Simon Stevens as the incoming head of the NHS will wish not to appear unduly sympathetic, despite his own background with a US healthcare corporation.

When Eaton spoke to Burnham, he revealed that he will soon travel to Brussels to lobby the EU Commission to exempt the NHS (and healthcare in general) from the agreeement. He said:

I’ve not said it before yet, but it means me arguing strongly in these discussions about the EU-US trade treaty. It means being absolutely explicit that we carry over the designation for health in the Treaty of Rome, we need to say that health can be pulled out.

In my view, the market is not the answer to 21st century healthcare. The demands of 21st century care require integration, markets deliver fragmentation. That’s one intellectual reason why markets are wrong. The second reason is, if you look around the world, market-based systems cost more not less than the NHS. It’s us and New Zealand who both have quite similar planned systems, which sounds a bit old fashioned, but it’s that ability of saying at national level, this goes there, that goes there, we can pay the staff this, we can set these treatment standards, NICE will pay for this but not for this; that brings an inherent efficiency to providing healthcare to an entire population, that N in NHS is its most precious thing. That’s the thing that enables you to control the costs at a national level. And that’s what must be protected at all costs. That’s why I’m really clear that markets are the wrong answer and we’ve got to pull the system out of, to use David Nicholson’s words, ‘morass of competition’.

I’m going to go to Brussels soon and I’m seeking meetings with the commission to say that we want, in the EU-US trade treaty, designation for healthcare so that we can exempt it from contract law, from competition law.

Burnham’s opposition to HS2 was also highly significant.

Now it seems, from a totally unaccountable rumour, that Ed Miliband is to veto a policy by Burnham to hand over control of billions of pounds of NHS funding to local councils. Burnham, outlined proposals last year that would have committed a future Labour government to transfer around £60 billion of NHS money to local authorities to create an integrated health and social-care budget. It appears now that proposals have been rejected by both Miliband and Balls. Both men believe that the policy is misguided and would allow the Tories to accuse Labour of imposing another top-down reorganisation in England. Labour will still attempt to integrate health and social-care budgets to provide “whole person care”, but funding is likely to remain within the NHS.

But it is of course possible that Burnham wants increasingly to not pin his personal fortunes to Ed Miliband, but to what he believes in. And Ed Miliband may not necessarily taking Labour in the direction of a NHS relatively free from a ‘free’ quasi-market.

There are particular concerns about the potential implications of a mechanism called Investor-State Dispute Settlement (ISDS), if it is included in the trade agreement. ISDS allows investors to challenge governments in an international tribunal if the government’s actions threaten their investments. There is concern that this could bypass national courts and limit the ability of democratic governments to enact their own policies. This on top of the EU procurement law fixes the domestic government in a rather tight spot, threatening our national legal and political sovereignty potentially.

There are also particular concerns that the ISDS could apply to the NHS. The Health and Social Care Act (2012), widely held to be a ‘vanity project’ from Andrew Lansley but actually legislated by a neoliberal coalition including the Conservative Party and Liberal (Democrat) Party allows American health care companies to compete for and win NHS contracts. There is a risk that if ISDS was applied to the NHS, repealing the Health and Social Care Act could be deemed to be in breach of the free-trade agreement. This would be a catastrophic legacy for Labour to pick up in May 2015, regardless of whether Burnham is in situ. Of course, many hope dearly he will be Labour’s Secretary of State for Health.

Negotiations are still going on, and Labour will continue to pressure the Government to ensure that the agreement does not place undue limits on future administrations. While Labour are in favour of a transatlantic trade agreement, once a draft agreement is reached, a review will be needed as a matter of some urgency.

Click to listen highlighted text! Powered By GSpeech