The US President Donald Trump’s recent state visit to the UK understandably caused a stir in the media, although not necessarily for all the right reasons. It was his comments, and comments from Robert Wood Johnson, the US ambassador to the UK, on the NHS in particular which set quite a few hares running.
“When you’re dealing with trade everything is on the table, so the NHS or anything else” said Trump—a sentiment which the Ambassador to the UK Woody Johnson shared only a few days earlier.
Although Trump made one of his usual U-turns when later questioned on this by Piers Morgan, one could be forgiven for doubting such an abrupt change of heart.
We have every right to be concerned about what he said and here’s why.
Brexit has left us in a vulnerable position. We have very real concerns that particularly in a “no-deal” scenario, the UK will be under pressure to secure new trade agreements with the US and others. The worry of course being that if the US is to be the knight in shining armour, our health service will suddenly find itself up for grabs.
The market-driven approach favoured by the US isn’t a beacon of good practice from where we are sitting. The recent story of James Cavatore from Texas is case in point. James was born prematurely and in need of a long hospital stay and multiple surgical operations. Sadly, James died in a hospice at the age of seven months. His parents were presented with medical bills over $1.1m and this has become their “second trauma.” This is by no means an isolated case: it won’t come as a surprise to you (but may to some in the UK) that medical billing is the biggest reason for bankruptcy in the USA.
Allowing sections of our health service to be farmed out to private companies abroad will only contribute to the worrying increase in publicly funded care being delivered by the independent sector. The last thing that our health service needs is further fragmentation. Profits must never come before patients as they often do in the US.
The BMA has consistently opposed private sector provision of NHS care, which has a destabilising effect on NHS services, and frequently represent poor value for money. The mantra we hold by is an NHS that is publicly funded, publicly provided, and publicly accountable.
The UK and US approach also differs considerably when it comes to risk assessment, product safety standards, and regulation to promote public health. I’m thankful that the UK’s product safety standards are among the highest in the world which ensures that human, animal health, and the environment, are at the centre of decision-making.
When it comes to any future trade negotiations, it is time for the government to make clear what their stance is on this issue and promise to protect the NHS from external profit-driven motives.
The message from UK doctors is clear: our NHS is not for sale.
David Wrigley is a GP in Carnforth, Lancashire. He is also deputy chair of BMA Council, and the co-author of the books NHS for Sale and NHS SOS. You can find him on Twitter @davidgwrigley. The views in this article are his own and don’t represent any organisation he’s affiliated to.
Competing interests: I am deputy chair of BMA UK Council and member of the BMA General Practitioners Committee. I am co-author of the books ‘NHS for Sale’ and ‘NHS SOS’