Brexit is opening the door to NHS chaos in so many ways - including concerns over the medical workforce and medicine supplies. But we are now presented with a new threat.
There have been concerns for many years that the 2012 Health and Social Care Act opens the way to privatising not only NHS services but also commissioning itself. Fighting the impact of the 2012 Act and its offspring such as ACOs/ICSs has been paramount.
By shrinking the state at the same time as imposing austerity, the Conservative government has created the conditions for increasing mortality rates - and figures from the Office for National Statistics show mortality is on the rise.
But Brexit has opened a new front - trade deals struck after the UK quits the EU could open the door to privatisation of the NHS on a scale not seen before.
A policy document - The Ideal US-UK Free Trade Agreement – A Free Trader’s Perspective - published by a right-wing think tank shows how Brexit can become a nightmare for the NHS.
The paper was released in September and is a US/UK collaboration of right-wing institutes fronted by the Initiative for Free Trade and the Cato Institute. Conservative MP and Vote Leave co-founder Daniel Hannan is a co-author.
The document spells out a vision in which all sectors of the economy would be opened up to investment from business. It should open all services markets without exception to competition.
The authors say: 'The ideal free trade agreement is one that removes all barriers to trade in goods and services, opens up all sectors of the economy to investment and, ultimately, goes as far as possible to remove all administrative impediments to integration of the economies of the parties without encroaching on the sovereignty of governments to pass laws and regulate in the public interest in ways that do not discriminate against foreign goods, services and companies.'
They call for 'zero restrictions on competition for government procurement'.
They have a particular interest in health services. The document says: 'Health services are an area where both sides would benefit from openness to foreign competition, although we recognise any changes to existing legislation will be extremely controversial.
'Perhaps, then, the initial focus should be on other fields such as education or legal services, where negotiators can test the waters and see what is possible. That said, we envisage a swift, time-tabled implementation of recognition across all areas within five years.'
There it is – a blueprint for privatisation, starting with what they deem softer areas like education and moving on to the NHS within five years.
The document goes into some detail about how such a free trade agreement would deal with a range of other arenas and issues.
Milton Friedman, one of the principal architects of the current neo-liberal world order now failing the world, said: 'There is nothing as powerful as an idea when its time has come. I say that time is a crisis, actual or perceived. When the crisis occurs, the actions that are taken depend on the ideas lying around.'
Hannan and his co-conspirators are seeding these ideas so that they become available when needed.
Beware Brexiteers bearing false promises – many were hoodwinked by the lies about massive NHS investment. Trade agreements are likely to offer similar attractive lies. We must remain vigilant against these crazy and dangerous proposals.
- Dr Brian Fisher is a GP in Lewisham, east London, and honorary vice president of the Socialist Health Association.