The US Ambassador to the UK, Woody Johnson, has sparked concerns in the UK by claiming that the NHS would be on the table in any future post Brexit UK/US trade deal.

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During a Marr Show interview on BBC1 yesterday, the US Ambassador to the UK, Woody Johnson, said that the entire UK economy would be included in any post Brexit trade deal with the US, which could mean including US firms bidding for NHS contracts.

And he said that his country was:

"…..looking at all the components of the deal and trying to get everything lined up so when the time comes we're ready to go."

And specifically on the subject of healthcare he said:

"I think probably the entire economy, in a trade deal all things that are traded will be on the table."

Now, on the face of it this sounds worrying and those with political agendas will claim that the NHS will be sold off and people will have to get insurance or pay at the desk before getting their medicines and medical procedures. And that those without the wherewithal to pay will die in agony.

One thing to point out is that it's not quite as simple as 'our' NHS. Healthcare services are devolved within the UK so you've got four: NHS England, NHS Scotland, NHS Wales and in Northern Ireland you've got Health and Social Care.

So this concept of 'selling off the NHS' is more complex than some think. But I will keep it simple by referring to 'the NHS'.

Now just to step back in history a bit, it was the proposed EU/US secretly negotiated trade deal called the Trans-Atlantic Trade and Investment Partnership or TTIP that many saw as a threat to the NHS.

TTIP was basically halted by President Trump, but talks have resumed on a modified version of it.

So, if we were still members of the EU, if and when that got through, the UK NHS system could be bound to any agreements contained in it.

And I do not trust the EU not to sell out on the NHS, if it got other EU countries a better deal. After all, why would Eurocrats care specifically about the NHS?

But if the UK is a fully independent and sovereign nation, then the people can decide how they want their healthcare provided.

The people of the UK are now very comfortable with the idea of free healthcare at the point of need – except that's not actually what we have in reality.

Think of paying for opticians, dentists and prescriptions for example.

But at least for the serious stuff like Accident and Emergency it's free.

Now as far as I see it, people are worried that in some form or another, either through tax or through insurances and fees, healthcare will become more expensive, or even inaccessible, just to line the pockets of shareholders.

But healthcare, from research to medicine production to equipment manufacture to training to staff costs etc is an extremely complex beast.

And at the start you have private companies from across the world involved in our NHS that spend billions on research for new ways to cure and mend broken bodies. They need to be properly recompensed so they can continue research for better cures.

Then there are the non-UK based companies that make the imaging machines, hospital beds and syringes.

Then there are those involved in the building and refurbishing of hospitals.

The list goes on.

Some would argue that all of that should be publicly owned and funded so that no company ever makes a profit from healthcare – but would that be either sensible or desirable or even sustainable, surely competition has its place in driving down costs?

What matters here are the public bodies involved in assessing the safety of medicines and equipment etc, who decide on what to buy and where to buy it from.

From a personal perspective, what really matters is how we use properly compensated private enterprise to drive competition at one end that feeds into a properly regulated state controlled healthcare system that is free at the point of use at the other end.

And for me it is the crossover point that is the contentious bit for most people – i.e. how far up or down the various production chains does it become a fully state controlled function.

Hard line communists want the state to do everything from research to pill production to equipment manufacture to training to nursing. While hard line capitalists would put it all in the hands of private enterprise and insurance companies.

Most people I know are, like me, somewhere in the middle and that I think is where the public debate lies.

And if that debate includes sourcing the best medicines and medical equipment at the best prices from anywhere in the world allowing us to get more bang for our buck, then don't you think that would be a good thing?

Sources:

https://www.independent.co.uk/news/uk/politics/donald-trump-nhs-trade-deal-woody-johnson-matt-hancock-a8940861.html

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