The EU and the NHS: Debunking the Myths of a “Trump Brexit” and Left Remain
I've heard it said that those at the top of society and those at the bottom have always understood each other; it’s those annoying people in the middle who don’t understand either who are the problem.
Boris Johnson will play on this myth to win him the next election. He will claim to be fighting a culture war on behalf of ordinary folk against the irritating chattering classes and Brexit will be at the centre of it. The polls are on his side: one recent poll showed 72 percent of voters believe that the new PM should be given a “proper chance” to take the UK out of the EU without Parliamentary interference. Significantly, that included 49 percent of those who voted Labour in 2017. By opposing Brexit, Jeremy Corbyn is walking into a trap. Not a carefully hidden “booby trap”, but one that may as well have “TRAP” written on it in glowing neon.
At the Durham Miners Gala this year, and in his recent Labour Party conference speech, Corbyn talked about opposing a “Trump Brexit”, where US firms are given control of the NHS. This was despite the fact that, on his visit to Britain, Donald Trump ruled the NHS out of any possible trade deal. But we don’t need to take Trump’s word for it to see that it’s wrong to equate Remain with protecting the NHS.
Firstly, supporters of the EU have conveniently forgotten about the Trans-Atlantic Trade and Investment Partnership (TTIP), which the EU negotiated with the US government in secret meetings from 2013-16. A key part of TTIP was the “harmonisation” of EU and US regulations, including around the healthcare sector. The UK’s notorious Health and Social Care Act (HSCA, 2012), which further opened up the sector to private involvement, was in large part intended to do this. TTIP also established Investor State Dispute Settlement (ISD) arrangements, which would have allowed private companies to sue governments for any reversion of their privileges. So, even if a Labour government subsequently decided to repeal the HSCA and reverse healthcare privatisation, the multinational corporations involved would have been able to take the government to court and sue for loss of profits. This would have applied even in cases where patient care was inadequate.
Secondly, US and other foreign private companies have already been involved in the NHS for many years. It was a Labour government that enabled this through the 1998 Competition Act and 2002 Enterprise Act. So, for example, from 2006, the Hospital Corporation of America (HCA) has formed several NHS-HCA Ventures: public-private partnerships that provide NHS facilities only to private patients. The HCA’s UK subsidiary is part of the Private Hospitals Alliance, a lobbying firm that calls for greater private sector involvement in the NHS. US firms have also acquired UK healthcare companies. In 2015, the US firm Tenet Healthcare acquired Aspen Healthcare, which operates private hospitals in the UK. On taking over Aspen, Tenet talked about privatisation of the UK healthcare sector and increased opportunities within the NHS. Wailing about a “Trump Brexit” now is akin to locking the stable door after the horse has bolted.
Thirdly, EU competition law entrenches market competition once it has been established in any given sector, including healthcare. Accordingly, far from simply being a UK problem, healthcare privatisation is now rampant across the continent – as documented in an October 2010 report from the European Federation of Public Services Unions, Big Healthcare Companies Continue to Penetrate European Health Services. The report found multinational corporations had used the 2008 financial crisis to enhance their position in all areas, including healthcare, and the further “expansion of private healthcare providers in Europe” would be fuelled by “the proposed European Commission Directive on healthcare cross border mobility”. The UK’s Health and Social Care Act (2012) merely embedded this trajectory in EU policy into UK law. Yet, if a future Labour government were to repeal this law, private providers could still fall back on EU Competition Law to resist any attempt to roll back NHS privatisation.
These uncomfortable facts point to the cold, hard reality of the EU – which is very different to the myths peddled by left Remainers. Many Remainers think the UK is a horrible neoliberal outlier in social-democratic Europe, clinging to the EU as a supposed safeguard of what’s left of the welfare state. In reality, the EU is promoting healthcare privatisation and the interests of multinational corporations. The EU’s core values are not humanitarian ones like health and safety, or workers’ rights. The fundamental basis of the EU is the Four Freedoms – freedom of movement of goods, people, services and capital across borders. It is the last “freedom”, that of capital, that ultimately underpins the marketisation of the NHS.
Some might respond that this is why we must “remain and reform”. The idea that the EU needs reform clearly undermines the mythical claims about all the wonderful things it provides and safeguards. Moreover, as shown in depth on The Full Brexit, the EU cannot be reformed. “Remain and reform” is simply leftish sugar coating for a right-wing position. Some of its advocates have become born-again Trotskyists by smearing left Leavers as supporters of “Socialism in One Country”, yet conveniently forget Trotsky’s opposition to “unaccountable bureaucracy”. “Socialism in One Country” is better than Thatcherism in One Continent.
Ranting about a “Trump Brexit” clearly has no basis in reality, really it is just a desperate attempt to distract from Labour’s disarray on Brexit. Labour would much rather talk about “Our NHS” (or any other issue) than the biggest issue of the day.
Will it work in a general election campaign? Probably not. In the 2017 election, Theresa May hoped that Brexit would dominate, yet the issue had already been dealt with by the 2016 referendum, Labour’s pledge to honour the result, and Parliament passing the EU Withdrawal Act. Ironically this made Brexit a non-issue, allowing Labour to present their popular manifesto to the public and utilise a leader who was not as unelectable as we were told.
Today, the terrain is very different. Brexit is now the issue and, with Labour pushing for Remain, the party is fighting with one hand behind its back. Labour’s policies are still very popular and one recent poll even Labour three points ahead of the Tories, on 28 percent. However, the combined Tory and Brexit Party vote came to 44 percent, and most polls put the Tories well ahead of Labour. Peddling myths about the EU and the NHS is clearly not enough to get Jeremy Corbyn into Downing Street.
Brent Cutler is a history teacher and member of the Labour Party.