It is a pleasure to serve under your chairmanship, Sir Roger. I thank my hon. Friend Mike Hill for introducing the debate and setting out the petitioners’ concerns about this important issue.
I start by picking up the comments made by Craig Mackinlay that what we want is a matter for this House to discuss. It seems to me that this House, directed by my constituents and many others, is saying clearly that we do not want our NHS opened up to trade agreements and we do not want it exposed to international competition. That comes across very clearly to me as I speak to my constituents, whatever their views on Brexit. Everyone cares passionately about the NHS, and in the north-east we are about it especially. We have good services that we treasure, so my constituents are saying, “This is not for sale. It is not negotiable.” That is the setting.
As my hon. Friend said, words here are not enough. Earlier this year I took part in a debate on the Trade Bill during which we heard frequently that constituents were telling their Members of Parliament that they did not want the NHS to be opened up to competition or part of a negotiation. That message came through loud and clear. I am glad that people have been making that statement and making that argument time and again. We need to keep reinforcing the fact that when we are talking about trade deals, that is something “up with which we shall not put”. As I said, people feel strongly about it. The Trade Bill debate went into a great deal of detail, with the NHS being one of the recurring issues. The Secretary of State and the Trade Ministers who presented and wound up the debate were keen to say that the NHS was to be protected. It is excluded from EU agreements on services, and we would want to replicate that. However, whatever happens after Brexit, we will have to negotiate new trade agreements, with all the clauses and requirements involved, which requires a hell of a lot of detail. In any negotiation, there are at least two parties—often more—with their red lines. We have ours—the NHS must be one of them—and other parties have theirs. We have differing views and different agendas, but I think the petitioners are telling us that we really must stick to those red lines. On President Trump’s visit, he made a statement about the NHS being on the table. Did he take it off the table again? We are clear that it is not on the table. It must not be on the table.
As my hon. Friend and the petitioners have said, just stating “the NHS is not for sale” is not the answer; fine words butter no parsnips. In all agreements, we need lots of detail clearly setting out how we will protect our NHS in many different circumstances. For example, there are currently charges in dentistry. How will we ensure that NHS dentistry is protected if there is already external private sector charging? Is it for profit or not for profit? We must also ensure that we can protect the existing overseas involvement in our NHS. There is a huge amount of detail. I have no doubt that a team of negotiators is looking at that, but that is the kind of fine detail that we cannot always get into when we discuss these matters in the House. It is crucial that we do get into that detail.
As we have heard, 7.3% of NHS expenditure is already spent on contracting. Many of us think that is far too much and that we should review it to ensure that we retain NHS services in-house, not because of the simplistic argument of “public good, private bad” but because we have seen too many failures of services. Yes, there are examples of good services, but plenty are not great. People will want to look at that angle. We need much more detail, and we need a strong debate and measures to protect our NHS. We need the headline commitments, which must be not just about having an NHS free at the point of delivery but about looking after the public and preserving our services in-house in the UK. In the Trade Bill debates there was lots of talk about scrutiny of trade deals. It is imperative that we have an open and transparent way of scrutinising any proposals.
My hon. Friend Rachael Maskell talked about concerns about the impact on drug budgets and big pharma, as well as the fear that this may be seen as a ripe opportunity for prices to increase. I have just come from the main Chamber, where we were talking about access to medicine and treatments for Batten disease. Cost is one pressure that, sadly, can result in many people with rarer diseases being unable to get access to medicines and treatments that would improve their lives and, in some cases, extend or save them. There is a real concern that we may see drug prices increase in the future.
The petitioners have a quite simple message, but it is one that people are hearing loud and clear and want us to reiterate. We must protect our NHS in the context of any trade agreements. We do not want our NHS to be privatised or outsourced—even by accident. We care about our NHS and we must preserve it. It is one of our great features. I thank the petitioners for drawing our attention to this issue.