NHS and Future Trade Deals — [Sir Roger Gale in the Chair]

Part of the debate – in Westminster Hall at 5:21 pm on 22nd July 2019.

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Photo of George Hollingbery George Hollingbery Minister of State (International Trade) 5:21 pm, 22nd July 2019

The hon. Lady anticipates exactly the section of my speech that I am about to come on to.

I was talking about the £1.3 trillion invested overseas and the fact that ISDS arrangements are incredibly useful in guaranteeing the delivery of justice of some sort for those who have invested under certain terms in less certain legal markets. However, they cannot force the UK to change the way we run our public services. The proof of that—I hope that this will answer the hon. Lady’s question—is in the results. The UK has more than 90 bilateral investment treaties in place, yet there has never been a single successful ISDS claim against the UK Government on any issue. Nor has the threat of potential claims affected the Government’s legislative programme. I therefore do not believe that there is a chilling effect. The UK Government have legislated exactly as they wished on every issue, despite those 90 bilateral investment treaties.

That is not to say that bringing services that have already been opened up to private providers back into public ownership might not lead to challenges. That is true, and we should not sit in the Chamber today and not admit it. Of course, that does not necessarily rely on ISDS agreements. In the UK we have perfectly competent courts, and I suspect that many people might pursue those issues through the regular courts under contract law. However, ISDS indeed provides another avenue. Even the shadow Chancellor, John McDonnell, recognises that compensation would have to be offered if any fairly let contracts were not honoured because of a change in policy. That much is clear, and we have heard him say so directly. However, that is wholly different from being able to force the private letting of contracts that a state wants to remain public. That cannot happen under any ISDS arrangement.

Another concern that has raised its head today is medicine costs, and the idea that a trade deal with the United States would raise the cost of medicines the NHS needs. Across all nations of the UK, we have an excellent set of systems that generate great outcomes for patients at an affordable price. We are proud of the way we assess the value of and agree commercial deals for medicines here in the UK‎, which is good for the NHS, for patients, and for companies that want to do business with us. We are absolutely clear that in any future negotiations we could not agree to any proposals on medicines pricing or access that would put NHS finances at risk or reduce clinician and patient choice—and what on earth would the incentive be? We have a system in place that works, ensuring that patients have access to medicines they need at prices that are affordable to the NHS. That is in the best interests of patients in the UK.

It is simply not a matter for the UK that the US is a highly fragmented market for pharmaceuticals and medical equipment, and so has reduced buying power. Neither is that issue a matter to be contemplated in any potential trade deal. There is no protectionism here; it is simply a matter of market power. Ultimately, it is a matter for US domestic politics. If the US takes a different route, it will have more buying power. We have taken a different route, and we have much more buying power. I can think of a thousand different markets where the US has much larger buying power than us. Are we supposed to petition it suddenly in a US trade agreement to bargain away its buying power? I do not think so, and I do not see why it should be any different in this case.

Some people—not in this debate, but it is worth dealing with, as there has been so much interest in the debate, in terms of the number of signatories to the petition —have raised the related issues of patent protection, extensions and generics. There is a complex web of interactions around those issues. On the one hand, there is a need to allow innovation in pharmaceutical and medical technology research and, on the other, there is a need to ensure that when patents expire—I nearly said “when patients expire”; forgive me—generic or bio-similar alternatives are quickly brought to market. We will seek to balance those as we always have, in a way that stimulates research and innovation, together with the cost of supplying healthcare free at the point of use in the UK.

Let me turn to concerns about the potential use of NHS data. The Government take seriously the use and sharing of that data. I reiterate what the Secretary of State for Health and Social Care said recently:

“NHS data must always be held securely, with the appropriate and proper strong privacy and cyber-security protections.”—[Official Report, 18 June 2019;
Vol. 662, c. 114.]

The Government will ensure that trade negotiations do not undermine the safeguards that we have in place around health and care data. Those safeguards allow the public to have trust in how and why their data is used, and it is incredibly important that we maintain them.

To be clear, free trade agreements of course have a role in data. At the Department for International Trade, we are tasked with ensuring that data flows on a legal, safe and secure basis. We would seek to review any rules in place to safeguard data, such as data localisation requirements, and ensure that they are not overly protectionist. However, that should not be confused with the data that actually flows. We set up the pipework, but whether or not the taps are turned on is a matter for the regulators. In our case, that is the Information Commissioner’s Office, which is entirely clear about the need for privacy and cyber-security.

I will deal with one or two other issues that were raised that do not fit neatly into the categories in my written speech. First, on FTA scrutiny, Judith Cummins will know full well that we laid a Command Paper earlier this year that made a full and generous offer on scrutiny. I am well aware of her party’s position on scrutiny, and I absolutely agree with her and her Front-Bench colleagues on the need for real transparency on and scrutiny of free trade deals. I absolutely understand about the incentives to control every part of the passage through Parliament by votes. I would happily sit down with her at some stage and talk through why I think that is perhaps not deliverable, and perhaps not exactly what she wants.

I am clear that we must have responsible scrutiny, and that the Government must be as transparent as they can under the auspices of an FTA. When negotiating an FTA, plainly there are things that we cannot reveal in public; otherwise, we simply give away any negotiating advantage we might have. At the same time, there needs to be accountability to Parliament. I therefore think we are largely of one mind, at least on the principle, if not the actual solution.

Stewart Hosie chose very carefully the two examples he gave—Norway and Switzerland. They, of course, are two free trade agreements that the EU has with partners that have very close arrangements with it in any event, in other ways. It is precisely because of the relationships that they have with the European Union that they cannot match in a continuity agreement what they can match in an agreement with the EU. The fact that those agreements are not as comprehensive as they might be is a consequence of our leaving the European Union, not of our inability to negotiate or, somehow, a failure on the part of the Government. I think we have achieved remarkable amounts, given the circumstances that Switzerland and particularly the EEA countries face.

I shall comment briefly on positive and negative lists, ratchets and so forth. In the end, having taken advice and listened to arguments from officials one way and the other, I have to say that, on the whole, it does not matter a great deal whether the list is positive or negative; the only thing that matters is that it is right, so that the outcomes—what the agreements actually achieve—are precisely what the UK wants. We can either include everything on the list and strike bits out, or exclude everything from the list and allow things in, but it seems to me that in the end that is a nice distinction, in the legal sense, and that actually what matters is the effect when we have finished. This is something that people talk about a great deal. In the end, all I want to do is ensure that we actually get the outputs that we need.

I hope we can agree that the picture is at least slightly rosier now than when this debate started. The legal protections are there to provide robust protection for the national health service. The commitment from the Government is there to ensure that that remains the case. The opportunities are there for us to make the most of our world-class experience and expertise in healthcare and the life sciences. As we look back at all the NHS has given us—particularly after its 70th birthday last year—we can be hugely proud of our past, but we can also be extremely optimistic about our future on the global stage.

I shall finish by repeating what I said earlier. This Government, the two candidates for the leadership, the outgoing Prime Minister and, indeed, all of us on the Government Benches are clear that we have no interest in privatising the national health service. We do not want to use free trade deals to do that either. We understand the concerns of the petitioners, and I hope very much that what I have set out today gives some reassurance.