SHOTS WERE FIRED in the first full week of campaigning in the British general election this week, with controversies plaguing both the main parties.
The Conservatives had to contend with Cabinet member Jacob Rees Mogg under fire for comments made about the victims of the Grenfell Tower fire and lost its Welsh Secretary Alun Cairns resigned amid claims an aide had sabotaged a rape trial.
Labour, meanwhile, had its deputy leader Tom Watson step down in a “personal, not political” move.
Sky’s Kay Burley gave an interview to an empty chair where – depending on who you listen to – the chairman of the Conservative party was or was not supposed to be, and both parties were at loggerheads over an edited video of Labour’s Brexit spokesperson Keir Starmer.
Flagged before the campaign got under way, one issue which has again come to the fore is that of the UK’s National Health Service (NHS) and what US President Donald Trump’s plans are for it.
So, what’s all this about? And how likely is that “Trump is coming for the NHS”?
With the NHS usually a key election battleground anyway, Brexit and a future US trade deal are adding fuel to the fire of how the Conservatives and Labour are clashing over the health service.
The NHS
The UK’s health service was founded in 1948 by Clement Attlee’s Labour government, with founding principles that health care would be universal and free at the point of delivery. It has a mammoth annual budget of almost £140 billion a year, and provides a comprehensive range of healthcare to citizens across the UK.
In the post-war period where the British economy struggled, the NHS quickly embedded itself within society and has been consistently cited as a source of pride for British people. It’s always an election issue in the UK, as any attempts to try to dilute or reduce the services on offer are met with a furious response.
Fears have been raised about the NHS’s future in recent years – such as how much more funding it will need, privatisation and Brexit.
With an aging population and an already huge spend on the NHS, the pressures on funding will only heighten in the coming years with every pound spent under scrutiny.
As it funds GPs and heavily subsidises prescriptions and other medicines, the NHS aims to ensure it gets the best deal on the cost of these drugs.
Under its voluntary pricing and access scheme (VPAS), the total bill the NHS has to pay for medicines is capped.
The most recent deal struck by the UK government on its VPAS scheme with pharmaceutical companies means that spending on medicines must grow by no more than 2% over the next five years, the Financial Times reported.
When it comes to privatisation, partnerships have existed for decades between the NHS and the likes of dentists, optometrists and pharmacies.
However, over the last decade in particular, private contracts issued by the NHS have included a £1.2 billion tender for end-of-life care and cancer care in Staffordshire and an £800 million contract for services for older people in Cambridgeshire.
Charity The King’s Fund has said that in many cases the use of private providers to treat NHS patients reflects “operational challenges within NHS providers”.
The Labour party, however, has said that privatisation within the NHS reflects a near-decade of the Conservatives being in power.
So where does Trump and the US come in?
Brexit has cast further uncertainty to add to the problems facing the NHS in the coming years.
There had been fears that a no-deal Brexit could lead to medicine shortages given the number of drugs the UK imports.
The UK government’s Operation Yellowhammer paper – which set out the “worst case scenario” plans under a no-deal – detailed how disruption of imports could last for “up to six months”. While some medicines could be stockpiled, others could not due to “short self lives”.
Brexit will also require the UK to negotiate new trade deals with other countries around the world.
One of those will be the US, and President Trump stoked fears about what that could mean for the NHS during a meeting with then-Prime Minister Theresa May back in June.
The US health system is of course radically different to that in the UK with no form of universal healthcare. The health system in America is largely operated by the private sector with most people either seeking private health insurance or on a US government form of insurance.
Prices for medicines tend to be much higher in the US than the UK.
In a press conference in June with Theresa May, Trump sparked outrage by saying “everything is on the table” in a post-Brexit UK-US trade deal, including the NHS.
“So NHS or anything else. A lot more than that,” Trump said.
He later sought to clarify those remarks, telling ITV: “I don’t see it being on the table.”
Trump added: “Somebody asked me a question today and I say ‘everything’s up for negotiation’ because everything is, but that’s something that I would not consider part of trade.”
On the table?
So what is meant by “on the table”?
Firstly, in a trade deal, there are fears in the UK that it could end up having to pay more for medicines under a US trade deal.
The US has already set its stall out for what it wants in future trade negotiations with the UK, which includes “full market access for US products” when it comes to medicines.
The NHS Confederation – a membership body of services that make up the NHS – said that hospitals and patients could have to pay billions more for medicines under a post-Brexit trade deal with Trump and the US.
The VPAS system currently used in the UK caps the prices, but the NHS Confederation said: “One can assume that such a scheme would not meet the USA’s objectives, which if achieved would result in higher prices for medicines and pass on costs to both patients and the NHS.”
Furthermore, UK trade officials have held meetings with US counterparts to discuss drugs pricing, Channel 4 Dispatches reported earlier this week.
Drug pricing expert Dr Andrew Hill told Dispatches that the US spends 2.5 times more per capita than the UK on medicines – which would equate to an extra £500 million a week if drug prices were to increase in the UK to match the US.
Battleground
Labour has seized on this £500 million figure – although there are no real figures as of yet of note given the UK has still yet to leave the EU and trade talks with the US are nowhere near starting – as similar to the slogan used by Brexiteers during the referendum campaign.
A mocked up photo was made to look like the Brexit red bus from the 2016 campaign.
Alongside that, the Labour party also fears further privatisation of the NHS under another five-year Tory government. Any increased spending in an already-stretched NHS is likely to lead to claims that services could be cut as a result.
Leader Jeremy Corbyn said this week that Boris Johnson wanted to “hijack Brexit to unleash Thatcherism on steroids”.
“Johnson and the Leave campaign promised to rebuild our NHS,” he said. “Johnson stood in front of a bus and promised £350 million a week for the NHS.
Now we find out that £500 million a week could be taken out of the NHS and handed to big drugs companies under his plans for a sell-out trade deal with Donald Trump.
For the Conservatives part, they’ve denied the claims that they’ll “sell off” the NHS.
Prime Minister Boris Johnson said in September at a press conference with Trump that the NHS “is not for sale”.
His health secretary Matt Hancock and trade secretary Liz Truss went further in an article for the Daily Telegraph last week.
They said: “The price the NHS pays for drugs won’t be on the table. And the services the NHS delivers won’t be on the table.”
The senior Conservatives also said that Labour was attempting to “spread lies about the NHS” and described this as “shameful”.
There is certainly no evidence – at this stage – to suggest the Conservatives will be sending £500 million a week to the US drug companies after Brexit. There are no concrete plans for the Conservatives to “sell off” the NHS, but Labour is looking to position itself as the party who will protect the NHS from any such plans in future.
In any case, it will no doubt continue to remain a hot topic as the election campaigning heats up ahead of the 12 December polling date.
With reporting from AFP, PA
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