Skip to main content

NHS: US Companies

Volume 790: debated on Thursday 22 March 2018


Asked by

To ask Her Majesty’s Government whether they plan to permit United States companies to bid for NHS contracts as part of any future United Kingdom-United States trade deal.

My Lords, it is in the best interests of patients that, as currently, the NHS continues to consider any UK or overseas organisation wishing to bid for contracts, provided that the NHS’s high standards are met. However, private companies are not legally guaranteed any right to bid for these contracts through an FTA. The Government will continue to protect the UK’s right to regulate public services in all trade agreements to which it is party.

The Minister will be aware that I have had a number of exchanges about the likely agenda for the negotiations on the USA-UK trade deal. I have been seeking to establish whether the NHS will be part of those negotiations, and I have been told that vigorous protection will be given to the NHS. Is not the most vigorous protection that could be given not to have it on the agenda at all?

I can reassure the noble Lord again—I know that some Written Answers have been given to him. Protecting the NHS is of the utmost importance to the UK as we leave the EU. The Government will continue to ensure that decisions about public services are made by UK Governments, not by our trade partners. As we leave the EU, the UK will also continue to ensure that rigorous protections for the NHS are included in all trade agreements that it is party to.

My Lords, does my noble friend not accept that the anxiety that the noble Lord, Lord Brooke, has would arise if the EU proposals in respect of TTIP were implemented? Is not the glory of leaving the European Union the fact that we will be able to decide this for ourselves?

My noble friend is right. The main point to make is that the same strong safeguards as we have now will be in place once we leave the EU. These include: that all providers of NHS healthcare in the UK must meet our standards of safety and quality; that staff must be registered with UK regulatory bodies; that decisions on which services to provide are locally led by clinicians; and that NHS hospitals will remain state owned.

Does the Minister accept that there is a considerable lack of transparency in the discussions taking place in the US-UK trade working group currently under way? If the group had been set up under the aegis of the European trade rules there would have been a scoping exercise about the breadth of the discussions, which would have been published, and the Commission and the Council would have sought a mandate from the European Parliament. Is it not unacceptable that Britain’s representatives in the European Parliament would have a greater degree of oversight over any discussions than its representatives in this Parliament would? That is perhaps why, under TTIP, access to the National Health Service was indeed excluded.

The noble Lord raised the question of transparency. Perhaps I may point out to him that, as we set out in the White Paper Preparing for our Future UK Trade Policy, we are committed to a transparent and inclusive trade policy. So it is there in writing, and the noble Lord should be reassured.

My Lords, do the Government recognise the article published in the Times highlighting our propensity to sell off valuable assets from healthcare, particularly inventions, at knock-down prices, thereby missing out, historically, on the profits that come from them? Do they recognise that the NHS data itself is extremely valuable to different companies across healthcare? Will they ensure that it is not sold off at a knock-down price without all the protections in place that are required for long-term confidentiality, and that we will reap the benefits of having an NHS that collects data?

The noble Baroness is absolutely right. I have already made it quite clear that the strong safeguards in place now will remain in place. The barriers to entry for companies outside the UK are very high. On the other hand, it is important that patients come first, and that medicines and drugs for them that come in, very necessarily, from outside the UK, continue to do so. That is one of the things under discussion.

My Lords, does the Minister concede that American companies are already playing a big part in the running of the NHS? Is he aware of the Written Answer given to me by the noble Lord, Lord O’Shaughnessy, last October, which, talking about one of the three companies that oversee the supply of agency nurses used by every trust in the UK, stated:

“We can confirm that Health Trust Europe”—

one of the three—

“is owned by Health Care America and is a privately owned company”.

Will the Minister not come clean and tell us what part American companies play in running the NHS?

I do not think there is anything to come clean about, because I have already reassured the House that no privatisations will take place, and there is no privatisation in place now. The Government’s position is that the NHS is now, and always will be, a public service free at the point of need, and that it is not, and never will be, for sale to the private sector, whether overseas or domestic. No trade agreements will ever alter these fundamental facts.

My Lords, does my noble friend have any evidence that the NHS has suffered from having Americans bidding for its contracts?

I do not believe that there is any evidence for that, but I remind my noble friend and the House that, to ensure that important drugs and medicines came in from the outside, it was the Labour Government in 2003 that brought in the ISTCs, which allowed privately owned companies to supply the NHS.

The Labour Government brought in some private sector involvement to reduce the waiting lists that had grown during the Conservative years, and which are now growing again. The Minister needs to address the question that my noble friend asked about the penetration of American companies into the UK health market already, and what that will mean. He could take a lesson from his noble and learned friend Lord Keen—a simple “no” to my noble friend’s Question at the beginning of this debate would have sufficed.

I can only reassure the noble Baroness that the safeguards are in place. I have listed a number of items that make it very difficult for outside companies to come in and take over companies in the UK.

My Lords, if I have this correct, the Royal Free has already transferred to DeepMind—a subsidiary of Google—in excess of 1 million health records to be used as part of its AI development programme. Would the Minister care to rethink some of the answers that he had given to this House in the light of that?

Let me look into the particular matter that the noble Baroness has raised. Let me write to her once I have looked into the facts of that issue.

Could the Minister clarify his point that the NHS was free at the point of delivery? Is he not aware that for dentistry that is very much not the case any more?

Following up on the question asked by my noble friend, the Minister gave an assurance that NHS data will not be sold off at a knock-down price. Will he will give an assurance to the House that NHS data will not be sold off at all? The NHS needs to benefit over time from that incredibly valuable resource.

The noble Baroness is absolutely right. I can give that guarantee. If there is any change to that I will write to her, but I am certain that that is the case.