Free trade agreements and the NHS

Free trade agreements (FTAs) might seem a million miles from the NHS. However, FTAs are not just about the trading of goods. They also cover services (sometimes defined as  “anything you can’t drop on your foot”), including public services like the NHS. What’s more, 

“There is an inherent tension between public services and agreements governing trade in services. Public services strive to meet basic social needs affordably, universally and on a not-for-profit basis. Public services are usually accompanied by regulation that consciously limits commercialization and chooses not to treat basic services as pure commodities. Trade agreements, by contrast, deliberately promote commercialization and redefine services in terms of their potential for exploitation by global firms and international service providers.  In most instances, trade treaties do not force governments to privatise. But they do facilitate privatisation and commercialisation in several ways.”

The UK Government has been hugely supportive of negotiations for FTAs between the European Union (EU) and a range of other countries. These treaties, largely negotiated in secret by the European Commission on behalf of the EU member states, include

  • the Comprehensive Economic and Trade Agreement (CETA) with Canada (now being provisionally implemented while awaiting full ratification by EU member states);
  • the Transatlantic Trade and Investment Partnership (TTIP) with the US (currently on hold); and
  • the Trade in Services Agreement (TiSA) (negotiations still in process).

It’s clear from leaks or the texts published by the EU in  later stages of negotiations that, despite reassurances from the European Commission and the UK government, these deals can have disastrous consequences for the NHS.   

The vote for Brexit means that there is now considerable uncertainty about what these deals will mean for the UK. For example, if CETA is fully ratified before the UK leaves the EU, we are likely to be subject to some of CETA’s measures for some years to come. In any event, it seems likely that treaties like CETA will form the template for deals that the UK wants to negotiate with the EU or other major economies after Brexit. The UK government is already consulting on the kind of new, bilateral trade deals the UK might want in future and it’s feared that these deals will pose serious threats to the NHS.

For a collection of views and international perspectives on what happens next, see

In these pages of the website we attempt to explain more about FTAs and how those currently being negotiated or agreed by the EU would affect public services, especially the NHS. For more details see:

  • What these trade agreements mean for the NHS?

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