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.

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

  • the Comprehensive Economic and Trade Agreement (CETA) with Canada (currently at the last stage of ratification);
  • the Transatlantic Trade and Investment Partnership (TTIP) with the US (more or less thrown out by President Trump although it may provide a model for future UK-US deals); and
  • the Trade in Services Agreement (TiSA).

Under these treaties, health services are treated as things to be bought, sold and profited from. These agreements are largely negotiated in secret until they are close to being agreed (although there have been numerous leaks during negotiations). Whether from leaks or the publishing of texts by the EU in the later stages of negotiations it’s become clear 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, CETA has been signed by the European Parliament and is being provisionally implemented before it’s finally ratified by EU member states, which may happen before the UK leaves the EU. This means we are likely to be subject to some of the treaty’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. 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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