20 th July 2020 Dear MPs, Re: Please vote for amendments to the Trade Bill to protect UK health services As public health and healthcare professionals, we ask politicians to protect all aspects of the NHS by supporting amendments to the Trade Bill. Protection of the NHS must be written into the Trade Bill, otherwise, the NHS will be on the table in future trade deals. ‘Negative listing’ in trade law means that unless explicitly excluded, the NHS will be automatically included in trade deals. Mechanisms to protect all aspects of the NHS, current and future, must, therefore, be written into the forthcoming Trade Bill. Failure to exclude the NHS from trade deals may result in unavoidable and irreversible marketisation of the UK healthcare. Due to the nature of international law, failing to exclude the NHS from a trade deal could ‘lock-in’ marketisation and privatisation within the NHS. Trade mechanisms include the Investor-State Dispute Settlement (ISDS), which allows a company to sue a government for threatening their profits by imposing barriers to trade. Such mechanisms give increased power to corporations and make it very difficult to reverse any contracting of services, even when a company fails to meet contractual obligations or standards. Free trade deals risk increasing the price of medicines (which can cost more than twice as much in the USA as in the UK), reducing access to medications, compromising the safe storage and processing of NHS data (which could be mined by companies based in countries where fewer data protections exist) and undermining the National Institute for Clinical Excellence (NICE) if companies challenge NICE’s decisions as ‘barriers to free trade’. Marketisation is detrimental to the NHS, due to increased transaction costs, fragmentation of the health system and cherry-picking by private providers. Contracting out NHS services is inefficient and has not improved quality of care. Private companies have the option of choosing where, when and to whom to provide services. Large multinational companies may have less ability to identify local needs, partner with local organisations and be accountable to local communities. Private companies ‘cherry-pick’, only delivering services when it is profitable for them. For example, ‘GP at Hand’ an app provided by the company Babylon, has been criticised for misleading advertising to patients and cherry-picking (83% of its patients are aged 20- 39 years). Protecting the NHS from Trade Deals has public support. 84% of the British public said that they want the NHS to be fully public. In last year’s elections, all major political parties pledged to protect the NHS. To fulfil their promise, we ask politicians to support amendments to the Trade Bill to mandate adequate scrutiny of all trade deals and to provide explicit protection to the NHS in future trade deals. Yours sincerely,
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20th July 2020
Dear MPs,
Re: Please vote for amendments to the Trade Bill to protect UK health services
As public health and healthcare professionals, we ask politicians to protect all aspects of the NHS by supporting amendments to the Trade Bill.
Protection of the NHS must be written into the Trade Bill, otherwise, the NHS will be on the table in future trade deals.
‘Negative listing’ in trade law means that unless explicitly excluded, the NHS will be automatically included in trade deals. Mechanisms to protect all aspects of the NHS, current and future, must, therefore, be written into the forthcoming Trade Bill.
Failure to exclude the NHS from trade deals may result in unavoidable and irreversible marketisation of the UK healthcare.
Due to the nature of international law, failing to exclude the NHS from a trade deal could ‘lock-in’ marketisation and privatisation within the NHS.
Trade mechanisms include the Investor-State Dispute Settlement (ISDS), which allows a company to sue a government for threatening their profits by imposing barriers to trade. Such mechanisms give increased power to corporations and make it very difficult to reverse any contracting of services, even when a company fails to meet contractual obligations or standards.
Free trade deals risk increasing the price of medicines (which can cost more than twice as much in the USA as in the UK), reducing access to medications, compromising the safe storage and processing of NHS data (which could be mined by companies based in countries where fewer data protections exist) and undermining the National Institute for Clinical Excellence (NICE) if companies challenge NICE’s decisions as ‘barriers to free trade’.
Marketisation is detrimental to the NHS, due to increased transaction costs, fragmentation of the health system and cherry-picking by private providers.
Contracting out NHS services is inefficient and has not improved quality of care. Private companies have the option of choosing where, when and to whom to provide services. Large multinational companies may have less ability to identify local needs, partner with local organisations and be accountable to local communities. Private companies ‘cherry-pick’, only delivering services when it is profitable for them. For example, ‘GP at Hand’ an app provided by the company Babylon, has been criticised for misleading advertising to patients and cherry-picking (83% of its patients are aged 20-39 years).
Protecting the NHS from Trade Deals has public support.
84% of the British public said that they want the NHS to be fully public. In last year’s elections, all major political parties pledged to protect the NHS. To fulfil their promise, we ask politicians to support amendments to the Trade Bill to mandate adequate scrutiny of all trade deals and to provide explicit protection to the NHS in future trade deals.
Chris Bem Consultant ENT and Neck Surgeon, Bradford Teaching Hospitals NHS Foundation Trust NHS Clinician
Chris Course ST6 Neonatal Registrar NHS Clinician
Chris Rooney Retired GP Retired General Practitioner
Christelle Blunden GP NHS Clinician
Christina Lange Diabetes Specialist Nurse NHS Clinician
Christina MacMillan Clinical Psychologist NHS Clinician
Christina Sosseh Retired NHS Nurse Retired NHS Nurse
Claire O'Brien staff nurse NHS Clinician
Claire Rees GP NHS Clinician
Clare McIntyre Registered Nurse and health visitor NHS Clinician
Coral Jones GP NHS Clinician
Cyril Couve Training Psychoanalyst at BPAS
Tavistock Unit Head Adult Department 1996-2008
Damien joseph Consultant Anaesthetist NHS Clinician
Daniel Puntis Doctor NHS Clinician
Danielle Robinson Mental health practitioner NHS Clinician
Dann Gooding Staff Nurse NHS Clinician
David ASHLEY Price Consultant in Infectious Diseases NHS Clinician
David Bareford UKAS assessor Public health professional in practice
David Bell Consultant Psychiatrist NHS Clinician
David Curnock Emeritus Consultant Paediatrician, and Clinical Contact Caseworker for NHS Test & Trace NHS Clinician
David D Smith GP NHS Clinician
David McCoy
Professor of Global Public Health at the Centre for Primary Care and Public Health at Queen Mary University of London
Public health professional in practice
Deborah Colvin Dr (GP Partner, Chair of City & Hackney GP Confederation) NHS Clinician
Deborah Lawlor Professor of Epidemiology MRC Integrative Epidemiology Unit at the University of Bristol
Public health professional in practice
Deborah Maynard General Practitioner NHS Clinician
Debra Stiles Architectural technician Patient
Derek Bell Academic Physician NHS Clinician
Diana Majeed GP NHS Clinician
Diana Wellesley Consultant in Clinical Genetics NHS Clinician
Dipti Dinesh Consultant NHS Clinician
Dominic Craver ST5 emergency medicine registrar NHS Clinician
Dorrie Imeson Doctor NHS Clinician
Dr A Ford Consultant Medical Oncologist NHS Clinician
Dr Aaminah Verity GP registrar NHS Clinician
Dr Adam Rutherford Honorary Senior Research Fellow
Genes, Evolution and Environment, University College London
Dr Alison A. Leaf Honorary Consultant Neonatologist, University of Southampton NHS Clinician
Dr Alyson Hall Hon Consultant Child & Adolescent Psychiatrist retired but involved in international health work
Dr Andar Gunneberg Consultant Chemical Pathologist NHS Clinician
Dr Andrea Franks Recently retired consultant dermatologist NHS Clinician
Dr Ann O'Brien GP and medical educator NHS Clinician
Dr Ann Sandison Consultant Histopathologist NHS Clinician
Dr Annabel Hayes Highly Specialist Clinical Psychologist NHS Clinician
Dr Anthea Mowat Retired Anaesthetist NHS Clinician
Dr Antony Lempert GP NHS Clinician
Dr Arti Maini Deputy Director for Undergraduate Primary Care Education NHS Clinician
Dr Arun Baksi Emeritus consultant physician NHS Clinician
Dr Arun John Baksi Consultant Cardiologist NHS Clinician
Dr Barbara Palmer GP NHS Clinician
Dr Beth Oxley GP Partner, Leeds NHS Clinician
Dr Bettina Harms Consultant Paediatrician NHS Clinician
Dr Bharat Pankhania Senior Clinical Lecturer, University of Exeter
NHS Clinician, Public health professional in practice
Dr Brian Gibbons FRCGP Retired GP
Former Health & Social Care Minister, Welsh Government
Dr Charles Clarke Neurologist Retired NHS: in practice
Dr Chris Foster Emergency medicine doctor NHS Clinician
Dr Chris Foster Emergency medicine doctor NHS Clinician
Dr Chris Gale Reader in Neonatal Medicine and Consultant Neonatologist NHS Clinician
Dr Chris MacGregor Psychotherapist NHS Clinician
Dr Christopher A Birt Retired consultant / senior lecturer
Other NHS staff, Public health professional in practice
Dr Christopher Verity Consultant Paediatric Neurologist NHS Clinician
Dr Claire Davies GP, Tower Hamlets NHS Clinician
Dr Clive Kelly FRCP, MD Consultant Physician and Senior Lecturer NHS Clinician
Dr Colin Hutchinson Chair, Doctors for the NHS Retired Consultant Ophthalmologist
Dr Dave Baillie Consultant Psychiatrist, East London NHS Clinician
Dr David Hawkins Consultant Physician NHS Clinician
Dr David Nylander Consultant Gastroenterologist NHS Clinician
Dr Dianne LeFevre Doctor, retired consultant psychiatrist
Retired Consultant Psychiatrist (now in private practice)
Dr Donatella Soldi Speciality dr in community paediatrics NHS Clinician
Dr Duncan Davidson Consultant Neurologist -retired NHS Clinician
Dr Elizabeth Newson Retired former GP Retired GP
Dr Faisal Yousif FY1 Doctor NHS Clinician
Dr Fiona Duxbury GP NHS Clinician
Dr Fiona Godlee Editor, The BMJ Health journal editor
Dr Fraz Mir Consultant Physician and Head of School of Postgraduate Medicine, East of England NHS Clinician
Dr Freya Scott GP NHS Clinician
Dr Gail Dovey-Pearce Consultant Clinical Psychologist NHS Clinician
Dr Gary Singh Marlowe GP, CCG Vice-Chair and Planned Care Clinical Lead NHS Clinician
Dr Georgie Sowman GP NHS Clinician
Dr Helen Leveret Paediatric Registrar NHS Clinician
Dr Helen Palmer Paediatrician ( Retired) Retired NHS Clinician /Voluntary roles wrt NHS
Dr Hosnieh Djafari-Marbini Anaesthetic Consultant NHS Clinician
Dr Ian Cooper Cardiologist NHS Clinician
Dr Jack Czauderna Retired Family Doctor Retired NHS Clinician
Dr James R Lawrence Honorary researcher, ex-Medical Director NHS Clinician
Dr Janet Anderson Retired consultant paediatrician
Retired but teaching health professionals and committed to the NHS Trustee of Compton Care(hospice) supported with in part NHS monies
Dr Janet Pilkington Clinical Psychology Clinical Psychologist in Private Practice
Dr Jasmin Khan-Singh Associate Specialist in Psychosexual Medicine and SRH NHS Clinician
Dr Jean Daniel Dubois Specialty Doctor in Oncology NHS Clinician
Dr Jennie Read Doctor NHS Clinician
Dr Jens Ruhbach GP NHS Clinician
Dr Jess Gaddie Junior doctor, GUM / HIV medicine NHS Clinician
Dr Johanna Feary Consultant NHS Clinician
Dr John H Tripp Retired clinical academic paediatrician NHS Clinician
Dr Jonathan Fluxman Retired GP, back with Covid CAS NHS Clinician
Dr Joyce Leeson Director of Public Health ( retired ) As Above -Retired Director of Public Health
Dr K H Mackay retired GP NHS Clinician
Dr Kailash Chand OBE Past deputy chair of BMA NHS Clinician
Dr Karen Horridge Consultant Paediatrician (Disability) NHS Clinician
Dr Karen Leyden Consultant Anaesthetist NHS Clinician
Dr Kate Lockwood Consultant Psychiatrist NHS Clinician
Dr Kate Whitaker Clinical Psychologist NHS Clinician
Dr Katy Morris GP NHS Clinician
Dr Keith Greenish General Practitioner NHS Clinician
Dr Lianne Sahu GP NHS Clinician
Dr Lis Hawthorne Recently retired GP Retired GP
Dr Louise Irvine General Practitioner NHS Clinician
Dr M Valerie Kyle Retired Consultant Rheumatologist NHS Clinician
Dr Manisha Ahuja Specialist Registrar in Immunology NHS Clinician
Dr Manni Waraich Consultant Neurocritical Care & Neuroanaesthetics NHS Clinician
Dr Maria Hyde Locum GP NHS Clinician
Dr Mark Edwards GP NHS Clinician
Dr Martin Heardman GP NHS Clinician
Dr Matthew Sawyer GP NHS Clinician
Dr May van Schalkwyk
Pubic Health Specialty Registrar and Doctoral Research Fellow, London School of Hygiene and Tropical Medicine
Public health professional in practice
Dr Mir Saaduddin Ahmad Emergency Medicine Consultant NHS Clinician
Dr Miriam Frank Consultant Anaesthetist Retired Consultant Anaesthetist
Dr Miriam Orcutt Senior Research Fellow, Institute for Global Health, University College London
Academic Public Health professional
Dr Monica Mary Cooper Doctor Retired
Dr Morris Bernadt Retired consultant psychiatrist; currently, medical member of disability Tribunals.
NHS Clinician, Medical adviser to Ministry of Justice.
Dr Nadia Masood Consultant Anaesthetist NHS Clinician
Dr Naomi Jones Paediatrician NHS Clinician
Dr Nicholas Barnes Retired consultant paediatrician retired consultant paediatrician
Dr Nicholas Hopkinson Reader in Respiratory Medicine, Imperial College London NHS Clinician
Dr Nick Thompson Consultant Gastroenterologist NHS Clinician
Dr Nicole Lowe Anaesthetist NHS Clinician
Dr Nigel Speight Paediatrician NHS Clinician
Dr Peter Carter FRCPsych
Consultant Psychiatrist, Director of Medical Education, NE London NHS Clinician
Dr Peter Dannatt Doctor NHS Clinician
Dr Phillip Ambler Doctor Other NHS staff
Dr Richard Cunningham Consultant Microbiologist NHS Clinician
Dr Richard Eyre Consultant in Child and Adolescent psychiatry NHS Clinician
Dr Richard Horton Editor, The Lancet Health journal editor
Dr Richard Savage MSc FRCGP NHS Clinician
Dr Richard Thompson retired physician
emeritus NHS professional
Dr Rita Issa GP Academic Clinical Fellow, Tower Hamlets NHS Clinician
Dr Robert Primhak Consultant Paediatrician (Ret) NHS Clinician
Dr Rochelle A. Burgess, PhD, FRSPH
Deputy Director, UCL Centre for Global Non-CommunicableDiseases; Director, MSc in Global Health and Development; Lecturer in Global Health, UCL Institutefor Global Health
Academic Public Health professional
Dr Rupert Payne Consultant Senior Lecturer in Primary Health Care NHS Clinician
Dr Ruth Taylor Retired GP NHS Clinician
Dr Sadiq Yousuf BMBS MRCGP General Practitioner NHS Clinician
Dr Sally Mitchison Consultant Psychiatrist (Retired) NHS Clinician
Dr Samina Ishaq FRCA, FFPMRCOA Anaesthetic consultant NHS Clinician
Dr Sarrah Tayabali Haematology Registrar NHS Clinician
Dr Shabbir Ahmed GP NHS Clinician
Dr Simone Herrmann Emergency Medicine Registrar NHS Clinician
Dr Sonia Adesara National Medical Director’s Clinical fellow 18/19 and GP registrar NHS Clinician
Dr Sonia Kumar Director Of Primary care Education NHS Clinician
Dr Sophie North Lecturer Healthcare educator
Dr Tess Guilding Retired GP NHS Clinician
Dr Tessa Katz GP NHS Clinician
Dr Thomas Cummin Haematology Specialist Registrar NHS Clinician
Dr Tim Jaspan Consultant Neuroradiologist NHS Clinician
Dr Vanessa Jessop GP NHS Clinician
Dr Veronica Hickson Associate Specialist Community paediatrics NHS Clinician
Dr Will Gray GP NHS Clinician
Dr William Shatwell Consultant Radiologist NHS Clinician
Dr Zaib Davids Consultant Child and Adolescent Psychiatrist
NHS Clinician, Health professional in training for UK practice
Dr. Birgit Hauffe GP NHS Clinician
Dr. Helen Farebrother GP, Hackney, London NHS Clinician
Dr. Judith M Stevens Retired NHS Consultant Physician Retired
Dr. Mahesh Kamdar GP NHS Clinician
Dr. Maryann Noronha Emergency Medicine Consultant NHS Clinician
Edward Kunonga Consultant in Public Health, Ex-Director of Public Health Public health professional in practice
Elin Jones ICU staff nurse NHS Clinician
Elio Riboli, FFPH, FMedS,
Professor in Cancer Epidemiology and Prevention, School of Public Health Director of Public Health Research, Imperial College Healthcare, NHS Trust Director, St Mary’s Campus, Imperial College London
Jean Hardiman Smith Honorary Secretary Socialist Health Association
Other NHS staff, Lead of health think tank for the Labour Party + Patient Leader
Jeevi Hari Medical Student Health professional in training for UK practice
Jeff Gawler Consultant Neurologist NHS Clinician
Jennifer Preston Deputy Named Nurse Childrens safeguarding NHS Clinician
Jenny Vaughan Consultant Neurologist Other NHS staff
Jeremy Radcliffe NHS Consultant NHS Clinician
Jessica Manson Consultant Rhematologist NHS Clinician
Jessica Sibson GP partner NHS Clinician
Jillian Creasy Medicolegal report writer for Freedom from Torture
Medicolegal report writer for Freedom from Torture
Jo Stutchbury GP trainee NHS Clinician
Joanna MacLachlan Senior Cardiology Research Nurse Other NHS staff
Joe McManners GP NHS Clinician
John Launer MedIcal educator Other NHS staff
John Painter Consultant Gastroenterologist NHS Clinician
John Puntis Consultant Paediatrician, Leeds NHS Clinician
John Robson Academic GP Academic GP
John Whalley Mental Health Nurse NHS Clinician
John Wills RGN RMN DSN NHS Clinician
Jonathan Coates GP NHS Clinician
Jonathan Darling Honorary Consultant Paediatrician NHS Clinician
Jonathan Folb Consultant microbiologist NHS Clinician
Jonathan Green Management Consultant Health Professional no longer practicing
Jonathan Miller Consultant Anaesthetist
Independent Sector Treatment Provider Employee
Jose Catalan Honorary consultant psychiatrist
Retired NHS Consultant, now holding honorary position.
Joshua Clough ST6 EM NHS Clinician
Judith Flanagan Practice nurse
NHS Clinician, Health professional in training for UK practice
Judith King Retired GP Retired GP
Jugnoo S Rahi
Professor of Ophthalmic Epidemiology and Honorary Consultant Ophthalmologist; NIHR Senior Investigator; Head, Population, Policy and Practice Research and Teaching Department; Director, Ulverscroft Vision Research Group GOS Institute of Child Health, UCL / Great Ormond Street Hospital NHS Foundation Trust NHS Clinician
Julia Betancour-Roth Counselling Psychologist Trainee
Health professional in training for UK practice
Julia Cambitzi Lead nurse. NHS Clinician
Julia Nelki Child Psychiatrist NHS Clinician
Julian Peto FMedSci FRS
Professor of Epidemiology London School of Hygiene & Tropical Medicine
Public health professional in practice
Julie Parsons Registered Nurse NHS Clinician
June Anne McKnight RGN Other NHS staff
Justine Friedlander Nurse Other NHS staff
Karen Bisset GP Partner NHS Clinician
Karen Varisco Principal clinical pharmacist NHS Clinician
Karl Wild Doctor NHS Clinician
Kate Drummond Speech and Language Therapist NHS Clinician
Kate Sheehan Registered Nurse NHS Clinician
Kate Wheeler Consultant in Paediatric Oncology NHS Clinician
Kath Grinter Contraception and Sexual Health Dr (retired) Retired
Katherine Mack Midwife NHS Clinician
Katherine Rouse SAS Doctor NHS Clinician
Katie Friend Retired Consultant Child and Adolescent Psychiatrist NHS Clinician
Peter Fisher Consultant Physician (retired) NHS Clinician
Peter Godfrey Doctor NHS Clinician
Peter Harper Emeritus Professor Retired hon Consultant Physician
Peter Sullivan Professor NHS Clinician
Piyush Pushkar Doctor, core trainee in psychiatry NHS Clinician
Prof David J. Hunter, MBBS, MPH, ScD, FAFPHM,
Richard Doll Professor of Epidemiology andMedicine, Nuffield Department of Population Health, University of Oxford,
Academic Public Health professional
Prof David Pearson GP & Hon Professor, Primary Care, Hull York Medical School, UK NHS Clinician
Prof Iain E. Buchan
Executive Dean, Institute of Population Health Sciences; Director of Digital Strategy and Partnerships, Liverpool Health Partners; Chair of Public Health and Clinical Informatics Faculty of Health and Life Sciences University of Liverpool
Public health professional in practice
Prof John S Yudkin Emeritus Professor of Medicine, University College London Clinical Academic
Prof Maggie Rae President, Faculty of Public Health Public health professional in practice
Prof Martin McKee, Professor of European Public Health, London School of Hygiene and TropicalMedicine
Academic Public Health professional
Prof Nuala McGrath Professor of Epidemiology and Sexual Health, Faculty of Medicine, Southampton General Hospital NHS Clinician
Prof Paolo Vineis, MD, MPH, FFPH
Chair in Environmental Epidemiology MRC Centre for Environment and Health School of Public Health Imperial College London
Public health professional in practice
Prof Parag Singhal Consultant NHS Clinician
Prof Steph Taylor,
Professor in Public Health and Primary Care, Deputy Dean Research Impact & Director Complex Intervention and Social Practice in Health Care unit, QMUL
Public health professional in practice
Prof Tim Colbourn Ph.D.
Associate Professor of Global Health Epidemiology and Evaluation UCL Institute for Global Health
Public health professional in practice
Professor Dame Marcela Contreras FRCP FMedSci
Retired Professor of Tranafusion Medicine Royal Free and University College Hospital Medical School Retired from NHSBT
Professor Dame Marcela Contreras FRCP FMedSci
Retired Professor of Tranafusion Mesicine Royal Free and University College Hospitala Medical School Retired from NHSBT
Professor David Oliver Consultant in Geriatrics and General Internal Medicine NHS Clinician
Professor John Feehally Emeritus Consultant Nephrologist NHS Clinician
Professor Neena Modi FMedSci Professor of Neonatal Medicine NHS Clinician
Professor Raymond Tallis Professor Raymond Tallis
Emeritus Professor of Geriatric Medicine University of Manchester
Professor Richard Walker Consultant Physician NHS Clinician
Professor Sir Stephen O'Rahilly
Hon consultant physician, Addenbrookes Hospital Cambridge
NHS Clinician, Director MRC Metabolic Diseases Unit
Professor Sonia Saxena Professor of Primary Care/ GP
NHS Clinician, Public health professional in practice, Head of Child Health at Imperial School for Public Health
Quen Mok Consultant Paediatric Intensivist NHS Clinician
R Radhika Consultant NHS Clinician
Rachael Sage Practice nurse NHS Clinician
Rachel Ambrose Charge Nurse, CAMHS NHS Clinician
Rachel Andrew Specialist Health Visitor TB NHS Clinician