In theory our health service is safe from the European Union. In theory...
The National Health Service is part of the culture of Britain. So it should come as a relief to note that the treaties underlying the European Union specifically leave health systems as an area of national competence. Brussels, you might think, can’t tell us how to run the NHS. Think again. The NHS is in fact under threat from the EU in at least three major ways.
First, the EU’s policy of the free movement of labour has led to requirements on NHS hospitals to recognise nursing and medical qualifications from EU countries that are lower than existing British ones. It has also removed the requirement for incoming health professionals to prove to regulators that they have English to at least GCSE standard.
Some organisations have been speaking up about this, like the Patients Association. “We are concerned that some healthcare professionals from non-English speaking countries are not proficient enough in the English language to provide safe and effective care in the NHS hospitals,” it said in 2011.
Second, the EU’s free trade negotiations with the US threaten to allow US corporations to bid for any NHS contract. Worse, the operation of any trade agreement, once signed, will be taken out of the control of national governments and legal systems and handed over to secretive arbitration panels run by corporate lawyers.
All power to corporations
These so-called “investor-state dispute settlement” mechanisms will allow corporations to sue governments, bypassing the World Trade Organisation rules that only allow governments to sue governments. US health corporations would be able to sue for profits lost (now and in the future) if these panels rule the firms have been “unfairly” excluded, or challenge the NHS’s decision to remove them as a provider.
In practice, this is likely to mean that once a service is privatised, the government would be unable to take it back into public ownership. Parliament would be powerless.
What regulations are being discussed in the negotiations? Since the talks are secret, no one can be sure, but they will almost certainly include regulations that can prevent US-grown GM seeds and food being sold, and that allow countries to grant defence contracts to their own companies, or that determine how a health service might be run – and about the kinds of employees multinationals can shift around the globe without having to satisfy normal immigration controls.
Ominously for health, they include public procurement – whether a country can give preferential treatment to its own nationalised (or even private) suppliers – and which professional qualifications a country will recognise. Britain already has to recognise inferior European qualifications in health, but with the free trade agreement it faces having to recognise qualifications from anywhere in the world.
It’s no surprise that the threat of the free trade agreement is prompting concern and opposition around Europe. But what is a surprise – though perhaps it shouldn’t be – is the utterly supine and collaborationist attitude of Britain’s TUC. In August it gave written evidence to the Department for Business Innovation and Skills endorsing enthusiastically the surrender of Britain’s sovereignty in trade to the European Union.
Control over budgets
The third threat is direct EU control. Brussels has used the economic crisis it helped to make to set up new rules allowing it to pore over national budgets in great detail and force countries to follow its “recommendations”. It is doing this through the little-known “European semester”.
The European Union has a distinctive way with language. It takes a word you think of as meaning one thing, and uses it to mean another. “Semester”– to most people a university term – has become something completely different: it is now the EU’s principal mechanism for extending its control of national budgets well beyond the limits set in European treaties.
The process starts in November each year, and it works like this. First the European Commission presents its Annual Growth Survey, defining its economic priorities for the coming year. Then the European Parliament and the Council of Europe have their say, so that in March they set overall “policy orientations”.
In April national governments submit their plans to the Commission, which responds with country-specific recommendations on all budget areas, including those like health (and education) that are not supposed to be part of the EU’s remit.
Only then, and only after they have done the EU’s bidding, are Eurozone governments allowed to submit their plans to their own parliaments. Britain, being outside the zone, still has to submit its plans, but not before parliament has looked at them. Eurozone countries that ignore the recommendations can be forced to adopt them.
The result: “The health system is no longer viewed in exclusively national terms,” said Paolo Testori Coggi, Health and Consumers Director General at the Commission, whose tentacles now reach into every health ministry in Europe.
And if you think the European semester sounds ominous, then spare a thought for debt-stricken Portugal, Greece and Cyprus (and, until recently, Ireland). The semester doesn’t apply to these countries, because they are under what the EU coyly calls “financial assistance” and under direct rule from the “troika” of the European Commission, the European Central Bank and the International Monetary Fund. Their instructions don’t even come under the cover of “recommendations”. ■