Policy & Management

Daniel Legg, Category Manager (Medical & Surgical) UCLPartners Procurement Service

TTiP and the NHS

The central objective of TTiP is to remove regulatory barriers to trade for big business including food safety law, consumer protection standards, environmental legislation and the sovereign powers of individual states.

So how does this affect the NHS? One of the main aims of TTiP is to open up access to public services for US trans-national corporations; this could lead to the privatisation of the NHS as dominant US healthcare companies bid for public healthcare contracts. In June 2014, an EU document was leaked confirming that medical and health services, social services and many other public services were on the table during TTiP negotiations. In return, the EU is seeking to outlaw ‘Buy America’ provisions which are designed to protect local jobs in the USA.

Secrecy regarding the negotiations hasn’t helped to allay public fears regarding how TTiP will affect public services; the majority of information regarding the on-going negotiations has come from leaked documents and Freedom of Information (FoI) requests. The EU has imposed a 30 year ban on public access to the negotiating documents which is effectively denying transparency and democracy at the same time. The US Government has placed a five year block on public access to TTiP documents.

Opening up market access means that any remaining state monopolies must be abolished. These include public services that are provided by the state or by a limited number of suppliers, such as the NHS. If a country doesn’t want to open its public services to wider competition, it must leave those services out of any trade agreement but there is little precedent of this in existing trade agreements between the USA and its trade partners.

Possibly more worrying, TTiP seeks to grant foreign investors the right to sue sovereign Governments for the loss of future profits. Under the Investor State Dispute Settlement (ISDS) mechanism, US trans-national corporations would be entitled to challenge public health policy and sue sovereign states for colossal sums. For example, the American company Renco sued Peru for $800m because its contract was not extended after the companies smelting operation caused environmental and health damage.

It’s this type of mechanism that leads many to believe TTiP isn’t about reducing trade tariffs but an attempt by trans-national corporations to prise open and deregulate markets on both sides of the Atlantic for their own profit making agendas.


Whilst politicians on both sides of the Atlantic have been attempting to fast track the agreement, the original deadline was to conclude talks by the end of 2015, there are doubts that a deal will be achieved prior to President Barack Obama’s term of office ends in January 2017. The delay may provide sufficient time for the negotiations to conclude that public health should sit outside of the trader agreement or for negotiations to break down completely but until then the public are more than likely to be kept in dark until it’s too late.