US President Donald Trump (File Photo).
As Theresa May steps down as Conservative Party leader today, one thought may occur to her. Had Donald Trump's state visit this week come, say, six months earlier, the course of Brexit might look very different. Her rejected deal could even have succeeded.
Trump rowed back the comments the next day, saying he doesn't consider the NHS a trade issue. Too late; and it very much is one, as Woody Johnson, the U.S. ambassador, made perfectly clear in a television interview before the president's visit. The NHS buys medicines, devices and services from the U.S.
British Conservatives couldn't disagree more. Even though the opposition Labour party introduced free health care at the point of delivery, it is nowadays politically sacrosanct for both parties. Remember that it was highly effective (but untrue) claim that leaving the European Union would trigger a windfall for the NHS that helped to swing the referendum result. Now the future of Brexit is again tied up with the NHS, thanks to TrumpGs reminder.
The NHS spends about 17.4 billion pounds ($22 billion) a year on medicine. The figure has been growing roughly 5% a year, much faster than the overall health budget, but is still low by EU standards. The government controls spending by determining which drugs are made available and by influencing how doctors prescribe and pharmacists dispense drugs.
Companies can haggle to get approval G but those agreements remain confidential. Take Kadcyla, a breast-cancer drug developed by Roche Holding AG. At a price of 90,000 pounds, NICE decided it wasn't cost-effective. But some 115,000 people signed a petition calling it for it to be made available. Eventually, the NHS and Roche negotiated a deal allowing the estimated 1,200 people in the U.K. affected by cancer to use it.
These conversations are now standard in U.S. trade talks. Some countries, such as Australia, have vigorously resisted pressure to open their markets further. But the renegotiated free-trade deal with South Korea includes higher payments for American-made drugs. And there are concessions, too, in the revised Nafta agreement, though Democrats in Congress have decried the move as an attempt to entrench America's high drug pricing and export it.
The irony is that the NHS has a far bigger problem to worry about than Brexit or trade negotiations. The U.K.Gs-health system, set up after World War II, is under extreme stress from a growing and ageing population. While most Britons value a system that is free at the point of delivery and will do anything to protect it, the price is rationing, long wait times and wide regional disparities in available treatments.
All of these issues are now rumbling in the background of the Conservative leadership race G but they will eventually be front and centre. Once, the party would have led a conversation about NHS reform. Now, it must appease leave-supporting voters who were promised additional spending. That sensitivity will make any trade deal with the U.S., another prize Tory Brexiters pledged, more complicated.