TTIP – what is the Trade and Investment Partnership

The People’s NHS is a community campaign to stop NHS Privatisation from taking place, which would mean the sale of our NHS services.

Since 2011 billions of pounds have been handed to private companies to run our NHS – and we think that’s wrong.

Here is No Health Sell-off Morecambe Bay and the People’s NHS taking our message to the Conservative Party Conference on the eve of David Cameron’s big speech:

No NHS sell-off projected onto Conservative party conference building on eve of Cameron's speech


But it’s about to get a whole lot worse.

  • A new EU trade deal with the US could make those NHS sell-offs, and all that follow them, irreversible.
  • Under the agreement, our elected government would not be able to bring NHS services back into public ownership. Otherwise, they could get sued by American multinationals.

Negotiations are taking place right now, and neither the European Union or the Government can agree on whether the NHS is safe or not. David Cameron can clear up all this confusion and protect the NHS.  All he has to do is to threaten to use his veto unless all mention of Health is removed from the treaty.
We can make him do it. We can stop the Privatisation of the NHS and make sure it stays in our control, not big companies’.


Please sign our petition, and tell Cameron to save the NHS from TTIP

The People’s NHS has seen explosive legal advice, from one of the UK’s top QCs, that shows quite clearly that the NHS is under threat from TTIP. You can read it here.

The official excuses keep changing


We clearly have the politicians rattled. A series of contradictory and increasingly desperate sounding justifications (excuses) have been given by the government for why the NHS is:

“Not in TTIP”

“In TTIP but safe”

“Only there because otherwise our drug companies could’nt sell to the US”

“Not being sold anyway”


And here is a summary of some other legal advice, obtained by Unite the Union that flatly contradicts some of the Government’s weak-sounding assurances on TTIP:




Unite commissioned legal advice from Dr. Kyriaki-KorinaRaptopoulou.  She is a specialist practitioner in Medical Law,Health Law, Social Security and Public Procurement Law. She is qualified in Greece and she also holds a PhD in European Law from King´s College London, where she also taught EU Law. She has acted as a research associate at UCL, School of Law and her book on ‘EU Law and Healthcare Services’ will be published in March 2015 by Kluwer Law International.


Threats identified in the legal advice:


• The NHS is included in the material scope of TTIP and without a full and clear exemption it will clearly be subject to the agreement. The main threats come from features of the market access principle, the ‘fair and equal treatment standard’ and ‘the principle of protection against unlawful expropriation’ both of which could trigger an investment claim if the UK Government changes the legal and business environment for healthcare investors or impedes their establishment in the UK.
• TTIP is likely to provide for ‘full restitution’ in expropriation cases. This means that if the Government brings NHS services back into the public sector, future lost profits may have to be compensated for as well as the market value of any property or business lost (which is the only measure under UK law).
• The potential impacts of TTIP on the NHS are not solely dependent on Investor-State Dispute Settlement (ISDS) being in place. Investors could still bring cases against the UK Government and bypass domestic courts via the US Government though State-State arbitration.
• TTIP arbitration cases will be judged by arbitrators lacking in independence and democratic legitimacy, in procedures subject to confidentiality with no right of appeal.
• ISDS in particular will promote the risk of suppressing future healthcare legislation through the phenomenon of ‘regulatory chilling’.
• The official liberalising rationale which underpins TTIP does not allow for the protection of social and health systems like the NHS to be taken into account when assessing the positive or negative ‘welfare’ outcomes of TTIP.



A few points to consider when weighing up the Government’s assurances:


➢ The EU Commission and the Government have pointed to the protections in the General Agreement on Trade in Services (GATS) and the EU-Canada trade agreement (CETA) that applies to “services supplied in the exercise of governmental authority” as if these will protect the NHS.
✗ The legal advice shows that this protection does not apply to NHS services. This is partly because there are public and private providers in the NHS; partly because NHS Foundation Trusts take part in commercial activities and use private funding.


➢ They have also claimed that the NHS is protected as a ‘service of general economic interest’, a ‘public utility’, and/or a ‘public service’
✗ The legal advice shows these categories can only exemptthe NHS from certain features of the ‘market access’obligations (in other words the Government could still be sued for bringing these NHS services back into public ownership).


➢ Finally the pro-TTIP lobby have pointed to the Annex II reservations (which member states can draft themselves) in CETA, saying that these include specific exemptionson healthcare that protect the NHS.
✗ The legal advice analysed the UK’s Annex II reservations concerning health services in CETA. It turns out that the UK has made sure that public ambulance services and all secondary care services (i.e. services provided by doctors and nurses in hospitals – public and private) are subject to the agreement with no reservations whatsoever, except for the EU´s general exemption for non-private healthcare, which again may give rise to controversy.
And here we try to explain the problems with some of the offficial ‘explanations’:


  • Excluding health from TTIP would damage our pharmaceutical and medical devices sectors
    • Are profits of those companies really more important than the irreversible sale of our NHS?
    • The government could easily demand an exemption for the health service that doesn’t include this sector if they wanted.
    • Pharmaceutical sector have already got free access to EU and US markets, tariffs between the EU and US for the sector are already at zero.
    • They have been lobbying for rules to make it harder for the NHS to set fair prices for medicines and delay the arrival of cheaper, generic drugs.


  • NHS services are already exempted from TTIP
    • The EU’s Chief Negotiator has made it clear that Wall Street investors and US health corporations will have their contracts covered by TTIP’s ‘investor protection’ chapter.
    • This means they will get new powers to sue the government in tribunals operating outside the UK legal system for unlimited sums of money if it tries to take NHS services back into public hands.


  • The Investor-State Dispute Settlement (ISDS) mechanism in TTIP is still under negotiation – following a public consultation – and we will protect the government’s interests
    • If ISDS was removed it would probably be replaced with some State-to-State investor protection. This would mean that American investors could still use the agreement to sue – but would have to go via the US Government.
    • In any case, the incoming and outgoing EU Trade Commissioners have given strong signals that they want to ignore the outcome of consultation when 150 000 people and organisations wrote to say they want ISDS out of TTIP.


  • You can’t stop the sell-off because of The Public Contracts Regulations introduced in 2006
    • When the Regulations came in they only applied to commercial tendering for non-clinical NHS services. They were extended to NHS commissioning of clinical services (the provision of healthcare by doctors in hospitals) by the Health and Social Care Act 2012, which decoupled the NHS from central government.


  • TTIP will not undermine the principal that the NHS should be “free at the point of use, based on clinical need and not ability to pay”
    • If the provisions of TTIP had protected the private owners of hospitals in 1948 we would never have got the NHS “free at point of use” in the first place. It would have been treated as ‘expropriation’.
    • If future governments do introduce ‘charging initiatives’ they will be locked in by TTIP and we may never get “free at point of use” back again.


  • TTIP will not force the Government to privatise NHS services
    • The government do not need to be forced to privatise NHS services. They are doing it by themselves. The problem arises when we get a government that wants to stop selling off the NHS and bring it back into public hands.


  • You can’t just exempt a sector from investor protection/ the whole agreement
    • The French have done it with audio-visual and the EU Trade Commissioner has said that the government can exempt the NHS if they want to.

Click here to take action


3 Responses to “TTIP – what is the Trade and Investment Partnership”

  1. Ann Moore

    I tried to sign the petition for the Welsh MP’s vote next week. Every time I finish writing on the website my personal letter. I go to the area to add my name and address and the website crashes. Goes bake to the original page to start again!! [this is with the supplied tool by Andrew Tobert, The Peoples NHS]

    This means many others who may be trying to write will be unsuccessful, damaging your campaign.


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