In a previous article, we outlined how Britain’s membership of the European Union has and will continue to put unsustainable pressure on the National Health Service.
But whilst that piece was focused on the impacts of free movement and EU rules regarding immigration and employment law, the negative impact of European law is much more far-reaching than that. If the UK fails to take back control of health regulation we risk losing access to cutting edge medicines – and perhaps even the ability to defend our public NHS.
Let’s start with the big claim first: how could EU membership possibly threaten the foundational principles of our NHS?
Well, as we have discussed previously one of Brussels’ over-arching ambitions is ‘harmonisation’ – short for making products and services the same wherever you travel inside the EU – and the simple fact is that the British healthcare model is not the European norm.
Most Member States have so-called ‘mixed’ systems, which use public funds to support an insurance system served by private providers. This is therefore the template used by EU lawmakers when they’re trying to create ‘European’ healthcare structures.
The threat this poses to the NHS has been obvious for at least ten years. In 2007 Labour MPs fiercely objected to Brussels’ proposed ‘patients’ rights directive’, fearing that it would force the UK to create an internal market in healthcare. That finally became law in 2011.
It was swiftly followed in 2014 by new and extensive directive governing ‘public procurement’ which, according to the Crown Commercial Service, is intended to “open up the public procurement market” in ways which will “require competition”. That’s a problem for the NHS, which as a virtual monopoly provider of healthcare is inevitably something close to a monopsony buyer of related products.
Senior figures with experience of these matters have sounded repeated warnings about the direction of travel, from back in 2007 to the debates around the Transatlantic Trade and Investment Partnership (TTIP) in 2016.
Inside the EU, Britain risked sleepwalking into a legal system which forced us to break up the NHS in the name of ‘competition’ – yet at no point did protections for the Health Service feature in the renegotiations, nor did previous governments take any actions to demand the legal protections we need to protect our unique system.
And that’s just the big picture stuff. Let’s take a look at how Brussels’ meddling undermines UK medical progress on a more detailed level.
Take the Clinical Trials Directive. Introduced in 2005 to harmonise regulation of these crucial tests of new medicines and technologies, by 2007 the European Journal of Cancer was reporting that it “resulted in a doubling of the cost of running non-commercial cancer clinical trials in the UK and a delay to the start of trials” and “both increased the cost and caused delay to non-commercial cancer clinical trials run by major public sector Clinical Trials Units in the UK.”
According to the European Commission, of all places, between 2007 and 2011 applications for clinical trials fell by 25 per cent, the cost of insuring commercial trials increased by 800 per cent, and the cost of administering non-commercial trials increased by 98 per cent. All of that is money wasted which could have been invested in cutting edge research, and it means that life-saving advances take longer to reach patients.
Obviously, none of this was enough to get the law changed. It will finally be repealed in the near future – to be replaced by a new one seven times as long.
Then we have Brussels’ bid to centralise ‘Health Technology Assessments’ (HTAs), the tests used by medical regulators to approve new technologies for general use. This will undermine the NHS in two ways.
Currently, our Health Service is obliged to offer and fund medicines and treatments approved by our domestic regulator, NICE. If the EU takes control of a centrally-run, European approval regime it will mean that British patients will need to wait for a green light from Brussels to access innovative care, even if British doctors have given it the all-clear.
Secondly, it might bring an end to the Cancer Drugs Fund, which operates under special dispensation from the British Government to support new and experimental treatments not yet cleared by NICE. If all medicines need an EU HTA, that system will no longer be possible.
The EU’s control over healthcare is already well-developed, and it tightens by the day. That’s why its vital that the Government delivers a Brexit which takes back control of our NHS.