Freedom to Trade and Safeguarding the National Health Service (NHS): Did the UK-Australia Free Trade Agreement Safeguard the NHS?

Abstract

The United Kingdom (UK) government has claimed that the National Health Service (NHS) was safeguarded throughout the negotiations of the Free Trade Agreement (FTA) with Australia. This article examines if this was achieved. We used public documents on the UK-Australia FTA, including impact assessments, public consultations, and the text of the negotiated agreement. Analytically, we drew on process tracing to assess whether and how the NHS was (i) included in impact statements and assessments, (ii) excluded from the agreement, and (iii) addressed in key chapters, focusing on (a) to what extent NHS safeguarding differs from that of other comparable public policy prerogatives, such as audiovisual services covering national broadcasting, (b) health-related limitations set by Australia, and (c) using the legal obligations of World Trade Organisation (WTO) membership as the null option. Our analysis shows that the NHS was not fully excluded from the trade agreement on the ground of the negotiated agreement compared with the null option of WTO provisions, including for services and public health protection. This would have been possible, but in several chapters was not considered. There was no overarching exclusion and the NHS gained less comprehensive exclusion in comparison to audiovisual services and, in some chapters, to the health-related restrictions set by Australia.