Dear Boris Johnson,
I am writing to you to about the protection of the National Health Service and other vital public services from the impact of a future trade deal with the United States.

The threat to the NHS from a future post-Brexit US-UK trade agreement, given the statements made by both US and British officials and politicians, is of profound concern to the British public.

Nowhere could this be clearer than in the cost of medicines to the NHS. The cost of patented drugs in the USA is approximately 2.5 times higher than in the UK, and the price of the top 20 medicines is 4.8 times higher than in the UK.

Your proposed trade deal with the US clearly threatens to drive up the cost at which our NHS buys drugs, which could drain £500 million a week from our health service.

While you have claimed that NHS medicines procurement is ‘not on the table’ in UK-US trade talks, that claim has now been shown to be false. The evidence is clear that you have misled the public.

Last week I revealed the leaked readouts from six secret meetings of the UK-US Trade and Investment Working Group held over the past two years.

The fourth round of UK-US meetings included a three-hour session dedicated solely to patents and pharmaceuticals, during which British government officials presented a full explanation of the operation of the patent system in relation to pharmaceuticals and the NHS.

It does not take three hours to say “not for sale”. That is because the evidence is clear: our NHS and public health services are up for sale. But you and your fellow Conservative leaders do not want the public to know that will be the price of a US trade deal.

President Donald Trump and his administration have made no secret of the fact that they intend to use a future trade deal with the UK to drive up the cost at which the NHS buys drugs.

In February this year, the Office of the US Trade Representative published its negotiating objectives for a US-UK trade deal. In the section on ‘Procedural Fairness for Pharmaceuticals and Medical Devices’, they call for “full market access for US products”.

President Trump has previously accused foreign governments of extorting “unreasonably low prices” from US pharmaceutical firms, and has directed his senior trade negotiator to make the issue “a top priority with every trading partner”.

In addition, the US Health and Human Services Secretary, Alex Azar, has said the US needs to get foreign countries to pay more for prescription drugs through trade agreements. The White House has called for a global crackdown on ‘foreign freeloading’ on drug prices.

Following the three hour session in the fourth round of the secret talks, the British official leading the discussions concluded: “We have reached a point (for Patents in Pharmaceuticals / Health) where… we are awaiting the clearance to negotiate and exchange text to really take significant further steps.”

By their own admission, UK government officials are poised to draft a trade agreement that could lead to a massive increase in the cost of pharmaceuticals to the NHS.

In addition, there is mounting concern that the NHS could be opened up to irreversible privatisation as a result of the UK-US trade talks.

The Health and Social Care Act 2012 expanded the delivery of NHS services through the private sector, with an increase in the number of contracts awarded to private healthcare providers. Despite your claim there would be ‘no privatisation’ of the NHS, privatisation has in fact doubled during the last decade of Conservative rule, and two thirds of NHS contracts since 2015 have gone to the private sector.

The increased privatisation of NHS services delivery will be permanently locked in through the inclusion of health services in a UK-US trade deal.

Throughout the six rounds of secret meetings to date, US officials have repeatedly emphasised that all service sectors are on the table for negotiation.

During the third round, for instance, the record shows that the US is pressing for an approach that makes “total market access the baseline assumption of the trade negotiations and requires countries to identify exclusions, not the other way around”.

In other words, if we don’t say it’s not for sale, it’s for sale. While the US side has issued a blanket ban on any mention of climate change or greenhouse gases in a future UK-US trade agreement, UK negotiators have at no point suggested that they wish to exclude the healthcare sector from the talks.

To assure the British public that the NHS will not be up for sale in any future trade agreement, I call on you as a matter of urgency to confirm that you will:

End NHS privatisation so that all services are delivered in-house and subsidiary companies are brought back in-house;

Repeal the Health and Social Care Act, reinstating the responsibility of the Secretary of State to provide a comprehensive and universal health service;

Discontinue UK-US trade talks until President Trump has amended the US negotiating objectives to:

a) Exclude any reference to pharmaceuticals;

b) Accept the role of the National Institute for Health and Care Excellence to set the threshold for the cost-effectiveness of drugs for the NHS;

c) Explicitly rule out US companies gaining access to UK public services through investor-state dispute settlement mechanisms beyond the reach of UK domestic courts.

With polling day fast approaching, full transparency about the threat to the future of our NHS is vital.

The public need to know that all aspects of our health service are genuinely off the table in any UK-US trade talks, and that no part of the NHS or our health system will be up for sale.

I look forward to receiving your clarification.