Keir Starmer's government has pushed through a medicine deal with the United States that independent experts say will cost the NHS billions and lead to hundreds of thousands of excess deaths, yet the treaty received almost no democratic scrutiny.
Deal details and lack of transparency
In December, Starmer and then-President Donald Trump agreed that the UK would spend more on branded drugs in exchange for the US not raising tariffs on British pharmaceutical exports. The Department of Health and Social Care, led by Wes Streeting, provided almost no detail on costs or consequences. The deal was enacted via a statutory instrument, bypassing full parliamentary debate.
Only after the deal came into effect did the government publish headline figures, sneaking them out before the Easter bank holiday. MPs finally debated the changes this week, but Labour backbencher Rachael Maskell told the Guardian, "long after the horse has bolted."
Cost analysis and impact
An analysis published in the British Medical Journal by three senior health researchers, including a former senior adviser to the National Institute for Health and Care Excellence, suggests the public has been misled. Streeting made three promises: the NHS is not on the table, no cuts to NHS services to fund the deal, and the cost would be around £1bn a year. All three now appear false.
The government will double drug spending as a share of national income from 0.3% to 0.6% over a decade. The BMJ analysis estimates the NHS will have to find almost three times the amount pledged by Streeting in the next couple of years, totaling £44.7bn by the end of the decade. For perspective, this week's headlines focused on a plan requiring an extra £15bn for defence, while the NHS may need triple that just for drugs.
Impact on public health
The extra money will flow from British taxpayers to shareholders of multinational drug companies. The study forecasts that this will cause an extra 229,000 deaths by 2036, based on data linking NHS spending to patient health. The academics describe this as a "conservative" estimate, but it is nearly double the avoidable deaths during the Covid pandemic.
The Department of Health and Social Care told the Guardian it does not recognise these figures but has not published its own impact assessment, despite requests from MPs. No inquiry by select committees on health, trade, or science has been conducted. The media has also been largely silent: national newspapers published only eight stories on the deal in six months, compared to 274 stories on whether Wes Streeting would become the next Labour leader.
Democratic failure
Aditya Chakrabortty, the Guardian columnist, argues that this represents a vast democratic failure. The deal was cooked up in private and shrouded in secrecy. He calls on the next prime minister, likely Andy Burnham, to reconsider the treaty. "Here's a test for Andy Burnham: is he really going to let this fatal deal stand?"
