Britain’s medicine prices are among the lowest in the world, thanks to the NHS’s buying power, and the tough value-for-money tests imposed by the National Institute for Health and Care Excellence. This is a major bone of contention. US prices are 2.5 times higher than ours, and Donald Trump thinks that Americans are “subsidising” low prices abroad, which is “unfair” and “ridiculous”. The US pharmaceutical industry wants to charge the NHS more, not just because the UK is a big market: NHS prices are used as benchmarks for 14 other nations.

Dr Andrew Hill of Liverpool University calculates that, in the worst-case scenario, the NHS drugs bill would rise from £13bn to £45bn – a massive extra expense. The Tory manifesto promises that neither the NHS nor drug prices will be “on the table”, but leaked documents noting preliminary talks show that the subject is certainly on the agenda: “competitive pricing” and extending patents for American drugs were both mentioned. US negotiators have driven hard bargains on drugs in recent deals with South Korea, Canada and Mexico. Britain would be a weaker partner in any deal and might find it hard to resist some concessions. (The Week 14 Dec 2019)

Meanwhile, polls show that British people overwhelmingly oppose privatization of the National Health Service. A 2017 YouGov survey found that 84% were against it., even as it has been, under the radar, significantly privatized already.  For right-wingers in power anything that doesn’t make a profit for themselves or their buddies is (horror!) socialism (several visits to a local private hospital last year suggest that the well-off are well- insured and use private doctors and hospitals already, so they are o.k, yes?).  The fact is that the private sector is now so embedded in the NHS that it cannot afford to sacrifice any of its capacity.  After France, Britain has had (past tense) the best health service in the world, until recently mostly free at point of delivery, even if expensive to the taxpayer. The NHS has offered peace of mind to the sick and the aged for seventy years; an Epicurean project.   Rest in peace?