I’m in awe of our NHS – we must not let it be destroyed

This is not perhaps the moment to make political points but then I did not ask the ignorant, misogynistic bully who occupies the White House (on a minority vote) to pitch up in London and announce that UK health needs will henceforth be subordinated to the profit demands of US capitalism.

Since the 2008 global bank crash, the value of US health stocks has increased an astonishing six-fold, thanks in part to the Obama “reforms” (which effectively use public money to subsidise private medical insurance firms) and to Trump’s latest corporate tax cuts. The trouble is that corporate greed feeds on itself in the capitalist system. American health insurers need to go on delivering these insane stock gains or be punished by the market (ie private equity funds). Result: the US health insurance industry desperately needs to colonise the British health care “market” over the next decade.

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The superb treatment received by my Angela and millions of others is now under existential threat.

Once the US medical leeches get their profit-driven hands on our NHS, costs – paid by the taxpayer or individual – will skyrocket. In particular, any public barrier to drug companies overcharging for medicines will disappear.

Of the top 10 American industries by profitability, pharmaceuticals come top with the big internet and software giants down at fifth. The average profit margin for US drug companies is circa 14%, according to a 2018 study by New York University’s School of Business.

But many companies have margins far greater than that. Gilead Sciences and Amgen are among the most profitable drug makers, with net margins of 35 to 45%.

But isn’t this cash used to subsidise new drugs? Bollocks. There is no correlation between the jump in drug cartel revenues and their research outlays. According to a 2017 report by the official US Government Accountability Office, sales revenue from commercial drugs in America increased from $534 billion to $775bn, between 2006 and 2015. That’s up 45%.

But spending on research in the same period rose from circa $80bn to $90bn, or only 12.5%.

The potential health market (and hence profits) just keeps growing. Between 2017-22, global health spending is expected to rise 5.4% cent annually to $10 trillion. Consumer tastes are fickle, and recessions come and go. But the need for human health care is not just a constant – it is exploding as a result of the poisoning of human beings through crap diet and the stressful lifestyle that follows from turning every human being into a consumer unit for global capitalism. That $10 trn global health market will just grow and grow. And Wall Street knows it.

One key battleground is the price paid for drugs by the UK NHS. This is a central issue for Trump, who is heavily funded by big US pharma companies. The NHS spent £15.4bn on medicines in 2016-17 – only salaries cost more. The price of medicines in the UK is governed by a voluntary agreement called the Pharmaceutical Price Regulation Scheme, which is negotiated between the global industry and the UK Government. This scheme has been in place since as far back as 1957. As a result, wholesale prices to the NHS of all drugs – including those sold by the big US pharma groups – are much cheaper.

Trump wants to end this scheme, or at least force the NHS to pay higher drug prices for US drugs. This – not letting US medical insurance companies take over direct NHS provision for patients – is the central demand the Trump administration has been pursuing. Do not be fooled. Trump can easily say he will not demand access to direct health care provision in the UK for US providers. But he will insist – as a key demand in any future trade talks – that the UK buys American pharmaceuticals at market prices.

For Trump, this is no minor issue. His left-wing Democratic opponents in the 2020 presidential election plan to run on a platform of introducing a British-style, socialised health care system. Trump is under fire – even from his wife Melania – for being too close to the big drug companies. Result: Trump has made a show of meeting with the pharma companies and telling them to lower prices. But that is just for show. The only way he can conceivably persuade US drug firms to charge American consumers less is if they can recoup any lost profits elsewhere. And that elsewhere is in Britain. Trump wants to charge the NHS more for drugs. His re-election depends on it – literally.

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A post-Brexit UK that is dependent on a US trade deal will, in the end, succumb to American financial blackmail – especially regarding the NHS. Quite literally, our lives are now in peril. Despite spending a much higher proportion of GDP on health (which effectively goes into profits) America has a poorer record on mortality rates compared to the other industrial countries for most major disease groups. Our lives, and those of our loved ones, now depend on thwarting Brexit.

Finally, can I thank all those hundreds of people who have written or messaged with kind thoughts on Angela’s passing. For more than 40 years she was a force of nature in the Scottish arts world, EIS and Yes politics. Her arts career included serving as chair, director, fundraiser, education officer or curator of a host of cultural organisations including the Traverse Theatre; the Fruitmarket, Demarco and 369 galleries; the Edinburgh International Festival, the Edinburgh Book Festival, the Northlands Festival and StAnza poetry festival; Celtic Connections and the Scottish Sculpture Trust.

Internationally, she curated Scotland’s first official presence at the prestigious Venice Biennale since 1897 and commissioned the Scottish contribution to Stavanger’s reign as European City of Culture in 2008.

Angela was a passionate feminist and a committed European.

In 1974, she was a key member of the coordinating committee of the unofficial EIS strike that brought 30,000 young teachers out of their classrooms, resulting in a 30% increase in teachers’ pay. In 2000, Angela became full-time director of the Hansard Society in Scotland, where she pioneered civic education in schools. Her last job was as my full-time constituency assistant in East Lothian.

In the oft factious world of Scottish politics Angela won many friends and admirers. Her passing has evoked condolences from across the divide, including from Alex Salmond, Culture Secretary Fiona Hyslop and Angus Robertson in the SNP; and from Lord George Foulkes, Ian Gray MSP and John McTernan in Labour. There were also official condolences from Plaid Cymru, the SDLP in Northern Ireland and the Catalan delegation in London; and from friends across the Europe she claimed as her homeland.

I stand in awe of the superb treatment Angela received from the Scottish NHS, since she was diagnosed with cancer in 2010.

I want others to go on receiving that level of care. If you want a reason to vote for Scottish independence, this is it.