2020 has been the most difficult year that I and many of my colleagues have ever experienced as NHS workers. Underfunding, Covid-19 and frequent reorganisations have brought the NHS to its knees, and yet these same crises have highlighted the value of our national, publicly-funded, publicly-provided health service. So the news that the Lords have voted this week to protect the NHS in future trade deals was more welcome than ever.

International trade influences every facet of our lives and livelihoods. Markets in labour, goods and services bring enormous benefits, but there is a reason that governments spend so long negotiating the terms of trade deals – there is a lot at stake. In the past, the EU has negotiated international trade deals on behalf of the UK.

Post EU exit, when the UK negotiates its own trade deals, there is a risk that we could be forced to accept the lowest bid regardless of a healthcare provider’s standards of care, protection of health data, understanding of local needs, and willingness to support training of staff and nurturing of good practice to allow the NHS to thrive. However, with attention to how they are negotiated, we can ensure that trade deals do not bring dangerous products (such as food containing unsafe levels of pesticides or other chemicals) onto our shelves. We can protect health services so that they can continue to be provided as public services.

I was both surprised and delighted when I heard about the Lords’ debate and votes on the UK Trade Bill; a piece of legislation which will lay the foundations for trade deals between UK and other nations following our exit of the EU. Despite the groundswell of public support for the NHS, the numerous direct letters, articles and phone calls, and a petition over 300,000 signature-strong that have called the Lords to give their support to the NHS, I admit that I feared the worst.

But, in this instance, the House of Lords has demonstrated a greater capacity to promote the will of the public than we have seen from MPs in Parliament. The Lords voted in favour of an amendment to the Trade Bill to protect the NHS and other UK health services by keeping them out of future trade deals, and therefore out of the international healthcare market.

Furthermore, the Lords voted for an amendment to the Trade Bill which could facilitate a more democratic process in negotiation of future trade deals. It has been called the ‘scrutiny amendment’ and it mandates that MPs would be provided with information about the objectives and terms at the start of a trade deal negotiation and have chance to vote on the text of the trade deal before the negotiations close.

The Lords strongly supported the scrutiny amendment; 233 votes for and only 143 against. The debate demonstrated that they had listened to those who had written to inform them about what was at stake and the implications of allowing trade deals to be negotiated in secret behind closed doors. Organisations including Global Justice Now, the Trade Justice Movement, We Own It, the Hansard Society and Keep Our NHS Public have been working with their members to research the implications of the Trade Bill, and to inform MPs through briefings, letters and conversations.

The next step is that the Trade Bill will go back to the House of Commons where MPs, our elected representatives, will vote on whether to uphold the amendments that the Lords have voted in. Ironically, there is a risk that MPs will vote against the Parliamentary scrutiny amendment, the amendment which givens MPs the chance to have say on the content of trade deals.

It is in MPs’ job descriptions to represent the views of their constituents – of you, of me, of the UK public. Yet, last time that MPs voted on the Trade Bill, before it went to the House of Lords, they did not represent the 75% of the public who said in a Survation poll that they want the NHS to be protected in future trade deals, or hundreds of UK health professionals who signed an open letter asking MPs to vote for the scrutiny amendment and to keep the NHS off the table in trade deals.

2020 has seen displays of public support for the NHS across the length and breadth of the country. If anything, Covid-19 has only made it more obvious that a fragmented health service, where some can afford it and others can’t, is not good enough.

For me, it was a breath of fresh air to see that the Lords have listened to what health professionals, trade experts and the public know and believe in. We now need to make it clear to MPs that they must not reverse the positive direction that the Lords have set.

For our NHS to recover from recent challenges, for me to be able to continue to provide health services without checking that my patient has their insurance papers or their bank card, MPs must follow the example of the Lords. They must say ‘aye’ to Trade Bill amendments that protect a democratic process and keep the NHS off the table in future trade deals.