Brexit and the battle for public health Reply

The Health and Sport Committee of the Scottish Parliament has produced its report into “The Impact of Leaving the European Union on Health and Social Care in Scotland”.

ASH Scotland made a written submission to their consultation, and then presented to one of the oral evidence sessions, so we were interested to see what the report would say.

Our view on Brexit is that there are both opportunities and risks, although we do appreciate that this is hardly a radical or unique take on the Brexit process.

For us the key message in any trade negotiations is that powers/freedoms/rights granted to companies selling harmful products (with tobacco companies being the go-to example of that category) mean reduced opportunities for governments to regulate the production, marketing and sale of those products. This is a clear zero-sum game – if one side gains the other loses.

There have been public health gains from EU membership that we would not like to lose (such as  partnership action on illicit tobacco, enhanced health warnings on packs, standards on electronic cigarettes and an eventual ban on menthol cigarettes), although these will generally be transcribed into UK law and will continue unless specifically changed.

On the other hand there are EU restrictions that currently make public health interventions more difficult, and removing these could pave the way for some creative public health interventions.

For example EU regulations currently stand in the way of setting license fees at rates that raise income. If the EU regulation was removed it would be easier to look at charging license fees that could raise funds for health services or for supporting retailers to diversify to less harmful products with better long-term prospects.

Any Scottish Government action to add plastic cigarette butts to the list of plastic items considered for restrictions would currently need to be notified to the EU, where any member state can oppose it on the grounds of it restricting internal trade in such products.

And of course the recent example of Minimum Unit Pricing for alcohol shows how a commercial appeal to EU protections can be used to oppose a popular, democratically-supported public health measure.

The Committee has taken much of this on board in its report, indicating that public health measures should not be undermined in future trade deals and expressing concern over the kind of investor-state dispute mechanisms we have previously argued give too much influence to commercial interests.

In any negotiations and/or new trade agreements we will look to see where the benefits lie – with the profits and market access of tobacco companies or with the health and well-being of the people of Scotland.

This report will now be passed on to those involved in the current, and any future, negotiations. Let’s hope they take note.

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