Letter to Regional Health Board Chairs:

[Chair

X Regional Health Board

Address]

Dear Chair,

The New Zealand Government is currently engaged in negotiations at the World Trade Organization to extend the free trade agreement on services known as the General Agreement on Trade in Services (GATS). It is due to table its initial ‘offer’ to commit further services to these rules in Geneva on 31 March 2003.

There is strong international concern that this agreement locks in a market model of health care that has failed to provide accessible, quality and affordable health services for all. In December 2002, for example, Save the Children wrote to the Guardian:

“When it comes to basic services such as healthcare . . . all governments have a prior obligation under human rights law to meet their own people’s needs first. This is the blind spot in current WTO Gats negotiations. Trading off market access opportunities against each other on purely economic grounds fails to address the negative social impacts of services liberalization in rich and poor countries alike.”

The GATS has potentially serious implications for the ability of the regional health board to choose how you meet the needs of our community. It could prevent you from giving preference to local providers of services or limiting the access of foreign companies to the services for which you are responsible, and restrict how you regulate those services. Despite this fact, there was minimal consultation with local health authorities when the original agreement was signed in 1994, and the same is happening again now.

Assurances from the Government that health services will not be brought under this Agreement cannot be taken at face value. The GATS requires governments to engage in ‘progressive liberalization’. The New Zealand’s Government’s stated position at the WTO is that commitments on all services should be made by all countries, and it is committed to free trade in services by 2010 within the APEC region.

According to this Agreement, health-related services come under many headings, not just that of health and related services. Nurses, midwives, paramedics and dentistry, for example, all come under the heading of Business Services. The Government has already committed dentistry, ambulance and aged care homes to free trade rules under the Closer Economic Partnership agreement with Singapore. There is a serious concern that the Government could do the same in the current GATS negotiations. Other ancillary services, such as cleaning, catering, laundry, testing, construction, data bases and health insurance are also sub-sectors that could be governed by these rules, limiting how regional health boards can operate in these areas.

The GATS also contains provisions that restrict the domestic regulations that governments can adopt in professional qualifications, licensing and technical standards. Current negotiations may see these extended to health services, even if the Government has not committed these services to the GATS rules.

The Government issued a technically worded consultation document on these negotiations on 30 January 2003, requiring a response by 28 February. This is simply not good enough.

I understand that you have received a copy of Serving Whose Interests?, prepared by Professor Jane Kelsey for the Action Research and Education Network of Aotearoa (ARENA), which sets out the current and potential implications of the agreement for New Zealand. I also suggest that you read the report from Hilary, J. The Wrong Model: GATS, trade liberalization and children’s right to health, Save the Children, November 2001, www.savethechildren.org.uk.

I urge you to put this issue on the next Regional Health Board agenda as a matter of the utmost urgency and to write to the Minister demanding that the Government takes no further steps in the GATS negotiations, and that instead it embarks on a full and informed consultation with regional health authorities and their professional and community constituencies.

Please inform me of the Board’s position on this vitally important matter.

Yours sincerely,