Brexit and trade policy: an analysis of the governance of UK trade policy and what it means for health and social justice

Abstract

Background There is an extensive body of research demonstrating that trade and globalisation can have wide-ranging implications for health. Robust governance is key to ensuring that health, social justice and sustainability are key considerations within trade policy, and that health risks from trade are effectively mitigated and benefits are maximised. The UK’s departure from the EU provides a rare opportunity to examine a context where trade governance arrangements are being created anew, and to explore the consequences of governance choices and structures for health and social justice. Despite its importance to public health, there has been no systematic analysis of the implications of UK trade policy governance. We therefore conducted an analysis of the governance of the UK’s trade policy from a public health and social justice perspective. Results Several arrangements required for good governance appear to have been implemented – information provision, public consultation, accountability to Parliament, and strengthening of civil service capacity. However, our detailed analyses of these pillars of governance identified significant weaknesses in each of these areas. Conclusion The establishment of a new trade policy agenda calls for robust systems of governance. However, our analysis demonstrates that, despite decades of mounting evidence on the health and equity impacts of trade and the importance of strong systems of governance, the UK government has largely ignored this evidence and failed to galvanise the opportunity to include public health and equity considerations and strengthen democratic involvement in trade policy. This underscores the point that the evidence alone will not guarantee that health and justice are prioritised. Rather, we need strong systems of governance everywhere that can help seize the health benefits of international trade and minimise its detrimental impacts. A failure to strengthen governance risks poor policy design and implementation, with unintended and inequitable distribution of harms, and ‘on-paper’ commitments to health, social justice, and democracy unfulfilled in practice. Although the detailed findings relate to the situation in the UK, the issues raised are, we believe, of wider relevance for those with an interest of governing for health in the area of international trade.

Fiscal Decentralization, Public Health Expenditure and Public Health–Evidence From China

“…The control variables are variables other than explanatory variables that may affect population health. Economic development, scientific and technological advancement, degree of urbanization, international trade and air pollution are closely related to public health improvements ( 20 – 22 ). The number of hospital beds and the density and distribution health workers are important embodiments of the resource level of the public healthcare system ( 23 ) and are confounding factors of public health.…”

Challenges of International Trade and Government Governance from the Perspective of Economic Globalization

“…At the national level in China, the macroeconomic forecast business of the National Macroeconomic Information Center is responsible for forecasting the main changes in China's domestic import and export economy, this year according to China's current domestic macroeconomic conditions and policy characteristics. e forecast results of the economic information center will become the most important basis for formulating Chinese government measures [13]. Figure 1 shows the total import and export trade volume of Shenzhen.…”

Impact on the NHS and health of the UK's trade and cooperation relationship with the EU, and beyond

“…In terms of the impact on health, this creates an increased risk of negative impacts from uninformed regulation on which there is a lack of stakeholder input; risks that will continue if similar trade deals in the future follow the same pattern (Van Schalkwyk et al ., 2021). The COVID-19 pandemic has shown the limits of government omniscience, especially in technical areas such as health.…”

“…Health occupies a peripheral place in the relevant legal texts. Yet, all trade agreements have important consequences for health (Barlow et al ., 2017; Gleeson and Labonte, 2019; Van Schalkwyk et al ., 2021). These agreements are no exception.…”