Abstract
This chapter differs somewhat in its approach to governance issues compared with the previous chapters as it goes beyond the national framework. In essence, the national and sub-national issues at stake do not quite capture the full picture when considering the future challenges of the provision of public healthcare services in the UK. This chapter looks at healthcare service exchanges across borders. Indeed, there has been a significant expansion of services trade, and in particular health services, which have grown not only thanks to a number of institutional frameworks but also to the support of the British government and health stakeholders. However, there are also a number of risks involved in the international exchange of health services, which can have a significant impact on public healthcare systems.
TopIntroduction
The international exchange of health services is a rather new development in the UK, but it would seem that the furthering of trade and investment in this sector could have a significant impact on the National Health Service (NHS). The British government and regional authorities are increasingly being warned by civil society and academics alike to bear in mind the risks of the globalisation of health on the British population. Yet limited data exists on the impact of advancing health services across borders with most studies looking at the overall negative effects on public health from trade liberalisation more generally. Health products, notably pharmaceutical goods, are part and parcel of the internationalisation process. However, the impact of the internationalisation of healthcare services, and especially the effects on public health provision, while gaining much media attention, particularly with the negotiation of recent Regional Trade Agreements (RTAs) to free up trade and investment, has remained largely allusive and has been given insufficient attention. The final chapter of this publication will thus examine the issues that have arisen from such processes, how they affect national governance and what might be the implications for public health service provision in Britain.