Politics and Governance (ISSN: 2183–2463)

2023, Volume 11, Issue 1, Pages X–X

https://doi.org/10.17645/pag.v11i1.5923

Article
Embedded Liberalism and Health Populism in the UK in a Post‐Truth Era
Louise Dalingwater

Faculty of Arts and Humanities, Sorbonne Université, France; louise.dalingwater@sorbonne‐universite.fr

Submitted: 21 June 2022 | Accepted: 25 November 2022 | Published: in press

Abstract
The National Health Service (NHS), as a symbol of public health protection in the UK, was weaponised in pro‐Brexit debates.
It was suggested that European integration might inherently have undermined embedded liberalism and notably con‐
tributed to what Ruggie described as the “unbundling of sovereignty” (Ruggie, 1993). The manipulation of the NHS by
right‐wing populists has already been the focus of a number of articles, but calls to protect public health care from global
threats have also come from left‐wing politicians and activists. This article is particularly interested in socialist populist
appeals to protect health care. It aims to show that for socialists the compromise between capital and labour and the pro‐
tection of welfare systems, which is referred to as embedded liberalism, has not been achieved. In fact, furthering trade
and investment is currently seen to be compromising the last remnants of a welfare state, which is embodied by the NHS
in the UK. This conceptual article will thus start by presenting the theory of embedded liberalism. It will then establish the
link between the breakdown of embedded liberalism in relation to health care systems. It will finally present populist and
activist narratives on health and the UK’s national health service from an international perspective. It draws on secondary
literature and a corpus of popular press articles and grey literature produced by civil society organisations.

Keywords
embedded liberalism; National Health Service; populism; UK

Issue
This article is part of the issue “Re‐Embedding Trade in the Shadow of Populism” edited by Kevin Kolben (Rutgers Business
School) and Michèle Rioux (Université de Québec à Montréal).

© 2023 by the author(s); licensee Cogitatio (Lisbon, Portugal). This article is licensed under a Creative Commons Attribu‐
tion 4.0 International License (CC BY).

1. Introduction notably protect the NHS. The manipulation of the NHS

by right‐wing populists has already been the focus of a
The literature on embedded liberalism rarely points number of articles, but calls to protect public health care
specifically to questions of health, but it is in fact in the from global threats have also come from left‐wing politi‐
area of public health care where the necessity to achieve cians and activists. This article is particularly interested in
a compromise between driving an efficient global mar‐ socialist populist appeals to protect health care. It aims
ket and the protection of citizens’ interests is perhaps to show that for socialists the compromise between cap‐
the most salient. The National Health Service (NHS), as ital and labour and the protection of welfare systems,
a symbol of public health protection in the UK, was which is referred to as embedded liberalism, has not
weaponised in pro‐Brexit debates. It was suggested that been achieved. In fact, furthering trade and investment
European integration might inherently have undermined is currently seen to be compromising the last remnants
embedded liberalism and notably contributed to what of a welfare state, which is embodied by the NHS in the
Ruggie described as the “unbundling of sovereignty” UK. This conceptual article will thus start by presenting
(Ruggie, 1993). Since the UK’s departure from the EU, the theory of embedded liberalism. It will then estab‐
both the Vote Leave campaign and British governments lish the link between the breakdown of embedded lib‐
have argued that Brexit has offered the opportunity for eralism in relation to health care systems. It will finally
the UK not only to regain sovereignty to pursue free present populist and activist narratives on health and the
trade, but also to enhance the provision of welfare, and national health service in the UK from an international

Politics and Governance, 2023, Volume 11, Issue 1, Pages X–X 1

perspective. It draws on secondary literature and a cor‐ skills within an institutional framework characterised by
pus of popular press articles and grey literature produced strong private property rights, free markets, and free
by civil society organisations. trade” (p. 2). The early 1980s can be seen as a turning
point when neoliberal policies were introduced in the US
2. From Embedded Liberalism to Neoliberalism under Ronald Reagan, and by Margaret Thatcher’s new
right government in the UK. The policies included the
Building on Polanyi’s work (1944) Ruggie’s seminal article privatisation of many state‐owned enterprises and the
published in 1982 first presented the idea of embed‐ deregulation of the labour market to promote increased
ded liberalism as a compromise between driving an effi‐ flexibility and a withdrawal of the state. The latter thus
cient global market and serving or protecting the inter‐ became the regulator of free market policies and free
ests of citizens (Ruggie, 1982). Ruggie describes the trade. In the UK, the Conservative governments of the
post‐war regime or compromise as a “form of multi‐ 1980s promoted global capital mobility and the impor‐
lateralism that is compatible with the requirements of tance of global market forces, even in areas such as pub‐
domestic stability” (Ruggie, 1982, p. 399). Compensation lic services where conventional market systems are often
came in the form of welfare systems, particularly in the considered to be unsuitable. From the 1980s, there was
post‐war period, but also Trade Adjustment Assistance an overhaul of key government sectors, privatisation in
programmes, which included unemployment insurance some sectors, and marketisation and commodification
and job training (Rahman, 2017). Wolfe and Mendelsohn of others including in public health services.
(2004) posit that embedded liberalism is by no means In his analysis, Harvey (2005) argues that neoliberal‐
a fixed agreement on levels of social spending, pro‐ ism is in sharp contradiction to “embedded liberalism” of
tectionism and the like, but a dynamic concept which the post‐war period when Keynesian demand‐side poli‐
allows countries to adjust to the multilateral frame‐ cies were applied, state spending increased, and gener‐
work. Referring to this notion of embedded liberalism, ous welfare protection was provided.
Rodrik (1997) explains that it involves creating a posi‐
tive relationship between openness and public spending. 3. The Breakdown of Neoliberalism and the Rise
Populations rely on the role of expanded government to of Populism
compensate for greater external risks.
While Ruggie’s conception of embedded liberalism However, especially since the financial crisis of 2008,
was about much more than trade, this article will be look‐ the neoliberal compromise has also started to fall
ing at the challenges to embedded liberalism within the apart owing to what Wolfe and Mendelsohn (2004)
realm of trade in line with the focus of the thematic issue. call “negative globalisation experiences,” which have
Ruggie argues that free trade has flourished since the resulted in anti‐globalisation, anti‐incumbent attitudes,
post‐war period thanks to compensation programmes and support for populist parties and candidates. Higgott
for individuals who might potentially lose out from open (2018) describes populism as a “contested, heteroge‐
borders (Ruggie, 1982). But most historians in the UK do neous, imprecise and stylistic discursive concept which
not refer to the notion of embedded liberalism when can be characterised by political behaviour which seeks
analysing the situation in this country, they talk about to appeal to the past and ensure spontaneous national
social democracy, which made a very brief appearance moral regeneration” (p. 7).
in this country between the 1940s–1970s. During the Brubaker (2017) considers populism to arise in
post‐war period, this led to the establishment of a com‐ response to long‐term structural issues and not immedi‐
prehensive welfare state including the UK’s NHS as a cen‐ ate problems or threats. There has been a rise in pop‐
tral part of welfare provision, collective bargaining, and ulist, essentially right‐wing, movements and parties in
generous state spending. Vernon (2016) underlines that Europe and the US since the 1980s; and particularly
this was short‐lived because of global conditions and the since the Great Recession of 2008, with the rise of the
overriding demands of free market capitalism faced with Tea Party and Donald Trump’s 2016 presidential victory,
internationalisation. but also in the UK, clearly evident during the debate in
Wolfe and Mendelsohn (2004) note that Ruggie’s the lead up to the referendum on the UK leaving the
essential conception of embedded liberalism, the European Union. Populist trends have been interpreted
implicit bargain between governments and citizens as a reaction to cultural change since the 1970s: changes
which ensures that governments will protect citizens to lifestyles, religions, and cultures which populist sup‐
from the negative impacts of the global economy, was porters tend to oppose, especially the elderly, white and
called into question from the 1980s onwards. In fact, the less educated males. They fear the upheaval or disap‐
ushering in of neoliberal policies served to undermine pearance of their own traditional social values. Populist
the social contract. While it is a somewhat contested politics can also be aligned with other ideologies, be it
theory and paradigm, Harvey (2005) describes neolib‐ socialist or nationalist, in order to achieve wider political
eralism as “a theory of political economic practice that agendas (Speed & Mannion, 2017). Closely connected to
proposes that human well‐being can best be advanced populism is the rise in nationalism because, as Inglehart
by liberating individual entrepreneurial freedoms and and Norris (2016) observe, populism tends to favour

Politics and Governance, 2023, Volume 11, Issue 1, Pages X–X 2

monoculturalism over multiculturalism. It also supports course the US. The objective of achieving further liber‐
national interest over international cooperation and alisation of trade through future trade deals post‐Brexit
open borders. While the focus of most populism is pro‐ raises further challenges for public health protection in
tecting borders from immigration, it can also extend to the UK.
a rejection of multilateralism and the global economy. Since leaving the EU, the British government has
Higgott (2018) argues that some of the populist argu‐ been pursuing an independent trade policy and pri‐
ments against globalisation are not without foundation. oritising free trade agreements, notably with the US,
The rise of global economies has indeed placed limits on Australia, and New Zealand. It has also requested to
national democracies and constrained the decisions of join the Comprehensive and Progressive Trans‐Pacific
sovereign states. Moreover, in the post‐Brexit period, it Partnership (House of Commons, 2020). This has raised
is indeed populist appeals in the realm of public health concern about the effects on public health and the
care which are of interest here. NHS following further trade liberalisation of services.
The fear generally is that this may reduce the ability of
4. The Demise of the Liberal Compromise and Public the government and devolved administrations to gov‐
Health in the UK ern and fund public health services. The debates on
the NHS have mainly focused on risks relating to its pri‐
Turning our attention now to the debate on embedded vatisation as a result of signing trade and investment
liberalism, populism, and public health in the UK: How deals post‐Brexit. Opponents have underlined what is at
does the populist turn and the demise of both the liberal risk for the UK in the trade arena post‐Brexit. The fear
compromise and neoliberalism relate to the health sec‐ is that these agreements may well “lock in” the lib‐
tor? The decline of welfare provision, increased inequal‐ eralisation of services which could prevent countries
ities, and the fear of cultural changes can explain why from intervening with restrictions or regulating in the
there has been a rejection of globalisation in the UK. national interest. Carve‐outs have been introduced to
Embedded liberalism and health care are not protect public services, but private companies under cur‐
debated in the literature, but health care is an area rent NHS legislation can still bid for contracts to pro‐
where a compromise between driving an efficient global vide NHS services in England. Under the Investor State
market and the protection of citizens’ interests is surely Dispute Settlement (ISDS), provisions in many of the
needed. This compromise has never really been achieved agreements (free trade agreements, bilateral investment
even in the post‐war period. International institutions, treaties) may undermine national legislation in order to
the European Commission, and national governments give greater power to investors. So the fear is that these
claim that the delivery of public health care is protected future trade deals may well enable foreign investors to
in international trade agreements and a compromise has challenge national governments in tribunals provided for
been reached in trade deals with carve outs for public under ISDS and claim compensation to carry out NHS
services in the General Agreement on Trade in Services contracts. Intellectual property rights are another cause
and subsequent regional and bilateral trade agreements. for concern because such rights could affect the provi‐
However, there is a wealth of literature which has under‐ sion of public services. Future trade agreements may well
lined that furthering trade and investment has had a net change medicine pricing and could also allow access to
negative impact on social welfare and population health NHS data (House of Commons, 2020). So we might con‐
(Andrews & Chaifetz, 2013; Blouin et al., 2009; Labonté, clude that populist appeals from the left are not with‐
2004; Labonté et al., 2009; Shaffer et al., 2005; Smith out foundation.
et al., 2009; Stiglitz, 2006, 2009). Empirical evidence has
shown that increased trade and investment agreements 5. Populism, Activism, and Save Our NHS Campaigns
have exacerbated unequal access to health services and
increased public bads (Baker et al., 2016; Schram et al., Speed and Mannion (2020) underline how political ide‐
2013, 2015; Smith, 2012; Thow & Gleeson, 2017). This is ology in the realm of health care is central to policy
a result of provisions in trade and investment deals that frameworks. Lasco and Curato (2019) have even invented
may limit access to medicines, constrain policy space for the term medical populism, which implies an appeal
health, and limit the scope that governments have to pur‐ to the people about perceived threats to public health
sue public health goals. Moreover, those public health and safety. Crisis health care is another popular compo‐
systems which have significantly liberalised public ser‐ nent of medical populism whereby populists underline
vices through marketization, such as the UK (and espe‐ that there are threats to collective interests of health
cially in England), are those which may be the most under care interventions (moral panics). Medical or health pop‐
threat. So the UK’s public health system, which is epito‐ ulism tends to be stronger in countries which have either
mised by the NHS, could well be under threat from the completely privatised systems or have undergone signif‐
development of a two‐tier system whereby health care is icant reforms to introduce a privatised or marketised
increasingly provided more efficiently by the private sec‐ component into the health care system. This is the case
tor at the expense of the public sector. There are exam‐ in the UK, wherein new public management reforms
ples where this is already the case, such as Israel and of led to an introduction of tendering out to the private

Politics and Governance, 2023, Volume 11, Issue 1, Pages X–X 3

sector, a command and control system, and diminished culated the fee at £250 million a year (Full Fact, 2017).
levels of trust. As a result, the populist health discourse In addition, it did not take into account the payments
post‐Brexit has led to welfare chauvinism, limited access which were made to UK farmers and regions. Given the
to care for immigrants, racism, and mistrust of the other costs of Brexit, even at the outset, it looked very unlikely
(Lasco & Curato, 2019). Another part of the discourse that there would be financial benefits from withdrawal
is also ensuring that existing structures remain intact. which could be reinvested in the NHS. Yet the Vote Leave
Health populist discourses which play on the popula‐ campaign was able to play on the emotions of the British
tion’s emotions became paramount during and beyond people by suggesting that an institution, much beloved
the Brexit campaign. by all, was under threat. Indeed, according to a Mori
The NHS is often projected as a symbol of all that poll, commissioned by the Health Foundation, protecting
is good in the UK, a fantasy of equality and the incar‐ the NHS from cuts was considered to be important for
nation of a socially cohesive and equal nation (Hunter, the majority of the general public, with 88% stating that
2017). It could be qualified as the last remnant of the the NHS/health care was the main area of public spend‐
welfare state, so in the context of embedded liberalism ing that should be protected (The Health Foundation,
the fear is that public health care is in jeopardy given 2017). Since the British population is aware of the finan‐
the prospect of further liberalisation. This institution is cial strains on the NHS through the press, galvanising fear
therefore an ideal target for populists to conjure up ideas of losing such a precious institution was a clear objective
from the past and the importance of keeping up past of the Vote Leave campaign.
traditions. That is the creation of a universal health sys‐ The remainder of this article considers how politi‐
tem following the post‐war settlement. Despite marketi‐ cians, activists on the left, and the populist left‐wing
sation, this ideal has been upheld but has also been media used similar techniques to those of the right to
weaponised because it is perceived as being under threat defend the NHS in future trade deals owing to fear of
from liberalisation. Fear of privatisation has increased the demise of the social compromise to protect health
in recent years and particularly since the enactment of from the excesses of globalisation in a post‐Brexit era.
the 2012 Health and Social Care Act, which has encour‐ Further liberalisation post‐Brexit has served as an emo‐
aged further contracting out of public health services tional trigger and proxy, scapegoat, or metaphor for
to the private sector. Beyond the domestic sphere, the the larger concern about the relationship between eco‐
study of this institution in an international context is an nomic liberalisation and the provision of domestic social
excellent example of how emotions can be galvanised welfare programmes. This relates to the compromise
by the state and sub‐state actors to support a case for whereby economies liberalise but nation‐states maintain
the demise of social democracy and especially health the ability to regulate domestically and provide social ser‐
democracy. As Wolfe and Mendelsohn (2008) point out vices, in part to blunt the negative effects of free mar‐
“opponents of globalisation are primarily concerned that ket economies. In practice, this is evident in the popular
it will damage cherished symbolic goods” (p. 224). While left‐wing press.
debates on compensation for the effects of increased lib‐
eralism generally focus on labour dislocation, ensuring 6. Social Populism and NHS Protectionism
that health and public health services are protected fol‐
lowing increased liberalism is no less important within The opposition party and civil society organisations have
this compromise. engaged in populist rhetoric to save the NHS. Left‐wing
Attention to the NHS from an international perspec‐ or social populism has not been given much attention
tive started to gain greater importance in the period in the literature, with most analyses concentrating on
leading up to the referendum campaign. Performative right or extreme‐right‐wing populism. Social populism
appeals were made on the long‐term sustainability of the can be described as a political ideology which combines
NHS alongside the importance of controlling and resist‐ left‐wing or socialist politics with populist rhetoric. This
ing access of immigrants to the labour market. The idea rhetoric usually consists of anti‐establishment, speaking
that immigrants and EU nationals were profiting from the for the common people combined with themes on eco‐
NHS and that the best way to protect it would be to leave nomic democracy, social justice, and scepticism of glob‐
the EU gained traction. Being part of the European Union alisation. As Wolfe and Mendelsohn (2008) found, those
was therefore presented as a strain on resources which who are in favour of larger welfare states are also those
could be used for the NHS. The Vote Leave campaign who are likely to oppose globalisation.
consisting of prominent conservative politicians (notably The latter part of this article thus focuses on populist
Michael Gove and Boris Johnson) travelled the country discourses on the NHS relating to further international‐
on a Vote Leave bus claiming that the cost of member‐ isation of health services and the concern of a demise
ship in the EU totalled £350 million a week. They argued in the social contract in the face of liberalism. It draws
that such resources could be used to provide the NHS on 24 articles in the popular tabloid press in the UK
with much needed funding. The full fact website refuted (The Sun, the Daily Mail, and The Mirror). It also exam‐
the claim that the UK sends £350 million a week to the ines discourse from civil society organisations. Indeed,
EU. In fact, when the rebate is taken into account, it cal‐ there are at least 14 civil society organisations whose key

Politics and Governance, 2023, Volume 11, Issue 1, Pages X–X 4

purpose is to campaign to maintain the NHS as a pub‐ sation entitled “Boris Johnson: An existential threat to
lically funded and administered service. Such discourse our NHS,” reiterates Corbyn’s fears that “all the signs are
was paramount in the lead‐up to the general election of that Johnson will try to score his big ‛deal’ by offering
2019 when there was a specific focus on this issue in par‐ up the NHS to the predatory vested interests that dom‐
liamentary debates, which were then reported in news‐ inate the catastrophically dysfunctional US health care
paper articles, and again in 2020 over a proposed amend‐ market” (Leak, 2019, para. 6). It further claims that the
ment to the trade bill. So the press articles retrieved anger of the people is evident: “Trump’s recent sugges‐
were those relating to the issue of “trade” and the “NHS” tion that the NHS is ‛on the table’ in trade talks drew a
between June 2019–June 2020. furious reaction from most people in the country, with
The main emotions that opponents of furthering free over 700,000 people in the UK signing a petition against
trade play on in the popular press, and tracts are nega‐ the idea” (Leak, 2019, para. 5). Another militant group,
tive emotions of fear in very much the same way as main‐ We Own It, contended that “it’s impossible to take the
stream populists did to suggest that the NHS was in finan‐ NHS ‛off the table’ without strong new legislation to end
cial jeopardy and leaving the EU could save it. However, privatisation” (We Own It, 2019, para. 2). The popular
in the case of post‐Brexit trade deals, instead of a distant daily The Mirror also reiterated these fears with the head‐
elite in Brussels, the elite, the government, and big busi‐ line: “Our NHS is up for sale and Trump has sights on a lot
ness are now perceived as a threat to a publically funded more” (2019).
system and the common interest of the people. Yet Boris Johnson dismissed the claims that the NHS
In analysing the keywords in popular press articles is up for sale in trade deals: “Under no circumstances will
and activist tracts, we can note a significant use of words we agree to any free trade deal that puts the NHS on
to incite fear: with the repetition of the words “risk,” the table. It is not for sale” (UK Parliament, 2019). Such
“threat,” and “unprotected,” and images related to out‐ negation of the perceived risks by opposition groups
side forces taking possession of the national institution was also reiterated in the popular right‐wing press with
(or a loss of possession of the institution which pro‐ the Daily Mail’s tabloid headline “Boris Johnson com‐
vides public health services to the population). Such pares Jeremy Corbyn to a UFO conspiracy theorist as he
words as “grab” and “prey” convey this idea. The NHS is gives Phillip Schofield a ‘cast iron’ guarantee the NHS will
described as “a rare jewel” threatened by international NOT be on table in trade deal with US despite Labour
forces and unprotected by the state (“Our NHS jewel,” ‘scare stories’” (“Boris Johnson compares,” 2019) and
2019). The promises to protect the NHS are considered “‘The NHS is not for sale’: Health Secretary hits back after
as “lies,” or “porkies.” On the other hand, the govern‐ US…” (“‘The NHS is not for sale,’” 2019), but also The Sun
ment and the popular press supporting the Conservative headline “Boris Johnson to tell Donald Trump the NHS is
party (Daily Mail and The Sun) dismiss the claims as off the table” (“Boris Johnson compares,” 2019).
“scare stories” or “scaremongering.” Diction relating to The Sun also published an article supposedly repeat‐
protection and security were taken from Boris Johnson’s ing a speech by trade secretary Liz Truss. In this published
speech and repeated in the popular right‐wing press, speech, she was reported saying: “As Trade Secretary,
claiming that the government offered “a cast iron” guar‐ I know that his claims are utterly baseless and it is dis‐
antee for the NHS. They claimed that the proof that the graceful that he is weaponising such an important issue,
NHS would be sold in an international market was unre‐ scaring vulnerable people to score political points” and
liable or “dodgy” (“Boris gives ‘cast iron guarantee,’ ” “Donald Trump has insisted the NHS would not be on the
2019; “Jeremy Corbyn’s dodgy,” 2019). table in a Brexit trade deal after sparking a massive row”
Jeremy Corbyn, the former leader of the opposition (“Liz Truss: The NHS,” 2019). She also warned them to
party, also revealed in the period leading up to the 2019 “ignore the scaremongering from Labour. The price the
general election that 451 pages of unredacted docu‐ NHS pays for drugs won’t be on the table” (“Liz Truss:
ments and information showed that the Conservative The NHS,” 2019).
government was negotiating behind closed doors to “sell The next incident to provoke a reaction and a resur‐
off” the NHS. He explained that negotiations had already gence of populist discourse was the rejection of an
led to an agreement to lengthen patents for medicines. amendment to the trade bill which gave powers to the
He implied that the Conservative government was in government to amend retained primary legislation in
collusion with big business, which could harm the NHS: order to implement trade deals without due scrutiny.
“Big pharma has ripped off and imperilled the health However, in December 2020, the House of Lords passed
of the American people for years. Now these secret a clause to prevent any agreement which was consid‐
reports show they’re looking to do the same to us—if the ered to impede the UK’s ability to secure “a comprehen‐
Conservatives are elected on December 12th” (Labour, sive publicly funded health service free at the point of
2019, para. 32). delivery” (UK Parliament, 2022). The amendment also
Civil society organisations such as Keep Our NHS included controls on drug pricing and the sale of patient
Public were also vocal in the run‐up to the 2019 gen‐ data. However, the bill was voted down in the House of
eral elections on the risks that Conservative policy rep‐ Commons by 357 votes to 266, with Conservative MPs all
resented for the NHS. An article written by the organi‐ voting against the protections.

Politics and Governance, 2023, Volume 11, Issue 1, Pages X–X 5

 Opponents from the left and especially civil society awareness of the need for the trade regime to find a
organisations were very critical of this dismissal of the way to accommodate both halves of the grand com‐
amendment by the Conservatives: promise of embedded liberalism. (Lang, 2006, p. 96)

As Students for Global Health UK, we stand in direct Health populist discourses have argued that the social
opposition to this decision. The absence of legisla‐ contract regarding public health has been called into
tive protection of the NHS from international trade question. Right‐wing rhetoric has moved from protect‐
deals risks undermining the ability of the NHS to pro‐ ing the NHS in Europe to promises that furthering trade
vide ‛a comprehensive publicly funded health service and investment as part of the “Global Britain” mantra
free at the point of delivery.’ (Students for Global will not compromise public health services. But social
Health, n.d.) populists are intent on calling into question this signif‐
icant compromise by attempting to galvanise fear and
“A service that is not public, free at the point of access doubt in the population through the weaponisation of
and accessible to all is far from our vision of a fair and the NHS. The fears of social populists are not groundless
just world in which equity in health is a reality for all” as significant literature on the risks to public health care,
(Students for Global Health, n.d.). and more general public health, have shown. However,
The Mirror reported a speech from Emily Thornberry, health populism from the left has failed to win over the
the shadow trade secretary, which expressed her con‐ British electorate despite such appeals regarding the dan‐
cerns on this issue: gers to a publically funded health system.

What it means is those same companies winning a Acknowledgments

greater right to provide services to the NHS through
open procurement contracts and thereby gaining Thank you to Sorbonne Université for their funding con‐
access to the vast resource of NHS patient data, tribution. Thank you to the blind peer‐reviewers for their
which, quite frankly, they have been actively pursu‐ insightful comments.
ing for years. (“Tory MPs vote,” 2021, para. 11)
Conflict of Interests
The same tabloid turned Boris Johnson’s “cast iron”
image on its head to claim that it was actually Labour The author declares no conflict of interests.
who would protect the NHS: “Tory MPs defeated a
Labour amendment to include ‘cast‐iron’ guarantees for References
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Politics and Governance, 2023, Volume 11, Issue 1, Pages X–X 6

Boris Johnson to tell Donald Trump the NHS is off the Our NHS is up for sale and Trump has sights on a lot more.
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About the Author

Louise Dalingwater is full professor at the Faculty of Arts and Humanities, Sorbonne Université. She
completed her PhD at Sorbonne Nouvelle University in 2009 with a thesis on the UK service economy.
Her work is focused on health policy, healthcare delivery, and well‐being (including well‐being and gen‐
der) in the UK, with some comparative research on European health systems and global health policy
research. She is chair of the Health, Wellness and Society Research Network, based in Illinois, USA. Her
research interests also include the dynamics of trade in services and the links between trade and health.
She is associate member of the Centre for Trade, Economic Integration and Globalisation Studies
(Centre d’études sur l’intégration et la mondialisation—CEIM) at Université de Québec, Montréal.

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