Labour have publicised a cache of leaked internal documents from the Department for International Trade (DIT) showing us what’s been happening behind the scenes in talks between US and UK trade negotiators.

The American and British governments are keen to negotiate a new bilateral free trade agreement which would kick in after Britain leaves the EU.

In recent weeks, Labour have accused the Conservatives of putting the finances of the NHS at risk by allowing American pharmaceutical companies to charge higher prices for medicines.

Boris Johnson has strenuously denied that the NHS will be up for negotiation in trade talks.

What’s in the leaked documents?

The documents were originally uploaded to Reddit.

There are more than 400 pages of notes covering preliminary meetings from July 2017 to July 2019 – a couple of weeks before Boris Johnson became Prime Minister.

The officials describe the talks so far as “the first lap”, “preliminary discussions across all the major policy areas that we might expect to feature” in a trade deal, ahead of “the formal phase of negotiations”.

Trade experts will probably spend weeks poring over the detail in these documents, but there are some headlines:

US negotiators have been asking about healthcare…

The papers show that the Americans have asked about Britain’s healthcare system in the context of “state-owned enterprises” – government bodies which the US team think “potentially disrupt trade flows”.

The British response was non-committal:

“Wouldn’t want to discuss particular health care entities at this time, you’ll be aware of certain statements saying we need to protect our needs; this would be something to discuss further down the line when we come to consider what entities would count as ‘enterprises’.”

DIT officials later said that they “do not currently believe the US has a major offensive interest in this space”.

They added: “We will need to be able to go into more detail about the functioning of the NHS and our views on whether or not it is engaged in commercial activities.”

… and drug prices

US negotiators said there was “a lot of conversation on drug prices” in America and “looking at what other countries pay and this is causing angst”.

This chimes with statements made by President Trump and other Republicans, who believe other countries should pay higher prices for US-made drugs. (See our previous FactCheck).

In these documents, the US negotiators appear to be very interested in issues that could affect drug pricing, like the length of time pharmaceutical companies get “market protection” for new products.

While a new drug has “market protection”, cheaper generic drugs cannot be put on the market.

A British official noted: “The US also said that the current Administration may want a shift in some areas of policy here so they were unable to answer some of the questions we posed.

“It was nevertheless a very helpful exposition on the key areas we can expect the US to push in an FTA and for us to start to determine the areas where we may find ourselves in difficult territory.

“The impact of some patent issues raised on NHS access to generic drugs (i.e. cheaper drugs) will be a key consideration going forward.”

Does this prove the NHS is “on the table”?

It’s debatable. These are still preliminary talks, and there is nothing in these documents that suggests British negotiators have agreed to higher drug prices, or made any other concessions on the NHS.

On the other hand, there is no evidence here of the British government having communicated to the Americans that they want to ring-fence the NHS and keep it out of any trade discussions.

Trade experts FactCheck has spoken to remain of the view that there is a danger here for the NHS.

The idea is that the UK, as the smaller country, will be forced to compromise to get a trade deal with the US over the line.

It’s clear that there is interest in pharmaceuticals from the American side, and the Trump administration has stated that it wants foreign countries to pay more US drugs.

Dr Andrew Hill, who contributed to a Channel 4 Dispatches documentary on this subject, said the difference in US and UK prices can be so great that it could cost the NHS billions if even one popular drug had its price raised to the American level.

Dr Hill said: “We know that there is discussion taking place with these documents, and this could potentially cost the NHS huge amounts of money.”

David Henig, UK director of the European Centre For International Political Economy, told us:

“The detail of trade negotiations is somewhat different to what Government has suggested – and food standards and the NHS could definitely be included”

So are Labour right?

There are political points that could be made on both sides here.

Labour are clearly keen to use the leaked documents to cause trouble for Boris Johnson.

But they cover preliminary trade discussions that took place before Mr Johnson became Prime Minister.

There is nothing in the documents that proves there is a secret plot by the government to privatise the NHS, sell parts of it off or dramatically increase the health services’ drug bill.

Essentially, we learn something about what the Americans might want from the final negotiations, but we don’t know what the British government is prepared to concede.

On the other hand, the documents do not chime with some public statements made by ministers about the trade negotiations.

Health secretary Matt Hancock is on record as saying that the NHS is “not up for discussion” in the talks.

The leak shows that healthcare and pharmaceuticals have in fact already been discussed in some detail – although we don’t know what the final outcome will be.