Intended for healthcare professionals


A trade deal between the United Kingdom and United States

BMJ 2017; 356 doi: (Published 30 January 2017) Cite this as: BMJ 2017;356:j491
  1. Martin McKee, professor of European Public Health1,
  2. Pepita Barlow, PhD student2,
  3. David Stuckler, professor of political economy and sociology2
  1. 1London School of Hygiene and Tropical Medicine, London, UK
  2. 2University of Oxford, Oxford, UK
  1. Martin.McKee{at}

Be careful what you wish for

The UK has something to celebrate, at least if you believe the tabloid headlines. It seems that it has moved from the back to the front of the queue to agree a trade deal with the US.

On the surface, a trade deal would be a good idea. The UK must now prepare to negotiate such deals with many countries, to replace those from which it will be excluded when it leaves the European Union.1 Failure to agree them risks defaulting to World Trade Organisation regulations, which would be severely damaging. Tariffs would make many British goods more expensive, and it may be impossible to trade some of the services that are now a major source of the UK’s foreign earnings. More important are non-tariff barriers, such as regulations and standards that allow the European single market to work, even if often mocked by Eurosceptics. Worst of all are quotas, which limit the amount of goods that overseas markets will import.

Although, in theory, the UK is entitled to a share of the EU’s quotas for international trade, in practice, negotiating this is fiendishly difficult. A recent worked example using something as seemingly simple as lamb and mutton quotas showed that this could take years to …

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