Skip to main content

Medicines and Medical Devices Bill

Volume 688: debated on Wednesday 27 January 2021

Consideration of Lords amendments

I must draw the House’s attention to the fact that financial privilege is engaged by Lords amendments 1 and 54. If any amendment engaging financial privilege is agreed to, I will cause the customary entry waiving Commons financial privilege to be entered into the Journal.

Before Clause 1

Establishment and core duties etc

With this it will be convenient to discuss the following:

Government motion to disagree with Lords amendment 2.

Government motion to disagree with Lords amendment 3.

Lords amendments 4 to 10.

Lords amendment 11, and Government amendments (a) to (d) thereto.

Government motion to disagree with Lords amendment 12.

Government motion to disagree with Lords amendment 13.

Government motion to disagree with Lords amendment 14.

Lords amendments 15 to 21.

Lords amendment 22, and Government amendments (a) to (c) thereto.

Government motion to disagree with Lords amendment 23.

Government motion to disagree with Lords amendment 24.

Government motion to disagree with Lords amendment 25.

Lords amendments 26 to 29.

Government motion to disagree with Lords amendments 30 and 31.

Lords amendment 32, and Government amendments (a) to (c) thereto.

Lords amendments 33 to 39.

Government motion to disagree with Lords amendment 40.

Lords amendments 41 to 47.

Government motion to disagree with Lords amendment 48.

Government motion to disagree with Lords amendment 49.

Government motion to disagree with Lords amendment 50.

Government amendments (a) to (c) in lieu of Lords amendments 2, 3, 12 to 14, 23 to 25, 30, 40 and 48 to 50.

Lords amendments 51 to 56.

I am extremely pleased to be back at the Dispatch Box to speak to this Bill. It is a changed Bill since we last looked at it but one that still has the patient at its heart. I am pleased that it comes back to us with the same spirit of consensus and collaboration that it left us with.

Since we had the Bill’s Third Reading, the pandemic’s evolution and the importance of the regulation of clinical trials, the roll-out and regulatory approval of a vaccine, and the ability of healthcare professionals to get medicines into patients has bought into sharp focus precisely how essential this Bill is. The Government made a number of amendments to the Bill through the other place in response to Committees of the House, the report of the independent medicines and medical devices review, led by Baroness Cumberlege, and, importantly, as a result of genuine, cross-party discussions on how to make this Bill better.

I am glad to say that the Bill still—and for those who know me, this is my passion—puts patients first: patients who will have the opportunity to trial new treatments; patients whose safety is paramount; patients who need to see quick and effective action from regulators in the event of an emergency. The Bill that left us on Report had a new change to it, anticipating Baroness Cumberlege’s report. The medical device information system, which will transform post-market surveillance of medical devices and improve the ability to track down patients and prevent harm, followed talks across this House and in the other place. I reiterate my thanks in particular to the hon. Members for Washington and Sunderland West (Mrs Hodgson) and for Central Ayrshire (Dr Whitford) for their contributions to that effort.

We said on Report that we awaited the conclusions of the Cumberlege review and that we would take steps when the review was published. I can tell the House now that we have, and Lords amendment 1 establishes a Patient Safety Commissioner—a champion for patients in relation to medicines and medical devices. I pay tribute to all those who have spoken here and in the other place of the impact of harm on patients and on women—those who have not been listened to whose stories are difficult and heart-wrenching. Much was said during the Bill’s passage in the other place about the whole system change to enshrine the voice of patients at the heart of the process and our commitment to it. The Patient Safety Commissioner will act within and outside the system. They will be an advocate for patients and ensure that the patient voice is primary. The commissioner will be able to seek information, make reports without fear or favour and expect responses, and, more importantly, get change.

Lords amendments 1, 41, 47, 54 and 56 together provide for both the appointment of a Patient Safety Commissioner and regulations to support this appointment. I congratulate Baroness Cumberlege and her team, and thank her and others who contributed to getting this into the Bill so quickly after her report.

Lords amendment 31 provides for a small but important change that was also recommended in that review: a power to put the devices expert advisory committee on to a legislative footing.

I am very conscious of the passion and commitment shown by the hon. Member for St Helens South and Whiston (Ms Rimmer) when we were last discussing the Bill. She has shown admirable determination. I am pleased to draw her attention to Lords amendment 8, which the Government were happy to support in the other place. That important amendment provides for provisions about the origin and treatment to be made in relation to the regulation of human medicines.

We have had two reports, one from the Delegated Powers and Regulatory Reform Committee and one from the House of Lords Constitution Committee.

When we last stood opposite each other, the hon. Member for Nottingham North (Alex Norris) challenged me on how to make it clear that patient safety was the absolute priority. I thank him and his team, and those who work in the other place, for their constructive dialogue on these issues. We all want to see patients receiving effective, safe medicines and medical devices, and we all want to ensure that the UK remains at the forefront of pharmaceutical innovation. Amendments 4, 5, 6, 7, 15, 16, 17, 18, 19, 26, 27, 28 and 29 all change the nature of the regulatory powers in clauses 1, 8 and 12. They introduce an objective to safeguard public health, putting it at the heart of regulations. They remove the word “attractiveness” from the Bill and set out what I hope is as agreeable here as it was in the other place—a list of the types of activity we would hope the UK would be a favourable place to conduct. Importantly, they apply a safety lock. Regulations that affect the safety of a medicine or a medical device can be made only if the benefits outweigh the risks.

Hon. Members here were very clear that we should go further to demonstrate that patient safety was absolutely paramount. These changes do that, but they also assist in turning a Bill that was called a skeleton Bill into a true framework Bill that makes it clear how delegated powers will be used and how, in making regulatory changes, safeguarding public health remains key. These changes better reflect the discussions in this House and the other place, and answer the criticisms of the DPRR and the Constitution Committee.

We have also made changes to criminal offences—another area of earlier concern. Amendments 9, 10, 20, 21 and 55 clarify the maximum penalty that may be created by regulations. Both the DPRR and the Constitution Committee recommended increased parliamentary scrutiny, and the shadow Minister’s colleagues also pressed for public involvement.

Amendments 44, 45 and 46 all provide for Parliament to have multiple opportunities to inform, and be informed by, the Government’s plans for regulatory changes. First, consultations have become public consultations under clause 44. Secondly, the appropriate authority is obliged to produce an assessment of how the regulatory proposal meets the overarching framework considerations at the time of going out for consultation. As Members are aware, the Government prepare a response to the consultation, and how the consultation responses are considered will be made public in that way. The amendments introduce a reporting requirement that means a separate report back to Parliament every two years summarising how regulations made under clauses 1, 8, 12 and 18 have been operating during that time. It must include any concerns raised, what has been done as a consequence, and any plans for further changes to regulations. This gives the flexibility for Parliament to be interested in—and if individual Members or Committees wish it, to submit responses to—any individual consultation, without requiring it to.

Last time we discussed this Bill, the hon. Member for Nottingham North asked whether we could accept a sunset clause as a way of settling his colleagues’ concerns as to how we might use the powers contained in the Bill. I hope that he can agree that how these powers can be used has materially changed as a result of the Bill’s going through the other place. Another option that was put forward in the other place, as well as a sunset clause, was a requirement to bring forward and publish draft legislation. Unfortunately, we cannot accept these changes. Three years is simply not long enough to have a fully settled regime in a steady state to make reassessment practical, and amendments 2, 12, 13, 23, 24 and 40 would definitely introduce a cliff edge for new legislation. That is not the best way to go about legislation in general, but in this Bill, where essential changes could be needed to protect patients, there are better and more effective alternatives. Lords amendments 3, 14, 25, 30 and 48 to 50 also introduce the use of the super-affirmative procedure for regulatory changes that introduce significant new policy or changes to policy. Quite aside from how difficult it would be to assess what “significant” means, it is very much using a sledgehammer to crack a nut—as we are often guilty of doing in this place. In both cases, I have heard the arguments for these amendments. People are concerned about the lack of detail in the new likely changes to the existing regulatory regimes, in particular for medical devices, and therefore Parliament wants greater visibility of what happens next. We have stressed the critical importance of consultation and have made changes there, and we have provided the reporting, as I have outlined.

Amendment (b) in lieu, in the name of my right hon. Friend the Secretary of State, proposes an alternative that goes further. This would require a report to be prepared within five years of Royal Assent that looked at the operation of the legislation. It would oblige the Secretary of State to take into account a report of any parliamentary Committee. That could mean, for example, a Select Committee choosing a report on the basis of a post-legislative scrutiny memorandum, and that report would need to address a series of considerations, such as whether the legislation needs restructuring or consolidating, whether certain parts of the legislation should be an Act of Parliament, and whether any of the powers in the Bill need amending or repealing. That provides the time needed to get the regulatory system into a steady state. It allows for consideration of how the system works on the ground and of all the factors that the hon. Member for Nottingham North and others have fairly raised in arguing in support of their amendments. I hope that he will support this solution.

I do not intend to spend very long on Lords amendments 11, 22 and 32 to 39, not because they are not important, but because they have been arrived at with significant consensus. We introduced these important powers to allow for information to be shared with relevant persons, such as regulators and regulatory networks outside of the UK, in order to give effect to international arrangements. These amendments provide safeguards on data shared by the Medicines and Healthcare Products Regulatory Agency and the Veterinary Medicines Directorate. They define patient information. They provide a definition of relevant persons with whom information can be shared. Government amendment (a) to Lords amendment 11 would remove the reference to pharmaco-vigilance from the requirement to share information in the public interest, as, of course, pharmacovigilance is in the public interest and therefore covered.

Madam Deputy Speaker, I do not intend to spend any time at all—you may be glad to hear—on Lords amendments 51 to 53, which make consequential commencement changes.

To finish, the Bill has gone through with a great deal of well-informed, well-intentioned debate and changes. I am pleased that the constructive discussions that we had before it left us have continued. The other place has brought something back to us that I hope we can agree delivers for UK patients and the UK life sciences industry, which is vital and enables us to build a stand-alone regulatory system for the UK for the future and one that has patients absolutely at its heart.

It is a pleasure to resume proceedings on this Bill, and we are now very close indeed to the finish line. For us and, I think, for all Members, this has always been about patient safety and about making sure that people of the United Kingdom have the best access to medicines and medical devices. The exchanges so far have been of a high quality in both content and tone. As the Minister has characterised, the Bill started as a skeleton, but it is certainly thin no more. There is much in there that will make a significant difference to our country.

I have been proud to take the lead for the Opposition since the Committee stage, and I thank my predecessor in the earlier rounds, my hon. Friend the Member for Washington and Sunderland West (Mrs Hodgson), for setting the tone for us. I am also grateful to the Minister for her level of engagement and for giving us generous access to her officials and the Government in general throughout this process. The stages of the Bill through the Commons were of a high quality, and clearly considerable progress has been made in the other place, which we consider today. 

I welcome the Government’s concessions on the Bill, and I congratulate my colleagues in the other place, particularly Baronesses Thornton and Wheeler and Lord Hunt, on their hard work on and dedication to securing these vital amendments. That hard work will ensure that the Bill will promote patient safety and privacy, as well as proper consultation and scrutiny. I might even be mischievous enough to say that I tabled a number of these amendments in Committee, but I was unable to get them accepted at that point. I am therefore delighted to see them accepted at this stage.

We will support the Lords amendments where the Government have indicated their support, and where they have tabled amendments in lieu we will accept those as a reasonable compromise. I therefore do not intend to divide the House this evening. Similarly, I do not intend to speak to all 56 amendments, but I might cover a few of the pertinent major themes.

The Minister was right to say that in previous exchanges I challenged her to demonstrate that safeguarding public health and, critically, patient safety was uppermost, and that is reflected in Lords amendments 4 and 5. I knew from the outset that that was the Minister’s intention, and I think the amendments improve and make the Bill clearer, as well as future-proofing it for future Ministers and—dare I say it?—future Governments. It is important that that was done, and we appreciate that.

On Lords amendment 1, it is welcome that the Government have heeded the second recommendation in the Cumberlege review, and legislated for an independent Patient Safety Commissioner. We were lucky to have a review as seismic as that one, which crystallised many decades of suffering and pain for lots of people who had been crying in the darkness and ignored for a long time. That report was a cathartic moment, but it cannot remain just a report, and the fact that we had primary legislation that was the perfect vehicle for the independent Patient Safety Commissioner was a real blessing. I am pleased we were able to find a way to include that.

Does my hon. Friend agree that many of the people he said were in the dark often felt that they were on their own, and it was only when groups were set up that they realised otherwise? Many doctors were telling them there was not a problem.

Yes, and I met as many of those groups as I possibly could. That commonality in the story of people often being ignored and left alone, or told that they were wrong, lying or making it up, added insult to the significant injuries that they had suffered. That collective action was a big part of people getting their salvation and securing that review which then vindicated them so strongly. That is so important. The presence of the independent commissioner will ensure that patient wellbeing is prioritised and there will be a voice for those citizens. That is an essential step forward to ensure that our wonderful national health care system is responsive and hears challenging messages, even if perhaps it does not always want to. That will give people a voice, which is important.

We welcome the amendments on transparency and accountability, and I pay tribute to the hon. Member for Central Ayrshire (Dr Whitford) for her leadership at other stages of the Bill. Frequent reporting will ensure that the system is monitored and accountable, which is good. With Lords amendment 31 the Bill will provide for the establishment of the independent statutory device expert advisory committee, to ensure that the regulation of devices is transparent, and that decision making is better structured and more accountable. That can only be a good thing. Making urgent regulation subject to positive affirmation, as in amendment (a) in lieu, will allow the regulatory system to respond to changing situations, while ensuring proper accountability and scrutiny.

As the Minister says, amendment (b) in lieu sweeps up and replaces the Lords amendments that relate to sunset clauses and clauses on the super-affirmation procedure. It was not quite what I was after, but I think it is a pretty fair deal. It is certainly more than I thought I would get—perhaps I should not say that before the amendments have been made. As a former trade union negotiator, I always thought that going in and getting 60%, 70% or 80% for our members was a pretty good outcome, so we will certainly take that. The five-year review is a good thing as it gives the Government more time—those arguments were well made by the Minister, and on reflection I think they are right.

At the root of this, the Secretary of State is acquiring significant powers, and it is right to review that as well as to have scrutiny down the line, and an opportunity for right hon. and hon. Members to determine whether the system might need consolidating or restructuring. That is vital to improve the quality of the regulatory system. I am really pleased that we got there, and with where we have arrived. I welcome the opportunity in Lords amendment 8 for the use of human tissue in medicine to be further regulated, thus preventing the NHS from being compromised by the trade in harvested organs, including those from ethnic minorities and political prisoners in authoritarian states. My hon. Friend the Member for St Helens South and Whiston (Ms Rimmer) will be pleased with that inclusion. It is her hard work that made that happen, and I commend her for it, as she battled away. She feels strongly about this, and what has come out is very positive indeed. As I say, I commend her greatly for that.

Briefly, I shall pick up a couple of outstanding things from the medicines and medical devices safety review, which the Minister may deal with in her response. Again, significant progress has been made in the Bill and in associated regulations to make those recommendations a reality, but there are still a number of things outstanding that are accompanied by the words “in due course”, so I would be keen to get a sense from the Minister of when that is. She will be asked about that by others, as will her colleague, the Minister for Patient Safety, Suicide Prevention and Mental Health, and many right hon and hon. Members. It is an important part of finishing the process that those recommendations are adopted. The decision has clearly been made that they were not within the scope of the Bill or that the Bill was not the best place for them. I hope that when she closes the debate the Minister will detail the Government’s plans or at least a timetable for plans to address that.

Finally, the Bill—certainly the guidance relating to it—has advanced the idea of making fundamental change to community pharmacy by moving towards a hub and spoke model. I will say what I said in Committee and on Report. The Government have chosen not to include that in the Bill—that is their decision—but I believe that they intend to do it, and it will be a seismic change for community pharmacy. I hope to hear from the Minister a clear commitment to something so significant that it requires wide-ranging consultation with all manner of stakeholders to make sure that we do it right. I think that that is the case, but I am keen to have on-the-record clarity.

In conclusion, the Bill deals with patient safety and making sure that the British people have access to the best medicines and medical devices. We have fought hard to make it the best Bill that we can, and I am really proud and pleased with the progress that we have made.

It is a pleasure to follow the hon. Member for Nottingham North (Alex Norris), and to have followed the Bill from afar. It is a shining example of cross-party support, and to see it emerge from a skeleton Bill into a framework Bill is a credit to everyone who participated in Committee and in the House of Lords, and to Members across the House.

It is, in short, a pleasure to be able to speak in this debate, and I support Lords amendments 1 and 54. The creation of a commissioner for patient safety has long been sought, and it will not only enhance the fact that the NHS is viewed as one of the safest healthcare systems in the world but will reinforce the view that it is an organisation that can learn from its mistakes. One such mistake is the unconsented and experimental use of TVT mesh. The intent was for the best of purposes, but in fact it caused utter devastation, both physically and emotionally, to those who suffered adverse side effects. Those effects went unreported and were misdiagnosed for a great length of time, and change was down to people such as Janet Peck and Susan Morgan—two of my constituents and victims themselves—who fought hard for action to be taken. Their determination and hard work have resulted in the excellent report by Baroness Cumberlege, which calls for the appointment of a Patient Safety Commissioner, which the Bill seeks to put in place, to ensure that scenarios such as those surrounding TVT mesh become never events.

The Minister for Patient Safety, Suicide Prevention and Mental Health gave a heart-felt and meaningful apology to those who have been failed by medical treatments as outlined by the Cumberlege report last year. The new position will be welcomed by patients and practitioners alike, and I hope that the Minister responding to the debate will go further and explain the commissioner’s remit and the parameters of their work, and how recruitment will find a suitable person to report back. I welcome the fact that the Government will respond further to the independent medicines and medical devices safety review. Finally—much of what I wanted to say has already been said—I pay tribute to Susan and Janet. Their fortitude and determination have helped to shape the Cumberlege report and shape this Bill and, as we have already heard, their repeated efforts to ensure that patient safety is put first have allowed the Bill to be created in such a way that it will have a long and meaningful impact on those who seek the best service possible from the NHS. As has already been said, the cross-party support is a credit to this House. I congratulate all Members who have taken a significant step in helping to shape the Bill.

In 2018, the imported bodies of political prisoners and human rights abuse victims in China were on display in Birmingham. It was supposed to be a Real Bodies exhibition, to inform the public about biology, yet in reality it was a barbaric travelling circus. The British public unknowingly paid £15 each to view the remains of these poor souls.

Since I learned of that horrific display, I have become determined to work on behalf of these human rights abuse victims to end forced tissue and organ harvesting. Our nation and the people who live here must not be complicit in the brutal acts of the Chinese communist regime. The first step is to put a stop to the importing of tissue and organs of human rights abuse victims. Currently, neither the human tissue regulations nor the Human Tissue Act 2004 requires appropriate consent for imported human tissues to be used in medicines. After several attempts to bring forward an amendment to achieve this, both here and in the other place, the Government have finally included a negotiated amendment in this Bill, which I welcome.

That amendment provides the opportunity to prevent complicity in this crime within the UK medicine industry, and gives Ministers the powers to do the right thing. It is important to stress that the amendment has not dealt with the issue of organ transplant tourism, or the issue of plastinated unclaimed bodies being imported and commercially displayed, as we saw in Birmingham. The amendment is a welcome start, but it is only the beginning; there is much more to do.

I hope the House will forgive me if I place my thanks on record, as securing that amendment has been a long, drawn-out battle across both Chambers. First, I congratulate Lord Hunt of King’s Heath for persevering so tenaciously, along with his co-signatories Lady Finlay, Lady Northover and Lord Ribeiro. I also thank Lord Alton and Lord Collins for their tireless efforts on this issue. Finally, I thank my hon. Friend the Member for Nottingham North (Alex Norris) for his support and advice.

One of my predecessors as MP for my home town, St Helens, was Sir Hartley Shawcross, the chief British prosecutor at the Nuremberg trials. Just like the Nazis he prosecuted for, among many reasons, using human beings for medical experiments, I hope and pray that one day, those responsible for these despicable, heinous acts will be prosecuted for their crimes against humanity, for that is what forced organ harvesting is. Last year, the China tribunal, led by Sir Geoffrey Nice QC, a former lead prosecutor at The Hague, concluded that

“Forced organ harvesting has been committed for years throughout China on a significant scale and that Falun Gong practitioners have been one—and probably the main—source of organ supply”,

and that

“In regard to the Uyghurs the Tribunal had evidence of medical testing on a scale that could allow them, amongst other uses, to become an ‘organ bank’.”

The amendment sends a very clear message that we will not tolerate such appalling acts against humanity and that we will deliver for the people of China, not for the Communist party of China. Let the amendment truly mark the beginning of a new relationship with China—a relationship that is not naive. Today, Holocaust Memorial Day, is the day when the world says “Never again” to genocide. Let this be the start of the Government putting those words into practice.

I thank the Minister for all the work that she has done on the Bill, and I commend the hon. Member for Nottingham North (Alex Norris) for his dedication.

The Bill seeks to address the regulatory gap by introducing dedicated regulation-making powers covering the fields of human medicines, including clinical trials of human medicines, veterinary medicines and medical devices. That is clearly absolutely necessary, and the most pertinent reason is one about which I wrote to the Secretary of State for Health and Social Care just last week: the ability of my young constituent Sophia Gibson to have continued access to her medication post Brexit. Her family were informed that there would be issues sourcing the medication—medicinal cannabis—that has made such a difference to her life. Her parents began their battle, still traumatised from their last battle to source this life-saving medication, and we began to work on it. The Secretary of State and the Northern Ireland Department of Health have worked hard, and initial reports are that we will produce the medication here, in co-ordination with the lab that creates it in the Hague. That is good news, although I await confirmation. It would appear that this is just one story that is working out, but it flags the necessity of the United Kingdom of Great Britain and Northern Ireland creating and prescribing our own medications. That is why this legislation is vital.

I echo and support wholeheartedly the comments of the hon. Member for St Helens South and Whiston (Ms Rimmer) in relation to the commercial forced organ harvesting that is happening in China against Falun Gong members, Christians and Uyghur Muslims. We need to address that, and I know that the Minister and other Ministers have that responsibility. It is very worrying, and I echo the hon. Lady’s comments about that.

I know that the thousands of people who believe that their quality of life has been affected by mesh, for example, will wonder why this legislation has not been in place before. I ask for clarity that the aim of the Bill will be achieved and that it will allow for much greater scrutiny and accountability in the world of medical devices.

The Lords amendments make a few suggested additions to the Bill. There is an understanding that we must allow our medical field the ability to produce medication and medical devices, but also that it must be better regulated and offer better protection to those who rely on these devices. The Bill extends to England, Northern Ireland, Scotland and Wales. Parts 1 and 2, relating to human medicines and veterinary medicines respectively, are within the legislative competence of the Northern Ireland Assembly. A legislative consent motion has been sought for those parts, and I welcome that following close on the heels of this debate.

Our goal is not simply to pass continuity legislation post Brexit but to improve and upgrade our legislation, and that is what the Bill achieves. The Government indicated in the background briefing to the Queen’s Speech and in a press release that they intend to use these powers to support the development of medicines and medical devices in the NHS and amend prescribing power. That needs to happen, and it needs to happen now; will the Minister confirm that that is the case? The Government stated in the explanatory notes to the Bill that they intend to use these powers to keep the existing regulatory frameworks updated, while consolidating the enforcement regime for medical devices. In addition, the Bill will provide the Secretary of State with the ability to impose civil sanctions as an alternative to criminal prosecution for breaches of the medical device regime.

I have long worked with those who believe that the use of mesh in their bodies has caused substantial harm—not just females and ladies, but males. I have had a number of meetings with them about that. We are all aware that, when something is termed a medical device and not a medication, the testing is less stringent. The civil sanctions will provide the emphasis that we all want to see, to ensure that any device placed in a person’s body has been tested to a high standard before widespread use. I commend the Government, and I commend all Members for their contributions.

When taking a Bill through the House, we always hope that it will be one that hon. Members from both sides can understand, support and improve. Our intention to have a gold standard of medicines and medical device regulation in this country, and to put the patient at the heart of it, has been long understood and has very much formed the foundation stone of the Bill.

I am very grateful for the support of hon. Members here; the spirit of collaboration is how we get this Bill done now—today. I would like to address one or two of the questions that hon. Members brought up. I reiterate my thanks to the hon. Member for Nottingham North (Alex Norris). He was right when he said that the timing of the Cumberlege report was fortuitous. In this House, we have been able to make sure that patient safety has been addressed. He was also right to say that it was a collective effort, and he and other Members were right in saying that the Bill very much reflects the voice of campaigners who often feel that their voices go unheard. Today, they have not gone unheard.

May I also mention the former Member for Pontypridd, Owen Smith, who is no longer in the House? He set up the all-party parliamentary group on surgical mesh implants, which did so much work to highlight this issue.


This has been a long time coming, and Members from both this House and the other place have been involved. I pay particular tribute to Janet Peck and Susan Morgan, the constituents of my hon. Friend the Member for Totnes (Anthony Mangnall), and their quiet determination to make sure that their challenges were seen and noticed. The Government then took the right decisions in helping them make sure that this does not happen to others. That was the right thing to do.

The hon. Member for Nottingham North asked me to address two or three points. We plan to respond in full to the report later in 2021. It has been incredibly impactful and has already served to put patient safety at the top of the agenda for the whole health and care system. If it had not been for the covid-19 pandemic, I think we would be discussing little else than patient safety because of the Bill before us. Just as covid-19 impacted on the publication of the report, it has impacted our response time. But I assure the hon. Gentleman that that response will come later in the year.

The hon. Gentleman also asked about the speed of the appointment of a patient safety commissioner. I very much want the right person. I cannot give a precise time, but I want to underscore the importance of patient safety and our belief that the patient safety commissioner will and must be effective in amplifying the voice of patients and improving patient safety in the use of medicines and medical devices. I hope that the process will not take too long, but we must appoint the right person, who will truly give the right voice.

On hub and spoke, which the hon. Gentleman and I both agree is so important, there will be a full public consultation. The Government will then report to Parliament, and include a summary of the concerns raised in the public consultation. To ensure that we get the right model to assist pharmacy going forward, we intend to be totally transparent.

To the hon. Member for Strangford (Jim Shannon), I can give an unequivocal yes. We have a thriving life science sector in the UK, contributing over £80 billion a year to the economy and over a quarter of a million jobs. We want to ensure that the UK remains an important market for medicines and medical devices, and to bring products to market here.

As I close, it is perhaps unusual to be pleased that there have been quite so many changes or challenges on a Bill, but I think they have been the right changes and the right challenges. To that end, I thank all hon. Members who have challenged and who have assisted in those changes. I also thank all those who have assisted behind the scenes—the Bill team, my officials and so on. We have arrived at a Bill that I think carries the support of all sides and of both ends of the Parliament, and one where patients, the sector and the public can understand how we do good work and how this Bill will work for them.

Lords amendment 1 agreed to, with Commons financial privileges waived.

Lords amendments 2 and 3 disagreed to.

Lords amendments 4 to 10 agreed to.

Government amendments (a) to (d) made to Lords amendment 11.

Lords amendment 11, as amended, agreed to.

Lords amendments 12 to 14 disagreed to.

Lords amendments 15 to 21 agreed to.

Government amendments (a) to (c) made to Lords amendment 22.

Lords amendment 22, as amended, agreed to.

Lords amendments 23 to 25 disagreed to.

Lords amendments 26 to 29 agreed to.

Lords amendment 30 disagreed to.

Lords amendment 31 agreed to.

Government amendments (a) to (c) made to Lords amendment 32.

Lords amendment 32, as amended, agreed to.

Lords amendments 33 to 39 agreed to.

Lords amendment 40 disagreed to.

Lords amendments 41 to 47 agreed to.

Lords amendments 48 to 50 disagreed to.

Government amendments (a) to (c) made in lieu of Lords amendments 2, 3, 12 to 14, 23 to 25, 30, 40 and 48 to 50.

Lords amendments 51 to 56 agreed to, with Commons financial privileges waived in respect of Lords amendment 54.