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NHS: Brexit-related Risks

Volume 792: debated on Thursday 5 July 2018


Asked by

To ask Her Majesty’s Government what assessment they have made of (1) the risks to the National Health Service, and (2) the implications for access to medical supplies, of the United Kingdom leaving the European Union without a withdrawal agreement.

Nearly there.

My Lords, patient safety is our priority in the exit negotiations, and maintaining continuity of supply of medical products is a key part of ensuring that patients continue to receive safe, high-quality care from day one after we leave the European Union. Extensive work has been undertaken to understand the implications of our EU exit on the NHS, considering a range of negotiation outcomes, including exit without a withdrawal agreement. This has included a focus on continued access to medical supplies.

My Lords, I congratulate the noble Lord on his stamina this morning—more Fleetwood Mac than Iron Maiden. Given that the Government seem a long way off getting any sort of Brexit deal on goods and services, will the Minister tell the House whether there is a plan B to ensure that the NHS has continuity of medical supplies, and will he explain how he expects the interface of the medicines approval regime and the international regulation of medicines to work post Brexit? Will he also guarantee comparable levels of patient safety after we leave the EU?

I am glad that the noble Lord’s train got him here in time for him to ask his Question. First, I do not share his pessimism about the outcome. We will publish the White Paper on our proposals next week and we expect it to get a warm welcome—and not just in this House. Nevertheless, it would be wrong if we were not working on contingency options. I think that the public would be surprised if we were not planning for every scenario. That is precisely what we are doing at the moment, and of course, as we do that, patient safety is our number one priority. We need to make sure that the supply of medicines and medical devices can come in to the country and be used by NHS patients, come what may.

My Lords, I declare an interest as the son of an ambulance driver who drove ambulances for the NHS for nearly half of its existence. Some 45 million packs of patients’ medicines are exported from the UK every year, and 37 million are imported into the UK every month. Merck, GSK and AstraZeneca have all forecast that if we leave the customs union, it could take five to 10 years for any technological solutions to replace the system we have at the moment. They are now considering stockpiling, given the levels of extra documentation and checks that will be required. This will place an increased burden on the NHS. Would not the best thing for the NHS be if the Cabinet tomorrow agreed that we will continue as part of the European Medicines Agency and the customs union? Given that the Minister has been on his feet so much this morning, the simple answer “yes” will suffice.

Will the Minister take the opportunity to recognise the contribution that the Windrush generation has made to the development and continuity of the National Health Service?

I am very pleased to do so. The Windrush generation has made a fantastic contribution to our NHS and caring services.

My Lords, I am glad that contingency plans are being made. The British public voted to leave the EU because of the promise of £350 million a week to save our NHS. We now hear, however, that Brexit could have catastrophic consequences for the NHS in areas such as staff recruitment and essential supplies and for the adequate resourcing of the NHS to the standard of our EU partners—a standard that we do not yet reach. Will the Minister admit that these promises were wrong and tell the British people that we may need to think again?

It would be a big mistake for anybody to tell the British people that they voted the wrong way. I point out to the noble Baroness, however, that, whatever was on any side of the bus, as a result of the funding plan announced by the Prime Minister there will be £394 million a week more in real terms for the NHS by 2024. I am also pleased to say that there are more EU staff working in the NHS today than two years ago.

My Lords, the problems and challenges of Brexit will only add to the massive challenges which, in our enthusiasm for the birthday of the NHS, we sometimes underestimate. These include demographic change, an ageing population, new inventions and therapies, new pharmaceutical products and so on. Although I very much welcome extra money, this problem will not be solved just by extra money; it will require massive organisation, radical restructuring, and innovation in technology on a massive scale. That will not be achieved by one party on its own. Why, therefore, do the Government constantly refuse the recommendations of some noble Lords and committees in this House to establish a cross-party consensus on this and take party politics out of it to the maximum extent? That is the only way—accompanied by money—that we can save the NHS for the next 70 years.

The noble Lord knows better than most the challenges of transforming the National Health Service, and is right about the big challenges that we face—although I think it is better to look at them as opportunities. He is also right that reform has to go hand in hand with extra money. We promised the extra money; we now need to see the reform. Every part of the health service—the department, the NHS, and others—needs to drive that through. On his point about consensus, I do not think there is anything stopping that consensus: the Government want consensus. We do not necessarily think that it needs to be in the form of a royal commission or a parliamentary commission. We want to work with all corners of this House and the other place to make sure that there is support for a broad plan for the NHS for the next 10 years.