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Medical Devices and Equipment

Volume 828: debated on Monday 20 March 2023


Asked by

To ask His Majesty’s Government what discussions have been held between the Department of Health and Social Care, NHS Supply Chain, and healthcare manufacturers regarding the impact of costs pressures on the supply of medical devices and equipment.

My Lords, we are back to medical matters. I beg leave to ask the Question standing in my name on the Order Paper.

My Lords, the department and NHS Supply Chain hold regular discussions with industry. There is an established process for reviewing price increase requests, which is set out in the terms of agreement of contracts. Each request is evaluated on a case-by-case basis. This Government are committed to working with healthcare manufacturers to secure value for money for taxpayers and support patients and care providers in accessing the products that they need.

My Lords, I think I detect that the Government acknowledge the importance of the provision of healthcare products to both the NHS and its patients. I refer in particular to operated medical beds and pressure mattresses, going all the way down the line to such matters as catheters and colostomy equipment—I mention those because your Lordships may be more familiar with that area.

I have two questions. Do the Government recognise that providers of healthcare products, mostly fixed-price products, have faced and are facing colossal increased costs, to the point that there is a real prospect that some of them will no longer be able to provide their healthcare products to the National Health Service? Do the Government recognise the importance of providers of healthcare products to the National Health Service?

I thank the noble Lord for his important question and pay tribute to his expertise in such matters. This Government recognise the importance of the provision of healthcare products to the NHS and its patients. In February, the Government published their first ever medtech strategy. Supply conditions are proactively monitored and officials engage extensively with industry to identify threats to the supply of medical equipment. The department works closely with NHS England and the NHS to minimise the impact of potential supply disruptions on patient care. The department has agreed annual increases on Part IX drug tariff products used in primary care, and an exceptional price increase request mechanism exists.

My Lords, on 31 January, the Minister’s noble friend, the noble Lord, Lord Markham, told me in a Written Answer that we still have 118 million items of PPE stored in the People’s Republic of China at a cost of £260,000 every single day. That is a massive cost to the NHS, both in opportunity cost and the cost to British taxpayers. The noble Lord said that the Government would act rapidly to end this. Can the Minister tell us whether we now have any items of PPE left in the People’s Republic of China and what the total cost to the British taxpayer has been?

My Lords, the People’s Republic of China is not part of the Question and remit I have here, but I will certainly pass the noble Lord’s question on to my noble friend Lord Markham.

My Lords, the Minister may be aware of research that we have carried out showing that many hospitals are using outdated equipment, including X-ray machines that are more than 20 years old. What are the Government doing to ensure that NHS England’s advice to replace equipment such as scanners and X-ray machines every 10 years is being followed? What are they doing to make sure that cost pressures do not become another reason to delay further the replacement of this essential equipment?

I am grateful for the noble Lord’s question. As somebody who used to deal in such equipment, I totally agree with him that you should always have the latest, most up-to-date equipment. Twenty years sounds like an awfully long time in technological development terms, so I take on board exactly what the noble Lord says.

My Lords, further to the question asked by the noble Lord, Lord Alton, the Question talks about

“the impact of costs pressures on the supply of medical devices and equipment.”

Therefore, the fact that we are paying for the storage of PPE that cannot be used is relevant; a Question on this was answered some time ago. Would my noble friend the Minister be good enough to reply in writing and set out the current position of these astronomical costs?

I am most grateful to my noble friend for that question. I hear it loud and clear and will feed it back to the Minister, my noble friend Lord Markham.

My Lords, one important set of healthcare products is the media which are used for embryo culture. They are widely used in in vitro fertilisation by different manufacturers, having been obtained commercially. Can the Government assure us that they are notified of the secret ingredients in these media? What control is made over those ingredients, which may have a detrimental effect, before they are used in human embryos?

The noble Lord raises a very important point. I will certainly ensure that the department hears it, and I will feed back to him.

My noble friend will recall that the Medicines and Healthcare products Regulatory Agency in this country was the leading regulatory agency for the approval of new medical devices, including 40% of the most significant such medical devices. What benefits for the authorisation of medical devices might stem from the announcement in the Budget last week of additional resources for the Medicines and Healthcare products Regulatory Agency?

I thank my noble friend for his question. The Government’s medtech strategy, published in February, will support medical device manufacturers by recognising the importance of domestic production to support resilience and identify practical support. The good news that was articulated in the Budget last week can only add to that.

My Lords, rising cost pressures affect not only the supply of medical devices and equipment; spiralling costs are also threatening the supply of drugs in the UK, particularly generic medicines. What assessment have the Government made of how many drug companies they expect to exit this market altogether due to lack of profitability? What assessment have they made of the impact on patient care and NHS finances if the NHS has to pay an increasing amount for a smaller range of drug options?

When agreeing contracts with healthcare manufacturers that stipulate fixed pricing the manufacturers have full opportunity to account for the inflationary pressures of their tenders. NHS Supply Chain has established processes, where suppliers can apply for price increases due to exceptional circumstances. It has accepted price increases where they were justifiable, and it continues to consider such requests.

My noble friend spoke earlier about the need to replace equipment in hospitals with the latest, most up-to-date equipment. Can he assure the House that, if it is serviceable, the redundant equipment will be put to good use? I am thinking particularly of Ukraine, where hospitals and kit have been blown to bits. We could at least send them stuff that we consider to be surplus.

My noble friend raises a very good point. Notwithstanding wanting to have the very latest state-of-the-art equipment in our hospitals, the surplus could still be workable and could be used elsewhere in the world, including in Ukraine. I will feed that back.

My Lords, it is reliably estimated that, in 30 years, the cost of the NHS will match 100% of GDP in this country. Can the Minister say something about what long-term strategic plans are being undertaken given the eventuality of the NHS simply running out of money and the country running out of money at the same time?

The noble Baroness raises an important point. As it is outside the Question and the remit I have here, I cannot give her a robust enough answer, I fear, so I will write to her.

My Lords, surely at the heart of this Question—and it relates to China—is that what we learned during the pandemic is that we were overreliant on supplies from China. The Government say that they wish to encourage alternative sources of supply, including from UK companies. However, we hear from those companies that the cost pressure on them means that they cannot invest sufficiently to produce alternative sources of supply. What is the Government’s approach to ensuring that we are not dependent on China in the way that left us so exposed during the pandemic?

The noble Lord raises an important point. Unfortunately, we were far more reliant on China, not just in the NHS but elsewhere in our economy. However, contracts and framework agreements fixed prices to provide budgetary certainty for the NHS and to avoid the need for frequent price reviews or constant retendering, which are inefficient for the NHS and for suppliers. When I reflect on my business career, I know from that context that the NHS is a very good customer, providing security on payment for goods and services, working under equitable terms and conditions of contract, and being prepared to encourage the concerns of suppliers facing exceptional pressures. It is a very good customer.