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Washable PPE

Volume 827: debated on Wednesday 8 February 2023


Asked by

To ask His Majesty’s Government what steps they are taking to encourage NHS Trusts to use British-made washable PPE garments with RFID (radio frequency identification) tags that can be laundered multiple times, instead of single use garments which go to landfill.

PPE waste is potentially hazardous, and recycling is challenging. However, the NHS is committed to sustainability and net zero across its operations and is working with UK manufacturers to encourage innovation. On PPE procurement, the NHS recently piloted reusable RFID-tagged gowns and has trialled reusable face masks, and the findings will inform the future approach. On waste, including PPE waste, NHS England intends to publish a full clinical waste strategy later this year.

My Lords, I thank the Minister for that Answer. I must declare an interest: I am the unremunerated chair of the company that produces these gowns. While I welcome what the Minister said, could I make a plea to him? This is a time when we need the NHS to make sensible economies and to look after the environment. It is not the fastest and nimblest organisation for adopting things that it should, so I would welcome an assurance that he will do everything possible to encourage every trust. They should not wait a year for trials—the trials have been successful; we know that it works. I would like to meet him to discuss how we can take this forward.

I thank the noble Lord for his question. I agree: the trials have shown that this is something we should be doing. It has shown big savings —about £180 million a year in procurement—so there is a very good case to do it. As ever, it is non-trivial. To begin with, we have a lot of PPE stock which we clearly need to use first, and we would need to put launderettes in place so that we can clean and recycle the PPE, but this is absolutely something we want to do going forward.

My Lords, can I appeal for a strengthening of that question? How many trusts currently have single-use PPE contracts? Will the Minister give a guarantee to this House that the Government will ensure that all those contracts are replaced by multiple-use contracts, as described, by the end of this year?

Right now, the Government are supplying all PPE centrally until next year, using up the excess stocks first, which I think we all agree should be the first thing we do. It will not be until next year that new contracts will be set. When they are set, I absolutely agree that we should push this agenda.

My Lords, the Minister is an experienced businessman—and, I am sure, an honourable one. Based on that experience, what would he say is a fair and reasonable profit margin for somebody to make when selling PPE to the NHS? How would he describe somebody who saw the pandemic as an opportunity to make super-profits by maximising the mark-up they could apply to that PPE? This may have been legal, but was it right?

I can only speak personally here; I believe that the best businesspeople look to have long-term customer relationships. That means you have long-term, sustainable and fair prices, which is the way to build real customer value in a business.

Did the trials find that, as well as being good for the environment, the washable PPE garments might be able to save the NHS money, which could be reinvested into health and care services?

Yes; as I say, the trials that we have seen so far definitely save money—the figure I have for the procurement savings is £180 million. A process of education also needs to happen. It has been shown that up to 50% of uses of disposable gloves are unnecessary. Understandably, however, medics got into the habit of using them during Covid. We absolutely want to be doing a lot more of this.

My Lords, the Government were elected on the promise of 40 new hospitals, but the Observer recently reported that only 10 have planning permission and are likely to be built during this Parliament. Are those 10 being built with laundry facilities—which the Minister referred to as needed—so that we can indeed stop using single-use items and go back to laundering them?

First off, we are committed to the 40 new hospitals, on which the House will be hearing more going forward. Some of those might not have planning permission because they are on the site already, so that should not be taken as read. All those hospitals have the net-zero targets built into their plans so that we can make sure that they are sustainable.

My Lords, can the Minister provide an update on the warning by the National Audit Office that because of poor financial controls over procurement of PPE during the pandemic, auditors may be unable to sign off the accounts for the UK Health Security Agency? Does he share the view of the chair of the Public Accounts Committee that the scale of waste of unusable PPE is yet another reminder of the vital importance of proper controls, including during a crisis?

I think we all agree that controls are a good thing. We all have to cast our minds back to two years ago, when planes were being gazumped in mid-air because they were carrying PPE and countries were trying to outbid each other. I think we all remember at the time that the strict instruction from everyone was, “Buy it, almost at any cost.” That is what happened. Were mistakes made? Absolutely, they were, but the priority was to make sure that we had PPE for our front-line medics. Are we looking to learn lessons? Yes, we are, and clearly the auditors’ role at the UKHSA is one of those situations.

My Lords, the Government have spoken about using the current stockpile of PPE. What lessons have been learned to make sure that we always hold a stockpile ready for the next pandemic and that we have high-quality PPE? In that way, the problem of long Covid following Covid contraction by staff who went into work knowing that they were putting their lives at risk and yet used PPE that they recognised as inadequate will not happen when the next pandemic comes along.

Clearly, we need to build resilience in the supply chain. A lot of that involves promoting domestic production. Through this whole exercise, over 4 billion items were bought from the UK. We must ensure that we keep that capability going forward. We should keep some level of storage, but, again, get the level right. Another question that I am often asked is, “How much are we paying in storage right now?” It is important that we get the balance right, with future resilience though not to excess levels.

My Lords, in addition to PPE and the steps laid out by the noble Baroness, what success has there been in analysing a sustainability strategy for the NHS? For example, switching patients from propellant inhalers to powdered inhalers could be a big step forward.

The whole agenda on this is close to my heart. I do not have that particular detail, but I know that with LED lighting, for instance, you save 25%, so if we put LED lighting across the estate it would cost £400 million and save £100 million a year. Those things clearly are good for the environment and good for the health service in terms of savings, so, absolutely, it is on my agenda to make sure that we pursue it.

My Lords, the NHS spends billions of pounds. Have the Government considered having a “buy British” policy, on which we can start to build up capacity not just in this area but in many other areas?

As I mentioned in answer to a previous question, when we started off, less than 1% of PPE was bought from the UK. We extended that, so that 4 billion items were bought by the end of it. To me, the beauty behind this whole question of sustainability is that it benefits domestic production, which is better for the environment as well. That is absolutely the direction of travel.

My Lords, I declare my interest as president of the Health Care Supply Association. Will the Minister join me in recognising that NHS procurement people have saved the health service millions of pounds through their efforts in the last few years? Does he agree that they need investment in training and development? Will he ensure that they receive it very quickly, so that more savings can be achieved?

Absolutely; wherever there is a savings case, I will be right on it. Also, it is about education and training for all our staff. As I mentioned before, a one-hour course can reduce disposable-glove usage by as much as 50%.

Is my noble friend aware—I can see no reason why he should be—that at the request of her daughter and son-in-law, both GPs, my wife made them three sets of multi-washable scrubs each, which to the best of my knowledge are still in use?