International Health Regulations 2005

(Limited Text - Ministerial Extracts only)

Monday 18th December 2023 Westminster Hall

[The Minister for Health and Secondary Care (Andrew Stephenson)]

It is a pleasure to see you in the Chair, Sir George, and I am grateful to the British public and the hon. Member for Lancaster and Fleetwood (Cat Smith) for raising the important issues covered in the e-petition we are considering today. I start by thanking for their contributions the hon. Member for North West Leicestershire (Andrew Bridgen) and my hon. Friends the Members for Shipley (Philip Davies), for Devizes (Danny Kruger) and for Christchurch (Sir Christopher Chope), as well as my right hon. Friends the Members for Wokingham (John Redwood) and for Rayleigh and Wickford (Mr Francois). I also thank the hon. Member for Birmingham, Edgbaston (Preet Kaur Gill) for her remarks. I am only surprised not to see our friend the hon. Member for Strangford (Jim Shannon) here, although I am sure that he would be if he were able.

We have held a similar debate on this matter already. However, this debate is slightly different from the one we had in April; the matter before us is whether the House should vote on amendments to the international health regulations. That has stirred discussions both in this place and outside because it relates to two vital aspects of our governance: our sovereignty and our national interest. On both, I am pleased to offer assurances to colleagues and the public that I am satisfied that our approach to the negotiations safeguards our national interest without compromising our sovereignty. I will set out why I believe that before turning to the specific questions put by my right hon. and hon. Friends during the debate.

Why are the negotiations in our national interest? Because the international health regulations do not just exist to protect others from health threats: they directly benefit the UK and help to keep our people safe. The last decade has shown that diseases such as covid, mpox and Ebola do not respect borders. In the case of other health threats, such as the recent case of botulism in France, the IHR allowed us to swiftly engage with French officials to identify and follow up with exposed UK citizens. When Vladimir Putin committed an act of terror on our own soil, the IHR helped to slow and stop the spread in Salisbury. The IHR provide international standards for what it means in practice for each WHO member state to prepare for, detect, prevent and respond to public health events.

[Andrew Bridgen]

I thank the Minister for the speech he is making. The point he is actually making is that the IHR are currently working perfectly adequately—in which case, why do we need to amend them?

[Andrew Stephenson]

The IHR are working well. However, as a number of my hon. and right hon. Friends said in the debate, there has been lots of criticism of how they worked. As the hon. Gentleman will remember, our right hon. Friend who is no longer in this place—Boris Johnson, the former Prime Minister—was one of the leading voices in saying that we should update the IHR, because we surely need to learn lessons and move forwards.

I believe that there is mutual interest—interest for us and for other countries—in working together. One example is delivering a sensitive surveillance system providing an early warning of potential threats to inform decisions that national Governments will make during public health events and emergencies.

[Mr Francois]

The House has already heard that we may have to vote on the amendments, along with others, by the end of May 2024. It is possible that by then we will already have had a general election. The House has heard very plainly from the hon. Member for Birmingham, Edgbaston (Preet Kaur Gill) that the Labour party would be minded to support all the amendments; when we challenged her, she stopped taking interventions. Labour would back these amendments if it was in government. What would the Conservative party do?

[Andrew Stephenson]

I thank my right hon. Friend for that point. I genuinely believe that a lot here is in all our interests, and I do not want to turn this into a party political ding-dong. I genuinely believe that having us in Government leading the negotiations and getting them settled before any general election is firmly in the UK’s national interest, because I believe that we will deliver a treaty that is in the interests of all our citizens and respects national sovereignty. However, I very much hope that an incoming Labour Government would do the same. That is one of the reasons why I believe that we need to make rapid international progress to agree any revisions to the IHR—because I believe that we are in a good place to do that now and should move swiftly, rather than kicking it into the long grass. The last pandemic taught us that trying to make things up as we go along was not the best course of action. Laying some good foundations and providing some better certainty on how things will be dealt with is the best way forwards.

[Sir Christopher Chope]

Surely the regulations and the changes are not just one block that we either accept or reject. The Government can deal with each proposed amended change seriatim—one by one. That is why I hope that my right hon. Friend will spell out, in response to the points that have been made, exactly which of the amendments he supports and which ones he does not.

[Andrew Stephenson]

My hon. Friend tempts me, but he will remember that we did not provide a running commentary on the Brexit negotiations. We do not provide a running commentary on our trade negotiations. We do not believe that is in the national interest. Indeed, it is very clear that no text in the latest draft of the accord, published in October and available on the WHO website, has been agreed yet. The whole text is still under negotiation. The draft is just a basis for negotiations, and it will evolve. There are areas of the new draft that we clearly reject and there are areas that we would like to make even stronger. This is an active negotiation between 193 member states to come up with revisions to the IHR that we all believe, by mutual consensus, will be in our global interest.

[Mr Philip Hollobone (Kettering) (Con)]

Would the Minister be kind enough to answer the question posed by my hon. Friend the Member for Devizes (Danny Kruger)? Who is actually negotiating on this country’s behalf, and which Minister has ultimate responsibility?

[Andrew Stephenson]

The negotiations are being led by civil servants across Whitehall. [Interruption.]

[Sir George Howarth (in the Chair)]

Order.

[Andrew Stephenson]

I do not believe it is right to name those civil servants. I am the overall lead on this in the Department of Health and Social Care. I am working closely and have already met with the Minister of State, Foreign, Commonwealth and Development Office, my right hon. Friend the Member for Sutton Coldfield (Mr Mitchell). Many other Government Departments will also have a very clear interest in this, including the life sciences Minister, my hon. Friend the Member for Arundel and South Downs (Andrew Griffith). Any treaty agreed will of course be subject to cross-Government write-rounds in the usual fashion, to agree a UK-wide position. It is fair to say that there will not just be one pair of eyes from the ministerial ranks looking at this. There will be multiple pairs of eyes looking at this from across Government to ensure that when we get to a deal, it is a deal that can be agreed across Government and that we believe is in the UK national interest.

[John Redwood]

The possibility that the language may shift from saying “may” to “shall” is fundamental. I welcome all that the Minister has said about the current collaboration. I am glad it is working so well, but that is based on advice and urging, rather than requirement. It seems to me that this is just like the British people voting for the Common Market with the assurance that we had a veto on any law we did not like, but then somebody came along and took the vetoes away without seeking the British people’s permission, and the relationship went wrong from thereon. This could do exactly the same to the WHO, if we take away the veto.

[Andrew Stephenson]

I hear where my right hon. Friend comes from and I share his concern. As I hope he will recognise, the WHO is led by its 193 member states, which are currently negotiating this. All international health regulations to date have been agreed by consensus, and we would hope that any changes to the regulations are also agreed by consensus. As I say, there are many amendments and parts of the draft that we would not agree to in their current form. I believe these negotiations will hopefully get us into a position—because I believe it is in all our interests and in the national interest—to agree revisions to the IHR. That has to be done through negotiation and consensus. I think that having an approaching deadline focuses minds, and I think it is the right thing to do.

I will give another concrete example of why I believe this is important. During the pandemic, the genomic data shared by our friends in India and elsewhere helped us to tailor vaccines as new variants emerged around the globe. We all saw over the pandemic that, as the shadow Minister, the hon. Member for Birmingham, Edgbaston said, no one is safe until everyone is safe and that global problems require global solutions.

The best way to protect the UK from the next pandemic is by ensuring all WHO members can contain and respond effectively to public health events through compliance with strengthened IHR. Targeted amendments to the IHR will further strengthen our global health security, by helping Governments plan together, detect pathogens swiftly, and share data where helpful and necessary. The pandemic highlighted weaknesses in the implementation of the IHR for global health emergency response. For example, covid demonstrated that the IHR could be strengthened through a more effective early-warning system with a rapid risk assessment trigger for appropriate responses to public health threats.

[Philip Davies]

Does my right hon. Friend the Minister not fear that what happens in the World Health Organisation negotiations will be very similar to what happens at things such as COP26, COP27 and COP28, at which all these countries sign up to something—most of them knowing full well they have absolutely no intention of following what they have signed up to—and we are left following the agreements when other countries do not even bother?

[Andrew Stephenson]

I hope that no Government would sign up to any treaty that it will not follow. I agree that, in a whole range of areas, countries around the world have sometimes not fulfilled their part of international obligations, but the UK Government will certainly not sign up to something that we do not believe is fair and proportionate, that is not our national interests and that we would not seek to follow ourselves. I share my hon. Friend’s concern that other countries have not followed regulations in the past, and there is no point in our passing strengthened regulations if we do not believe that other countries will follow them. We believe that the regulations are designed to prevent and control the international spread of disease. They are limited to public health risks and designed to avoid unnecessary interference with international traffic and trade. That is why we support the process of agreeing targeted amendments to the IHR as an important way to better prepare for future global health emergencies.

[Sir Christopher Chope]

Can the Minister explain the process in relation to the amendments? He talks about consensus, but what happens if this country does not get its way in relation to some of the amendments that it opposes? Would that mean that, if those amendments are incorporated in the final text, we can and will opt out of them?

[Andrew Stephenson]

Yes, that is exactly what consensus means. To be clear, the WHO secretariat is supporting both processes by hosting the international negotiating body and the working group on amendments to the regulations, and by supporting the chairs to prepare texts and answer questions from member states. Both negotiations, however, are member state-led processes. It is member states that are negotiating; it is not the World Health Organisation. I completely appreciate that some see this as a WHO power grab, but it is important to remember that it is a member state-led process.

We came together with other nations through the World Health Organisation to agree a process to negotiate targeted amendments to the IHR at the 75th World Health Assembly back in May 2022. By consensus, we adopted process-related amendments under article 59 of the regulations. The UK supported those amendments because they increased the timeliness of member states’ compliance with future amendments to the IHR. That will better protect us from future global health emergencies. As part of the agreed process, member states could submit proposed amendments for consideration, and to that end a working group, made up of all WHO member states, through which the amendments would be negotiated and agreed was created.

[Andrew Bridgen]

The Minister is being generous with his time. The crucial question on which the Chamber and the public would like an answer from the Minister, who is speaking on behalf of the Government who are negotiating the instruments, is whether the Minister believes that the WHO guidance—recommendations, as they were—becoming mandatory under amendments to article 1 and new article 13A of the treaty are compatible with retaining UK sovereignty.

[Andrew Stephenson]

I think that that was covered in the previous debate and has been covered by various Ministers. We have been clear from the outset of the process that we will not agree to any amendments that cede UK sovereignty. If the UK Government accept an IHR amendment that we have negotiated with our international partners, then, depending on the context of that amendment, changes to international law may be required. In those instances, the Government would prepare any draft legislation, and Parliament would vote on it in the usual way.

It is important to remember that, in and of themselves, IHR amendments and the new pandemic accord do not change the power of UK law. If required, we would ourselves change UK law through our sovereign Parliament, to reflect our international obligations under the IHR amendments. Let me be clear: in all circumstances, the sovereignty of the UK Parliament would remain unchanged and we would remain in control of any future domestic decisions on national public health measures.

[Mr Francois]

I thank the Minister for giving way so often. To be clear and to follow on from my earlier question, he has put on the record that we have a right to opt out of any amendments with which the UK does not agree. That is reassuring. On that basis, if an amendment were to be voted on by the WHO to say that it could impose a lockdown on the United Kingdom without our approval, will the Minister give a commitment that we would opt out of it?

[Andrew Stephenson]

I can give a categorical reassurance to my right hon. Friend that that is a red line for the UK Government. We would never allow the World Health Organisation to impose a lockdown in the UK. That is a clear red line for us. I cannot think of any Minister who would agree to such a request.

I can confidently say to my colleagues—as someone who campaigned for Brexit and who has helped to deliver Brexit in this place—that I am passionate about this country’s sovereignty. I believe that the Government’s position needs to be crystal clear and it is one that I endorse. We support the member state-led process of agreeing targeted amendments to the IHR and the new pandemic accord for the sake of global health preparedness, but we will not agree in any circumstances to provisions that would cede sovereignty to the WHO. That includes the ability to make decisions on national public health measures, whether lockdowns, which we just mentioned, or vaccine programmes.

[Philip Davies]

The Minister will understand people’s nervousness about this. As my right hon. Friend the Member for Wokingham (John Redwood) referred to, in the 1971 White Paper Ted Heath said that there was no question of Britain losing essential sovereignty by joining the Common Market. We saw how that went. My point, and what I am worried about, is whether the Government will have to bring forward proposals that the WHO insists on even if they do not like it, and so bring the power of Government voting to that decision. That is what I worry about, that Parliament will still decide, but that the Government will be forced to bring forward measures in Parliament, even though they may not necessarily agree with them.

[Andrew Stephenson]

I reiterate: this is a member state-led process, with 193 member states negotiating. It will be a difficult negotiation, but all previous regulations have been agreed by consensus. If the text ends up in a position where the UK Government do not feel that we can sign up to it, the other member states may decide to proceed, but they will not be regulations that we are bound by, because we will not agree to them. This is an evolving situation and we have agreed a pathway for negotiations. As right hon. and hon. Members know, the text and the amendments are available online.

May I turn to some of the contributions? I will start with those paying tribute to my right hon. Friend the Member for Rayleigh and Wickford in paying tribute to his wife and other NHS staff, who did an incredible job during the pandemic. Sometimes, when debating technical issues such as this, we can overlook their incredible contribution, but it is right what my right hon. Friend said today. He also talked about the importance of data sharing globally, which I think we would all agree is vital.

My hon. Friend the Member for Devizes asked when the next iteration of the text will be available. No new texts or amendments have been agreed yet, so there is nothing further to be shared. However, we expect negotiations to continue until May 2024, when member states will agree completion at the World Health Assembly. I am actively exploring ways in which I can keep the House informed of further developments, although as I say, the standing position of the Government on such issues is that we do not do a running commentary on negotiations. I am actively looking at what more we can do to keep Members informed.

That leads me on to another question that my hon. Friend asked about the costs of these measures. Obviously, as we have not agreed the provisions of the treaty, we cannot yet estimate how much it might cost and whether we would publish our red lines. Unfortunately, as I say, I will decline to say more on red lines now; I have set out one clear red line today and we have a very clear red line on sovereignty. However, I do not believe that we should run through these negotiations in public; I believe that we should give our negotiators time to reach as much international consensus as possible.

[Mr Hollobone]

The Minister is being extremely generous in giving way. One of the lessons from the Brexit negotiations was that civil servants in the room negotiating were not always following the ministerial line, so may I encourage my right hon. Friend to go himself to the negotiations, repeat what he has told the House today, and make sure that the civil servants who are in the room when he leaves get the message that he has just delivered?

[Andrew Stephenson]

I will certainly bear in mind what my hon. Friend has said. Some of the civil servants involved in the negotiation have already heard clearly from me, the Minister of State, Foreign, Commonwealth and Development Office, my right hon. Friend the Member for Sutton Coldfield, and my hon. Friend the life sciences Minister about various red lines and other things that we are very clear about, so there is clear ministerial input. There will be a part in this process where Ministers can get involved, but I will certainly look into what my hon. Friend the Member for Kettering (Mr Hollobone) suggests and what more I can do to ensure that UK sovereignty is in no way compromised, so that I can continue to provide further reassurance to all those right hon. and hon. Members who have spoken today.

We all want—well, maybe not all of us, but I believe the Government want a strong World Health Organisation that is fit for purpose and able to respond rapidly to global health challenges and future threats. The UK is working with our international partners to shape the WHO in that way.

Our priorities for the amendments and for the accord are global in scope but they are also in pursuit of our national interest. It is in our national interest to prevent another pandemic. Should—God forbid—another pandemic should occur, it is in the national interest to co-operate with others to slow and stop its spread. In these negotiations, I can assure right hon. and hon. Members that I would never countenance acting contrary to our national interest. We will protect our country from future public health emergencies without ceding an inch of sovereignty.

Question put and agreed to.

Resolved,

That this House has considered e-petition 635904, relating to the International Health Regulations 2005.