National Health Service (Procurement, Slavery and Human Trafficking) Regulations 2025
Debate between Baroness Wheeler and Lord Scriven
Captain of the King’s Bodyguard of the Yeomen of the Guard and Deputy Chief Whip (Baroness Wheeler) (Lab)
It is a privilege to represent His Majesty’s Government in bringing forward this important secondary legislation, and I am very grateful for the opportunity to present it for your Lordships’ careful scrutiny today.
Slavery remains one of the greatest evils in human history. This Government cannot and will not accept that we might inadvertently support forced labour or human trafficking through our supply chains. I wish to acknowledge the cross-party and Cross-Bench support on this issue, both in this House and in the other place. I pay tribute to all noble Lords, and to distinguished Peers such as the noble Lords, Lord Hunt of Kings Heath and Lord Alton, and the noble Baroness, Lady Brinton, who have all worked tirelessly to keep modern slavery at the forefront of our national conversation.
I will begin by setting out why these regulations are necessary. Many are shocked to learn that there are more enslaved people now, in absolute terms, than at any point in history. It is estimated that around 50 million people worldwide are living in modern slavery. Globalisation has brought immense opportunities for trade, but also for exploitation. We in the United Kingdom are not immune from these global networks of human trafficking.
In late 2023, the previous Government published a review into NHS supply chains, covering 60% of medical consumables—£7 billion of spend across over 1,300 suppliers, representing 600,000 products. The review found that just over a fifth of suppliers represented a risk. We know that staff working in the NHS would be appalled to learn that surgical items and face masks could be contaminated by modern slavery. I know I share this revulsion with colleagues across the NHS and across this House.
The review also recognised the wider benefits to the NHS of a better understanding of our supply chains, including improved product quality and supply resilience. It gave us clear recommendations, and today I am proud to present landmark modern slavery legislation to put these policies into practice. This is a first for England, and I hope our colleagues in the devolved Administrations will follow suit.
The NHS is one of the largest public sector procurers in the world, with an annual spend of around £35 billion and business with over 80,000 suppliers. We have a duty to ensure that no products we procure are tainted by forced labour, and an opportunity to use our purchasing power for good. These regulations will require all public bodies to assess modern slavery risks in their supply chains when procuring goods and services for the health service in England. They give effect to a duty established by the Health and Care Act 2022 requiring the Secretary of State to eradicate modern slavery wherever it is found in NHS procurement.
Public bodies will be asked to take reasonable steps to address and eliminate modern slavery risks, especially when designing procurement procedures, awarding and managing contracts, and setting up frameworks or dynamic markets. Reasonable steps may include enforcing robust conditions of participation, monitoring supplier compliance, reassessing risk through the contract’s life and requiring immediate mitigation where instances of modern slavery are discovered.
The regulations also require public bodies to have regard to relevant guidance issued by DHSC or NHS England for consistency and accountability across the system. The updated guidance is now published and publicly available, and the Explanatory Memorandum has been updated to share a link to it.
Some noble Lords may be concerned about legislative overlap, questioning the need for new regulations when modern slavery is already illegal. These regulations have been carefully drafted to fit in with existing statute, building on measures such as the Modern Slavery Act 2015 and the Procurement Act 2023, not replacing them. We are bringing all NHS England procurement into scope and creating a stronger legislative footing for enforcement. The aim is to introduce a single, enforceable risk management approach to modern slavery across the NHS, and we will continue to review our arrangements to ensure their effectiveness.
I do not pretend this will be easy. NHS supply chains are vast, making it difficult fully to assess the scale. The 2023 review was a snapshot, but it is likely that more than a fifth of our supply chains remain at high risk, as the review said and as I have previously stressed. Items included cotton-based products, surgical instruments and PPE gloves, all vital for hospitals across the country. That is why NHS organisations will be supported with clear guidance and resources to root out modern slavery wherever it is found.
It would be abhorrent to think that we procure such items cheaply by turning a blind eye. Ethical supply chains have been proven to be cost-effective in the long term, helping us to avoid litigation and supplier collapse, but even if this were not the case, I am confident that decent people across this country would never put a price on eliminating modern slavery.
In today’s debate we are considering the public and the NHS, but, most importantly, we remember the victims of modern slavery. We have a chance to send a message to enslaved people across the world: “What is happening to you is unjust. We have not forgotten you. We will ensure that our money does not go to those who keep you in chains”. I hope this proves that the Government are committed to rooting out and addressing modern slavery in NHS supply chains. I hope that I have been able to set out the purpose of and a clear rationale for the regulations. I look forward to what will, I am sure, be an informed and constructive debate. I beg to move.
Lord Scriven (LD)
My Lords, I am grateful to the noble Baroness, Lady Wheeler, for her clear and helpful introduction to the regulations. This is, quite rightly, a moment for us all to express collective support. The measure before us today is fundamentally about the moral application of public money. The NHS is arguably one of the largest single procurers, if not the largest, of goods and services in the country. When taxpayers’ money is spent, it must not, in any circumstances, inadvertently finance or sustain the abhorrent practice of modern slavery or human trafficking. This instrument, which is rooted in the Health and Care Act 2022, serves as a powerful declaration that our healthcare system will not tolerate this barbaric crime.
Having said that, I am a little confused on a point of governance and accountability. The Government’s Procurement Policy Note 009 Tackling Modern Slavery in Government Supply Chains already states unequivocally:
“This Procurement Policy Note (PPN) applies to all central government departments, their executive agencies, and non-departmental public bodies and NHS bodies when awarding public contracts”.
Given that PPN 009 already binds the NHS to a risk-based approach, will the Minister explain the precise interplay between these two existing policy requirements and the new statutory instrument?
In answer to questions placed by the Secondary Legislative Scrutiny Committee in its 37th report, on page 23, the Government seem to suggest that somehow this will be a more mandatory approach. I therefore seek to find out exactly how that interplay works out. Importantly, we need to understand what the fundamental flaw is in the existing PPN system that has led the Government to conclude that a policy note is insufficient to protect public money, compelling them to introduce new secondary legislation to ensure that the NHS supply chain is truly free from the stain of modern-day slavery and human trafficking. Are they saying that for other departments the PPN is not sufficient and there is a weakness within other public sector procurement if they do not introduce the equivalent of what the NHS is doing in this statutory instrument?
If these new duties are to be introduced over and above the existing PPN 009, we must be clear-eyed about the significant practical challenges that may arise during the implementation of these regulations. It is in the space between legislative intent and practical realities on the ground that problems can and sometimes do emerge.
First, on the scale of the administrative burden, the NHS supply chain is vast and notoriously complex, involving millions of different products—from common consumables to highly specialised medical devices—that are often sourced globally through multiple tiers of contractors. Imposing a mandatory risk assessment before every procurement process, as set out in the regulations, will place a substantial and, so far, uncosted administrative burden on already stretched NHS procurement teams. We must ensure that this work is not simply devolved to front-line staff without the requisite funding, training and specialist tools.
Baroness Wheeler (Lab)
My Lords, I thank the noble Lord and the noble Earl. I apologise that I will have to write on a number of issues, but I will try my best.
The noble Lord, Lord Scriven, asked what the difference is between PPN 009 and the regulations. PPN 009 sets out policy expectations, but the new regulations provide a statutory basis for enforcement, ensuring stronger accountability and compliance in NHS procurement.
On the impact on SMEs, the regulations do not impose direct duties on suppliers, including SMEs. We cannot accept any amount of modern slavery in our supply chains. The regulations allow for a proportionate approach to avoid deterring SME participation. Early market engagement and tailored procurement design will help SMEs compete fairly.
I turn to implementation, training and support. Guidance, training and tools, such as a central risk assessment tool, are being provided to support NHS bodies. The Department of Health and Social Care will take over guidance responsibilities from NHS England. I was asked what will happen and how the expected powers will be used when NHSE is abolished. All the powers will transfer to the Department of Health and Social Care. They have worked together so far and will continue to do so.
On compliance and monitoring, compliance checks are integrated into the NHSE procurement system that is used by more than 300 NHS bodies. We are encouraging commercial teams to embrace these checks as part of good governance. Line managers have real-time data monitoring, which enables effective oversight and accountability. Procurement regulations allow bodies to exclude suppliers and terminate contracts where risks are not remediated.
On the general concern, I understand totally the pressure on the NHS and on local authorities, which was not raised but is in the back of our minds. It is important that we use the NHS’s purchasing power—estimated at £35 billion—to raise standards across the globe without harming domestic suppliers. Ethical supply chains can still be cost effective in the long term by avoiding scandals, litigation and sudden supply collapse. I can reassure the noble Lord, Lord Scriven, and the noble Earl, Lord Effingham, on the point about NHS burdens and the impact on suppliers.
Lord Scriven (LD)
It is all right for the Minister to reassure the Committee, but have organisations such as the Federation of Small Businesses been consulted and given a view? Have they seen the regulations? Which small and medium-sized businesses have been involved and given the Minister the reassurance to be able to say that?
Baroness Wheeler (Lab)
Again, there was certainly full consultation. I will have to write to the noble Lord on the individual quotas, but we were very concerned to ensure that there was consultation across a wide range of groups.
I thank noble Lords for their valuable contributions to today’s debate and their commitment to ensuring that no goods or services procured are tainted by modern slavery. As I set out in my opening remarks, the NHS is one of the biggest buying organisations in the UK. We have a golden opportunity to leverage its purchasing power to influence supply chains in the UK, in Europe and right across the world. With this legislation, we can send a clear signal that we will not tolerate human rights abuses. I end by reminding colleagues that these regulations are about what we can do not just here in England but in eliminating modern slavery across the globe, and to say: “If you want to do business with the NHS, you must get your house in order”.
Lord Scriven (LD)
Before the Minister sits down, I asked a very specific question. The department wrote to the Secondary Legislation Scrutiny Committee that it aimed to publish the updated guidance for October 2025. Has that guidance been published? If not, when will it be?
Covid-19 Update
Debate between Baroness Wheeler and Lord Scriven(4 years, 1 month ago)
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Baroness Wheeler (Lab)
My Lords, I thank the Minister for reading the Statement.
Yesterday, the Secretary of State said that the pressures on the NHS due to Covid-19 are “sustainable”. Today, we have the Commons Statement desperately trying to reinforce this message when, in reality, we see ambulances backed up outside hospitals, patients waiting hour upon hour in A&E, cancer operations cancelled and NHS staff worn out and exhausted. Yet still, as we head into winter, the Government refuse to trigger plan B or tell us what the criterion is for doing so. Can the Minister spell out exactly what evidence and criteria will be used?
The British Medical Association is the latest front-line body to call for plan B’s immediate implementation. Why can we not just make the wearing of masks on public transport, for instance, mandatory now? We must remember that SAGE, the Government’s scientific advisers, called for plan B-type measures when the Government’s autumn and winter plan was first launched, with Sir Patrick Vallance stressing the importance of going early with measures to stop rising cases.
Once again, the Government have failed to learn the lessons of the early stages of the pandemic. This hesitation to follow advice will lead to more cases, more hospitalisations and more deaths. The Secretary of State’s warning that cases could rise to 100,000 is chilling. Today, we have the sobering update from the Government’s own Covid dashboard showing 52,009 new coronavirus cases—the highest daily total and the first time the daily tally has topped 50,000 since 17 July.
It is obvious that plan A just is not working. The vaccination programme is stalling, particularly given the very late vaccinations for 12 to 15 year-olds and the mixed messages and worryingly low uptake of booster jabs. Ministers cannot blame the public when 2 million people have not even been invited for a booster jab, and on current trends the booster programme will not be completed until March 2022. Currently, there are just 165,000 jabs a day. Will the Government commit to 500,000 booster jabs a day and ensure that the programme is completed by Christmas, as it needs to be, particularly given the growing evidence of waning vaccination protection among double-vaccinated older and more vulnerable people? We learned from leaked data yesterday that only a quarter of care home residents have received a booster vaccination. Can the Minister confirm that this is correct and tell the House what urgent action the Government are taking to address this?
On children, where the highest rate of infections is concentrated and infections are running at 10,000 a day, only 17% of children have been vaccinated. This is a stuttering and wholly inadequate rollout of the children’s vaccination programme. Does the Minister recognise that this slowness exposes the folly of the drastic cuts over the past decade in the number of school nurses and health visitors who support these immunisation programmes in our communities? Will retired medics and school nurses be mobilised to return to schools and carry out vaccinations?
As the winter crisis looms, the rollout of flub jabs is also crucial to bringing down hospital admissions and ensuring that the NHS can cope, but it is also painfully slow. Only 6% of over-65s have been vaccinated, and across the country we hear stories of cancelled flu jabs at GP surgeries and of pharmacists running out of supplies. Why are supplies apparently running so low, with infections, meanwhile, running so high? What are the Government doing to ensure adequate stocks at GP surgeries and chemists to meet the demand? Can the Government guarantee a flu jab to all those that need it by December? We must get ahead of this virus, because otherwise it gets ahead of us.
Can the Minister also comment on reports in today’s media that as well as plan B, there is now active consideration of a plan C: no household mixing—in other words,
“a lockdown by the back door”,
as the shadow Secretary of State, Jonathan Ashworth, has called it. Can the Minister tell the House what is actually under “active consideration”, in the words of the Health Minister on Radio 4 this morning? No household mixing would be deeply concerning for many people who were prevented from seeing their loved ones for months at a time during the first and second waves of lockdown.
I am sure noble Lords will have much to say on mask wearing, as they did during yesterday’s PNQ. Ministers continue to sow confusion, including among themselves, with the Secretary of State’s comments in the Commons yesterday that politicians should “set an example” and wear masks in crowded spaces—yet the Leader of the House subsequently told MPs that there was no such advice for workplaces. Can the Minister explain what is going on?
The Statement also refers to the agreement with Pfizer and MSD on two new antiviral drugs, which we of course welcome, as they play a vital role in stopping a mild disease from becoming serious. Can the Minister tell the House about the expected timetable for MHRA approval and any provisional details on availability and rollout?
Finally, on social care funding, as usual we welcome the announcement at the end of the Statement of additional funding for local authorities to support staffing and care work through the winter, assuming that the £162.5 million workforce retention and recruitment fund is actually new money and not part of previous repackaged funding. Could the Minister confirm this? Can he provide more details as to how and when this money is to be available and how it will be allocated to local authorities?
Lord Scriven (LD)
My Lords, I too welcome the Minister’s reading the Statement from yesterday. We are discussing this on the day when more than 50,000 Covid cases have been recorded in the UK for the first time since 17 July. There have been over 52,000 cases and 115 deaths; 8,142 people are in hospital with Covid, and 870 of those are on a ventilated bed. We are discussing this just hours after the Royal Cornwall Hospitals NHS Trust has declared a critical incident because of the pressures it is under serving the people of Cornwall.
That shows why this Statement is not a master class in providing a range of effective public health measures to tackle a virus that spreads at speed, and more a master class in trying to keep the libertarian wing of the Conservative Party happy. The “jab, jab, jab” message is important but, when some people go on to the booking system now, they are not able to book. They are told to ring 119, as my honourable friend in the other place, the Member for St Albans, Daisy Cooper, said early today; when they ring 119, operators tell them that they cannot override the system. I ask the Minister what is going on with the booking system and how soon it will be repaired. The “jab, jab, jab” message is important, but it is not, in itself, going to deal with the severity of the public health crisis we face. As Professor Adam Finn, a member of the JCVI, said yesterday, vaccinations in themselves are not going to stop us falling off the edge of the Covid cliff.
I want the Minister to explain these different rates, if plan A, of vaccination, is working. The seven-day rolling averages for Covid-19 cases per 100,000 of the population are: in the UK, just under 500, and rising sharply; in France, approximately 60, and falling; and in Spain, approximately 50, and falling. Even considering the variation in testing rates, the UK is clearly an outlier. Take a look at three months ago, when the Government removed all mandatory mitigation measures. The picture tells you the true story of why “jab, jab, jab”, as a public health strategy, is not enough to deal with the Covid-19 problems. Then, the UK had approximately 300 cases per 100,000, and it now has 500; France had approximately 220, and it now has 60; and Spain had approximately 350, and it now has 50. It is because France and Spain, as well as other countries, have jabbed, jabbed, jabbed but also mitigated, mitigated, mitigated. Indecision is our greatest enemy in the fight against this disease.
Let us be clear: those of us who ask for extra mitigation measures, such as the use of mandatory face coverings, do so to stop the crippling lockdowns that have come before. The Government, as the Health and Social Care Select Committee has reported, have acted too little too late before when dealing with this virus. This means that the damage, both to public health and the economy, is greater than it would have been if the Government had listened to the expert advice and acted sooner.
On one very important mitigation measure we could take, the mandatory use of face coverings, the Minister said yesterday, answering a PNQ:
“Personally, I do believe that many people should be wearing masks and that there is evidence for this.”—[Official Report, 20/10/21; col. 145.]
If good evidence exists that wearing face masks helps to reduce the transmission of Covid-19, why have the Government stopped their mandatory use in indoor settings? Could the Minister please enlighten the House on what evidence the Government have that asking people to use self-judgment on wearing a face covering in certain indoor settings is more effective than making them mandatory? I am sure that evidence will be at the Minister’s fingertips, as it is official government policy. They would not make up such an important policy to ditch a mitigation measure that could save lives without the use of good evidence—would they?
Furthermore, can the Minister explain why, at Prime Minister’s Question Time yesterday, hardly any Tory MP sat on the green Benches had a face covering on, and why, today, a Minister sat on the government Front Bench in this House wore a mask below his chin, with both his nose and mouth exposed? Whose evidence are they following? What leadership and example does it set to the nation if the Government are, on the one hand, asking us to use our self-judgment to wear a face covering, but government Ministers and MPs in the House of Commons do not?
The evidence of experts in public health and epidemiology, and figures from Europe, show that a mixture of vaccination and mandatory mitigation measures is required, if the spread of the virus is to be contained to manageable levels, so that later in winter we do not have to slam on the brakes and have yet another lockdown.
Can the Minister clarify something that he said yesterday during a PNQ? When asked whether the Government still had confidence in SAGE and its workings, the Minister replied:
“May I write to my noble friend on that?”—[Official Report, 20/10/21; col. 146.]
I know that the Minister is new and that he did not have all the details to hand, so I am giving him a second chance. Can he confirm from the Dispatch Box that the Government do have confidence in SAGE and the advice that it gives?
It is time to be clear that the message on vaccination take-up and extra mitigation on issues such as mandatory face coverings are required. Otherwise, we will be left in a situation where, unfortunately, more people will die than is necessary, the Government will be behind the curve in dealing with the virus and much more draconian measures will have to be taken. Now is the time for plan B, not for dithering and not taking the measures that are required.