Health and Care Bill

Lord Blencathra Excerpts
Relevant documents: 15th and 16th Reports from the Delegated Committee, 9th Report from the Constitution Committee
Baroness Henig Portrait The Deputy Chairman of Committees (Baroness Henig) (Lab)
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My Lords, we come to Amendment 213A. I inform the House that the noble Baronesses, Lady Brinton and Lady Harris of Richmond, will be taking part remotely.

Amendment 213A

Moved by
213A: After Clause 70, insert the following new Clause—
“Health service procurement and supply chains: genocide convention obligations
(1) Regulations whether made under section 70 or otherwise may, in particular, make provision for the purposes of ensuring that procurement of all goods and services for the purposes of the health service in England is consistent with the United Kingdom's obligations under the Convention on the Prevention and Punishment of the Crime of Genocide.(2) For the purposes of subsection (1), procurement is not consistent if a Minister of the Crown has assessed that there is a serious risk of genocide in the sourcing region.(3) A Minister of the Crown must make an assessment as to whether there is serious risk if the chair of a relevant select committee of either House of Parliament requests one, and must complete such assessment within two months.”
Lord Blencathra Portrait Lord Blencathra (Con)
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My Lords, I apologise for my enthusiasm to get stuck into this vital amendment. I will speak to Amendment 213A in my name and that of my noble friend Lady Hodgson of Abinger, the noble Baroness, Lady Kennedy of The Shaws and the noble Lord, Lord Alton of Liverpool, whom I also consider to be a noble friend.

Allow me to begin by stating the obvious: UK taxpayers do not want to be complicit in genocide. It feels strange that this still needs to be said in 2022, 73 years after the genocide convention was agreed and nearly 80 years after the world became aware of the abominations of Auschwitz. Yet here we are in the age of ESG and corporate social responsibility, when the UK boasts of leading the world in the fight against modern slavery, and what do we find? We find hundreds of millions in public money poured into the pockets of companies profiting from Uighur forced labour; hundreds of millions of pounds poured into a region that our closest ally, the United States, has identified as the site of an ongoing genocide—an area so tainted with forced labour that President Biden has just signed into law the Uyghur Forced Labor Prevention Act, banning all imports from Xinjiang province unless it can be proven that they are slavery-free.

Those wondering why this Bill and why now have the answer. Credible reports have demonstrated that our existing procurement policy has been insufficient to prevent the Government spending hundreds of millions on slave-made PPE. With noble Lords’ permission, I will address a concern with the amendment head on. I would normally favour this sort of regulatory reform to apply across all government departments and would therefore look askance at focusing on just one department solely, as I am today. However, health is a special case, especially during the current pandemic. According to its modern slavery statement from 2021, the first year that the department has produced any such statement, the DHSC procured 280 regular non-Covid-19 contracts, but how many contracts did it produce for Covid? The answer is 708—708 contracts to address the pandemic, with a heavy preponderance of contracts being awarded to China.

I hope that noble Lords will permit me a brief digression to note that the Government revealed in reply to a recent Parliamentary Question that a billion lateral flow tests were procured from China despite some local production capacity. Why we would eschew British business in favour of companies in China, with all the attendant human rights risks, is beyond me.

Back to the point of his amendment: how many of those 708 Covid contracts went to Xinjiang-based companies? We simply do not know. What did the DHSC have to say about PPE widely reported to have been made by Uighur slaves? It said:

“This statement does not cover the Vaccines Taskforce (co-owned by BEIS), personal protective equipment (PPE) or UKHSA (formerly Public Health England (PHE) and Test and Trace) contracts.”


Those 708 contracts excluded a huge variety of other contracts by different organisations of our Department of Health and associated bodies.

Frankly, that is not good enough. If our laws do not prevent investment in modern slave-traders then, simply, our laws need to be changed. Noble Lords will recall debates surrounding genocide during the passage of the Trade Bill. Your Lordships voted by huge majorities in favour of allowing the High Court to make determinations of genocide, agreeing with the noble Lord, Lord Alton, and others that it was insufficient to outsource our genocide convention obligations to international courts, especially where those courts lack the power to hold back certain states, such as China. These efforts were resisted by the Government and the amendment before your Lordships today does not attempt to resurrect that campaign.

This brings me to the function of the amendment. Its first and core purpose is to apply a human rights threshold to government health procurement. If this new clause stood part of the Bill, it would be illegal for the Government to procure health service equipment from any regions in the world where they believe there to be

“a serious risk of genocide”.

That is a very high bar. It will be present only where the most serious human rights abuses are widespread. We would expect to see crimes against humanity, torture and mass enslavement in such areas.

The spirit of the Modern Slavery Act goes much further than this, discouraging business with companies which facilitate modern slavery offences. Modern slavery is much more widespread and common than genocide, affecting an estimated 40 million people worldwide. But the spirit of the law and the letter of the law are very different things. It is widely acknowledged that Section 54 of the Modern Slavery Act, which seeks to regulate supply chains, lacks teeth.

This amendment seeks to give it some more teeth in a limited and proportionate way. It applies only to government health procurement, allowing us to get our house in order first before pointing the finger at business. It applies only to the most serious human rights abuses of all, those which indicate a serious risk of genocide. Best of all, it leaves the assessment of “serious risk of genocide” to the Government and allows broad scope for the Government to define a process surrounding these risk assessments through regulations. In short, it is a very reasonable amendment. Candidly, while Uighurs in Xinjiang province are being forcibly sterilised, forced to work and detained in their millions, we ought to be doing a lot more. But this is a modest little amendment.

That brings me to the second purpose of the amendment, which is to move forward UK policy on genocide. We have heard ad nauseum from the Government that they have no view on genocide and will only use the word when “a competent court” has ruled on it. This policy has many problems, chief among them being that it makes genocide prevention impossible. The Committee may or may not be aware that our responsibilities under the genocide convention arise “at the instant” we become aware of a “serious risk” of genocide. Those quotes are direct from the International Court of Justice’s Bosnia v Serbia judgment in 2007. Let me repeat; it should happen at the very instant we become aware of a serious risk of genocide. That is when our convention obligations should apply. They do not arise when a court formally determines genocide, which usually happens many years after the genocide in question has ended. They arise at the instant we learn of a serious risk of genocide.

That simply means that the United Kingdom should be making regular assessments of serious risks of genocide and acting where appropriate. But we do not do this. This amendment before your Lordships’ Committee today puts that right and gives Parliament a limited role in ensuring that such assessments are performed in a timely manner, commensurate with the severity of the issue. It does not require the UK to make a formal determination of genocide, nor for the Government to behave like a court. It merely requires the Government to do a risk assessment—something we ought to be doing already.

I shall address the criticism that this is an “anti-China amendment”. This is false. The amendment makes no mention of China and would apply to every country. But I make no apology whatever for my motivation in bringing this amendment forward, which is to address President Xi Jinping’s heinous persecution of the Uighurs.

Finally, I was contacted the other day by the British Medical Association, which says:

“The BMA is deeply concerned about labour rights abuses in supply chains. Evidence shows that medical equipment, including PPE, has been procured from regions in which labour abuses are common, as this BMA report shows. The BMA notes the Uyghur Tribunal judgment, which found the PRC guilty of genocide, and the extensive procurement of NHS supplies from this region of China. This is deeply troubling; acquiring PPE from this region continues the systematic oppression of the Uyghurs and other minorities. The BMA believes all NHS supplies must be ethically sourced and this amendment would significantly reduce the risk of health service goods used in the UK being produced by individuals who are having their human rights abused.”


I hope I have demonstrated the need for this amendment. Having led the world in confronting modern slavery, the UK is falling behind—and we do not need to fall behind. The Covid pandemic has been a sorry period for many reasons, and making the UK taxpayer complicit in the persecution of Uighurs through PPE procurement is one of the sorriest. Let us take the opportunity to put that right: life-saving must not be dependent on life-taking. I beg to move.

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Earl Howe Portrait Earl Howe (Con)
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My Lords, I am grateful to my noble friend for enabling us to debate the serious and important issue of ensuring that health service procurement and supply chains are consistent with the United Kingdom’s international obligations. I have listened very carefully to the contributions from all noble Lords who have spoken.

I begin by making clear what the regulation-making power under Clause 70 is designed to do, and not do. The Clause 70 power is limited in scope to healthcare services and, with the exception of some mixed procurements, will not extend to the procurement of goods. The vast majority of healthcare services procured by the NHS are provided by domestic suppliers or, indeed, by the NHS itself.

However, there is a wider point to address in response to the contributions of noble Lords. As a party to the Convention on the Prevention and Punishment of the Crime of Genocide, the UK is fully committed to the prevention and punishment of genocide as appropriate under the convention. Indeed, the UK is active in fulfilling its duties under the genocide convention. Given that the majority of mass atrocities occur in and around conflict, the Government believe that a focus on conflict prevention is the best means to prevent most mass atrocities. To that end, this Government adopt a consolidated, whole-of-government effort using our diplomatic, development, defence and law-enforcement capabilities to help find pathways to global peace and stability.

As my noble friend is well aware, it is the long-standing policy of the Government that any judgment as to whether genocide has occurred is a matter for a competent national or international court, rather than for Governments or non-judicial bodies. It should be decided after consideration of all the evidence available in the context of a credible judicial process.

Having said that, our policy on genocide determination does not prevent us taking robust action to address serious violations of human rights. The Government are clear that they expect all UK businesses to respect human rights throughout their operations, in line with the UN’s Guiding Principles on Business and Human Rights. In response to the guidelines, the UK is proud to be the first state to produce a national action plan, and we continue to develop our approach in line with the Modern Slavery Act 2015. Section 54 places a requirement on businesses with a turnover of £36 million or more to publish an annual modern slavery statement setting out the steps they have taken to prevent modern slavery in their operations and supply chains.

Following a public consultation, the Government committed to a package of measures to strengthen our transparency in supply chain requirements. This includes extending the reporting requirements to public bodies with a budget of £36 million or more to create public and private sector parity. The Government have led the way in this endeavour and, in 2020, the UK became the first country in the world to publish a government modern slavery statement, setting out the steps we have taken to identify and prevent modern slavery in our own supply chains. The noble Lord, Lord Collins, indicated that he had not seen evidence of action in this area. In November 2021, we published a progress report on how we have met the ambitious goals set out in that statement and, at the same time, each UK ministerial government department voluntarily published their first annual modern slavery statement. As the noble Lord mentioned, the FCDO and the Cabinet Office are also working together to introduce new guidance to UK government bodies to exclude suppliers where there is sufficient evidence of human rights violations in any of their supply chains. Further detailed guidance is being developed that will be mandatory for government contracting authorities.

The UK’s G7 presidency demonstrated how we are revitalising G7 co-operation to tackle the most pressing global challenges. At the meeting in Carbis Bay, in June 2021, G7 leaders reaffirmed their commitment to uphold human rights and committed to prevent, identify and eliminate forced labour in global supply chains. This was followed up by the G7 Trade Ministers’ meeting in October, building on those commitments to eradicate forced labour, protect victims and improve global supply chain transparency, including by upholding international labour standards in their own business operations and procurement policies. This is one of a number of recent, clear demonstrations of our continued leadership and commitment to ending human rights abuses in global supply chains.

The noble Baroness, Lady Brinton, indicated that she did not think that the Department of Health and Social Care in particular was doing enough in this area, but if we look at the health service specifically, we see that the Department for Health and Social Care published a statement in October 2021 explaining the steps it has taken to identify, prevent and mitigate modern slavery within its own operations and supply chains for all goods and services that it procures. This aligns with the Cabinet Office guidance advising public sector contracting authorities on how to assess suppliers in terms of mitigating the risk of modern slavery. Contracts are normally placed in line with the department’s terms and conditions, which include clauses requiring good industry practice to ensure that there is no slavery or human trafficking in supply chains.

My noble friend also asked why the 2021 modern slavery statement did not cover the Vaccine Taskforce, PPE, UKHSA—formerly Public Health England—or test and trace contracts. Some indication of preventive steps taken in relation to these areas were included in the statement, and, as was outlined later in that statement, all areas will be covered in 2022 statements.

My noble friend, and the noble Baronesses, Lady Brinton, Lady Harris and Lady Kennedy, the noble Lords, Lord Alton, Lord Collins and Lord hunt, my noble friends Lady Hodgson and Lady Sugg, and others, raised issues about Xinjiang, in particular. The Government have taken robust measures in respect of UK supply chains. We have introduced new guidance for UK businesses on the risks of doing business in Xinjiang, supported by a programme of ministerial engagement, and we have announced enhanced export controls, as well as the introduction of financial penalties under the Modern Slavery Act. Taken together, these measures will help to ensure that no British organisations —government or private sector, deliberately or inadvertently—are profiting from or contributing to human rights violations against the Uighurs or other minorities.

I am conscious that the noble Lord, Lord Alton, asked me a series of questions. If he will allow me, I will write to him on those that I am unable to answer today. The same applies to the points raised by the noble Lord, Lord Rooker, to whom I listened with great care.

For the multiple reasons that I have set out, I cannot accept my noble friend’s amendment. I hope, nevertheless, that I have been informative, and that he will have derived at least some reassurance from what I have said about the seriousness with which the Government view the issues around human rights violations, and the actions that we are taking.

Lord Blencathra Portrait Lord Blencathra (Con)
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My Lords, I am grateful to every noble Lord and noble Baroness who has taken part in the debate, every single one of whom spoke in favour of the amendment, apart from my noble friend Lord Howe—I perfectly understand that he had to adhere to the DHSC brief. I am certain that, if every other noble Lord were to speak in the debate, each one would support the amendment as well.

I am grateful for the particularly powerful speech of the noble Lord, Lord Rooker, on determining the provenance of goods. Just as an aside, I can tell the House that, before Christmas, I thought I would impress my wife by trying to buy a couple of Oxford pillowslips myself, without troubling her. I wanted something with a thread count of over 400—for my delicate little skin, of course—and it took me hours and hours on the web to try to find a supplier among the major retailers that could guarantee that it would not be from Xinjiang province. I ended up contacting one supplier and asking, and three weeks later it replied by email guaranteeing me that the cotton was not from Xinjiang. I bought the pillowslips, and I still do not know whether or not I have been sold a pup—but they are quite nice against the skin. The noble Lord is right: we can tackle this problem only if we can trace provenance, and using DNA or other scientific evidence may be the best way to do that.

I do not want to go down the route of criticising some of the initial contracts that the Government entered into, as some noble Lords have done. There is no doubt about it: we were ripped off by some of them, we bought some duff equipment, and there will have been some dodgy contracts. But I remember that, at the time, every medic was calling out, “Get us PPE from wherever you can!” The whole world was scrabbling to get PPE. If your house is on fire, you do not spend ages on the web trying to find the cheapest fire bucket; you buy whatever you can. So I do not want to spend time on whether those contracts were value for money; that is for another day.

Someone asked: when did genocide start? I recall that the noble Lord, Lord Adonis, who was in the Chamber briefly, made a powerful speech a few months ago, saying that when genocide was happening, the whole world noticed that it was happening but did nothing about it, and then afterwards said that it must not happen again. We knew that Jews were being exterminated, and after 6 million were killed we said, “It must never happen again”. We knew what Pol Pot was doing, and afterwards we said, “It must never happen again”. We knew what Stalin was doing, and afterwards we said, “We must never let it happen again”. Then there was Srebrenica, and afterwards we said, “We must never let it happen again”. We know that genocide is taking place in Xinjiang province, yet we are just putting in place systems that may, one day, eventually, stop us trading with some of the people there who are committing genocide. That is not good enough. We must act faster than that.