Health Security (EU Exit) Regulations 2021

Baroness Merron Excerpts

Monday 5th July 2021 Grand Committee

[Baroness Merron (Lab)]

My Lords, we debate these regulations today on the 73rd anniversary of the National Health Service. I am sure that all noble Lords take great pleasure in seeing the George Cross awarded to recognise NHS staff past and present across all disciplines and all four nations; it is indeed a worthy honour.

I thank the Minister for outlining the focus and intent of these regulations, which are certainly welcomed. We welcome the focus on co-ordinating data-sharing, epidemiological surveillance and a four-nations approach to the prevention and control of serious cross-border health threats. It is certainly important to see the devolved nations’ public health agencies working in a close, collaborative relationship, which is what we hope to see following the adoption of these regulations. It is worth noting that, throughout the course of the pandemic, we have seen considerable regulatory divergence and differing communication issues between the devolved Administrations and the UK Government, particularly at a political level. As we well know, and as has been referenced in this debate, global health—in fact all—threats do not recognise borders. They do not fit that neatly.

The First Minister for Wales, Mark Drakeford, has consistently asked for a “regular, reliable rhythm” to meetings between the devolved Governments and the UK Government. Can the Minister assure us that this will become the norm? I noted his complimentary comments about the collaborative nature of his recent discussions, and I certainly wish to be assured that that will continue.

According to the Government, the UK Health Security Agency will undertake functions in five core areas in relation to future infectious disease threats. It will also

“act to strengthen health protection capability from top to bottom”

and place a “strong focus” on reducing inequalities in the way that different communities experience, and are impacted by, infectious diseases or environmental hazards. However, there is still very little information about how this will work, and it remains unclear how it will address the wider socioeconomic determinants of health. Perhaps the Minister can help us here.

To be more specific, the UK lost its elimination status for measles in 2016 and that was not about an external threat. That was about the internal competence—or otherwise—of the Government in handling public health issues. Does the Minister share my concern that the decision to subsume Public Health England into a security-focused agency may result in large areas of public health being neglected amid a focus on future pandemics?

What emphasis will be given to tackling the wider determinants of health, which have had a huge impact on the UK’s very poor outcome with Covid? Does the Minister agree that the Government cannot afford to ignore non-communicable diseases, including cancer, the wider health of the UK and those social inequalities, such as cramped housing and unequal access to care, which have exacerbated the experiences of many throughout the pandemic?

One of the big problems as we went into the pandemic was that the health of the population was poor at the outset, and in many cases getting worse. The improvement in life expectancy had stalled from 2012 onwards. Can the Minister confirm whether the agency will deal with this? One of the major failures of the UK’s response to Covid has been the inability of people to isolate. How will the agency address people in precarious occupations in the informal economy—those who do not have access to paid leave in order to self-isolate—and people who live in multigenerational homes?

We welcome the investment in tackling future infectious diseases but remain concerned that at the same time there has been disinvestment in UK Research and Innovation research funding. UKRI has warned of a £120 million hole in its budget following recent cuts. Does the Minister share my concern that this shortfall threatens to undermine overseas scientific projects seeking to understand how we can better mitigate against zoonotic diseases such as Covid-19? Will the Government commit to bringing forward their commitment to increase research and development spending to 2.4% of GDP by 2027?

Like my noble friend Lord Hunt of Kings Heath, I refer the Minister to the comments of the Secondary Legislation Scrutiny Committee on the Explanatory Memorandum, which, it said

“does perhaps overestimate the average reader’s knowledge of the UK’s plans.”

I hope the Minister will be able to assure the Committee that the department will ensure that the Explanatory Memorandum will be explicitly clear on what Parliament is being asked to agree going forward.