Health Bill

Baroness Merron Excerpts

Committee stage
Wednesday 11th November 2026 Lords Chamber

I have nothing more to add, noble Lords will be grateful to hear. I just wanted to make that point, based on my experience. We look forward, much more than to my contribution, to the Minister’s response.

[The Parliamentary Under-Secretary of State, Department of Health and Social Care (Baroness Merron) (Lab)]

My Lords, I am most grateful to noble Lords for their contributions to this debate. As before, I will focus on the amendments before us. I start with the future of the NHS federated data platform and the noble Lord, Lord Clement-Jones, who spoke to his Amendments 158, 159 and 172E, and the noble Baroness, Lady Bennett, who spoke to her Amendment 172B.

As I hope noble Lords will agree, decisions about public contracts must be made through fair, open and non-discriminatory processes, which is the point the noble Lord, Lord Kamall, was making. This is governed by UK procurement law and it ensures we get the best outcomes and solutions for the National Health Service. NHS England is reviewing the contract to determine whether it should continue, subject to standard contract management processes and government approvals. This process remains ongoing and decisions will be announced formally.

I can assure your Lordships’ House that the FDP operates under the direction of the NHS and each trust and ICB that has signed up uses it as it sees fit. Furthermore, Article 25 of the UK GDPR, which requires organisations to include data protection by design and default, already applies to the FDP. Were data to be anonymised as Amendment 158 proposes, it would prevent the delivery of national services such as national vaccination and screening, and key activity supporting the management, operation and provision of national health services.

I feel it would be helpful to set out the potential implications of Amendment 172B. When it was tabled, the usual channels received advice from the House authorities that the amendment would, in their view, risk making the Bill hybrid as it seeks to put in the Bill that the contract of one specific company is not extended. If the Bill is hybridised through amendment, those affected will have the opportunity to petition, after which the Bill will be referred to a Select Committee.

[Lord Clement-Jones (LD)]

Can the Minister confirm the date when the decision will be announced on whether or not there will be retendering of that FDP Foundry contract?

[Baroness Merron (Lab)]

I am not able to confirm the exact date, but I can say, as I said earlier, that the decision will be announced formally, so noble Lords will be made aware.

On the questions of security, resilience and sovereign capability, as raised in Amendments 53, 171 and 289 by the noble Lord, Lord Tarassenko, the Government share his determination to protect patient data and to support the strong UK digital health market. However, I am not able to commit to an NHS digital sovereignty strategy, nor additional legislation. Supply risk is not determined by nationality or jurisdiction alone. What matters is the data involved, who can access it, the supplies controls and the contractual protections in place. We already have robust safeguards. The Procurement Act 2023, about which much has been spoken, provides powers to exclude suppliers where appropriate, including on national security grounds. It also provides for setting data protection and cyber security requirements.

I note specifically the noble Lord’s concerns about the procurement of the single patient record, and I am looking forward to a more focused discussion, as I know all noble Lords are, on the SPR at a later Committee stage. I can confirm now that the procurement will have to ensure the resilience of our systems, how we keep within the UK jurisdiction and that the data remains under NHS control. The noble Lord, Lord Tarassenko, raised concerns that foreign laws could require an overseas supplier to give access to NHS data. We take that risk extremely seriously and aim to ensure that the legal, contractual and cyber-security safeguards are in place to avoid this.

I fully endorse encouraging domestic innovation, as I hope noble Lords are aware. As the Chancellor set out in the recent Budget, the Government will use public procurement strategically to back British firms to strengthen domestic capability and to build resilience in key supply chains. We will continue to promote international investment and trade and to open opportunities for British businesses at home and in markets around the world.

The noble Baroness, Lady Kidron, indicated her agreement with the noble Lord, Lord Tarassenko, in this area. The points on sovereign data being an asset will come back in the group beginning with Amendment 142, and again I look forward to debating that. We want a vibrant UK market for tech, and practical action is already under way. NHS England is engaging industry ahead of procurements, structuring opportunities to increase SME participation, and using social value to support good jobs and skills, which we all want to see.

I turn to Amendment 279A, tabled by the noble Lord, Lord Austin. He too raises the important question of accountability within this amendment, and we agree that contracting authorities should be accountable to the objectives of the Procurement Act, which already apply directly to covered procurement. The Act also provides transparency and oversight mechanisms, including powers to investigate compliance. The Procurement Act 2023 already requires publication of contract details for contracts worth over £5 million and, where applicable, key performance indicators and annual assessments of supplier performance against them. This makes a further NHS-specific annual reporting duty unnecessary in our view. For medtech, our value-based procurement approach further supports decisions focused on patient outcomes, total care costs, and longer-term value.

[Lord Scriven (LD)]

The amendment from the noble Lord, Lord Austin, refers to

“medical devices, consumables and services”.

There are two laws in place for procurement for the NHS: one for services and one for goods. What about the services? We have heard about the goods, but what about the accountability and feedback for services?

[Baroness Merron (Lab)]

I made reference to the Procurement Act 2023, and that is the guide by which we go.

[Lord Scriven (LD)]

It is for goods, but NHS services come under the 2022 health Act. There was discussion about whether it should have all fallen under one procurement law, but for NHS goods it is the 2023 Act, and for services it is the 2022 health Act that is applicable. If the Minister could write to me and place a copy in the Library, it would be helpful to see how the health Act also applies.

--- Later in debate ---

[Baroness Merron (Lab)]

So many health Acts. I would, of course, be very happy to do that.

I turn to Amendments 144, 147 and 160, tabled by the noble Lord, Lord Clement-Jones. I recognise the importance of ensuring that NHS IT and data procurements are fair and competitive, and protect the interests of patients and taxpayers. However, there is already extensive procurement law governing the department and NHS organisations. The Government agree with the objective of avoiding supplier lock-in. However, ownership of all connector IP is neither necessary nor the most effective means of achieving that. Appropriate licensing rights, interoperability requirements, open standards and exit provisions can protect portability and future competition without prescribing a single ownership model. Similarly, a blanket prohibition on suppliers that have previously provided free services could have unforeseen consequences, including for voluntary sector providers. Existing procurement rules provide safeguards against unfair incumbent advantage.

--- Later in debate ---

[Lord Clement-Jones (LD)]

The Minister mentioned existing procurement rules, and she gave a partial nod to my Amendments 144, 147 and 160, but said it was not always desirable for all those elements to be observed. Perhaps she could write and say which bits of those amendments—which are quite technical, I admit, dealing with interoperability, data connectors and the prevention of supplier lock-in—she means. It would be helpful if she could write and explain how the procurement rules that she prays in aid achieve some of those objectives.

[Baroness Merron (Lab)]

I will be pleased to do so and thank the noble Lord.

[Baroness Bennett of Manor Castle (GP)]

The Minister referred to national security grounds being considered in the letting of these contracts. When we talk about national security, traditionally we have thought about hostile states proving a threat, but now we are in the context of the broligarchy—tech oligarchs who wield enormous power and influence, frequently opaquely held, with links to far-right politics and Governments who are funding far-right forces in the UK and around Europe. Is the Minister confident that that kind of national security threat is adequately considered when we look at contracts?

[Baroness Merron (Lab)]

That is not a matter I feel able to reply to in detail right now, although I will gladly write. However, to the best of my knowledge, the interpretation of what represents a threat to national security is set out and is understood.

[Lord Tarassenko (CB)]

I thank all noble Lords who have spoken. I think we have mostly sung from the same hymn sheet, with perhaps the odd discordant note—maybe even a few bars, maybe even a whole movement, some people might argue. I am grateful to the Minister for her comprehensive reply.

I found it heartening last week to hear the Secretary of State speak positively about sovereign data and sovereign AI—those were her words. We now have an opportunity to go from concept to implementation within the next two years—namely, the single patient record contracts; that is, not the FDP contracts but the new contracts for the single patient record.

I believe, and I believe that many other noble Lords agree with me, that we have a highly capable—world-leading, I would say—UK medical technology and software sector, with companies that are often university spin-outs now ready to scale up. None of my amendments is in contradiction with the Procurement Act. I believe these companies can win these SPR contracts on merit. We are talking about supporting UK excellence, but we need to remember that the US spends billions to support technology in a radically different, profit-driven healthcare system, which often produces software that has a very poor fit to the NHS. I am sure the noble Lord, Lord Lansley, will be able to tell us that the original EPRs, the electronic patient records, from companies such as Epic and Cerner were a poor fit because they were designed for billing purposes, not for optimising patient outcomes. We made that mistake with the EPRs; let us not make the same mistake with the SPR.

In general, because the UK businesses are much smaller than the Oracles, the Epics, the Palantirs and the IBMs, we need a level playing field. I suggest that we need a signal from the Government to those companies that the Government are keen for them, as was mentioned by the Minister, to use procurement strategically to back UK business. I think that signal is the NHS digital sovereignty strategy, and I believe we will come back to it on Report. I beg leave to withdraw my amendment.

--- Later in debate ---

[Earl Howe (Con)]

My Lords, I start by welcoming Amendment 54, as tabled by my noble friend Lord Lansley. It raises an important concern about eligibility for NHS continuing care. Someone suffering from a serious chronic condition, including severe dementia, should not find themselves disadvantaged in comparison with someone with terminal cancer simply because their condition fluctuates or because they are not considered to be approaching the end of life. Eligibility should be determined by the intensity and complexity of a person’s needs rather than by arbitrary distinctions. Having said that, and while the concept of continuing care is one that we can all embrace, its quality and delivery, as the noble Baroness, Lady Barker, so succinctly reminded us, often fall far short of the ideal. Can the Minister therefore say whether the Government will consider making the existing eligibility framework more responsive to the patients that my noble friend described?

I also welcome my noble friend Lord Harlech’s Amendment 279QE. Recognising the particular medical and dental fitness requirements of reservists is a sensible and clearly proportionate measure. The amendment does not displace the key principle, as he explained, that clinical need must remain paramount in this context. Can the Minister explain how the Government currently expect health bodies to recognise the particular circumstances of reservists and whether further guidance might be necessary?

This debate has been characterised by a consistent measure of concern around commissioning. We have seen this through Amendments 57, 59 and 73, as tabled by the noble Baronesses, Lady Grey-Thompson and Lady Pidgeon, who are seeking greater transparency through impact assessments and reporting requirements, particularly where specialised services are transferred to ICBs.

The noble Lord, Lord Hunt of Kings Heath, in Amendment 58, similarly highlights allergy provision. All this argues for Amendment 80, as tabled by the noble Baroness, Lady Grey-Thompson, which seeks greater scrutiny of the performance of ICBs.

As a significant number of the amendments in this group highlight, including those from the noble Baroness, Lady Scott of Needham Market, and the noble Lord, Lord Sharkey, there is concern that the Secretary of State, with so many priorities, will be unable to provide acceptable standards for certain groups. Accountability and consistency of standards cannot just be taken as a given or as things that will come out magically in the wash. It would be helpful if the Minister could explain to the Committee how the Government intend to reconcile these objectives.

In particular, where specialised commissioning is transferred to ICBs, who will be responsible for ensuring that the necessary commissioning capacity and expertise will be in place? Amendment 74, from the noble Lord, Lord Sharkey, and my noble friends Lady Sater and Lady Chisholm, asks a corresponding and equally important question around clinical leadership. As the noble Lord, Lord Scriven, expressed so well, the amendments in this group demonstrate the complexity of the decisions involved in commissioning healthcare, particularly for specialised services. I do think that further and better particulars are required from the Government before any of us can feel comfortable with the direction in which we are heading.

[Baroness Merron (Lab)]

My Lords, I am most grateful for this debate. I will endeavour to pick up most of the main points, but if I do not manage to do that, given the hour, I will of course be pleased to review the points raised and pick them up—in particular, looking at how I could be more helpful in providing some of the broader information that is being sought.

Perhaps I could start by emphasising that the whole point about the Bill is that Ministers are, of course, responsible to Parliament for how they discharge all their duties, including how they promote the comprehensive health service that we all seek and how we reduce health inequalities in access and outcomes.

The regulations prescribing the services retained for national commissioning will be subject to parliamentary approval. I assure your Lordships’ Committee that, in putting forward the regulations, Ministers have to have regard to patient numbers, provision costs and the number of providers, because they all relate to safety, effectiveness and value for money of commissioning at various different tiers.