European Union (Withdrawal Agreement) Bill

Baroness Thornton Excerpts

2nd reading & 2nd reading (Hansard): House of Lords & 2nd reading (Hansard)
Monday 13th January 2020 Lords Chamber

[Baroness Thornton (Lab)]

My Lords, rather like my noble friend Lady Jones, I rise with a heavy heart to make a speech which to some may sound familiar because it is. It is about the effect this Bill will have on health and medicine in the transition period and after 2021.

At every stage over the past two years, I have sought reassurance from the Government over matters of reciprocal healthcare, the free movement of medical and nursing staff, the regulation and supply of medicines, clinical trials and research, the conduct and regulation of which is so important in the UK. Indeed, access to the research portal is vital to patients across the UK and Europe. I thank the BMA, Cancer Research UK, the Royal College of Nursing and the King’s Fund for their excellent briefings on these matters. If the Minister cannot give me give me a comprehensive response to my questions, I anticipate a comprehensive written response that can be made available in the Library.

There remains some uncertainty about the status of current EU reciprocal healthcare arrangements in the event of the UK leaving the European Union without a negotiated deal. Will we have that deal by December and, if we do not, what will happen? At the moment, the National Health Service website says the following about reciprocal healthcare:

“If you’re using an EHIC issued by the UK, this will still be valid until”


the UK leaves the EU—is that at the end of this month or the beginning of next year? Can the Minister please tell me?—

“or if your treatment started before exit day.”

So perhaps you need to get a wiggle on if you want to have treatment. The website also says:

“You should prepare for possible changes to your access to healthcare”


if there’s a no-deal Brexit and

“if you’re a UK national travelling to the EU, Norway, Iceland, Liechtenstein or Switzerland … The … EHIC may not be valid if there’s a no-deal Brexit. This will depend on arrangements with individual countries and might mean you need to pay for treatment in full.”

Does the Minister think that that is satisfactory and that it will serve the citizens who might be affected by it? Perhaps he can give the House an update.

Following on from that is an issue concerning Ireland and Northern Ireland. Access to healthcare services through the common travel area differs for European reciprocal arrangements. The future of the border could have a significant impact on those areas, so I would like some clarification on that too.

In terms of staffing, nursing and other staff from the European Union not only care for our NHS patients but are active members of their local communities. However, the NHS continues to haemorrhage doctors, nurses, midwives, care staff and medical staff. The free movement of nursing staff and other healthcare professionals across the globe continues to make the UK a world leader in innovations in health treatments and care delivery. What comfort can the Minister give in that regard?

What arrangements for medical supplies are envisaged by this legislation? I failed to find them, so perhaps the Minister can help me out here. The Royal Pharmaceutical Society and many other bodies have warned that pharmacists are already struggling to obtain common medicines. Perhaps he would care to update the House on exactly what will happen in the next year and what might happen if we do not complete the transition by December?

I turn to the subject of the EMA and clinical trials. A close UK-EU relationship on medical research and the licensing of new medicines works for patients and researchers across the continent, and the medical research sector has been clear that continued close co-operation should be a priority in the negotiations. However, there is concern that recent government statements ruling out alignment with EU regulations could negatively impact UK-EU co-operation on medical research and medicines licensing, and put at risk the progress made by such collaboration. The UK’s membership of the EMA is a major advantage for UK patients, as companies generally prioritise launching new products in the European pharmaceutical market as opposed to other countries. I would like clarification from the Minister on how the Government intend to deal with this matter in the event of delays.

Finally, I turn to the subject of clinical trials. The UK’s world-leading clinical research environment is built on collaboration with European partners. This collaboration benefits all medical research and is particularly crucial for rare and childhood cancers where populations are often too small to run trials in individual countries. Likewise, as the most innovative research increasingly groups patients according to the genetic profile of their cancer, for example, the pool of eligible patients for some trials becomes smaller and one country alone may not have enough patients to make the evidence from the research meaningful.

If the UK falls outside the EU’s regulatory system for clinical trials, UK-led trials will be more burdensome and will be likely to be significantly more costly. There is already evidence that doubts about whether the UK will be part of the EU’s harmonised research system are affecting collaboration. A 2019 report found that UCL and eight other Russell group universities were running about 50 big European research collaborations in 2016 but that is now down to 20. Therefore, the key question for the Minister is whether the commitment to maintain regulations for clinical research trials in the UK still stands.