Health Bill (Thirteenth sitting) Debate
Full Debate: Read Full DebateDanny Chambers
Main Page: Danny Chambers (Liberal Democrat - Winchester)Department Debates - View all Danny Chambers's debates with the Department of Health and Social Care
(1 month ago)
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Dr Danny Chambers (Winchester) (LD)
For over 50 years, there has been a statutory independent patient voice in the health and care system. The creation of Healthwatch was, in part, a direct response to the issues raised by the Francis inquiry into Mid Staffs. In a 2024 Healthwatch poll, almost a quarter of NHS patients said that they had experienced poor care in the past year, but 56% of them—more than half—took no action. Of that 56%, 20% said that that was because they were scared that giving negative feedback directly to NHS services would affect their ongoing treatment. Women, people living in areas of greater deprivation, disabled people and unpaid carers were significantly more likely to give the fear of retribution as a reason for not speaking up.
The Government are stripping patients of their voice in our NHS. Rather than being able to go to an independent body and express how the NHS can work better for them, patients will now be able only to give feedback to the same organisation that might have failed them. I have had experience of that in the past few weeks. My partner Emma has endometriosis, which has been an ongoing condition. She was worried that speaking to the local hospital trust specifically about the treatment she received might affect her treatment going forward.
The Government have argued that the changes will bring patient insight closer to decision making, making it much more effective at securing change. The former Health Secretary, the right hon. Member for Ilford North (Wes Streeting), stated that patients do not need “ventriloquists”. That blatantly disregards the vital role played by Healthwatch in advocating not only for vulnerable patients who, understandably, do not feel confident navigating health services with often complex or combative systems, but for whole communities with a pre-existing distrust of the system.
We believe that removing Healthwatch leaves the health service to mark its own homework, which creates a conflict of interest. It will significantly undermine public trust, as independence is removed. Will vulnerable people who have suffered harm or poor experiences in the health and care system really have faith in a system headed by a director in the Department of Health and Social Care, which is the very organisation running the system that caused them harm in the first place? On a local level, will they have faith going to the same ICB that oversees the providers that have failed them? One need only look at the long list of maternity failings in Mid Staffs to see that internal functions can fail catastrophically. We know all too well that the NHS default is sometimes to cover up. The public knows that, too, so independence is everything.
Healthwatch has been keen in spotting and exposing challenges in the health service, such as widespread failures in the NHS referral process, yet there will be no incentive for the new system to investigate such issues, which are invisible in the main NHS performance metrics. The system does not always know what questions it needs to ask, so an independent route for unsolicited feedback is important. We also think that the provisions disadvantage hard-to-reach communities and those who may have a distrust towards the NHS and public authorities, making it harder to gain the feedback and concerns of those communities. That risks inadvertently further baking in inequalities.
More widely, clarity has not yet been provided on how those functions will be funded. The reform is coming alongside major reductions in ICB running costs. Healthwatch currently receives almost £26 million a year; that is already 60% less in real terms than the original DHSC estimate to fund the network. There is a risk that the money will be absorbed into wider budgets and never spent on the patient experience infrastructure. If people want to see the value of Healthwatch, they need look no further than the Cabinet Office briefing notes on the King’s Speech, which reference a May 2025 Healthwatch report on missing medical records to make the case for the single patient record.
Fundamentally, the Government are conflating patient voice with patient involvement in decision making. While greater patient voice in commissioning and decision making is needed, it is not a replacement for the advocacy and other functions of Healthwatch, which helps vulnerable people to navigate a complex health and care system and performs signposting functions. Splitting local healthwatch functions across ICBs and local authorities once again separates health and care and reinforces existing gaps between them. As we know, many issues span both areas and need a joined-up investigative approach. How will the new model ensure a joined-up view of people’s experiences across the NHS and social care? We urge the Minister to reconsider this decision. We have seen overwhelming support for Healthwatch across the sector, and it is becoming increasingly clear that many people in the NHS and the medical profession think that this is a huge mistake.
Healthwatch England has played a central role in escalating the findings of local healthwatch organisations and in advocating nationally. We have three examples. The first is the call to publish research highlighting inequalities in waiting times for disadvantaged groups, and for a demographic breakdown of waiting lists, which the NHS obliged with last summer. The second example arose after Healthwatch Sunderland supported a patient with a learning disability who had received accessible screening information but risked missing care because of inaccessible follow-up letters. Healthwatch England raised that gap with national bodies and highlighted inconsistencies in communication, and, as a result, the national easy-read templates were introduced across the cancer pathway, which improved accessibility and reduced risk. The third example is that Healthwatch feeds back patients’ horrific stories of corridor care—including that of a pensioner who was left in a corridor—to NHS leaders, and lobbies for increased transparency and oversight when it comes to corridor care.
I have several questions in three forms. Is the Minister genuinely sure that a director of patient experience in DHSC will be eager to advocate for patients and flag issues at a national level given that they will essentially be flagging to their bosses where work is not up to scratch? Is she sure that the level of persistence that has so often been needed to advocate for change at a national level would be forthcoming from a director employed by DHSC? What will be the mechanism for escalating local concerns that indicate national or systemic issues?
Will the Minister explain where the Government envision the new director sitting in the DHSC structure, and what the reporting lines will be? How will the Government ensure that they have the resources and sense of operational independence to investigate and raise concerns nationally? Healthwatch England has often flagged issues to MPs and to the Health and Social Care Committee as a way of applying pressure on NHS leaders and Ministers to enact change.
Joe Robertson
I am a member of the Health and Social Care Committee, and the hon. Member is absolutely right to say that Healthwatch England raises issues with us. When the Department assumes those roles and functions, I very much doubt that it will be as keen to disclose such issues to the Committee.
Dr Chambers
The hon. Gentleman must have read the next line of my speech. We are concerned that a DHSC employee appearing before that Committee will not clearly and openly state whether DHSC is failing.
New clause 78
“would ensure that Healthwatch England and local Healthwatch organisations are funded to the level estimated by the Department for Health and Social Care”
in 2013-14. We do not just want to protect Healthwatch; we want to strengthen it. As I mentioned, it receives almost £26 million a year, which is spread over 153 organisations. In real terms, that is about 60% less than the £43.5 million that DHSC originally estimated would be needed to fund the network. The Healthwatch network does such amazing work—I will not go through it all again—despite being underfunded compared with those original estimates. Imagine the work it could do if it was adequately funded.
Even more worryingly, there is still no clarity on how Healthwatch’s functions will be funded once they have been transferred to the new system. Given the ongoing constraints and cuts to ICB running costs, there is a real risk that the funding for Healthwatch will simply end up being incorporated into wider ICB budgets, and money for the patient experience infrastructure could end up being cut entirely. The new clause aims to ensure that the Healthwatch network is properly funded, but it also raises the point that, if this change is to go through, funding for patient experience infrastructure must be protected. Otherwise, the Bill risks not just weakening patient experience, but removing it altogether as the funding gets swallowed by wider NHS operational demands.
Dave Robertson (Lichfield) (Lab)
It is, as ever, a pleasure to see you in the Chair, Ms Lewell.
Healthwatch was established, at least in part, as a response to the Mid Staffs scandal. Mid Staffs came up three times in our evidence sessions, and the hon. Member for Winchester mentioned it just now. That scandal matters to everyone, but it has a particular resonance for my role in Parliament. Many of my constituents were harmed by the failing at Mid Staffs. I was born in that hospital, and I speak as a Staffordshire MP. None of us should ever forget what happened or allow it to be swept aside without examining it. There were a great many failings at Mid Staffs over a long period. Oversight was just not in the room when decisions were being made.
Staffordshire county council’s health and care overview and scrutiny committee clearly did not do that job. The Francis report stated:
“The arrangements for public and patient involvement, and for local government scrutiny in Stafford, were a conspicuous failure.”
The report recommended some changes to ensure that Healthwatch, which was in the process of being set up at the time, was funded properly. In that light, the framing of this debate is important and timely. Healthwatch has been going for well over a decade. It is right that we now examine its impact, as it is a significant part of patient voice within the NHS.
Despite the very best efforts of a great many hard-working staff and an army of committed volunteers across the country, the quality of local healthwatch organisations is pretty changeable. Over the past few weeks, I have spoken with right hon. and hon. Members from across the House. The feedback that I have received has ranged from, “My local healthwatch team is brilliant— I work with them really closely and they have really helped out with a huge amount; they deliver great things in my constituency” all the way to, “I have some pretty significant concerns about their impact.” In a couple of cases I heard, “What is Healthwatch? I have never heard of it.”
I thank the Minister for her response. Given the commitments that she has made, I do not intend to press the new clauses, but I hope she will be able to come back to us on Report with some more concrete progress. I beg to ask leave to withdraw the motion.
Clause, by leave, withdrawn.
New Clause 3
Assessment of risks posed by contracts with non-UK based suppliers
“(1) Within six months of the passing of this Act, the Secretary of State must conduct and lay before Parliament a risk assessment of all contracts between NHS organisations and suppliers based outside of the UK.
(2) In conducting an assessment under this section the Secretary of State must—
(a) pay particular regard to contracts which provide technology companies with access to confidential patient data;
(b) consult national security experts on the risks posed to UK sovereignty by such contracts;
(c) consider risks associated with the sharing of confidential patient data with organisations based outside of the UK;
(d) assess public and NHS staff attitudes to relevant suppliers and any implications such attitudes may have on the use and effectiveness of products or services provided under the contract; and
(e) consider the background of relevant suppliers, known contracts with other states and organisations, and any relevant ethical considerations.
(3) Where any significant risk is identified, the Secretary of State must set out the Government’s intentions to manage and mitigate such risks, including its intention to use or develop domestic technologies, systems or products in place of those provided under the relevant contract.”—(Dr Chambers.)
This new clause would require the Government to publish a risk assessment of contracts between NHS organisations and suppliers based outside of the UK.
Brought up, and read the First time.
The Chair
With this it will be convenient to discuss the following:
New clause 4—Duty on the Secretary of State to prioritise domestic suppliers—
“In the National Health Service Act 2006, after section 1CC (inserted by section 6 of this Act) insert—
‘1CD Duty to prioritise domestic suppliers
(1) In exercising functions in relation to the health and care service, the Secretary of State must prioritise the awarding of any contract that will involve the handling of NHS patient data to suppliers based in the United Kingdom.
(2) The Secretary of State may only seek to procure technology and information systems which will handle NHS patient data from suppliers based outside of the United Kingdom where a viable domestic alternative does not exist.
(3) Before signing any contract for the procurement of technology and information systems which will handle NHS patient data with a supplier based outside of the United Kingdom, the Secretary of State must consult with—
(a) patient groups,
(b) national security experts, and
(c) staff unions,
on the proposed contract and lay a report on such a consultation before Parliament.
(4) Where it is proposed to sign a contract for the procurement of technology and information systems which will handle NHS patient data with a supplier based outside of the United Kingdom, the Secretary of State must arrange for a motion agreeing to the signing of such a contract to be tabled in each House of Parliament, and no such contract may be signed where a motion for its agreement is negatived by either House of Parliament.
(5) If a contract is awarded for the procurement of technology and information systems which will handle NHS patient data with a supplier based outside of the United Kingdom, the Secretary of State must place a statement before both Houses of Parliament setting out whether the Government is taking, or is planning to take, steps to develop or support long-term domestic alternatives to the systems provided by the contract.’”
This new clause would place a duty on the Secretary of State to prioritise domestic, UK-based, suppliers for technology systems and contracts handling NHS patient data, and places restrictions on the signing of contracts for such systems with non-UK based suppliers.
New clause 5—NHS Digital Sovereignty Strategy—
“(1) The Secretary of State must, within 12 months of the passing of this Act, publish a strategy (‘an NHS Digital Sovereignty Strategy’) which sets out the Government's approach to maintaining the security and resilience of relevant NHS information systems by—
(a) assessing, managing and mitigating risks—
(i) associated with foreign interference,
(ii) arising from reliance on foreign-supplied technologies, and
(b) preventing over-reliance on foreign providers by building domestic capacity.
(2) For the purposes of this section, a ‘relevant information system’ is an information system with access to NHS patient data.
(3) An NHS Digital Sovereignty Strategy published under this section must—
(a) include risks associated with—
(i) hardware,
(ii) software,
(iii) supply chains, and
(iv) procurement processes;
(b) include a specific focus on security and resilience in digital procurement processes, detailing how the Government intends to reduce strategic dependencies on foreign-owned service providers to mitigate the risk of systemic disruption;
(c) include a commitment to prioritise the use of technologies developed in the UK by UK organisations in relevant information systems to reduce reliance on foreign technologies;
(d) recommend steps to support and develop sufficient domestic capability where it does not currently exist;
(e) where risks are identified, state how the Government intends to address these risks by supporting the use or development of domestic technologies or systems.”
This new clause would require the Government to publish an NHS Digital Sovereignty Strategy setting out how it intends to address risks to relevant information systems posed by foreign interference and reliance on foreign technologies, including by supporting the use of domestic technologies.
New clause 9—Retendering of contract for the NHS Federated Data Platform—
“The Secretary of State must, before February 2027, commence a competitive retendering for the contract to provide the NHS Federated Data Platform.”
New clause 10—NHS contracting for IT or data services—
“(1) The Secretary of State must, within six months of the passing of this Act, by regulations establish a governance framework for the contracting of any IT or data services by the Department of Health and Social Care or any NHS organisation.
(2) The framework established under subsection (1) must include the following provisions—
(a) a party may not bid for any contract for services where such services have previously been provided by the party on a free trial basis;
(b) the automatic extension of contracts should be subject to audit by the National Audit Office;
(c) contract terms must include provision for the department or NHS organisation to take ownership of any bespoke system built or developed by the contractor during the delivery of the contract;
(d) the department or NHS organisation must, at the end of the contract period (or following any extensions) conduct a competitive retendering process; and
(e) where a retendering process takes place under subsection (2)(d), the contractor may not assist in the preparation of the contract specification.
(3) Regulations under this section are to be made by statutory instrument subject to the affirmative procedure.”
New clause 43—Data obligations—
“A contract given in relation to the provision of NHS services must include an obligation to provide data under the Freedom of Information Act 2000 in relation to that contract and to the patients served.”
This new clause would oblige those receiving contracts to provide NHS services to make available FOI data in relation to the patients covered by the contract and the contract itself.
Dr Chambers
New clauses 3 to 5 are related to the publication of risk assessments of contracts between NHS organisations and suppliers based outside the UK. They would place a duty on the Secretary of State to prioritise domestic, UK-based suppliers in the case of technology systems and contracts involving the handling of NHS patient data, and place restrictions on the signing of such contracts with non-UK-based suppliers. New clause 5 would require the Government to publish an NHS digital sovereignty strategy setting out how they intend to address risks to relevant information systems posed by foreign interference and reliance on foreign technologies, including by supporting the use of domestic technologies.
We had a Westminster Hall debate on this subject recently. The lack of transparency in how some contracts are awarded is one of the central concerns about Palantir’s involvement with the NHS. We are particularly concerned about the national security considerations of offshoring the whole of our nation’s health data to any foreign company, which makes us vulnerable to political and economic changes in other countries, but especially to companies of questionable integrity in an increasingly authoritarian jurisdiction with little respect for privacy and sovereignty. We should all be worried that our health data has been so closely linked with such an organisation, which has shown itself all too eager to work closely with Donald Trump’s Administration. We know that his Immigration and Customs Enforcement agency has been using health data to identify people’s immigration status, and there is a lot of concern that people are not coming forward for medical treatment as a result. Doctors and patients have already voted with their feet and shown that they do not trust Palantir and its system for this very reason, which is also a key reason for the limited uptake of the federated data platform so far.
As such, we have tabled various new clauses to try to address those concerns, to ensure that they do not plague the single patient record, which we absolutely support and want to help the Government to deliver, along with any other vital technology or data system. New clause 3 would ensure that a risk assessment is conducted of all non-UK tech and data suppliers, with particular regard for national security. It is centrally important that doctors and patients trust the systems that hold their health data and that, as a country, we trust them to be safe and secure. We should not trust rogue actors with our nation’s health information. New clause 5 deals with how we mitigate that risk. It would require the Government to publish an NHS digital sovereignty strategy, setting out how they intend to address the risks of foreign interference and reliance on foreign technologies.
Our potential answer to both those questions lies in new clause 4, which would prioritise domestic suppliers that handle sensitive or confidential NHS data. We recognise that that will not always be possible, but where domestic capability does not exist and it is therefore necessary to work with foreign suppliers, to ensure the transparency and effective oversight of a contract with a foreign supplier, it must be brought before Parliament. Should a contract be signed with a non-UK supplier, it would also be subject to consultation with patient groups, national security experts and staff unions to make sure that the system is onside. If it is not, uptake of it will be stunted, as we have seen with the federated data platform.
Gregory Stafford
Obviously, I have sympathy for what the hon. Member is trying to achieve—ensuring that our data systems are free from potential hacking by either state or non-state actors is very important—but I cannot see anything in new clause 4 about the size of contracts. Does his suggestion relate to any contract, however small, that was given to a non-UK-based company? It is not clear what he means by a non-United Kingdom company. Is that one that is headquartered here, one that is listed on our stock exchange, or one that has a CEO who is a British citizen? I am not quite sure what he means by a UK-based company, but if we can define an outside-based one, is he saying that any contract of any size given to such a company will have to come to Parliament?
Dr Chambers
The size of the contract would be pretty much irrelevant; what matters is the implications arising from the contract being signed. Does a contract potentially compromise our data sovereignty? Alternatively, if a contract failed for any reason, whether it was because of the action of a state actor or a non-state actor, would the service continue to function?
Dr Prinsley
I am grateful to the hon. Member for taking my intervention and I am sorry that it is late in the afternoon. The question we are faced with is this: what is the best system to serve our patients? If the best system turns out to be a system that is procured from another country, would he in principle always object to that?
Dr Chambers
I would not always object to that, because the whole point of the new clause is that such a contract would come to Parliament and then might well be approved if it turned out to be the best system and in our national interest. The thrust of all three new clauses is to ensure that we do not get exposed and make ourselves vulnerable, which could affect the functioning of the NHS and compromise people’s data. A future Government could set up their own AI system in the UK. How would data be used by that system? We are looking at future-proofing people’s privacy and future-proofing the ability of our country to deliver a service properly.
There is also an economic opportunity. We should always prioritise domestic suppliers where possible, and even cultivate them, and help them to innovate and develop, because spending potentially tens of millions of pounds with foreign companies will not do anything to grow our own economy. Given the world-beating talent in our country, we see no reason why the long-term effect of domestic options to foreign systems could not be developed with sufficient Government support. As such, where a contract is signed with a foreign supplier, new clause 4 would require the Secretary of State to take steps to support domestic alternatives. We recognise the complexities involved with NHS procurement, and our new clauses represent one vision built on the core principles of domestic resilience and digital sovereignty.
I have a few questions for the Minister, which I would appreciate some comments on. How do the Government intend to build trust in the single patient record to make sure that it is not undermined, rather like the federated data platform has been? Does the Minister agree that the poor reputation of Palantir and distrust has been an important element in the slow roll-out of the federated data platform? Has she considered undertaking a risk assessment with a national security focus of current NHS digital and tech contracts? Does she agree that, in an ever more turbulent world, building domestic capability in this area is central to the security of our country?
Does the Minister agree that the domestic life sciences and tech sector is more than capable of developing and scaling many of the systems that we rely on foreign companies for at the moment? The Government have very much positioned AI and technology as the NHS’s white knight. We agree that the potential is huge, but do the Government not think that the NHS needs a long-term digital strategy to support a joined-up development and roll-out of these systems and technology? An analogy to this is how the defence investment plan and future defence procurement can help prioritise and boost economic growth in the UK. We think this is another way that economic growth could be nurtured.
I rise to discuss new clauses 3 to 5 and 43, which I am sure that the Whips will not let me forget. I understand the sentiment behind the Liberal Democrat new clauses. The hon. Member for Winchester is keen to ensure that uses of NHS data are limited to uses for which people can consent, uses in relation to their care or specifically approved research. Having heard examples of this data being tracked or leaked by accident, the hon. Gentleman is keen to ensure that that does not happen. He is particularly concerned about the risk of that happening in another jurisdiction where we have less control of the system. I am not sure that the new clauses have been properly thought through, however.
New clause 3 says:
“Within six months of the passing of this Act, the Secretary of State must conduct and lay before Parliament a risk assessment of all contracts between NHS organisations and suppliers based outside of the UK.”
That is “all contracts”. In subsection (2), it says that the Secretary of State must “pay particular regard” to contracts with technology companies, but not only to those. I am being a bit pedantic here, but has the hon. Member for Winchester considered the wording of “all contracts”? The NHS does not just provide drugs and medical technology; it provides bedding, blankets, pillows, bananas for people to eat at lunchtime, bedpans and loo roll. There is a whole range of things procured as supplies by the NHS that may or may not be procured from overseas. It would be cumbersome and completely unnecessary to include all of those.
Even with the tech companies themselves, there is a risk for small contracts for small pieces of tech to create a huge amount of bureaucracy. I am not sure that it would specifically improve data quality or data protection. It is reasonable that the Minister would consider risk assessments, and I hope that she would automatically consider them before contracts that are particularly sensitive or contain patient data, but I am not sure that the new clause works.
Moving on to new clauses 4 and 5, the hon. Member talked about Palantir. It may even have been his intention for these new clauses to target one specific American firm, but the actual impact would erect costly barriers to trade. The NHS contracts IT functions to firms based in other countries when the business case is strong. It uses Microsoft, an American company that offers software, cloud services and Outlook for emails; Oracle for standardising and automating financial processes; Sectra, a Swedish company, for transferring medical images and reports; and Dedalus, an Italian company, for migrating services to the cloud. To echo the point made by the hon. Member for Bury St Edmunds and Stowmarket, should the NHS prioritise a British company over an international company if the service has better functionality and a lower cost and is safe?
The hon. Member for Winchester spoke about the vibrant life sciences and tech sector in this country, but if we close off our markets to those from overseas, will others not do the same? Would he want those life sciences companies to be unable to export? There is a barrier to free trade here.
Dr Chambers
This is not about closing off markets or shutting off the potential to use foreign companies if they are most appropriate. It is about prioritising and investing in UK technology and our economy to solve some of our domestic problems while also providing security. Saying that we are closing off domestic markets is misunderstanding the thrust of the new clause.
I think it is about balance. I agree that we need to ensure that the data is kept safely. Using British technology where we can is a good thing, but we have to be reasonable about it. For example, there are alternatives to Microsoft Outlook, but how much more would that cost the NHS and how much would it affect patient care? There is a balance to be struck. I understand what the hon. Gentleman is trying to do in protecting our data. That is an extremely important issue, and I am sure the Minister will tell us about the work she is doing to ensure our data is kept safe.
New clause 43, in my name, is about private providers’ data. We often do freedom of information requests about, for example, surgical procedures, but one in 10 procedures are performed in private settings and are not subject to FOI, which means that less data is available to the public. Data from private independent providers is less transparent than that of standard NHS provision. This is a probing amendment to find out the Minister’s thoughts about how to ensure people can access transparent data on operations performed in local independent hospitals, particularly as the Government have signalled their intention towards more and more of those being provided.
I am grateful to hon. Members for tabling these new clauses. I recognise the concerns behind them. Contracts involving NHS data, digital services and technology must be subject to proper scrutiny. Patients expect their medical information to be protected, and NHS staff expect the systems that they use to be safe and reliable. The Government agree that Parliament should be entitled to test how those protections work.
I also want to be clear that the Government want British businesses to win more public contracts and build stronger UK capability in digital and technology. The Government are already using procurement to support British businesses, jobs, skills and national security. More than 90% of UK public contracts are currently awarded to UK suppliers, and the Government have set out reforms to make procurement do more to support British industry and supply chain resilience.
I do not think that new clause 3 is the right way to achieve proper scrutiny. It would require the Secretary of State, within six months, to conduct and lay before Parliament a risk assessment of all contracts between NHS organisations and suppliers based outside the United Kingdom. That would include contracts regardless of the value—we heard a little about that from the Opposition—and of the services being provided, the type of data and whether there is evidence of any sort of concern. Risk is driven by the nature of the data involved, not just where the supplier is located. That is why the Government’s approach is based on targeted assessment and proportionate control.
We already have the tools we need in the Procurement Act 2023, which gives contracting authorities the powers to exclude suppliers and terminate contracts where the legal tests are met, including on national security grounds. They may also refer suppliers for a debarment investigation. The National Security Unit for Procurement supports Ministers in assessing suppliers on national security grounds, working closely with Departments and the intelligence community. In health and digital contracts, those procurement powers sit alongside data protection legislation and data protection impact assessments, in line with the digital, data and technology playbook. That is not an argument for complacency; we should continue to identify risks before procurement begins.
A broad duty of the kind in new clause 3 would risk becoming a reporting exercise and would not necessarily make the highest-risk contracts safer. It could, however, draw time and resource away from the assurance activities that matter most. The right approach is to strengthen the targeted controls, not to create a single statutory risk assessment covering every non-UK supplier.
Similarly, on new clause 4, a blanket “buy British” rule would not be the right test for NHS data contracts, although I hope that I have assured the hon. Member for Winchester that home-grown domestic products are absolutely what we are trying to focus on. The UK must treat suppliers from countries with reciprocal procurement access fairly. Our international obligations matter and are an important driver of the UK economy, including the World Trade Organisation agreement on Government procurement, which gives British businesses guaranteed access to £1.3 trillion in public procurement opportunities overseas annually.
As the hon. Member will understand, new clause 5 would require the Government to commit to a new programme of work to develop domestic capability, to reduce reliance on overseas suppliers of IT services and technology. The strategy would also require us to set out an approach to managing the risk associated with our current use of technology provided by overseas suppliers. I welcome the notion of encouraging domestic innovation to ensure the security and resilience of our IT infrastructure. However, ensuring the security of our data and the resilience of our systems is already embedded in everything we do. The new clause is therefore simply not necessary.
Hon. Members will accept that we want to see continued growth of digital and tech industries in this country; it is one of our real success stories. However, it will not be achieved by cutting across procurement law and not seeking the solutions that provide the best value for our money and the right service for the NHS. Our approach to securing the best IT and tech solutions should always be to seek the best on offer in a diverse, global market, not to prioritise based on location. Prioritising domestic providers means making a decision on grounds other than the quality, integrity or value for money of a solution.
I understand the concern behind new clause 43, which the hon. Member for Sleaford and North Hykeham spoke to. However, where public money is used to provide NHS services, there should be proper transparency about the contract, the service being delivered and the use of public funds. Patients and the public are entitled to expect that information is not placed beyond reach simply because a service is delivered through a contract. I do not think the new clause necessary, and I am concerned that it could create confusion about the operation of the Freedom of Information Act 2000. The Act already deals with information held by another person on behalf of the public authority. The key issue is not where the information physically sits. It does not matter whether it is held by the authority or by one of its commercial partners; what matters is whether it is held for the public authority’s purpose.
The Government agree with the principle of transparency, but new clause 5 would not improve the existing framework. It would risk duplicating duties that already exist, cutting across standard contract terms and creating uncertainty about patient information, which is rightly protected. For all those reasons, I ask hon. Members not to press the new clauses.
Finally, I say to the hon. Member for Winchester that we have already debated the single patient record. Public trust is key, and there will be multiple suppliers. We are bringing patients and the public with us and will continue to do so. The hon. Member asked about the FDP roll-out. I do not think it was about the supplier. I think it was about the money. It was about inertia in rolling out some good technology that provides good efficiency. It was also about capacity, capability and an attitude to productivity, which we absolutely need to drive more of.
Dr Chambers
I appreciate the Minister’s response and the comments of other Members, which were insightful as usual.
When we discussed whether carers could access parts of the single patient record, Members made very good points about privacy and historical health issues that a patient might not want a carer to know about. Those are very sensible concerns, but someone watching these proceedings or looking back over the record would think that there had been a lot more agonising over whether someone caring for a patient could access relevant information than over the potential systemic misuse of health information facilitated by private companies. A lot of people are worried about that when it comes to procurement, trust and sovereignty.
I thank the Minister for her comments on new clause 3. I beg to ask leave to withdraw the motion.
Clause, by leave, withdrawn.
New Clause 4
Duty on the Secretary of State to prioritise domestic suppliers
“In the National Health Service Act 2006, after section 1CC (inserted by section 6 of this Act) insert—
‘1CD Duty to prioritise domestic suppliers
(1) In exercising functions in relation to the health and care service, the Secretary of State must prioritise the awarding of any contract that will involve the handling of NHS patient data to suppliers based in the United Kingdom.
(2) The Secretary of State may only seek to procure technology and information systems which will handle NHS patient data from suppliers based outside of the United Kingdom where a viable domestic alternative does not exist.
(3) Before signing any contract for the procurement of technology and information systems which will handle NHS patient data with a supplier based outside of the United Kingdom, the Secretary of State must consult with—
(a) patient groups,
(b) national security experts, and
(c) staff unions,
on the proposed contract and lay a report on such a consultation before Parliament.
(4) Where it is proposed to sign a contract for the procurement of technology and information systems which will handle NHS patient data with a supplier based outside of the United Kingdom, the Secretary of State must arrange for a motion agreeing to the signing of such a contract to be tabled in each House of Parliament, and no such contract may be signed where a motion for its agreement is negatived by either House of Parliament.
(5) If a contract is awarded for the procurement of technology and information systems which will handle NHS patient data with a supplier based outside of the United Kingdom, the Secretary of State must place a statement before both Houses of Parliament setting out whether the Government is taking, or is planning to take, steps to develop or support long-term domestic alternatives to the systems provided by the contract.’”—(Dr Chambers.)
This new clause would place a duty on the Secretary of State to prioritise domestic, UK-based, suppliers for technology systems and contracts handling NHS patient data, and places restrictions on the signing of contracts for such systems with non-UK based suppliers.
Brought up, and read the First time.
Question put, That the clause be read a Second time.