Caroline Johnson Portrait Dr Johnson
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I will be relatively brief. New clause 15 would require the Secretary of State to lay before Parliament any trade negotiation requiring NHS spending or funding exceeding £100 million, in the form of regulations subject to the affirmative procedure. New clause 76 would require the arrangements between the United States and the United Kingdom on pharmaceutical pricing to be laid before the House to be voted on.

A key concern is costing. There have been various estimates of the additional cost of medicines. The former Secretary of State, the right hon. Member for Ilford North (Wes Streeting), said that he would not change or cut the NHS budget to pay for that increased cost. Will the Minister tell us the estimated extra cost of medicines, and where that money will come from, if not from the DHSC budget?

Gregory Stafford Portrait Gregory Stafford (Farnham and Bordon) (Con)
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It is a pleasure to serve under your chairship, Ms Lewell. Like the shadow Minister, I will be relatively brief. [Interruption.] It was not clear whether that was a sound of appreciation or disappointment from the Minister. I will assume that she receives everything I say with the same noise and grace.

Yesterday, the Secretary of State appeared before the Health and Social Care Committee—on which my hon. Friend the Member for Isle of Wight East and I sit—and was questioned at some length by the Chair, the hon. Member for Oxford West and Abingdon (Layla Moran), about the UK-US trade deal. It was striking that the Secretary of State appeared unable to answer the basic question of whether an impact assessment could be presented to the Committee—under whatever terms of secrecy or confidentiality the Department wanted to place on it—to allow us to assess the costs, as the hon. Member for Winchester outlined, and, one would hope, the benefits.

The Secretary of State was very clear that there were benefits, but he was unable to outline what they were. He cited commercial confidentiality, which I do understand; there will be commercially confidential elements to the deal. What was really striking, however, was that even though the Select Committee was very happy to receive the information under whatever strictures he wanted to put on it, so that we could scrutinise it, it was not given. That is serious cause for concern.

I understand what the hon. Member for North Shropshire seeks to achieve through new clauses 15 and 76, but there are some problems in their drafting. There will be commercially confidential elements to the deal, so laying it before the House essentially completely unredacted, as new clause 15 would require, might pose real problems. Likewise, I assume that the intention of new clause 76 is to focus specifically on the UK-US trade deal as currently formulated.

Peter Prinsley Portrait Dr Prinsley
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Much of the conversation around those trade deals relates to pharmaceuticals from the United States. Our patients should be able to access the best available treatments, whatever deals we cook up. We must support innovative research based in our own country, particularly clinical trials for new medicines. To do that, we need to support clinical academics—the doctors who work in universities and organise research. Does the hon. Gentleman acknowledge that the number of clinical academics fell under the previous Conservative Administration? Most clinical academics are now very senior, and we are not recruiting replacements effectively. We need to look after our home-grown pharmaceutical industry so that we do not need such trade deals.

Gregory Stafford Portrait Gregory Stafford
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I certainly agree with the hon. Gentleman’s penultimate point: we need to support home-grown clinical academics and the life sciences industry in this country. As he has drawn me down that line, I declare that my wife works in the life sciences industry in the UK. I entirely agree with him on that point. However, if he is saying that a corollary is that we should not do pharmaceutical trade deals with other countries, I do not agree, because UK patients need the best medicines no matter where they come from. If that was not what he was saying and I am putting words into his mouth, I apologise, but that is how it sounded to me. I agree that we should support the home-grown, but obviously we need access to medicines from around the world.

That brings me to my concerns about new clause 76. I understand why the hon. Member for Winchester supports it, but the way it is written means that, for the lifetime of the Act, any trade deal with America would have to follow those strictures. Although I accept that he does not like the current deal or the incumbent in the White House, it seems odd that we are singling out in statute, and putting a stricture on, one country over every other. I still probably would not have voted for it, but the new clause might have been more acceptable had it referred to any trade deal with any country, or even a group of countries—I know he is a big fan of one particular group of countries. That might have made it difficult. It would be dangerous essentially for the Bill to put a stricture on a trade deal with one specific country—especially one that is probably our strongest ally. I think that sits very badly.

Sojan Joseph Portrait Sojan Joseph
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Does the hon. Gentleman agree that the existing constitutional arrangements already provide mechanisms, ministerial accountability and parliamentary scrutiny? Singling out one country is a politicising measure, and it will have long-term consequences for our relationship.

Gregory Stafford Portrait Gregory Stafford
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Yes, I agree entirely with the hon. Gentleman. It would be a very slippery slope to write that into legislation. I understand the motivation—as I often do—behind Liberal Democrat new clause 76, but I do not think its drafting is appropriate in this context, and I cannot support it.

Joe Robertson Portrait Joe Robertson
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As my hon. Friend the Member for Farnham and Bordon said, we on the Health and Social Care Committee heard from the Secretary of State yesterday. These new clauses were obviously drafted in advance, but the timing of their consideration is rather good.

We had the opportunity to ask the Secretary of State, who sits right at the top of the Department, some fairly basic questions about the deal that will apparently see the NHS pay 25% more for US drugs than it does currently. We asked, for example, how much it will cost. The Chair of the Select Committee, the hon. Member for Oxford West and Abingdon, skewered the Secretary of State within minutes. A short while later, once the Secretary of State had had the chance to reflect on her queries, I had the opportunity to ask some even more basic questions. I asked not what the figure was, but whether one even existed or whether any analysis had been done. We ended up going backwards.

We parliamentarians and the public still do not know the answers to some basic questions, even though a deal has been done. Do we know how much it will cost? Does a figure exist? Has an analysis been done? Are we talking about a figure or a bracket? On what basis was the deal agreed? We received absolutely no answers at all to those questions. To conclude, I posed a fairly obvious question: how on earth can we strike a deal to pay 25% more for drugs that we already get without knowing how much it will cost? No answer was given to that question either.

It is no wonder that these fundamental questions have effectively come in the middle of the Bill’s passage. This is not the place for them, but in the absence of basic answers, I can see why the hon. Member for Winchester and others have raised these issues. I will ask the same questions of the Minister. If her boss cannot answer them, perhaps she can, as the Department has had 24 hours to reflect. How much will the deal with the US cost? Are there—even if the Government do not want to disclose them—a figure and an impact assessment?

If the Government can confirm that a figure or bracket exists, why are they not willing to discuss them? If the Government can confirm that some sort of impact assessment has been done, when did it happen and why are they not disclosing it? Until we get those answers, so that people can see the fundamental considerations on which the Government base their decisions, this is a fairly unappealing way of going about securing investment for life sciences.

The Secretary of State talked about the benefits of this deal, and I am sure that there are benefits. I do not disagree with the principle of paying more for drugs if it has benefits for research and development—I understand and support that principle—but I want to be able to see what those intended benefits are, in some form of document or analysis. I do not want bare statements that say, “Research and development is good.” We all know that; I want to see the cost.

New clause 15 would also set a cost threshold of £100 million. The Government are not in a position to confirm whether the US deal would qualify under clause 15. It would at least force the Government’s hand. I suspect that the sum is far higher—into the billions—but we do not know. We are left to sit and speculate, despite the Secretary of State’s appearance before the Health and Social Care Committee. He must have expected that question to be asked. He was flanked by the permanent secretary of the Department and the chief executive of NHS England. By the way, he was a Treasury Minister prior to becoming the Secretary of State just two months ago. We had all the key people in the room to give some sort of indication about cost and benefit, yet none was forthcoming.

Although I cannot back the new clause, because I do not think statute is the right place to ask these questions, I completely understand why it was tabled. She will not accept the new clause, but could the Minister at least answer some of the questions that parliamentarians and the public are asking?

--- Later in debate ---
Caroline Johnson Portrait Dr Johnson
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I should say that I am a member of the Education Committee. As the hon. Member for Winchester says, new clause 28 would extend the powers of the first-tier tribunal so that, when determining an appeal, it may order that EHCPs must include health and social care needs and provision, rather than just making recommendations on those matters.

It is clearly important that children with special educational needs get the support they need. We are all very aware, from our inboxes, that that does not always happen. I do not know whether putting this into legislation would make it happen, or whether it would need much more work than one clause, but clearly it is a very important aim and I support the principle of it. I would be grateful for the Minister’s comments on how she thinks this could work in practice and whether it is legislation or a more widespread plan that is required.

Gregory Stafford Portrait Gregory Stafford
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I rise briefly to speak on this as well. I should note for the record that I am the vice-chair of the all-party parliamentary group on special educational needs and disabilities.

The hon. Member for Winchester, on behalf of the hon. Member for Oxford West and Abingdon, made the case very strongly. I am a member of the Health and Social Care Committee, and we took evidence as he described. The lack of a statutory obligation in the current EHCP process is a fundamental problem. We need to ensure that the health elements are put on the same footing as the social care ones. As I am sure is the case in every hon. and right. hon Member’s constituency inbox, the number of children who are receiving or require support with special educational needs and disabilities, and the frustrations with the process both locally and nationally, are rightly something that we, as parliamentarians and policymakers, need to get a grip on.