Department of Health and Social Care

Joe Robertson Excerpts

Tuesday 30th June 2026 Commons Chamber

[Dr Luke Evans (Hinckley and Bosworth) (Con)]

I will dispense with the formalities to jump straight in. The hon. Member for Oxford West and Abingdon (Layla Moran) asked whether the Government have a clear, funded and transparent plan. Simply put, the Government appear to have made commitments they cannot properly explain, cannot fully cost, and cannot tell Parliament how they intend to pay for.

We are of course talking about the UK-US pharmaceutical arrangement, which will see 0.3% of GDP in 2026, rising to at least 0.6% by 2036—or an overall medicine spend of 10% to 12% of the UK NHS budget by 2036. That may bring benefits and investment, it may avoid tariffs, and it may help some patients get treatment faster, but those benefits do not remove the three key basic questions: what will this cost, how will it be funded, and what will the NHS have to forgo as a consequence? Those questions remain unanswered, which is a running theme from this Government.

Since Labour took office in July 2024, the pharmaceutical sector has issued a serious set of stark warnings. In January 2025, AstraZeneca cancelled its £450 million expansion near Liverpool, citing as a factor in the decision

“the timing and reduction of the final offer compared to the previous Government's proposal”.

However, that was not isolated. In March 2025, the leaders of some of the UK’s biggest pharmaceutical companies warned that the country risked becoming “uninvestable”. That warning turned into decisions, with MSD cancelling its plans for a £1 billion research centre in London, Eli Lilly pausing its work on the Gateway Labs hub, and Sanofi saying that it would not make substantial UK R&D investment until it saw appropriate recognition of the value of innovation.

[Joe Robertson (Isle of Wight East) (Con)]

Given that there are so many unanswered questions and such little information, rather than estimates day, wouldn’t the better name for this debate be “a complete stab in the dark” day?

[Dr Evans]

Or guesstimates day, for want of a better pun. That is part of the problem. If the Government are so confident, why do they not produce the impact report so that they can justify this? At the end of the day, we have seen that those decisions are not isolated; they are different companies, making different decisions, but all with the same concern. It is a pattern: tax rises, more regulation, more red tape—a more toxic concoction.

The Government will say that the deal is part of the answer, but Ministers cannot point to potential benefits while avoiding certain costs. The House of Commons Library is clear that the Department’s main estimate for 2026-27 does not include budget cover to meet the expected increase in pharmaceutical spending associated with the UK-US arrangement. That is the central problem. The Government say that the total cost in the current spending review period is expected to be around £1 billion, but the former Minister, the hon. Member for Glasgow South West (Dr Ahmed), also said,

“Total costs over the Spending Review period are expected to be approximately £1 billion. The final costs will depend on which medicines NICE recommends and the actual uptake of these.”

That is an important admission, because the final cost depends on future NICE decisions and uptake, and other estimates are higher.

The Library briefing cites analysis suggesting that spending could be around £1.7 billion by the end of 2028, and around £14 billion by 2036, depending on the assumptions. Is the £1 billion the central estimate, and if so, what are the lower and higher ends of the estimate range? Why will the Government not publish the modelling so that we can see? My next question is even sharper: where is the money coming from? We know from leaked WhatsApp messages that Labour MPs have been asking who they can tax to pay for benefits, so where is the money coming from? Both the House and the public are right to ask.

The Government have said that additional costs will be funded from existing NHS budgets, with future funding settled at the next spending review. However, if the money is coming from existing NHS budgets, it is coming from somewhere within the NHS. It might be the workforce, services, capital or future growth, but it will not be cost free. As Jonathan Benger, the chief executive of NICE, put it,

“If they choose to spend money on defence, they’ve got to pay for that somehow, either by raising taxes or removing money from somewhere else. If they choose to spend money more on medicines, similarly, that has to be paid for.”

That is the reality.

The former Secretary of State told the House that the Government would not cut NHS budgets to fund the pharma deal, but the former Health Minister, the hon. Member for Glasgow South West, later turned around and said:

“The deal will be funded by allocations made at the Spending Review, where record funding for the NHS was secured. Future funding will be settled at the next Spending Review.”

Those statements need reconciling. If it is funded from NHS allocations, that is NHS money. Can the Minister rule out any cuts from the frontline?

Finally, I will turn to transparency. I want to point out that the UK-US pharmaceutical arrangement is not a treaty-based free trade agreement. It has not been through the Constitutional Reform and Governance Act process. We have not seen what is going on. The Government need to publish their impact assessment, and yet they cite commercial sensitivity. Of course, there is a way round that: the Minister could redact it and give that to the Committee so that we and this House can see what is going on.

I will cut my speech short there. I will simply pose—