Health Bill (Fifteenth sitting)

Joe Robertson Excerpts

Committee stage
Thursday 9th July 2026 Public Bill Committees

[Dave Robertson]

I very much appreciate that intervention, and I congratulate the hon. Gentleman on getting published in a very important journal. I am not in any way saying that the Secretary of State should not have any regard—[Interruption.] Now that he has made a joke, I want to say that I think he looks like a trombonist, rather than a trumpeter.

There is a very important point to draw out here. Although Departments can think about the public health impacts of the work that they undertake—I am sure many Ministers will do so—I am not sure there needs to be such a requirement to focus on public health for the Ministry of Defence, which obviously has a very significant, serious role.

New clause 80 would require all Ministers to have regard to public health. I really appreciate and value that—I think this is a good debate for us to have—but if the Minister for investment has managed to secure an investor to save a large business that is essential to the economy of an area, do I want them to be held up by having to demonstrate that the investment will ensure public health? I am not sure I do. A lot of decisions have to be made very quickly. I am not going to go through a long list of Ministers; we would all be here until next week. I just think the wording of the new clause is too broad, and I am not sure I can support it in its current form because it would place too much of a requirement on too many Departments to focus too much on areas that are not their core responsibilities.

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

It is a pleasure to serve with you in the Chair, Ms Lewell. I find myself unequal to the level of analysis and detail that the hon. Member for Lichfield brought to public health in the Ministry of Defence.

I will add just a few brief thoughts. The good intention of extending the life expectancy of the people in this country—although my hon. Friend the Member for Sleaford and North Hykeham made the good point that it is about living well, not just for a long time—is not always best served by creating committees, and additional duties, reports and responsibilities in legislation.

The hon. Member for Winchester argued—I paraphrase, but it is a matter of record—that he would like all Departments to have an eye on the health of the nation. That sounds sensible. There are other things that I would hope all Ministers have an eye on in everything they do, such as the wealth of the nation and inequality, but I would not advocate for embedding those things—I hope they would come with good governance, public duty and responsibility—in legislation as a duty, a committee, a set of meetings and a report. Indeed, it is things done with good intentions that lead to growing bureaucracy, which slows down decision making and requires more people to be employed to discharge those duties at a growing cost to the public purse. It is something that western democracies do all too well, and not always for the good. I would not want this well-intended set of new clauses to lead to growing bureaucracy with very little benefit. The benefit that the hon. Gentleman wants to see, which I agree with, can be best delivered in other ways.

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[Gregory Stafford]

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]

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?

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[Karin Smyth]

I understand the intent of the hon. Member for North Shropshire and her commitment to parliamentary scrutiny, as well as that of her hon. Friend the Member for Oxford West and Abingdon. I hope that some of my points will address that.

New clause 15 duplicates existing processes and creates responsibilities for the Secretary of State for Health that would cut across our important procedures for scrutiny. No trade agreement can, by itself, change UK domestic law or require new public expenditure without the usual domestic processes being followed. Any changes to legislation necessary to implement a trade agreement would be subject to parliamentary scrutiny in the usual way. It is right that the Government be held to account, to ensure that trade deals deliver for the country. However, those processes are already in place and are working.

[Joe Robertson]

To strip this back further, can the Minister confirm whether a deal has been done?

[Karin Smyth]

I am not party to the negotiations. That is above my pay grade, like the conversation yesterday that the hon. Gentleman alluded to. I will get back to him on any outstanding questions, as the Department will to the Select Committee with other details.

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[Dr Chambers]

I thank the Minister for her comments. It is good to hear cross-party recognition of how important the life sciences sector is in the UK, to universities and businesses as knowledge transfer partnerships. This is a huge opportunity not only to improve the health of the nation and the treatments available, but to boost the economy.

We will withdraw new clause 15, but I thought the hon. Member for Isle of Wight East spoke extremely well about his concerns relating to the trade deal.

[Joe Robertson]

I think that the hon. Member has spoken very well, too, and I am grateful to him for airing this important subject through his new clause.

[Dr Chambers]

I appreciate that. Just to reiterate, I am talking specifically about the trade deal with the United States, not about every single trade deal. We completely accept that primary legislation is not necessarily the best way to scrutinise a trade deal, but given the lack of options at the moment, we must use every political mechanism available to create transparency.

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[Sojan Joseph]

As the chair of the APPG on adult social care, I pay tribute to unpaid carers for the enormous contribution they make to their families, their communities and wider society. I often have meetings with them, and as part of my job before I became an MP—I worked in the NHS—I had a lot of contact with carers. I have seen so many vulnerable patients benefit from the enormous amount of work that carers do. In some services, such as the mental health service, there is already provision for identifying carers, carers’ assessments and support for carers. Carers provide extraordinary support, often at great personal sacrifice.

Although the intention here is to make the wellbeing of carers a statutory duty, we need to be careful that we do not put any statutory responsibility for that on the NHS and create more administrative burden for it. I would appreciate it if the Minister would respond to that point, and if the Government would consider something to support carers, while not putting any more administrative burden on the NHS, where we are focusing on providing more support on the frontline.

New clauses 16 and 17 would impose new obligations on integrated care boards to promote carers’ wellbeing and to identify and record unpaid carers whenever they come into contact with NHS services. I want to make it clear that we should not create any more administrative burdens for NHS frontline services. Although identifying and supporting carers is important, the requirement would add to the administrative burden on NHS organisations at a time when they should be focusing on delivering frontline care.

We should be cautious about creating new statutory duties that divert resources and staff time away from patients. The proposal for a national respite care scheme is similarly well intentioned, but it risks imposing a centralised, one-size-fits-all model across a system that already makes local authorities and health boards responsible for assessing local needs and delivering support. Again, although we need more support for carers, we should be careful that we are not duplicating any of the services that are already available. Some charities also do a brilliant job of supporting carers. The provisions in these new clauses should be looked into, but we need to be cautious that we do not create more burdens for our existing systems.

[Joe Robertson]

I am grateful to the hon. Member for Winchester for introducing these new clauses and for the debate that that is allowing us to have. Unpaid carers are too often a silent and fundamentally unappreciated part of society, which the system could not cope without. They are family members who are thrown into the role of looking after their loved ones, which they did not expect to have to do. Most of them have no formal qualifications, but through love and family ties, they provide unpaid support, which in many cases has a negative effect on the financial wellbeing of the household and involves a huge amount of emotional toil.

The crisis in social care has lasted for decades under different Governments, who have struggled to tackle it, and it is putting increasing pressure on family carers. Many do not see themselves as a carer—they see themselves as a husband, wife, daughter, son or friend—but they provide millions of hours of care and support, year in and year out. My former role was at a national nursing charity that seeks to support the families of those living with dementia. I saw for myself how much wraparound care can achieve in relieving pressure and unnecessary suffering, not just for the person living with dementia—it does not have to be dementia, but that is what I have experience of—long-term frailty or conditions that require support, but for their family and carer. Very often, the biggest care need for the person living with dementia is the biggest need their family carer has; if we can sort the family carer’s biggest need, they can go on and do so much more for the person they love.

I thank the hon. Member for Winchester for allowing us to have this debate. I urge the Government, if they do not adopt these new clauses, to do all they can to relieve the pressure on unpaid carers up and down the country and to provide support for them.