NHS PPE Supply Chains: Forced Labour

Maria Caulfield Excerpts

Thursday 14th July 2022 Westminster Hall

[The Minister of State, Department for Health and Social Care (Maria Caulfield)]

It is a pleasure to serve under your chairmanship, Ms Rees.

I start by congratulating the hon. Member for Strangford (Jim Shannon) on securing this debate and on all his hard work, alongside Members such as my hon. Friend the Member for Congleton (Fiona Bruce), on this significant issue. It is important to debate the supply chain for NHS PPE, to learn lessons from the past and to ensure that robust systems are in place for the future. I reassure him, and all hon. Members, that this matter is a priority for the Department and we continue to take steps to ensure that there are robust systems to safeguard against the coming into the system of supplies that may be linked to slavery or forced labour. I am pleased that this issue was debated during the passage of the Health and Care Act 2022, and further legislation will be introduced to address it.

However, I must put it on the record that our priority during the pandemic, as Members will understand, was to protect our frontline staff. This was a global crisis, in which we were competing against many countries to secure PPE for our frontline workers. Nevertheless, we had and still have a responsibility to those across the PPE supply chain to make sure that when PPE is procured, it is done responsibly and does not put people in any part of that chain at risk. It is absolutely important that we do that both globally and domestically, because although the hon. Member for Strangford rightly mentioned the Uyghurs in China, we have heard only too well this week from Mo Farah that slave labour and slavery exist in this country as well.

I take the point that the hon. Member for Coatbridge, Chryston and Bellshill (Steven Bonnar) raised about his concerns about the Government’s approach, but I will gently say that the Herald on Sunday stated that during the pandemic, half a billion pounds-worth of procurement in Scotland did not go through the usual scrutiny process, either—and that was just one report. That reflects the fact that all countries during the pandemic had to make tough decisions to get supplies through, safeguard frontline services and ensure that those pieces of equipment were in place. Where lessons need to be learned, we absolutely will do so. Since the pandemic, almost 40 billion items of PPE have been ordered and almost 20 billion were distributed by March 2022. We are still distributing over 600 million items a month. That shows the scale of the amount of PPE that we have had to distribute. Hon. Members will be aware that covid rates are still high at the moment, so PPE is still very much needed by our frontline staff.

Global chains were used to procure many supplies, whether aprons, gloves or masks, but where possible we have tried to escalate domestic supply, because while it is not 100% failsafe against slavery, it is more likely that there are robust systems in place. To effectively distribute the supply across health and social care settings, we have built a distribution network from scratch and adopted a sophisticated sales and operations planning system to regulate supply and distribution. We have a clear understanding of where the stock has come from and the processes in place to ensure that slavery or forced labour was not used in any part of that chain. Part of the network is using technology to track and trace where that supply comes from, and if there are queries or concerns in the future, we are able to look back and see where those supplies came from. Since April 2020, over 6.9 billion PPE items have been ordered through that e-portal system.

As we move to living with covid, the decision has been made to step down some of the Department’s work on the PPE programme, and we are handing that over to the NHS supply chain more generally. Safeguards in the Act ensure that some of that work will continue to happen. Modern slavery encompasses the offences of slavery, servitude, forced and compulsory labour and human trafficking. The NHS has a significant role to play in combating modern slavery, including by taking steps to ensure that the NHS supply chains and business activities are free from labour abuses. The Government rely on their suppliers for the delivery of many important public services, and we expect high standards of business ethics from our suppliers—and their agents. They will be routinely checked for that.

The Department follows a procurement approach, as set out in the UK Government modern slavery statement, that includes a zero-tolerance approach to modern slavery and a commitment to ensure that respect for human rights is built into all our contracts, self-assessments, audits, training and capacity building. I reassure the hon. Member for Strangford that if there is a complaint or a suggestion of any supply being involved in slavery or forced labour, we can lock down that stock until an investigation is concluded. We can then unlock it if no evidence is found, but we can stop some of those contracts if there is evidence of forced labour. We look at what happens in other countries—he touched on the US—and if other countries are finding evidence of slave labour used in any part of the supply chain, investigations will start on UK stock as well.

[Jim Shannon]

I thank the Minister for her positive response. Clearly, the United States has taken a line of legislative action. Has the Minister had a chance to discuss or get ideas from what the States are doing and what drove them to do that? I posed that question and both hon. Members who spoke asked the same question. If they can do it in the States, we can do it here.

[Maria Caulfield]

Absolutely. We have secondary legislation coming forward that will enact what was agreed in the Health and Care Act 2022, which will look at some of this issue. The Procurement Bill is also passing through the House of Lords and will come to our Chamber. It will look at procurement more generally, not just NHS procurement. If he and other hon. Members with a keen interest in the subject, such as my hon. Friend the Member for Congleton, have specific questions on NHS procurement, I am happy for them to write to me and we shall see whether we can look at them as part of scrutiny of the Bill as it progresses. He is right that we want to ensure that we are learning lessons and sharing best practice across the board. I cannot speak for other Departments, but we are keen to get that right for the NHS where possible.

We are taking steps to achieve greater supply chain visibility, particularly where risks are highest, with the recognition that workers in the lower tiers of supply chains are often the most vulnerable. In line with that, we ensure that all contracts placed by the Department adhere to standard terms and conditions that include clauses requiring good industry practice to ensure that there is no slavery or human trafficking in supply chains.

Suppliers appointed to NHS supply chain frameworks must also comply with those standards or they can be removed from consideration for future opportunities. All the suppliers of PPE frameworks let in conjunction with the Department were registered and required to complete a modern slavery assessment and a labour standards assessment. Our purchase process includes safeguards to strengthen due diligence and to terminate a contract should there be substantiated allegations against a provider.

We are not content to rest on the status quo, which is why the Health and Care Act contained a regulation-making power that will come into force, designed to eradicate the use in the NHS of goods or services tainted by slavery or human trafficking. The regulations will set out the steps that the NHS should be taking to assess the level of risk associated with individual suppliers and the basis on which it should exclude them from a tendering process. Those regulations will help to ensure that the NHS, the biggest public procurer in the country, is not buying or using any goods or services produced by or involving any kind of slave labour. It represents a significant step forward in our mission to crack down on the evils of modern slavery wherever they are found. We are grateful to the work of modern slavery campaigners, who hailed the regulations as

“the most significant development in supply chain regulation since the Modern Slavery Act 2015”.

Alongside those regulations, the Health and Care Act also requires the Secretary of State to carry out a review into the risk of slavery and human trafficking taking place in NHS supply chains and to lay before Parliament a report on its outcomes. That review will focus on NHS supply chain activity, as well as supporting the NHS to identify and mitigate risks with a view to resolving issues. The review and the regulations will send a clear signal to suppliers that the NHS will not tolerate human rights abuses in its supply chain; they will create significant incentives for suppliers to review their practices; and they will block, if necessary, any suppliers that are found to be using human trafficking or slave labour.

I was moved to hear the cases of the Uyghurs that the hon. Member for Strangford raised. He is right that that goes far beyond the NHS, which is why the Procurement Bill, currently passing through the other place, is an important piece of legislation. I am sure that he and other hon. Members, such as my hon. Friends the Members for Wealden (Ms Ghani) and for Congleton, and my right hon. Friend the Member for Chingford and Woodford Green (Sir Iain Duncan Smith), who are assiduous campaigners on the issue, will take a keen interest in that.

I conclude by thanking all hon. Members for their contributions. Modern day slavery is a deplorable practice that causes irreversible harm to those affected. We all have a responsibility to call it out. As a Department, we take it extremely seriously. I hope that, by sharing what is happening, I have given hon. Members confidence that we will do all we can to root it out and take out of our supply chains any affected pieces of equipment.

[Catherine West]

The Minister is being generous; I recognise that she is speaking from a health perspective. Will she undertake to write to hon. Members present about the Government’s progress on cross-departmental best practice sharing from her Department?

[Maria Caulfield]

I am very happy to do that. While I have been able to highlight what the NHS is doing, some good cross-departmental work is also being done on procurement and on identifying where slavery is happening both globally and domestically. I highlighted the evidence from Mo Farah this week. We must not take it for granted that slavery is not happening in this country. I am happy to write to the shadow Minister and those who have taken part in the debate to highlight the work that is happening across the Government. It has to be a cross-Government initiative to make sure that we are all working together to root this out. Much remains to be done to ensure that we deliver the message that modern day slavery is completely unacceptable. I look forward to working with MPs across the House to make sure that we all do our bit.

[Christina Rees (in the Chair)]

Jim Shannon, would you like a couple of minutes to wind up?