Pandemic Prevention, Preparedness and Response: International Agreement

Debate between Steve Brine and Justin Madders

Monday 17th April 2023 Westminster Hall

[Steve Brine]

As a former health Minister with responsibility for the WHO, I worked with the organisation. It is supranational, but it is 100% driven by its members and we, as the second largest donor and one of its founding members, are one of the most respected members round the table, so we are designing the process. We should be proud of that. We are at the heart of that and we should submit it to scrutiny by us in this House. Does the hon. Member not agree?

[Justin Madders]

I am grateful to the Chair of the Health and Social Care Committee, who has a great deal of experience in this area. As a country, we are leaders in the field. We should be proud of our role in creating the WHO and fighting the pandemics that have happened in recent years. It is also the case that, as with all treaties, there is an opportunity for parliamentary intervention. That is already established, and the Government have committed that any subsequent domestic regulations would need to be passed before the treaty was ratified.

As we have already heard, we can, if we so decide, opt out, so there is no question that this is something that will be done to us. As a sovereign nation we have the opportunity to say no. Given the amount of time that this House has spent debating questions of national sovereignty over the past five or six years, would we do something that would give away sovereignty? There are important principles about parliamentary accountability that we need to bear in mind. It would be unfair to allow some of the wilder conspiracy theories to overshadow legitimate concerns about any potential infringement on our sovereignty and democracy.

On the specifics of the treaty, as I have said already, the key point to note is that it has not been finalised yet, but we do know the broad parameters of negotiations set out in the latest “zero draft” published in February. From that we can see that the guiding mission is:

“to prevent pandemics, save lives, reduce disease burden and protect livelihoods, through strengthening, proactively, the world’s capacities for preventing, preparing for and responding to, and recovery of health systems from, pandemics.”

I would be very surprised if anyone objected to that as a set of guiding principles, but it is reasonable to ask what the definition means in practice, what the procedure is for declaring a pandemic, and what safeguards will be in place to ensure individual liberty and rights are protected.

Those questions and that ambiguity have been seized upon by those who want to undermine global co-operation. They state fears that the treaty will restrict freedom of speech to the extent that dissenters could be imprisoned, that it will impose instruments that impede on our daily life and that it will institute widespread global surveillance without warning and without the consent of world leaders. In other words, some of the hallmarks of totalitarian Governments are to be combined with supercharged lockdown measures, which are all, of course, already in the power of the Government under the Public Health (Control of Disease) Act 1984. Under this treaty, those things will apparently be done without our Government having a say.

If those claims had any basis in fact, we would all be rightly concerned, but they do not stand up to scrutiny. Fact checkers have consistently stated that the WHO would have no capacity to force members to comply with public health measures. A WHO spokesperson said:

“As with all international instruments, any accord, if and when agreed, would be determined by governments themselves, who would take any action while considering their own national laws and regulations.”

The idea that we would allow our citizens to be imprisoned by a third party for expressing an opinion on something in this country is absurd. It is just not going to happen. We live in a liberal democracy and I know that Members from across the House are determined to keep it that way. It is those nations that want to undermine western liberal democracies and to create disarray that are pushing the narrative that there is an unaccountable, unelected, global group of people seeking to take control of our lives.

We can both protect our values of freedom and democracy and work more closely with other countries in the face of a global threat. Those two aims can be entirely consistent with one another. Creating a global treaty is an entirely reasonable and responsible course of action. One of the most important messages to emerge from covid-19 was that we need to be better prepared for the next pandemic. We have learned that global co-operation is crucial to success, whether that is by co-ordinating measures to suppress transmission or conducting vaccine roll-outs. It took the world far too long to understand that in a pandemic no one is safe until everyone is safe.

To my mind, the question is much more about whether this Parliament and this Government are up to the task of dealing with another public health emergency in a way that ensures that democratic accountability and public confidence are maintained. As someone who spent many hours dealing with public health regulations during the covid pandemic, I think there is much to be done to improve Parliament’s role. We know that, at times, decisions had to be taken quickly, but far too often covid regulations were debated weeks or even months after they were introduced. As the pandemic progressed, I felt that no effort was being made to ensure that regulations were debated before they came into force. On numerous occasions, there was no objective reason why that needed to be case. Indeed, sometimes the rules were made publicly available on the Government website only minutes before they became law. Trying to obtain clarity about which measures, individually or collectively, were considered likely to lead to an increase or decrease in transmission rates was mission impossible.

When we were able to see the minutes of meetings of the Scientific Advisory Group for Emergencies—in the early stages of the pandemic, we were not—there was often very little correlation between them and the measures being debated. Sometimes, there was no statement in the explanatory memorandum that the measures being put forward in the regulations had even been considered by a scientific adviser. Often, there were no SAGE minutes that stated that these matters had been considered either. Often, what SAGE recommended did not even make it into regulations.

I am sure that many of us can remember the contradictions and the confusion about some of the measures: around why an area was in a particular tier, the lack of clarity about how areas moved in and out of tiers, the decision to close pubs—

Fertility Treatment and Employment Rights

Debate between Steve Brine and Justin Madders

Tuesday 1st November 2022 Westminster Hall

[Justin Madders (Ellesmere Port and Neston) (Lab)]

It is a pleasure to see you in the Chair, Sir Edward. I congratulate the hon. Member for Cities of London and Westminster (Nickie Aiken) on securing this debate and on her excellent speech. She said that there is little legal, medical, practical and emotional support for those seeking fertility treatment. That encapsulates the broad issues facing people in that situation; obviously, we are looking at a very specific issue today. I agree that IVF should not be considered on a par with cosmetic surgery—it is a very different thing altogether.

The hon. Lady really brought it home to me how far we need to go. She gave the example of her constituent who was told that she would be sacked if she undertook IVF treatment. That is the sort of thing that we would expect to have been said in the ’70s to someone who said they were pregnant. Rightly, society and the law have said that that kind of response is unacceptable. The hon. Lady summed it up well when she said that people should not be penalised for being unable to conceive naturally.

There were a lot of good speeches from Back Benchers. As always, the hon. Member for Strangford (Jim Shannon) gave a good contribution. I think everyone was pretty much in agreement about the importance of this issue.

The right hon. Member for Romsey and Southampton North (Caroline Nokes), who does an excellent job in all sorts of areas on equality in the workplace, said that we need to create a culture of openness and support for employees, and I hope this debate engenders that. She also asked about an employment Bill. The Minister is standing in today, but she may know that I have asked many previous Ministers when we can expect such a Bill. I am not expecting an answer, so to the right hon. Lady I say that I suspect it will take a Labour Government to introduce the plethora of employment legislation that this country desperately needs.

I am grateful to the hon. Member for Cities of London and Westminster for securing this debate. This issue has not traditionally received the attention it deserves because people understandably find it difficult to talk about, but we need to foster a culture of openness.

As we have heard, infertility and fertility treatment are the second most common reason for a woman to visit her GP—the most common is pregnancy. About one in seven couples are affected by infertility, which is about 3.5 million people in the UK. Since 1991, 1.3 million IVF cycles have been undertaken, resulting in 390,000 babies being born. IVF has become commonplace over those three decades: 6,700 IVF cycles took place in 1991, and 69,000 took place in 2019. I doubt that a tenfold increase in employers’ awareness has accompanied the increase in IVF treatment, which is why this debate is so important.

[Steve Brine]

It is interesting to hear those figures. There is a group who are not included in those figures, for whom all these issues around fertility challenge do not exist because they are banned from fertility treatment. Current legislation means that people living with HIV are banned from using such treatment. HIV medication is so effective these days that someone with HIV who is on it cannot pass HIV on, so their babies can be born without HIV. There is therefore no medical reason for this law to still exist. Are the Opposition aware of that situation? Do they think that law is a really brutal bit of discrimination that belongs to another age?

[Justin Madders]

I thank the hon. Gentleman for his intervention. I was not aware of that; obviously it is a matter that comes within the Department of Health’s bailiwick, so I would have to defer to my shadow colleagues in that sector. However, perhaps in a few days he will have a new role that will enable him to put a focus on this issue in a way that we have not seen so far.

We have heard a number of statistics that show why fertility treatment is such an important issue in the workplace. Fertility Network UK says that 56% of those seeking such treatment reported decreased job satisfaction; 63% admitted to reduced engagement; 36% had increased sickness absences; and 38% had seriously considered leaving their job or actually quit their job because they were trying to conceive—a statistic that should shame us all. Similarly, recent research published by Zurich found that 58% of women undergoing IVF treatment withheld that information from their employer and 12% of women left their job completely because their employer was unsupportive. These are statistics that we absolutely have to challenge and change.

It is easy to see why those undergoing fertility treatment report such experiences. Both from what we have heard today and from issues reported in the media, it is easy to see why so many people—particularly women—report feeling vulnerable and distressed about discussing these issues with their employer. I think that almost all in society are sensitive to how emotionally challenging and stigmatising seeking fertility support can be. However, having to physically administer treatment while in the workplace, and possibly while alone in a toilet stall, must be extremely difficult for those who have to do it, and fearing that a line manager might be questioning where they are while they do that can only add to the anxiety that people feel. Then there is the issue of whether someone’s treatment will negatively impact on their career, because they have an unsympathetic line manager. The experience can be very isolating. We have to change the culture to make sure that women feel supported and do not feel alone during these times.

In conclusion, the statistics that I have cited and the testimony today should give us all food for thought about whether we have got the balance right and make us consider whether there is sufficient support for those with fertility issues. The picture that has been presented today overwhelmingly suggests that we have not got that balance right at all.