Question to the Department of Health and Social Care:

To ask His Majesty's Government whether they have conducted any checks of products they use which contain cotton to ascertain where the cotton was grown.

Section 47 of the Health and Social Care Act 2022 mandated my Rt Hon. Friend, the Secretary of State for Health and Social Care to conduct a review of the risks associated with slavery and human trafficking in National Health Service supply chains, with an emphasis on cotton-based products. The report was laid in parliament on 14 December 2023.

The report revealed that while many NHS tier one suppliers are United Kingdom-based, their supply chains often connect through multiple tiers to higher-risk countries, where many of the suppliers of cotton are based. Approximately 34% of high-risk suppliers were registered as based in China, where there is significant concern of forced labour, especially in Xinjiang's cotton production. Concern has also been raised about Pakistan's Sialkot region, a major source of surgical instruments where production is often subcontracted to the largely unregulated informal sector. Concerns also extend to cotton-producing nations like Uzbekistan and Turkmenistan, and to Malaysia and China for personal protective equipment manufacturing.

The supply chain mapping undertaken for the purpose of the review was identified as inappropriate for the size and range of products supplied to the NHS, requiring extensive effort by the buyer and suppliers to collect information that was still insufficient to affect change. Many of the suppliers identified as having high risk supply chains are UK based, however their supply chains are global.

In response to the findings the review makes a series of recommendations, outlined in detail in the publication. It advises a joint-department strategy for better risk assessment and mapping in NHS supply chains, urging ongoing emphasis on managing modern slavery risks, including updating procurement practices and standardising assessments integrated with e-commerce systems.

It recommends bolstering NHS staff's ability to tackle modern slavery, and improving supply chain mapping capability. Upcoming regulations under Section 12ZC of the NHS Act 2006 will further aid the NHS in assessing and mitigating modern slavery risks in individual procurements, alongside the introduction of a consistent risk assessment embedded into the health family’s e-commerce system.