Department of Health and Social Care

[Relevant documents: Correspondence between the Health and Social Care Committee and the Department of Health and Social Care, on the Supplementary Estimate 2025-26, reported to the House on 1 May and 25 March, Session 2024-26; Correspondence from the Health and Social Care Committee to the Parliamentary Under-Secretary of State for Health Innovation and Safety, on the UK-US Arrangement on Pharmaceuticals Pricing and Tariffs, reported to the House on 28 April, Session 2024-26.]

Motion made, and Question proposed,

That, for the year ending with 31 March 2027, for expenditure by the Department of Health and Social Care:

(1) further resources, not exceeding £108,291,452,000, be authorised for use for current purposes as set out in HC 1855 of Session 2024-26,

(3) a further sum, not exceeding £115,924,112,000, be granted to His Majesty to be issued by the Treasury out of the Consolidated Fund and applied for expenditure on the use of resources authorised by Parliament.—(Lilian Greenwood.)

(2) further resources, not exceeding £7,899,179,000, be authorised for use for capital purposes as so set out, and

(3) a further sum, not exceeding £115,924,112,000, be granted to His Majesty to be issued by the Treasury out of the Consolidated Fund and applied for expenditure on the use of resources authorised by Parliament.—(Lilian Greenwood.)

The debate will be opened by the Chair of the Health and Social Care Committee. Before I call her, I wish to alert Members that the same time limit of three minutes will be imposed in this debate, and I am sure the Chair of the Select Committee will be cognisant of that during her opening remarks. I call Layla Moran.

I thank the Backbench Business Committee for granting this debate on the NHS estimates and, in particular, the impact of the UK-US pharmaceutical deal.

Let me start by briefly talking about the estimates themselves. I am sure that every Member has a copy of them; I have one every year. Given that we spend £211 billion on the NHS, it is rather extraordinary that £201 billion of that is simply two lines in this document. Last year, I made a request of the Department of Health and Social Care, in the light of the deal, that we get not just a better breakdown of the costs of the deal, but, more importantly, the ability to scrutinise the estimates.

The Treasury’s own guidance says that the information in the estimates should be “informative” to readers. We can all read it, but—goodness me!—it tells us absolutely nothing. My request of the Department again, and much more publicly, is to sort this issue out. Other Departments do this much better, so there is no reason why we cannot. The information exists; it is a question of putting it correctly in a spreadsheet.

Today, I hope that we will discuss the pharmaceutical deal. I have to admit that I had seen stuff about the deal, but it was not until a whistleblower came to my surgery that I really began to understand the implications of it. They said:

The hon. Member is making an excellent speech, and is trying to draw out the details of this deal; I am glad that one of her constituents drew her attention to it. I was lobbied by Karl Claxton at the University of York, who described this deal as an existential threat to the NHS because of the potential costs. Interestingly, the Department has not yet published its impact assessment on the deal. Does she agree that it is high time that the Department published the impact assessment and let us know the true cost of the deal?

I believe that by the end of my speech, the hon. Gentleman and I will be in violent agreement, if we are not already. There is one more aspect of this, incidentally: the supply chains deal, which I understand is being crafted. We do not have time to go into that.

I commend the hon. Lady on the speech she is making. It is really important that we talk about the disadvantages of this deal, and there is a clear disadvantage to Northern Ireland. Access to everyday medicines in rural communities in Strangford and across Northern Ireland will be inhibited, so does the hon. Lady agree that the Northern Ireland Assembly in particular should receive the resources necessary to deliver vital frontline service improvements? At this moment, it is not receiving those resources.

That is a really good point. I will come back to generics, which make up nine in 10 of the medicines that the NHS uses. There is also an issue of devolution here, which I am sure other Members will cover. At the moment it is very complex, and it is not at all clear how the deal will apply in Scotland and Northern Ireland in particular.

We cannot divorce this deal from the geopolitics. It is only happening because Trump decided that he wanted to slap tariffs on every country in the world and on a number of different sectors. The reason why the US came after the NHS is that historically, we get an incredibly good deal, but we have to admit—this is why this debate is so important—that we are using the NHS and NICE in geopolitical negotiations to appease the current President of the United States. Although Trump probably wants to be President for much longer than he will be, his term will come to an end, but the effects of this deal will last much longer than the period of time he might be in office, and the amounts of money involved are eye-watering. I wish we had more information in the estimates, but everyone knows the pressure the NHS is under.

Does the hon. Lady agree that the Government’s failure to publish the impact assessment means that NHS authorities across the country do not know how much this deal will cost them? My constituents in Somerset cannot get a GP appointment or see an NHS dentist. That is far more important to them than this obscure deal.

The hon. Gentleman is absolutely right, and that lack of transparency is the nub of my speech today.

There are some potential positives in the deal. At the 10 February sitting of the Business and Trade Committee, a representative of the Association of the British Pharmaceutical Industry said that zero tariffs and commitments to the pharmaceutical market in the UK were “welcome” and had been “sought for some time”. The Government’s press release points out that patients will get access to innovative new medicines—who does not want that? Of course we all want that, especially those who have incurable cancers and so on, but there is a trade-off. We all want to bolster innovation in the UK. I have an interest—I am the MP for Oxford West and Abingdon. We are the other side of the Oxford-Cambridge growth arc. Biomedical sciences are going to drive my local economy, so I absolutely want that to happen, but there are also some important criticisms of this deal.

First, Medicines UK, which represents a large number of pharmaceutical companies based here in the UK, has real concerns. The life sciences sector plan has stalled, and Medicines UK points out that even though the companies it represents supply nine out of 10 medicines to the NHS, those companies are basically not recipients of what is good in this deal. Mark Samuels, its chief executive officer, has also pointed out that while there may be new investment in this country, particularly in R&D, if we want to create jobs and strengthen the economy, we must also address the inadequate support for the production of goods in the UK. That is where long-term value is created, and it is where the UK misses out compared with other countries. I point colleagues to Denmark, for example, which has had extraordinary success in its economy because it not only invests in R&D, but ensures that a proportion of the manufacturing happens in Denmark. That is what drives economic growth.