UK Parliament / Open data

Health and Care Bill

Proceeding contribution from Earl Howe (Conservative) in the House of Lords on Thursday, 3 March 2022. It occurred during Debate on bills on Health and Care Bill.

My Lords, the amendments in this group bring us to three discrete topics which are nevertheless linked by a common thread—that of human rights. Because they engage us in issues of great sensitivity, I begin by saying something that may sound unusual. There is probably no one in this Chamber who is not instinctively drawn towards these amendments. All three are honourably motivated. In pointing out any shortcomings, I would not want noble Lords to think that the Government did not understand or sympathise with why they have been tabled.

I will start with the issue of organ tourism. Like the noble Lord, Lord Hunt, I find it abhorrent that individuals exist who are in the business—often the lucrative

business—of sourcing human organs from provenances that are both illegal and supremely unethical. They then entice desperate and seriously ill people to go to a foreign country to have such organs transplanted within them. This idea is unconscionable. As far as we can, we should have no truck with it. The Human Tissue Act already prohibits the giving of

“a reward for the supply of, or for an offer to supply any controlled material”

in any circumstance where a substantial part of the illicit transaction takes place in England, Wales or Northern Ireland.

The Modern Slavery Act makes it an offence to arrange or facilitate another person’s travel, including travel outside the UK, for the purposes of their exploitation, which includes the supply of organs for reward in any part of the world. The law as it stands addresses a substantial element of potential criminality. How widespread is this criminality? What do we know about the scale of organ tourism as it relates to UK residents? I have obtained some figures from the department. In 2019-20, the last reporting year before international travel was curtailed by the pandemic, a total of 4,820 organ transplants took place in this country. At the same time, NHS Blood and Transplant data shows that only seven UK residents received a transplant abroad, many if not all legitimately, and had follow-up treatment in the UK.

Therefore I am thankful to say that the scale of the problem of illicit organ tourism, as it relates to UK residents, is small. If the noble Lord, Lord Hunt, were to say to me that one such case is one too many, I would agree, but the House should not support this amendment, because it is not right to support an amendment that could cause vulnerable transplant patients who receive a legitimate transplant overseas to face imprisonment because they may not have the right documentation. That is what the amendment could lead to. Checking such documentation and creating individually identifiable records for every UK patient who has received a transplant overseas would put healthcare professionals in an invidious and inappropriate position by blurring the line between medic and criminal investigator.

More to the point, it could also prevent those who legitimately receive an organ transplant abroad—particularly those from minority-ethnic backgrounds—from seeking follow-up treatment, for fear of being treated as a criminal suspect. Following that thought through, I say that the effect that this amendment could have in exacerbating health inequalities is likely to be far greater than its effect in deterring transplant tourism, especially, as I have emphasised, because there are already legal provisions in place covering most cases of organ tourism.

I listened with care to the noble Baroness, Lady Finlay, particularly regarding her examples of the exhibition that she went to. I join her in being somewhat incredulous that there could be consent to some of the exhibits that she witnessed. However, where consent has been obtained, it must be unequivocal. As I emphasised, the law as it stands now prohibits the exhibition of bodies or body parts where express consent cannot be fully demonstrated.

I undertake to speak to the Human Tissue Authority, to see that, should there be another exhibition of this kind proposed, there is full transparency in the form of labels under each exhibit making clear how consent was obtained and what it consisted of.

Targeting those who receive an organ, rather than the traffickers and their customers who initiate or negotiate the arrangements, risks imprisoning vulnerable patients who may have been misled as to the provenance of their organ. That would be disproportionate. The Government’s view remains that the best approach is to continue targeting traffickers and their customers, while doing all that we can to help UK residents who are in need of an organ by focusing our efforts on improving the rates and outcomes of legitimate donations.

6.15 pm

I turn to Amendment 173 relating to the public display of cadavers. Again, this is an issue of great sensitivity about which we all have personal views. I am sorry that I read out the wrong reply to the noble Baroness, Lady Finlay, just now. The noble Lord, Lord Hunt, has been assiduous in pursuing the case for a complete ban on these displays and we have heard the powerful case that he and others put in support of such a ban. But once again I will say why I think the amendment should not be supported.

The law already prevents new public displays of bodies and body parts where the donor has not given their express consent, and that is as it should be. The question we now need to answer is whether the law should also prevent the display of bodies and body parts where such express consent has been given. This is where I return to the points I made about the speech of the noble Baroness, Lady Finlay. There may well be individuals who express their desire to donate their bodies after death for the purpose of an exhibition devoted to the display of the human anatomy. Some people sincerely feel that such exhibitions have educational and artistic merit on the grounds that they provoke interest in the inner workings of the human body. Some of us may find the idea of such exhibitions distasteful, but I say gently to noble Lords that in a liberal and free society such as ours it is not the role of government or, I suggest, this House to be the arbiter of taste. We should respect the principle that we have always championed in our debates concerning human tissue, which is that of informed consent. I suggest that this case is no different.

In turning to Amendment 108, I recognise the enormous strength of feeling in the House on the human rights violations that we hear from many sources are being perpetrated in Xinjiang. I also acknowledge the concerns raised by several noble Lords that items procured by the NHS may be sourced from regions where forced labour or other serious violations of human rights are occurring. As we have heard, this is a complex issue—complex because supply chains are complex—and I do not wish to sound complacent or uncaring if I say that there are no easy answers. But I reassure the House that the Government are resolutely committed to taking robust action to tackle this challenge, not just in the NHS but across all our supply chains. I will demonstrate to the House exactly how we are doing that, both currently and prospectively.

Over the past year, we have introduced a number of robust, evidence-based measures to help ensure that no UK organisation, public or private, is complicit in the human rights violations occurring in Xinjiang. Those measures include new guidance for UK businesses on the risks of doing business in Xinjiang, the announcement of enhanced export controls and commitments to introduce financial penalties for non-compliance with Section 54 of the UK’s Modern Slavery Act, as well as new procurement guidance to help exclude companies linked to modern slavery violations.

We are also working closely with international partners to ensure a co-ordinated approach to supply chains. Under our G7 presidency last year, G7 leaders committed to working together to ensure that global supply chains are free from the use of forced labour. That effort is government-wide and across all sectors of business.

Within the NHS specifically, we have taken and continue to take action in line with procurement and modern slavery law. Since 2020, NHS Supply Chain has utilised the UK Government’s portal, the Supplier Registration Service, to undertake assessments of both modern slavery and labour standards where, through risk assessment, a contract is deemed high-risk. We fully recognise, however, that further work is needed across government to meet the scale of the challenge. That is why the Government have announced a comprehensive review of their 2014 modern slavery strategy, with a new strategy due to be published this spring. This is a major undertaking, including a thorough review of all aspects of our approach to tackling modern slavery. We are also looking at introducing further measures through the upcoming procurement Bill. Those measures would be in addition to new legislation to strengthen further and future-proof the transparency and supply chain provisions of the Modern Slavery Act, when parliamentary time allows.

This ongoing work does, I trust, demonstrate the Government’s commitment to taking a robust, holistic and co-ordinated approach to meet the complex challenge posed by the risk of human-rights violations in global supply chains. That is why, despite our having no doubt as to the honourable intentions behind this amendment, we do not believe that building it into the Health and Care Bill would further our efforts in taking robust action to address human rights violations, wherever they may take place.

The UK is strongly committed to early and effective action to prevent all mass atrocities—whether that is genocide, war crimes, crimes against humanity, or ethnic cleansing—and we will do this through a variety of means: early-warning tools, diplomacy, development and programmatic support, human rights monitoring, and coercive measures such as sanctions and defence tools. Our work in this area is long-standing, both in terms of preventing atrocities and in securing accountability and justice for atrocities committed. The issues and concerns raised today by the noble Lord, Lord Alton, and other noble Lords require a comprehensive and carefully considered response befitting both their gravity and complexity. We do not, however, consider this Bill to be an appropriate instrument through which to tackle this issue.

That said, I acknowledge the strength of feeling in this House relating to the NHS, specifically about ensuring that no part of the NHS is inadvertently complicit in human rights violations, where they exist in supply chains. Therefore, in addition to the range of measures we are already taking, I am pleased to make a commitment that the department will undertake a new, focused internal review of NHS supply chains to address the concerns that have been expressed with regard to the risk of exposure. In conducting this review, the Government would welcome further engagement with the noble Lord, Lord Alton, my noble friend Lord Blencathra, and, indeed, all noble Lords who have spoken in this debate. Your Lordships’ insights will, I have no doubt, be greatly valued as we take forward this important work. I was grateful to the noble Lord, Lord Alton, for the references and pointers that he mentioned in his speech.

I hope that this provides noble Lords with further reassurance about the Government’s approach but, more than that, I hope that the undertaking I have just given, combined with the statements I have made to the House about the extensive work now in train across government to bear down as hard as we can on modern slavery and the abuse of human rights across the world, may persuade the noble Lord, Lord Alton, to withdraw Amendment 108.

Type
Proceeding contribution
Reference
819 cc1042-6 
Session
2021-22
Chamber / Committee
House of Lords chamber
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