Health Bill

Lord Austin of Dudley Excerpts

Committee stage
Wednesday 11th November 2026 Lords Chamber

We have become accustomed to thinking about health policy largely in terms of what happens when someone becomes ill and what treatment the NHS can provide, rather than all the other factors that make up our health. Of course, many businesses make a positive contribution to public health; others make money from products and practices that damage it. We need to understand that influence and make sure that it does not shape government policy. Those interests are there. A study of parliamentary groups found that pharma companies and industry-funded patient organisations provided more than £2.1 million to health-related APPGs, accounting for 30% of their total funding. People are always trying to strengthen the rules around APPGs, but there is a responsibility for the Government to make sure that the influence being put on them and the way they are considering and making decisions is not unduly commercially influenced. This is not or should not be a controversial principle, but it is one that needs to be actively protected.

[Lord Austin of Dudley (Non-Afl)]

My Lords, I will speak to Amendment 279A in my name and comment on the potential impact of the amendments tabled by the noble Baroness, Lady Bennett of Manor Castle.

My amendment would require the Secretary of State to report annually to Parliament on NHS and social care procurement of medical devices, consumables and services in England, assessing its performance against the objectives in Section 12(1) of the Procurement Act 2023, and would confine the report to those objectives. Noble Lords scrutinised the Act carefully, including the objectives that authorities must have regard to when carrying out procurement: delivering value for money; maximising public benefit; sharing information so that suppliers and others can understand procurement policies and decisions; and acting, and being seen to act, with integrity. Those duties are already established in law. My amendment would provide Parliament with a focused, regular account of how they are being applied in an area of considerable importance to patients and taxpayers.

In the NHS, as we heard earlier, value for money cannot simply mean the lowest purchase price. An MRI scanner that costs less to buy may prove more expensive over its working life through maintenance, breakdowns or additional training requirements. Reliability and clinical effectiveness matter, as do the consequences for patients when equipment is unavailable. An annual report would help Parliament to examine whether those considerations are being weighed properly. The Act does not require each objective to receive equal weight in every procurement, so the report should explain how they have been applied in practice.

Proposed new subsection (2) would keep the report focused on those established objectives; other applicable legal duties would continue to apply. Proposed new subsection (3) would exclude procurement still governed by the previous regulations under the transitional arrangements. The reporting arrangements should be proportionate, drawing wherever possible on information already collected. I hope the Minister can explain how the department intends to account to Parliament for the application of these objectives, and whether the Government would consider the focused annual reporting duty proposed in this amendment.

Amendment 172B raises serious legal and procedural problems. In singling out one company, it raises the question of whether it would make this Bill a hybrid Bill. It also risks breaching the United Kingdom’s obligations under the WTO Agreement on Government Procurement. The Ministerial Code expressly requires Ministers to comply with international law and treaty obligations. Will the Minister explain how this amendment could be implemented consistently with those duties? Your Lordships’ House spent many hours scrutinising the Procurement Act; this was serious work to protect public money, secure good services and ensure that suppliers are treated fairly. This amendment could completely undermine that work.

The amendment singles out one company by name, even though many tech companies provide services to the NHS. It seeks to end its contract at the first opportunity and exclude it from the replacement. It asks us to substitute a subjective political judgment for the outcome of a competition in which bids were assessed against objective published criteria. If its supporters believe that different standards should apply, they should explain what those standards are and apply them consistently; they should not ask Parliament to settle the outcome for one company in advance. What opportunity would the company have to demonstrate that it could meet the requirements? It would have none. However effective its technology and however competitive its price, the amendment would already have decided the answer. That is an extraordinary approach to spending public money. The precedent would extend well beyond this contract. We should be particularly careful about singling out a supplier by a political test that no elected body has defined.

Why should a company spend time and money competing for a public contract if the published rules can be set aside after it has won? The risks are clear: there would be fewer companies willing to bid, weaker competition and higher prices for taxpayers. While politicians argued about which suppliers they approved of, public services would wait longer for the technology they needed. If there is evidence that a supplier threatens national security, there are statutory powers for dealing with that. Serious allegations should be examined against the evidence, through the proper processes. Patients and taxpayers are entitled to ask what they would gain from this proposal. Would it mean shorter waits, safer care or lower costs? What would replacing the system cost? How would services be protected during the change? Where is the evidence that this amendment would deliver better care or better value?

We have already seen the consequences of the dispute over technology procurement. This is a different subject, but the principles still apply. When the Met was facing substantial financial pressures, the commissioner wanted to use technology to reduce administrative work and protect front-line services. He also said that it could help the police catch people who threaten the public

“at a pace that simply isn’t possible without”

the enabling technology. Yet the proposed contract was blocked and the commissioner warned that between 500 and 700 officers and staff posts delivering services to Londoners could be affected, which would make the city and its residents less safe. The mayor’s office said its concerns were about procurement and value for money. Those questions deserve proper examination, of course, but why were Londoners originally told suppliers should

“share the values of our city”?

Procurement requires evidence and a proper assessment of the consequences. It cannot become a test of whether politicians approve of a company’s so-called values. The same principle applies to the NHS. I think this amendment is a political boycott dressed up as procurement policy. It seeks to exclude a company from serving the NHS because of its relationship with Israel—but Israel, as the only liberal democracy in the Middle East, is deeply integrated into the world’s technology and medical industries. Major companies operate there, invest there and work with Israeli institutions. Palantir is one of many tech firms working in Israel. Perhaps its offence is that it is not embarrassed about it. Oracle came second in the bid process for the federated data platform; it has supplied software to the Israeli military. IBM came third; it has contracted to build data centres for the Israeli military. Microsoft has supplied the Israeli military with cloud technology. Nobody complains about Parliament using Microsoft Word and Outlook to conduct our business. If every corporate association is now a test of political purity and individual politicians’ values, there will be much more boycotting to be done in future.

This amendment singles out one company. It offers no consistent standard against which every supplier would be judged. Doing business with Israel should not disqualify a company from serving the NHS. Contracts should be awarded in line with the rules and on the basis of whether they can fulfil the contract, the quality of their work and value for money—open, free and fair competition which increases quality and reduces costs to the taxpayer.

The standards for technology in our health service should be demanding. Suppliers must demonstrate that their systems work, protect patient information and provide value for money. They must show how their technology helps doctors and nurses deliver better patient care. Every supplier should face those tests, because patients should come first. A patient waiting for cancer treatment gains nothing from a political boycott. If technology can help bring an operation forward, we should establish whether it works and can be used safely. Procurement decisions must not be turned into an instrument of somebody else’s foreign policy. If a system can help get someone treated sooner, I want the NHS to be able to use it. There should be fair rules, applied consistently, with patients and taxpayers coming first. Those are the principles that I ask the Minister to uphold.

[Baroness Kidron (CB)]

My Lords, I will speak to Amendments 53, 171 and 289 in the name of my noble friend Lord Tarassenko, and Amendment 160 in the name of the noble Lord, Lord Clement-Jones, all of which I added my name to. I have my own amendment on NHS data as a sovereign data asset in a later group, which is remarkably poor organising on my part, but it does give the Minister two shots at saying we are right.

The primary difference between the amendments in this group and those in the later group is that these amendments focus largely on the use of NHS data by companies contracted and procured to provide services to the NHS, rather than primarily on how the benefits from technology trained on NHS data are retained in the UK. However, both sets of amendments cover the key elements and, whichever approach is finally taken, determining who has access to UK health data, and on what terms, is an extremely urgent issue.

During debates on the Data (Use and Access) Bill last year, I tabled an amendment on sovereign data assets, of which the NHS’s data was a key example but not the only one. At the heart of that debate, which I urge officials to look at, was a warning that has become only more urgent. The speed at which the Government are giving access to our data is swifter than the plans they have to protect its financial or societal value. We are nearly two years on and there is still no published strategy or government policy to maintain British control over valuable data assets. We do not have a clear plan for how our data or the systems that host it will be resilient to foreign interference. We do not have a clear strategy for building technological capability within the NHS for its data or ensuring that all the healthcare and economic value that comes from our data will indeed come back to the UK as a benefit.

Amendment 53 offers a road map for the conditions for access to NHS contracts, with a focus on control of data, building sovereign capability for data handling and reducing the dependencies and risks from foreign firms. This is not government data; it is data held in trust for the British public and they are being poorly served.

Amendment 160 looks at how contracts are awarded and ownership of the architecture that supplies services to the NHS. It singles out the way in which free or low-cost services are used to gain access, create dependency and result in vendor lock-in, which a number of noble Lords have already described well.

Amendments 171 and 289 would require the Secretary of State to publish a digital sovereignty strategy for the NHS, including control of systems that host data, control over the data itself, avoiding vendor lock-in and capitalising on our data to build technological capability and commercial value. It is an exhaustive checklist, but it mirrors those issues I laid in the Data (Use and Access) Bill and the Cyber Security and Resilience Bill, and in the debate on digital sovereignty in July. It also aligns with multiple recommendations by committees of both Houses, including—I will try to say this very quickly—the Commons Science, Innovation and Technology Committee’s report, Rewiring the State; the Commons BIST Committee’s report, Investing in the UK Economy, the Joint Committee on the National Security Strategy’s report on undersea cables; and the Lords Science and Technology Committee’s inquiry into financing and scaling UK science and technology. The Lords committee also has an open inquiry on innovation in the NHS and personalised medicine. How many times do we have to make the same recommendation? This is a flashing warning light.