Department of Health and Social Care
29 Jun 2026 · Commons Chamber · 44 speeches · Official record
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I must declare an interest as a registered pharmacist for nearly two decades and an expert on pharmacy procurement. Let be begin by saying that I welcome the UK-US pharmaceutical trade agreement, and also by saying something quite controversial: President Donald Trump is right. We do underpay for drugs-not just our expensive, lifesaving rare cancer drugs, but the everyday drugs that we purchase. Full speech
Speaker
(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.) Full speech
That is an incredibly relevant point in this debate. Many of us have examples of that, which is why we need to have a wider debate about the supply of drugs, their effectiveness and how they are evaluated. I thought we had a relatively objective system, but the deal throws that objectivity into question. Figures on the scale of deaths have been bandied about. I want to hear the Government’s view and their proper analysis of that, because we have to engage with the reports from Karl Claxton, Andr... Full speech
What is the policy’s true cost? How will it be paid for? What will be displaced in the NHS to make it happen? Full speech
Will the hon. Gentleman to comment on the fact that the NHS pays 10 times the manufacturing costs for over 80% of the licensed medicines that we buy? How is that underpaying? Full speech
I am happy not to. Question deferred (Standing Order No. 54). Full speech
I will try to answer all the questions that have been put to me in the short time I have. First, I am grateful for the contributions made by hon. Members, and I thank the Chair of the Health and Social Care Committee, the hon. Member for Oxford West and Abingdon (Layla Moran), for securing this debate. The UK-US pharmaceuticals arrangement is an important step forward for patient access to innovation and the future of our life sciences sector. This arrangement is fundamentally about patients by ... Full speech
With respect, I am going to answer the questions that have been put to me by many hon. Members, and I am coming to the impact assessment. We have been clear that the estimated short-term impact is around £1 billion in England over the spending review period. Costs will increase over time as NICE approves more medicines, but precise long-term costs cannot be modelled as a single figure; they depend on future medicines, NICE approvals, uptake and wider commercial developments. Members mentioned a ... Full speech
Given that there are so many unanswered questions and such little information, rather than estimates day, wouldn’t the better name for this debate be “a complete stab in the dark” day? Full speech
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 innovat... Full speech
Speaker
[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.] Full speech
Speaker
That, for the year ending with 31 March 2027, for expenditure by the Department of Health and Social Care: Full speech
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. Full speech
Speaker
(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, Full speech
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. Full speech
In conclusion, I welcome the deal. I hope we find a way to pay for drugs correctly in this country, so that we value them properly and can value the rest of the system. Full speech
Order. We are running out of time. Minister, please respond as briefly as you can. Full speech
I call the Liberal Democrat spokesperson, who I thank for agreeing to make a very short speech. Full speech
I am not sure where the hon. Gentleman’s figures come from. When we look at the drug tariff reimbursement, which is the system that we use to pay, and compare it with the arrangements in other countries, it is clear that we underpay significantly. Perhaps he is referring to something of which I am unaware; I should be happy to chat to him outside. We in this country are addicted to low-cost drugs for our health service, and what does that addiction mean? It means that we have the lowest costs an... Full speech
Order. You mean “the hon. Member”, not “you”-I do not need to go anywhere. I ask the hon. Member please to wrap up as soon as he can, because we have many speeches to get in. Full speech
I, too, thank the Chair of the Select Committee, the hon. Member for Oxford West and Abingdon (Layla Moran) for securing this debate, and I, too, wish we had more time. I also thank my hon. Friend the Member for North Somerset (Sadik Al-Hassan), who made some difficult, but really important points. This is a timely debate, because pharmaceuticals are core both to supporting a healthier population and to delivering economic growth. The main estimates memorandum outlines an expectation of just und... Full speech
I thank the Chair of the Health and Social Care Committee, the hon. Member for Oxford West and Abingdon (Layla Moran) for her comments. Life sciences are one of the country’s great strengths. We have world-leading universities, brilliant researchers, innovative companies, NHS experts and public investment. The life sciences support high-skilled jobs, drive growth and, most importantly, transform patients’ lives. The UK invented the covid vaccine, pioneered in vitro fertilisation and sequenced DN... Full speech
Speaker
(2) further resources, not exceeding £7,899,179,000, be authorised for use for capital purposes as so set out, and Full speech
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. Full speech
Today we are being asked to approve a motion on the main estimates for the Department of Health and Social Care for 2026-27, in which pharmaceutical spending is not separately identified, in either the estimate or its accompanying memorandum. We are being asked to approve spending without clear visibility of exactly how much is budgeted for medicines. That is against the principle of estimates day, which is to scrutinise spending before it is authorised. This is yet another example of the lack o... Full speech
I will give Front Benchers a heads-up: we are not going to have a huge amount of time, so please edit your speeches accordingly. Full speech
This debate should have taken place long before a deal was signed, and the fact that we are having it months afterwards shows that there is still no transparency. Last December, the pharma and health tech deal was signed, and it was made clear that money would have to be taken out of the Department of Health while the Government were trying to solve a Treasury problem. As we have heard, that problem was the trade deal with the US and the wider relationship. The big question that has not been ans... Full speech
I will dispense with the formalities to jump straight in. The hon. Member for Oxford West and Abingdon (Layla Moran) asked whether the Government have a clear, funded and transparent plan. Simply put, the Government appear to have made commitments they cannot properly explain, cannot fully cost, and cannot tell Parliament how they intend to pay for. We are of course talking about the UK-US pharmaceutical arrangement, which will see 0.3% of GDP in 2026, rising to at least 0.6% by 2036-or an overa... Full speech
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... Full speech
Order. Very quickly, shadow Minister. Ten seconds. Full speech
The NHS will carry out screening and evaluation of newborn babies for spinal muscular atrophy, or SMA, which causes spinal cord deterioration. It is a devastating genetic condition. The evaluation will start in October in England, but not in Northern Ireland or anywhere else. Does my hon. Friend agree that the will must be found to ensure comprehensive cover for all nations? We can have no more delays. We need action now to save the lives of children and prevent trauma for families. Full speech
I am trying to get through all these questions as quickly as I can. I will give way to the hon. Gentleman shortly. On the VPAG changes and rebates, alongside changes to NICE recommendations, the arrangement affects how pricing and repayment mechanisms operate through the voluntary scheme for branded medicines pricing, access and growth. To ensure predictability for the industry going forwards, given the unexpectedly high payment percentage for newer medicines for 2025, the Government have commit... Full speech
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 k... Full speech
Or guesstimates day, for want of a better pun. That is part of the problem. If the Government are so confident, why do they not produce the impact report so that they can justify this? At the end of the day, we have seen that those decisions are not isolated; they are different companies, making different decisions, but all with the same concern. It is a pattern: tax rises, more regulation, more red tape-a more toxic concoction. The Government will say that the deal is part of the answer, but Mi... Full speech
First of all, Medicines UK does not disagree with me; its members disagree that the value from the UK-US trade deal will go to people other than them. Medicines UK actually thinks that companies are not paid enough for drugs in this country. Unfortunately, you might need to go and have a chat with the association about that, because you might have misunderstood. Full speech
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 ... Full speech
The debate we have had so far highlights the issue at hand. This is an immense change to the way in which we will determine the delivery of drugs to the NHS, and one of my fears is that it will begin to weaken the existing controls. I think it politicises the process, because what will happen now is that Ministers will be able to determine the thresholds. In addition, I am concerned that decision making in the negotiations with the pharmaceutical companies has been transferred from NHS England t... Full speech
I recognise the Committee’s request for the impact assessment, but the analysis is scenario-based, contains commercially sensitive assumptions and remains linked to live policy development. Officials should be able to produce confidential advice for Ministers to inform trade and other negotiations, and we will not apologise for maintaining such confidentially where doing so is in the national interest. Full speech
I am grateful to the hon. Gentleman for his speech, because he is showing how important this debate is. A lot of this has not been flushed out. Medicines UK, which is responsible for a lot of the generics that he talks about, disagrees with him, but that is a conversation for another time. My question is specific: does he agree that the lack of transparency behind this deal, and the lack of an impact assessment, is a material issue and that we should ask the Government to release such informatio... Full speech
I am frustrated, because everything the Minister is saying is in the press release. Can she please answer the question? Will the Government release the impact assessment? If they will not, will they at least allow a Select Committee to see it confidentially? Full speech
I call Layla Moran to wind up the debate briefly, in under a minute. Full speech
The Minister would save a lot of time simply by publishing the impact assessment, which would answer every one of the questions that she is trying to find the answers to in her folder, so will she-yes or no? Full speech
An estimated 229,000 excess deaths by 2036-that is the eye-watering figure that BMJ analysis identifies as the upshot of diverting NHS funding to pay more for pharmaceuticals in response to Trump’s threats. Estimates day debates exist to scrutinise how public money will be spent before that spending has happened, not least when the decisions could have such damaging consequences for the health of our nation. This estimates day debate does not include the full budgetary consequences of the UK-US ... Full speech
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 t... Full speech