Baroness Finlay of Llandaff (CB)

My noble friend Lord Alton’s commendable inquiry has shone a light in dark places. Abuses occur beyond first-tier suppliers, affecting women and the environment in particular. It made us think, and his opening speech today will have made us think further. As the NHS is one of the largest commercial organisations in the country, and the fifth-biggest employer in the world, I want to focus on its supply chain. Antibiotics alone constitute about half of NHS primary care prescriptions, mostly penicillin based. Their manufacture depends on the precursor 6-APA, for which 85% to 90% of global manufacture is in China. In the NATO area, Sandoz in Kundl, Austria, is the only producer of 6-APA for penicillins, which it manufactures. The surgical equipment supply is similarly worrying. Over one-fifth of equipment, especially disposables, is produced in northern Pakistan, with supplier companies in Europe or the US. Labourers manufacturing surgical instruments are often paid less than $1 per day and have poor job security and woefully inadequate health and safety protection, and many employees are children, some as young as seven. Some 150 billion pairs of disposable gloves are produced every year, mostly in Malaysia, Thailand and a few other Asian countries, from factories often known already for their serial labour rights concerns. In Malaysia, migrant workers producing surgical gloves have reported unsafe factory conditions, confiscation of passports, illegal withholding of pay, and debt bondage from high recruitment fees paid to agents to secure the job. In 2016, procurement agencies for the NHS started introducing contractual requirements. But our “strategic vulnerability” was evident in Covid, buying £150 million-worth of equipment from Chinese companies whose factories were using Uyghur and North Korean forced labour with extensive links to human rights abuses in Xinjiang. The report’s recommendations warrant action. Our short-term approach, with procurement based on price, leaves us complicit with human rights abuses and perilously vulnerable to disruptions in critical health supplies. In Sweden, procurement directors included effective labour clauses into a regional contract with an Indian healthcare uniforms manufacturer. It can be done, it must be done, and I hope the new Minister, who I congratulate, will urgently press for the supply of medical instruments and medicines to be tackled across ministries.