My Lords, I rise to move Amendment 9 and speak to Amendment 11 in my name on the Marshalled List. Even since Committee stage began in your Lordships’ House last Wednesday, the Brexit world has shifted again and is doing so even today. The Prime Minister has had her summit at Chequers and my own leader is posing a serious challenge to the Government. We have to wonder how many millions are following the detail of hard Brexit; soft Brexit; tariff-free access; managed divergence or even ambitious managed divergence; hard and soft borders; regulatory alignment; cake philosophy, which is something to do with cherry-picking and having your cake and eating it; the three baskets theory, which I understand is a bit like the cake philosophy, only it is three choices; transition or implementation; and, finally, a bespoke economic partnership.
The media is full of it. The Westminster bubble and the chatterati—from which I do not exclude myself—talk of little else. That is because it is important to our nation’s future and our prosperity, or otherwise. However, I will propose one amendment, and speak to another, on matters which do not at present feature in the headlines or in the huge and momentous agenda being discussed in your Lordships’ House, but which do affect millions of citizens in the UK and the EU, including every Member of this House. These amendments affect all who work and travel in Europe; who buy medicines and take for granted the supply and availability of the most up-to-date, clinically approved remedies.
Like millions of UK citizens, I have been on holiday and travelled all over the EU. Most often, my summer holidays have been in France with my children. Every year while my children were growing up we had at least one ear infection, sometimes a dose of tonsillitis and, one memorable year, an adult with Bell’s palsy. The wonderful Dr Duterte in Brantôme came to know us quite well over 25 years. My son lived in Brussels for five years and, although mostly healthy, he and we thankfully did not need to worry ourselves about his access to healthcare. An important part of a stress-free holiday with a mother with chronic obstructive pulmonary disease was knowing, with confidence, that the oxygen supply would be waiting in the house—free, like in the UK. I tell these everyday stories precisely because they are so ordinary. It is the experience of millions of us: the package holidays; the weekends; the hen parties in Barcelona; the stag dos in Amsterdam and elsewhere; the conferences in all sorts of places. We and our fellow citizens are accustomed to travelling with ease and confidence. The ease with which people can do what they are used to doing is a matter which will colour how they judge whether Brexit is succeeding and whether it has been worth while.
Amendment 9 concerns the EU reciprocal healthcare arrangements which allow citizens of EU and EEA nations, as well as Switzerland, to access health and social care services while in any other of these nations, on the same basis as a resident of that nation would at no or low cost. The schemes include the EHIC, the European healthcare insurance card, which provides access to state-provided healthcare for short-term visitors; and the SI scheme, which, for example, allows ongoing access to health services for people working abroad and social care services for individuals such as pensioners living abroad. This is important for workers, students, the retired and holidaymakers, and, as I said, it affects millions of us.
Post Brexit, the UK could lose access to these arrangements, depending on the final outcome of ongoing negotiations between the EU and the UK Government. So far, the two parties have agreed that UK pensioners already living in the EU will be able to use the SI and EHIC schemes post Brexit, but no deal has been reached on wider access to them. Losing access to these arrangements would have a significant impact in a number of areas. This is one area where some progress seems to have been made but, as with many other matters, there is some uncertainty about what will happen after Brexit. The latest joint EU-UK document on the Brexit talks in November said that citizens who live in another EU country on the day that the UK leaves will still be eligible for the same healthcare as citizens and will still be able to use the EHIC scheme when visiting another EU country. This includes citizens who work or study in another country or are retired there. However, agreement has not been reached on whether the EHIC would be available to those who travel to, or go and live in, another EU country after the UK has left the bloc. It would seem that the EU wants discussions on that to be included in the negotiations on the future relationship between the UK and the EU, which will come only after sufficient progress has been made on the divorce issues.
Our amendment seeks to prioritise the negotiation of continued access to existing EU reciprocal healthcare schemes, or the creation of comparable alternatives. We need to fully assess the impact which loss of access to the schemes might have on patients and health services. For the UK, this approach would ensure continuity of care for its citizens living abroad and ease of access for UK citizens visiting the EU or EEA and avoid increased demand on and costs for the NHS.
My Lords, I support the amendment on reciprocal health arrangements in the name of the noble Baroness, Lady Thornton, to which I have added my name. I cannot imagine what it must be like to go on holiday to the EU without packing my passport with my EHIC tucked in the middle for security and assurance. I think that I was luckier than the noble Baroness: my children managed to stay well throughout all their holidays.
I am also happy to support Amendment 353 in the name of my noble friend Lord Stephen, Amendment 11 in the name of the noble Baroness, Lady Thornton, concerning medicines and medical devices, and Amendment 205 on the EHIC.
I have Amendment 101 in this group, which is about over-the-counter medicines and devices—all the household names which we have grown up with and which could well be under threat if regulation is not sorted out well in advance of our departure from the EU, should that happen. The intention behind the amendment is to ensure that, on leaving the EU, the UK does not deviate from the existing rules for the regulation and licensing of over-the-counter medicines, medical devices and food supplements. These products are subject to the highest-quality standards and regulations, which the UK, as part of the EU, has helped to deliver over the last 40 years. They ensure that the healthcare products we use are appropriately safe and effective. This amendment seeks to ensure harmonisation and continued collaboration between EU and UK regulators with regard to consumer healthcare products, including hay fever tablets, cold and flu treatments and painkillers—the everyday items that we buy over the counter from our pharmacies and local supermarkets in taking care of our health and well-being to ensure that we continue with our day-to-day activities.
Throughout the manufacture and distribution process, consumer healthcare products face multiple checks and tests by highly skilled, qualified persons in various licensed facilities. They can cross multiple EU country borders throughout this process, yet, due to EU-wide collaboration on regulation, this is a seamless and streamlined process. Leaving the EU puts this process at risk. The UK imports an estimated £1.5 billion-worth of consumer healthcare products from the EU each year. Without harmonised regulatory standards within the EU and without agreeing to mutually recognised inspections and testing after Brexit, we risk having medicines held up at the border while they await retesting for release in the UK. Companies will have to set up new facilities to accommodate this, resulting in duplication, delays and disruption in the supply of basic healthcare products to UK shelves.
Without sufficient assurances that there will be no divergence from existing rules for the licensing and regulation of over-the-counter medicines, medical devices and food supplements, manufacturers will not have the certainty and stability to take action to guarantee the supply chain of these products. Companies have to take these actions now for products that are due to be on our shelves in two years’ time so that there is no delay. Amendment 101 would prevent the Government deviating from these existing trusted regulations and standards. It would lay the necessary legislative groundwork for the regulatory harmonisation required ultimately to put in place the mutual recognition agreements that will guarantee that, post Brexit, we can still access the same consumer medicines, medical devices and food supplements as we can today.
The Government recently launched a campaign to drive more people to their local pharmacy to access self-care for minor ailments and self-treatable conditions. At a time of historically low rates of growth in NHS funding and annual cuts to public health and community pharmacy budgets, it is absolutely vital that public access to healthcare in the UK is not put at risk.
Will the Minister therefore commit to three things? First, will he commit to pursue regulatory harmonisation and mutual recognition agreements, not only for medicines but for medical devices and food supplements, as an objective of the phase 2 negotiations? Secondly, in the event of no deal, will he commit to ensure that UK regulators unilaterally recognise any decisions taken by EU regulators for the foreseeable future? Finally, in the event that there is regulatory divergence following withdrawal, will he commit to ensure that the industry is fully consulted on the period of time it will be given to adjust to the new arrangements, given that the sector body estimates that at least five years will be required to achieve all this? Then, and only then, will there be an assurance that, once the UK has left the EU, there will be no fewer consumer healthcare products on UK shelves and they will be no less safe than they are today.
My Lords, I will address Amendment 11, to which I have added my name. There are a large number of partnership agreements concerning medicines and clinical devices between the UK and Europe, and they are both formal and informal. They are important to our economy, as well as to the health and well-being of our citizens. Amendment 11 seeks to avoid these being ruptured. One of the most important of these international collaborations is of course the European Medicines Agency—the EMA—which provides and co-ordinates licensing, expertise and support for medicines and medical devices throughout the EU. For any pharmaceutical company seeking to license its product across Europe, the EMA is the body through which this is achieved. Our own domestic regulator, the Medicines and Healthcare products Regulatory Agency, operates as a crucial part of the EMA’s regulatory network to ensure frictionless access to medicines for the NHS without delay.
As the Secretary of State for Health and Social Care told the House of Commons Select Committee on Health on 24 January last year, we are one of the EMA’s most important members, overseeing up to 40% of its testing and taking on,
“often the most difficult and challenging cases”,
presented to it for testing and licensing. We have already lost the EMA’s headquarters, and the 900 or so jobs it provided and the economic benefits that came with these, from London to Amsterdam. A greater concern is the potential loss of quality assurance that our membership presently guarantees. For example, the common trademark system allows parallel imports across Europe.
The Healthcare Distribution Association, which represents medicines and medical device suppliers in the UK, has warned that our departure from this framework risks medical shortages and potential increases in the cost of medicines. The Healthcare Distribution Association estimates that the current system saves the NHS more than £100 million a year. Its executive director, Martin Sawyer, has already warned MPs that, when it comes to drugs,
“we take the supply chain for granted”,
and that Brexit could,
“throw a lot of cogs out of a very complicated machine”.
It is a warning worth echoing in this Chamber.
Our current perilous predicament seems to originate from the Government’s refusal to accept that appeals over licensing ultimately go to the European Court of Justice. But the EMA is not officially part of the EU, so there seems to be no constitutional justification for UK leaving it as part of Brexit. Indeed, this position has been put forward by the current chairman of the MHRA, Professor Sir Michael Rawlins, who in evidence to the Lords Science and Technology Select Committee last year stated that not only could the UK technically remain within the current system but that it may even be able to continue to influence new regulations and directives by doing so.
The sole reason that the Government have outlined for voiding their membership of the EMA is that it means accepting the jurisdiction of the European Court of Justice, which deals with legal processes such as licensing appeals. Having identified the jurisdiction of the European Court as one of their negotiating red lines, the Government therefore seem to believe that this renders the continuation of our membership untenable. In short, as is increasingly the case in a number of areas pertaining to Brexit, the Government would appear to be willing to jeopardise the security of our own medicines, drugs and medical devices for our citizens, and the prosperity of industry, for the sake of an ideological inclination.
My Lords, I apologise for not having spoken in the debate at Second Reading, but I was unable to be here on the first day. The amendments I am supporting for the most part try to deal with the obstacles put in the way of ordinary people, both young and old, who are on holiday, working or studying abroad. These include the amendments that seek to protect the European health insurance card scheme and Erasmus+, which is the subject of the next group. I have added my name to Amendment 9, moved by the noble Baroness, Lady Thornton, and I have my own Amendment 205 in this group which seeks specifically to retain the EHIC scheme and to which the noble Lords, Lord Judd and Lord Davies of Stamford, have added their names.
To focus on the holidaymaker’s point of view, I am a great believer in the EHIC scheme. Like millions of others across Europe, I carry the card with me when I go abroad, and I certainly would not travel without it. It has been a help to me personally when I had a combination of a flu-like virus and asthma in Germany. It is also clear from the stories I have heard—ranging from needing stitches after a hotel poolside fall to pulled muscles and broken legs on the ski slopes—how extraordinarily helpful the scheme has been to others, and I have even heard about a case of amnesia. All these are situations where immediate medical attention is required. In those circumstances, the last thing people want to worry about when on holiday or on a business trip is having to book the next flight back to the UK or having to claim immediately on their travel insurance. Apart from the fact that treatment is free and comparable to what one would receive at home, the scheme reduces stress. In the case of a concussion that I was told about, it meant that the person could return to the hospital for monitoring without the worry of paperwork or bills. It also gives peace of mind to the many people who have not needed to use the card but carry it nevertheless—something which cannot be overestimated.
Once you have the card, it is a simple and bureaucracy-free system for the holidaymaker. It does not replace travel insurance, but works well in conjunction with it. I realise that my speech is an unashamed advert for a scheme which saves British people thousands of pounds in bills and reduces the claims and costs of travel insurance. The fear of course is that those costs will rise steeply if we lose the scheme. A replacement scheme or schemes might do all this, perhaps through agreements with individual countries, but presently the one card covers all the single market countries, the 31 EEA countries and Switzerland. Clearly, it would not be in our interests to adopt a scheme that is less comprehensive geographically, and retaining the scheme would be the easiest and most convenient option. If we stay in the single market in some form, there should be no problem.
It is worth noting that citizenship itself is not an aspect of the EHIC scheme; rather, it is based on country of legal residence so that British people living in France or Spain, for example, can apply for a card through their health services. It should not be forgotten that the scheme works for the benefit of British people living abroad as well as those from other countries living here. It is a properly co-operative system—a two-way street.
Accusations of health tourism always ignore what we as individual citizens get out of the system. A freedom of information question in 2015 revealed that in 2013-14, the treatment of ill British tourists in other countries of the single market cost more than five times that which European visitors cost the NHS. Perhaps the one improvement we can make here in the UK is to become better at recouping the moneys we are entitled to through the use of the scheme, and last year’s Public Accounts Committee report, NHS Treatment for Overseas Patients, stated that the systems for cost recovery appear to be chaotic. Other countries recoup what is owed to them and there is no external reason why we cannot do so as well. But that does not invalidate a scheme that continues to work tremendously well for the benefit of millions of people throughout Europe, including millions of British citizens both here and abroad.
The process of leaving the EU has thrown light on a lot of the concerns of ordinary people that perhaps were taken for granted. The EHIC scheme is one of those areas. No one voted for higher travel insurance costs and no one voted for less healthcare support while they are on holiday. The Government should pledge to retain this scheme.
My Lords, no one voted for insecurity. A very strong and powerful case has been made, particularly by the noble Baroness, Lady Finlay of Llandaff. This is a simple issue. Disease is no respecter of persons, boundaries or sovereignty. In chasing this mythical beast of sovereignty we seem to be prepared to lay so many things upon the altar that we need not lay.
It has been said in the course of this brief debate that we have no obligation to opt out of the EMA. My reading would support that. So why does a party that has always prided itself, for as long as I have been a member of it—for the last 60 years—on not being doctrinaire erect a doctrine and then seek every opportunity, regardless of the consequences, to jeopardise what exists and works perfectly well? It is a nonsense. I hope that there will be no vote on this amendment—it is a probing amendment—but I sincerely hope that, if the Government cannot accept the irrefutable logic of what has been said, we will return to it on Report and be well prepared to vote on it.
My Lords, I will speak on Amendment 11 and in support of what my noble friend Lady Thornton, the noble Baroness, Lady Finlay of Llandaff, and the noble Lord, Lord Cormack, said. I do so as the former chair of Great Ormond Street Hospital Foundation Trust, which I chaired for more than eight years until last summer. As many noble Lords know, it treats children with rare diseases and very serious illnesses. Much of its ground-breaking and innovative work, which is internationally renowned, is done as a result of, and based on, its research, much of which is carried out in collaboration with colleagues across Europe.
I will illustrate this in three different areas, which I think will bring home to your Lordships just how important it is that we do not abandon or neglect this issue. I will start with childhood cancer. Some 92% of our most important clinical trials for children with cancer in the UK require international collaboration. In 30%, the UK is the lead country, co-ordinating the international collaborative trials. This leadership role would sadly change rapidly if we no longer followed the same regulatory framework for clinical research as the rest of the European Union.
I turn to childhood epilepsies. Children and young people with epilepsies that are resistant to current therapies represent, as a group, at least 137 rare diseases with seizures as a common symptom. Collaborative European multi-centred trials are, I stress, the only way forward in assessing new targeted treatments. There are simply not enough patients in these categories of the many different aspects of epilepsy to do this work in one country alone.
I turn thirdly to children with HIV infection. Trials in paediatric HIV infection over the last 25 years have all been international. The UK works in partnership and collaboration with trial centres throughout Europe, and in particularly close collaboration with Italy, France and Spain. HIV treatment is very fast moving. It is vital that medicines for children do not get left behind. Our important European collaborations, including EU funding of our network, training and capacity building, have ensured the timely availability of drugs for children, not only in Europe but worldwide.
I cannot overstate the concern of the consultants and research specialists involved in this work about the threat posed for them by leaving the European Union. I do not think it an exaggeration to say that, without such work, the lives of very sick children would be sacrificed. I hope we can think again about this.
My Lords, while I strongly support all that has been said about the continuation of the EHIC scheme, I want to speak to Amendment 353 in my name and thank my noble friend Lady Jolly and the noble Lord, Lord Warner, for adding their names to it.
The amendment would require the UK Government to make arrangements for an independent evaluation of the impact of the European Union withdrawal legislation and of Brexit on the health and social care sectors across England, Scotland, Wales and Northern Ireland. It is intended to be a simple, common-sense amendment. In the Brexit debate, a lot of attention is on trade and the economy, or, today, on the customs union, but our care services and our NHS will also be affected in a major way by our withdrawal from the EU. There will be many impacts on care and support for children and young people, for people with disabilities, for people with long-term conditions and for those with additional support needs. Not all these impacts are yet known or understood. It is clear, however, that many are likely to be negative. That is certainly the risk and it is why we must be vigilant and aware.
So the purpose of the amendment is to say, “Let’s be concerned about these issues; let’s give them a higher priority than at present, and let’s monitor the situation very closely, because if we get it wrong, NHS services and the care of thousands of vulnerable people could be badly affected”. The proposal is to review such issues not more than one year after Brexit takes place to see what has happened, to understand the impact and to allow the Government, local authorities and the NHS to take appropriate action. The intention is to involve in this independent process the devolved Governments, the staff of the NHS and our care services, charities, voluntary organisations and others.
The amendment was inspired by Camphill Scotland, which has many EU staff and volunteers living and working in its outstanding care communities. Camphill also operates in England, Wales, Northern Ireland and right across the EU, and now around the globe, but its very first community was on the Camphill estate in Milltimber, near Aberdeen in Scotland.
More than 50 charitable and voluntary organisations support the amendment. These organisations do not care about the politics of Brexit; they care about the vulnerable children, disadvantaged adults, older people and those with mental health problems or long-term illnesses to whom they give support.
I believe that the amendment will be strongly welcomed also by many people in the NHS, not all of whom were entirely convinced by the message on the side of the “Boris bus” during the campaign. Staff from right across the EU work in our NHS and in our care services. More than 10% of our doctors in the UK are from EU countries and, in total, more than 60,000 staff from the EU work in our British NHS, with many thousands more in the charitable and voluntary sectors. If Brexit means that we lose only some of these people, we could still have big problems. If it becomes more difficult to recruit new staff from EU countries, this could become a major crisis for our hospitals, our care homes, our special needs schools and many other vital services.
I ask the Government and the Minister to respond positively to the amendment. It is the sort of amendment that makes sense and can so easily be agreed to, with little to lose and a great deal to gain.
My Lords, I have put my name to Amendment 205, which has already been very ably explained by the noble Earl, Lord Clancarty. First, I want to say a word or two in support of the noble Baroness, Lady Finlay, who made a most impressive speech. I hope that, for once, the Government will listen to her; they certainly ought to because she has a very special position of respect in the medical world. The medical profession in this country has been, at least up to now, one of the leading professions in the world, and she has a great deal of experience behind her and behind the words she set forth just now.
On that matter, as the noble Baroness said, the decision to leave the EMA was completely gratuitous. There was no reason for it at all. It was going to be perfectly possible to carry on with full membership while we left the European Union. A lot of us did not want us to leave the European Union—your Lordships know that I am among them—but there is no point in throwing away the whole loaf if you can keep even 5% of the bread. In this case, there would have been no difficulty at all in our remaining part of the EMA. The Government have given no explanation for this extraordinary move, which is a threat, a potential threat at least, to the advance of medical science and a certain threat to the position of the British pharmaceutical industry and to the willingness of companies to set up pharmaceutical operations and research and development operations in this country in the future—indeed, to the willingness of British pharmaceutical majors to remain as committed to this country as they have been up to now. It has really quite devastating industrial as well as medical effects.
The only reason we have ever heard for doing this is that we could not stay in the EMA because it involves some contact with the CJEU. That is quite extraordinary when this is a matter involving the health of the nation and involving one of the major industries in this country, of which we are all very proud. We do not have all that much in the way of successful manufacturing these days, but we undoubtedly do extraordinarily well in the pharmaceutical area, or have done up to now, and this industry is now to be handicapped for no better reason than one of theological fanaticism. It is incomprehensible to most of the world, either inside or outside this country. I hope that the Government will weigh very carefully the words of the noble Baroness and the representations that I know they have received from many branches of the medical profession and of the pharmaceutical industry, and for once just take account, soberly, carefully, thoughtfully and calmly of the values involved that are being thrown away and threatened by this extraordinary decision. I give an undertaking that I shall not gloat in any way if the Government do a U-turn on this: I shall congratulate them, sincerely and openly and I hope that they can find the moral courage to do what is right in this case.
I turn to Amendment 205, which was very ably set out by the noble Earl, Lord Clancarty. I shall not repeat what he said, but I want to talk about one section of the population that will be particularly affected by the abolition of the health insurance card in the European Union, and that is older people. Perhaps I should declare an interest here because I am certainly an older person, but I may be lucky because I have not so far been refused health insurance by anybody or charged exorbitant sums and probably, if I did have to pay a premium on my insurance policy to travel aboard, I would be able to afford to do so. A lot of people in this country, probably the majority, would not.
We all know that healthcare costs can be enormous, particularly in areas such as North America. One American friend of mine, who can actually afford to pay, was recently given a bill for more than $35,000 after a two-day stay in the Houston Medical Center. It involved a number of diagnostic tests, admittedly, as well as the board and lodging in the centre, but it gives an impression of the kind of costs that one can incur. There are countries in the world where you can get first-class medical care much cheaper than you can in Europe, let alone America, such as India, but not many. Countries tend to have medical care which is not up to the standards of North America, Japan or the European Union, or the costs are quite exorbitant, or in many cases both. Switzerland is another example, like the United States, where it is both.
For people who are older or have some particular medical record which makes them a bad insurance risk, underwriters will want to charge a very strong premium for insuring them at all. It is already quite difficult for them to travel outside the European Union. Many of us know people, friends of ours, who for that reason will not now travel outside the European Union. They will not even go and visit their family in the United States or Canada. They hope their family will come and visit them here, of course, but they simply cannot take the risk of falling seriously ill outside the European Union.
If the Government have their way and we go down this road that they have set out for us, the effect will not be just that people cannot go outside the European Union; they will not be able to go to Calais, Amsterdam, Berlin, Dublin, Copenhagen or Stockholm. That is the most terrible restriction of the horizons of a very large number of people. People may not have much time to travel when they are younger. They have business and professional commitments and a lot of strains on their budget because they are bringing up children and so forth. A lot of people look forward to being able to travel when they have retired, and the Government are saying to them, “When we have got this Bill through, you guys will not be able to travel at all—ha ha! You will be stuck here in this country”, which of course will be wonderful because we will have had Brexit and paradise on earth will result. That is a terrible—indeed, devastating—piece of news for a very large number of deserving people in this country. Once again, I hope the Government will have second thoughts.
My Lords, I will speak to Amendment 353 in the name of the noble Lord, Lord Stephen. I thought I had appended my name to it but clearly it had not quite arrived. I also support the comments made on the other linked amendments. I particularly identify with the comments of the noble Baroness a moment ago about Great Ormond Street Hospital, whose brilliant services we as a family had to avail ourselves of some decades ago. I cannot speak too highly of it and I hope that the points that were so well made are noted.
This group of amendments touches on one of the most sensitive areas of public policy: health and social care. There is a widespread unease in Wales—as there is, no doubt, throughout the rest of the UK—about the potential impact of Brexit on these vital services. On one level, one might not expect changes in our trading relationships to impact this sector as severely as, say, manufacturing or agriculture, but in fact there are already discernible effects on that key component of healthcare: the availability of a skilled workforce with adequate resources. A totally unnecessary uncertainty has been created, both for the existing NHS workforce, many of whom have come to the UK from EU countries, and with regard to recruiting potential new staff from those countries.
First, I have heard from those involved in healthcare—in Wales and in England, as it happens—about skilled staff employed in the NHS now actively seeking similar posts in other EU countries, just in case they feel forced to leave at a later date, perhaps for professional or social reasons. They fear that others will do likewise and that the available jobs will then dry up and they will need to move quickly to look for them. Secondly, I heard from a very authoritative source that EU-based specialist staff are currently holding back from applying for jobs in the UK because of the uncertainty caused by Brexit. Incidentally, this is not impacting just hospital services but university medical research and manufacturing companies in the healthcare sector.
The potential reduction in the number of key workers available to the NHS needs to be very carefully monitored. If we are to go for a soft Brexit in which we will agree the free movement of those coming for specific jobs and guarantee no dilution of their employment rights, that is all well and good; we might not need the amendment. But at this stage we just do not know what sort of Brexit awaits us. If it is a hard Brexit, with no agreement, we most certainly do need the review mechanism contained in this group of amendments, and we need it for a purpose because in a no-deal scenario we may need to make alternative plans to import key workers from other parts of the world—if we can find them—and to do so quickly. For these reasons I support the amendment.
Let me first thank noble Lords very much indeed for bringing this important topic before the House today. I reassure them that the Department of Health and Social Care is actively supporting my department in its negotiations with the EU, including forming part of the negotiation team where the topic is of direct relevance to healthcare. It is also working closely with its arm’s-length bodies, the territorial offices and others across government in preparing for EU exit under all eventualities.
I will address this group of amendments now but I note that the noble Lord, Lord Warner, who I think is not in his place at the moment, has also tabled an amendment on health to Clause 6. This will be responded to formally when we reach that group and I note his specific interest in the subject.
Amendment 11, in the name of the noble Baroness, Lady Thornton, would delay the repeal of the European Communities Act 1972 until such time as the Secretary of State has set out a strategy for ensuring the mutual recognition of medicines and devices between the EU and UK. The Government have already set out a very clear offer to the EU for the UK to continue to work in partnership in the area of medicines. It is in the interests of patients and the life sciences industry for us to find a way to continue UK-EU co-operation on medical regulation, even if our precise relationship with the EU will by necessity change. Discussions are ongoing and the outcome will form part of our future relationship with the EU. We cannot and should not delay commencement of this Act until those discussions have concluded. The UK’s medicines and medical devices regulator, the MHRA, is a strong leader that will continue to ensure that medicines and medical devices are safe and effective, regardless of the outcome of negotiations and any agreement on recognition in this area. Indeed, it is currently recognised globally as an authority in its licensing and inspections.
In response to the questions from the noble Baroness, Lady Finlay, and the noble Lords, Lord Cormack and Lord Davies, I can be extremely clear that the UK’s preferred outcome is to find a way to continue to co-operate on medicines regulation with the EMA. We have made that extremely clear to the EU. Even though our relationship with the EMA will have to change as we leave the EU, it is in our mutual interests to continue to co-operate and share scientific expertise. We believe that desire is shared by the EU.
Can I ask for some clarification from the Minister about his statement about the preferred outcome? What exactly does that mean? If we do not achieve what we want to in that preferred outcome, what exactly happens and what do we do next? What is the timescale for this? That is why the amendment is framed in the way it is.
It is obviously difficult for me to speculate on what happens if we do not achieve the outcome that we want. As I said, we strongly believe that since we contribute an awful lot of work through the MHRA—something like 40% of the EMA’s work is contributed to by UK authorities—it is in our mutual interests to continue to co-operate. If that is not possible, we will set out an alternative course of action but we believe that it is and should be.
We have a window of about two years in which to get this right. I was talking to the trade bodies for over-the-counter medicine last week and they were saying that a change to make all over-the-counter medicines UK-based would need about a five-year timescale. It is just not doable, so there is an absolute imperative to get these regulations sorted out in pretty short order.
The noble Baroness makes a powerful point. It is one of our priorities. We have a number of priorities in the negotiations but it is important that we get this one right. The MHRA already licenses nationally 90% of all medicines available in the UK but there is a small percentage regulated abroad, so we need to reach a mutual agreement on that.
Amendment 101, tabled by the noble Baroness, Lady Jolly, would prevent the Government making changes to the licensing or regulation regimes for over-the-counter medicines, to which she just referred. The Government will need to correct deficiencies arising from withdrawal in relation to the regulation regimes for over-the-counter medicines, self-care medical devices and food supplements where the UK’s exit from the EU would result in the retained EU law which governs the regimes being deficient or not operating effectively and where manufacturers of these products would have to adapt to divergent UK requirements, potentially leading to a temporary or permanent withdrawal of their product from our market.
The noble Baroness asked a number of specific questions. The Government have already made it clear that we wish to retain a close working relationship after exit. The Government have been engaging with industry and research charities through the ministerial and industry co-chaired life sciences group, and we will continue to work with that group and industry to ensure adequate notice and sufficient time to implement any changes necessary.
Whatever the outcome of negotiations, the principles which will underpin post-Brexit regulation for this sector will be that patients should not be disadvantaged, that innovators should be able to access the UK market as quickly and simply as possible, and that we will continue to play a leading role in Europe and the world in promoting public health. Over-the-counter products will continue to have an important role in relieving pressure on health professionals and promoting consumer choice to improve public health.
In the event that it is not possible to reach a deal that secures ongoing, close collaboration between the UK and Europe, we will set up a regulatory system in the UK that protects the best interests of patients and supports industry to grow and flourish. I hope that my comments will provide the noble Baronesses, Lady Thornton and Lady Jolly, with the reassurance they need not to press their amendments.
Amendments 9 and 205 were tabled by a number of noble Lords, including the noble Baroness, Lady Jolly, and the noble Earl, Lord Clancarty. The Government recognise how important reciprocal healthcare is to the 190,000 UK pensioners who currently benefit from it, to UK tourists who use the European Health Insurance Card scheme and to EU nationals visiting and living in the UK. This point was powerfully made by the noble Lord, Lord Davies. We want to protect reciprocal healthcare arrangements and have made important progress towards this in this first phase of negotiations. It is the intention of the UK and the EU that the final withdrawal agreement will protect reciprocal healthcare rights for UK citizens resident in the EU on exit day and vice versa on a reciprocal basis.
The Minister said that important progress has been made. Will he tell the Committee what that progress is?
The important progress was announced in the agreement reached in December in the first phase of the negotiations. Reciprocal healthcare benefits were guaranteed for existing UK residents in the EU and for existing EU residents here. The next phase is what happens in the future.
The points I raised related not to the important matter of residents, whether continental residents living here or British residents living on the continent, but to travellers—people who may want to travel for a short period for tourism, family reasons or what have you. Has any progress been made on that front? If not, are the Government proposing to make any progress and, if so, what progress?
That will be for the next phase of the negotiations. We have guaranteed the right of existing residents from the EU in the UK and for UK residents in the EU. The next phase of the negotiations is for people who will travel there in future.
Is the Minister saying that the Government intend to retain the EHIC reciprocal agreement or is he talking about something else?
We would like to retain an arrangement similar to the EHIC if possible. We cannot give any guarantee about what might happen in the next phase of the negotiations.
We welcome the progress made, but we are clear that we want a wider agreement on reciprocal healthcare. I am sure that noble Lords will appreciate that this is not something we can simply legislate for in the withdrawal Bill, but must be negotiated with the EU, which is what we have been doing. We are very clear that we want to protect reciprocal healthcare arrangements.
On 8 December, the UK and EU Commission reached an agreement which delivered on the Prime Minister’s number one priority: to safeguard the rights of people who have built their lives in the UK and EU.
I asked the Minister for information about billing across borders to date, because that information must have been available to the Government before they started negotiating over the travel arrangements.
I will need to write to the noble Baroness with the exact amount of billing, as I do not have those figures in front of me at the moment.
I turn to Amendment 353, tabled by the noble Lord, Lord Stephen. The Government already keep NHS performance and health outcomes constantly under review, including through the NHS outcomes framework, which measures a number of health indicators intended to form an overarching picture of the current state of health and care services in England. We are committed to positive and productive engagement with the devolved Administrations going forward as we seek a deal that works for the entire United Kingdom.
The Secretary of State for Health and Social Care also publishes an annual assessment on the performance of NHS England, including how it has met its mandate from the Government, as well as an annual report on the overall performance of the health service.
As the Minister has confirmed that there is in fact ongoing, detailed monitoring of these matters, can he confirm that we are losing National Health Service staff returning to the European Union and are having greater difficulty in recruiting from Europe to fill the vacant spaces?
I am not sure that is the case. Obviously there are people returning to the EU all the time, and different people coming to the UK to take up job offers. We can get into detailed figures, but I do not think there is any large-scale exodus of health service staff.
For the reasons I have set out, this amendment is both unnecessary and risks creating unwelcome new burdens at a time when that is least appropriate. I hope I have been able to provide noble Lords with sufficient reassurance.
My noble friend is batting on a difficult wicket. We understand that. He has my total personal sympathy for the plight in which he finds himself, but what he has said this afternoon just ain’t good enough. It is important that he takes on board what has been said during this debate, particularly by the noble Baroness, Lady Finlay of Llandaff, and that when we come to this on Report, he has some substantial and detailed specific progress to report to your Lordships’ House.
I thank my noble friend for his comments. A lot of these matters are still to be negotiated in the next phase. We made substantial progress in the first phase, and we will endeavour to ensure that we make good progress to achieve a good working relationship with the EMA and to guarantee the rights of travellers through a system similar to the European health insurance card for those travelling in future. I hope to be able to provide more information on Report.
Following on from the comments of the noble Lord, Lord Cormack, could the Minister provide us with data in writing on the numbers of EU staff who have applied for jobs in healthcare in the last 12 months and the numbers of EU staff who have left? We need to have the data rather than bald statements about what is happening based on anecdotes, because it may well be that the Minister is hearing a quite different set of anecdotes from the ones the rest of us are hearing.
Will the Minister also confirm, or not, my interpretation of his comments on the outcome if there is no agreement? Here I return in part to Amendment 11, but to others as well. If there is no agreement with these regulations, will the Government then simply adopt European regulations de facto? I cannot see any other way for our pharmaceutical and biotech industries to continue to function. We need them for our economy, quite apart from needing them to ensure that there is a supply of medical and biotech advances for our patients. It is particularly important because biotech is an emerging field in which to date, within Europe, the UK has been the leader. I should declare an interest here because my son is a senior lecturer in bioengineering and cardiology, so he is involved in some of this ground-breaking work.
It would be helpful for us to know that and whether, in the context of there being no deal, the Government are already establishing dialogue between different Ministers in the devolved Administrations. As the noble Lord, Lord Wigley, has pointed out, there are very real implications for Wales, particularly west Wales—I declare my interest as someone who lives and works there—because we know there are large gaps there. We have to know how the Government intend to behave in the event of there being no deal at all.
The noble Baroness has made some valuable points. On the question of data on EU staff applying to jobs in the UK, if that information is available then we will certainly share it with her.
She asked what happens if there is no agreement. As I said, the MHRA already issues national licences for some 90% of medicines on the UK market. If we are no longer co-operating with the EMA on the regulation of new novel medicines, the UK will ensure that our own procedures do not lead to any delay in patient access to new medicines and are no more burdensome to industry.
The noble Baroness’s point about working with the devolved Administrations is a good one and we will ensure that that happens.
My Lords, I thank the noble Baroness, Lady Finlay, who as always is much more qualified than me and indeed most of the House, for her support. I respectfully suggest that the Minister needs to actually talk to some of these bodies about how complicated, difficult and costly it will be if we do not reach an agreement. That needs to be taken into account.
I thank noble Lords for their support across the House for this suite of amendments. The amendment from the noble Baroness, Lady Jolly, is important and—like my own, I hope—very practical. This is about what medicines people buy over the counter, what health supplements they have access to and whether those will change post Brexit.
The noble Earl, Lord Clancarty, tabled Amendment 205, and I thank him for his support for my amendment. He and I want the same thing: we want this scheme, which protects people’s right to healthcare, to continue, and as the noble Lord, Lord Cormack, said, its current form would be the easiest form for it to do so. It is often the case that the noble Lord, Lord Cormack, makes the observation that you wish you had—in this case, about disease knowing no boundaries. He is absolutely right.
My noble friend Lady Blackstone made an eloquent point about cutting-edge research and the importance that that has for children and the rare diseases that they experience.
I do not deny that the amendment from the noble Lord, Lord Stephen, is important. It will be very important that we know what the impact of Brexit has been, not just a year later but ongoing. However, the argument that we are having on the earlier part of this suite of amendments is about what happens in the negotiations and what happens if they fail. It is about the action that we take now.
The noble Lord, Lord Wigley, is quite correct about the uncertainty that has been created for NHS staff in terms of their retention and recruitment. In fact I asked a Question of the Health Minister about precisely that not so long ago. Those figures have been collected by organisations such as the Royal Colleges so we know that the number of nurses coming from Europe in the last year has fallen by, from memory, around 80%. That is a huge drop in the number of nurses prepared to come and work in this country from Europe.
I say to the Minister that we understand—I agree with the noble Lord, Lord Cormack—that this is a difficult time and the Government are in the middle of negotiations. However, it is a long time since the referendum and we are a short time away from falling off the edge of the Brexit cliff, and issues of licensing of medicines and access of citizens to healthcare can none of them brook a two or three-year negotiation after Brexit because of the suffering that would cause and the impact it would have. That is what the amendments concern.
I hope that between now and the next stage of the Bill, we will make some progress on both those issues. If we do not, we shall return to them. I beg leave to withdraw the amendment.
My Lords, we now come to an amendment which concerns two EU programmes which are clearly at risk as a consequence of the Brexit withdrawal. The first is Horizon 2020, which is a major funder of research, principally in our universities. One cannot talk about this funding programme without making reference to the impact on the UK economy.
I remind the Minister that the Government’s industrial strategy sets a goal for the UK to have the world’s most innovative economy. It states that we are recognised as a global leader in science and research but that neither the Government nor the private sector are investing enough in R&D. As the Government’s paper points out, we spend 1.7% of GDP, compared with 2.8% in the US and 2.9% in Germany. Commendably, the Government have set the goal to raise total research and development investment to 2.4% of GDP by 2027. They state their intention to work with universities and research institutes to increase global investors and R&D activities taking place in the UK. That is highly commendable but also challenging in the context of Brexit.
There are a number of factors in this. First, I hark back to our previous debate on regulation. The Minister says that because 90% of medicines in use in the UK are licensed by the MHRA, we should not worry if there is no deal, and the MHRA becomes a stand-alone regulator. That misses the point that any medicines licensed by the MHRA in this country can then be taken to be licensed throughout the EU. The reason is that we play by the same rules. Unless we reach a mutual recognition agreement with the EU, it is absolutely clear that pharma’s investment in research in the UK will fall dramatically. It is not just regulation, it is funding, it is multicentre research collaboration, it is research policy and it is movement of researchers.
At the moment, many of those research programmes are at risk, none more so than Horizon 2020. This is a programme which funds major research in our universities. Rather like the UK’s general research position, we have a hugely impressive number of universities engaged in high-quality research. We know that despite the relatively low share of global investment in R&D, UK research accounted for 50% of the world’s most highly cited research articles. Part of that success has been in attracting more than £1 billion from overseas every year, with £840 million coming from the EU in 2015-16. Horizon 2020 is the biggest EU research and innovation programme and the UK has done very well out of it. It is the second in order of recipients of that programme within the EU. Around 15% of funds allocated from Horizon 2020 have gone to the UK. Indeed, Cambridge, UCL, Imperial and Oxford universities are the top four recipients to date. Other universities, including Edinburgh, Manchester and Birmingham have also done well.
Clearly, the question is: what will happen with withdrawal from the EU? At the moment, the position is that UK researchers will remain fully eligible for EU funding for at least the next 17 months. The Government have given a guarantee to pay out any funding applied for and awarded before we leave. But, of course, the question is: what happens post 2020? The Government’s position on that is non-committal. We have had positive messages from the Prime Minister in her Lancaster House and Florence speeches, and in the Government’s science and innovation discussion paper, but since then, there has been no clarification at all of the UK’s status in relation to this funding after Brexit.
Of course, the worry is that simply the loss of funding will have a big impact on our research capabilities and also collaboration with European universities. My amendment would ensure that we either remain a member of, or seek to maintain some kind of participatory relations with, Horizon 2020 and its successor programmes. I should say that part of the problem is that if academics do not know, it is very difficult for them to plan research collaborations with European universities going beyond the due date. Any week lost in terms of uncertainty is sure to put some of those programmes at risk.
I propose a similar approach in relation to the Erasmus+ programme. I should have thought that, post Brexit, the need to encourage young people from the UK to maintain and develop links with the rest of Europe is self-evident if we are to avoid drifting apart from the continent. Yet our withdrawal from the Erasmus+ programme could make that more difficult. This EU-funded scheme has enabled 600,000 people from the UK to go abroad to study, train or volunteer over the last 30 years. It is open to education, training, youth and sports organisations across all sectors of lifelong learning, including school education, further education, adult education and the youth sector, as well as higher education, for which I suspect it is most well known. For young people, this has had a hugely positive impact, leading to better job prospects and lower unemployment. The British Council, which oversees it, reports that young people who participate in international opportunities return with increased language and intercultural skills.
The programme is not just about the EU—it has enabled UK universities to develop new or to reinforce existing partnerships with universities in Asia, Latin America and the US. The British Council believes that the UK should seek to remain in a successor Erasmus+ programme, and I very much agree with that. If we do not, the UK will have to set up numerous bilateral relationships which will be time consuming and costly, and frankly, I doubt the capacity of government to be able to do it any time soon. Here we have an entirely positive programme, enabling young people from this country and other countries of the EU to enjoy fulfilment and open their horizons. I should have thought that at least in this programme, it would have been possible to agree our future participation. I hope the Minister will be able to confirm that. I beg to move.
My Lords, I have added my name to Amendment 10, tabled by the noble Lord, Lord Hunt, and have Amendment 163 in this group in my name and those of my noble friend Lord Storey and the noble Earls, Lord Clancarty and Lord Dundee. The noble Lord, Lord Hunt, has set out clearly why we feel that assurances on Erasmus+ and Horizon 2020 are essential if our world-leading universities are to retain their reputation and our students be given the best opportunities to broaden horizons.
Does the Minister recognise the benefits of scientific research—including, as the noble Lord, Lord Hunt, has set out, for the economy? In particular, can he provide some clarity on how the UK Government intend either to remain in or replace the range of EU funds as we leave the European Union? Of course, it is not only the funding. Crucial to research is collaboration. Working with other European researchers and academics has resulted in work of benefit to the UK, the EU and, indeed, worldwide. As a recent CBI report set out:
“With science and innovation increasingly becoming globalised, the UK’s role as a leading global scientific power is at risk without an agreement”.
What a loss it would be if we were to walk away from these EU programmes.
Horizon 2020, as we have heard, is the biggest EU research and innovation programme, with nearly €80 billion of funding available over the seven years of 2014 to 2020. In addition to Horizon 2020, there is a range of other EU-based funding, which has included, for instance, valuable support for environmental science and the environment, whose future must also be carefully considered by the Government. Protecting the environment is best done in collaboration. We believe that these funds are key.
Horizon 2020 is a highly important source of funding for research in the UK. There are other funds such as Interreg and Life, which support applied research in the UK and are instrumental in turning academic research into public policy and maximising its benefits for society. As for the Erasmus exchange programme, it has been described as one of the greatest culture and character-building programmes that you can have in your whole life. The Liberal Democrats have long wholeheartedly supported Erasmus. It is heartening to hear that wholehearted support coming from the Labour Benches—it would be even better to hear it from the Government Benches, and not just for the niggardly couple of years that Ministers have mentioned so far but as an ongoing and enduring commitment.
Erasmus is aimed at cross-border co-operation between states to aid the growth of international studying, international understanding and fostering good international relations—and my goodness we will need all those in spades, if and when we leave the European Union. With over 4,000 students involved in the programme at any one time, it offers an excellent chance of experience abroad, which, we know, is highly valued by employers. Those from disadvantaged backgrounds can be helped by the Erasmus+ EU grant to help cover the travel and subsistence costs incurred in connection with their period of study abroad.
Erasmus has been of life-changing importance to so many young people from all walks of life. It would be an act of folly not to continue this scheme for our young people. I hope the Minister will respond favourably to these two amendments, in the interests of students, researchers and the greater good of the country.
I support this amendment and will go a bit further. As we have heard, the UK is a major player in research and innovation in European countries and worldwide. A recently published document, Building a Strong Future for European Science: Brexit and Beyond, is Wellcome’s recommendation from the future partnership project, based on a survey of 200 institutions and top scientists in Europe. It might form the framework based on which the Government may wish to negotiate beyond Brexit.
If nothing were to change and we were to remain as we are, there would be no problem—the UK would remain a major player in science and innovation. But on the basis that we will have to negotiate post Brexit, I would say, as the document says:
“Brexit presents the UK and EU with choices about their future relationship on research and innovation”.
European nations, including the United Kingdom as a major player, have developed,
“a world-leading location for research and innovation”.
The EU and associated countries—there are countries which are not part of the EU but are currently associated with Erasmus and other EU research programmes—
“should accelerate and deepen development of the European Research Area (ERA), to help Europe and EU Framework Programmes capitalise on the strengths and talents of a wider group of nations”.
Each of these nations, including the UK, contributes heavily to these programmes. We have to find a way to continue, both for Europe and for us.
An EU-UK research and innovation agreement for Brexit could be possible:
“Evidence and views gathered through the Future Partnership Project showed the importance of finding a way for the EU and UK to maintain their important partnership”.
There was a strong view, both from scientists and research organisations in Europe, outside the UK, that they would like this partnership and strong relationship to continue.
As to funding, as has already been mentioned:
“The EU’s Framework Programmes are the most effective multilateral funding schemes in the world”.
The UK needs to be part of this, so:
“The UK should therefore secure Associated Country status in an excellence-focused Framework Programme 9”—
that will follow programme 8—
“as this would be the best way to participate in European research. To achieve this, the UK should be pragmatic about the cost of a good deal to access FP9, and the EU should be pragmatic about the terms of FP9 association for the UK”.
There are benefits for both sides, which the science community certainly recognises.
There will, of course, have to be some alliance with regulation and research policy. A later amendment in my name relates particularly to clinical trials, which are important for the life sciences industry in this country. It is important, therefore, for,
“the UK to participate in the EU’s harmonised clinical trials system”,
including the new system that will come. The report states:
“A research and innovation agreement should promote dialogue on areas of research policy where the EU and UK can provide global leadership, for example on open research … A research and innovation agreement should support full researcher mobility between the EEA and UK”.
Proposals of this kind, which have come from Wellcome and the Royal Society, could be the framework for future negotiations, particularly on research and innovation.
My Lords, as has been said, that our current advantages from international student mobility might now be under attack is clearly of great concern.
In 2014-15, it was estimated that international students contributed around £25.8 billion in gross output to the United Kingdom economy. There are also the considerable social and cultural benefits to which they contribute, not least the United Kingdom’s soft power overseas.
Yet recently, and unfortunately, those heartening figures and prospects have got worse, our market share slipping against rival English-speaking countries such as Australia, New Zealand and Canada, as well as against European countries, which now offer more courses in English.
These amendments seek to prevent further decline by protecting continuing UK participation in the Erasmus and Horizon 2020 schemes. As we know, the Government have guaranteed participation for the next three years.
Nevertheless, does my noble friend the Minister agree that, as other noble Lords have urged, by far the best plan is to negotiate with the EU to stay within these very effective education initiatives, while at the same time doing all we can to support and work with our universities to increase international student mobility both in Europe and elsewhere?
My Lords, I too support the two amendments in this group. I have a special interest in Oxford University, which benefits exponentially from Horizon 2020, and our students also benefit from Erasmus. As my noble friend said, Oxford, Cambridge, UCL and Imperial are the top four recipients to date. This has been invaluable in achieving their status in global league tables. However, my concern is about not just Oxford but our higher education sector as a whole. We often repeat the mantra that we are global leaders, and we are: our higher education system is the envy of the world and that is a matter for celebration. But too often we forget that some of our research and innovation success derives from the funding and, often more importantly, the collaboration that we enjoy as part of Horizon 2020, which built on its predecessor framework programmes. The partnerships that have enabled our universities to thrive are now being undermined by Brexit.
We are assured that our UK researchers will remain fully eligible for Horizon 2020 support for at least the next 17 months, but I have to tell the Minister that the reality is sometimes quite different. In many cases we are no longer considered the lead partner in a project because there is so much uncertainty about the future relationship. I fear that we will find, more and more, that we simply do not win the bids. As for the future, what are the Government’s intentions? Will our universities continue to be leading players in the successor to Horizon 2020, which will start in 2021—a programme over which, I regret, we will have little or no influence?
How are our universities supposed to plan, especially at a time when there is great uncertainty about the future funding of the sector as a whole? University staff and lecturers are under the cosh, facing pension cuts and living with the uncertainties caused by Brexit. Louise Richardson, vice-chancellor of the University of Oxford, said in a recent article that we must remember:
“Universities are engines of social mobility, drivers of the economy and generators of new ideas”.
I am sure that the Government agree, yet the lack of commitment in relation to the next EU research and innovation programme will undoubtedly make it more difficult to retain and recruit the best researchers—the very people who generate the new ideas and find solutions to the problems of today and the challenges of tomorrow.
Many facts and figures have already been given but I remind noble Lords that, in terms of research, development and innovation activities, in the last seven-year financial framework, the UK contributed €5.4 billion to the EU and the EU contributed €8.8 billion to the UK. The UK is not only the most active participant in Horizon 2020 but our institutions co-ordinate about 20% of the projects that have been funded so far. In Germany it is a mere 11% and in France 9%, to name just two partners. Our influence and collaboration are extraordinary. I fear that without full participation in Horizon 2020, that will diminish.
Last year, we celebrated the 30th anniversary of the Erasmus programme. It is important to note that a higher proportion of those who study abroad achieve a first-class or 2:1 degree compared with those who stay in one place, and have improved employment prospects. It is not only our students who benefit, and have benefited, from this culture and character-building programme but all the public, private and voluntary associations in which the young people later find work. The experience of a year abroad gives them language and communication skills, sometimes provides professional experience, nurtures confidence and builds resilience. As the world of work undergoes a profound change thanks to new technologies, artificial intelligence and the pressures and opportunities resulting from globalisation, these skills are needed much more, not less.
Erasmus students who come to the UK are an important part of the international student community in our universities and communities. They also make an economic contribution to the UK. However, as has been mentioned, perhaps the soft power is of greatest benefit. Erasmus funding is also available to support staff mobility, joint master’s courses and collaborative projects. Many assume that student exchanges relate only to modern languages, but many law students, engineers and biochemists, to name but a few, also benefit from the arrangements. The UK National Agency for Erasmus+, a partnership between the British Council and Ecorys UK, remains wholly committed to the Erasmus+ programme and its benefits. The agreement reached in December between the UK and the EU confirmed that we will be able to participate in EU programmes, including Erasmus, until the end of 2020.
But what then? Will the Government continue to pay for participation in this excellent programme? Students starting university this September will want to be sure that they can participate in Erasmus, and students applying for university in 2018-19 must have certainty so that they can make informed choices. Labour’s position is absolutely clear, and always has been: we will continue to pay, and I warmly welcome that. I look forward to the Minister’s reply, in which I hope that he will also tell your Lordships how the Government are continuing to shape the next Erasmus+ programme so that it is more efficient, more inclusive and has an even greater impact.
The amendments before us today are probing but I trust that the Minister will be able to give a positive response to my noble friend; otherwise, I hope that further amendments will be tabled on Report. In his response, I trust that the Minister will also provide assurance that the Government’s lack of future commitment to date has nothing to do with the way in which the concerns of Brexiteers are being assuaged. I presume that they too would be in favour of maximising research funding and collaboration with European partners that leads to excellence, as well as enhancement of the skills and experience of our students.
My Lords, I have added my name to both the amendments in this group. I have tabled Amendment 204, which will be discussed later in Committee, on maintaining rights and opportunities for young people, and Erasmus+ is a part of that amendment.
If we lose our programme membership of Erasmus, it will be a huge blow not just to our young people, which would certainly be bad enough, but to the whole higher education sector, which benefits from the many projects that Erasmus has to offer, including not only the student exchange scheme but staff exchanges and projects involving the institutions themselves. The exchanges also include work placements, which can provide much experience of other work environments for British students. This is of course not just about experience and learning in the narrow sense; it is about the reciprocation of ideas, the effect of cultural exchange, and the knowledge that British students gain of other cultures and of how things are done elsewhere—and indeed vice versa, as there is also an extremely important soft power element in the creation of so many UK alumni across Europe.
Student exchange schemes embody an open-mindedness—even an open-heartedness—which is a far cry from the attitudes taken by some sections of the British press, which are currently crowing about the number of EU nationals leaving our shores.
There are some who say that, instead, we should develop independent arrangements with universities further afield. The fact is that we are developing relationships further afield anyway. For example, my nephew is at Northern Arizona University for a year, where he is studying American history as part of a degree course at Swansea University, with which Northern Arizona has an agreement. In a poll two years ago, 42% of students said that they were interested in travelling to non-Anglophone countries, some outside the EU. It should not be a case of either/or. To close down or risk closing down these wonderful educational opportunities for young people on our own continent would be perverse and a giant step backwards. Nothing in Erasmus says that one thing precludes the other.
The Government guarantee our current membership only up to 2020. There needs to be something much more concrete. Jessica Cole, head of policy at the Russell group said this month:
“We are expecting the European Commission to put forward proposals for the next Erasmus programme later … this year. There is an opportunity now ... for the UK to help shape that programme ... The UK Government needs to be engaged in this important process, especially whilst we still have a seat at the table”.
She goes on to say that,
“it should be a priority for the UK Government to secure continued UK participation from 2021 onwards ... the Prime Minister should indicate whether the UK intends to negotiate participation at the earliest opportunity”.
I ask the Minister: when will this indication be made?
On the wording of the amendments before us, one thing that we need to be careful about is the status of membership. It is possible—probably very likely—that we will retain membership technically, but there is a huge difference in the actions possible between programme membership, which we have presently, and partner membership, where we will be effectively left out in the cold. The phrase “on existing terms” in the amendment of the noble Baroness, Lady Garden, is crucial. We need absolutely to maintain the existing level of participation.
It needs to be said that, if we do leave the single market, we risk losing our programme membership. Witness what happened to Switzerland, which was expelled from the programme membership of Erasmus and from Horizon 2020 following a referendum that allowed a policy which compromised its own free movement deal with the EU. Switzerland has now realised what it was in danger of losing, and has since re-joined Horizon 2020 and is likely to re-join Erasmus+ properly in 2021.
In this and in so many other instances, it is wrong to think only of how the EU is treating us. We have enjoyed access to these programmes through our membership of the EU—at the very least, through being part of the single market. They have been an integral part of the deal, which has always been a two-way street. We should instead be asking ourselves: do we really want to risk losing access to programmes which have been, and still are, so beneficial to our young people, the higher education sector and research development in the UK—and, therefore, to the country as a whole?
My Lords, it is some 500 years since the great humanist scholar Erasmus came to this country to visit his friend, Thomas More. I always thought it was particularly appropriate that this programme, which has come to dominate today’s debate, was named after that extraordinary European. Whatever our nationality and identity, we are all European.
I should declare an interest, in that I was a visiting parliamentary fellow and have for many years been a senior associate member of St Antony’s College, Oxford. I have therefore seen at first hand how crucial it is that highly intelligent young people from different countries get to know each other. The programme has done untold good for this country, because so many from that particular college have gone back to their countries to occupy high positions in government and the civil service, and sometimes the highest position of all as head of state.
I have raised the Erasmus issue a number of times in your Lordships’ House and I have never been reassured by the answer I have been given from the Front Bench. A guarantee for 17 months is no good at all. As has been said already in this debate, those who are in charge of academic programmes, be they scientific or in the humanities, need to be able to look ahead. I have two granddaughters who are undergraduates—one will graduate this year and the other in two years’ time—and they may just benefit from this, but there is no absolute guarantee. Yet I know that their studies and their outlook on life would be immeasurably enriched by their having the opportunity to travel and to study abroad, in particular to study on our continent of Europe.
It really is important that we continually make the point that we are Europeans. No act of this Parliament or any other can alter that fact, and nor can any referendum result, be it on 23 June 2016 or on 23 June in some other year.
There has been much talk about a deep and rich partnership, and of course we want that, but we have to start now to be specific. One thing we can be specific about is this: here is a magnificent programme from which students and university staff have, over the past 30 years, benefitted enormously.
A couple of weeks ago, I was at a 21st birthday dinner at the University of Lincoln, a university that has risen spectacularly in the tables. It regards its 10% of foreign students as enormously important, and the chance its students have to study abroad as enormously important.
We know that there are countries outside the EU that benefit from Erasmus: so what, in the name of goodness, is holding back the Government from saying, “We are making an unequivocal commitment to continue this”? There is no reason why we cannot; there is every reason why we should. We are in an unfortunate position at the moment, with no clarity, much confusion and contradictory statements being made by different members of the Cabinet. I am told they are at one now, following their outing in Chequers last week, and I hope that is right.
However, we could make things so much better by making a number of pledges and commitments. We are part of this and intend to remain part of it because, if this country is to flourish after Brexit, it will depend, perhaps more than anything else, upon the quality of our education and, particularly, of our university education.
Those who are Brexit orientated should particularly remember that there is no doubt that the vast majority of young people in England, Scotland, Wales and Northern Ireland wanted to remain part of the EU. I deeply regret that we are not going to, but we can hang on to some of the best aspects of it, and this is one.
My Lords, I declare an interest in that I am chairman of the Committee on Climate Change, which means that I depend considerably on the relationships between universities doing the kind of research that is necessary. I also have a daughter who had an Erasmus scholarship and I therefore care about this issue considerably.
I listened with great care to my noble friend’s response to the previous debate about medical matters. I emerged little the wiser as to where the Government were, intended to be, might be, would have been, thought they could have been, may in the future be if this or that might happen. We cannot go through 10 days or more in Committee—this will go on for some time—in which that will be the answer to every question put forward. There have to be sensible answers to sensible questions. This is a sensible question to which there is only one sensible answer. He is on a strong wicket on this occasion because he does not need to think any harder than deciding that doing both of these things will in no way interfere with the negotiations we have with the European Union. When we come to discuss everything else, it will not make a jot of difference if we have been sensible about these two things because they are clearly issues in which both we and the rest of Europe have a common concern and understanding.
On the research position of our great universities, we would be foolish to imagine that that happens by accident or that it is an eternal verity which will go on forever despite anything we may do. One of the reasons—not the only one—that our universities have been able to maintain and improve their position has been their openness to the rest of Europe, both in terms of the people with whom they work and the universities and institutions with which they can be the lead in so many of the occasions supported by Horizon 2020. The Government need to think carefully about the ease with which we can slip back down that list of leadership if we do not take the right decisions.
The Government must also not be blinded by a fear that anyone who disagrees with anything in this Bill is somehow or other perpetuating an anti-Brexit position. Everyone knows that I am entirely anti-Brexit and shall go on being so; that is absolutely true, but I am talking about something quite different. It is a simple matter concerning our universities and our young people. My daughter was one of the 300,000 people—a huge number—who have enjoyed this experience and she now speaks a little Catalan as a result, which is a useful skill at the moment.
This is a wonderful opportunity for my noble friend because what he could do now is make the Committee feel that the Government are genuinely listening to genuine discussions. I do not want to embarrass anyone, but a number of people in this House are dedicated Brexiteers but on this particular matter they are on our side. That is because it ain’t something about Brexit; it is about the sensible way forward. I therefore ask my noble friend this: why not accept this very sensible amendment? In case he is not apprised of this, let me tell him why he has been told not to do so. The rule is that nothing must change based on the argument that if anything changes, it will all be too late and we will not get it right. This is one thing that can be changed and will make no difference whatsoever to the timetable, so that argument will not wash. However, no doubt it is on his list of responses, but if I have said it, perhaps he will not say it himself.
The second reason that my noble friend will no doubt put forward is that it is all part of the negotiations. “We are working very hard to get closer to the rest of the European Union”. I can tell you how to stay close to the European Union, and that is not to try to leave it. If you are not going to do that, do not tell us that the Government are working hard to get closer when this is a way to do it. Just say, “We want to stay in the Erasmus programme and in Horizon 2020. We will play our full part and we will work with the Union in the way it wants us to. We are not going to be silly enough to say that this is just another item in the long list of things that we are going to discuss with the rest of Europe”.
I say to my noble friend that here is a chance for him to shine. Here is an opportunity for him to show that he has a mind of his own and say the obvious thing, which is yes.
My Lords, I rise to speak briefly in support of Amendment 10, with particular reference to the Erasmus+ programme, for two specific reasons. First, if we were no longer part of Erasmus+, there would be adverse consequences for the employability of our young people in general. Secondly, Erasmus+ is an essential part of the pipeline for modern foreign language teachers, where there is already a significant shortage. Uncertainty over our continued participation in Erasmus+ is one of the reasons for the continued decline in university applications to study modern languages. Over the past 10 years, applications have dropped by 57% and more than 50 universities have now scrapped some or all of their MFL degree courses.
Of course, Erasmus is not just for linguists and I cannot emphasise strongly enough how important Erasmus+ is for employability prospects across the board. Not only does the Erasmus year abroad help to improve language skills, it also helps to develop an international mindset and a cross-cultural attitude to work. We know from British Academy research and from a recent US study that employers rate these skills in some cases even more highly than expertise in the STEM subjects. We also know that graduates who have spent their year abroad under the Erasmus+ programme are 23% less likely to be unemployed than those who have not done so.
So, as others have said, it really is not good enough for the Government to commit to funding Erasmus+ only to 2020. That is no help at all to people in their first year of university now, whether they are linguists or studying some other discipline, who do not know whether they will be able to spend their third year abroad. It is of no help to sixth-formers or those coming up shortly into the sixth form who might be thinking about keeping up a modern language.
We need a clear commitment to be part of Erasmus+ beyond 2020 in exactly the same way as Norway and other non-EU countries, including Macedonia, Iceland, Liechtenstein and Turkey, which are all full programme partners. We would certainly be cutting off our nose to spite our face if we do not do this, not least because the European Commission is planning to double participation in Erasmus+ by 2025 by extending opportunities for exchanges and placements to school pupils, which, it is very easy to see, might turn out to be a critical factor in encouraging the continued take-up of modern languages at A-level and university. At the moment, we are simply not producing enough graduate linguists to meet the needs of teaching, business or the body of interpreters and translators working in international organisations such as the UN.
The other element of self-inflicted backlash if we ditch Erasmus+ would be to turn our backs on a vital part of the supply chain for modern language teachers. The Department for Education estimates the current shortage to be 3,500 if the Government are to meet their EBacc target. This shortage risks getting worse and more precarious post Brexit because such a significant proportion of MFL teachers and language classroom teachers are non-UK EU nationals. If they are not guaranteed residency status post Brexit, language teaching in our schools will become very precarious indeed. I implore Her Majesty’s Government to exercise a massive amount of enlightened self-interest and ensure that the UK remains a full programme partner and a full member of the Erasmus+ programme in the long term.
My Lords, I will talk about two aspects of Horizon 2020. One is the question of certainty and the other is how this links with freedom of movement. I declare two interests. My wife has been on some of the advisory committees concerned with the definition of Horizon 2020 and what happens beyond it. British participation in defining research priorities across the European Union has been high in the last two or three exercises. That is not something that has been imposed on us and it is one of the things that we will lose.
My second interest is that I have a son who is a mathematical biologist and who spent his graduate and postgraduate years—up to 10 years—in the United States and came back to this country under an EU-funded scheme to bring bright young researchers back to Europe. He had his two-year Marie Curie fellowship and was advised not to apply for European Research Council fellowship, which would have naturally followed on, because we were perhaps leaving the European Union and that would make it difficult for him. The uncertainty is absolutely there. Happily, he now has another grant. He was persuaded to return to the University of Edinburgh by an Italian professor who led a multinational team there. That is how British universities work. I have been to many universities in other European countries where the overwhelming majority of staff and students come from that country or, in one or two countries such as Belgium and Spain, from that region. Those universities are not of the same quality or calibre.
I sometimes fear that there are hard Brexiteers in this country who think that we have too many foreigners in our universities already and that it would be much better if we went back to being proper British universities again, which would be much more in tune with the British national spirit.
As a mathematical biologist, my son is currently in Paris for six weeks at the Institut Pasteur, having spent some weeks last year in Heidelberg, because the sort of work you do in the life sciences is multinational and naturally collaborative. That requires easy movement, short term and long term. Anything which raises difficulties of travel in and out of this country, which is part of the intention of leaving the European Union, will make it make much more difficult for our universities to go on being quite as good as they are. So I stress that, as we leave the European Union, we have to ensure that we remain internationally competitive and, in our universities, this matters.
Since the Government intend to leave the European Union in 13 months’ time, we need some rapid certainty on Horizon 2020. I suggest to the Minister that, well before the Bill leaves this House, the Government should have a clear answer, highly relevant to the Bill which takes us out of the European Union, on what the implications are of leaving and on which bits we are not leaving. Please may we have an answer?
My Lords, I will not only say that I will be brief but will be brief. I shall not pursue what has been said about Erasmus, with which I strongly agree—Erasmus must have been very grateful for all we have said about him today, although I think he would have some doubts about the present state of rationality in some our political debate in this country.
I will instead follow the point made so well by the noble Baroness, Lady Royall. I declare an interest, which is not financial. As the noble Lord will know, I was chancellor of a Russell group university in the north-east of England. I am chancellor today of another Russell group university. Perhaps just as significant, when I ceased to be a European Commissioner, I was asked to chair the committee which established the European Research Council. It did so on the basis of the recommendations in particular of Lord May, one of the greatest contributors to the debate about research and about universities in this country.
We established the research council on the basis that it would distribute funds by peer group review—not according to what individual countries had contributed but according to the research capacities of those countries and of particular institutions. And guess what? It demonstrated that we have the second-best higher education system in the world and arguably the best higher education system in Europe: we did extraordinarily well out of that research budget. As the noble Baroness pointed out, we get a great deal more back from the European budget than we put into it, which indicates how good our research community is in this country.
I realise that there are constraints under which the Minister has to operate—he has our sympathy and our prayers as he moves forward. I agree with what my noble friend Lord Deben said earlier: we do not expect him to do wonders. I am not sure that he will be able to tell us now what the Government’s intentions are in relation to the European research community. I do not blame him if he cannot do that, because I do not think that anybody in the Government has the faintest idea—certainly, I do not know anybody in Europe who has the faintest idea of what we want to happen—but I hope that, at the end of the day, as right reverend Prelates might put it, we will still be members of that research community.
So I do not expect the Minister today to be able to spell out precisely what arrangements we will have in the future—whether they will be similar to those which Switzerland has today, whereby it is part of the community but takes no management decisions about it. Israel is in a similar position. However, I hope that, even if he cannot tell us exactly what the relationship will be, he will at least give us one simple guarantee—and I am sure that the Chancellor of the Exchequer would want to stand over this very strongly.
When we leave the European Union we will lose the considerable surplus that we have at the moment in research spending—as I said, getting back more than we put in. Will the Minister guarantee this evening, even if he cannot give us any details about our future relationship with the European research community, that any shortfall in that funding after we leave the European Union will be made good by the Government?
My Lords, I support Amendments 10 and 163 on the need to ensure that the immense benefits of the Erasmus+ programme continue to be available to students throughout these islands and that the Horizon programme will continue to be funded. I have a particular attachment to the Erasmus programme from the early days, now decades ago, when a very good friend of mine and, I believe, a friend of a number of colleagues in this Chamber tonight, Hywel Ceri Jones, in his work in the European commission helped to pioneer the Erasmus programme. In fact, our parliamentary secretary in another place, Heulwen Huws, became one of his first administrators. I very much want to see this programme survive for those and many better reasons. The one point I want to impress upon the Committee is that the Erasmus programme has a very large input from the UK: it is not some programme being imposed upon us and owned by other people, it is something that we have a shared ownership of and we want to make sure the shared benefit continues for our young people.
The higher education sector in Wales has been a major part of the growing Welsh economy: 50,000 jobs in Wales depend upon it. Much of the success can be attributed to European investment, both structural and research-specific. Bangor University—I declare my interest in that university—has benefited over the last decade from about £100 million of funding. Swansea University’s Bay Campus has benefited from a similar level of EU funding. Incidentally, Swansea has benefited from £60 million of European Investment Bank funding. It would be interesting, although it may be outside the ambit of this short debate, if the Minister addressed that: the question of continued eligibility for European Investment Bank funding for our universities is one that could well do with clarification.
If we are in danger, in the event of a hard Brexit, of losing EU funding for higher education purposes and projects, I impress on the Government, as have a number of colleagues, the need to set up some alternative source of funding to ensure that vital work undertaken in our universities goes forward. We need a UK convergence strategy that will reproduce the European principle of equalisation and provide equivalent funds on a needs basis. This will enable universities, in Wales and elsewhere, to compete on the higher education world stage and continue to educate and innovate, as it currently does thanks to EU funding. Will the Minister clarify what the Government’s objectives are for these purposes as they enter the detailed negotiations? Do they aspire to some ongoing eligibility for access to cross-border and transnational funding programmes? Seeking single market participation is certainly the aim in the Welsh White Paper, but if the Government have rejected single market participation, as seems to be the noise coming out, can they guarantee, with no ifs or buts, that all the present levels of EU funding will be replaced, as was promised at the time of the referendum in 2016? This is particularly important for research funding: the Horizon 2020 programme has been a vital source of funding for universities throughout the land. So far the Government have refused to provide any statutory guarantee that these funding levels will be maintained. Will the Minister now take the opportunity to do so?
My Lords, I support these two important amendments and I apologise to the Committee for having being unavailable to speak at Second Reading. I therefore take the opportunity to declare my interests as chair of the Henry Royce Institute, a member of the Committee on Climate Change and chairman of the Adaptation Sub-Committee of the Committee on Climate Change. As we have heard from many noble Lords, the Horizon 2020 and Erasmus+ programmes are critical to our world-class academic institutions, to research and to our students. I will not take up any time by repeating the arguments but I remind the Committee that historically UK students are some of the least internationally mobile in Europe, particularly young people from less advantaged groups. If we are to compete ever more widely on the international stage after leaving the EU, ensuring that UK students from all backgrounds have the kinds of experiences that are enabled by the Erasmus+ programme should surely be a national priority.
We have not heard much about what Horizon 2020 does outside our outstanding academic institutions. It is a key funding source for industrial collaboration, supporting important initiatives such as helping Rolls-Royce develop new generations of more efficient and environmentally friendly aero engines. It also plays a key role in supporting innovation and entrepreneurship schemes, such as the knowledge and innovation communities, with a great example at Imperial College: Climate-KIC, which has already seen a number of new entrepreneurs with low-carbon technologies start to develop businesses in the UK.
In my own area of interest, Horizon 2020 supports environmental research. The UK wins around £147 million per annum for environmental research. Sadly, that rather dwarfs the £5 million investment in the new northern forest. Other EU funds, such as Interreg and LIFE, are important not only for environmental research but to cross-border collaboration on the island of Ireland; for example, supporting shared environments through the cross-border Loughs Agency, as well as other types of cross-border community projects. This is hugely important work that the House of Lords EU Select Committee was able to see and hear about at first hand on our recent visit to both sides of the Irish border. It is a really important element of the peace settlement on the island of Ireland.
These funding mechanisms play a critical role in our economic growth, as we have heard; in cross-border relations and well-being in Ireland; and in helping the Government achieve their stated aim to leave nature in “a better state” for the next generation. For these reasons, the amendments have my very strong support.
My Lords, I would not wish to disagree in any way with all those noble Lords who have said how excellent the Erasmus+ and Horizon 2020 programmes are. Undoubtedly, the United Kingdom contribution to them is very significant, just as the United Kingdom’s gains from being a participant in them are hugely beneficial. Nevertheless, one thing that has not been said by any noble Lord is that after Brexit we will have considerably more money to spend on important programmes than we have while we are making net contributions to the European Union of £10 billion to £12 billion a year. I have never been one to use the £350 million a week figure because that was the gross contribution, but the net contribution is about half that.
My noble friend Lord Patten pointed out that our contribution to the Horizon 2020 programme is about £5 billion but we receive £8 billion back. Presumably, this means that the organisers of the Horizon 2020 programme appreciate that the United Kingdom knows better than some other participants how to use the money wisely. Indeed, we continue to use the money from such programmes extremely well. Furthermore, if one looks at the participants in Horizon 2020, there are 17 countries which are not EU members. The European Commission website makes it clear that non-members participate on exactly the same terms as members. Therefore, I see no reason at all why we should not be welcomed as a continuing participant in Horizon 2020.
Does the noble Viscount not understand that if we participate from outside the European Union, instead of getting more back than we put in we will get exactly the same back as we put in?
I hear what the noble Lord says but I am not sure whether that follows at all. As far as the Horizon 2020 programme is concerned, presumably our contribution would still be assessed and valued in the same way that it is now. The deservability of the programmes for which we seek support would also be considered on the same basis as now, so I do not see why it should make any difference. But overall, we will have a considerable amount more money to spend, not less, because we will not be making the very large net contributions to the European Union budget that we make at present.
Can I clarify for my noble friend the position of countries from outside the European Union sharing in the European Research Area? I am sure he is aware that while some of them participate—I mentioned Switzerland and Israel– they play no part whatever in managing the programmes. They do not determine the priorities or what the money will go on. We could negotiate membership of the research council, I guess, although it would be with the financial consequences that the noble Lord, Lord Hannay, mentioned and the additional consequence that we would have no say in managing the programmes.
My Lords, it is a great pleasure to follow the noble Lord, Lord Patten of Barnes, and in so doing I remind noble Lords of my declared interests at Second Reading.
This has been an important debate because it has highlighted the vital contribution that European Research Council funding, in the Horizon 2020 programme and others, has made to our national research effort—both the research effort delivered by our universities and, more broadly, the research undertaken through industrial and SME participation in such research programmes. It has also identified the invaluable contribution we have made as a nation to the delivery of those programmes by the European Union. The leadership provided by UK institutions has ensured strong delivery by those programmes and the global impact of that research effort.
In that regard, it is vital that Her Majesty’s Government are able to identify a way forward for our continued contribution to the development of the programmes that follow Horizon 2020. That is a matter of negotiation currently and the discussion takes place at a sensitive time, with Horizon 2020 coming to the end of its life and a new framework programme 9 being established. It would be useful for Her Majesty’s Government to identify how they are currently participating in that negotiation. How are they trying to influence that agenda while they define their final position on our future participation as a nation?
For instance, coming together at this moment is UK Research and Innovation, which will bring together our research councils and our national innovation structure. What role will UKRI potentially play in focusing our national research contribution with regard to those ongoing negotiations? Can Her Majesty’s Government confirm that they will not only secure funding for our research base beyond departure from the European Union but ensure that that funding can be directed towards continuing collaboration in European networks? It is the network participation, as much as the quantum of funding available, that has provided the strong base for our research effort and the high-quality outputs that we now enjoy.
There is very deep anxiety about this question because if we are unable to make an appropriate contribution to framing future programmes and ensuring the priorities that those programmes will address, then whether or not we participate in future the value of our own national contribution and the ability of our nation to benefit from that participation will be diminished. That is a question beyond the final disposition of our participation in those programmes, which is of course a matter of broader withdrawal negotiations.
My Lords, I will be brief. I support these amendments, and I apologise for not speaking in the Second Reading debate for reasons which are too painful to burden your Lordships with tonight. Having listened to the debate, to me it seems that accepting the amendments is a no brainer, and I hope that the Minister agrees. Way back in the past century when I was dean of a medical school and the Erasmus programme and the predecessor of Horizon 2020 were introduced, we welcomed them with open arms. They were marvellous initiatives. They opened up research potential across Europe in a way which we had not had until then and the value to our students of being able to go abroad became pretty obvious. We loved, it, we welcomed it and it has continued in the same vein ever since. It has never faltered. It has grown from strength to strength, so why on earth would we want to jettison something that works so well and try to introduce something which will undoubtedly be more bureaucratic, will probably be more costly and which will not be nearly so valuable to our research effort or to the competitiveness of the UK? I hope the Minister will take note.
My Lords, I support Amendments 10 and 163 and declare my interest as a governor of the London School of Economics. I echo many noble Lords across the House, including my noble friends Lord Deben, Lord Cormack and Lord Patten. This is another example of what appears to be an ideologically driven, irrational decision that is pretty impossible to justify. I cannot think of any rationale for risking our position in the Horizon 2020 and Erasmus programmes. This is not required as a result of the EU referendum. The British public surely would not support the UK failing to secure ongoing participation beyond 2020 in these programmes.
Research is a vital investment in our future. Horizon 2020 is open to all and simple. It reduces red tape and allows researchers to launch projects and get results quickly. These programmes allow knowledge exchange and collaboration on innovation and research. Horizon helps entrepreneurs scale up businesses rapidly to establish a global leading position and to improve our industrial base. This is a flagship initiative designed to secure improved global competitiveness. Is this not exactly what we need for our future growth and success with or without Brexit?
This goes beyond funding. It is the spirit of co-operation and leadership that is so important. It gives our students, graduates and entrepreneurs the opportunity to exchange ideas and research collaboratively with other countries. There is no need for the UK to go it alone. There is obvious strength in collaboration. I hope the Minister will take careful note of the strength of feeling across the Committee, including on his own Benches, that we must not countenance whatsoever and under any circumstances turning our back on these programmes. The future of our country, our young generations and our world-beating research and academic institutions must not be put at risk. The UK has far more to lose than the EU if we are no longer a leading participant in these programmes. I hope my noble friend will return on Report with his own proposals to commit to ongoing participation beyond 2020.
My Lords, the mere fact that we require these amendments is shocking in itself. UK universities receive an additional 15% in funding from the European Union. Academics will now struggle to co-operate on research projects. The change in the visa regime that takes place may deter high-calibre academics joining British universities. That is happening already. When European universities have a chance to collaborate they already think twice before collaborating with a British university, and that is shameful.
The Erasmus programme is 30 years old. Are we going to throw away 30 years of that wonderful initiative? Hear what the Europeans say:
“‘The absence of physical mobility after Brexit would take us apart’, said João Bacelar, executive manager at the European University Foundation. ‘Student exchange is kind of the antidote to the malaise of Brexit. It is profoundly unfair if young people would pay a price for something they didn’t want’”.
Employers value the Erasmus brand. More than 200,000 British students have benefited from Erasmus. We have heard that other countries that are not part of the European Union can be part of Erasmus. Let us beware of what happened with Switzerland. When Switzerland voted to restrict European migration, it was taken out of the Erasmus programme. It has had to spend extra money to put a new programme in place. Do we want to go through all that? I do not think we should.
The best thing about Erasmus is that it is for everyone. It allows students who cannot afford it to study abroad in a variety of subjects. My noble friend Lady Coussins spoke about language skills. Erasmus involves 725,000 European students annually—a huge number. We do not want to be left out of it. We are the third most popular destination; 30,000 students want to study in Britain and 40,000 of our students are over there. These are huge numbers. If that mobility goes, we are going to suffer.
Will the Government keep their promise to maintain and protect all funding streams for EU projects in the UK? Will they ensure that there is no cliff edge for funding for scientific research at the conclusion of the Brexit negotiations? Will the Government confirm that British researchers must be able to continue to participate in an unrestricted manner in current and future EU science initiatives? Will they never prevent highly skilled scientists coming into this country? I would like that assurance from the Minister.
We have heard time and again about our funding and research power. We have 1% of the world’s population but produce 16% of the most highly cited research articles. That is how good we are. Every committee—including the House of Lords Science and Technology Committee and the House of Commons committee—is saying that this would be damaging for the UK. A recent YouGov survey showed that 76% of non-UK EU academics are already considering leaving the country. What are we doing?
There are two messages here, one about collaboration and the other about funding. As the noble Lord, Lord Patten, said, we get more than we put in. We are asking the Government for a guarantee that we are going to get that funding. But more important than the funding is the power of collaboration. As chancellor of the University of Birmingham, I am proud that it received a Queen’s Anniversary Prize last week. When I was in India, we cited an example of the power of collaboration between the University of Punjab and the University of Birmingham. The University of Birmingham’s field-weighted citation impact is 1.87. The University of Punjab’s is 1.37. When we do collaborative research, it is 5.64. When the University of Birmingham does collaborative research with Harvard University it is 5.69. Its impact in collaboration is three times greater than it is as an individual university, and that applies to all the collaborations that we carry out with programmes such as Horizon.
Finally, this is about universities and our youth. This is depriving them of their future. I speak at schools and universities regularly, and I ask students every single time how many of them, if they were given a choice, would choose to remain in the European Union. Without exaggeration, almost 100% of the hands go up. There are two years’ worth of 16 and 17 year-olds who did not get a say in the wretched referendum two years ago, and this is their future, in which they will want a say. That is what this amendment is about: the future of our youth through Erasmus and Horizon 2020. We cannot take that future away from them. We have to go through with these amendments, and it is most likely we will end up remaining in the European Union.
My Lords, I was not intending to intervene in this interesting discussion, not because I do not care deeply about these issues—as chair of Lancaster University, I realise how much we benefit from both Erasmus and the Horizon programme—but because I had not realised until I heard this excellent debate what a cliff edge these important programmes now face. This really is a very serious matter that has come out this afternoon.
There are two reasons for the cliff edge. First, the European Union, in the Commission, will now be thinking about the next framework programme, which will come in at the start of 2021. It will be devising its priorities and working on the assumption that Britain is not part of the next Horizon programme. That is a very serious point. Secondly, when the Select Committee went to see Mr Barnier last week in the Commission and he set out to us how the Commission envisages the Brexit negotiations, he put dealing with what he calls “future co-operation” in one of the four treaties that are to be negotiated after we have left. That is when he is assuming that these negotiations will start: in March next year, after we have left. One is on foreign policy, one is on security questions, one is on trade and the other is this basket of future co-operation. This is really serious. Unless we set a higher priority, more quickly, to sorting these questions out, we will end up with a lot of loss of initiative and of partnership, and networks in which we are involved no longer being sustained. We have to do something.
What are the Government proposing to do? It occurs to me that the Government, first of all, must make clear now that they want to continue to participate fully in both these programmes. They must make clear now that they are prepared to put a substantial sum of money on the table so that we can continue to participate in these programmes. They should also say, without equivocation, that for anyone from an EU country who has a place at a British university as a student, researcher or lecturer, or at a research institute, there will be no question of there being any additional immigration barriers to them taking up those places after Brexit. Why can that declaration not be made? The money, the free movement, the determination to participate—why can that not be said now? Why can the Government not, in this area, try to speed up Mr Barnier’s timetable by actually tabling their own text of the agreement that they want to reach? I hope the Minister can provide a satisfactory answer to these perfectly reasonable points.
Exactly. I strongly support what the noble Lord, Lord Liddle, has just said. I would like to be helpful to the Minister—it is my main purpose in life. I detect that this debate is at present all going one way, although I do not know if the Minister agrees with me on that. If he is a cynic, he might say that that is not altogether surprising, as the collective noun for a group of chancellors, vice-chancellors and university chairmen is the House of Lords.
It is important that the Minister should listen to the Cormack-Deben advice. It really would not do to answer this debate with the same answer he started off with to the last debate about medicines and Amendment 11—where, as I recall, his line was that publishing a strategy would introduce an unwelcome, undesirable and impossible delay to commencement. I may have misunderstood him, but it seems to me that the time when we need such a strategy—the strategy that is called for in this amendment—is now. We need it to be helpful to the Minister because if on Report we do not see a strategy, there is absolutely no doubt how the House would vote. This debate has made very clear, from all sides of the House, that continued membership or a close relationship with the research framework programme and with Erasmus is seen as sine qua non. If the Government do not give us the strategy which they think may achieve that, I am confident we will vote for these amendments.
The strategy would have to contain a little more than a declaration of intent. In relation to Erasmus, it would, as the noble Lord, Lord Liddle, said, have to include something about visas. I think it would also have to include something about fees. It is relatively easy to see what one would have to say. On the much bigger issue of research, it would have to include something from the Treasury. If the sensible suggestion from the noble Lord, Lord Patten, was accepted by the Treasury, that would be excellent. But it seems to me that the Treasury is going to have to accept a lesser commitment, which is that when it is pay as you go—which is what it is going to be, as my noble friend Lord Hannay has pointed out—we will pay for whatever we get. That seems to me to be a sine qua non.
It is of course the case that we will not be taking the decisions or laying down the policy anymore. But it will still be essential for our universities to have access to these networks. This would not just be helpful for the Minister on Report and in the negotiations in Brussels, where such a Cormack-Deben voluntary offer would go down extremely well, but also be something to deal with the uncertainty problem which the noble Baroness, Lady Royall, drew attention to. We are no longer desirable partners in research networks, because it is assumed that we will be country cousins or non-players.
We are no longer receiving the same demand from foreign students to come here to research. We are damaging the sector now—this is an area where the damage of Brexit precedes the deed. So in three contexts, it would be helpful to the Minister if he would say that he will take this away and think about producing a government strategy in both areas before Report.
My Lords, I agree with every word that the noble Lord, Lord Kerr, has just uttered. The noble Lord, Lord Patten, said that we were not expecting miracles from the Minister. I think even the Minister’s most ardent admirers do not credit him with miraculous powers, and he is not going to able to produce any rabbits out of a hat for us this evening. But it is not miracles we need here: all we need is a continuation of the status quo. This is one of those areas we come back to time and again—we had it in the long debate on Euratom last week: all we need to do is to avoid massive, self-inflicted damage.
There is no need to create whole new programmes and ways of working. We have Horizon 2020 and Erasmus; the latter has been going on for the best part of 30 years and is a highly successful programme. When you are doing something well, the usual trick is just to keep on doing it. There are so many things that do not work that the idea that Parliament and Government should be spending their time dismantling things that do is clearly crazy. What we want to hear from the Minister is simply that he is open-minded to continuing with the present arrangements. The sooner the Government are prepared to say that, the better.
The most telling contribution to this debate came from the noble Baroness, Lady Brown of Cambridge. In the higher education world, there is—I shall choose my words slightly diplomatically—a pronounced air of self-congratulation on how excellent everything is in this country and how brilliantly we do it, and if only the rest of world copied us then they would be a great deal better off. In many areas that is true, but in one we have a very poor international record: the propensity of our students to study abroad. According to the Erasmus figures, twice as many European students come to Britain as Brits go abroad. The noble Baroness was right to say there is a big problem with students from poorer backgrounds studying abroad. When I was preparing figures for this debate, I found that it looks as if Singapore, a country less than one-tenth the size of the UK, has about as many students studying abroad as we have in our entirety.
The fact is that we do not have nearly enough of our students studying abroad. When I visited Singapore as Minister for Schools, they were aiming—by about now, so maybe they have achieved it—at requiring all students at the National University of Singapore, regardless of their course, to spend at least six months, one semester, studying abroad. Can your Lordships imagine if we had anything like that commitment here? It might be a good thing if in due course we did. The great irony is that one of the great slogans to emerge from this Brexit policy as it has developed is “Global Britain”—but how can there ever be a global Britain unless far more of our students go and see the rest of the globe and spend time studying there? The first requirement for that is that we should not make the situation worse than it currently is.
The noble Lord, Lord Kerr, was right that what we seek from the Minister is not a miracle; we are clearly not going to get that from the present Minister. We simply expect a commitment to continue with the current programmes, and it is absolutely within the scope of the Government to say unilaterally that the negotiating position of Her Majesty’s Government now, in 2018, is that these programmes will continue with full British participation after 2020. If the Minister does not say that, he is staring at near-certain defeat on this issue on Report.
My Lords, I thank noble Lords for another excellent debate. I thank the noble Lord, Lord Hunt, and the noble Baroness, Lady Garden, for their Amendments 10 and 163, which respectively seek clarification on the Government’s future membership of the Erasmus and Horizon 2020 programmes. I am particularly grateful to my noble friends Lord Deben and Lord Patten for their helpful attempts to rewrite my notes for me before I started.
At the December European Council last year, the Prime Minister confirmed that UK students will continue to be able to participate in the Erasmus student exchange programme for at least another three years, until the end of the current budget period. She welcomed the opportunity to provide clarity to young people and the education sector, and she reaffirmed our commitment to the deep and special relationship that we want to build with the EU.
In response to my noble friend Lord Cormack, I say that the Government have made it clear many times that we value the Erasmus+ programme and international exchanges more generally. Cultural exchange helps to build important business, political and diplomatic bridges around the world, not to mention lifelong friendships.
I am grateful for that, but if that is the case then why do we not carry on beyond the three years?
If my noble friend will have some patience, I will come to that in a second. Supporting young people to study, work, volunteer, teach and train abroad, and supporting their schools, youth and sports organisations to build transnational partnerships, helps us to create a new generation of globally mobile, culturally agile people who can succeed in an increasingly global marketplace.
In response to the noble Baroness, Lady Royall, I say that the UK has a strong offer to EU and international students, with four universities in the world’s top 10 and 16 in the top 100. In fact, as the noble Lord, Lord Adonis, pointed out, we received many more students under Erasmus than we sent. Erasmus is an important programme, but it represents only about half the student exchange programmes we have in the UK.
Our young people get first-hand experience of different cultures, helping them to broaden their horizons and their ambitions. Students who have spent time abroad as a part of their degree are much more likely to achieve better degree outcomes, improved starting salaries and stronger employment prospects, as noble Lords have pointed out. This is especially the case for students from disadvantaged or less represented backgrounds.
In response to the noble Earl, Lord Dundee, no decisions have yet been made about post-2020 programme participation as the scope of that programme has not been agreed. We look forward to the Commission’s proposal, which we expect to be published in May. Participation in the successor to the Erasmus+ programme, which we think is valuable, will form part of the negotiations.
The UK fully participated in the mid-term evaluation of the current programme and we reached broadly the same conclusions as the Commission: the programme works well but there is room for improvement and simplification, especially for smaller applicants. UK respondents to the mid-term evaluation made many detailed comments and criticisms, but few suggested that radical change was needed. The proposal for the next programme will be published in May, as I said, and we are currently shaping the debate and looking forward to further discussions with the Commission about that.
We see future co-operation in education programmes as an area of mutual benefit to both the EU and the UK, provided that we can agree a fair ongoing contribution.
My Lords, what reassurance can the Minister give to students who are beginning their courses in September this year or September next year? Will they be able to participate in Erasmus or does that depend on whatever decisions the Government take after May? Is that not too late for certainty?
They will be able to participate in the existing Erasmus scheme up till 2020, should they wish to do so, and, as I said, we will see what the next programme will be. We await the proposals from the Commission in May, and we will discuss our participation in that with them.
As I said, we see future co-operation in education programmes as an area of mutual benefit to both the UK and the EU, provided that we can agree a fair ongoing contribution. We are giving this matter careful consideration as we negotiate the UK’s exit and are listening to the views of the sector.
As many noble Lords are aware, we have proposed a time-limited implementation period based on the current structure of rules and regulations. Looking to the future, we recognise the value of international exchange and collaboration in education and training as part of our vision for the UK as a global nation. That is why we said in our science and innovation policy paper, published in September, that we would discuss with the EU future arrangements to facilitate the mobility of researchers, academics and students engaged in cross-border collaboration. The UK and EU agreed in December that UK entities’ right to participate in current EU programmes for their duration will be unaffected by withdrawal. This includes the Horizon 2020 framework programme for research and innovation.
A number of noble Lords—the noble Lords, Lord Hunt and Lord Wallace, the noble Baroness, Lady Royall, the noble Earl, Lord Clancarty, and my noble friend Lord Deben—have asked me about the future of the Horizon programmes. Horizon will be succeeded by the ninth framework programme, as the noble Lord, Lord Kakkar, reminded us. This programme is also still being developed by the European Commission, and we are participating in discussions on that. The UK has declared that it would like to reach an ambitious science and innovation agreement with the EU that would include future framework programmes. It is too early to speculate on whether the UK will seek to associate to framework programme nine which, as I said, is still being developed.
The Government are deeply conscious of the importance of the Horizon 2020 and the future framework programmes to research in the UK, in which we have an international reputation. We are working hard to secure a research and innovation agreement with the EU that will take effect after Brexit.
The Minister says it is too early to decide whether we will co-operate. Can he tell us in what circumstances we will decide that it is not in the national interest for the UK to participate in the next Horizon programme?
I very much expect that it will be in our interest to participate in it. As I said, we are taking part in discussions. We have not yet seen the detail of how it will be financed, but, given a fair ongoing contribution, I suspect that we will want to participate. But they are a matter of negotiation. It is fine for us to say that, yes, we would like to take part; we need the EU side, the other side to the negotiation, to say that, yes, they would like us to take part as well. It is a negotiation. We can give a commitment that we would like to; we cannot give a commitment that we will be accepted.
As part of the new deep and special partnership with the EU, we will recognise our shared interest in maintaining and strengthening research collaboration. The UK will seek an ambitious agreement, one that promotes science and innovation across Europe now and in future. For the avoidance of any doubt, in response to the many questions that have been asked, let me say that we support Erasmus, we support Horizon 2020, but, contrary to what many noble Lords have suggested, these are EU programmes. The UK cannot adopt a unilateral stance; there has to be bilateral agreement on them. That agreement depends, first, on understanding the shape of the Erasmus programme in May and framework programme nine, when it is clarified by the Commission, and finding a mutually acceptable financial arrangement. Subject to those conditions, we would be very happy to be able to participate in both those programmes in future.
My Lords, I am not sure whether the Minister is drawing to an end, but he has not managed so far to say anything about the movement of researchers and students. Why can he not state categorically that we will not introduce any new impediments to students or researchers offered places in our universities? That would be entirely consistent with the introduction of a work permit scheme, because neither of those two categories come to our universities without a work offer. Why can he not say that now? Mobility is crucial in this area, but he has not said a word about it.
I totally agree with the noble Lord that mobility is crucial. I am fairly certain that we would not want to introduce restrictions on mobility in these areas—we want as many students to come as possible—but, as I am sure he is aware, this will be a matter for the Home Office to decide in the immigration policy that will be discussed shortly.
Indeed so. I was hoping that the Minister would say that there is not now, and never has been, any limit on the number of genuine students who can come to the UK. I would have thought that that is bound to continue: this is a false issue.
Yes, we have been a proud recipient of and destination for thousands of international students in the past. They are welcome in this country, they contribute greatly to our education services and I am sure that we will want that to continue in future, but I cannot speculate on what a future immigration policy may look like.
If this is a non-issue, why cannot my noble friend say very simply: “There will be no additional stops or impediments on students”? Does he not understand that constantly saying how wonderful everything is but that he cannot actually tell us anything is very difficult for anyone trying to plan their future and very unfair on young people?
As I said, I am fairly certain that we will want to continue to welcome as many students and researchers as want to visit this country in future, but, as I am sure the noble Lord will understand, I cannot speculate on what a future immigration policy might be before it has been announced by the Home Office and published by the Government.
Nevertheless, let me say for the avoidance of doubt that I have heard the message from all parts of the House and I will certainly reflect on these matters before we come back to the issue on Report. I understand that there are very strong feelings from all parts of the House about these issues and we will certainly see what we can do about that.
My Lords, first, let me say that I welcome the Minister saying that he will reflect on this debate, because I think it is the first chink of light from him on any of these important debates in Committee. It has been a remarkable debate. We have heard from many noble Lords about the importance of the Erasmus programme. I agree with my noble friend Lord Adonis: the noble Baroness, Lady Brown, speaking from huge experience as a former vice-chancellor of Aston University of the impact that Erasmus has had on the students who go to Aston and the way it has widened their horizons, is for me one of the most important illustrations of why future participation by the UK in Erasmus is so important.
On research, again, my worry is that the Government are hugely complacent about the UK’s position. Consider the consequences of uncertainty over Horizon 2020, which is having an impact on universities at this very moment in terms of collaboration on future research bids. Even where European Union universities will still collaborate with UK universities—and it is by no means certain that they will continue to do so in every case—they are reluctant for UK universities to be in the lead. Added to the uncertainties about the movement of both academics and students, we are entering a hugely uncertain position for a very important sector.
I listened with care to what the Minister said. To be fair, he has said that the Government value both Erasmus and Horizon 2020 and he repeated the Prime Minister’s comments, particularly in relation to Horizon 2020. He then said that while he values these programmes, the EU is working out the next stage of both Erasmus and Horizon 2020, that the UK is part of some discussion about that but they will form part of the negotiations and that there is nothing more he can say.
I think there is something more that the Minister can say. I think it is without question that it is in our national interest that we continue wholeheartedly to take part in those programmes. Thinking about the negotiations and the UK Government’s tactics, this niggardly, churlish approach does not seem to be getting us very far. This Government would attract a hell of a lot of good will if in relation to just these two programmes they said, “Whatever, we are going to stick with it, and we will make good any deficiency in UK university research programmes if the price of sticking with it means that we will get less than we did in the past”.
The whole Committee—almost all Members—really wants these programmes to continue. We will obviously come back at Report. The Minister has kindly said he will reflect on it. I very much hope that he will do so. I beg leave to withdraw the amendment.
Committee (2nd Day)
Relevant documents: 12th Report from the Delegated Powers Committee, 9th Report from the Constitution Committee
9: Clause 1, page 1, line 3, at end insert—
“( ) Regulations bringing into force subsection (1) may not be made until the Secretary of State has set out a strategy for seeking to ensure that any citizen of the United Kingdom or of an EU country, who requires health care in a different country of the EU or in the United Kingdom, will be treated as if they live in the country in which they require treatment, with the home country reimbursing the country where care was provided.”
For the EU this approach would secure access to reciprocal healthcare for EU citizens visiting or residing in the UK and maintain ease of travel for UK visitors to the EU, including holidaymakers. Should there be a failure to agree a withdrawal agreement by March 2019, access to reciprocal healthcare arrangements for UK citizens and residents within the EU and EU citizens and residents within the UK would end. This could lead to significant disruption for those individuals’ healthcare arrangements, an increase in the cost of insurance and uncertainty regarding accessing healthcare abroad. Moreover, the NHS may face a drastic increase in demand for services, which would increase its costs and place greater pressure on doctors and clinical staff because the UK citizens living in, or visiting, the EU would be required to return to the UK for treatment or purchase expensive healthcare or travel insurance, thus increasing pressure throughout the whole system. This is an issue on which it is very important that there is certainty, and that we know what will happen in March 2019.
I turn to Amendment 11. For some time now, it has not been possible to develop a new medicine in one country. This is a global industry and you need to run your clinical trials everywhere. Patients in the UK can access EU-wide trials for new treatment, particularly for rare diseases and in relation to children. Should the UK find itself unable to access this network, there may be an impact on the high-quality research in which we get involved, to say nothing of the funding of that research at UK institutions. From the clinicians’ point of view, participating in trials means that they get to know and experience the use of medicines under development. A lack of engagement, however, means that they can miss out and will know about the advantages and disadvantages only once an approval has been given. At present, gene therapies, cell therapies and all the oncology therapies are regulated at a European level. This is the cutting edge of drug therapy. For example, around 70% to 80% of the drugs under development are biologically based, and for many of those the work is often initiated here in the UK. We really are at the forefront of this work. Antibodies and DNA were discovered here but we cannot do clinical trials just in the UK because they require a larger pool of patients, particularly with rare diseases. It is important therefore that we have a wider network and the funding to keep those trials moving. As we negotiate our exit from the EU, all this seems in jeopardy.
The UK’s strong science base, world-leading universities and an NHS which provides a huge patient database and source for trials mean that we could possibly try to go it alone. However, even if we develop and produce approved medicines on our own, it will be difficult for us to break into an EU market from a regulatory point of view. As we are not the largest market in terms of sales, and if we cannot ensure that we run trials, we will slip down the list of where companies want to do their work. Therefore, as the UK negotiates a new relationship with the EU, significant challenges must be overcome, not just to ensure the stability and continued growth of the UK’s pharmaceutical industry but to ensure that patients can continue to access the medicines they need. Ensuring close co-operation on medicines and continued collaboration in clinical trials is crucial.
The clinical trials regulation—CTR—that the UK was heavily involved in developing will harmonise the assessment and supervision process for clinical trials via a central EU portal and database being set up by the European Medicines Agency. Implementation, however, has been pushed back because of delays in the establishment of the EU portal and database, meaning that it will be implemented in 2019 rather than this year. The CTR therefore will no longer be automatically captured by the EU (Withdrawal) Bill and the Government’s planned response remains unclear despite what the Minister said in a letter to my noble friend Lady Hayter on 26 January, which provided some comfort in this area. We have tabled this amendment because we think it is vital that Ministers set out a strategy that will ensure the mutual recognition of medicines and clinical devices licensed in both the UK and the EU and will resolve the issue of the European Medicines Agency and the portal and database which will be so important for the development of these medicines. Like Amendment 9, this amendment seeks to ensure that the European Communities Act 1972 is not repealed until the Secretary of State has set out a strategy for the continued mutual recognition of medicines and clinical devices licensed either in the UK or in the EU.
I am very grateful for the support that these amendments have received from across your Lordships’ House and I hope that the Government will be able to provide sufficient certainty to put millions of our fellow citizens’ minds at rest. I beg to move.
While both the Health and Social Care and Business Secretaries of State maintain that they would like to find a way to continue to collaborate with the EU in the interests of public health and safety, the Government have made it clear that they intend to leave the EMA post Brexit in the hope of securing a new regulatory alignment. One of the Government’s outlines for this is in a policy paper on collaboration in science and innovation, published in September 2017, which stated that the UK would draw upon existing agreements between the EMA and third countries such as Switzerland or the USA to provide a precedent.
However, this is not the simple solution the Government make it out to be. In Switzerland, for example, regulatory processes mean that marketing approvals are agreed on average 157 days after EMA approval—in other words, almost six months after they otherwise would be under EMA authority. Both current and former heads of the MHRA have expressed concern that, given that the UK market is relatively small compared to that of Europe, America or Japan, drug manufacturers may not view obtaining a licence to sell in the UK as a priority. This apprehension has been restated in a report by the Government’s own UK-EU Life Sciences Steering Committee, which admitted that, by leaving the EMA, the UK would, among other concerns, effectively become a “second priority” launch market.
The MHRA has stated that, rather than the sovereign authority the Government are so keen to impose on it, it wants a system of mutual recognition whereby the UK and the EMA abide by the recommendations of one another’s regulatory systems. The Nuffield Trust has called for a single regulatory process across the two jurisdictions to enable pharmaceutical companies to approach either the MHRA or the EMA, with the resulting recommendation adopted potentially across both organisations. Such a situation would leave the UK outside the supervision of the European Court, even though the Commission and its decisions would remain within its domain.
That scenario may provide a best-case solution to the current predicament, but the Government must clearly commit to ensuring the mutual recognition of medicines and medical devices across the two areas to assuage present uncertainties. In realising their dream of escaping the oversight of the European Court of Justice, the Government, I fear, risk driving us towards a future which damages our life sciences sector and the global standing of the UK as a leader in this field, potentially jeopardising parts of our highly skilled workforce and risking delays in access to new treatments for patients.
Patients often ask about advances. They want to know about new-horizon drugs and trials. They willingly enter trials across many nations because they realise that that is the way to advance care, not only for themselves but for others. This applies particularly to people with rare conditions, where we will never have enough patients for a critical mass in this country to conduct the appropriate trials. So the mutual recognition of medicines and clinical devices across both the UK and the EU, as set out in Amendment 11, is essential for our scientific advancement and for our patients.
I will make one comment on Amendment 9. I fear that we may have a bureaucratic nightmare in trying to define who is or is not eligible, and the criteria for such eligibility, among people in our country—not only when we go abroad, as has been clearly outlined.
In answering, it would be helpful if the Minister could tell us exactly how much money is involved in cross-border billing at the moment and what the estimate is of the costs of the bureaucracy behind the processes that will have to be put in place in order that we can recoup funding for those people from Europe who happen to have an accident or fall ill while they are here.
Amendment 9 withdrawn.
10: Clause 1, page 1, line 3, at end insert—
“( ) Regulations bringing into force subsection (1) may not be made until the Secretary of State has set out a strategy for seeking to remain a member of, or a strategy seeking to maintain equivalent participatory relations with, Erasmus+ and Horizon 2020 and Horizon 2020’s successor programmes.”
Amendment 10 withdrawn.
Amendment 11 not moved.