passes all -party amendment on the procurement of products made for the NHS by slave labour in states accused of Genocide. Thanks to the Lords, the House of Commons will now get to vote on this proposal which is backed by Sir Iain Duncan Smith MP.
Mar 3, 2022
Lord Alton of Liverpool (CB)
My Lords, as we move to Amendment 108, I should declare my interests as set out in the register: my involvement in a number of all-party parliamentary groups, and that I am patron of the Coalition for Genocide Response. I should also declare my support for the other two amendments in the group, Amendments 162 and 173, which will be spoken to by the noble Lord, Lord Hunt, who has trenchantly and consistently pursued the arguments around forced organ harvesting and the public exhibition of anonymous cadavers from Chinese jails. I have spoken in favour of those amendments previously and will not repeat my arguments today.
Like those two amendments, Amendment 108 is an all-party amendment, which was tabled in Committee by the noble Lord, Lord Blencathra, by the noble Baronesses, Lady Hodgson of Abinger and Lady Kennedy of The Shaws, and by myself, and supported by the noble Baroness, Lady Brinton, who is a sponsor today. It would have been moved by the noble Lord, Lord Blencathra, but he has had to self-isolate in Cumbria with Covid, and we all wish him a speedy return to his place.
Yesterday the noble Lord, Lord Blencathra, was able to attend an online meeting with the noble Earl, Lord Howe, and the noble Lord, Lord Kamall, and he asked me to move the amendment in his place. I thank both Ministers for their constructive engagement, and perhaps I might pursue further with them some of the arguments and issues raised yesterday. During our discussion the department told me that it had found no evidence of child labour, forced labour or unethical behaviour. Indeed, that was a repeat of a statement made to me in a parliamentary reply by the noble Lord, Lord Bethell, when he was a Minister.
How does that square with reports to the contrary in the public domain? On what basis was a c grade given to the companies which have been buying merchandise from China? Who went into the Xinjiang factories and forced labour camps? I should say that today at 4.34 pm I was sent a letter from the department saying that 13 performance areas were asked about according to something called amfori BSCI monitoring—it is not explained in the letter what that is and perhaps the noble Earl will be able to tell us—and that they had reached “an acceptable level of maturity.” What does that mean? What is an acceptable level of maturity and how does that square with the so-called c grade that these 13 performance areas had previously been given? Were these in Xinjiang? What were these performance areas? Where were they? Did we look at forced labour camps and what did we see? How was the judgment arrived at? I asked about this in Committee and again during yesterday’s meeting. This is an issue that should go on the public record, and I hope the noble Earl will agree to put the letter that I was sent just before today’s proceedings into the Library of your Lordships’ House so that everyone will be able to study it.
The issues underlining the amendment tabled by the noble Lord, Lord Blencathra, were aired at length in Committee, building on his consistent complaint that we are insufficiently self-reliant and have become too dependent on goods made by slave labour which by their very definition will always be cheaper and therefore destroy competitiveness both here and elsewhere.
In Committee I asked specifically about a Guardian report concerning MedPro. All I have received are coveralls about commercial sensitivity and mediation processes, and that is reiterated in the letter today. That does not give enough information for the House about vast sums of public money and even more importantly about where the goods originated.
To avoid repetition of all the arguments, the signatories of this amendment have circulated an article on yesterday’s edition of PoliticsHome setting out the arguments in favour of the amendment. In summary, the amendment is about the procurement of merchandise for the National Health Service from states credibly accused of genocide. Why is it needed? It is because of the possibility that perpetrators of this crime above all crimes are benefitting from procurement by the UK Government and because spending taxpayers’ money on the proceeds of genocide and slave labour is unacceptable and should be unconscionable.
Although the amendment is generic and does not name any country, the noble Lord, Lord Blencathra, made it clear in Committee that this would have a significant effect on the procurement of goods from Xinjiang, where both the Foreign Secretary and the House of Commons after a vote declared that a genocide is under way. For the avoidance of doubt, the Department for Health and Social Care’s records show that over the course of the pandemic the department generated orders for 36.9 billion items of personal protective equipment and that of these, 24.1 billion items have a country of origin recorded as China, including 10.7 billion gloves.
In a reply I received last year I was told that we had bought 1 billion lateral flow tests from China. Curiously, the letter I have received today—perhaps again the noble Earl will be able to amplify this—on one hand says it would be commercially sensitive to tell me what has been spent on these items of PPE and specifically on lateral flow tests, but elsewhere tells me that £4.8 billion has been spent. So, it is either commercially sensitive or it is not, and I do not understand what the figure therefore relates to.
So how does the amendment address this? What is its purpose? In the light of reports of slave labour-made PPE entering our supply chains, it meets the clear and urgent need to address health procurement. Recall that Dominic Raab rightly described the industrialisation of more than 1 million incarcerated Uighurs in Xinjiang. The amendment requires the Government to address our heavy dependence upon regions which, in whole or part, produce slave-made PPE and which too often goes unaddressed. This House is being consistent with its earlier decisions in urging the Government to come forward with a comprehensive policy on genocide which is long overdue.
As the noble Lord, Lord Blencathra, said in Committee, in comparison with the bipartisan legislation in the United States, with its rebuttable presumption on all trade with China, this amendment is modest. In a proportionate and balanced way, it does not circumnavigate the Government’s position that a determination of genocide is for competent courts only. It only requires a response where serious risk of genocide is said to occur. If the Foreign Secretary is right, how can we justify spending billions of pounds on billions of items made by slave labour in a state that she has accused of genocide? The amendment lays a duty on a Minister of the Crown to assess whether there is a risk of genocide in the sourcing region if the chair of a relevant Select Committee of either House requests such an assessment to be made.
It is worth reminding the House that the list of those supporting the amendment includes the British Medical Association, Accountability Unit, atrocity prevention organisations such as the World Uyghur Congress and many others. I also drew the attention of the seminar about this amendment held in your Lordships’ House two days ago to the valued support of my noble friend Lord Stevens of Birmingham, the former chief executive of the National Health Service.
Why would anyone want to oppose this? The department tells us that it is not appropriate to address genocide in a health Bill. However, not only is there a specific and huge issue centred on National Health Service procurement—very much a Department of Health and Social Care issue—but genocide is not a narrow departmental matter. It is something which, under the 1948 convention on the crime of genocide, we are all required to address, in whatever capacity and right across government. The department is also bound by the law. The requirements are set out in Theresa May’s landmark legislation, the Modern Slavery Act, which I gave my total support to when it passed through your Lordships’ House in 2015. There are legal duties here.
I also take this opportunity respectfully to suggest to the noble Earl that we must not make sweeping claims about the good state of our health supply chains. There is much more to this than the Telegraph report which linked £150 million of PPE directly to Xinjiang. I mentioned to the noble Earl in conversation that Professor Laura Murphy’s seminal report In Broad Daylight details various NHS providers who are heavily implicated in China’s labour transfer schemes, which are widely acknowledged to be involuntary work schemes targeted at ethnic minorities.
I am also aware that analyses are under way of NHS-procured PPE, which is highly likely to show that many constituents originate in Xinjiang. I particularly draw the attention of the House to the extraordinary and remarkable speech the noble Lord, Lord Rooker, made in Committee, where he talked about the work of Oritain and how it can determine right down to the last shred the origins of cotton. That is obviously very significant in this context, and I was grateful that the final paragraph of the letter I have referred to says that the department’s officials will be happy to meet Oritain. That is extremely welcome.
While I am at it, I also refer the noble Earl to the House of Commons Business, Energy and Industrial Strategy Committee’s fifth report of Session 2019-21, which said:
“We were disappointed by the Government’s statement, as it introduced no significant new measures to prohibit UK businesses from profiting from the forced labour of Uyghurs in Xinjiang and other parts of China. We are also deeply concerned about reports that the Government procured personal protective equipment from factories in Xinjiang and other parts of China implicated in modern slavery during the early part of the Covid-19 pandemic.”
So, this is not scaremongering on the part of noble Lords or people who are perceived to be hostile to the Chinese Communist Party. This is a reputable report from a House of Commons Select Committee along with people of high academic distinction. The noble Earl will perhaps want to study it in more detail.
The department tells us it is not appropriate to address genocide in a health Bill, but not only is there a specific and huge issue centred on NHS procurement—very much a health department issue—but genocide is not a narrow departmental matter: it is, as I said, something that every department in government needs to address, and the House needs to reach decisions on this and on the other two amendments in this group.
I end by simply citing public support: two-thirds of those polled, some 65%, say they would support preventing the Government from procuring health equipment for the National Health Service from regions where they believe there is a serious risk of genocide. So there is widespread public support for what the promoters of this all-party amendment are asking the House to do. The House should seize this opportunity to ensure that our National Health Service is free from slave labour and, on behalf of the noble Lord, Lord Blencathra, I beg to move.
The Deputy Speaker (Lord Duncan of Springbank) (Con)
I now call the noble Baroness, Lady Brinton.
Baroness Brinton (LD) [V]
My Lords, I am sorry to hear that the noble Lord, Lord Blencathra, is unwell, and I thank the noble Lord, Lord Alton, for his excellent introduction to Amendment 108, to which I have added my name. I also support the other two amendments in this group, which are in the name of the noble Lord, Lord Hunt, who I commend for his consistent campaign on these issues over the years. His Amendment 162 would ensure that there must be informed consent, with no coercion or financial gain, when organs are donated or when UK citizens go abroad for transplants. Amendment 173 would ensure that cadavers would no longer be used for public display unless it is the body of a person which is at least 100 years old, because, as with Amendments 108 and 162, there is real concern that people have been forced to have organs removed, or their bodies have been used after their death—sometimes murder, sometimes execution—but without their consent.
Returning to Amendment 108, it has two clear objectives: the first is to prevent the Government procuring health service goods produced in regions where there is a serious risk of genocide. While the Government say there is no evidence, a New York Times investigation found that PPE made through the Xinjiang labour transfer programme was present in US and international healthcare systems. As we have heard from the noble Lord, Lord Alton, there is increasing evidence that the NHS has procured such items already.
The second objective is to create a process through which the UK Government can be required to assess regions for serious risk of genocide and publish their assessment. This is necessary because the UK Government have given out PPE contracts worth almost £150 million to Chinese firms with links to forced labour abuses in the Uyghur region.
The Government have said that genocide amendments are not appropriate in the Bill and that the Modern Slavery Act 2015 offers protection, but the reality is that the UK is not leading the world here. The US Uyghur Forced Labor Prevention Act creates a “rebuttable presumption” banning all goods sourced in whole or in part from the Xinjiang region of China, unless clear and persuasive evidence can be provided to the contrary; and the European Union is now considering bringing forward new legislation to ban products made with forced labour from entering the European market. The UK’s Modern Slavery Act does not go nearly as far as either of these proposals, merely requiring that companies publish—but not that they act upon—modern slavery statements. People’s lives and human rights are at stake here. Frankly, it is time the UK followed suit with stronger legislation. This amendment would be a strong and careful start that means government and Parliament cannot look away. I look forward to the Minister’s response.
Baroness Kennedy of The Shaws (Lab)
I shall speak very briefly, because I am conscious of the time and that we have a lot of business to do. This amendment seeks nothing more than to create another human rights threshold for health procurement, adding to those that are already in place, which seek to address slavery but have major shortcomings, as the noble Baroness, Lady Brinton, has just described. I keep hearing it being said that a health Bill is not the proper place for an amendment concerning genocide. Well, I am afraid that I do not agree. This is an appropriate place.
We are not asking the Government or the Department of Health to decide whether there is a genocide taking place; we are asking the Minister to take on the duty to assess whether the source of instruments, test kits, protective equipment or whatever may be from forced labour and a situation of slavery. Xinjiang province is the obvious place for us to be concerned about, but there are other places—for example, in India—that we should be concerned about too, and I think that placing that duty on the shoulders of the Minister is a way of concentrating minds. That is why I really press this amendment and I pay tribute to the way the noble Lord, Lord Alton, has so assiduously pursued this. That is all I wanted to say, but I will support this amendment and I urge the House to support it too.
Lord Hunt of Kings Heath (Lab)
My Lords, it is a great honour for my two amendments to be grouped with that in the names of the noble Lords, Lord Alton and Lord Blencathra. As the noble Lord has discussed the supply chain, I should declare my interest as president of the Health Care Supply Association, although I am not speaking on its behalf when it comes to my strongly supporting his amendment, which sets the context for my own two amendments.
We debated this issue very fully in Committee. I think that the House believes strongly that the commercial exploitation of body parts in all forms is unethical and unsavoury. When it is combined with mass killing by an authoritarian state, we cannot stand by and do nothing. In 2019, the China Tribunal, led by Sir Geoffrey Nice QC, stated:
“The Tribunal’s members are certain—unanimously, and sure beyond reasonable doubt—that in China forced organ harvesting from prisoners of conscience has been practiced for a substantial period of time involving a very substantial number of victims.”
In June this year, 12 UN special procedure experts raised the issue of forced organ harvesting with the Chinese Government in response to credible information that Falun Gong practitioners, Uighurs, Tibetans, Muslims and Christians had been killed for their organs in China.
Currently, human tissue legislation covers organ transplantation within the UK, where we have a very ethical approach, but it does not cover British citizens travelling abroad for transplants, and British taxpayers’ money will pay for anti-rejection medication regardless of where the organ was sourced or whether it was forcibly harvested from prisoners of conscience.
I shall not repeat all that I said in Committee, but I have had a helpful meeting with Ministers for which I thank them. In that meeting and in subsequent meetings, the Minister was concerned that my amendment in relation to organ tourism would penalise vulnerable people seeking to pay for a transplant. I have thought about that carefully, but, in the end—and the noble Baroness, Lady Kennedy, expressed so well why this Bill is highly appropriate for these kind of amendments—we have to draw a line in the sand. That is particularly so today, in the horrific circumstances that we meet. We have to draw a line in the sand and send out a powerful message globally that we will not support these abhorrent practices in any way.
My Amendment 162 comes later, but I shall seek the opinion of the House at that time.
Baroness Northover (LD)
The noble Lord, Lord Hunt, has very effectively introduced the amendments to which I have put my name, Amendments 162 and 173, and I wish briefly to express the support of these Benches for those. We also support Amendment 108, to which my noble friend Lady Brinton has put her name.
As noble Lords know, we have been inching forward on these matters with Ministers, and I welcome that forward movement. I note, however, recent warnings from Ministers that, for example, there are “opportunity costs” in implementing these measures, as ensuring that proper standards are enforced requires effort and potential cost. I understand that. Nevertheless, we cannot allow ourselves to become complicit in any way in organ tourism where the source of those organs is forced or where selling the organ is to address appalling poverty.
Some say that this trade may be declining in and from China. If so, that is welcome and might reflect international pressure, not least on the Chinese medical profession. It is not clear that those involved in the China Tribunal and the Uyghur Tribunal would agree that it is declining.
Even if we were to accept that, and Ministers seemed to indicate that they thought that might be the case, we are also hearing now of an increase in the selling of organs in Afghanistan because of the dire situation there. There have been recent reports of journalists seeing the scars of those who have sold their kidneys. That is a terrible indictment of our walking away from Afghanistan and failing to address the appalling conditions that we have left there. How can we regard such potential “donors” as being anything other than the most extremely vulnerable? How can you put that up against the vulnerable who may need to have donations?
As for the bodies exhibitions, we have discussed before how distasteful they are—but then we realise with horror exactly where these bodies seem to have been sourced: among other things, from Chinese prisons. We should never have condoned that, turning a blind eye. I agree with the noble Baroness, Lady Thornton, who argued in Committee that they should simply be banned. There is no reason whatever to agree to their continuation.
I now hear that the Government may argue—and this is incredibly familiar—that these amendments are flawed. As the noble Earl knows, often Ministers are given briefs that say, “This is a flawed amendment, so turn it back.” I am very familiar with them. In those circumstances, the best thing is for your Lordships to pass these amendments, because Ministers know, or should know, that the essence is extremely clear, and with government lawyers we can work out how best to sort out any unintended consequences. I hope that I do not hear anything about these amendments being flawed—and I say that to the Box. I therefore commend them to your Lordships.
Baroness Finlay of Llandaff (CB)
My Lords, I support all the amendments in this group, and I shall speak specifically and briefly to Amendments 162 and 173.
These amendments are updates to the Human Tissue Act, which was born out of public outrage following the Alder Hey scandal, when over 100,000 organs, body parts and entire bodies of foetuses and stillborn babies were stored in NHS facilities. The body parts of dead patients, including children, were removed without consent. Today, the Human Tissue Authority’s guiding principles, as set out in its code of practice, are consent, dignity, quality, honesty and openness. These principles should not only reflect how human tissue sourced from within our own nation is treated, we must treat human tissue and organs with the same principles when sourced overseas.
In China, as has been said, there is substantial evidence of Falun Gong practitioners and Uighurs—as well as some evidence of Tibetans and house Christians—being killed on demand for their organs. Blood is taken off them for tissue-typing at the time when they were taken into custody, often with no idea why they were taken into custody at all, other than that they belong to one of those groups. There is no consent, no dignity and no transparency.
On 7 December last year, the British Medical Association released a statement on the abuse of Uighurs in China, expressing
“grave concern regarding the situation in China and the continuing abuse of the Uyghur population of the country as well as other minorities.”
It went on to state:
“We are particularly alarmed by the reports of organ harvesting, forced birth prevention, and the use of genomics data for racial profiling.”
“the UK government and international actors to exert pressure on the Chinese government to cease its inhumane actions towards the Uyghurs”.
If we do not pass amendments as laid before the House today, we will be complicit with these practices, because we will be looking at them with Nelson’s eye, with all the evidence that we have that they are going on.
On Amendment 173, on the exhibition of whole bodies using a plastinated technique, I suggest that there is no transparency whatever. Any attempt to claim that there has been consent is extremely suspect, because consent is very easily falsified. I went to one of these exhibitions because I thought you ought to go and see what you are criticising. This was not an anatomical, educational experience but a visual display of plastinated bodies in all kinds of different poses. But the one that horrified me the most was a pregnant woman, quite advanced in her pregnancy and with the foetus in her womb, which had been plastinated. I do not believe that that woman would have given consent for plastination. That raised real questions as to why such an advanced foetus was in the womb of a dead woman without something there explaining the nature of her death, the cause of death and the circumstances in which she had decided to consent to such a procedure.
Baroness Smith of Newnham (LD)
My Lords, I will speak to Amendment 108, while supporting the other two amendments introduced so powerfully by the noble Lord, Lord Hunt, and my noble friend Lady Northover, and to which the noble Baroness, Lady Finlay, spoke so eloquently.
I am completely in support of those amendments, but I wish to speak briefly to the genocide amendment today. On various occasions during the Covid pandemic questions were asked of the then Health Minister about the procurement of PPE. He was not able to give me a straight answer to say, “We can guarantee that no PPE procured could have had anything to do with slave labour or could have come from Xinjiang.”
The NHS seeks to be world leading. We all support it and want it to be able to deliver for every citizen in this country. But that should not be at the expense of the lives of those in other parts of the world. It is not good enough to say that we have the Modern Slavery Act if that will not lead to a change in practices. It is absolutely essential that our supply chains do not include anything that comes from forced labour.
If one looks at what is going on in Xinjiang, it is possible to barter to get numbers of people, just as it was 200 years ago during the slave trade. That is not acceptable. It may be the case that, as the noble Baroness, Lady Kennedy of The Shaws, pointed out, we will be told, “This is not the right piece of legislation.” If it is not, what will the Government bring forward that will mean that every point of our supply chain—every part of government procurement—ensures that we are not procuring things that have been made using slave labour?
We must not be complicit. This House should support the amendments, and if the Minister is not able to support the amendment, perhaps he could come back with a revised and better version of the amendment that will do what we all seek to achieve.
Lord Moylan (Con)
My Lords, I will speak briefly only to Amendment 108, which I understand the Government are likely to resist when my noble friend the Minister comes to speak. I say simply, very briefly, that to be persuasive, my noble friend has to explain how through administrative measures the National Health Service will achieve the effects of this amendment. He has to explain that in a credible way and that the effects will be rapid and comprehensive. Any idea that this will be kicked into a long review that ambles on and may or may not produce the effects required by at least the first two proposed new subsections of the amendment will lack credibility; I am less concerned about the chairman of the Select Committee part that comes in the third one. I would like my noble friend to know before he speaks that that is what I think we all want to hear.
Baroness Walmsley (LD)
My Lords, China has been found out. Thanks to surveillance and other types of technology, and courageous on-the-ground reporting, it is clear that China does use slave labour. As we know, the UK has a duty under the genocide convention, and there is strong evidence that much of the material produced by slave labour, even possibly by genocide, is being used by NHS staff—and even by noble Lords ourselves when we use lateral flow tests, since we are not confident about where they came from. They come from areas where there is serious risk of genocide and as the noble Baroness, Lady Kennedy, said, it is not necessary to determine genocide in order to be obliged to do a risk assessment and take action; and we are not doing enough of that. Over half of these products come from places where there is no conflict, so action against conflict is not adequate. More needs to be done. We must not fail to do it because it is more convenient to buy products to keep us safe without investigating how they are produced. Our safety must not be on the backs of people whose rights, and even their lives, are being taken from them.
The same applies to organ-harvesting from unwilling donors. There is incontrovertible evidence that it is not just happening but happening increasingly, and it absolutely has to stop. My noble friend Baroness Northover made a strong case that the exhibiting of cadavers should not happen in a civilised society, and I hope that the Minister is going to tell us how the Government are going to stop it.
Lord Eatwell (Lab)
My Lords, I rise to give my strong support to Amendment 108, and I do so because of the terms of the genocide convention to which this Government are committed and are obligated to support. It is important for the House to note that genocide is not defined solely as mass killing. It is also defined as
“causing serious bodily or mental harm … deliberately inflicting … conditions of life calculated to”
destroy the protected group
“in whole or in part … imposing measures intended to prevent births”,
“forcibly transferring the children of the group to another group.”
The Government are a signatory to the genocide convention, and I think the noble Earl, Lord Howe, is obligated by that signature to support this amendment.
Baroness Merron (Lab)
My Lords, it is impossible to turn away from the connection between procurement of products and services and the message and support that such procurement may give to those who seek to exploit, oppress, damage and murder.
I thank the noble Lord, Lord Alton, for introducing this amendment, in the name of the noble Lord, Lord Blencathra, who we wish well. Genocide and the abuse of human rights do not respect the imposed boundaries of government departments, and that is why it is appropriate that these amendments, which have extensive support both inside and outside your Lordships’ House, have been tabled today. Amendment 108 has cross-party support and if the will of the House is tested, we on these Benches will support it.
The NHS is the biggest single procurer of medical products in the world. It has a huge amount of leverage to be a force for good or otherwise when it comes to ethical procurement. It can starve abusive regions of resources. It can also remove a veneer of acceptability from those regions.
If we are serious about being global Britain and a force for good in the world, we need to act as such. It is surely wrong that, for example, we are using bandages which have been produced by forced labour. We must hold the Government to their commitment to provide guidance and support to UK government bodies to use public procurement rules to exclude suppliers where there is sufficient evidence of human rights violations in any of their supply chains. As expressed by my noble friend Lady Kennedy, this is about giving the Minister the opportunity to act. It is about focusing minds. I hope that the amendment will find favour with the noble Earl.
In Committee, my noble friend Lord Collins spoke of the need not to be tied down by a very strict legal definition of genocide. He also emphasised that we must focus on broader human rights issues. As the noble Lord, Lord Alton, said, we need to take a comprehensive, joined-up approach. Amendment 108 gives us this opportunity.
I thank my noble friend Lord Hunt for continuing to press home the need for action, as outlined in Amendments 162 and 173. We heard explicitly and movingly about the realities of how this affects people’s bodies, alive and dead, and the distaste and abuse related to it. It is surely right that UK citizens are safeguarded against complicity in forced organ harvesting as the result of genocide. Countries such as Spain, Italy, Belgium, Norway and Israel, among several others, have already taken action to prevent organ tourism in respect of China. We have the opportunity to do so today.
I hope that the noble Earl will feel able to accept these amendments. I am grateful to the noble Lord and his officials for the opportunity to discuss these matters. I hope only that your Lordships’ House can assist in improving this aspect of the Bill by taking action, as we should, about genocide and the abuse of human rights.
Earl Howe (Con)
My Lords, the amendments in this group bring us to three discrete topics which are nevertheless linked by a common thread—that of human rights. Because they engage us in issues of great sensitivity, I begin by saying something that may sound unusual. There is probably no one in this Chamber who is not instinctively drawn towards these amendments. All three are honourably motivated. In pointing out any shortcomings, I would not want noble Lords to think that the Government did not understand or sympathise with why they have been tabled.
I will start with the issue of organ tourism. Like the noble Lord, Lord Hunt, I find it abhorrent that individuals exist who are in the business—often the lucrative business—of sourcing human organs from provenances that are both illegal and supremely unethical. They then entice desperate and seriously ill people to go to a foreign country to have such organs transplanted within them. This idea is unconscionable. As far as we can, we should have no truck with it. The Human Tissue Act already prohibits the giving of
“a reward for the supply of, or for an offer to supply any controlled material”
in any circumstance where a substantial part of the illicit transaction takes place in England, Wales or Northern Ireland.
The Modern Slavery Act makes it an offence to arrange or facilitate another person’s travel, including travel outside the UK, for the purposes of their exploitation, which includes the supply of organs for reward in any part of the world. The law as it stands addresses a substantial element of potential criminality. How widespread is this criminality? What do we know about the scale of organ tourism as it relates to UK residents? I have obtained some figures from the department. In 2019-20, the last reporting year before international travel was curtailed by the pandemic, a total of 4,820 organ transplants took place in this country. At the same time, NHS Blood and Transplant data shows that only seven UK residents received a transplant abroad, many if not all legitimately, and had follow-up treatment in the UK.
Therefore I am thankful to say that the scale of the problem of illicit organ tourism, as it relates to UK residents, is small. If the noble Lord, Lord Hunt, were to say to me that one such case is one too many, I would agree, but the House should not support this amendment, because it is not right to support an amendment that could cause vulnerable transplant patients who receive a legitimate transplant overseas to face imprisonment because they may not have the right documentation. That is what the amendment could lead to. Checking such documentation and creating individually identifiable records for every UK patient who has received a transplant overseas would put healthcare professionals in an invidious and inappropriate position by blurring the line between medic and criminal investigator.
More to the point, it could also prevent those who legitimately receive an organ transplant abroad—particularly those from minority-ethnic backgrounds—from seeking follow-up treatment, for fear of being treated as a criminal suspect. Following that thought through, I say that the effect that this amendment could have in exacerbating health inequalities is likely to be far greater than its effect in deterring transplant tourism, especially, as I have emphasised, because there are already legal provisions in place covering most cases of organ tourism.
I listened with care to the noble Baroness, Lady Finlay, particularly regarding her examples of the exhibition that she went to. I join her in being somewhat incredulous that there could be consent to some of the exhibits that she witnessed. However, where consent has been obtained, it must be unequivocal. As I emphasised, the law as it stands now prohibits the exhibition of bodies or body parts where express consent cannot be fully demonstrated. I undertake to speak to the Human Tissue Authority, to see that, should there be another exhibition of this kind proposed, there is full transparency in the form of labels under each exhibit making clear how consent was obtained and what it consisted of.
Targeting those who receive an organ, rather than the traffickers and their customers who initiate or negotiate the arrangements, risks imprisoning vulnerable patients who may have been misled as to the provenance of their organ. That would be disproportionate. The Government’s view remains that the best approach is to continue targeting traffickers and their customers, while doing all that we can to help UK residents who are in need of an organ by focusing our efforts on improving the rates and outcomes of legitimate donations.
I turn to Amendment 173 relating to the public display of cadavers. Again, this is an issue of great sensitivity about which we all have personal views. I am sorry that I read out the wrong reply to the noble Baroness, Lady Finlay, just now. The noble Lord, Lord Hunt, has been assiduous in pursuing the case for a complete ban on these displays and we have heard the powerful case that he and others put in support of such a ban. But once again I will say why I think the amendment should not be supported.
The law already prevents new public displays of bodies and body parts where the donor has not given their express consent, and that is as it should be. The question we now need to answer is whether the law should also prevent the display of bodies and body parts where such express consent has been given. This is where I return to the points I made about the speech of the noble Baroness, Lady Finlay. There may well be individuals who express their desire to donate their bodies after death for the purpose of an exhibition devoted to the display of the human anatomy. Some people sincerely feel that such exhibitions have educational and artistic merit on the grounds that they provoke interest in the inner workings of the human body. Some of us may find the idea of such exhibitions distasteful, but I say gently to noble Lords that in a liberal and free society such as ours it is not the role of government or, I suggest, this House to be the arbiter of taste. We should respect the principle that we have always championed in our debates concerning human tissue, which is that of informed consent. I suggest that this case is no different.
In turning to Amendment 108, I recognise the enormous strength of feeling in the House on the human rights violations that we hear from many sources are being perpetrated in Xinjiang. I also acknowledge the concerns raised by several noble Lords that items procured by the NHS may be sourced from regions where forced labour or other serious violations of human rights are occurring. As we have heard, this is a complex issue—complex because supply chains are complex—and I do not wish to sound complacent or uncaring if I say that there are no easy answers. But I reassure the House that the Government are resolutely committed to taking robust action to tackle this challenge, not just in the NHS but across all our supply chains. I will demonstrate to the House exactly how we are doing that, both currently and prospectively.
Over the past year, we have introduced a number of robust, evidence-based measures to help ensure that no UK organisation, public or private, is complicit in the human rights violations occurring in Xinjiang. Those measures include new guidance for UK businesses on the risks of doing business in Xinjiang, the announcement of enhanced export controls and commitments to introduce financial penalties for non-compliance with Section 54 of the UK’s Modern Slavery Act, as well as new procurement guidance to help exclude companies linked to modern slavery violations.
We are also working closely with international partners to ensure a co-ordinated approach to supply chains. Under our G7 presidency last year, G7 leaders committed to working together to ensure that global supply chains are free from the use of forced labour. That effort is government-wide and across all sectors of business.
Within the NHS specifically, we have taken and continue to take action in line with procurement and modern slavery law. Since 2020, NHS Supply Chain has utilised the UK Government’s portal, the Supplier Registration Service, to undertake assessments of both modern slavery and labour standards where, through risk assessment, a contract is deemed high-risk. We fully recognise, however, that further work is needed across government to meet the scale of the challenge. That is why the Government have announced a comprehensive review of their 2014 modern slavery strategy, with a new strategy due to be published this spring. This is a major undertaking, including a thorough review of all aspects of our approach to tackling modern slavery. We are also looking at introducing further measures through the upcoming procurement Bill. Those measures would be in addition to new legislation to strengthen further and future-proof the transparency and supply chain provisions of the Modern Slavery Act, when parliamentary time allows.
This ongoing work does, I trust, demonstrate the Government’s commitment to taking a robust, holistic and co-ordinated approach to meet the complex challenge posed by the risk of human-rights violations in global supply chains. That is why, despite our having no doubt as to the honourable intentions behind this amendment, we do not believe that building it into the Health and Care Bill would further our efforts in taking robust action to address human rights violations, wherever they may take place.
The UK is strongly committed to early and effective action to prevent all mass atrocities—whether that is genocide, war crimes, crimes against humanity, or ethnic cleansing—and we will do this through a variety of means: early-warning tools, diplomacy, development and programmatic support, human rights monitoring, and coercive measures such as sanctions and defence tools. Our work in this area is long-standing, both in terms of preventing atrocities and in securing accountability and justice for atrocities committed. The issues and concerns raised today by the noble Lord, Lord Alton, and other noble Lords require a comprehensive and carefully considered response befitting both their gravity and complexity. We do not, however, consider this Bill to be an appropriate instrument through which to tackle this issue.
That said, I acknowledge the strength of feeling in this House relating to the NHS, specifically about ensuring that no part of the NHS is inadvertently complicit in human rights violations, where they exist in supply chains. Therefore, in addition to the range of measures we are already taking, I am pleased to make a commitment that the department will undertake a new, focused internal review of NHS supply chains to address the concerns that have been expressed with regard to the risk of exposure. In conducting this review, the Government would welcome further engagement with the noble Lord, Lord Alton, my noble friend Lord Blencathra, and, indeed, all noble Lords who have spoken in this debate. Your Lordships’ insights will, I have no doubt, be greatly valued as we take forward this important work. I was grateful to the noble Lord, Lord Alton, for the references and pointers that he mentioned in his speech.
I hope that this provides noble Lords with further reassurance about the Government’s approach but, more than that, I hope that the undertaking I have just given, combined with the statements I have made to the House about the extensive work now in train across government to bear down as hard as we can on modern slavery and the abuse of human rights across the world, may persuade the noble Lord, Lord Alton, to withdraw Amendment 108.
Baroness Finlay of Llandaff (CB)
Before the noble Earl sits down, may I apologise to the House? I should have declared that I am the UK chair of Commonwealth Tribute to Life, which aims to establish a memorandum of understanding across the Commonwealth over ethical transplantation.
The Minister, in his reply, spoke of seven patients who are known to have travelled abroad for organs. Most of those were legally arranged, so the numbers are very small; yet the clinical services in the UK are not aware that it is illegal to arrange to purchase an organ abroad if most of that transaction happens in the UK, or to procure the travel to go. I wonder whether the Minister would be able to undertake to work with us in NHSBT to ensure that all the clinicians working in the field are aware of this and can brief patients appropriately at the time they sign up to be on the transplant list, so that they understand that, although they are eligible for a transplant, they should not be seeking transplants in other countries, even when tempted to do so. It can look quite alluring, and I am concerned that, within the profession itself, there might be some misunderstanding. I realise this is a difficult question and the Minister might prefer not to answer it now; it might be something we could discuss later.
Earl Howe (Con)
My Lords, that is a perfectly valid question from the noble Baroness, and I would be happy to take that back to those in the Department of Health and Social Care who have direct responsibility in this area.
Lord Alton of Liverpool (CB)
My Lords, I know that this is a complex and long Bill, and that the House will want to move quite quickly to the next business. I will end by simply thanking every noble Lord who has participated in today’s debate, especially the noble Baronesses, Lady Walmsley and Lady Merron, from the opposition Front Benches, and the noble Lords on the Government Benches who have supported the noble Lord, Lord Blencathra, and the noble Baroness, Lady Hodgson, at every stage of the progress of this amendment.
I know that when the noble Earl, Lord Howe, said that he was instinctively drawn to these amendments, and that he found many of these practices abhorrent, he was speaking as he feels. I am grateful to him, not only for the meeting that we had yesterday with the noble Lord, Lord Kamall, but for his promise to look at this further. Among those to whom I would like to introduce him is a Uighur surgeon I have met, who has given evidence here in the House about being forced to remove organs and to kill the patient in the course of that. This is the ethical issue here. If people profit from that in any way whatever, even if inadvertently, we must not be complicit.
A year ago, we were promised that there would be an urgent review of exports to Xinjiang and fines for businesses which failed to comply with the Modern Slavery Act, when parliamentary time allowed. Those things have not happened. The urgent review has just been completed, but it ended up dealing only with military exports and there have been no fines applied one year later. It is never the right Bill or the right time. The noble Lord, Lord Forsyth, and I were told this on the telecommunications Bill, we were told it again on the then Trade Bill. We are told it on every Bill. That is why it is inevitable that we come back with amendments like this until the comprehensive plan, to which the noble Earl referred, actually happens.
The House really needs to send this amendment further. We have had between Committee and now for the Government to help us redraw it, if there are any defects or flaws. I am unaware of what they may be; they have never been pointed out to us. The noble Earl also knows that the Government could say to us, “Bring this back at Third Reading and we will help to draw up such an amendment.” However, I am told that this is not possible either. Therefore, the only way for us to ensure that this amendment can proceed and be perfected is to send it to another place. I am glad to be able to tell the House that a former leader of the Conservative Party, Sir Iain Duncan Smith, has agreed that he will personally promote this amendment if it is passed in your Lordships’ House today and take it further there. He says that he is with us 100%. I would like to seek the opinion of the House.