Below is the text of the speech made by Baroness Thornton in the House of Lords on 10 January 2019.

My Lords, I make no apology for the fact that I will continue to press the Minister, and the Government, about the effects of the political agreement on our health services.

I start by thanking the Minister for addressing some of the questions that I raised in my speech in December, particularly those concerning medical research. It saves me from repeating the whole speech, which, as good as it was, would be tedious for me and for the House. However, I will return to some of the unresolved and serious matters that the NHS, the research community, pharma and medicine face, post Brexit—and to how very serious the issues of safety and availability will become if we should be so foolish as to crash out of the EU in a couple of months. I make no apology for continuing to speak about health and social care issues. I did it during the passage of the Brexit Act. I have been doing it during the extensive and somewhat bizarre debates about the “in case we crash out” statutory instruments. We tackled those concerning the regulation of human tissues, embryology, organs and blood yesterday. I will continue to raise these serious matters today and will do so during the passage of the Trade Bill.​

At every stage I have sought reassurance from the Government over matters of reciprocal healthcare, the free movement of medical and nursing staff, the regulation and supply of medicines, clinical trials and research, the conduct and regulation of which is so important in the UK. Access to the portal is vital to patients across the UK and Europe.

The response of the noble Lord, Lord Callanan, in his opening remarks yesterday, was welcome, after a fashion. However, I want to raise two issues. What the noble Lord said was in many ways too aspirational and not concrete enough. It was about wanting to explore new relationships, not to continue the ones that work already and are beginning to fall apart. Secondly, it was about the future. The noble Lord said:

“We have been clear that we want to explore association with EU research and innovation programmes”.—[Official Report, 9/1/19; col. 2224.]

While research programmes are protected to 2020, this completely ignores the fact that most research programmes take years to design, negotiate and fund. Brexit is already having a chilling effect on future research. What do the Government intend to do about this? How can they ensure that our universities and research organisations are not severely disadvantaged by being excluded from the funding and regulatory regimes of which they need to be part?

I shall return to the issue of the portal, which the noble Lord failed to address in his opening remarks; I hope he will do so at the end of this debate.

Agreement must be reached in the negotiations on UK participation in the single assessment procedure and access to the portal and database, which underpin the cross-national clinical trials regulation and come into operation in the next year. No access to the portal will severely reduce the ease of UK-EU trials set up and hurt our thriving life sciences environment. Clinical trials take years to plan and run. As things stand, UK researchers will enter the implementation period unsure what regulatory conditions they will face when they exit it. What is the Minister doing to resolve this issue with the necessary urgency? Is he aware of the cost of failing to do so? The deal as it is expressed does not achieve access to the portal. The political declaration makes no reference to how UK-EU clinical trials will operate after Brexit and this is of significant concern. As every day passes, uncertainty continues to increase in the research community over what the regulatory framework will be after 29 March and whether UK institutions will continue to be able to lead on UK-EU trials.

A further aspect is the mobility of researchers. The publication of the immigration White Paper in December has not clarified how changes to the rules will affect medical research; perhaps the Minister would care to do so. The current Migration Advisory Committee recommendation is for a salary threshold of £30,000 per annum, a figure that would penalise many research technicians—skilled workers who form the backbone of the research workforce but are often not highly paid. EEA nationals will now be subject to the immigration health surcharge and immigration skills charge. Students from the EEA will be required to have a visa to study, as current non-EEA students do.​

On UK-EU mobility, it is good that the importance of the international movement of researchers is recognised in the political declaration, but there is not enough detail on the extent to which this will continue, either for researchers moving across borders to live and work, or for short-term travel for shared projects such as clinical trials. Could the Minister clarify that?

It is absolutely essential for our world-leading medical research environment, and for the breakthroughs that benefit patients, that we continue to attract, recruit and retain global scientific talent at all levels. At present, neither the political declaration nor the immigration White Paper offer this certainty. Yesterday, the Minister made no mention of medicines, which is an issue I will continue to raise because of the supply of medicines in the short term.

Finally, I raise the issue of the European reference networks following Brexit. The ERNs are virtual networks of medical specialists across Europe. They facilitate discussions on complex or rare diseases and conditions that require highly specialised treatment. As such, they are an essential resource for the 30 million rare disease patients in Europe. I agree with the Specialised Healthcare Alliance that continued UK involvement in European reference networks is vital to driving forward improvements in rare disease care in both the UK and the European Union. However, at present, the ERNs are open only to EU member states and EEA members, which means that there is a clear risk that the UK will no longer be able to participate. Can the Minister ensure that the Government work with the European Commission to ensure that the UK is able to contribute to ERNs following Brexit, in the interests of patients with rare diseases? I hope the Minister will be able to answer these questions at the end of this debate.