Oral answer (Lords) on Brexit: Insulin Supplies - Jan 24

To ask Her Majesty’s Government what steps they are taking to ensure a sufficient supply of insulin when the United Kingdom leaves the European Union.

My Lords, we understand that insulin is vital to many people with diabetes in this country; indeed, I am a diabetic myself. Our contingency plans aim to ensure that the supply of insulin and other essential medicines is not disrupted in the event of a no-deal exit. In August last year, the Department of Health and Social Care wrote to all pharmaceutical companies that supply prescription-only and pharmacy medicines to the UK from or via the European Union or European Economic Area, asking them to ensure by 29 March a minimum of six weeks’ additional supply over and above existing business-as-usual buffer stops.

Is the Minister aware that 99% of the insulin used in the UK is manufactured in Denmark and Germany, and that 421,000 type 1 diabetic users of insulin are feeling quite anxious about what will happen? Can she give us a guarantee—a copper-bottomed, simple pledge—that there will be enough insulin available if we Brexit? Can the Government also assure us that every single insulin user will have a legally binding contract from the Government pledging the availability of sufficient insulin for them in the future?

My Lords, of course it is important that we give assurances to all patients, irrespective of whether they are insulin users. The Government have given that assurance. We have made strong contingency plans to ensure that supplies come into the UK unhindered. The noble Lord is right: based on the regulators’ licensing data from early 2018, three-quarters of medicine is imported via the EU. I cannot give copper-bottomed guarantees; there are no such things as guarantees in life, but I can—

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Please—the Government take this issue very seriously and have put in place proper contingency plans. I am assured, as a diabetic, that those plans are suitable.

As the noble Lord, Lord Roberts, says, all analogue synthetic human insulin comes from outside the UK. The Government have already warned us that ports such as Dover and Folkestone will have greatly reduced capacity for at least six months if we crash out of the EU, and the stockpiles mentioned by the Minister will last six weeks—certainly not six months. In the circumstances of a looming shortage of life-saving medication, how do the Government plan to ration insulin? How will they decide who gets it and who does not?

My Lords, there will be no such thing as rationing. We will not ration insulin; I make that absolutely clear. As well as the six-week stockpiling activities that remain critical as part of our contingency planning, we are ensuring sufficient roll-on roll-off frigate capacity—

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—to enable these vital products to continue to move freely into the UK. Medicines and medical products will be prioritised to ensure they can use alternative routes; the Government have agreed this. In respect of capacity, we will have a number of warehouse facilities where we can keep refrigerated and other medicines to be used as and when necessary. On top of that—this is important—a serious shortage protocol was agreed on 18 January. It was laid before Parliament via the Human Medicines (Amendment) Regulations. This statutory instrument ensures that, if there is a serious shortage, we will enable pharmacists to look at other ways of dealing with this issue.

My Lords, first, is it not the case that the main manufacturer of insulin, to which the noble Lord, Lord Roberts, referred—the Danish company Novo Nordisk—has four months’ supply in this country already? Secondly, is it not the case under the WTO pharmaceutical tariffs elimination agreement, which applies to everybody, that there are no tariffs on medicines? This applies to 10,000 different products and covers 90% of the world’s trade in pharmaceuticals. Given what was announced today by the head of Calais port in this morning’s newspapers about extra flows and flow being maintained as normal in Calais, is it not ridiculous to think that we are going to obstruct things that we need or that the Europeans are going to obstruct things that they want to sell to us?

My Lords, I could not have put it better myself. I entirely agree.

My Lords, there is already evidence that some insulin is going on restricted supply, which means that a pharmacist, once she has used up her allowance, will have to spend valuable time going direct to the manufacturer to prove that she has the prescription. Pharmacists tell me that this is a nightmare and takes up a lot of time that they could otherwise spend advising patients. What advice will the Minister give to pharmacists in this situation?

My Lords, the department is certainly not aware of the kind of issues that the noble Baroness has raised. We are working closely with the regulator, with pharmacists and indeed with the Pharmaceutical Services Negotiating Committee. We are keeping everything under review. As I have said, we have in place both a shortage protocol and clear contingency plans. We have facilities that will enable stockpiling for companies. We are working very closely and constructively with pharmaceutical companies and the supply chain to ensure that there are no shortages of insulin to the UK and that, when it does arrive in the UK, it will move as freely as it does currently.