He talks to Andrew McConaghie about why he made a stand on medicines regulation, why a second vote is far from being undemocratic – and why big business should speak out against Brexit.
As the clock ticks down to Brexit day on 29 March 2019, the UK looks ever closer to crashing out of the European Union with no deal. That’s because Prime Minister Theresa May’s ‘Chequers’ plan has already been all but rejected by the other EU member states – and there is likely to be no majority in a deeply divided UK Parliament for it or any other single Brexit deal, soft, hard or otherwise.
These developments are causing particular alarm in healthcare, as the UK pharma industry, the wider field of medical research, the NHS and patients all stand to lose out if and when the UK departs from Europe, but especially via a no deal Brexit.
But for many in the UK – and especially in the life sciences sector – it remains clear that any form of Brexit will put up new barriers in trade, regulation and migration, which threaten the future of the sector.
This has been driven by a number of factors: voters are bewildered by the lack of progress towards Brexit since the July 2016 referendum, are unimpressed with Theresa May’s negotiating skills and infighting in the Conservative party, and warnings of the economic damage Brexit will inflict have also taken their toll.
Another potentially decisive shift was the Labour party’s recent vote to ‘keep all options open’ including backing for a second referendum if the Conservatives fail to deliver a viable deal – although what Labour’s leadership really wants is a general election and the chance to seize power.
Speaking out for patients
Conservative MP Dr Phillip Lee, a medical doctor by training, has been calling for a second referendum since he resigned from his ministerial post in the summer in protest over Brexit.
He makes a clear analogy with medical practice – and says a second vote is needed to obtain the “informed consent” of the British public.
“If you decide to have an operation, the surgeon comes along and tells you about the likely risks and the benefits and asks if you still want to go ahead with the operation? Then you can say: ‘No I don’t doctor’, or ‘yes I do’. That consent is all I am asking for.”
He says he has always maintained that Brexit in any form would be against the better interests of the country and Bracknell, his constituency in southern England. This outspokenness underlines his bravery in quitting his ministerial role, as his electorate in Bracknell voted narrowly for Brexit during the referendum.
Now dedicating himself to drumming up broad support for a People’s Vote, he dismisses the Brexiteer argument that a second poll would be to ignore a clear signal from voters.
“There isn’t a deal to discuss yet – Chequers is a proposal which has already been ruled out by the other side [Europe]. So we will obviously have to come back with something else – my guess is that she [Theresa May] is going to tack towards the harder Brexit side of things, and we will get Canada plus and some fudge on Northern Ireland.”
Dr Phillip Lee quit his role as justice minister in June, resigning in protest at what he saw as the government trying to block Parliament playing a full role in scrutinising and approving the Brexit process.
While a backbench rebellion over parliament’s final say was quashed, Dr Lee landed a blow against the government by defeating it in a Commons vote – one of potentially huge significance to the NHS, the UK pharma industry and patients.
He tabled the NC17 amendment to the Trade Bill that set out to keep the UK a member of the European Medicines Agency – and won the vote with a majority of 305 against 301,
as he and 11 other Conservative colleagues voted with opposition MPs for the measure. The legislation now stipulates that the government must make the UK remaining a member of the European Medicines Agency (EMA) a key objective in its negotiations with the EU.
He told the Commons at the time: “This [amendment] is vital because that is how we get our people and our NHS the medicines they need. It is also important for our pharmaceutical sector.
“The European medicines regulatory network partnership makes the process of accessing life-saving new medicines and moving medicines quick and easy. If we leave that partnership, the NHS would get groundbreaking new drugs like those for cancer, dementia and diabetes long after other parts of the world.”
If we leave that partnership,the NHS would get groundbreaking new drugs like those for cancer, dementia and diabetes long after other parts of the world.”
There is no doubt that the amendment was seen in the UK pharma industry as a huge vote of support – even if trade organisation the ABPI is very careful about speaking out against the government or Brexit. Speaking to me in Westminster a few months later in September, Dr Lee says he was driven by a professional obligation as a doctor to do the best for patients.
It’s no accident, either, that three of the co-signatories on the amendment were also medical doctors –Conservative Dr Sarah Wollaston, Labour’s Dr Paul Williams and the SNP’s Dr Philippa Whitford – as they all know what UK healthcare stands to lose.
Dr Lee says the vote to preserve the EMA links gave all pro-EU members of parliament a boost.
“It was the first time since before Christmas that the government had lost. It is now in law that we should not be detached from the EMA. And I think its symbolism was powerful.”
The amendment certainly looks incompatible with the UK remaining a full EMA member, as this would require it remaining in the European Economic Area (EEA), as it’s linked to the single market which Theresa May has pledged to leave as part of Brexit.
As many in the pharma industry know, the EEA allows Norway, Iceland and Liechtenstein to be part of the EMA and gain access to the new medicines at the same time.
“The [amendment] means that we need to be in the EEA, so it is back to the government to see how it squares that off. Fundamentally I was driven by a desire to secure the supply medicines of all types… I have yet to see a coherent plan to guarantee that.”
May and her cabinet looked to address concerns about medicines access in the Chequers plan, which proposes a ‘common rulebook’ with Europe across a number of fields, including medicines regulation. In essence, this is an attempt to keep hold of EEA-like levels of alignment with Europe without being part of the single market. However this ‘cherry-picking’ approach has been repeatedly rebuffed by the EU27, and is equally seen as far too soft a Brexit by the likes of Johnson and Rees-Mogg, and so looks doomed to failure.
“Not particularly,” he says. “There is a pharmaceutical company on my patch, Boehringer Ingelheim, so I am aware of the broader concerns within the industry around the supply chain and taking out warehouse space and stockpiling and those sorts of things, but my primary motive was to protect patients.”
“The way out of this is to have a proper referendum where both sides are clearly defined, the costs and benefits are clearly defined and if the country still votes for Brexit in these circumstances, then we can say, we must honour that decision.”
Asked if he fears the pharma industry disinvesting in the UK, he says the NHS will always represent a big market for medicines, but does think many will “have to rethink their [business] strategy” if Brexit goes ahead.
Pharma should speak up
So does he think pharma companies should actually come out and throw their support behind a People’s Vote?
“Yes. Or they may not have to support a People’s Vote, but I do think they should stop pulling their punches about the decisions they are making.”
He says the reluctance of big business to get involved in UK politics is part of the problem.
“If a series of big companies stood up and said, just so everyone is clear, if you vote this way it is going to make a difference to our investment over the next 5-10 years, and where we hold our offices and everything else. If a politician stands up and says that, it’s Project Fear. But if the head honcho of XYZ plc stood up, people could say, well that might be true then.”
Brexit has overwhelmed the civil service and Westminster, he says, but he is reluctant to point the finger of blame at any individual. However he is unsparing in his criticism for fellow Tory MP and outspoken Brexiteer Boris Johnson, whom he says never had a plan for Brexit, and whom he calls “deeply irresponsible”.
He concludes by saying that he believes that a second referendum is now ‘inevitable’, though it’s far from clear when it might come. Time is running out for such a plebiscite to be arranged before 29 March 2019, which means it might be held during the proposed transition period up to 2020.
And what of the wording of any second referendum ballot paper? Dr Lee says the choice should be as clear as possible, but believes it should be between a clearly defined Brexit and a Remain option that must contain some pledges that European regulation on migration can be updated.
He says this would reflect genuine EU- wide concerns about migration, and believes these changes are already in the pipeline.
”Can we have this vote after we exit? Every different option is possible at the moment. We could transition in and then transition out and still be a member – all of these things are possible because ultimately they are political decisions.
“I am quite optimistic actually. I think the [political] weather is changing. And my little amendment is quite significant in that respect.”