Peers from different parties used a House of Lords debate on the Health Bill to press the government to make value-based procurement routine across the NHS and social care in England, arguing that choosing medical products on price alone can cost more in the long run and damage patient care.
The debate focused on an amendment tabled by Labour peer Lord Hunt of Kings Heath and supported by crossbench peer Baroness Finlay of Llandaff. It would oblige ministers to report to Parliament each year on progress towards adopting value-based procurement across the NHS and social care in England. The measure was considered during the Bill's Lords stage.
Value-based procurement takes account of patient outcomes, clinical benefits and the wider cost of care rather than only the initial purchase price. National guidance on the approach was published in June, and the health service has already begun introducing it.
Lord Hunt, a former health minister and long-standing advocate of the policy, said procurement existed to secure value for money for the NHS but could achieve more. The aim, he argued, was to move away from always buying at the lowest price and towards quality that improves what patients experience.
He cited a pilot run by South Tyneside and Sunderland NHS Foundation Trust with Essity, a global health and hygiene company. Giving patients continence products matched to their individual needs produced a 48% reduction in leaks and an 8% fall in product use, he said.
Baroness Finlay, a professor of palliative medicine, praised the work of the Department of Health and Social Care's Medical Technology and Innovation Directorate and called for the approach to be taken up more widely in the NHS and social care. She argued that cheaper equipment can prove a false economy where it leads to complications or further treatment, with the resulting costs often met from different NHS budgets. Specialist cardiac pacemakers, she said, illustrate how a more expensive device can help prevent serious infections in vulnerable patients and may avert costly intensive care.
She also argued that clinicians are best placed to judge which devices deliver the best results, and that this knowledge should be built into tendering rather than left to purchasing rules alone.
Purchasing rules questioned
The proposals drew support from former health secretary Lord Lansley, a Conservative peer, who warned that rigid price thresholds could prevent more expensive products from being properly assessed for their wider benefits. Liberal Democrat health spokesperson Lord Scriven called the national guidance a genuine step forward but cautioned that financial pressure could still lead NHS buyers to prefer immediate savings over better long-term outcomes.
Replying for the government, health minister Baroness Merron restated its commitment to value-based procurement and confirmed that NHS Supply Chain has adopted a "comply or explain" approach for future purchasing frameworks. The intention, she said, is for the approach to become routine when NHS teams buy medical devices, consumables and services. The government has also commissioned independent monitoring of the national guidance, with annual reports over the next three years to assess its impact.
The debate also exposed doubts about whether current purchasing practice matches the policy. Lord Hunt questioned NHS Supply Chain's decision to identify a further 79 product categories for possible inclusion in its Core List of standardised supplies, including urinary catheters and colostomy bags. He said such items are highly personal rather than standard commodities and criticised the absence of prior consultation with the relevant trade associations.
Baroness Merron acknowledged that products should be tailored to individual patients but did not directly address the proposed expansion of the Core List, leaving open how the NHS will reconcile greater standardisation with its stated commitment to clinically led, patient-centred procurement.
Chris Whitehouse, a health policy lobbyist whose agency Whitehouse Communications worked on the amendment with Essity, said there is now clear cross-party support for value-based procurement and a real desire to see it rolled out with momentum across the NHS in England.