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Reducing Modern Slavery in the Health Sector's Supply Chains for Personal Protective Equipment

Lead Research Organisation: Newcastle University
Department Name: Sch of Geog, Politics and Sociology

Abstract

Our AHRC-funded research on 'Tackling Modern Slavery in Malaysian Medical Gloves Factories Using a Whole-Systems Approach to the Supply Chain' provided robust evidence of forced labour issues in the medical gloves sector during the COVID-19 pandemic and suggested opportunities for remedies. It focused on identifying labour issues, specifically indicators of forced labour, in the production of medical examination gloves in Malaysia, and their supply to the UK's National Health Service (NHS), during the pandemic. Using the International Labour Organisation's 11 indicators of forced labour as a framework, our research found evidence of all 11 indicators before and during the COVID-19 pandemic, with evidence that four - restriction on movement, isolation, abusive working and living conditions, and excessive overtime - worsened during the pandemic. However, labour issues in this supply chain are longstanding. The ongoing issues of forced labour demonstrate a need for policy, legal, and commercial measures at all points in the supply chain to go further to address modern slavery and poor working conditions.

Follow-on impact and engagement activities will facilitate and broaden the adoption of our recommendations for tackling modern slavery in Personal Protective Equipment (PPE) supply chains within and beyond the medical gloves sector and UK procurement from Malaysia. Research findings and recommendations from the project on medical gloves can inform how modern slavery is tackled in other PPE supply chains, including those for masks, gowns, and aprons. Moreover, there is scope to engage governments beyond the UK who are grappling with the same challenges. Engagement with the public sector in improving the ethical sourcing of goods contributes to a wider agenda of leveraging government procurement for social good. A multi-disciplinary team from Newcastle University, the Universities of Sussex and Nottingham, and ethical trade consultancy, Impactt Limited, will conduct the work in partnership with the Modern Slavery and Human Rights Policy and Evidence Centre.

The original research garnered interest from MPs, media, and industry, and is cited in the Home Office's first Modern Slavery Statement. However, working to facilitate the adoption of the recommendations was beyond the scope of the original project - yet it is key to advancing positive change. We propose four work packages engaging supply chain stakeholders in opportunities for change focused on reducing modern slavery. The work packages will involve evaluating and comparing different mechanisms recommended by the research project for reducing modern slavery globally, including greater supply chain transparency, labour standards monitoring and audits, import bans such as those recently imposed by US and Canadian governments when forced labour is found, the role of media, grievance mechanisms, and improvement plans for corrective action. Work Package 1 takes forward our previous research to engage with, support, and advance what is working most effectively in the UK health sector's PPE supply chains, including the production of an awareness-raising video for procurers to be developed from the original research. Work Package 2 engages with migrant workers' lived experiences to establish what is working and what is not working in terms of addressing workers' grievances. Work Package 3 involves international knowledge exchange to share best practice and foster opportunities for aligning different national and regional government approaches to tackling modern slavery in global PPE supply chains. Work Package 4 concludes with an international, multi-stakeholder event to debate and establish best practice, impacts, and next steps.

Success indicators will include cases where specific companies and state departments have used our resources and/or taken up our recommendations, as well as where evolving policy and approaches have become more aligned because of knowledge exchange.

Publications

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Title Video and landing page for procurement practitioners - education, awareness-raising and resources for confronting modern slavery in supply chains: Tackling Modern Slavery 
Description Video and landing page for procurement practitioners - education, awareness-raising and resources for confronting modern slavery in supply chains: Tackling Modern Slavery 
Type Of Art Film/Video/Animation 
Year Produced 2024 
Impact Video and landing page rolled out nationally to NHS trusts and healthcare procurement professionals for educational purposes. 
 
Description Key findings and recommendations
Stakeholder Engagement Findings
• Negligible improvements in workers' living and working conditions since 2020. The living and
working conditions of workers in Malaysian medical gloves factories often remain poor.
• NHS Supply Chain has restructured, bringing more buying teams in-house (previously out
sourced), allowing more oversight over buying behaviour, including ethical procurement.
• NHS Supply Chain is continuing to reform its Labour Standards Assurance processes, including
increased training, improved pre-tender mapping of high-risk products and geographies, and
monitoring labour standards throughout the contract.
• Medical gloves supply chains have increased sourcing from China. This may be an unintended
consequence of the labour rights focus on Malaysian medical gloves factories.
• There is optimism that changes in national human rights due diligence legislation from individual
European countries and from the European Union will promote positive change.
• The US import bans seem to have been effective but may require follow up actions and more
research into longer-term effectiveness.
• The UK Modern Slavery Act is insufficient. Smaller supplier companies to the NHS with a lower
turnover threshold than that required by the Act often believe the Act does not apply to them and
require capacity building to address NHS requirements
Exploitation Route Video being taken up nationally and in some parts of Europe to educate procurement professionals in addressing the risks of modern slavery in their supply chains.
Sectors Healthcare

 
Description Impact being generated. Educational film produced and rolled out.
First Year Of Impact 2024
Sector Healthcare
Impact Types Economic

Policy & public services

 
Description Stakeholder engagement workshops 
Form Of Engagement Activity Participation in an activity, workshop or similar
Part Of Official Scheme? No
Geographic Reach National
Primary Audience Professional Practitioners
Results and Impact 4 stakeholder workshops held online to discuss findings and recommendations
Year(s) Of Engagement Activity 2024