Sir Desmond Swayne TD

Sir Desmond Swayne TD

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Compassionate Use Medicines

14/06/2026 By Desmond Swayne

When David Cameron was Prime Minister and I was Parliamentary Private Secretary, he used to say that we spent half our time trying to find out what the Government was doing a and the other half trying to stop it.
The machine of government steers on and it takes a positive and determined effort to alter course. One of the essential purposes of weekly Prime Minister’s Questions is that, because the Prime Minister can be asked anything for which he has responsibility, he has to have the time and discipline to be thoroughly briefed on every aspect of government.
Now and again, inevitably, something will slip through under the radar, and there will be a last minute scramble to unwind some daft decision.

This week the His Majesty’s Customs and Revenue has started to levy VAT at 20% on medicines given freely, without charge, for the purpose of clinical trials or or compassionately as the last hope for some very sick patients, under the Compassionate Use Medicines Scheme.

Was this decision just bonkers, or was it mean spirited?
Was it an example of the machine ploughing onwards because the Prime Minister at the wheel, or whoever else it might have been, hadn’t been briefed?
Or was it an example of what Pat McFadden, Secretary of State for Work and Pensions, in his WhatsApp message to Peter Mandelson, described as Labour determined to find anyone to tax in order to pay benefits to somebody else?

Whichever it was, the consequences are disastrous. People in extremis, dying with rare cancers, will be denied a last hope. More damaging still, Drug companies will withdraw clinical trials from the UK and pursue them in a more tax friendly environment.

My charitable nature prompts me to suggest that this is a cock-up rather than mean spirited conspiracy. The problem, however, is that the Opposition had repeatedly warned ministers over the last few months that HMRC was planning to do this. Now they’ve done it: Nobody thought to grab the rudder and avoid the iceberg.

When the Minister was summoned to the Commons this week to explain. She complained that no new rules had been introduced and that the last government could have changed the rules if it had wished to do so. Implying that had the last Conservative government changed the rules, then this decision to impose VAT could not have been taken!
What a ridiculous position to take. The rules of the scheme have been set for the last 30 years. The plain fact is that previous governments chose not to impose VAT even though they could have done so. Imposing VAT is a choice that this government has made.

I smell another U turn coming. And that will be welcome.

Filed Under: DS Blog

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