Written questions by Sobel.

What steps his Department is taking to support (a) women wishing to become pregnant and (b) all people diagnosed with Fanconi Anaemia.

The Government is committed to improving the lives of those living with rare diseases, including Fanconi Anaemia. Where possible, the National Health Service offers reproductive options for carrier couples wishing to have a baby, including prenatal counselling prior to conception, testing in early pregnancy, and preimplantation genetic testing. The UK Rare Diseases Framework also sets out four priorities collaboratively developed with the rare disease community, which include: getting a final diagnosis faster; increasing awareness of rare diseases among healthcare professionals; better coordination of care; and improving access to specialist care, treatments, and drugs. We published the annual England action plan in February 2025, where we report on the steps we have taken to advance these priorities. The Government will be working with the devolved administrations this year to review what comes next, following the expiry of the UK Rare Diseases Framework in 2026, to support all those diagnosed with a rare diseases, including Fanconi Anaemia.

What steps his Department is taking to support research for a cure for Fanconi Anaemia.

The Department funds research on health and social care through the National Institute for Health and Care Research (NIHR). The NIHR welcomes funding applications for research into any aspect of human health and care including Fanconi Anaemia.These applications are subject to peer review and judged in open competition, with awards being made on the basis of the importance of the topic to patients and health and care services, value for money, and scientific quality. Topics for new research can be proposed to the NIHR via the following link:https://www.nihr.ac.uk/get-involved/suggest-a-research-topicThe NIHR also works closely with other Government funders, including UK Research and Innovation, which is funded by the Department for Science, Innovation and Technology and which includes the Medical Research Council, to fund research into a range of conditions, including Fanconi Anaemia.

What steps his Department is taking to improve access to treatments to manage Fanconi Anaemia.

Working under the UK Rare Diseases Framework, the Government is committed to improving the lives of those living with rare diseases, such as Fanconi Anaemia. The UK Rare Diseases Framework sets out four priorities collaboratively developed with the rare disease community. The fourth priority of the framework is improved access to specialist care, treatment, and drugs. Action under this priority has included reviewing the medicines access pathways, namely the Early Access to Medicines Scheme, the Innovative Licensing Pathway, and the Innovative Medicines Fund, for their suitability for rare disease therapies and reforming clinical trial regulations. Information on Fanconi Anaemia is included on the NHS England GeNotes page, supporting healthcare professionals with easy access to information on the diagnosis and treatment of this condition.

What steps his Department is taking to encourage (a) allergen awareness and (b) cross-contamination training for staff in (i) hospitality and (ii) food service businesses.

The Food Standards Agency (FSA) regularly runs campaigns to raise awareness of allergens for both consumers and businesses.In March 2025, the FSA published new best practice guidance to help food businesses provide clearer written allergen information for those in hospitality, such as restaurants. This is available at the following link:https://www.food.gov.uk/business-guidance/allergen-information-for-non-prepacked-foods-best-practice-summaryIt is recommended that this is supported by a conversation with the consumer. Additional guidance includes the ‘Safer Food Better Business’ guide, along with the FSA’s ‘Food allergen labelling and information requirements technical guidance’.The FSA is dedicated to improving the provision of information for people with allergies and working with food businesses to increase allergen training in the sector. Free training is provided on the FSA website for local authorities and food businesses, including those working in hospitality and food service. The training covers all aspects of allergen management, including mitigating and communicating the risk of allergen cross-contamination.Under food safety regulations, businesses are expected to ensure their staff are competent in managing allergens. The FSA training has proved to be very popular, with 915,238 users since the launch of the platform in September 2020, and the FSA is currently working to improve the offering.

What recent assessment his Department has made of the progress made on (a) preventing and (b) treating all types of brain tumours.

The Government recognises that too little is currently known about how to prevent, diagnose and manage brain tumours, and they remain one of the hardest cancers to treat and a challenging area for research.As with many other cancers, there is currently no guaranteed way to prevent a brain tumour, as the causes of most are unknown and not directly related to lifestyle or environmental factors. However, the risk of a brain tumour can be reduced by avoiding or limiting exposure to unnecessary radiation and carcinogens like smoking. Maintaining a healthy lifestyle, including a diet rich in antioxidants, getting adequate sleep and exercising regularly supports overall health and may help reduce some cancer risks.The Department of Health and Social Care recognises that there are currently limited treatment options available for people who have been diagnosed with brain tumours. The forthcoming National Cancer Plan, which will complement the 10-Year Health Plan, will include further details on how we will improve outcomes for all cancer patients including those with rarer and less common cancers such as brain tumours. The Department ran a Call for Evidence to inform the development of the National Cancer Plan, including a question on priorities for cancer research. Over 11,000 responses were received, and although no assessment was separately taken on the prevention and treatment of brain tumours, all of the responses have been analysed to prioritise recommendations in the Plan.Additionally, in September 2024, the National Institute for Health Research announced a new package of support to stimulate high quality brain tumour research applications, as part of the Government’s commitment to developing new lifesaving and life-improving research, supporting those diagnosed and living with brain tumours.A new national Brain Tumour Research Consortium was established in December 2024 to bring together researchers from a range of different disciplines and institutions with the aim of driving scientific advancements in how to prevent, detect, manage and treat cancers in adults and children.In addition to speeding up diagnosis and treatment, the work being undertaken by the Consortium aims to ensure that patients have access to the latest treatments and technology and to clinical trials. This will make a significant contribution to bringing the UK’s cancer survival rates back up to the standards of the best in the world.

What steps he is taking with NHS England to support ICBs to review fertility guidelines.

In the light of broader pressures on the National Health Service and on-going changes within NHS England, we have been looking again at achievable ambitions to improve access to fertility services and fairness for all affected couples.The National Institute for Health and Care Excellence is currently reviewing its fertility guidelines, which will be the clinical standards for the future NHS offer.The Department is considering how best to support integrated care boards to improve their local offer.

What steps his Department is taking with NHS England to support ICBs to improve the availability of treatments for fertility patients.

In the light of broader pressures on the National Health Service and on-going changes within NHS England, we have been looking again at achievable ambitions to improve access to fertility services and fairness for all affected couples.The National Institute for Health and Care Excellence is currently reviewing its fertility guidelines, which will be the clinical standards for the future NHS offer.The Department is considering how best to support integrated care boards to improve their local offer.

What steps his Department is taking to (a) reduce the delay for a bipolar diagnosis and (b) bring it in line with early intervention targets for other conditions.

It is unacceptable that too many people are not receiving the mental health care they need, and we know that waits for mental health services are far too long, including for people with bipolar disorder. We are determined to change that.As part of our mission to build a National Health Service that is fit for the future, we will provide access to a specialist mental health professional in every school in England, create a network of open access community Young Futures hubs, recruit an additional 8,500 mental health workers to cut wait times and provide faster treatment, and modernise the Mental Health Act.We are also committed to new models of care for mental health, including reforming care for people experiencing a mental health crisis. We are testing neighbourhood mental health centres for people aged 18 years old and over with serious mental illness. These six pilot schemes are based in Tower Hamlets, Lewisham, Sheffield, York, Birmingham, and Whitehaven.These models will offer 24/7 open access care closer to home, with an integrated service which includes healthcare providers, local authorities, and the voluntary sector. These pilots build on international evidence that shows that similar models have led to a reduction in hospitalisation and waiting times, and support our efforts to move more care into the community.Since 2021, all areas of the country have been transforming and increasing access to community mental health services for all people with severe mental illness, including people with bipolar disorder. The vision for the transformation programme was set out in the Community Mental Health Framework, which included ensuring that services were needs led, rather than requiring people to have a specific diagnosis to access care.

Whether his Department plans to establish specialist care pathways for people with bipolar to (a) improve treatment and (b) reduce misdiagnosis.

It is unacceptable that too many people are not receiving the mental health care they need and we know that waits for mental health services are far too long, including for people with bipolar disorder. We are determined to change that. As part of our mission to build a National Health Service that is fit for the future, we will provide access to a specialist mental health professional in every school in England, create a network of open access community Young Futures hubs, recruit an additional 8,500 mental health workers to cut wait times and provide faster treatment, and modernise the Mental Health Act. NHS England is continuing to roll out the Community Mental Health Framework. The framework sets out a plan to deliver more flexible, personalised, and holistic care for more people with serious mental illness, including for people with a diagnosis of bipolar disorder. We are also committed to new models of care for mental health, including reforming care for people experiencing a mental health crisis. We are testing neighbourhood mental health centres for people aged 18 years old and over with serious mental illness. These six pilot schemes are based in Tower Hamlets, Lewisham, Sheffield, York, Birmingham, and Whitehaven. These models will offer 24/7 open access care closer to home, with an integrated service including healthcare providers, local authorities, and the voluntary sector. These pilots build on international evidence that shows that similar models have led to a reduction in hospitalisation and waiting times, and supports our efforts to move more care into the community In addition, people of all ages who are in crisis or who are concerned about a family or loved one can now call 111, select the mental health option, and speak to a trained mental health professional. NHS staff can guide callers with next steps such as organising face-to-face community support or facilitating access to alternative services, like crisis cafés or safe havens, which provide a place for people to stay as an alternative to accident and emergency or a hospital admission.

What guidance his Department provides on safe levels of fluoride in drinking water.

Fluoride is a naturally occurring mineral found in water and some foods. The amount of naturally occurring fluoride in water varies across the United Kingdom due to geological differences. Drinking water regulations contain a standard for fluoride which is a maximum of 1.5 milligrams per litre. This is the same level as the World Health Organisation health-based guideline value for fluoride in drinking water. If the standard of 1.5 milligram per litre is breached, the Drinking Water Inspectorate has the power to take enforcement action to require the water company to rectify the breach.In some areas of England, the level of fluoride is adjusted through a water fluoridation scheme to improve dental health. In these areas, the target level for fluoride is one milligram per litre, well within the regulatory limit. There is a legal duty to monitor the effects of water fluoridation schemes on health and report on it every four years. Previous reports are available at the following link, with the next due to be published in 2026:https://www.gov.uk/government/publications/water-fluoridation-health-monitoring-report-for-england-2018The Drinking Water Inspectorate has published an advice leaflet on fluoridation of drinking water which can be found here:https://www.dwi.gov.uk/consumers/learn-more-about-your-water/fluoridation-of-drinking-water/

What steps his Department is taking to help increase the number of dietetic apprenticeships.

We will refresh the NHS Long Term Workforce Plan next summer, to ensure the National Health Service has the right people, in the right places, with the right skills to deliver the care patients need, when they need it. This will include how we ensure that we train, through all training routes, and provide the staff the NHS needs, including allied health professionals such as dieticians, to care for patients across our communities.

What training the NHS offers on pathological demand avoidance.

Pathological Demand Avoidance (PDA) is most often understood as a characteristic experienced by or observed, or both, in some autistic people, but professional consensus on its status is still required. PDA is not a recognised and stand-alone diagnosis within the Diagnostic and Statistical Manual of Mental Disorders or the International Classification of Disease.There is a variety of training available for staff providing care to autistic people, although not specifically for PDA. The Health and Care Act 2022 requires that, from 1 July 2022, Care Quality Commission registered providers must ensure staff receive specific training on learning disability and autism, appropriate to their role. Individual employers are responsible for ensuring their staff are trained and competent to carry out their role.The standard of training for health care professionals is the responsibility of the respective independent statutory regulatory bodies, who set the outcome standards expected at undergraduate level and approve courses. It is the responsibility of higher education institutions to write and teach the curricula content that enables their students to meet the regulators’ outcome standards.Whilst not all curricula may necessarily highlight a specific condition, they all emphasise the skills and approaches a healthcare practitioner must develop in order to ensure accurate and timely diagnoses and treatment plans for their patients.

What steps his Department has taken to support (a) people diagnosed with pathological demand avoidance and (b) their carers.

Pathological Demand Avoidance (PDA) is most often understood as a characteristic experienced by or observed, or both, in some autistic people, but professional consensus on its status is still required. PDA is not a recognised and stand-alone diagnosis within the Diagnostic and Statistical Manual of Mental Disorders or the International Classification of Disease.It is the responsibility of integrated care boards (ICBs) to make available appropriate provision to meet the health and care needs of their local population, including support for autistic people, in line with National Institute for Health and Care Excellence (NICE) guidelines.The NICE guideline, Autism spectrum disorder in under 19s: recognition, referral and diagnosis, recommends that as part of autism assessments, healthcare workers should consider PDA and carry out appropriate referrals.In respect of carers, the Care Act 2014 requires local authorities to deliver a wide range of sustainable, high-quality care and support services, including support for carers. Local authorities are required to undertake Carer’s Assessments to support people caring for their family and friends who appear to have a need for support, and to meet their eligible needs on request from them.

If he will make an assessment of the potential merits of a permanent national menopause network supported by specialist nurses to (a) support and (b) offer advice on (i) diet, (ii) exercise, (iii) the workplace and (iv) other issues to people going through the menopause.

No specific assessment has been made. The Government sympathises with the difficulties women experiencing menopausal symptoms face, and we are committed to prioritising women’s health as we reform the National Health Service.The NHS website provides information and advice for women on menopause symptoms, healthcare support, including treatment options, and advice on lifestyles changes, including diet and exercise. NHS England has also developed a self-care fact sheet. This fact sheet is available at the following link:https://www.selfcareforum.org/menopause/Women should not have to suffer in silence and anyone needing advice on managing symptoms should seek advice from their general practitioner or other healthcare professional. In addition, the Department has invested £25 million over 2023/24 and 2024/25 to support the establishment of at least one pilot women’s health hub in every integrated care system. Menopause care is a core service for the pilot women’s health hubs.

What steps his Department is taking to help reduce health inequalities for women managing menopause in areas of high health inequalities.

The Government is committed to prioritising women’s health as we build a National Health Service fit for the future, and women’s equality will be at the heart of our missions.Integrated care boards (ICBs) are responsible for providing services that meet the needs of their local population, including menopause services. ICBs are also expected to have a dedicated focus on tackling health inequalities.A recent rise in prescriptions for Hormone Replacement Therapy (HRT) is a promising sign that more women are getting the advice and help they need. The HRT Prescription Pre Payment-Certificate continues to provide significant savings for patients who are prescribed applicable HRT medications.The Department has invested £25 million over 2023/24 and 2024/25 to support the establishment of at least one pilot women’s health hub in every integrated care system. One of the aims of women’s health hubs is to improve health outcomes and reduce health inequalities. Menopause care is a core service for pilot women’s health hubs.

If his Department will make an assessment of the potential merits of introducing mandatory menopause training for GPs.

The Royal College of General Practitioners (RCGP) has a holistic curriculum of training that all GPs must cover before they are able to pass the examination to become a member of the RCGP and work independently as a GP. There is a specific section on women’s health, including the menopause. As a result, the menopause is already a core competency of all qualified GPs.To support practicing GPs, the RCGP has developed a Women’s Health Library drawing together educational resources and guidelines on women’s health so primary healthcare professionals have the most up-to-date information. This includes a specific section on menopause, and more information on the Library is available at the following link:https://elearning.rcgp.org.uk/course/index.php?categoryid=57

Whether his Department (a) is taking and (b) plans to take steps to support increased capacity for adult ADHD assessments in (i) Leeds and (ii) England.

The Department is currently considering next steps to improve access to attention deficit hyperactivity disorder (ADHD) services. It is the responsibility of integrated care boards (ICBs) to make appropriate provision to meet the health and care needs of their local population, including ADHD care pathways, in line with relevant National Institute for Health and Care Excellence guidelines.We are supporting a taskforce that NHS England is establishing to look at ADHD service provision and its impact on patient experience. The taskforce will bring together expertise from across a broad range of sectors, including the National Health Service, education, and justice, to better understand the challenges affecting people with ADHD and help provide a joined-up approach in response to concerns around rising demand.The West Yorkshire ICB advises that the Leeds and York Partnership NHS Foundation Trust (LYPFT) is taking steps to assess and respond to the impact of the suspension of non-urgent referrals. This includes working to redesign the adult ADHD pathway in Leeds and setting up a new care navigator service for people on the waiting list who would like to discuss what support they need and their options under the NHS Choice Framework.The ICB will be working with the ADHD patient support groups for Leeds and West Yorkshire on what they can do collectively to support patients during the pause to referrals, as well as involving them in the redesign of the local service.A quality impact assessment and an equality impact assessment have been completed by the LYPFT, which will continue to be updated as the local NHS learns more about the impact of the suspension.

Whether his Department (a) is taking steps and (b) plans to take steps to support the adult ADHD service in Leeds to reopen their referrals.

The Department is currently considering next steps to improve access to attention deficit hyperactivity disorder (ADHD) services. It is the responsibility of integrated care boards (ICBs) to make appropriate provision to meet the health and care needs of their local population, including ADHD care pathways, in line with relevant National Institute for Health and Care Excellence guidelines.We are supporting a taskforce that NHS England is establishing to look at ADHD service provision and its impact on patient experience. The taskforce will bring together expertise from across a broad range of sectors, including the National Health Service, education, and justice, to better understand the challenges affecting people with ADHD and help provide a joined-up approach in response to concerns around rising demand.The West Yorkshire ICB advises that the Leeds and York Partnership NHS Foundation Trust (LYPFT) is taking steps to assess and respond to the impact of the suspension of non-urgent referrals. This includes working to redesign the adult ADHD pathway in Leeds and setting up a new care navigator service for people on the waiting list who would like to discuss what support they need and their options under the NHS Choice Framework.The ICB will be working with the ADHD patient support groups for Leeds and West Yorkshire on what they can do collectively to support patients during the pause to referrals, as well as involving them in the redesign of the local service.A quality impact assessment and an equality impact assessment have been completed by the LYPFT, which will continue to be updated as the local NHS learns more about the impact of the suspension.

If his Department will make an assessment of the potential impact of the temporary suspension of non-urgent adult referrals by the adult ADHD service in Leeds on people with ADHD in that area.

The Department is currently considering next steps to improve access to attention deficit hyperactivity disorder (ADHD) services. It is the responsibility of integrated care boards (ICBs) to make appropriate provision to meet the health and care needs of their local population, including ADHD care pathways, in line with relevant National Institute for Health and Care Excellence guidelines.We are supporting a taskforce that NHS England is establishing to look at ADHD service provision and its impact on patient experience. The taskforce will bring together expertise from across a broad range of sectors, including the National Health Service, education, and justice, to better understand the challenges affecting people with ADHD and help provide a joined-up approach in response to concerns around rising demand.The West Yorkshire ICB advises that the Leeds and York Partnership NHS Foundation Trust (LYPFT) is taking steps to assess and respond to the impact of the suspension of non-urgent referrals. This includes working to redesign the adult ADHD pathway in Leeds and setting up a new care navigator service for people on the waiting list who would like to discuss what support they need and their options under the NHS Choice Framework.The ICB will be working with the ADHD patient support groups for Leeds and West Yorkshire on what they can do collectively to support patients during the pause to referrals, as well as involving them in the redesign of the local service.A quality impact assessment and an equality impact assessment have been completed by the LYPFT, which will continue to be updated as the local NHS learns more about the impact of the suspension.

What his Department's latest estimate is of the total cost of the rebuild of Leeds General Infirmary.

The standard process confirming the total funding amount for major infrastructure projects involves review and approval of a Full Business Case. All trusts in the Programme have previously received indicative funding allocations to support planning, however these are commercially sensitive. The New Hospital Programme had confirmed £3.7 billion in funding up to the end of 2024/25.Up to the end of 2023/24, the total amount received by Leeds Teaching Hospitals NHS Trust in funding for their new hospital schemes is £32.8 million.The breakdown of how much the Trust received for its new hospital scheme is published annually as part of the Department’s Annual Reports and Accounts, with Public Dividend Capital to individual Trusts included in the Financial Assistance Report under section 40 of the National Health Service Act 2006. The 2022/23 report is available at the following link:https://www.gov.uk/government/publications/dhsc-annual-report-and-accounts-2022-to-2023The Trust is currently developing its Outline Business Case for the new Leeds General Infirmary scheme and is at Royal Institute of British Architects (RIBA) stage 2.