Written questions by Snowden.

What assessment he has made of the potential impact of a levy on international student fees on the higher education pipeline for NHS workforce training.

The Government’s ‘Restoring Control over the Immigration System’ white paper sets out a series of measures that will achieve a reduction in net migration, while maintaining the UK’s globally competitive offer to international students and making a significant contribution to growth by boosting our skills base.This includes the commitment to explore the introduction of a levy on higher education provider income from international students, with proceeds to be reinvested in the domestic higher education and skills system.More detail around the levy will be set out in the Autumn budget, and we will work with the Department of Education to consider the impact on the higher education pipeline for NHS workforce training.

What provisions will be made for children over 18 months who have missed the initial two-dose chickenpox vaccine schedule.

On 29 August, the Government announced plans to introduce chickenpox (varicella) vaccination into the routine childhood immunisation schedule from 1 January 2026. Eligible children will receive an MMRV vaccine during routine general practice (GP) appointments, which protects against measles, mumps, rubella and chickenpox.Eligibility will primarily be based on a child’s age on 1 January 2026, and not whether a child has previously received an MMR vaccine. The eligibility criteria, including which age groups will receive the vaccine, will be announced ahead of the programme launch.It is important that children continue to come forward for their vaccinations when they are due, including the MMRV vaccine when it is available.As with other childhood immunisations, parents will be contacted by their GP surgery to arrange an appointment if their child is eligible. The National Health Service and GP practices send reminders to families of those who are not fully vaccinated, and will provide catch-up doses to children who have missed any jabs.Parents and carers can contact their GP surgery to check their child’s vaccination record and arrange a catch-up appointment, and details of vaccinations can also be found in a child’s Red Book.

What steps he is taking to support people with bladder and bowel control conditions in (a) Fylde and (b) Lancashire.

Lancashire and South Cumbria (LSC) Integrated Care Board (ICB) commissions several community bladder and bowel/continence services across Fylde and Lancashire. These services consist of specialist nurses and allied health professionals, who work collaboratively with primary care, secondary care and wider community nursing services to ensure there is comprehensive support and end to end treatment pathways for residents of Lancashire and South Cumbria.Bladder and bowel services provide a holistic continence assessment, including routine observations, bladder scans and skin integrity checks, as well as reviewing past medical history, medication, mobility, carer support, and diet and fluid. They offer ongoing support and products for any bowel and/or bladder issues that are identified and may refer patients to specialist nurses for further support or district nurses for ongoing care. Self-care advice is always given, and independence is promoted during assessments, such as pelvic floor exercises for stress urinary incontinence, or bladder training and fluid intake advice for overactive bladder.LSC ICB has a dedicated programme of work supporting the transformation of core community services in line with the Government’s 10-Year Health Plan, and bladder and bowel services are considered as part of the community transformation programme ensuring all residents of Lancashire and South Cumbria have access to evidence-based bladder and bowel care when and where they need it.The community services are aligned to acute National Health Service trusts. Where there needs to be surgical management or specialist input, this is generally presented through a routine referral to urology, gynaecology or gastroenterology services. All localities across LSC ICB provide these services. LSC ICB is continually reviewing and working towards transformation of clinical pathways and services to manage demand as closer to home as possible via specialist multi-disciplinary teams within the community.Across LSC ICB, there is also a urogynaecology programme that is developing the front-end of the gynaecology pathway for access to specialist women’s health physiotherapists rather than referrals direct to secondary care gynaecology services. This aims to reduce pressure in gynaecology services and to provide specialist assessments and treatments with reduced waiting times for patients.

What recent discussions he has had with the Food Standards Agency on the regulation of imported protein (a) powders and (b) supplements.

The Food Standards Agency (FSA) is the lead department for food safety, including food supplements. Local authorities, and district councils in Northern Ireland, are the enforcers of food law in their respective local authority areas. The FSA produces advice and guidance for businesses, local authorities and consumers.While food supplements, including those that are imported, are not required to receive pre-market approval before being placed on the United Kingdom market, there is a legal duty on businesses to only place onto the market food that is safe. The FSA provides guidance for businesses to aid legal compliance and provides clarity to local authorities in the form of a toolkit to help support enforcement.The FSA also provides advice for consumers on the consumption of food supplements containing caffeine, and it is currently working on general food supplements advice aimed at helping consumers consume supplements safely.

What funding has been allocated to support (a) GP surgeries and (b) health visitors in delivering the chickenpox vaccine as part of the MMRV jab.

From January 2026, the measles, mumps, rubella, and varicella (MMRV) vaccination programme will form part of the routine childhood immunisations offered in England. The MMRV vaccine will be offered at general practices (GPs) as part of routine infant vaccination appointments.GPs are funded for vaccines through a mix of national contracts and service-based payments from NHS England. They receive a base fee per patient on their list, plus payment of an Item of Service (IoS) fee for specific vaccines.From 1 April 2025, following negotiations for the 2025/26 GP contract, GPs have received an IoS fee of £12.06 for the delivery of MMR vaccines, in line with other routine childhood immunisations. The IoS of £12.06 will also apply to the delivery of MMRV vaccinations from January 2026.NHS England is working with local systems to establish a pilot scheme in some areas across England which will explore delivery of the Government’s manifesto commitment to enable vaccinations to babies and young children as part of health visits. Pilots are currently in the development stage, but funding has been allocated in 2025/26 to support delivery of this programme.

How many buildings managed by his Department have been found to have reinforced autoclaved aerated concrete in (a) Fylde constituency and (b) Lancashire.

The National Health Service has been surveying hospital sites to identify the presence of reinforced autoclaved aerated concrete (RAAC) since 2019. The table below shows the number of NHS sites found to have RAAC in the Fylde constituency and Lancashire:AreaNumber of sitesFyle Constituency0Lancashire3Note: the three sites in Lancashire were the Blackpool Victoria Hospital, now eradicated, the Royal Blackburn Hospital, and the Blackburn Ambulance Station. The Department has published a full list of sites with confirmed RAAC on GOV.UK website, at the following link: https://www.gov.uk/government/publications/reinforced-autoclaved-aerated-concrete-raac-in-hospitals-management-informationOnce the presence of RAAC is confirmed at a hospital site, the trust joins NHS England’s national RAAC programme, which has delivered mitigation and eradication works across all hospital sites with confirmed RAAC to keep facilities safe and open, and which is working to remove RAAC fully from the NHS estate.The Government is committed to removing RAAC from the NHS estate as a priority and will continue to support NHS England’s RAAC programme with £440 million in 2025/26.

If he will make an assessment of the potential merits of making it a mandatory requirement for defibrillators to be fitted in patient transport vehicles.

Many non-emergency patient transport service (NEPTS) ambulances operated by National Health Service trusts already carry a defibrillator.However, the contractual requirements for the provision of NEPTS services are determined by each integrated care board (ICB), based on their assessment of the needs of the local population. Therefore, each ICB can determine whether they wish to specify the carrying of a defibrillator on non-emergency ambulances as a contractual requirement, along with the cost and crew training implications.Patients undergo regular assessment for patient transport service (PTS) journeys. If significant clinical issues are identified as part of that assessment, then the PTS provider could allocate additional measures for that patient. This might include having particular equipment, including a defibrillator, on board, and/or having crews with a higher training level.

Pursuant to the Answer of 21 July 2025 to Question 67568 on Obesity: Drugs, what estimate her Department has made of the number of adverse health incidents associated with weight loss medications obtained through online private providers in the last 12 months.

The Medicines and Healthcare products Regulatory Agency (MHRA) is responsible for ensuring medicines, medical devices, and blood components for transfusion meet applicable standards of safety, quality, and efficacy. The MHRA rigorously assesses available data, including from the Yellow Card scheme, and seeks advice from their independent advisory committee, the Commission on Human Medicines, where appropriate to inform regulatory decisions.Information collected via the Yellow Card scheme in relation to where the medicine was obtained cannot differentiate private providers specifically. A question regarding where the patient obtained their medicine is included on a Yellow Card report, however this is not mandatory and is a free text field. This free text information is therefore available to support signal detection and assessment, but cannot be extracted or analysed in an aggregated format.The MHRA publishes data received via the Yellow Card scheme in the form of interactive Drug Analysis Profiles (iDAPs). These interactive profiles display a complete listing of all suspected adverse drug reactions (ADRs) that have been reported to the MHRA via the Yellow Card scheme for particular drug substances. This includes all reports received from healthcare professionals, members of the public, and pharmaceutical companies. On iDAPS it’s possible to find information for several different data points such as the number of ADR reports by year, age, and sex, as well as information on the types of reactions included in the reports. Guidance concerning the interpretation of the information included is provided at the bottom of each iDAP page. It is particularly important to note that reports are not confirmed side effects to a medication, and that incidence cannot be derived since a number of factors influence the reporting of ADRs. Further information on iDAPs is available at the following link:https://yellowcard.mhra.gov.uk/idaps

Pursuant to the Answer of 21 July 2025 to Question 67568 on Obesity: Drugs, whether his Department has issued any guidance to the public on the risks of obtaining weight loss medications through online-only providers.

The Medicines and Healthcare products Regulatory Agency (MHRA) continually monitors the safety of all medicines, including weight loss drugs such as GLP-1 receptor agonists (GLP-1 RAs).Patient safety is our top priority, and no medicine would be approved unless it met the MHRA’s expected standards of safety, quality, and effectiveness. The MHRA has safety monitoring and surveillance systems in place, and when a safety issue is confirmed, the MHRA will act promptly to inform patients and healthcare professionals and take appropriate steps to mitigate any identified risk.In December 2024, January 2025, and June 2025, the MHRA published communications on the safe use of GLP-1Ras, namely:‘The MHRA reminds healthcare professionals to advise patients of the side effects of GLP-1 agonists and to report misuse’, which is available at the following link: https://www.gov.uk/government/news/mhra-reminds-healthcare-professionals-to-advise-patients-of-the-side-effects-of-glp-1-agonists-and-to-report-misuse;‘UK medicines regulator warns against buying weight loss medicines without a prescription this New Year’, which is available at the following link: https://www.gov.uk/government/news/uk-medicines-regulator-warns-against-buying-weight-loss-medicines-without-a-prescription-this-new-year; and‘GLP-1 medicines for weight loss and diabetes: what you need to know’, which is available at the following link: https://www.gov.uk/government/publications/glp-1-medicines-for-weight-loss-and-diabetes-what-you-need-to-know.The first communication advised healthcare professionals on the safe use of GLP-1 RAs, including being alert to the potential for misuse and that the benefit risk is only positive when used within the approved indications as detailed in the product information. The MHRA also advised that those purchasing privately online should do so from an authorised source such as a registered pharmacy.The second communication was aimed towards the public with similar messaging, warning the public of the dangers of accessing medicines from unregulated sources, such as online-only, unverified providers, and emphasised that GLP-1 RAs should only be used with a valid prescription and under clinical supervision. The guidance also urged healthcare professionals to advise patients on recognised side effects and to report misuse via the MHRA’s Yellow Card scheme, with further information available at the following link:https://yellowcard.mhra.gov.uk/Most recently, the MHRA issued some general guidance to the public on how to safely and effectively use GLP-1 RAs. The MHRA strongly emphasised the importance of obtaining these medicines from a legitimate pharmacy, including those trading online, with a prescription issued by a healthcare professional. The guidance directed the public in Great Britain to check on the General Pharmaceutical Council’s (GPhC) website that it is properly registered, and for Northern Ireland to refer to the Pharmaceutical Society of Northern Ireland’s (PSNI) website. Further information on the GPhC and the PSNI is available, respectively, at the following two links:https://www.pharmacyregulation.org/registershttps://registers.psni.org.uk/The MHRA continues to keep the safety of these medicines under continual review.

How many people are on the waiting list for tinnitus treatment in Fylde constituency.

The Department does not hold information in the format requested.

What progress he is making on reducing waiting times for cancer treatment in Fylde.

We will reduce cancer waiting times so that patients are diagnosed and treated faster, including patients in Fylde.We have now exceeded our pledge to deliver an extra two million operations, scans, and appointments, and we have now delivered over three million more appointments as the first step to ensuring faster diagnosis and timely access to treatments.The National Cancer Plan will include further details on how we will improve outcomes for cancer patients across the country, including in Fylde, as well as speeding up diagnosis and access to treatment. It will ensure that patients have access to the latest treatments and technology.

Pursuant to the Answer of 21 July 2025 to Question 67568 on Obesity: Drugs, what steps his Department is taking to ensure that private online clinics prescribing weight loss drugs are compliant with (a) Medicines and Healthcare products Regulatory Agency and (b) General Medical Council guidance.

The safest way to access medicines privately is to do so via a United Kingdom-registered prescriber and pharmacy, whether in-person or online. All UK prescribers, whether employed privately or by the National Health Service, are expected to take account of appropriate national guidance, and are regulated by UK regulators. Using UK-registered pharmacies also means that the medicines received will meet UK standards of safety and efficacy. The Medicines and Healthcare Products Regulatory Agency (MHRA) has reminded prescribers to explain the possible side effects of these medicines, and the risks around falsified products.Any UK prescriber operating in a private capacity must be a healthcare professional who is regulated by a professional regulator such as the General Medical Council (GMC) for doctors, or the General Pharmaceutical Council or Pharmaceutical Society of Northern Ireland, for pharmacists.When prescribing, doctors are expected to follow the GMC’s Good practice in proposing, prescribing, providing and managing medicines and devices, which refers to guidance from the MHRA. The General Pharmaceutical Council has strengthened safeguards for online pharmacies, including the need for extra checks to verify eligibility for obesity medicines. Guidance for registered pharmacies providing pharmacy services at a distance, including on the internet, is available at the following link:https://assets.pharmacyregulation.org/files/2025-02/gphc-guidance-registered-pharmacies-providing-pharmacy-services-distance-february-2025.pdf The Care Quality Commission (CQC) is the independent regulator of health and social care providers in England. Private online clinics that prescribe weight loss medicines need to register with the CQC for the regulated activity of Treatment of Disease, Disorder or Injury as set out by the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014.The CQC can take regulatory or enforcement action where they find fundamental standards have been breached.

Pursuant to the Answer of 21 July 2025 to Question 67568 on Obesity: Drugs, what steps he is taking to ensure that patients accessing weight loss medications through private online platforms undergo appropriate clinical assessments and safeguarding procedures.

Prescribers, whether National Health Service or private, are accountable for their prescribing decisions, and are expected to take account of appropriate national guidance.In addition to the duty of the prescriber, patients themselves must be honest when providing information to an online prescriber so that they receive advice and medicines which are appropriate for them and so that risks can be managed. Prescribers need full information to be able to prescribe safely.In February 2025, the General Pharmaceutical Council published updated guidance for online pharmacies. Prescribers are expected to verify the information given to them by the patient to ensure any medicines prescribed are appropriate, for example, through a video consultation, using a patient’s clinical record, or contacting the patient’s general practice. This helps to safeguard vulnerable patients, including minors.

What steps his Department is taking to help support people who have been newly diagnosed with (a) blindness and (b) severe visual impairment in Fylde.

When someone is newly diagnosed as sight impaired or severely sight impaired, they become eligible for a Certificate of Visual Impairment (CVI). This can act as referral route to local authorities who, under the Care Act 2014 and Care and Support (Assessment) Regulations 2014, are responsible for ensuring that people with visual impairments in their area access the right care and support. Where individuals do not meet the eligibility threshold, they can get support from their local authorities in making their own arrangements for care services, as set out in the Care Act 2014. In addition, under the Equality Act (2010), local authorities must make reasonable adjustments to ensure that disabled people are not disadvantaged.We are taking steps to update the process by which individuals receive their CVI form, to improve the signposting of patients newly certified as sight impaired or severe sight impaired to local sight loss charities for additional support.

What steps he is taking to increase access to care in the community in (a) Fylde constituency and (b) Lancashire.

As part of the 10-Year Health Plan, the Government is committed to building a Neighbourhood Health Service that will embody our new preventative principle that care should happen as locally as it can, digitally by default, in a patient’s home if possible, in the community when needed, and only in a hospital if necessary.Neighbourhood Health Services will bring together teams of professionals closer to people’s homes, including nurses, doctors, social care workers, pharmacists, health visitors, and more, to work together to provide comprehensive care in the community.In addition, over the course of the plan, our aim is to have one Neighbourhood Health Centre in each community that brings together National Health Service, local authority, and voluntary sector services in one building, to help create a holistic offer that meets the needs of local populations.Moreover, in the future, there will also be neighbourhood health plans drawn up by local government, the NHS, and its partners. The integrated care board will bring together these plans into a population health improvement plan for their footprint, which they will use to inform commissioning decisions.We will transform access to primary and community care services, including general practice, NHS dentistry, and community pharmacy, and provide more urgent care and outpatient appointments in the community, to ensure better value for money and to reduce unnecessary attendances and stays in hospital.

What guidance his Department provides to the public and healthcare providers on the treatment and prevention of horsefly bites.

The National Health Service provides advice on insect bites, including those from horseflies, which can be found at the following link:https://www.nhs.uk/conditions/insect-bites-and-stings/

What steps he is taking to ensure that NHS podiatry services are adequately resourced in Fylde constituency.

Integrated care boards (ICBs) are responsible for commissioning the majority of health and care services, including podiatry services, in England. ICBs arrange healthcare services to meet the needs of their local population, within available resources, and reduce inequalities in access to, and outcomes from, healthcare services.The Lancashire and South Cumbria ICB recognises podiatry services as a vulnerable and vital service where challenges, including recruitment and retention, are reflected nationally. In response to this, it has mobilised a centralised system-wide approach looking at the range of services it provides across its integrated care system. This includes baseline review work for services, which includes the Fylde Coast services. The next steps include validating demand capacity data with provider organisations in order to support future service models that support access for our residents.

What assessment his Department has made of the adequacy of regulation of private online providers offering weight loss medications.

The Department has currently made no assessment of the adequacy of the regulation of private online providers offering weight loss medications.

What steps he is taking to help reduce waiting times for patients eligible for NHS-prescribed weight loss medications.

The medicines liraglutide, under various brand names, semaglutide, brand name Wegovy, and tirzepatide, brand name Mounjaro, are already being made available for managing obesity for some patients attending National Health Service specialist weight management services, depending on factors like local pathways and clinical eligibility. From 23 June, the newest obesity medicine, tirzepatide, started to become available in primary care, meaning it can be prescribed by general practitioners, or other competent prescribers. Approximately 220,000 people could receive tirzepatide over the first three years of NHS rollout. Access will be prioritised based on clinical need. To support equitable access across the NHS in England and to help integrated care boards (ICBs) to fulfil their duty to make the medication tirzepatide available to eligible patients for treating obesity, NHS England has provided funding to ICBs, based on each area’s estimated population of people living with obesity. It has also provided guidance to ICBs and is continuing to work with them to implement the phased rollout of tirzepatide, as well as other weight loss medications where appropriate. The National Institute of Health and Care Excellence will review progress at three years. Rollout will be sped up if possible, and the NHS is developing and testing new models of care to support this. As we set out in our 10-Year Health Plan, we are committed to expanding access to weight loss medications through the NHS to ensure that people are able to access them based on clinical need, rather than ability to pay. We will build on the current plans by establishing pioneering relationships with industry and local health systems to test further innovative models of delivering weight loss services and treatments to patients effectively and safely. Additionally, we will explore a range of innovative commercial models that aim to increase patient access, whilst ensuring improved health outcomes and value for money.

What steps his Department is taking to support research into antimicrobial resistance in relation to sepsis treatment.

The Department funds research through the National Institute for Health and Care Research (NIHR). Over the past five years, the NIHR has allocated over £6 million in programme funding to support research into antimicrobial resistance in relation to sepsis treatment. The funded research studies multiple aspects of sepsis treatment, including optimising treatment for sepsis and investigating the impact of antibiotics in patients with sepsis.The Department also funds sepsis research through investment in NIHR infrastructure. For example, NIHR Biomedical Research Centres (BRCs) support translational research, to move scientific discoveries toward patient benefit. The NIHR Sheffield BRC is conducting research to better understand how different blood components contribute to the development of sepsis, to improve patient outcomes and identify potential targets for new sepsis treatments.The NIHR welcomes funding applications for research into any aspect of human health and care, including into antimicrobial resistance in relation to sepsis treatment. 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. The NIHR supports translational and applied research, working closely with the life sciences industry, medical research charities, and UK Research and Innovation.