Written questions by Snowden.

What assessment his Department has made of the potential impact of weight loss drugs on (a) public health outcomes, (b) obesity rates and (c) associated health conditions.

Obesity is estimated to cost the NHS £11.4 billion per year and wider society around £74.3 billion.The National Institute for Health and Care Excellence (NICE) is the independent body responsible for assessing the clinical and cost-effectiveness of new medicines and health technologies for the National Health Service in England. NICE uses a structured process, including the assessment of clinical and economic evidence and the use of quality-adjusted life years (QALYs), to determine if a new treatment offers good value for money. NICE takes into account all health-related costs and benefits, which may include public health outcomes and impacts on associated health conditions. These assessments allow NICE to make evidence-based recommendations on whether a medication should be routinely funded by the NHS. The newest obesity medicines, semaglutide (Wegovy®) and tirzepatide (Mounjaro®) have been assessed and recommended by the NICE as clinically and cost-effective treatment options on the NHS for obesity. They can provide an effective tool, when prescribed alongside diet, physical activity and behavioural support, to support some people living with obesity to lose weight. Clinical trials of Mounjaro® have found an average weight loss of approximately 20%. Weight loss is associated with significant improvements in both the management of existing conditions and the risk of developing weight related health conditions. Generally, greater weight loss is associated with more health benefits so obesity medicines could have a potential impact on a number of obesity associated health conditions such as diabetes, cardiovascular disease, obstructive sleep apnoea and non-alcoholic fatty liver disease, as well as on obesity rates.

What steps he is taking to (a) inform and (b) educate parents about the new chickenpox vaccine, and to tackle vaccine hesitancy.

On 29 August 2025, the Government announced plans to introduce chickenpox vaccination into the routine childhood immunisation schedule from 1 January 2026, using the MMRV vaccine which protects against measles, mumps, rubella and chickenpox (varicella).The launch of the chicken pox vaccination programme in January 2026 will see a press campaign with the UK Health Security Agency and NHS England working together to inform and educate through the use of low and no cost communications. This will continue throughout the year with key bursts of activity on all childhood vaccines.The Department will also launch a national childhood vaccination paid marketing campaign in February 2026 to encourage uptake of all childhood vaccinations for those aged 0-5 years and will include high impact advertising across video on demand, online video, radio, out of home posters and social media. This will be supported by partnerships across a range of sectors including retailers, nursery providers and charities. Activity will be upweighted to key low uptake communities and geographical areas across the country.Ahead of the launch, NHS England is hosting vaccine confidence sessions for health care workers to help them have vaccine conversations and address questions or concerns with parents and carers.Communications toolkits and assets will be issued to primary care teams across all regions to support the launch of the MMRV programme, which includes material for parents and carers on the new vaccination programme.

Whether he will make an assessment of the potential merits of (a) mobile or (b) school-based vaccination programmes as part of the catch-up campaign for chickenpox vaccination.

On 29 August 2025, the Government announced plans to introduce chickenpox (varicella) vaccination into the routine childhood immunisation schedule from 1 January 2026. Eligible children will receive a MMRV vaccine during routine GP appointments, which protects against measles, mumps, rubella and chickenpox.The eligibility criteria, including which age groups will receive the vaccine, will be announced ahead of the programme launch.In line with the NHS vaccination strategy, NHS England are driving excellence in operational delivery by ensuring a high-quality core vaccination offer to eligible cohorts.

If he will take steps to fund specific communications campaigns in (a) Lancashire and the (b) North West to (i) raise awareness of the chickenpox vaccine and (ii) address misinformation.

On 29 August 2025, the Government announced plans to introduce chickenpox vaccination into the routine childhood immunisation schedule from 1 January 2026, using the MMRV vaccine which protects against measles, mumps, rubella and chickenpox (varicella).The launch of the chickenpox vaccination programme in January 2026 will see a press campaign with the UK Health Security Agency and NHS England working together to inform and educate through the use of low and no cost communications. This will continue throughout the year with key bursts of activity on all childhood vaccines. The last national childhood vaccination campaign was elevated in the North West area, with outdoor advertising up weighted in funding and exposure in the North West’s lowest uptake areas.The Department of Health and Social Care will also launch a national childhood vaccination paid marketing campaign in February 2026 to encourage uptake of all childhood vaccinations for those age 0-5 years and will include high impact advertising across video on demand, online video, radio, out of home posters and social media. This will be supported by partnerships across a range of sectors including retailers, nursery providers and charities. Activity will be upweighted to key low uptake communities and geographical areas across the country.Ahead of the launch, NHS England is hosting vaccine confidence sessions for health care workers to help them have vaccine conversations and address questions or concerns with parents and carers.Communications toolkits and assets will be issued to primary care teams across all regions to support the launch of the MMRV programme, which includes material for parents and carers on the new vaccination programme.

Whether he has made a comparative assessment of the cost to the NHS of procuring pharmaceutical drugs from suppliers based in the (a) USA, (b) UK and (c) EU.

NHS England has not made a comparative assessment of the cost to the NHS in England from procuring pharmaceutical drugs from suppliers based in other domains, including the EU and the USA, compared to from the UK.

Whether his Department has issued guidance to (a) schools and (b) colleges on the use of protein supplements by students engaged in sports programmes.

No specific guidance on the use of protein supplements has been issued to schools and colleges. However, the School Food Standards (SFS) are mandated to ensure that schools provide pupils with healthy food and drink options, enabling children to get the energy and nutrients they need across the school day. Protein supplements are not included under the SFS and so should not be provided by schools. Compliance with the SFS is mandatory for all maintained schools, academies and free schools, including sixth form colleges attached to secondary schools. Schools are encouraged to have a whole school approach to healthy eating, including local policies for food and drinks that can be brought onto the school site from home. School governing boards are responsible for setting their school food policies and ensuring compliance with the SFS. The National Diet and Nutrition Survey 2019 to 2023 reported that population level protein intakes exceed recommendations across all age and sex groups. As such, protein supplementation is largely unnecessary for the majority of the population, including children engaging in sports activities at school or college.

What steps he has taken to ensure post-market surveillance of NHS-provided weight loss drugs to monitor their long-term effects in patients.

The newest obesity medicines, liraglutide, under various brand names, semaglutide, under the brand name Wegovy, and tirzepatide, under the brand name Mounjaro, have only been licensed and recommended for use for the treatment of obesity over the last few years. We recognise the need to collect long-term data on both the effectiveness and side effects of these medicines. The Medicines and Healthcare products Regulatory Agency (MHRA) continually monitors the safety of medicines during their use, including weight loss medications. The MHRA has robust safety monitoring and surveillance systems in place for all healthcare products.For example, although semaglutide and some other GLP-1 treatments have been used in the treatment of diabetes for some-time, semaglutide, when used for weight management, as well as newer medicines like tirzepatide are subject to more intense monitoring by the MHRA as part of its Black Triangle scheme.The MHRA also strongly encourages patients and healthcare professionals to continue reporting suspected side effects to GLP-1 medicines through its Yellow Card Scheme, which collects reports of suspected adverse effects for all healthcare products. In addition, NHS England is working with the National Institute for Health and Care Excellence, the MHRA, and academic partners to collect real world evidence on the use of tirzepatide in National Health Services. This includes monitoring prescribing patterns, patient outcomes, and long-term safety signals through existing national datasets and local system level services.These measures ensure that the benefits and risks of using medicines for weight management are kept under ongoing review, and that appropriate action can be taken if safety concerns arise.

What steps he is taking to help improve access to (a) podiatry and (b) physiotherapy services for patients with plantar fasciitis.

Integrated care boards (ICBs) are responsible for commissioning services to meet the needs of their local populations, which includes the provision of physiotherapy and podiatry services for the management of plantar fasciitis.NHS England does not hold condition-specific data that would allow identification of access issues for patients with plantar fasciitis. However, aggregate data on community health services, including physiotherapy and podiatry, is available at the following link:https://www.england.nhs.uk/statistics/statistical-work-areas/community-health-services-waiting-lists/It is important to note that this data set does not include services delivered by acute providers. For information on waiting times for specific conditions, individual providers would need to be approached directly, although such data is unlikely to be routinely collected or reported at that level of detail.The Getting It Right First Time Musculoskeletal (MSK) Community Delivery Programme is funded by the Joint Department for Work and Pensions and Department of Health and Social Care Work and Health Directorate with a key objective being the reduction of waiting times for community MSK services. The programme is using a six-point plan, a handbook with case studies, and regular meetings with senior ICB officials to support 17 systems in the reduction of their waiting times. This programme is currently being evaluated with the aim of sharing lessons across the National Health Service.

What steps he is taking with international regulatory bodies to harmonise the regulation of weight loss drugs.

The Medicines and Healthcare products Regulatory Agency (MHRA) is an executive agency of the Department of Health and Social Care and regulates medicine, medical devices and blood components for transfusion in the UK. The MHRA is responsible for ensuring medicines meet appropriate standards of safety, quality, and efficacy.Weight loss medicines, like all medicines, are regulated nationally, but global harmonisation happens through bodies like the International Committee for Harmonisation (ICH), which the MHRA is a full member of.The ICH guidelines include common standards for safety, efficacy, and quality. In addition, the World Health Organisation provides international norms.Differences remain in how countries balance risks and benefits, meaning access and approval of weight loss medications can still vary worldwide. This is so that each approval matches the pathway of care in their country.To support our post-marketing signal monitoring processes, the MHRA contributes to the International Post-Market Surveillance (IPMS) teleconference between the regulatory authorities in the US, Canada, Australia, New Zealand, Switzerland and Singapore. Each authority provides topics to discuss, and share information, which has on occasion included safety topics relating to weight loss medications.

What estimate he has made of the number of NHS facilities using outdated radiator systems; and what plans he has to replace them with more efficient alternatives.

The Department has not made a specific assessment of the number of National Health Service facilities using outdated radiator systems. However, we continue to support efforts to modernise the secondary care estate and to address maintenance issues, including through investment in trust heating and energy systems. The Government’s recently published 10 Year Infrastructure Strategy set out ten-year maintenance budgets for the public estate, confirming £6 billion per year for maintenance and repair of the NHS estate up to 2034/35. In 2025/26, this includes a £750 million Estates Safety Fund which will deliver vital safety improvements, enhance patient and staff environments, and reduce disruptions to NHS clinical services, as well as over £4 billion in operational capital to be allocated to local needs. In addition, the Department for Energy Security and Net Zero has invested over £1 billion on NHS decarbonisation energy projects through the Public Sector Decarbonisation Scheme since 2019.

Whether his Department holds data on instances where the cost of drugs sourced from American pharmaceutical companies has significantly increased in the last five years; and what steps he is taking to mitigate the impact of such increases on NHS budgets.

NHS England do not record or hold data related to the medicines purchased by the NHS categorised by base of the parent company of the supplier.

What discussions he has had with the Secretary of State for Education on the ability of universities to deliver healthcare and medical training courses in the context of declining revenues.

The Department for Health and Social Care works closely with the Department for Education (DfE) on a wide range of matters, including healthcare education and training funding. Matters relating to the income of universities are the responsibility of DfE.Latest figures from the Universities and Colleges Admissions Service (UCAS) for 2025 show that acceptances to undergraduate nursing and midwifery courses at English providers have increased by 2% when compared to the same point last year, and by 5% compared to pre-pandemic numbers in 2019. These are not final numbers. The UCAS Clearing cycle closes in October.

What estimate his Department has made of the potential savings to the public purse following the introduction of the chickenpox vaccine programme.

The chickenpox vaccination programme is considered cost-effective and is expected to relieve pressures on health services that currently result from treating cases of chickenpox, saving the NHS an estimated £15 million a year in costs.The vaccination programme forms part of the Government’s wider ambition to raise the healthiest generation of children ever as part of our Plan for Change, boosting the nation’s health and ensuring the future sustainability of the NHS as we shift the focus of healthcare from treatment to prevention.

How the Medicines and Healthcare products Regulatory Agency plans to improve the (a) monitoring and (b) reporting of adverse effects related to weight loss drugs; and what systems are in place to ensure that (i) patients and (ii) healthcare providers can report those effects.

The Yellow Card scheme collects reports of suspected adverse effects for all healthcare products including weight loss drugs. Reporting is open to all healthcare professionals and members of the public through a variety of methods including online, via the Yellow Card app, phone, email and paper forms. To make reporting as quick and easy as possible, there is also direct integration of Yellow Card reporting functionality available within some clinical IT systems. This includes covering over 93% of GP practices across England.To improve the quality of information captured on a Yellow Card report for weight loss medicines, we have recently introduced a number of additional questions to support ongoing monitoring of the safety of these products and rapid identification of potential safety issues.Reporting to the scheme is voluntary and therefore requires sustained efforts to promote and raise awareness of the scheme. To promote the reporting of side effects, a call to report side effects is included in all communications for weight loss medicines. For example, the Medicine and Healthcare products Regulatory Agency (MHRA) guidance on GLP-1 medicines contains several links to the Yellow Card Scheme, as do the Drug Safety Updates for healthcare professionals that the MHRA have published relating to these medicines. Reporting has also been encouraged on press releases issued on the illegal sales of GLP-1s and posts on the MHRA social media platforms (X, Instagram and Facebook).Alongside data collected through the Yellow Card scheme, the MHRA also monitors for adverse events through a variety of other data sources including scientific literature, epidemiological studies, regulatory reports from other countries, and periodic safety data submitted by pharmaceutical companies. All safety concerns are evaluated by our multidisciplinary teams and expert advisory groups, and where necessary, regulatory action is taken.

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 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 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 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.

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.