Written questions by MacDonald.

For what reason planning for a specialised service for very severe ME/CFS has been paused until April 2027.

The action within July 2025’s final delivery plan on myalgic encephalomyelitis, also known as chronic fatigue syndrome (ME/CFS), to consider whether a specialised service should be prescribed by my Rt Hon. Friend, the Secretary of State for Health and Social Care, for very severe ME/CFS has been delayed until April 2027.Officials in the Department and NHS England are currently considering, alongside ME/CFS stakeholders, interim measures to support patients with very severe ME/CFS.

What clinical monitoring arrangements are in place for Palestine Action activists on hunger strike; and whether hospital care will be provided if medically advised.

Healthcare services in the prison estate are commissioned by NHS England. All prison healthcare providers are commissioned and contracted to use National Institute for Health and Care Excellence guidelines and have pathways of care in place for people refusing food and/or fluid. If a person requires hospital care this will also be available and facilitated.

What steps his Department is taking to ensure that gambling harm prevention campaigns reach rural and remote communities.

The introduction of the new statutory levy on gambling operators, which came into effect in April 2025, guarantees sustainable funding for the research, prevention, and treatment of gambling-related harms which is entirely independent of the influence of the gambling industry.The Office for Health Improvement and Disparities (OHID), as the gambling harms prevention commissioner in England under the levy, acknowledges the role that public health and awareness-raising campaigns can play in preventing health harms, including harms associated with gambling.OHID is working at pace to develop its gambling harms prevention programme, working closely with the gambling harms prevention commissioners in Scotland and Wales. OHID is considering the role of prevention campaigns in the future prevention programme at a national and Great Britain-wide level and will consider the reach of such activity across specific populations such as rural and remote communities. Further details will be confirmed before the end of this financial year.

What assessment he has made of trends in the level of geographical variation in access to community care equipment in (a) general, (b) rural areas and (c) remote areas.

Local authorities in England have a statutory duty under various pieces of legislation, including the Care Act 2014, to make arrangements for the provision of disability aids and community equipment, to meet the assessed eligible needs of individuals who are resident in their area. Responsibility for managing the market for these services, including commissioning and oversight of delivery, rests with local authorities.

How many doctors who completed foundation training (a) successfully secured a specialty training post immediately after completion, (b) remained without a specialty training post one year after completing foundation training and (c) have taken up medical employment abroad in each of the last five years.

Data published by the General Medical Council shows it is becoming more common for doctors to not progress from completion of the second year of the foundation programme directly into specialty training. The following table shows the proportion of foundation year two (F2) doctors who had progressed into speciality training within 12 months of completion of foundation training and the proportion who had not progressed into speciality training within 12 and 24 months of completing F2 for each of the last five years where data is available. Doctors not progressing are not necessarily leaving employment but more likely to enter periods of employment under locally employed doctor contracts or to undertake planned periods working in other settings or countries. Foundation Two YearIn speciality training within a yearNot in speciality training after a yearNot in speciality training after two years201837.5%62.5%33.1%201933.6%66.4%36.5%202030.7%69.3%40.5%202129.6%70.4%43.7%202224.9%75.1%47.7%202322.4%77.6% Source: General Medical Council, Education Data Tool Progression Reportshttps://edt.gmc-uk.org/progression-reports/recruitment-from-f2 The United Kingdom Foundation Programme Office, the body which operates and develops the UK medical foundation training programme has in some years run a Career Destination Survey for those completing F2.In 2024, 13.4% of respondents to the F2 Career Destinations Survey went abroad after completing their foundation programme (into training, service posts, or still seeking a post outside of UK), which is a higher proportion compared to 2019 (9.3%).It is important to note though when comparing these results that the F2 Career Destinations Survey was mandatory to the completion of the foundation year programme in the year 2019 leading a response-rate of 93.1%. In 2024, the F2 Career Destinations survey was not mandatory leading to a response rate of 18%.The Department is unable to provide information on the number of doctors who completed their training taking up medical employment abroad in the years 2020-2023 as the UK Foundation Programme’s F2 Career Destinations Survey was not run during this period.The 2024 F2 Career Destinations Survey report is available at the following link:https://foundationprogramme.nhs.uk/wp-content/uploads/sites/2/2025/06/UKFP-2024-F2-Career-Destination-Survey-Report.pdfThe 2019 F2 Career Destinations Survey report is available at the following link:https://foundationprogramme.nhs.uk/wp-content/uploads/sites/2/2024/04/F2%20CDS_2019.pdfAs set out in our 10-Year Health Plan, we will work across Government to prioritise UK medical graduates for foundation training, and to prioritise UK medical graduates and other doctors who have worked in the NHS for a significant period for specialty training. We will set out further details in due course.

What steps his Department is taking with devolved Administrations to help reduce waiting times from GP referral to first routine dermatology appointments.

It is unacceptable that patients across the United Kingdom continue to wait lengthy periods for treatment. Although health is a devolved matter, bringing down the elective waiting lists, including for dermatology, is a top priority across the four nations of the UK. We are working collaboratively with the devolved administrations to drive forward our objective of supporting people to lead more independent, healthier lives for longer.This includes special cross-border arrangements for patients who live on the English and Welsh border to make sure they receive healthcare without confusion or delay, and that patient data can be accessed by relevant professionals. We will continue to ensure these arrangements support high-quality care for patients in both England and Wales.We continue to work with colleagues across all the devolved administrations to share knowledge and insights into National Health Service data and performance across all specialities, including dermatology.

What discussions his Department has had with the Scottish Health Minister on the importance of early detection of testicular cancer in young people.

Policy for cancer care is a devolved matter in Scotland, and is therefore the responsibility of the Scottish administration.The Department is committed to getting the National Health Service diagnosing cancer earlier in England so that more patients survive, including young people. To achieve this, the NHS in England has delivered an extra 40,000 operations, scans, and appointments each week as the first step to ensuring early diagnosis and faster treatment.To support timely and effective referrals, the National Institute for Health and Care Excellence (NICE) has set out detailed guidance for general practitioners in England on the symptoms of cancer in children and young people aged zero to 24 years old, which recommends referral within 48 hours for those presenting with a range of potential cancer symptoms. Since its relaunch on 4 February 2025, the Children and Young People Cancer Taskforce for England has worked to identify tangible ways to improve outcomes and experiences for children and young people aged zero to 24 years old with cancer in England. The taskforce is exploring opportunities for improvement across genomic testing and treatment, research and innovation, patient experience, and early detection and diagnosis. Although the taskforce is England-only, and no formal discussions have taken place with Scotland or other countries, once the taskforce finalises its work, any recommendations for cross-border collaboration will be considered where appropriate.The forthcoming National Cancer Plan for England will include further details on improving outcomes for cancer patients, including young people with cancer, and will highlight how the Department will support the NHS to improve diagnosis rates for people in all parts of England.

What discussions his Department has had with the Scottish Health Minister on the importance of early detection of breast cancer in young people.

Policy for cancer care is a devolved matter in Scotland, and is therefore the responsibility of the Scottish administration.The Department is committed to getting the National Health Service diagnosing cancer earlier in England so that more patients survive, including young people. To achieve this, the NHS in England has delivered an extra 40,000 operations, scans, and appointments each week as the first step to ensuring early diagnosis and faster treatment.To support timely and effective referrals, the National Institute for Health and Care Excellence (NICE) has set out detailed guidance for general practitioners in England on the symptoms of cancer in children and young people aged zero to 24 years old, which recommends referral within 48 hours for those presenting with a range of potential cancer symptoms. Since its relaunch on 4 February 2025, the Children and Young People Cancer Taskforce for England has worked to identify tangible ways to improve outcomes and experiences for children and young people aged zero to 24 years old with cancer in England. The taskforce is exploring opportunities for improvement across genomic testing and treatment, research and innovation, patient experience, and early detection and diagnosis. Although the taskforce is England-only, and no formal discussions have taken place with Scotland or other countries, once the taskforce finalises its work, any recommendations for cross-border collaboration will be considered where appropriate.The forthcoming National Cancer Plan for England will include further details on improving outcomes for cancer patients, including young people with cancer, and will highlight how the Department will support the NHS to improve diagnosis rates for people in all parts of England.

What assessment he has made of the potential impact of the calorie labelling system in restaurants on people with avoidant restrictive food intake disorder.

Legislation requiring large businesses in England, with 250 or more employees, to display calorie information on non-prepacked food and soft drinks came into force in 2022.The Department continues to evaluate the impact of the Calorie Labelling (Out of Home Sector) Regulations and have commissioned studies through the National Institute for Health and Care Research, which includes an evaluation to understand the impact of the rules, including on people living with eating disorders.We will publish a post-implementation review within five years of implementation which will consider the effectiveness and impact of the policy, including on people living with eating disorders.

What assessment he has made of the potential impact of the calorie labelling system in restaurants on people with bulimia.

Legislation requiring large businesses in England, with 250 or more employees, to display calorie information on non-prepacked food and soft drinks came into force in 2022.The Department continues to evaluate the impact of the Calorie Labelling (Out of Home Sector) Regulations and have commissioned studies through the National Institute for Health and Care Research, which includes an evaluation to understand the impact of the rules, including on people living with eating disorders.We will publish a post-implementation review within five years of implementation which will consider the effectiveness and impact of the policy, including on people living with eating disorders.

What discussions his Department has had with the British Medical Association on medical students receiving less than two hours of teaching on eating disorders throughout their undergraduate training.

The Department has not had conversations with the British Medical Association about the amount of teaching on eating disorders in undergraduate medical training. The standard of training for doctors is the responsibility of the General Medical Council (GMC). The GMC sets the outcome standards expected at undergraduate level and approves courses and medical schools to write and teach the curricula content that enables their students to meet the GMC’s outcome standards.Since the 2024/25 academic year, medical students graduating from UK universities have been required to pass the Medical Licensing Assessment, for which the GMC has published a content map documenting the conditions which students are expected to have knowledge. This is available at the following link: https://www.gmc-uk.org/-/media/documents/mla-content-map-_pdf-85707770.pdf. Eating disorders are included in the content map.

What assessment he has made of the potential impact of the calorie labelling system in restaurants on people with anorexia.

Legislation requiring large businesses in England, with 250 or more employees, to display calorie information on non-prepacked food and soft drinks came into force in 2022.The Department continues to evaluate the impact of the Calorie Labelling (Out of Home Sector) Regulations and have commissioned studies through the National Institute for Health and Care Research, which includes an evaluation to understand the impact of the rules, including on people living with eating disorders.We will publish a post-implementation review within five years of implementation which will consider the effectiveness and impact of the policy, including on people living with eating disorders.

What assessment he has made of the potential impact of the calorie labelling system in restaurants on people with other specified feeding and eating disorder.

Legislation requiring large businesses in England, with 250 or more employees, to display calorie information on non-prepacked food and soft drinks came into force in 2022.The Department continues to evaluate the impact of the Calorie Labelling (Out of Home Sector) Regulations and have commissioned studies through the National Institute for Health and Care Research, which includes an evaluation to understand the impact of the rules, including on people living with eating disorders.We will publish a post-implementation review within five years of implementation which will consider the effectiveness and impact of the policy, including on people living with eating disorders.

Whether he has met with families who have lost relatives following missed diagnoses within the NHS.

NHS England places the utmost importance on optimising the performance of diagnostic services in support of improved patient outcomes. Integrated care boards and trusts are being supported to improve diagnostic performance, including through capital investment, with the aim to significantly shorten long waits for diagnostic tests, reducing the risk of avoidable harm while patients are waiting for them.Where evidence of patient harm emerges, NHS England has taken a proactive approach to addressing the lessons from any incidents and supporting providers to make the necessary changes. An example of this is NHS England’s response in addressing the systemic failings highlighted by the Parliamentary and Health Service Ombudsman’s report Unlocking Solutions in Imaging, published July 2021, and subsequent investigations by the Healthcare Safety Investigation Branch. In this case, NHS England formed a dedicated board to review the recommendations and oversee changes, which included:the publication of the Radiology lifecycle by the Royal College of Radiologists (RCR) in February 2025 outlining the roles and responsibilities of clinicians at each stage of the imaging journey, with further information available at the following link: https://www.rcr.ac.uk/media/4mnpxmhw/rcr-publications-radiology-lifecycle-guidance.pdf;the establishment of national standards for reporting turnaround times, published August 2023, with further information available at the following link: https://www.england.nhs.uk/long-read/diagnostic-imaging-reporting-turnaround-times/;the development of a culture of continuous learning through network and regional Radiology Events and Learning Meetings, or REALMS. The RCR launched an online learning hub, REAL online, in 2023, which is an interactive learning resource for radiologists. Further information is available at the following link: https://www.rcr.ac.uk/cpd-and-events/radiology-events-and-learning-real/; andinvestment in improvements in digital interoperability and connectivity through national capital to support faster, more reliable access to imaging data across the system.My Rt Hon. Friend, the Secretary of State for Health and Social Care often meets with families who have faced failings in their care whilst using the National Health Service. It is important to learn from the experiences of patients and families to improve care in the NHS and learn from any failings.

What recent assessment he has made of the adequacy of NHS diagnostic services in helping to prevent avoidable deaths.

NHS England places the utmost importance on optimising the performance of diagnostic services in support of improved patient outcomes. Integrated care boards and trusts are being supported to improve diagnostic performance, including through capital investment, with the aim to significantly shorten long waits for diagnostic tests, reducing the risk of avoidable harm while patients are waiting for them.Where evidence of patient harm emerges, NHS England has taken a proactive approach to addressing the lessons from any incidents and supporting providers to make the necessary changes. An example of this is NHS England’s response in addressing the systemic failings highlighted by the Parliamentary and Health Service Ombudsman’s report Unlocking Solutions in Imaging, published July 2021, and subsequent investigations by the Healthcare Safety Investigation Branch. In this case, NHS England formed a dedicated board to review the recommendations and oversee changes, which included:the publication of the Radiology lifecycle by the Royal College of Radiologists (RCR) in February 2025 outlining the roles and responsibilities of clinicians at each stage of the imaging journey, with further information available at the following link: https://www.rcr.ac.uk/media/4mnpxmhw/rcr-publications-radiology-lifecycle-guidance.pdf;the establishment of national standards for reporting turnaround times, published August 2023, with further information available at the following link: https://www.england.nhs.uk/long-read/diagnostic-imaging-reporting-turnaround-times/;the development of a culture of continuous learning through network and regional Radiology Events and Learning Meetings, or REALMS. The RCR launched an online learning hub, REAL online, in 2023, which is an interactive learning resource for radiologists. Further information is available at the following link: https://www.rcr.ac.uk/cpd-and-events/radiology-events-and-learning-real/; andinvestment in improvements in digital interoperability and connectivity through national capital to support faster, more reliable access to imaging data across the system.My Rt Hon. Friend, the Secretary of State for Health and Social Care often meets with families who have faced failings in their care whilst using the National Health Service. It is important to learn from the experiences of patients and families to improve care in the NHS and learn from any failings.

What assessment he has made of the potential merits of developing new NICE criteria for rare conditions that do not meet the 300 patient threshold for the Highly Specialised Technology appraisal system.

Decisions on whether medicines should be evaluated through the National Institute for Health and Care Excellence’s (NICE) highly specialised technologies (HST) programme are taken by NICE itself against a set of published criteria that have been developed through public and stakeholder engagement.NICE recently reviewed and consulted on updates to its HST criteria and the refined criteria have been implemented since April 2025. The purpose of the review was not to change the number or nature of the topics that are evaluated through the HST Programme, but to ensure that the criteria are sufficiently clear and predictable for companies and patient groups and are aligned to the HST vision.There are currently no plans for NICE to develop new criteria for conditions that do not meet the 300-patient threshold outlined in the current HST criteria. However, NICE’s standard medicines evaluation process has been proven to be suitable for the evaluation of rare disease medicines, where companies are willing to price their medicines fairly.NICE’s approval rate for medicines for rare diseases is in line with its overall approval rate for new medicines. Between April 2024 and April 2025, NICE recommended all 15 of the rare disease drugs that it evaluated through its standard technology appraisal programme, which are now available for the treatment of NHS patients.

What plans he has to improve healthcare provision for people with Friedreich’s Ataxia.

The Government is committed to improving the lives of those living with rare diseases, such as Friedreich’s ataxia. The UK Rare Diseases Framework sets out four priorities collaboratively developed with the rare disease community. These are: 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 Rare Diseases Action Plan in February 2025, where we reported on the steps we have taken to advance these priorities.NHS England has revised the national service specification for specialised neurology following extensive consultation. The service specification was published on 13 August 2025 and includes guidance on both specialised and core neurology services. The specification includes an Annex which provides greater clarity for neurology sub-specialties, including the categories of both movement disorders and neurogenetics into which Friedreich’s Ataxia would fall.Additionally, the national specialised commissioning neurology transformation programme has developed guidance as part of an integrated care system toolkit, specifically to support the implementation of the service specification. Every specialised neurology centre could and should see patients with Friedreich’s Ataxia.

What assessment he has made of the importance of (a) early intervention and (b) prevention before the cure in eating disorder treatment.

The Government recognises that the earlier that treatment is provided, the better the chance of short-term recovery. We are committed to ensuring that everyone with an eating disorder can access specialist help.As part of our mission to build an NHS fit for the future, there is a critical need to shift treatment of eating disorders from hospital to the community. NHS England is currently seeking to expand the capacity of children’s community eating disorder services, to allow for crisis care and intensive home treatment. Improved care in the community will give young people early access to evidence-based treatment involving families and carers, improving outcomes and preventing relapse. By preventing eating disorders from progressing to adulthood, we will build on our aim of raising the healthiest generation of children.Early intervention is a priority for adults with eating disorders too, as set out in NHS’s Adult Community Mental Health Framework. NHS England have established 15 Provider Collaboratives focusing on adult eating disorders. These Collaboratives are working to redesign care pathways, and focus resources on community services. By providing treatment earlier and closer to home, we will see better outcomes for adults with eating disorders and their families.

What discussions he has had with the Scottish Health Minister on the importance of focusing on early intervention in eating disorders in Scotland.

Close collaboration between the devolved governments is important and takes place on a regular basis. Although no recent specific discussions have taken place with the Scottish Health Minister on this topic, we acknowledge that specialist expertise and facilities are shared between the four nations to combat eating disorders.The Government recognises that the earlier that treatment is provided, the better the chance of short-term recovery, and is committed to ensuring that everyone with an eating disorder can access specialist help.

With reference to p.16 of the document entitled Fit for the future: 10 Year Health Plan for England, published on 3 July 2025, what progress his Department has made on the development of the business case for the proposed use of Public-Private Partnerships in Neighbourhood Health Centres.

As set out in the 10-Year Health Plan, the Department and the National Infrastructure and Service Transformation Authority are working on a business case for a public-private partnerships model around Neighbourhood Health Centres that sets out the potential and an assessment of the value for money so that a final decision on the approach can be taken by the time of the 2025 Budget.