Written questions by Midgley.

What assessment he has made of the potential merits of introducing a targeted national screening programme for prostate cancer for men identified as high risk.

The Government is guided by the independent scientific advice of the UK National Screening Committee (UK NSC). It is only where the offer to screen provides more good than harm that a screening programme is recommended. The UK NSC makes its recommendations based on internationally recognised criteria and a rigorous evidence review and consultation process. The UK NSC is currently considering the responses to a public consultation on their draft recommendation to:- offer a targeted national prostate cancer screening programme to men with confirmed BRCA1/2 gene variants every two years, from the age 45 years old to age 61 years old;- not recommend population screening;- not recommend targeted screening of black men;- not recommend targeted screening of men with family history; and- collaborate with the Transform trial team to answer outstanding questions on screening effectiveness for black men and men with a family history, as soon as trial data becomes available, and await the results of the study to develop and trial a more accurate test than the prostate specific antigen test alone, to improve the balance of the benefits and harms of screening.The evidence that supports this recommendation can be found on the following link:https://nationalscreening.blog.gov.uk/The modelling used to arrive at the recommendation included cost benefit analysis.

Whether his Department has conducted a cost-benefit analysis of offering routine prostate-specific antigen testing to high-risk groups.

The Government is guided by the independent scientific advice of the UK National Screening Committee (UK NSC). It is only where the offer to screen provides more good than harm that a screening programme is recommended. The UK NSC makes its recommendations based on internationally recognised criteria and a rigorous evidence review and consultation process. The UK NSC is currently considering the responses to a public consultation on their draft recommendation to:- offer a targeted national prostate cancer screening programme to men with confirmed BRCA1/2 gene variants every two years, from the age 45 years old to age 61 years old;- not recommend population screening;- not recommend targeted screening of black men;- not recommend targeted screening of men with family history; and- collaborate with the Transform trial team to answer outstanding questions on screening effectiveness for black men and men with a family history, as soon as trial data becomes available, and await the results of the study to develop and trial a more accurate test than the prostate specific antigen test alone, to improve the balance of the benefits and harms of screening.The evidence that supports this recommendation can be found on the following link:https://nationalscreening.blog.gov.uk/The modelling used to arrive at the recommendation included cost benefit analysis.

What estimate his Department has made of the cost of epilepsy to (a) the NHS and (b) the wider economy; and how this estimate informs decisions on funding for epilepsy research.

While the Government has not made a formal estimate of the cost of epilepsy to the National Health Service and the wider economy, we are aware of a report published by Economist Impact in February 2024, titled, The value of action: mitigating the impact of neurological disorders in the United Kingdom, which estimated that idiopathic epilepsy cost the economy £1.7 billion or 0.07% of gross domestic product in 2019. This report is available at the following link:https://impact.economist.com/health/value-action-mitigating-impact-neurological-disorders-united-kingdomThe Department funds research into epilepsy via the National Institute for Health and Care Research (NIHR). Between 2020/21 and 2024/25, the NIHR invested £12.8 million in direct research funding on epilepsy.The NIHR welcomes funding applications for research into any aspect of human health and care, including epilepsy. 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. Welcoming applications on epilepsy to all NIHR programmes enables maximum flexibility both in terms of the amount of research funding a particular area can be awarded, and the type of research which can be funded.

What assessment he has made of the adequacy of his Department's funding for epilepsy research.

The Department funds research into epilepsy via the National Institute for Health and Care Research (NIHR). Between 2020/21 and 2024/25, the NIHR invested £12.8 million in direct research funding on epilepsy. This investment in epilepsy research allows us to continue developing our understanding of the condition and make a real difference to people living with epilepsy, as demonstrated by the examples of impact outlined below.In 2022, the NIHR-hosted James Lind Alliance (JLA) carried out a UK Epilepsy Priority Setting Partnership (PSP), funded and convened by the Epilepsy Research Centre, with epilepsy patients, carers, and service providers to identify the most pressing research priorities for ongoing epilepsy research investment. Many NIHR-funded research projects align to and address the priorities set out by the JLA PSP, boosting epilepsy research. These include:the Ultra Long-Term EEG to Guide Rapid Treatment Changes for People with Epilepsy (LEG-RTC) study, which that is studying how the first ever ultra-long term seizure recorder could help improve outcomes and reduce risk of harm for patients with epilepsy whose condition cannot be controlled by medication, with further information available at the following link: https://www.fundingawards.nihr.ac.uk/award/NIHR209057;the Medicinal Cannabis in Refractory Epilepsies study, which aims to explore whether two different cannabis-based medicines are a useful treatment for refractory epilepsy in reducing seizures, and whether these medicines impact learning, sleep, behavior, quality of life, stress, and anxiety, with further information available at the following link: https://www.fundingawards.nihr.ac.uk/award/NIHR131309; andthe Developing a wireless intracranial neuromonitoring device for drug-resistant epilepsy study, to develop a wireless neuromonitoring device for drug-resistant epilepsy, aiming to create a minimally invasive, implantable device which allows for extended monitoring of seizures without the need for patients to remain in hospital leading to less patient distress, better localization data, reduced clinical costs, and better surgical outcomes. Further information is available at the following link: https://fundingawards.nihr.ac.uk/award/NIHR204209.Other examples of NIHR-funded epilepsy research and impact include:the Epilepsy: what are the chances of having a second seizure? study, where, in 2023, NIHR-funded researchers found that an individual’s risk of having a second seizure after an initial unprovoked seizure was highest in the first six months, although the risk remained elevated for two years and beyond, providing critical insights for doctors counselling their patients on repeat seizure risks. Many studies in this review had a follow-up period of less than two years. This review therefore highlights the need for further research which can estimate the risk of seizure recurrence beyond two years. Further information is available at the following link: https://evidence.nihr.ac.uk/alert/epilepsy-what-are-the-chances-of-having-a-second-seizure/; andthe How can we support the mental health of children with epilepsy? study, which evaluated the remotely delivered Mental Health Intervention for Children with Epilepsy (MICE), delivered by epilepsy clinicians with limited formal training in psychological interventions. Compared with usual care, when clinicians used the intervention, young people with epilepsy and their carers had improved mental health. The evidence from this research suggests that a variety of clinicians can effectively and safely treat children with epilepsy and mental health difficulties. The remote delivery of MICE was beneficial in terms of less travel time and less time out of school for children. Further information is available at the following link: https://evidence.nihr.ac.uk/alert/how-can-we-support-the-mental-health-of-children-with-epilepsy/.The 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 includes the Medical Research Council, to fund research into epilepsy to improve treatments and prevent poor health outcomes for patients.The NIHR welcomes funding applications for research into any aspect of human health and care, including epilepsy. 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. Welcoming applications on epilepsy to all NIHR programmes enables maximum flexibility both in terms of amount of research funding a particular area can be awarded, and the type of research which can be funded.

What plans his Department has to publish a national strategy for palliative and end of life care.

The Government is developing a Palliative Care and End of Life Care Modern Service Framework (MSF) for England.The MSF will drive improvements in the services that patients and their families receive at the end of life and will enable integrated care boards to address challenges in access, quality, and sustainability through the delivery of high-quality, personalised care. This will be aligned with the ambitions set out in the recently published 10-Year Health Plan.Further information about the MSF is set out in the Written Ministerial Statement HCWS1087, which I gave on 24 November 2025.

What steps his Department is taking to ensure the NHS is appropriately prepared for winter flu-related admissions in 2025 and early 2026.

We have started earlier and done more than ever to prepare for winter this year. We continue to monitor the impact of winter pressures on the National Health Service over the winter months, providing additional support to services across the country as needed.The Department is continuing to take key steps to ensure the health service is prepared throughout the colder months. This includes taking actions to try and reduce demand pressure on accident and emergency departments, increasing vaccination rates, and offering health checks to the most vulnerable, as well as stress-testing integrated care board and trust winter plans to ensure they are able to meet demand and ensure patient flow.Flu is a recurring pressure that the NHS faces every winter. There is particular risk of severe illness for older people, the very young, pregnant people, and those with certain underlying health conditions. The flu vaccine remains the best form of defense against influenza, particularly for the most vulnerable, and continues to be highly effective at preventing severe disease and hospitalisation.  This year we have:expanded the use of the National Booking Service for flu vaccination;carried out a major campaign aimed at eligible people, encouraging them to take up their vaccinations; anddeveloped the “flu walk-in finder” so that, from October 2025, patients can easily look up when they can walk into a community pharmacy to get a vaccination.

What measures are in place to reduce pressure on the NHS from flu-related hospital admissions this winter.

We have started earlier and done more than ever to prepare for winter this year. We continue to monitor the impact of winter pressures on the National Health Service over the winter months, providing additional support to services across the country as needed.The Department is continuing to take key steps to ensure the health service is prepared throughout the colder months. This includes taking actions to try and reduce demand pressure on accident and emergency departments, increasing vaccination rates, and offering health checks to the most vulnerable, as well as stress-testing integrated care board and trust winter plans to ensure they are able to meet demand and ensure patient flow.Flu is a recurring pressure that the NHS faces every winter. There is particular risk of severe illness for older people, the very young, pregnant people, and those with certain underlying health conditions. The flu vaccine remains the best form of defense against influenza, particularly for the most vulnerable, and continues to be highly effective at preventing severe disease and hospitalisation.  This year we have:expanded the use of the National Booking Service for flu vaccination;carried out a major campaign aimed at eligible people, encouraging them to take up their vaccinations; anddeveloped the “flu walk-in finder” so that, from October 2025, patients can easily look up when they can walk into a community pharmacy to get a vaccination.

What plans his Department has made to ensure sufficient NHS staffing and resources during the 2025–26 flu season.

Decisions about recruitment and resourcing are a matter for individual National Health Service employers, who manage this at a local level to ensure they have the staff they need to deliver safe and effective care. We continue to monitor the impact of winter pressures on the NHS over the winter months, providing additional support as needed.The Department is continuing to take key steps to ensure the health service is prepared throughout the colder months. This includes taking actions to try and reduce demand pressure on accident and emergency departments, increasing vaccination rates and offering health checks to the most vulnerable, as well as stress-testing integrated care board and trust winter plans to ensure they are able to meet demand and ensure patient flow. The Government is committed to publishing a 10 Year Workforce Plan to set out action to create a workforce ready to deliver the transformed service set out in the 10-Year Health Plan. The 10 Year Workforce Plan will ensure the NHS has the right people in the right places, with the right skills to care for patients, when they need it.

If he will bring forward the removal of requirements for same-sex female couples to self-fund intrauterine insemination cycles before becoming eligible for NHS-funded IVF treatment.

The Government recognises that fertility treatment across the National Health Service in England is subject to variation in access. Work continues between the Department and NHS England to better understand the offer around NHS-funded fertility services including the issue for female same sex couples.Funding decisions for health services in England are made by integrated care boards (ICBs) and are based on the clinical needs of their populations. We expect ICBs to commission fertility services in line with National Institute for Health and Care Excellence (NICE) guidelines, which are currently under review and will take into consideration whether the current recommendations for access to fertility guidelines are still appropriate.In the light of broader pressures on the NHS and on ongoing changes within NHS England we have been looking at achievable ambitions to improve access to fertility services and fairness for all affected couples.The Government is committed to prioritising women’s health as we build an NHS fit for the future. Through our 10 Year Health Plan, we are delivering our manifesto commitment that never again will women’s health be neglected.

What his planned timetable is for (a) removing financial barriers for same-sex couples accessing fertility treatments on the NHS and (b) full implementation of the Women’s Health Strategy.

The Government recognises that fertility treatment across the National Health Service in England is subject to variation in access. Work continues between the Department and NHS England to better understand the offer around NHS-funded fertility services including the issue for female same sex couples.Funding decisions for health services in England are made by integrated care boards (ICBs) and are based on the clinical needs of their populations. We expect ICBs to commission fertility services in line with National Institute for Health and Care Excellence (NICE) guidelines, which are currently under review and will take into consideration whether the current recommendations for access to fertility guidelines are still appropriate.In the light of broader pressures on the NHS and on ongoing changes within NHS England we have been looking at achievable ambitions to improve access to fertility services and fairness for all affected couples.The Government is committed to prioritising women’s health as we build an NHS fit for the future. Through our 10 Year Health Plan, we are delivering our manifesto commitment that never again will women’s health be neglected.

Whether the UK Health Security Agency has undertaken any recent analysis of the incidence of invasive meningococcal disease in age groups currently not eligible for NHS vaccination; and if he will publish that analysis.

The United Kingdom’s world‑leading vaccination programmes against invasive meningococcal disease have resulted in substantial declines in incidence across all age groups since the introduction of the first meningococcal group C (MenC) vaccine in 1999.The UK Health Security Agency (UKHSA) undertakes continuous, real‑time surveillance of invasive meningococcal disease in England, covering all age groups, which includes those not currently eligible for NHS vaccination. Summary data are routinely published in the UKHSA Health Protection Report, with further analyses appearing in peer‑reviewed journals.The Joint Committee on Vaccination and Immunisation (JCVI) keeps all immunisation programmes under regular review. The most recent data for the 2023 to 2024 epidemiological year (July 2023 to June 2024) are available at the following link: https://www.gov.uk/government/publications/meningococcal-disease-laboratory-confirmed-cases-in-england-2023-to-2024. Quarterly data for the first three quarters of the 2024 to 2025 epidemiological year are available at the following link: https://www.gov.uk/government/publications/meningococcal-disease-laboratory-confirmed-cases-in-england-2024-to-2025.

If he will consider extending NHS provision of the (a) Meningitis ACWY and (b) Bexsero vaccines to those who are currently ineligible under the national immunisation programme.

The Government relies on expert advice from the Joint Committee on Vaccination and Immunisation (JCVI) when making decisions about which vaccines are offered through the NHS.The JCVI has advised that extending the Meningitis ACWY vaccine to infants or toddlers is unlikely to be cost-effective, as very few cases would be prevented thanks to the success of the current adolescent programme.For the Bexsero (MenB) vaccine, the JCVI has found that while it has reduced disease in infants, it does not stop the spread of the bacteria among teenagers. As a result, offering it to adolescents is also unlikely to be cost-effective at this time.

What recent assessment his Department has made of the adequacy of the eligibility criteria for NHS provision of the Bexsero vaccine for Meningitis B; and whether the Joint Committee on Vaccination and Immunisation has considered expanding access to additional age groups since its 2016 review.

The Joint Committee on Vaccination and Immunisation (JCVI) most recently considered meningococcal B (MenB) vaccination in June 2024 and February 2025. Over the past decade, the number of cases of invasive meningococcal disease in infants has fallen significantly, largely due to the success of the MenB vaccination programme.The JCVI advised that MenB vaccination should continue to be offered to infants, and that the second dose should be given at 12 weeks of age to provide earlier protection from the full course.The JCVI has also reviewed the potential for an adolescent MenB vaccination programme. Evidence shows that MenB vaccines do not prevent adolescents from carrying the bacteria that cause the disease, meaning such a programme is highly unlikely to be cost-effective.

What steps he is taking to ensure that all Integrated Care Boards provide equal access to fertility treatments across England.

The Government recognises that fertility treatment across the National Health Service in England is subject to variation in access. Work continues between the Department and NHS England to better understand the offer around NHS-funded fertility services including the issue for female same sex couples.Funding decisions for health services in England are made by integrated care boards (ICBs) and are based on the clinical needs of their populations. We expect ICBs to commission fertility services in line with National Institute for Health and Care Excellence (NICE) guidelines, which are currently under review and will take into consideration whether the current recommendations for access to fertility guidelines are still appropriate.In the light of broader pressures on the NHS and on ongoing changes within NHS England we have been looking at achievable ambitions to improve access to fertility services and fairness for all affected couples.The Government is committed to prioritising women’s health as we build an NHS fit for the future. Through our 10 Year Health Plan, we are delivering our manifesto commitment that never again will women’s health be neglected.

What steps his Department is taking to help support people living with rheumatoid arthritis.

Services for those with musculoskeletal (MSK) conditions, including arthritis, are commissioned locally by integrated care boards (ICBs). The Department expects MSK services to be fully incorporated into integrated care system planning and decision-making. As announced in the Get Britain Working white paper, we are delivering the joint Department for Work and Pensions, Department of Health and Social Care, and NHS England Getting It Right First-Time (GIRFT) MSK Community Delivery Programme. Launched in December 2024, with 17 ICBs selected in the first cohort, GIRFT teams have deployed their proven Further Faster model to work with ICB leaders to reduce MSK community waiting times, including for those with arthritis, and improve data, metrics, and referral pathways to wider support services. The GIRFT programme is continuing to develop the approach to better enable integrated care systems to commission the delivery of high-quality MSK services in the community, which will benefit patients now and into the future. To support health and care professionals in the early diagnosis and management of rheumatoid arthritis, the National Institute for Health and Care Excellence has published expert guidance for rheumatoid arthritis, which is available at the following link: https://www.nice.org.uk/guidance/ng100

If he will take steps to increase the number of specialist rheumatology nurses in the workforce.

The training of nurses is the responsibility of the health care independent statutory regulatory body, the Nursing and Midwifery Council (NMC). It has the general function of promoting high standards of education and coordinating all stages of education to ensure that nursing students and newly qualified nurses are equipped with the knowledge, skills, and attitudes essential for professional practice.The training curricula for postgraduate training for nurses to specialise as a specialist rheumatology nurse is set by the Royal College of Nursing, and has to meet the standards set by the NMC.We will publish a new workforce plan to deliver the transformed health service we will build over the next decade, and 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.

What steps his Department is taking to improve (a) diagnosis times and (b) access to care for people with inflammatory arthritis.

Services for those with musculoskeletal (MSK) conditions, including arthritis, are commissioned locally by integrated care boards (ICBs). The Department expects MSK services to be fully incorporated into integrated care system planning and decision-making. As announced in the Get Britain Working white paper, we are delivering the joint Department for Work and Pensions, Department of Health and Social Care, and NHS England Getting It Right First-Time (GIRFT) MSK Community Delivery Programme. Launched in December 2024, with 17 ICBs selected in the first cohort, GIRFT teams have deployed their proven Further Faster model to work with ICB leaders to reduce MSK community waiting times, including for those with arthritis, and improve data, metrics, and referral pathways to wider support services. The GIRFT programme is continuing to develop the approach to better enable integrated care systems to commission the delivery of high-quality MSK services in the community, which will benefit patients now and into the future. To support health and care professionals in the early diagnosis and management of rheumatoid arthritis, the National Institute for Health and Care Excellence has published expert guidance for rheumatoid arthritis, which is available at the following link: https://www.nice.org.uk/guidance/ng100

What recent steps his Department has taken to help support people affected by Primodos in Knowsley constituency.

While the Government is sympathetic to the families who believe that they have suffered because of using Hormone Pregnancy Tests, the currently available scientific evidence does not support a causal association between the use of Hormone Pregnancy Tests during early pregnancy and adverse pregnancy outcomes.The Medicines and Healthcare Products Regulatory Agency has committed, together with the wider Government, to review any new scientific evidence which comes to light since the conclusions of the 2017 independent Expert Working Group convened by the Commission on Human Medicines.

When the Medicines and Healthcare products Regulatory Agency will complete its consideration of the recommendations of the Commission on Human Medicines on the findings of the Danielsson et al on primodos.

The Medicines and Healthcare products Regulatory Agency (MHRA), together with wider Government, has committed to reviewing any new scientific evidence which comes to light.The new publication by Danielsson et al has been reviewed by the MHRA, and advice has been sought from the Government’s independent advisory body, the Commission on Human Medicines (CHM), who have provided their independent expert advice on our assessment of whether the findings of the latest publication justify a further review. The MHRA will consider the recommendations given by the CHM before deciding whether any further action is warranted.The minutes of the November CHM meeting will be made publicly available through the GOV.UK website at the earliest opportunity.

How much funding his Department had allocated to the National Cancer Plan.

The Department has not made a specific funding allocation for preparing the National Cancer Plan. Further funding for cancer services will be considered as part of the upcoming spending review.The National Cancer Plan will have patients at its heart and will cover the entirety of the cancer pathway, from referral and diagnosis to treatment and aftercare. It will seek to improve every aspect of cancer care to improve the experience and outcomes for people with cancer, including anyone with secondary and metastatic cancer. Our goal is to reduce the number of lives lost to cancer over the next ten years. On 4 February 2025, we launched a Call for Evidence, in which the views of people across the country will inform our plan to improve cancer care. Those who wish to share their views can do so on the new online platform. Further information is available at the following link:https://www.gov.uk/government/calls-for-evidence/shaping-the-national-cancer-plan