Written questions by Johnson.

What assessment he has made of the potential of (a) vaping and (b) passive vaping on the risk of invasive meningococcal disease.

There is established evidence that exposure to tobacco smoke increases the risk of meningococcal disease. Tobacco smoking increases the risk of meningococcal carriage and meningococcal disease by damaging the nasopharyngeal mucosa and suppressing immune responses.Vaping could plausibly carry similar risks for carriage but the association with increased risk of disease is unknown.When either active or passive smoking occurs in an enclosed and intimate setting over a prolonged period, the risk of transmission is increased.The highest risk of transmission is associated with prolonged exposure to droplets of saliva.Where there has been repeated or prolonged salivary exposure in an enclosed and intimate venue such as a nightclub, the risk is higher.

What assessment he has made of the potential impact of (a) smoking and (b) passive smoking on the risk of invasive meningococcal disease.

There is established evidence that exposure to tobacco smoke increases the risk of meningococcal disease. Tobacco smoking increases the risk of meningococcal carriage and meningococcal disease by damaging the nasopharyngeal mucosa and suppressing immune responses.Vaping could plausibly carry similar risks for carriage but the association with increased risk of disease is unknown.When either active or passive smoking occurs in an enclosed and intimate setting over a prolonged period, the risk of transmission is increased.The highest risk of transmission is associated with prolonged exposure to droplets of saliva.Where there has been repeated or prolonged salivary exposure in an enclosed and intimate venue such as a nightclub, the risk is higher.

How many overseas prescriptions are dispensed in a) the UK and b) England i) in total, ii) by medicines dispensed and iii) by origin country.

The United Kingdom only recognises overseas prescriptions from European Economic Area (EEA) countries and Switzerland. Most medicines, with the exception of schedule 1 to 3 controlled drugs and specials, prescribed in these countries can be dispensed by United Kingdom pharmacies, so long as the prescriber is from a profession recognised by the statutory guidance that is legally entitled to issue a prescription of that kind in the country in which the prescription is issued.As they are dispensed as private, or non-National Health Service, prescriptions, we do not have any data for the number of EEA/Swiss prescriptions that have been dispensed in the UK.

Whether the current Chair of the adult clinical reference group for adult gender dysphoria services refused to comply with requests for data for the date linkage study which was recommended by the Cass review.

It is well documented that a number of adult gender clinics were unwilling to collaborate with data sharing requests made of them previously, in respect of the data linkage study, and that this meant that the data linkage study was unable to proceed at the time. Further engagement with a range of stakeholders has since led to small but important proposed improvements in study design. These have been subject to positive feedback from representatives of commissioned adult gender clinics and should support collaboration on data sharing once the necessary research approvals are in place to enable the study to begin. Given the importance of this study as part of the wider national gender research programme, the Department will continue to closely monitor progress in partnership with NHS England and consider whether any further support is required to enable study delivery.

Pursuant to the written statement on 26 February 2026 titled Data Linkage Study, what is his expected timeframe for research and ethics approval.

Important final steps are currently being taken to enable the data linkage study to begin, including the laying of an updated statutory instrument, or Order, to provide appropriate legal protections for those individuals and organisations who will be sharing or processing data for the specific purpose of the study, that are potentially subject to the specific protections of the Gender Recognition Act 2004. In parallel, refreshed research approvals are currently being sought from the Health Research Authority (HRA). The HRA provides independent scrutiny and approval of research studies, with the outcome of the data linkage study’s application expected in the next few weeks. Both the new order and HRA study approvals will need to be in place before the study, including data sharing, can begin.

On what date he plans to bring into force the provisions of the Medical Training (Prioritisation) Bill.

The Medical Training (Prioritisation) Act 2026 received Royal Assent on 5 March 2026. The Medical Training (Prioritisation) Act 2026 (Commencement) Regulations 2026 were made on 5 March 2026, which brought into force all provisions of the Act on 6 March 2026.

Pursuant to the written statement on 26 February 2026 titled Data Linkage Study, whether he plans to complete the data linkage study before the Pathways puberty blockers trial commences.

The data linkage study is an important commitment within a wider national gender research programme, which is being jointly delivered by NHS England and the National Institute for Health and Care Research.The data linkage study is observational in nature, linking and analysing existing, routinely collected healthcare data for adults who, as children, were referred into the former Gender Identity Development Service, previously operated by the Tavistock and Portman NHS Foundation Trust. It is important to highlight that as the study is not designed as a comparative clinical trial, it will not provide direct evidence on the cause or effect of any individual treatment approach, nor provide evidence relating to any treatment’s safety or efficacy. Its findings will relate to a former, decommissioned model of NHS care and to a previous cohort of children and young people with gender incongruence.The PATHWAYS suite of studies, including the currently paused clinical trial, and the data linkage study, have very different designs and will generate different types of new evidence. They remain separate elements of the wider national gender research programme, and their delivery timelines are not co-dependent.

Pursuant to the written statement on 26 February 2026 titled Data Linkage Study, whether he expects the data linkage study to be completed before the abolition of NHS England.

The Department currently expects the data linkage study analysis to have been completed, or be close to completion, by April 2027, dependent on the timing of research approvals being secured. However, should any remaining actions be required to complete, and publish the findings of, the study at the point NHS England is abolished, these will transfer as legacy delivery commitments for completion by the Department.

Pursuant to the written statement on 26 February 2026 titled Data Linkage Study, what the small but important improvements in study design are to which he refers in his statement.

Small but important proposed improvements include refining the data sharing requirement of adult gender clinics, so that data is only requested that directly relates to the study cohort. Careful consideration has also been given to how best to run the study-specific data opt out so that it is simpler and more accessible to individuals in the study cohort, and can remain open longer. This will provide the parallel benefit of reducing the administrative burden on individual gender clinics.

How many deaths there have been of (a) women, (b) babies and (c) stillbirths where the termination of pregnancy through pills-by-post has been considered a contributory factor.

The information requested is not routinely collected centrally.The Department collects information on abortions in England and Wales via the HSA4 abortion notification form. The HSA4 form includes a section for recording the death of a woman within 14 days of an abortion, where this is known to abortion providers. This is not routinely published because the 14-day time frame limits the data’s usefulness for counting the total number of deaths amongst women following abortion. Also, it does not record whether the method of abortion, including home use of early medical abortion pills, was a contributory factor in a death.Since 2020, zero deaths of women following an abortion have been reported to the department via the HSA4 form, rounded to the nearest five. Following the 2023 abortion statistics publication, all data is rounded to the nearest five. As a result of this change, counts of zero can mean no or a small number of procedures in the given field.Information on the deaths of women, babies following a live birth, and stillbirths are recorded by the Office for National Statistics using data derived from information collected in death registrations. However, it is unusual for wider contextual factors such whether the deceased had taken early medical abortion pills at home to be recorded on the death certificate.

With reference to the Written Statement of 23 February 2026 on Clinical trials, HCWS1347, in which the letter from MHRA refers to correspondence from 7 November 2025, if he will publish that correspondence.

The Medicines and Healthcare products Regulatory Agency is not releasing the 7 November letter at this point as the decision is the subject of litigation, and the Medicines and Healthcare products Regulatory Agency does not comment on ongoing litigation proceedings.

Whether he has reviewed the findings of the independent analysis commissioned by Prostate Cancer Research on the economic model used by the UK National Screening Committee.

The independent analysis commissioned by Prostate Cancer Research was submitted to the UK National Screening Committee’s public consultation on its draft recommendation on screening for prostate cancer. This consultation has now closed, and the committee is considering the responses.We anticipate a final recommendation on screening for prostate cancer soon. Following this, my Rt Hon. Friend, the Secretary of State for Health and Social Care, will make a decision on whether to accept the recommendation, and what next steps are needed.

Whether he plans to conduct a full Equality Impact Assessment as part of the decision making process on prostate cancer screening recommendations.

Yes, a full equality impact assessment will be undertaken as part of the decision-making process on prostate cancer screening recommendations.On 28 November, the UK National Screening Committee opened a 12-week public consultation on a draft recommendation on screening for prostate cancer. This consultation has now closed, and the committee is considering the responses.We anticipate a final recommendation soon. Following this, my Rt. Hon. Friend, the Secretary of State for Health and Social Care, will make a decision on whether to accept the recommendation, and what next steps are needed. Any policy developed from the recommendation will be supported by an equality impact assessment to ensure that health inequality that could be caused by the policy will be mitigated against.

With reference to the Written Statement of 23 February 2026 on Clinical Trials, what information his Department holds on when the letter from MHRA to King's College London was (a) sent and (b) received; and on what date his Department became aware of (i) the letter and (ii) the concerns raised in the letter.

Given that there are live legal proceedings, we are unable to comment on the details of the PATHWAYS trial.

With reference to the Written Statement of 23 February 2026 on Clinical trials, whether (a) he, (b) Ministers and (c) officials had discussions with MHRA on the Pathways clinical trial prior to February 2026.

Given that there are live legal proceedings, we are unable to comment on the details of the PATHWAYS trial.

Whether any children were recruited for any arm of the Pathways clinical trials prior to it being paused.

As announced on 20 February 2026, the PATHWAYS clinical trial has been paused, following new queries raised by the medicines regulator, the Medicines and Healthcare products Regulatory Agency. No participants have been recruited to the trial and while it is paused recruitment will not start; therefore no children or young people will receive puberty suppression during this period.As the intensive element of PATHWAYS HORIZON is designed to provide a matched control group for the trial, and as PATHWAYS CONNECT is designed to compare children and young people receiving puberty suppression with a group in the intensive element of PATHWAYS HORIZON, it is not possible for these aspects to progress without the TRIAL element. The other PATHWAYS study projects are not affected by this pause.

Whether (a) he, (b) Ministers and (c) officials had discussions with (i) NHS England, (ii) University of York and (iii) other researchers on the Data Linkage study in (A) November 2025, (B) December 2025 and (C) January 2026.

The data linkage study remains an important commitment and forms part of a wider national research programme underpinning the design and delivery of the new model of National Health Service care in place in England for children and young people with gender incongruence/dysphoria. No discussions were had with the University of York in November 2025, December 2025 and January 2026 about the data linkage study. The Department has, however, continued to regularly engage with and support NHS England, which has taken on responsibility for study delivery. Important final steps are currently being taken to enable the study to begin. On 26 February, an updated order was laid in both Houses of Parliament to facilitate delivery of the data linkage study. The order will provide appropriate legal protections for those individuals and organisations who will be sharing or processing data potentially subject to the specific protections of the Gender Recognition Act 2004, for the purpose of the study. The order is expected to come in to force on 20 March 2026. Final Health Research Authority study approval will also need to be in place before the study can begin.

Whether all arms of the Pathways clinical trials have been paused.

The PATHWAYS TRIAL focuses on the effects of puberty suppressing hormones on young people’s physical, social, and emotional well-being specifically when offered alongside the new model of National Health Service gender care based on comprehensive assessment and tailored psychosocial support. Therefore, the PATHWAYS study includes three non-interventional research projects:PATHWAYS Voices involves speaking to young people, parents and staff about their experiences of living with gender incongruence and their care in NHS Gender Services;PATHWAYS Horizon tracks the physical, social and emotional wellbeing of all young people attending United Kingdom NHS Gender Services who want to take part in the Horizon study, along with their parents; andPATHWAYS Connect studies whether puberty suppressing hormones affect young people's thinking and brain development through cognitive tests and brain scans. It would include some young people in the PATHWAYS trial and also some of the young people from the Horizon study.As announced on 20 February, the PATHWAYS clinical trial has been paused, following new queries raised by the medicines regulator, the Medicines and Healthcare products Regulatory Agency. While it is paused, recruitment of children and young people into the trial will not start, and therefore no children or young people will receive puberty suppression. As the intensive element of PATHWAYS Horizon is designed to provide a matched control group for the trial, and as PATHWAYS Connect is designed to compare children and young people receiving puberty suppression with a group in the intensive element of PATHWAYS Horizon, it is not possible for these aspects to progress without the trial element. The other PATHWAYS study projects are not affected by this pause.

How many full time equivalent civil servants are working on his Department's response to the Hughes Report: Options for redress for those harmed by valproate and pelvic mesh, published on 7 February 2024.

Civil servants often contribute to a range of policy areas within the Department, therefore it is not possible to provide specific staff numbers for those that are exclusively working on the Department’s response to the Hughes Report.

What number of UK citizens have obtained a primary medical degree outside the UK by country in each of the last five years.

The Department does not hold the data requested. Data is available that shows the scale of doctors employed in National Health Service trusts in England who qualified outside the United Kingdom and who declare a UK nationality. The data is not available by year of graduation, but an indication of annual numbers is possible by using the year of first General Medical Council (GMC) registration.Within NHS trusts in England, an average of 473 UK nationals who qualified outside the UK had registered with the GMC annually in the latest five years of available data, from 2019 to 2023. This will not count doctors who do not work in NHS trusts in England, and may include international medical graduates who gained UK citizenship after graduation or UK employment. The table attached presents the total number of doctors employed in NHS trusts in England who qualified outside the UK and who declare a UK nationality, and the ten largest countries of qualification for the years 2019 to 2023.