Written questions by Efford.

What steps have been taken towards implementing Recommendation 9 of the Infected Blood Inquiry.

It is crucial we protect the safety of haemophilia care, and the Government is committed to implementing recommendation 9 of the 2024 Infected Blood Inquiry report.The Government is committed to improving the lives of those living with rare diseases, such as haemophilia. The UK Rare Diseases Framework sets out four priorities collaboratively developed with the rare disease community: these include 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 fifth annual England action plan in February 2026, where we report on the steps we have taken to advance these priorities.In relation to recommendation 9, a to c, of the Infected Blood Inquiry, peer review of United Kingdom comprehensive care centres has been an essential part of haemophilia services for many years. The triennial audit was replaced in 2019 with a more formal peer review process on a five-year cycle.The final peer review report is expected to be published imminently and once published, it will be shared with the NHS England Specialised Commissioning Quality Oversight Group for consideration and action. This will be supported by a letter to integrated care boards and trust boards, emphasising the valuable role of peer review and asking for confirmation of their commitment to review and implement the peer review findings.The Haemophilia Service Specification has been updated by the Blood Disorders Clinical Reference Group and is making its way through final approvals, having undergone public consultation. The new specification includes a contractual requirement for providers to participate in and act upon peer review findings.Regarding 9d, the Clinical Community and the NHS England Clinical Reference Group for Blood Disorders supports the need to develop and strengthen multi-disciplinary networks. NHS England has drafted a proposed National Clinical Network Specification specifically for these networks, which is dependent on additional funding, and which would embed key new requirements for providers to participate in a networked model of care.In response to 9e, all diseases or conditions where a non-plasma treatment exists to replace a plasma/blood-derived treatment are now addressed by commissioning policies or funding agreements. There are some specific regimens which are subject to ongoing clinical policy development but in each case there are alternative regimens or treatment approaches which negate the use of plasma-derived medicines.Of particular interest to the clinical and patient community is the development of a clinical commissioning policy for recombinant Von Willebrand factor, which is currently licensed for prophylaxis in adults, as regular treatment for those with the severest bleeding, but which is not currently commissioned for this indication. Funding will be required to implement this clinical policy for all ages, and this has not yet been identified.Finally, for 9f, NHS England currently provides ‘central’ funding of approximately 40% of the total annual cost for running the National Haemophilia Database. A task and finish group relating to the database has been established, reporting into the overarching recommendation 9 expert group.As of February 2026, stakeholders involved in the recommendation 9f working group are in agreement that the registry has been and remains immensely valuable in supporting the provision of clinical care. NHS England continues to work with the United Kingdom Haemophilia Centres Doctors' Organisation to understand the requirement for increased funding.Further progress on implementing recommendation 9 is subject to additional funding, and this has not yet been identified. NHS England and the Department will continue to work together to provide progress updates on the Government Reporting Integration Platform.

What progress he has made on establishing functioning multi-disciplinary networks to ensure best practice is followed in the treatment and care of haemophilia.

It is crucial we protect the safety of haemophilia care, and the Government is committed to implementing recommendation 9 of the 2024 Infected Blood Inquiry report.The Government is committed to improving the lives of those living with rare diseases, such as haemophilia. The UK Rare Diseases Framework sets out four priorities collaboratively developed with the rare disease community: these include 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 fifth annual England action plan in February 2026, where we report on the steps we have taken to advance these priorities.In relation to recommendation 9, a to c, of the Infected Blood Inquiry, peer review of United Kingdom comprehensive care centres has been an essential part of haemophilia services for many years. The triennial audit was replaced in 2019 with a more formal peer review process on a five-year cycle.The final peer review report is expected to be published imminently and once published, it will be shared with the NHS England Specialised Commissioning Quality Oversight Group for consideration and action. This will be supported by a letter to integrated care boards and trust boards, emphasising the valuable role of peer review and asking for confirmation of their commitment to review and implement the peer review findings.The Haemophilia Service Specification has been updated by the Blood Disorders Clinical Reference Group and is making its way through final approvals, having undergone public consultation. The new specification includes a contractual requirement for providers to participate in and act upon peer review findings.Regarding 9d, the Clinical Community and the NHS England Clinical Reference Group for Blood Disorders supports the need to develop and strengthen multi-disciplinary networks. NHS England has drafted a proposed National Clinical Network Specification specifically for these networks, which is dependent on additional funding, and which would embed key new requirements for providers to participate in a networked model of care.In response to 9e, all diseases or conditions where a non-plasma treatment exists to replace a plasma/blood-derived treatment are now addressed by commissioning policies or funding agreements. There are some specific regimens which are subject to ongoing clinical policy development but in each case there are alternative regimens or treatment approaches which negate the use of plasma-derived medicines.Of particular interest to the clinical and patient community is the development of a clinical commissioning policy for recombinant Von Willebrand factor, which is currently licensed for prophylaxis in adults, as regular treatment for those with the severest bleeding, but which is not currently commissioned for this indication. Funding will be required to implement this clinical policy for all ages, and this has not yet been identified.Finally, for 9f, NHS England currently provides ‘central’ funding of approximately 40% of the total annual cost for running the National Haemophilia Database. A task and finish group relating to the database has been established, reporting into the overarching recommendation 9 expert group.As of February 2026, stakeholders involved in the recommendation 9f working group are in agreement that the registry has been and remains immensely valuable in supporting the provision of clinical care. NHS England continues to work with the United Kingdom Haemophilia Centres Doctors' Organisation to understand the requirement for increased funding.Further progress on implementing recommendation 9 is subject to additional funding, and this has not yet been identified. NHS England and the Department will continue to work together to provide progress updates on the Government Reporting Integration Platform.

What consideration he has given to supporting the National Haemophilia Database through additional central funding.

It is crucial we protect the safety of haemophilia care, and the Government is committed to implementing recommendation 9 of the 2024 Infected Blood Inquiry report.The Government is committed to improving the lives of those living with rare diseases, such as haemophilia. The UK Rare Diseases Framework sets out four priorities collaboratively developed with the rare disease community: these include 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 fifth annual England action plan in February 2026, where we report on the steps we have taken to advance these priorities.In relation to recommendation 9, a to c, of the Infected Blood Inquiry, peer review of United Kingdom comprehensive care centres has been an essential part of haemophilia services for many years. The triennial audit was replaced in 2019 with a more formal peer review process on a five-year cycle.The final peer review report is expected to be published imminently and once published, it will be shared with the NHS England Specialised Commissioning Quality Oversight Group for consideration and action. This will be supported by a letter to integrated care boards and trust boards, emphasising the valuable role of peer review and asking for confirmation of their commitment to review and implement the peer review findings.The Haemophilia Service Specification has been updated by the Blood Disorders Clinical Reference Group and is making its way through final approvals, having undergone public consultation. The new specification includes a contractual requirement for providers to participate in and act upon peer review findings.Regarding 9d, the Clinical Community and the NHS England Clinical Reference Group for Blood Disorders supports the need to develop and strengthen multi-disciplinary networks. NHS England has drafted a proposed National Clinical Network Specification specifically for these networks, which is dependent on additional funding, and which would embed key new requirements for providers to participate in a networked model of care.In response to 9e, all diseases or conditions where a non-plasma treatment exists to replace a plasma/blood-derived treatment are now addressed by commissioning policies or funding agreements. There are some specific regimens which are subject to ongoing clinical policy development but in each case there are alternative regimens or treatment approaches which negate the use of plasma-derived medicines.Of particular interest to the clinical and patient community is the development of a clinical commissioning policy for recombinant Von Willebrand factor, which is currently licensed for prophylaxis in adults, as regular treatment for those with the severest bleeding, but which is not currently commissioned for this indication. Funding will be required to implement this clinical policy for all ages, and this has not yet been identified.Finally, for 9f, NHS England currently provides ‘central’ funding of approximately 40% of the total annual cost for running the National Haemophilia Database. A task and finish group relating to the database has been established, reporting into the overarching recommendation 9 expert group.As of February 2026, stakeholders involved in the recommendation 9f working group are in agreement that the registry has been and remains immensely valuable in supporting the provision of clinical care. NHS England continues to work with the United Kingdom Haemophilia Centres Doctors' Organisation to understand the requirement for increased funding.Further progress on implementing recommendation 9 is subject to additional funding, and this has not yet been identified. NHS England and the Department will continue to work together to provide progress updates on the Government Reporting Integration Platform.

What progress is being made in replacing plasma-derived products with recombinant coagulation factor products, where clinically appropriate, in accordance with Recommendation 9 of the Infected Blood Inquiry Report.

It is crucial we protect the safety of haemophilia care, and the Government is committed to implementing recommendation 9 of the 2024 Infected Blood Inquiry report.The Government is committed to improving the lives of those living with rare diseases, such as haemophilia. The UK Rare Diseases Framework sets out four priorities collaboratively developed with the rare disease community: these include 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 fifth annual England action plan in February 2026, where we report on the steps we have taken to advance these priorities.In relation to recommendation 9, a to c, of the Infected Blood Inquiry, peer review of United Kingdom comprehensive care centres has been an essential part of haemophilia services for many years. The triennial audit was replaced in 2019 with a more formal peer review process on a five-year cycle.The final peer review report is expected to be published imminently and once published, it will be shared with the NHS England Specialised Commissioning Quality Oversight Group for consideration and action. This will be supported by a letter to integrated care boards and trust boards, emphasising the valuable role of peer review and asking for confirmation of their commitment to review and implement the peer review findings.The Haemophilia Service Specification has been updated by the Blood Disorders Clinical Reference Group and is making its way through final approvals, having undergone public consultation. The new specification includes a contractual requirement for providers to participate in and act upon peer review findings.Regarding 9d, the Clinical Community and the NHS England Clinical Reference Group for Blood Disorders supports the need to develop and strengthen multi-disciplinary networks. NHS England has drafted a proposed National Clinical Network Specification specifically for these networks, which is dependent on additional funding, and which would embed key new requirements for providers to participate in a networked model of care.In response to 9e, all diseases or conditions where a non-plasma treatment exists to replace a plasma/blood-derived treatment are now addressed by commissioning policies or funding agreements. There are some specific regimens which are subject to ongoing clinical policy development but in each case there are alternative regimens or treatment approaches which negate the use of plasma-derived medicines.Of particular interest to the clinical and patient community is the development of a clinical commissioning policy for recombinant Von Willebrand factor, which is currently licensed for prophylaxis in adults, as regular treatment for those with the severest bleeding, but which is not currently commissioned for this indication. Funding will be required to implement this clinical policy for all ages, and this has not yet been identified.Finally, for 9f, NHS England currently provides ‘central’ funding of approximately 40% of the total annual cost for running the National Haemophilia Database. A task and finish group relating to the database has been established, reporting into the overarching recommendation 9 expert group.As of February 2026, stakeholders involved in the recommendation 9f working group are in agreement that the registry has been and remains immensely valuable in supporting the provision of clinical care. NHS England continues to work with the United Kingdom Haemophilia Centres Doctors' Organisation to understand the requirement for increased funding.Further progress on implementing recommendation 9 is subject to additional funding, and this has not yet been identified. NHS England and the Department will continue to work together to provide progress updates on the Government Reporting Integration Platform.

What steps have been taken to address funding shortfalls and inequities between haemophilia centres around the UK, identified by 2024-25 peer review of haemophilia care.

It is crucial we protect the safety of haemophilia care, and the Government is committed to implementing recommendation 9 of the 2024 Infected Blood Inquiry report.The Government is committed to improving the lives of those living with rare diseases, such as haemophilia. The UK Rare Diseases Framework sets out four priorities collaboratively developed with the rare disease community: these include 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 fifth annual England action plan in February 2026, where we report on the steps we have taken to advance these priorities.In relation to recommendation 9, a to c, of the Infected Blood Inquiry, peer review of United Kingdom comprehensive care centres has been an essential part of haemophilia services for many years. The triennial audit was replaced in 2019 with a more formal peer review process on a five-year cycle.The final peer review report is expected to be published imminently and once published, it will be shared with the NHS England Specialised Commissioning Quality Oversight Group for consideration and action. This will be supported by a letter to integrated care boards and trust boards, emphasising the valuable role of peer review and asking for confirmation of their commitment to review and implement the peer review findings.The Haemophilia Service Specification has been updated by the Blood Disorders Clinical Reference Group and is making its way through final approvals, having undergone public consultation. The new specification includes a contractual requirement for providers to participate in and act upon peer review findings.Regarding 9d, the Clinical Community and the NHS England Clinical Reference Group for Blood Disorders supports the need to develop and strengthen multi-disciplinary networks. NHS England has drafted a proposed National Clinical Network Specification specifically for these networks, which is dependent on additional funding, and which would embed key new requirements for providers to participate in a networked model of care.In response to 9e, all diseases or conditions where a non-plasma treatment exists to replace a plasma/blood-derived treatment are now addressed by commissioning policies or funding agreements. There are some specific regimens which are subject to ongoing clinical policy development but in each case there are alternative regimens or treatment approaches which negate the use of plasma-derived medicines.Of particular interest to the clinical and patient community is the development of a clinical commissioning policy for recombinant Von Willebrand factor, which is currently licensed for prophylaxis in adults, as regular treatment for those with the severest bleeding, but which is not currently commissioned for this indication. Funding will be required to implement this clinical policy for all ages, and this has not yet been identified.Finally, for 9f, NHS England currently provides ‘central’ funding of approximately 40% of the total annual cost for running the National Haemophilia Database. A task and finish group relating to the database has been established, reporting into the overarching recommendation 9 expert group.As of February 2026, stakeholders involved in the recommendation 9f working group are in agreement that the registry has been and remains immensely valuable in supporting the provision of clinical care. NHS England continues to work with the United Kingdom Haemophilia Centres Doctors' Organisation to understand the requirement for increased funding.Further progress on implementing recommendation 9 is subject to additional funding, and this has not yet been identified. NHS England and the Department will continue to work together to provide progress updates on the Government Reporting Integration Platform.

What steps she is taking to reduce Government borrowing.

We need to address the UK’s borrowing and debt, so we spend less on debt interest and more on the priorities of working people. The government has a credible consolidation plan that ensures borrowing is falling in every year of the forecast. Borrowing this year is set to be the lowest for 6 years. The government is reducing borrowing while protecting investment, and is maintaining an increase of over £120 billion departmental capital spending over the Parliament. From 2025 to 2030, the UK is reducing government borrowing more than any other G7 country.

What steps he is taking to help ensure the (a) oversight and (b) regulation of (i) specialist pharmacies and (ii) aseptic services within hospitals.

The Department has asked NHS England to continue to progress work on the Infusions and Special Medicines Programme, which is tasked with the implementation of Lord Carter’ 2020 report, Transforming Pharmacy Aseptic Services in England. The work included publication of guidance for the quality assurance of aseptic production in National Health Service hospitals and improved audits in unlicensed aseptic medicines preparation units, using digital tools to improve the transparency of the work. These hospital aseptic medicines preparation units make unlicensed ‘special’ medicines, which include ready to administer chemotherapy injections and intravenous nutrition products. The majority of these units are regulated by the Care Quality Commission. A minority of aseptic medicines preparation services in hospitals are licensed units with a Medicines and Healthcare products Regulatory Agency (MHRA) Specials Authorisation. These units are regulated by the MHRA.

What discussions he has had NHS England on the future (a) oversight and (b) regulation of (i) specialist pharmacies and (ii) aseptic services within hospitals.

The Department has asked NHS England to continue to progress work on the Infusions and Special Medicines Programme, which is tasked with the implementation of Lord Carter’ 2020 report, Transforming Pharmacy Aseptic Services in England. The work included publication of guidance for the quality assurance of aseptic production in National Health Service hospitals and improved audits in unlicensed aseptic medicines preparation units, using digital tools to improve the transparency of the work. These hospital aseptic medicines preparation units make unlicensed ‘special’ medicines, which include ready to administer chemotherapy injections and intravenous nutrition products. The majority of these units are regulated by the Care Quality Commission. A minority of aseptic medicines preparation services in hospitals are licensed units with a Medicines and Healthcare products Regulatory Agency (MHRA) Specials Authorisation. These units are regulated by the MHRA.

With reference to the commitments he made when giving evidence to the Infected Blood Inquiry on 7 May 2025, when he plans to respond to the five areas of compensation regulations following his review.

As I said in my oral evidence to the Inquiry, I am open to considering a number of areas of the Scheme where doing so does not cause undue delay to the delivery of compensation. The Inquiry will be producing a further report and the Government will respond to this report when it is published.

What assessment he has made of the adequacy of the tariffs for people infected with Hepatitis C through contaminated blood products.

The impact of a Hepatitis infection can range from very mild to very severe, including liver failure and death as a direct result of the infection. In its second interim report, the Infected Blood Inquiry recommended that the compensation scheme should reflect the different impacts of infection by developing severity bandings. The Expert Group provided the Government with clinical advice on the distinctions between these impacts. This meant the Government could set severity bands for Hepatitis infections based on clear clinical markers. As set out in the Infected Blood Compensation Scheme Regulations 2025, where someone’s experience of Hepatitis, whether it is historic or in the present day, has been more severe, they will receive more compensation.

Pursuant to his evidence to the Infected Blood Inquiry on 7 May 2025, whether he intends to review (a) the compensation regulations and (b) the tariffs.

As I said in my oral evidence to the Inquiry, I am open to considering a number of areas of the Scheme where doing so does not cause undue delay to the delivery of compensation. The Inquiry will be producing a further report and the Government will respond to this report when it is published

With reference to the Infected Blood Compensation Scheme, if he will review the supplementary route for people for whom the impact of their viruses and their treatments are not fully captured by the core route tariff.

The Infected Blood Inquiry Response Expert Group provided advice on the design of infection severity bands for the core route. They considered the health impacts and treatments that applicants are likely to have experienced. This includes many side effects of treatments, including interferon, and conditions such as chronic fatigue. The core route tariffs therefore already take into account conditions that infected people are likely to experience as a result of their infection or treatment. The supplementary route, as set out in the Infected Blood Compensation Scheme Regulations 2025, provides additional awards for applicants whose circumstances necessitate a higher compensation payment. As a result, the eligibility criteria for the Severe Health Condition award reflects the conditions and impacts the Expert Group identified as not being addressed in other aspects of the scheme, including the core route or Exceptional Loss award.

Whether she plans to fine utility companies for inconvenience caused when their roadworks overrun.

Utility companies are already incentivised to complete works on time with charges of up to £10,000 per day for works that overrun. We have announced that these charges will apply to weekends and bank holidays. We are also doubling fixed penalty notices for companies that breach permit conditions. These conditions can include setting days and times when works can take place.

Whether she plans to incentivise utility companies to not overrun on roadworks.

Utility companies are already incentivised to complete works on time with charges of up to £10,000 per day for works that overrun. We have announced that these charges will apply to weekends and bank holidays. We are also doubling fixed penalty notices for companies that breach permit conditions. These conditions can include setting days and times when works can take place.

Media and Sport, whether her Department plans to implement the recommendations made by the Leveson Inquiry on independent press regulation.

The Government has clearly laid out its priorities in the manifesto and in the King’s speech, and the second part of Leveson is not among them. There are no current plans for further legislation.

If she will take steps to update the technology required to read (a) diacritical characters and (b) accents marks in the biographical information of UK passport holders.

British passports meet the standards set by the International Civil Aviation Organisation (ICAO). While these standards permit the use of either diacritic marks or their transliteration, the number of countries that have adopted use of diacritics in their passport is very low.There are currently no plans to introduce the inclusion of diacritic marks in the British passport. However, this will remain a consideration ahead of any future system developments.