Written questions by Smith.

What assessment he has made of the adequacy of progress on the establishment of a specialised NHS service for people with very severe Myalgic Encephalomyelitis/Chronic Fatigue Syndrome, including timelines, funding arrangements and decision-making criteria.

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 assessment he has made of the potential merits of informing parents/guardians of the estimated wait time for an autism or ADHD assessment upon application.

The Government has recognised that, nationally, demand for assessments for autism and attention deficit hyperactivity disorder (ADHD) has grown significantly in recent years and that people are experiencing severe delays for accessing such assessments. The Government’s 10-Year Health Plan will make the National Health Service fit for the future and recognises the need for early intervention and support.It is the responsibility of integrated care boards in England to make appropriate provision to meet the health and care needs of their local population, including providing access to ADHD and autism assessments, in line with relevant National Institute for Health and Care Excellence guidelines. In April 2023, NHS England published a national framework and operational guidance for autism assessment services, which can be found at the following link: www.england.nhs.uk/publication/autism-diagnosis-and-operational-guidance. This guidance highlights that, for each integrated care system, the following information should be publicly available and proactively shared across multiple locations, for example, social media and local authority publications, as well as all service provider websites: - accurate and up-to-date information about the autism assessment offer in each area, including details for services providing autism assessments, such as name, address, contact details, general remit, eligibility criteria, referral process, and documentation; and- an indication of waiting times for an autism assessment at each service, with further information available at the following link: https://www.england.nhs.uk/long-read/operational-guidance-to-deliver-improved-outcomes-in-all-age-autism-assessment-pathways-guidance-for-integrated-care-boards/#stage-1-identification-and-referral The Medium-Term Planning Framework, published 24 October 2025, was explicit that integrated care boards and providers are expected to optimise existing resources to reduce long waits for ADHD and autism assessments and improve the quality of assessments by implementing existing and new guidance, as published. My Rt Hon. Friend, the Secretary of State for Health and Social Care, announced on 4 December 2025 the launch of an Independent Review into Prevalence and Support for Mental Health Conditions, ADHD, and Autism. This independent review will inform our approach to enabling people with ADHD and autistic people to have the right support in place to enable them to live well in their communities.

What assessment he has made of the potential impact on children's mental health of an expanded play therapy offer in the NHS.

Whilst no such specific assessment has been made of the impact on children’s mental health of an expanded play therapy offer in the National Health Service, we are committed to ensuring that children and young people can access the support they need for their mental health. As part of that, we are committed to understanding the best evidence around therapeutic support for children and young people, including play therapy.It is the responsibility of NHS integrated care boards to commission health and care services suitable for children and young people in their local area.Improving access to timely mental health support for children and young people is a priority for the Government. In the first 12 months of the Government, nearly 40,000 more children and young people received support than in the previous 12 months, supported by the recruitment of over 8,000 additional mental health workers since July 2024. We are accelerating rollout of Mental Health Support Teams in schools and colleges to reach full national coverage by 2029. We have also announced a £7 million top-up for 24 Early Support Hubs, enabling at least 10,000 additional mental health and wellbeing interventions and supporting evaluation of these services in 2026/27.

What steps his Department is taking to help ensure that local health authorities provide parents with clear information regarding expected waiting times for autism spectrum disorder (ASD) and attention deficit hyperactivity disorder (ADHD) assessments for children; and whether he plans to implement a standardised minimum waiting time announcement for such appointments.

There are currently no plans to implement a standardised minimum waiting time for autism and attention deficit hyperactivity disorder (ADHD) assessments for children.The National Institute for Health and Care Excellence (NICE) guideline for the diagnosis of autism recommends the length of time between referral and first appointment should be no more than 13 weeks. We know that this is not happening routinely across the country. In respect of ADHD, the NICE guideline does not recommend a maximum waiting time for people to receive an assessment for ADHD or a diagnosis, however it sets out best practice on providing a diagnosis.The Government has recognised that, nationally, demand for assessments for autism and ADHD has grown significantly in recent years and that people are experiencing severe delays for accessing such assessments. The Government’s 10 Year Health Plan will make the National Health Service fit for the future and recognises the need for early intervention and support.It is the responsibility of integrated care boards (ICBs) to make available appropriate provision to meet the health and care needs of their local population, including provision of autism and ADHD services, in line with relevant NICE guidelines.Through the NHS Medium-term planning framework, published 24 October 2025, NHS England has set clear expectations for local ICBs and trusts to improve access, experience, and outcomes for autism and ADHD services over the next three years, focusing on improving quality and productivity.The Secretary of State announced on 4 December 2025 the launch of an Independent Review into Prevalence and Support for Mental Health Conditions, ADHD and Autism. This independent review will inform our approach to enabling people with ADHD and autistic people to have the right support in place to enable them to live well in their communities.

What steps his Department is taking to ensure that patients awaiting elective surgery are provided with clear and timely information about their position on waiting lists; and whether his Department has considered introducing a system that allows patients to (a) track their approximate place in the queue and (b) receive regular updates on expected waiting times.

The Government is committed to putting patients first. This means making sure patients are seen on time and have the information they need to have the best possible experience of care.As set out in the Elective Reform Plan, published January 2025, patients should expect clear communications that meet their needs throughout their time on a waiting list. This includes information about how long they might wait for their appointment and details about how and when to contact their provider. We are currently working with patients and carers to publish minimum standards patients should expect while they wait for planned care. This includes considering patients’ communication needs.We have also taken steps to deliver important digital interventions to ensure patients can receive clear and timely information whilst waiting for care. Since March 2025, patients at 87% of hospitals can view information about their elective appointments, estimated waiting times, and average waiting times by specialty on the NHS App. By March 2027, we will significantly improve information about waiting times on the NHS App for patients in elective care and will expand proxy access for parents and carers. We will also review the role and functionality of My Planned Care, which currently provides average waiting times and other information for patients waiting for care. High quality non-digital options should always be in place for those that need them.

Whether he considered including people suffering from Long Covid within the Clinical risk group eligible for the covid-19 vaccination in the Autumn 2025 vaccination programme.

The Government is committed to protecting those most vulnerable to COVID-19 through vaccination, as guided by the independent Joint Committee on Vaccination and Immunisation (JCVI). The primary aim of the national COVID-19 vaccination programme remains the prevention of serious illness (hospitalisations and deaths) arising from COVID-19. Population immunity to COVID-19 has been increasing due to a combination of naturally acquired immunity following recovery from infection and vaccine-derived immunity. COVID-19 is now a relatively mild disease for most people, though it can still be unpleasant, with rates of hospitalisation and death from COVID-19 having reduced significantly since COVID-19 first emerged.The focus of the JCVI advised programme has therefore moved towards targeted vaccination of the two groups who continue to be at higher risk of serious disease, including mortality. These are the oldest adults and individuals who are immunosuppressed.On 13 November 2024, JCVI published advice on who should be offered vaccination in autumn 2025. On 26 June 2025, the Government accepted the JCVI’s advice that in autumn 2025, a COVID-19 vaccination should be offered to the following groups:adults aged 75 years and over;residents in care homes for older adults;individuals aged 6 months and over who are immunosuppressed (as defined in the ‘immunosuppression’ sections of tables 3 or 4 in the COVID-19 chapter of the UK Health Security Agency Green Book).The Government has no plans to change eligibility for autumn 2025. It has accepted the JCVI advice for this campaign in full. As for all vaccines, the JCVI keeps the evidence under regular review.

Whether he has considered including lipedema as a relevant condition for NHS prescription of (a) Mounjaro injections and (b) other weight loss treatments.

Semaglutide, brand name Wegovy, tirzepatide, brand name Mounjaro, and liraglutide, brand name Saxenda, are approved for the management of obesity. They are recommended as cost-effective for use on the National Health Service for people who have a body mass index (BMI) over a certain threshold, and one or more weight-related comorbidities.The marketing authorisations for tirzepatide and other weight loss medicines do not include an exhaustive list of qualifying comorbidities, and it is for the prescriber to apply their clinical judgement in determining whether a patient meets the eligibility criteria.The exact causes of lipoedema are not clear, and the NHS.UK website states that it’s not caused by being overweight, and that it is a separate condition to obesity.The NHS is currently rolling out tirzepatide in primary care, using a phased approach based on clinical need. Approximately 220,000 individuals are expected to be eligible over the next three years. NHS England worked with clinical experts, NHS integrated care boards, patient and public representatives, healthcare professionals, charities, and royal colleges on its prioritisation approach, which it set out in its interim commissioning guidance, at the following link:https://www.england.nhs.uk/publication/interim-commissioning-guidance-implementation-of-the-nice-technology-appraisal-ta1026-and-the-nice-funding-variation-for-tirzepatide-mounjaro-for-the-management-of-obesity/At the current time, patients will be eligible for treatment in primary care if they have a BMI of at least forty, and four or more out of five ‘qualifying' conditions. The qualifying conditions for tirzepatide treatment are cardiovascular disease, hypertension, dyslipidaemia, obstructive sleep apnoea, and type 2 diabetes mellitus.

What discussions he has had with (a) campaigners and (b) stakeholders on treatment for (i) lobular breast cancer and (ii) other rare cancers.

Improving outcomes and experiences of cancer treatment, including lobular breast cancer and other rare cancers, is a priority for the Government. Engagement with campaigners and partners is vital to achieving this.My rt. Hon. Friend, the Secretary of State for Health and Social Care, accompanied by my hon. Friend, the Minister of State for Health, met with representatives of the Lobular Moonshot Project on 14 July 2025 to discuss their work. Following this meeting, the Chief Scientific Adviser and officials from the Department and the Medical Research Council (MRC) met again with the Lobular Moonshot Project to provide advice on existing funding options. Both the MRC and the National Institute for Health and Care Research have committed to continuing to work with the Lobular Moonshot Campaign team to support the development of fundable research proposals in this area and help drive our collective ambition to increase understanding and effective management of this disease.In April 2025, I attended an event with Cancer Research UK, Macmillan, and Cancer52. The was followed by a roundtable in May 2025, in which I met with Cancer52 members, representing a wide range of cancer types, to discuss how the National Cancer Plan can prioritise rare cancers, to make a meaningful difference to how patients experience cancer treatment, and to bring cancer survivability back up to the standards of the best in the world. I have also met with brain cancer campaigners and All-Party Parliamentary Group members on several occasions since taking up post.The National Cancer Plan will include more details about improving treatments for all tumour types, including lobular breast cancer. The Department continues to engage with a wide range of cancer partners on the Plan, including charities and patient representative bodies.

What assessment he has made of the potential implications for his policies of reports of Ulcerative Colitis and Crohn’s Disease not being eligible for free prescription charges as chronic health conditions.

While the Department has made no assessment, approximately 89% of prescription items are dispensed free of charge in the community in England, and there is a wide range of exemptions from prescription charges already in place for which those with ulcerative colitis and Crohn’s disease may be eligible. Eligibility depends on the patient’s age, whether they are in qualifying full-time education, whether they are pregnant or have recently given birth, whether they have a qualifying medical condition, or whether they are in receipt of certain benefits or a war pension.People on low incomes can apply for help with their health costs through the NHS Low Income Scheme. Prescription prepayment certificates (PPCs) are also available. PPCs allow people to claim as many prescriptions as they need for a set cost, with three-month and 12-month certificates available. The 12-month PPC can be paid for in instalments.

How many additional GPs have been hired in North Northumberland constituency through Government funding.

As of 31 May 2025, 58 general practitioners (GPs) have been recruited through the Additional Roles Reimbursement Scheme in the North East and North Cumbria Integrated Care Board (ICB) since 1 October 2024, the ICB in which the North Northumberland constituency is located. Data is not available at a constituency level.Earlier in the year we announced that we are investing an additional £889 million through the GP Contract for 2025/26 to reinforce the front door of the National Health Service, bringing total spend on the GP Contract to £13.2 billion. This is the biggest increase in over a decade.Every year we consult with the British Medical Association’s General Practice Committee both about what services practices provide, and the money they are entitled to in return under their contract, taking account the costs of delivering services. Practices are required to provide services to meet the reasonable needs of the patients registered at their practice. This includes making their own workforce plans.

What assessment he has made of the potential impact of the 10-year plan on waiting lists in the North East.

We are committed to delivering the National Health Service constitutional standard that 92% of patients wait no longer than 18 weeks from referral to consultant-led treatment by March 2029, including in the North East and Yorkshire.The 10-Year Health Plan sets out a transformed vision for planned care by 2035, where most interactions no longer take place in a hospital building, instead happening virtually, online, or via neighbourhood services. Planned care will be more efficient, timely, and effective, and will put control in the hands of patients.By 2035, two thirds of outpatient care will take place digitally or in the community closer to home, with patients able to access the best of their local hospital in a much more responsive way via their phones. For patients who do need to be admitted, we will carry out more procedures as day cases and will reduce the time spent in hospital and recovery, as providers make greater use of surgical robots and innovations in anaesthetics and postoperative care.

What steps he is taking to ensure the NHS is prepared for future demographic changes.

The 10-Year Health Plan sets out our plan to get the National Health Service back on track and make it fit for the future through delivering three big shifts in how the NHS works. By moving more care from hospital to community, shifting from analogue to digital, and reaching patients earlier by shifting from sickness to prevention, the NHS will be better enabled to meet future demographic changes.Integrated care boards are expected to have a deep understanding of their population’s needs and will engage with the public to develop long-term plans that meet these needs.

What assessment he has made of the potential impact of the Neighbourhood Health Service on healthcare in rural constituencies.

The Neighbourhood Health Service will mean millions of patients, including those in rural constituencies, are treated and cared for closer to their home by new teams of health professionals. Our priority will be to address underperformance and health inequalities in the areas with the worst health outcomes, such as rural and coastal communities, where we know access to healthcare services is often particularly poor.We expect neighbourhood teams and services to be designed in a way that reflects the specific needs of local populations. While we will be clear on the outcomes we expect, we will give significant licence to tailor the approach to local need.Our 10-Year Health Plan is creating a National Health Service truly fit for the future, keeping patients healthy and out of hospital, with care closer to home and in the home. An impact statement for the plan will be published in shortly.

What steps he has taken to support adult social care in rural areas.

The Government recognises the challenges facing adult social care and is taking action to improve the system across the country, including in rural areas. We have launched an independent commission into adult social care as part of our critical first steps towards delivering a National Care Service, and are also taking forward a package of reforms to enable more people to live independently for longer.We are also updating the Adult Social Care Relative Needs Formula for the first time since 2013/14 to ensure adult social care funding reflects an up-to-date assessment of need. Our proposals are set out in the Fair Funding Review 2.0 consultation document, a consultation on local government funding reform which sets out our plans for ensuring central Government funding is allocated to the places that need it most, ensuring the best value for money for the Government and taxpayers. This wider consultation includes proposals to more effectively account for variations in the relative cost and demand of delivering services between rural and urban areas. We are proposing to do this by considering the remoteness of an area alongside its accessibility in the Area Cost Adjustment.

What assessment he has made of the potential impact of the Neighbourhood Health Service on dental services in rural constituencies.

On 3 July 2025, the Government announced the 10-Year Health Plan and set out its vision for a Neighbourhood Health Service set up in local communities across the country, to improve access to National Health Services, including NHS dental services.We expect neighbourhood teams and services to be designed in a way that reflects the specific needs of local populations. We will be clear on the outcomes we expect, and will give significant licence to tailor the approach to local need. Our priority will be to address underperformance and health inequalities in the areas with the worst health outcomes, such as rural and coastal communities, where we know access to healthcare services is often particularly poor.

What assessment he has made of the potential impact of the 10 year plan on older residents in rural areas.

The 10-Year Health Plan will ensure a better health service for everyone, regardless of condition or geography. The 10-Year Health Plan has been built on what we heard during engagement with the public. Our reimagined National Health Service will be designed to tackle inequalities in both access and health outcomes, and will ensure a better health service for everyone, regardless of age or geography.The neighbourhood health service will reflect the specific needs of local populations, including the needs of older residents in rural communities. Neighbourhood health centres will be available in every community, providing easy access to NHS, local authority, and voluntary sector services. New technology-led services, including wearable and monitoring technology, will support patients such as older people with frailty to enable them to continue living independently in their own home.Equality has been considered throughout, and we expect to publish an Equality Impact Assessment later this month.

What steps he is taking to ensure the availability of stroke-related medicines in Northumberland; and what steps he is taking to ensure the equal provision of medicines across England.

We are aware of a supply issue affecting aspirin 300 milligram suppositories until late June 2025, which are used outside of their license of pain and inflammation, for their antiplatelet effect after a stroke. We have issued shortage management guidance to the National Health Service advising on the alternative, aspirin 150 milligram suppositories, which remain available for affected patients. The Department monitors and manages medicine supply at a national level so that stocks remain available to meet regional and local demand. Information on stock levels within Northumberland is not held centrally.Medicine supply chains are complex, global, and highly regulated, and there are a number of reasons why supply can be disrupted, many of which are not specific to the United Kingdom and outside of Government control, including manufacturing difficulties, access to raw materials, sudden demand spikes or distribution issues, and regulatory issues. We have drawn on up-to-date intelligence and data on the root causes of medicine supply issues, with manufacturing problems being the most dominant root cause. The Department works closely with industry, the NHS, manufacturers, and other partners across the supply chain to make sure patients across the UK can access the medicines they need.The resilience of UK supply chains is a key priority, and we are continually learning and seeking to improve the way we work to both manage and help prevent supply issues and avoid shortages. The Department, working closely with NHS England, is taking forward a range of actions to improve our ability to mitigate and manage shortages and to strengthen our resilience. As part of that work, we continue to engage with industry, the Medicines and Healthcare products Regulatory Agency, and other colleagues across the supply chain as we progress work to co-design and deliver solutions. We have plans underway to increase the awareness of our work.

What assessment his Department has made of the adequacy of the provision of emergency healthcare in (a) rural and (b) urban areas in the North East.

Integrated care board are responsible for commissioning services to meet the needs of their local communities, including in the North East, as they are best placed to take those decisions.However, more broadly, the Government recognises that urgent and emergency care performance is not at the high standard that patients should expect. We are committed to returning to the safe operational waiting time standards set out in the NHS Constitution.We have set out plans on the action to be taken to improve services this year and will shortly publish a 10-Year Health Plan, which will set out the radical reforms needed to make the National Health Service fit for the future.

What steps he is taking (a) to ensure the provision of Pfizer vaccines to people who cannot take Moderna and (b) with ICBs which have insufficient supplies of the Pfizer vaccine in North Northumberland constituency.

The UK Health Security Agency (UKHSA) procures vaccines that have been approved by the Medicines and Healthcare products Regulatory Agency and are advised for use in COVID-19 booster programmes by the Joint Committee on Vaccination and Immunisation (JCVI). The make-up of vaccine availability can vary from campaign to campaign based on the latest JCVI and clinical advice and procured stock available.Published advice in the COVID-19 Green book, chapter 14a recommends that those with known contraindications to COVID-19 vaccination should seek advice from a relevant specialist. This may include an allergy specialist, who can make a clinical assessment of the individual's risks and benefits of vaccination. If suitable, these individuals may be advised to be vaccinated in hospital under medical supervision.During the 2025 Spring COVID-19 vaccination campaign, UKHSA did not receive any reports of supply issues in North Northumberland.Vaccine deployment is managed by NHS England which works with the regional teams and integrated care boards to ensure the vaccine is readily available for those eligible, as per the JCVI advice. UKHSA has worked and continues to work with all deployment partners to ensure the supply and provision of vaccines.

What discussions he has had with hospices on (a) their role in and (b) funding in relation to the forthcoming NHS 10 Year Plan.

We want a society where every person receives high-quality, compassionate care from diagnosis through to the end of life. The Government is determined to shift more healthcare out of hospitals and into the community, to ensure patients and families receive the care they need when and where they need it, including those who need palliative and end of life care.As part of the work to develop a 10-Year Health Plan, we have been carefully considering policies, including those that impact people with palliative and end of life care needs, with input from the public, patients, health staff, and our partners, including the hospice sector.