Written questions by Mierlo.

What consideration his department has given to the Amos Review's interim report's findings that some women and families felt their concerns were not listened to during pregnancy and labour, and how this will inform future policy development.

In her interim report, Baroness Amos has identified a key issue of women and families being disregarded and not listened to during pregnancy and labour, repeatedly hearing from women and families about a lack of transparency, clear communication, and learning when things went wrong.Unfortunately, too many women are not listened to by the National Health Service, and the Government has been clear that it is unacceptable. Health professionals need to listen to women and respond appropriately, and that is why we introduced Jess’s Rule and are rolling out Martha’s Rule to every acute hospital, which ensure patients get their voices heard and their concerns aren’t dismissed. We're putting women's voices at the heart of our renewed Women's Health Strategy, which will be published soon.My Rt Hon. Friend, the Secretary of State for Health and Social Care’s maternity and neonatal taskforce will address the recommendations from the investigation when they are published in June, through the development of a national action plan. The taskforce will also hold the system to account for improving outcomes and experiences for women and babies. Families’ voices will be central to the taskforce.

What comparative assessment he has made of expected outcomes for babies with spinal muscular atrophy living in areas (a) included in the in-service evaluation of newborn screening for SMA and (b) not included in the in-service evaluation.

The Government recognises the challenges faced by those living with rare diseases and their families and is committed to improving outcomes. This is why the National Health Service is planning a large-scale in-service evaluation (ISE) of screening for spinal muscular atrophy (SMA) in newborn screening services. This ISE is due to start in January 2027 and will offer screening to over 400,000 babies.As the ISE is still in the planning stages, the Department has not yet made a comparative assessment of expected outcomes for babies identified through the evaluation compared with babies born in areas not included in the evaluation.Babies born outside the evaluation would continue to receive the current standard of care, including access to specialist clinical assessment and National Institute for Health and Care Excellence approved treatments where clinically appropriate. Clinical decisions for babies with suspected or confirmed SMA are made by specialist clinicians, regardless of where a child is born.My Rt Hon. Friend, the Secretary of State for Health and Social Care, has asked NHS England to investigate whether it would be appropriate and feasible for the ISE to be rolled out across the whole of England.Any screening programme that would impact approximately 650,000 babies per year in the UK must be underpinned by high quality robust evidence that demonstrates that screening will do more good than harm. The ISE will help inform a future UK National Screening Committee recommendation on whether screening for SMA should be added to the NHS Newborn Blood Spot Screening Programme.

What analysis his department has undertaken of the staffing and capacity pressures identified in the Amos Review's interim report, and what options are being examined to support maternity and neonatal units facing these challenges.

The Government is committed to tackling the retention and recruitment challenges that face the National Health Service. This includes work in maternity and neonatal services to introduce a midwifery and nursing retention self-assessment tool, mentoring schemes, a Graduate Guarantee that has already delivered 700 additional roles for newly qualified midwives, and funded speciality training for neonatal nurses to have the additional skills they need to care for critically ill babies. In addition, the Department’s upcoming workforce plan will make sure the NHS has the right people in the right places, with the right skills to care for patients, when they need it. Baroness Amos’ interim report details insights gathered so far in the national independent investigation into NHS maternity and neonatal care. Evidence is still being collected and analysed, and a coherent single set of national recommendations will be published in June. My Rt Hon. Friend, the Secretary of State for Health and Social Care, will chair a new National Maternity and Neonatal Taskforce that will address the interim insights and final recommendations of the investigation, forming them into a national action plan to drive improvements across maternity and neonatal care.

Whether she plans to reinstate funding to the Support After Suicide Partnership.

We recognise the importance of suicide bereavement services and acknowledge the difficult financial position for many voluntary, community, and social enterprise organisations.Commissioning responsibility for local suicide bereavement services sits with integrated care boards and it is for them to commission appropriate services for their local population while considering their overall financial position.

What steps his Department is taking to identify and tackle systemic causes of avoidable harm in maternity and neonatal services.

While the vast majority of births in England are safe, we know that systemic causes of avoidable harm exist in maternity and neonatal services, and this is not acceptable.This is why my Rt Hon. Friend, the Secretary of State for Health and Social Care, asked Baroness Amos to lead an independent investigation in National Health Service maternity and neonatal care to help us understand the systemic issues behind why so many women, babies, and families experience unacceptable care. The investigation will publish its final report and recommendations in June 2026.The Government is also setting up a National Maternity and Neonatal Taskforce, chaired by my Rt Hon. Friend, the Secretary of State for Health and Social Care. The taskforce will address the recommendations of the investigation by developing a new national action plan to drive improvements across maternity and neonatal care. The taskforce will also hold the system to account for improving outcomes and experiences for women and babies.We are not waiting to take action. We have already recruited over 800 more midwives, we’re investing over £140 million to address critical safety risks on the maternity estate, and we are rolling out guidance to tackle the leading causes of maternal death. We are also rolling out programmes to tackle discrimination and racism and avoidable brain injuries.

Whether his Department plans to publish a response when the final part of the Amos Review has been delivered; and what preparatory work his Department has undertaken to respond to the anticipated recommendations.

The Maternity and Neonatal Taskforce, chaired by my Rt. Hon. Friend, the Secretary of State for Health and Social Care, will be launched imminently. The taskforce will develop a national action plan to address the National Maternity and Neonatal Investigation’s recommendations. The Department has been engaging with bereaved and harmed families and stakeholders on how the taskforce is set up, including the Terms of Reference and membership. It will be made up of a breadth of independent clinical and international expertise including those who can speak to the inequalities within maternal health, as well as family and staff representatives, charities and campaigners. The taskforce will work closely with families in developing the action plan, ensuring their voices are central to this work.Previous reviews and research have provided a clear picture of the challenges facing maternity and neonatal services. The National Maternity and Neonatal Investigation will bring together and prioritise all the existing recommendations, as well as the new evidence they are collecting. The investigation’s interim report details the insights gathered so far but much evidence is still being collected and analysed. Baroness Amos has advised that the investigation will publish its final report and recommendations in June.Alongside this, the Government is taking immediate action to boost accountability and safety as part of the Government’s mission to build a National Health Service fit for the future. This includes measures to hold the system to account, a system to better identify safety concerns, rolling out a programme to all trusts to tackle discrimination and racism, and new best practice standards in maternal mortality.

What consideration the Department has given to Baroness Amos' interim report’s findings regarding the limited progress on recommendations from previous maternity investigations, and how this will influence future review and implementation processes.

The Maternity and Neonatal Taskforce, chaired by my Rt. Hon. Friend, the Secretary of State for Health and Social Care, will be launched imminently. The taskforce will develop a national action plan to address the National Maternity and Neonatal Investigation’s recommendations. The Department has been engaging with bereaved and harmed families and stakeholders on how the taskforce is set up, including the Terms of Reference and membership. It will be made up of a breadth of independent clinical and international expertise including those who can speak to the inequalities within maternal health, as well as family and staff representatives, charities and campaigners. The taskforce will work closely with families in developing the action plan, ensuring their voices are central to this work.Previous reviews and research have provided a clear picture of the challenges facing maternity and neonatal services. The National Maternity and Neonatal Investigation will bring together and prioritise all the existing recommendations, as well as the new evidence they are collecting. The investigation’s interim report details the insights gathered so far but much evidence is still being collected and analysed. Baroness Amos has advised that the investigation will publish its final report and recommendations in June.Alongside this, the Government is taking immediate action to boost accountability and safety as part of the Government’s mission to build a National Health Service fit for the future. This includes measures to hold the system to account, a system to better identify safety concerns, rolling out a programme to all trusts to tackle discrimination and racism, and new best practice standards in maternal mortality.

What assessment he has made of the potential implications for his policies of the cultural and leadership issues referenced in the Baroness Amos' interim report; and whether those findings will inform future approaches to supporting maternity teams.

The Maternity and Neonatal Taskforce, chaired by my Rt. Hon. Friend, the Secretary of State for Health and Social Care, will be launched imminently. The taskforce will develop a national action plan to address the National Maternity and Neonatal Investigation’s recommendations. The Department has been engaging with bereaved and harmed families and stakeholders on how the taskforce is set up, including the Terms of Reference and membership. It will be made up of a breadth of independent clinical and international expertise including those who can speak to the inequalities within maternal health, as well as family and staff representatives, charities and campaigners. The taskforce will work closely with families in developing the action plan, ensuring their voices are central to this work.Previous reviews and research have provided a clear picture of the challenges facing maternity and neonatal services. The National Maternity and Neonatal Investigation will bring together and prioritise all the existing recommendations, as well as the new evidence they are collecting. The investigation’s interim report details the insights gathered so far but much evidence is still being collected and analysed. Baroness Amos has advised that the investigation will publish its final report and recommendations in June.Alongside this, the Government is taking immediate action to boost accountability and safety as part of the Government’s mission to build a National Health Service fit for the future. This includes measures to hold the system to account, a system to better identify safety concerns, rolling out a programme to all trusts to tackle discrimination and racism, and new best practice standards in maternal mortality.

Whether he plans to prioritise the assessment of breakthrough implantable devices in the MHRA Early Access Service.

In July 2025, the Medicines and Healthcare products Regulatory Agency (MHRA) published a statement of policy intent for the development and implementation of an Early Access Service for innovative medical devices. The statement of policy is available at the following link:https://www.gov.uk/government/publications/statement-of-policy-intent-early-access-to-innovative-medical-devices/statement-of-policy-intent-early-access-to-innovative-medical-devices#next-stepsThe service aims to speed up safe access to innovative medical devices for patients, supporting the Government’s Life Sciences Sector Plan. Implementing the Early Access Service will require new systems and processes to be established. The MHRA is currently investing in internal capability and working closely with stakeholders to support the establishment and implementation of the service. Further information on this work, including details of the products that will initially be in scope, will be provided later this year.

Pursuant to the answer on 20 November 2025 to question 90583 on medical treatments, (a) what progress has been made on the establishment of the MHRA Early Access Service and (b) when they expect to formally launch the service.

In July 2025, the Medicines and Healthcare products Regulatory Agency (MHRA) published a statement of policy intent for the development and implementation of an Early Access Service for innovative medical devices. The statement of policy is available at the following link:https://www.gov.uk/government/publications/statement-of-policy-intent-early-access-to-innovative-medical-devices/statement-of-policy-intent-early-access-to-innovative-medical-devices#next-stepsThe service aims to speed up safe access to innovative medical devices for patients, supporting the Government’s Life Sciences Sector Plan. Implementing the Early Access Service will require new systems and processes to be established. The MHRA is currently investing in internal capability and working closely with stakeholders to support the establishment and implementation of the service. Further information on this work, including details of the products that will initially be in scope, will be provided later this year.

What steps are being taken to ensure that screening as part of the in-service evaluation of newborn screening of spinal muscular atrophy is commenced.

The Government recognises the challenges faced by those living with rare diseases and their families and is committed to improving outcomes. This is why the National Health Service is planning a large-scale in-service evaluation (ISE) of screening for spinal muscular atrophy in newborn screening services, starting in January 2027.Over 400,000 babies would be offered screening as part of this ISE. My Rt Hon. Friend, the Secretary of State for Health and Social Care, has asked NHS England to investigate whether it would be appropriate and feasible for the evaluation to be rolled out across the whole of England.Spinal muscular atrophy (SMA) can be a devastating condition, and we recognise that if treatment is given before a baby shows any symptoms, outcomes can be significantly improved. However, any screening programme that would impact approximately 650,000 babies per year in the United Kingdom must be underpinned by high quality robust evidence that demonstrates that screening will do more good than harm. The ISE will will help inform a future UK National Screening Committee recommendation on whether screening for SMA should be added to the NHS Newborn Blood Spot Screening Programme.

What steps are being taken to mitigate disparities in outcomes associated with partial geographical coverage of the in-service evaluation of newborn screening for spinal muscular atrophy.

The Government recognises the challenges faced by those living with rare diseases and their families and is committed to improving outcomes. This is why the National Health Service is planning a large-scale in-service evaluation (ISE) of screening for spinal muscular atrophy in newborn screening services, starting in January 2027.Over 400,000 babies would be offered screening as part of this ISE. My Rt Hon. Friend, the Secretary of State for Health and Social Care, has asked NHS England to investigate whether it would be appropriate and feasible for the evaluation to be rolled out across the whole of England.Spinal muscular atrophy (SMA) can be a devastating condition, and we recognise that if treatment is given before a baby shows any symptoms, outcomes can be significantly improved. However, any screening programme that would impact approximately 650,000 babies per year in the United Kingdom must be underpinned by high quality robust evidence that demonstrates that screening will do more good than harm. The ISE will will help inform a future UK National Screening Committee recommendation on whether screening for SMA should be added to the NHS Newborn Blood Spot Screening Programme.

What assessment has been made of the potential impact that delays in access to newborn screening for spinal muscular atrophy will have on those not part of the upcoming in-service evaluation of screening for the condition.

The Government recognises the challenges faced by those living with rare diseases and their families and is committed to improving outcomes. This is why the National Health Service is planning a large-scale in-service evaluation (ISE) of screening for spinal muscular atrophy in newborn screening services, starting in January 2027.Over 400,000 babies would be offered screening as part of this ISE. My Rt Hon. Friend, the Secretary of State for Health and Social Care, has asked NHS England to investigate whether it would be appropriate and feasible for the evaluation to be rolled out across the whole of England.Spinal muscular atrophy (SMA) can be a devastating condition, and we recognise that if treatment is given before a baby shows any symptoms, outcomes can be significantly improved. However, any screening programme that would impact approximately 650,000 babies per year in the United Kingdom must be underpinned by high quality robust evidence that demonstrates that screening will do more good than harm. The ISE will will help inform a future UK National Screening Committee recommendation on whether screening for SMA should be added to the NHS Newborn Blood Spot Screening Programme.

Whether his Department plans to ensure that the (a) psychological, (b) social and (b) financial impacts of caring for someone with Alzheimer’s disease are accounted for as part of National Institute for Health and Care Excellence methods for evaluating novel treatments.

In developing its recommendations, the National Institute for Health and Care Excellence (NICE) takes into account all health-related costs and benefits for patients and caregivers, in line with its established methods and processes.In 2022, NICE undertook a detailed review of whether it should broaden the perspective it uses in its economic evaluations, including consideration of wider societal impacts. NICE found that robust methods for quantifying wider societal effects are not yet sufficiently developed, and that evidence on the wider societal benefits of interventions, and of the services that might be displaced, is limited. NICE has also noted that expanding assessments to capture socioeconomic impacts could introduce ethical challenges, such as advantaging interventions for populations with higher workforce participation over those for children, older adults, or people unable to work.Following this review, and after examining both international comparisons, and the significant methodological and ethical challenges involved, NICE’s Board concluded that it should retain its current approach of using a health-sector perspective routinely but with the flexibility to include wider societal benefits when they are especially relevant.

What steps his Department is taking to ensure that overseas visitor charging regulations are applied uniformly across NHS trusts.

The overseas visitor charging regulations apply to all National Health Service trusts in England. The Department is working closely with NHS England to ensure the NHS (Charges to Overseas Visitors) Regulations 2015 are applied fairly and consistently across all NHS trusts.

Pursuant to the answer of 19th January to question 105612, to ask what role the Department for Health and Social Care will have in drug price negotiations following the abolishment of NHS England.

The target operating model for the integration of NHS England operations into the Department has yet to be finalised. However, drug-price negotiations will continue uninterrupted up to and beyond April 2027, when NHS England will cease to exist as a separate entity.

Pursuant to to the answers of 5 and 17 October 2025 to Questions 77387 and 86538, what progress he has made on ensuring a reliable supply of testosterone and oestrogen HRT implants.

We are continuing to work closely with the Medicines and Healthcare products Regulatory Agency (MHRA) to ensure safe access to these products. We have reached out to Specialist Importers who can source unlicensed medicines in order to find alternative sources of both oestrogen and testosterone hormone replacement therapy (HRT) implants, which are not licenced in the United Kingdom. We are engaging with companies globally to source supplies of HRT implants for UK patients. We are aware of a Specialist Importer who is able to source unlicensed testosterone implants. The decision to prescribe an unlicensed imported medicine sits with the prescriber. We are also engaging with companies globally to source supplies of HRT implants for UK patients. The MHRA has been working closely with current importers of the product and are also looking to encourage other applications for a licenced medicinal product. As oestrogen and testosterone HRT implants are not licenced in the UK, the MHRA is encouraging applications to supply products through the licenced medicines route.

How much funding was allocated to dementia research by (a) the National Institute for Health and Care Research and (b) UK Research and Innovation in each of the last five years.

Government responsibility for delivering dementia research is shared between the Department of Health and Social Care, with research delivered via the National Institute for Health and Care Research (NIHR), and the Department for Science, Innovation and Technology, with research delivered via UK Research and Innovation (UKRI).The table in the document attached shows the NIHR and UKRI’s spend data for dementia research across the five financial years from 2020/21 to 2024/25Spend for dementia research is calculated retrospectively, with a time lag due to annual reporting cycles, therefore 2024/25 is the most recent year we have data for. The Department does not centrally hold data on dementia research funding from other public bodies, and 2024/25 data from UKRI is still being confirmed.The NIHR welcomes funding applications for research into any aspect of human health and care, including dementia. These 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 dementia 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 potential impact of the length of time medical malpractice legal proceedings take to complete on (a) families and (b) staff.

NHS Resolution handles claims for compensation against National Health Service providers of healthcare and has a strategic priority to keep patients and healthcare staff out of litigation to minimise distress. To achieve this, NHS Resolution deploys a range of dispute resolution techniques including mediation, resolution meetings, and early neutral evaluation, and aims to resolve claims promptly and fairly. As a result, the percentage of cases resolving without litigation has continued to increase, reaching 83% of clinical claims in 2024/25. Each case must be, however, considered on its own merits in line with the prevailing law with appropriate investigation into legal liability and the amount of compensation due. Court involvement remains necessary for those who lack capacity and may also be required to determine points of law or where there is conflicting evidence.

What assessment he has made of the potential impact of activity management plans on patient waiting times for elective surgery.

Integrated care boards have existing contractual powers to manage activity by providers, which were enhanced in 2025/26 with central support for setting and managing activity. The NHS Standard Contract includes the ability to set Indicative Action Plans (IAPs) to help providers and commissioners plan demand, capacity, and expenditure. While not binding, if activity exceeds the agreed plan, and therefore the funding agreed, an Activity Management Plan (AMP) can be agreed to bring activity back in line.The provision and use of IAPs and AMPs is designed to deliver the activity levels required to achieve the goal of at least 65% of patients waiting no longer than 18 weeks for treatment by March 2026 whilst also living within financial budgets set for 2025/26.Any planning assumptions based on waiting times need to support commissioners’ overall duties to the populations they serve and our waiting time targets, including our commitment to return to the 18 week standard. AMPs allow commissioners and providers to work together to manage elective activity within agreed performance and financial targets, all whilst working towards improving patient waiting times overall.