Written questions by Kirkham.

What recent discussions his Department has had with NHS England on expanding medical exemption criteria to include people with multiple sclerosis dependent on long-term medication.

Awaiting answer.

What assessment he has made of the (a) adequacy of the time taken and (b) effectiveness of the General Optical Council's action in cases of malpractice.

The Department has regular discussions with the General Optical Council (GOC) on regulatory matters.While the GOC is an independent regulator responsible for managing its fitness to practise processes, the Government expects the GOC to take steps to improve the efficiency and timeliness of case handling.In March 2026, the Professional Standards Authority (PSA) published its 2024/25 performance review of the GOC, concluding that that it met all 18 Standards of Good Regulation, including those relating to fitness to practise. The PSA found that most fitness to practise investigations were timely and adequate, with risks managed appropriately. However, the PSA identified some areas for improvement which the GOC is addressing through an action plan. The PSA will monitor the progress of this plan as part of its continuous oversight of GOC’s performance.In parallel, the Department is progressing wider, longer-term reforms to the regulatory frameworks of the healthcare professional regulators. These will enable them to be more responsive to changes in the health and care workforce and give them the flexibility to modernise their fitness to practise processes whilst maintaining public protection.

What steps he has taken to protect whistleblowers in the NHS.

The Employment Rights Act 1996, as amended by the Public Interest Disclosure Act 1998, gives employees protection against unfair dismissal and detriment in employment on the basis that they have made a protected disclosure, as well as a right to seek remedy through an employment tribunal where this occurs. Separate regulations also protect National Health Service job applicants from discrimination on the grounds they have made a protected disclosure in the past. In addition to legal protections, there is a range of support in place for NHS workers who wish to report concerns, including local Freedom to Speak Up Guardians, a National Freedom to Speak Up policy, and support from independent organisations such as Speak Up Direct. Through delivery of the 10‑Year Health Plan, we will ensure that the Care Quality Commission, as part of its existing inspection and regulatory responsibilities, takes account of whether NHS providers have effective Freedom to Speak Up arrangements, where this forms a relevant line of enquiry. Where relevant, this includes whether providers have effective whistleblowing arrangements in place and whether staff feel able to raise concerns safely without fear of detriment.

For what reason unpaid carers are not eligible for vaccination against Coronavirus, in the context of them being eligible for vaccination against flu.

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, resulting in hospitalisations and deaths, arising from COVID-19.Although seasonal flu and COVID-19 can both cause severe disease, they differ in their epidemiology and pathology. As such, the population groups at higher risk of severe disease will not necessarily be the same for each pathogen and the JCVI has considered each programme individually.The JCVI advised in its autumn 2024 advice that, in the current era of high population immunity to COVID-19 and with all cases due to Omicron sub-lineages of COVID-19, currently available COVID-19 vaccines provide limited protection against transmission and mild or asymptomatic disease. The JCVI therefore advised that the focus of the programme should be on offering vaccination where it directly protects an individual at higher risk. In line with this advice, unpaid carers ceased to be offered COVID-19 vaccination in autumn campaigns from autumn 2024. Eligibility for the spring COVID-19 vaccination campaigns has never included unpaid carers.The focus of the COVID-19 vaccination programme is on vaccination of older adults and individuals who are immunosuppressed. These are the two groups who continue to be at higher risk of serious disease, including mortality.In line with JCVI advice for spring 2026 and autumn 2026, a COVID-19 vaccination is being offered this spring and autumn to the following groups:- adults aged 75 years old and over;- residents in care homes for older adults; and- individuals aged six months old and over who are immunosuppressed.The JCVI keeps all vaccination programmes under review.

What steps he is taking to prevent further reductions in opening hours and patient access for community pharmacies.

Last year, the Government increased funding for community pharmacy to almost £3.1 billion, representing the largest uplift for any part of the National Health Service across 2024/25 and 2025/26.Pharmacies in areas of high health need and limited provision continue to receive additional support through the Pharmacy Access Scheme, helping to maintain reasonable access to NHS pharmaceutical services.The Department is consulting Community Pharmacy England on proposals for contractor reimbursement and remuneration for 2026/27 and will announce the outcome once the consultation concludes.The majority of community pharmacies are contractually required to open for a minimum of 40 core hours per week, with a small proportion required to open for 72 hours. If changes to pharmacy opening hours risk limiting patient access, integrated care boards can take action locally.

If he will make an assessment of the potential merits of making unpaid carers eligible for vaccination against Coronavirus.

I refer the hon. Member to the answer I gave to the hon. Member for Suffolk Coastal on 3 March 2026 to Question 115220.

If his Department will commission research to better understand the health impacts of breast implants.

The Department delivers research via the National Institute for Health and Care Research (NIHR). The NIHR welcomes funding applications for research into any aspect of human health and care, including the health impacts of breast implants. Through the NIHR, the Department funded a study to explore the long-term outcomes and cost-effectiveness of different methods of breast reconstruction, including implants, for women following a mastectomy. This research showed which methods of breast reconstruction were more likely to require later revision, supporting patients to make informed decisions about their treatment.

What steps he is taking to improve the MHRA's yellow card system.

The Medicines and Healthcare products Regulatory Agency (MHRA) is committed to continually strengthening the Yellow Card scheme to support patient safety. The MHRA regularly promotes awareness through public health campaigns, conferences, established networks, and new educational resources available on the Yellow Card website. Further information is available at the following link:https://www.gov.uk/government/organisations/medicines-and-healthcare-products-regulatory-agencyThe MHRA is expanding and improving digital reporting routes. Every National Health Service webpage relating to a medicine or vaccine now links to the Yellow Card scheme, and the MHRA is working with NHS colleagues to enhance integration with the NHS App to increase visibility and reporting by the public. Yellow Card reporting is now embedded in almost all general practice clinical IT systems, enabling healthcare professionals to submit reports directly on behalf of patients.Over recent years, the MHRA has delivered a major upgrade programme to modernise the Yellow Card scheme’s technology and infrastructure. This includes improving the quality and timeliness of submitted information, making it easier to report, adding conditional questions to reduce follow up, and support real time signal detection of safety issues.The Yellow Card app has also been modernised to mirror the website, broaden reporting options, including defective and counterfeit medicines, and improve access to safety data. Multi‑factor authentication has been introduced to enhance account security and enable future integration with NHS login. The app has also been upgraded to a progressive web application, providing a seamless and engaging user experience across devices.Together, these improvements increase public awareness, make reporting easier, and enhance the MHRA’s ability to identify and assess emerging safety concerns across healthcare products.

If he will introduce regular testing of approved breast implants to ensure continued compliance with safety standards.

Under existing medical device regulations, UK Medical Devices Regulations 2002, all medical devices must meet the Essential Requirements, which includes the use of designated standards that specify mandatory safety and performance criteria for those devices. As breast implants are the highest class medical device, class III, they must undergo rigorous pre-market testing by the manufacturer, which is then assessed by a third party such as a United Kingdom approved body or European Union notified body, before being registered with the Medicines and Healthcare products Regulatory Agency (MHRA) and prior to being placed on the market in the UK. Once on the market, the manufacturer must continuously review the safety of their devices. The manufacturer is subject to annual surveillance and monitoring, alongside unannounced audits to ensure claimed standards of quality and safety management are being applied in practise. The MHRA also monitors emerging signals to determine if previously unrecognised risks exist or if the nature of known risks is changing.Following the Cumberlege recommendations in the Independent Medicines and Medical Devices Safety Review, the MHRA has introduced post-market surveillance regulations to require that safety issues with medical devices are identified early. Further information on the review is available at the following link:https://immdsreview.org.uk/The MHRA is also developing a future regulatory framework to strengthen pre-market requirements for medical devices. This intends to introduce requirements for unique device identifiers, implant cards, and new rules to ensure that claims are consistent with intended purpose to better reflect potential risks to patients, increase containment of safety issues, and reduce patient harm.

What steps he is taking to help ensure that all surgeons, including private surgeons, record the implants they have done in the Breast Implant Registry.

The Outcomes and Registries Directions 2024 require that all healthcare providers of National Health Service funded care contribute data to the Breast and Cosmetic Implant Register. Therefore, compliance from both NHS and private clinicians, in relation to NHS funded care, is mandatory. Furthermore, work is ongoing within NHS England to ensure that all NHS and independent sector providers contribute data to the Medical Devices Outcomes Registry, following the recommendations of the Cumberlege Inquiry, with further information available at the following link: https://www.england.nhs.uk/outcomes-and-registries-programme/

What steps his Department is taking to help make primary care workers aware of the potential for a link between autoimmune conditions and breast implants.

Guidance for clinicians and patients called Symptoms sometimes referred to as Breast Implant Illness, including autoimmune conditions, was published by the Medicines and Healthcare products Regulatory Agency in 2020 and updated in 2023. Healthcare professionals and anyone experiencing any symptoms that they believe to be associated with their breast implants are strongly encouraged to report these through the Yellow Card scheme.Continuing professional development (CPD) opportunities for primary care workers are provided by royal colleges and professional bodies for each profession.Primary care workers should ensure their own clinical knowledge remains up to date and are responsible for identifying learning needs as part of their CPD. This activity should include taking account of new research and developments in guidance, such as that produced by the National Institute for Health and Care Excellence, to ensure that they can continue to provide high-quality care to all patients.General practices and primary care networks also have access to a regional Primary Care Training Hub, which will bring together education and training resources from National Health Service organisations, community providers, and local authorities. Training hubs are usually run by a clinical leader and a manager supported by a network of primary care staff with education and training professionals based in the community. They work closely with primary care networks and integrated care systems to support workforce priorities and tackle health inequalities to help meet patient and population demand.

What steps his Department is taking to ensure a nationally consistent delivery model for NHS-commissioned clinical nursing services for children and young people in education settings.

The Government is committed to delivering the healthiest generation of children ever.  The National Health Service is responsible for meeting the health needs of children and young people diagnosed with an illness or medical condition, including long term conditions.On 5 February Standardising community health services – core component descriptions was published, and is available at the following link:https://www.england.nhs.uk/publication/standardising-community-health-services-core-component-descriptions/It includes the core components of a special school nursing service and community children's nursing service. This document is primarily to support integrated care boards’ strategic commissioning of Community Health Services.Within this document, NHS England outlines the core responsibilities of these services, including their role in supporting children with medical conditions to access education settings.

Whether his Department considers clinical nursing care delivered in education settings to constitute NHS healthcare for which Integrated Care Boards hold commissioning responsibility under existing statutory duties.

The Government is committed to delivering the healthiest generation of children ever.  The National Health Service is responsible for meeting the health needs of children and young people diagnosed with an illness or medical condition, including long term conditions.On 5 February Standardising community health services – core component descriptions was published, and is available at the following link:https://www.england.nhs.uk/publication/standardising-community-health-services-core-component-descriptions/It includes the core components of a special school nursing service and community children's nursing service. This document is primarily to support integrated care boards’ strategic commissioning of Community Health Services.Within this document, NHS England outlines the core responsibilities of these services, including their role in supporting children with medical conditions to access education settings.

What steps his Department is taking to help prevent teenagers and young adults from contracting Meningitis B.

Meningococcal disease is rare, and the incidence has declined over the last two decades following the introduction of vaccines targeting meningococcal disease including the MenACWY teenage vaccination programme.There is no current Meningitis B (MenB) vaccination programme for teenagers and young adults.The importance of raising awareness in parents, teenagers and other adults about the signs and symptoms of meningitis and septicaemia remains key. There are a range of resources developed by the UK Health Security Agency (UKHSA), co-branded with the National Health Service, that set out these key messages and their importance, such as the teenage guide to immunisation. The guide is available at the following link:https://www.gov.uk/government/publications/immunisations-for-young-peopleThe UKHSA collaboratively produces a university vaccine communications toolkit. This is shared with the distribution lists of Universities UK and the Association of Managers of Student Services in Higher Education (AMOSSHE), and is available at the following link:https://find-public-health-resources.service.gov.uk/University%20vaccine%20communications%20toolkit/UNI24In addition, United Kingdom guidance on the public health management of meningococcal disease provides clear advice on the management of confirmed and probable cases of invasive meningococcal disease, including MenB, to minimise onward transmission and further associated cases. This guidance is available at the following link:https://www.gov.uk/government/publications/meningococcal-disease-guidance-on-public-health-management

When the Joint Committee on Vaccination and Immunisation will next consider the potential merits of offering the Meningitis B vaccine to teenagers on the NHS.

The Joint Committee on Vaccination and Immunisation (JCVI) meningococcal sub-committee have met several times over 2024 and 2025 to discuss the meningococcal vaccination programme. In June 2025, the sub-committee noted that when available, they would like to review a model evaluating the impact of the Meningitis B (MenB) vaccination when given in a teenage programme in a two-dose schedule, including impact on meningococcal disease and gonorrhoea.In 2013, the JCVI advised that the cost-effectiveness of an adolescent MenB vaccination programme would be dependent on the impact of the vaccine on protection against meningococcal carriage, which was uncertain at the time. Since this advice was published, the JCVI has continued to review the MenB vaccination programme. Recent evidence, discussed by the JCVI meningococcal sub-committee in March 2025, indicated that MenB vaccination in adolescents has little to no effect on meningococcal carriage.

How many women have been affected by faulty PIP breast implants in Truro and Falmouth constituency.

The Breast and Cosmetic Implant Registry (BCIR), set up in 2016, collects all implant data, and explant data where possible.Practically, it is always difficult and often impossible to identify a model and product code on an explant. If explanted devices, or patients undergoing explant, cannot be linked to data collected at time of implant, then this often reduces explant data to 'patient, surgeon, location, date'. This in turn makes it impossible to monitor trends in explant/failure.NHS England is in the process of clarifying and mandating the detail required in the BCIR and other device-related collections. This will place a greater responsibility on trusts to either identify a device at the point of explant, or to identify the device from internal trust records created during the same patient's implant procedure.This will only be possible if the implant and explant are performed at the same trust. It is then the intention of NHS England to provide the same matching service for implant/explant where the trusts differ.This solution will, when implemented, give a full, proactive picture of device longevity/risk, for the purposes of research and surveillance, alongside the existing ability to identify patients affected by a device recall notice.Alongside this work, as part of the its reforms to the Medical Devices Regulations 2002, the Medicines and Healthcare products Regulatory Agency (MHRA) has introduced updated requirements for the post-market surveillance of medical devices, including implants, enabling both the manufacturer and the MHRA to identify issues with medical devices more easily and where necessary, for the MHRA to take fast action to safeguard public health.Later this year, the MHRA intends to introduce a requirement for clinicians to provide patients with an implant card and information regarding any warnings, precautions, or measures to be taken by the patient or healthcare professional. This will strengthen transparency and support patients in understanding their implants.

What steps are being taken to encourage the use of a surgical robot in Cornwall, in the context of it being the only region in England and Wales without one.

Our 10-Year Health Plan commits to expanding surgical robot adoption over the next decade. We recognise the importance of ensuring equitable access and we will establish national registries for robotic surgery data from 2029 and develop telesurgery networks to support geographical equity of access to robotic assisted surgery.Decisions on the procurement of robotic‑assisted surgery are made locally by NHS trusts and integrated care boards, in line with local need and national guidance. The Royal Cornwall Hospitals NHS Trust (RCHT) has a robotic surgery programme as a commitment in their refreshed 10-year strategy, which was approved at the RCHT Board on 8 January 2026.

When guidance on clinical delegation will be published.

The regulators of registered healthcare professionals, including the General Medical Council (GMC) and the Nursing and Midwifery Council (NMC), are independent of the Government, are directly accountable to Parliament, and are responsible for operational matters concerning the discharge of their statutory duties. The United Kingdom’s model of healthcare professional regulation is founded on the principle of regulators operating independently from the Government.The GMC has published the guidance ‘Delegation and referral’ while the NMC has published its guidance ‘Delegation and accountability’. Both regulators expect their registrants to follow the appropriate guidance when delegating clinical work.

What steps his Department is taking to support Royal Cornwall Hospitals NHS Trust in addressing the long waits for ambulances and emergency care at the acute hospital in Cornwall.

We are committed to improving urgent and emergency care and returning to the waiting time standards set out in the National Health Service constitution through actions set out in Urgent and Emergency Care Plan for 2025/26 and the Medium Term Planning Framework for 2026/27 to 2028/29.On the 6 June 2025, we published our Urgent and Emergency Care Plan for 2025/26, backed by a total of nearly £450 million of funding. The plan focuses on improvements that will see the biggest impact on urgent and emergency care performance next winter and on making urgent and emergency care better every day, including reducing ambulance handovers to a maximum of 45 minutes and actions to support at least 78% of patients in accident and emergency being seen within four hours.The Royal Cornwall Hospitals NHS Trust has been focusing on its ‘clinical vision of flow’, alongside whole system work which is delivering improvement in urgent and emergency care performance.

How many of the 10,910 additional urgent dental appointments allocated to Cornwall and the Isles of Scilly Integrated Care Board have been delivered since April 2025.

We have asked the integrated care boards (ICBs) to commission extra urgent dental appointments to make sure that patients with urgent dental needs can get the treatment they require. ICBs have been making extra appointments available from April 2025.Appointments are available across the country, with specific expectations for each region. These appointments are more heavily weighted towards those areas where they are needed the most.Data on delivery of urgent dental care, including additional delivery, will be published annually as part of the NHS Dental Statistics England Official Statistics series. These statistics are released each August and are the primary source of data on the delivery of NHS dental care.