Written questions by Brown-Fuller.

What steps he is taking to reduce diagnostic waiting times for endometriosis in (a) England and (b) Chichester constituency.

Patients waiting for an endometriosis diagnosis may receive diagnostic tests such as magnetic resonance imaging (MRI) and ultrasound, though the only definitive way to diagnose endometriosis is by a laparoscopic procedure. The laparoscopy is also used to treat endometriosis.To improve diagnosis times, we are transforming diagnostic services and taking steps to increase diagnostic capacity. This includes expanding existing community diagnostic centres (CDCs), building up to five new ones as part of £600 million capital funding for diagnostics in 2025/26 and opening more CDCs 12 hours per day, seven days a week.NHS Sussex ICB have increased diagnostic capacity by setting up a well-established CDC programme. Seven CDCs operate across Sussex, including University of Chichester Bognor CDC, and are expected to deliver an additional 460,000 diagnostic tests in 2025/26, including 40,000 MRI scans, and nearly 90,000 ultrasound scans.

Whether his Department has reviewed research indicating that speech and language intervention for children with Down syndrome should begin in the first year of life.

National Health Service guidance sets out information on how to help children and young people with Down syndrome, including that they may need the support of a Speech and Language Therapist. Further information is available at the following link: https://www.nhs.uk/conditions/downs-syndrome/how-to-help-children-and-young-people/ Through implementation of the Down Syndrome Act 2022, we want to improve the lives of people with Down syndrome. Under the Down Syndrome Act, my Rt Hon. Friend, the Secretary of State for Health and Social Care, is required to give guidance to relevant authorities in health, social care, education, and housing services on what they should be doing to meet the needs of people with Down syndrome.We considered a range of evidence from our Call for Evidence and engagement when developing the draft Down syndrome guidance, currently out for public consultation, including research on speech and language therapy (SLT). The draft guidance highlights that people with Down syndrome are likely to have communication needs and sets out support that can be provided, including that people with Down syndrome should be able to access speech and language assessment and support in a timely manner. The draft guidance is clear that NHS commissioners and providers may offer people with Down syndrome and their families and carers a range of SLT services and interventions to support their communication, tailored to their specific needs. This should include early intervention services starting from birth, continuing through early years to support a good start in life, and then into primary and secondary school and beyond. The draft guidance is also clear that support should be tailored to individual needs, and it is also important that local systems have the discretion to determine how best to meet the needs of their local communities.

What guidance his Department has issued on the age at which clinical guidance recommends that speech and language intervention should begin for children with Down syndrome; and whether that guidance includes supporting assistance with speech sounds in infancy.

National Health Service guidance sets out information on how to help children and young people with Down syndrome, including that they may need the support of a Speech and Language Therapist. Further information is available at the following link: https://www.nhs.uk/conditions/downs-syndrome/how-to-help-children-and-young-people/ Through implementation of the Down Syndrome Act 2022, we want to improve the lives of people with Down syndrome. Under the Down Syndrome Act, my Rt Hon. Friend, the Secretary of State for Health and Social Care, is required to give guidance to relevant authorities in health, social care, education, and housing services on what they should be doing to meet the needs of people with Down syndrome.We considered a range of evidence from our Call for Evidence and engagement when developing the draft Down syndrome guidance, currently out for public consultation, including research on speech and language therapy (SLT). The draft guidance highlights that people with Down syndrome are likely to have communication needs and sets out support that can be provided, including that people with Down syndrome should be able to access speech and language assessment and support in a timely manner. The draft guidance is clear that NHS commissioners and providers may offer people with Down syndrome and their families and carers a range of SLT services and interventions to support their communication, tailored to their specific needs. This should include early intervention services starting from birth, continuing through early years to support a good start in life, and then into primary and secondary school and beyond. The draft guidance is also clear that support should be tailored to individual needs, and it is also important that local systems have the discretion to determine how best to meet the needs of their local communities.

What steps his Department is taking to ensure that speech and language therapy for children with Down syndrome is delivered on a preventative basis from infancy.

National Health Service guidance sets out information on how to help children and young people with Down syndrome, including that they may need the support of a Speech and Language Therapist. Further information is available at the following link: https://www.nhs.uk/conditions/downs-syndrome/how-to-help-children-and-young-people/ Through implementation of the Down Syndrome Act 2022, we want to improve the lives of people with Down syndrome. Under the Down Syndrome Act, my Rt Hon. Friend, the Secretary of State for Health and Social Care, is required to give guidance to relevant authorities in health, social care, education, and housing services on what they should be doing to meet the needs of people with Down syndrome.We considered a range of evidence from our Call for Evidence and engagement when developing the draft Down syndrome guidance, currently out for public consultation, including research on speech and language therapy (SLT). The draft guidance highlights that people with Down syndrome are likely to have communication needs and sets out support that can be provided, including that people with Down syndrome should be able to access speech and language assessment and support in a timely manner. The draft guidance is clear that NHS commissioners and providers may offer people with Down syndrome and their families and carers a range of SLT services and interventions to support their communication, tailored to their specific needs. This should include early intervention services starting from birth, continuing through early years to support a good start in life, and then into primary and secondary school and beyond. The draft guidance is also clear that support should be tailored to individual needs, and it is also important that local systems have the discretion to determine how best to meet the needs of their local communities.

Whether foundation trusts will retain the option to maintain councils of governors under the 10 Year Health Plan for England.

The Council of Governors at National Health Service foundation trusts have a range of statutory roles and powers including representing the views of local populations, staff, and other stakeholders to the foundation trusts’ board. The removal of the Council of Governors forms part of the wider 10-Year Health Plan’s aim to ensure that hospitals put patient experiences and outcomes at the heart of their decision-making. While governors have provided helpful advice and oversight for some foundation trusts, we now need to move to a more dynamic model of drawing on patient, staff, and stakeholder insight. The removal of the Council of Governors will require primary legislation which the Government will bring forward when Parliamentary time allows.

Whether foundation trusts will retain the option to have councils of governors under the 10‑Year Health Plan for England.

The Council of Governors at National Health Service foundation trusts have a range of statutory roles and powers including representing the views of local populations, staff, and other stakeholders to the foundation trusts’ board. The removal of the Council of Governors forms part of the wider 10-Year Health Plan’s aim to ensure that hospitals put patient experiences and outcomes at the heart of their decision-making. While governors have provided helpful advice and oversight for some foundation trusts, we now need to move to a more dynamic model of drawing on patient, staff, and stakeholder insight. The removal of the Council of Governors will require primary legislation which the Government will bring forward when Parliamentary time allows.

What his planned timetable is for the removal of the requirement for foundation trusts to have governors.

The Council of Governors at National Health Service foundation trusts have a range of statutory roles and powers including representing the views of local populations, staff, and other stakeholders to the foundation trusts’ board. The removal of the Council of Governors forms part of the wider 10-Year Health Plan’s aim to ensure that hospitals put patient experiences and outcomes at the heart of their decision-making. While governors have provided helpful advice and oversight for some foundation trusts, we now need to move to a more dynamic model of drawing on patient, staff, and stakeholder insight. The removal of the Council of Governors will require primary legislation which the Government will bring forward when Parliamentary time allows.

If he will undertake a review of publicly funded fellowship programmes for training overseas doctors.

There are currently no plans to review publicly funded fellowship programmes for training overseas doctors. A range of international postgraduate medical training schemes operate across the National Health Service. These are governed by individual NHS trusts, medical royal colleges, the Academy of Medical Royal Colleges, and indirectly, NHS England, and the General Medical Council. These programmes are expected to be properly governed, provide value for money, and ensure fair treatment for all participants. We expect all NHS organisations to operate in line with these principles.

Whether he has made an assessment of the potential impact of the online GP booking system introduced on 1 October 2025 on the digitally excluded.

The contractual change made on 1 October 2025 required general practices to keep their existing online systems open during core hours, allowing patients to contact the practice online between 8am and 6.30pm. Telephone and in-person routes continue to operate as before. As non-digital routes remain available, a separate assessment of the impact on digitally excluded patients was not required.It is not a standard practice to write to citizens where services remain unchanged.National Health Service organisations must ensure all patients have equitable access to care, and that decisions or policies do not unfairly disadvantage people or lead to an increase in inequalities. All NHS organisations are legally obliged not to discriminate. Although digital first services are encouraged for those who choose to use them, a non‑digital solution must be available for patients who cannot or do not wish to engage digitally. The GP contract is clear that telephone and face to face access must remain in place, and online tools can only be provided in addition to not instead of other routes.These requirements apply across all NHS services. We recognise that not all patients can or want to use online services. To ensure that patients are not digitally excluded, the GP Contract is clear that patients should always have the option of telephoning or visiting their practice in person, and all online tools must always be provided in addition to, rather than as a replacement for, other channels for accessing a GP. We have also committed to work with digital transformation teams in integrated care boards (ICBs) and with groups at risk of digital exclusion to ensure digital solutions are inclusive.Based on the data currently available, the time between booking and attending a GP appointment has remained stable following the introduction of the 1 October 2025 contractual requirement for online consultation systems to operate throughout core hours.Data for October to December 2024 and the corresponding period in 2025 show only marginal variation. 37.9% to 46% of appointments were booked on the same day in 2024 compared with 38.7% to 46% in 2025, and 74.9% to 82.7% were seen within two weeks in 2024 compared with 75% to 82.8% in 2025. This is consistent with the fact that many practices were already operating their systems in this way prior to the contractual change. Access to general practice has continued to improve. In December 2025, 88.8% of appointments not usually booked in advance were seen within 14 days, the highest proportion in 2025. Nationally, patient satisfaction with GP access has also improved, rising from 61% in July 2024 to 75.2% in December 2025.

Whether the Government has considered writing to every pension-age person to inform them they can phone or go in-person to book a GP appointment following the introduction of the online booking system on 1 October 2025.

The contractual change made on 1 October 2025 required general practices to keep their existing online systems open during core hours, allowing patients to contact the practice online between 8am and 6.30pm. Telephone and in-person routes continue to operate as before. As non-digital routes remain available, a separate assessment of the impact on digitally excluded patients was not required.It is not a standard practice to write to citizens where services remain unchanged.National Health Service organisations must ensure all patients have equitable access to care, and that decisions or policies do not unfairly disadvantage people or lead to an increase in inequalities. All NHS organisations are legally obliged not to discriminate. Although digital first services are encouraged for those who choose to use them, a non‑digital solution must be available for patients who cannot or do not wish to engage digitally. The GP contract is clear that telephone and face to face access must remain in place, and online tools can only be provided in addition to not instead of other routes.These requirements apply across all NHS services. We recognise that not all patients can or want to use online services. To ensure that patients are not digitally excluded, the GP Contract is clear that patients should always have the option of telephoning or visiting their practice in person, and all online tools must always be provided in addition to, rather than as a replacement for, other channels for accessing a GP. We have also committed to work with digital transformation teams in integrated care boards (ICBs) and with groups at risk of digital exclusion to ensure digital solutions are inclusive.Based on the data currently available, the time between booking and attending a GP appointment has remained stable following the introduction of the 1 October 2025 contractual requirement for online consultation systems to operate throughout core hours.Data for October to December 2024 and the corresponding period in 2025 show only marginal variation. 37.9% to 46% of appointments were booked on the same day in 2024 compared with 38.7% to 46% in 2025, and 74.9% to 82.7% were seen within two weeks in 2024 compared with 75% to 82.8% in 2025. This is consistent with the fact that many practices were already operating their systems in this way prior to the contractual change. Access to general practice has continued to improve. In December 2025, 88.8% of appointments not usually booked in advance were seen within 14 days, the highest proportion in 2025. Nationally, patient satisfaction with GP access has also improved, rising from 61% in July 2024 to 75.2% in December 2025.

Whether his Department has assessed the impact of the online GP booking system introduced on 1 October 2025 on (a) patient access to GPs and (b) appointment waiting times.

The contractual change made on 1 October 2025 required general practices to keep their existing online systems open during core hours, allowing patients to contact the practice online between 8am and 6.30pm. Telephone and in-person routes continue to operate as before. As non-digital routes remain available, a separate assessment of the impact on digitally excluded patients was not required.It is not a standard practice to write to citizens where services remain unchanged.National Health Service organisations must ensure all patients have equitable access to care, and that decisions or policies do not unfairly disadvantage people or lead to an increase in inequalities. All NHS organisations are legally obliged not to discriminate. Although digital first services are encouraged for those who choose to use them, a non‑digital solution must be available for patients who cannot or do not wish to engage digitally. The GP contract is clear that telephone and face to face access must remain in place, and online tools can only be provided in addition to not instead of other routes.These requirements apply across all NHS services. We recognise that not all patients can or want to use online services. To ensure that patients are not digitally excluded, the GP Contract is clear that patients should always have the option of telephoning or visiting their practice in person, and all online tools must always be provided in addition to, rather than as a replacement for, other channels for accessing a GP. We have also committed to work with digital transformation teams in integrated care boards (ICBs) and with groups at risk of digital exclusion to ensure digital solutions are inclusive.Based on the data currently available, the time between booking and attending a GP appointment has remained stable following the introduction of the 1 October 2025 contractual requirement for online consultation systems to operate throughout core hours.Data for October to December 2024 and the corresponding period in 2025 show only marginal variation. 37.9% to 46% of appointments were booked on the same day in 2024 compared with 38.7% to 46% in 2025, and 74.9% to 82.7% were seen within two weeks in 2024 compared with 75% to 82.8% in 2025. This is consistent with the fact that many practices were already operating their systems in this way prior to the contractual change. Access to general practice has continued to improve. In December 2025, 88.8% of appointments not usually booked in advance were seen within 14 days, the highest proportion in 2025. Nationally, patient satisfaction with GP access has also improved, rising from 61% in July 2024 to 75.2% in December 2025.

What steps his Department is taking to provide consistent funding for fertility treatment across all NHS Trusts.

Access to NHS-funded fertility services varies across England, which is unacceptable.Revised National Institute for Health and Care Excellence (NICE) fertility guidelines are due this Spring.Funding decisions for health services in England are made by Integrated Care Boards (ICBs), based on their population’s clinical needs. We expect ICBs to commission fertility services consistent with these new guidelines, ensuring equal access to treatment across England.

What steps he is taking to improve access to specialist care, treatment and medication for a) children and b) people with phenylketonuria.

The Government is committed to improving the lives of those living with rare diseases, such as phenylketonuria, through the UK Rare Diseases Framework. A priority of the framework is improved access to specialist care, treatment, and drugs. In February last year the England 2025 Rare Diseases Action Plan was published, including progress made under this priority, namely:meeting to discuss the effectiveness of early access pathways for rare disease therapies;launching a review of the National Institute for Health and Care Excellence highly specialised technology programme for evaluating rare disease treatments;introducing two new actions on reforming clinical trial regulations; anddeveloping an operational framework for individualised therapies in the National Health Service.Information about symptoms, medicines, tests and treatments, is provided on the NHS England webpage on phenylketonuria, at the following link:https://www.gov.uk/government/publications/pku-suspected-description-in-brief/phenylketonuria-pku-detailed-informationThe treatment sapropterin is eligible for people with phenylketonuria. Clinical trials suggest that approximately four in 10 people may benefit from sapropterin, improving their quality of life significantly and reducing restrictions on the food they can eat.

What steps he is taking to increase the availability of medication options for bronchiectasis.

The National Institute for Health and Care Excellence (NICE) published guidance in 2019 on antimicrobial prescribing for managing and preventing acute exacerbations of bronchiectasis, sometimes called non-cystic fibrosis. The guideline is available at the following link:https://www.nice.org.uk/guidance/ng117NICE guidelines are based on a thorough assessment of the available evidence and should be taken fully into account by healthcare professionals in the care and treatment of individual patients.NICE makes recommendations for the National Health Service on whether all new licensed medicines should be routinely funded by the NHS based on an assessment of the available evidence. NICE has selected brensocatib for treating non-cystic fibrosis bronchiectasis in people 12 years old and over as a topic for guidance development, and currently expects final guidance to be published by July 2026, subject to it being granted a marketing authorisation by the Medicines and Healthcare products Regulatory Agency. The progress of this appraisal can be followed on NICE’s website, at the following link:https://www.nice.org.uk/guidance/indevelopment/gid-ta11564

What steps his Department is taking to improve the collection of data on triple-negative breast cancer.

Data on triple negative breast cancer for England is collected through the National Disease Registration Service (NDRS). An NDRS Quality Assurance Team is in place to identify, investigate, and monitor data quality issues, with over 130 Quality Assurance reports being run each month as well as quarterly reports to assess the completeness of key data.To drive up the completeness of the data, progesterone receptor status, human epidermal growth factor receptor in situ hybridization status, and oestrogen receptor status are assessed as part of the Cancer Outcomes and Services Data set, which supports national registration.

What steps he is taking to reduce the time taken for occupational therapy a) assessments and b) reassessments.

Integrated care boards are responsible for the commissioning Occupational Therapy services that meet the needs of their local populations. This includes overseeing waiting lists for access to Occupational Therapy services, improve outcomes and deliver best value from the health budget.

What assessment his Department has made of the adequacy of levels of public understanding of winter illness (a) transmission and (b) prevention; and if he will consider a public information campaign on infection prevention, in addition to vaccination programmes.

The UK Health Security Agency (UKHSA) Public Perceptions Tracker provides insight into public attitudes and behaviours in relation to priority public health issues. It is a quarterly online survey, with a sample of approximately 1,000 participants per wave. The sample is representative of the following groups in England: gender identity; age; region; and social grade; interlocked with ethnicity.In addition to vaccine campaigns, the UKHSA runs annual no-cost public information campaigns each winter, focused on promoting infection prevention behaviours. The campaign includes social media content, downloadable digital assets, and stakeholder engagement.The UKHSA produces 'Virus Watch' which includes 60-second expert videos, explanatory infographics, and data summaries. This aims to help people understand which viruses are circulating and take the right actions to protect their health and prevent spread.

What steps he is taking to (a) help reduce delays in continuing healthcare reviews for previously unassessed periods of care and (b) reduce the associated administration.

The Department and NHS England published guidance in 2023 for assessing requests for Previously Unassessed Periods of Care (PUPoC). This guidance sets out how integrated care boards (ICBs) should approach and address PUPoC assessment requests. The guidance is available at the following link:https://www.gov.uk/government/publications/continuing-healthcare-previously-unassessed-periods-of-care/dealing-with-requests-for-assessments-of-previously-unassessed-periods-of-care-from-1-april-2012The guidance states that ICBs should set their own reasonable and proportionate timeframes for responding to requests. It provides best practice examples for how ICBs should complete PUPoC requests, based on the timeframe for the unassessed period of care and the completion of the required application and consent forms. NHS England publishes quarterly statistics relating to the activity of NHS Continuing Healthcare and National Health Service-funded Nursing Care which includes PUPoC data, reporting on the number of cases agreed eligible, both total and per 50,000. This is available at the following link: https://www.england.nhs.uk/statistics/statistical-work-areas/nhs-chc-fnc/

What assessment he has made of access to specialist endometriosis services for young people aged 17 and under.

We know that girls and women deserve better, which is why we are renewing the Women’s Health Strategy, to assess the progress that has been made so far and to continue progressing delivery while empowering women with information about heavy menstrual bleeding and reproductive health conditions.All hospitals providing specialised care and treatment for endometriosis for patients aged 17 and under must have a paediatric gynaecologist as part of their multi-disciplinary team, who will be a part of the treatment planning and decision-making process. The individual’s parents or a person with parental responsibility must also be involved where applicable. If this is not available, these patients must be referred to a paediatric and adolescent gynaecology service.

What assessment he has made of the adequacy of criteria for (a) parental and (b) professional involvement in decision-making for young people who lack the capacity to make the appropriate decisions to keep themselves safe after they turn 18.

People over the age of 18 years old come under the Mental Capacity Act (MCA) 2005, which has the statutory principle that an individual must be assumed to have capacity unless it is established otherwise. All practicable steps must be taken to help any individual above 18 years old to make a decision by themselves, and if unsuccessful, then all decisions made on their behalf must be in their best interests.On 18 October 2025, my Rt Hon. Friend, the Secretary of State for Health and Social Care announced the intention to launch a public consultation on the Liberty Protection Safeguards (LPS) in the first half of 2026. The consultation will cover a revised Code of Practice and will incorporate changes in case law, legislation, and good practice in application of the MCA.The LPS, as introduced by the Mental Capacity (Amendment) Act 2019, aims to deliver greater involvement of families and professionals in providing care to vulnerable people in circumstances that amount to a deprivation of liberty.