Written questions by Brown-Fuller.

What assessment he has made of the level of support available to children with situational mutism in Chichester constituency.

It has not proved possible to respond to the hon. Member in the time available before Prorogation.

When self-referral to community audiologists will be enabled on the NHS app.

The Government is committed to enabling patients to access digital health and care services to manage their health. As part of its work to support self-referral services for National Health Service patients in the musculoskeletal community, the Government is assessing how to develop these services for other communities, including those of audiologists. Work is expected to take place this financial year and will consider whether the NHS App is the best mechanism for self-referral.

What assessment he has made of the impact of mandatory Advice and Guidance requirements on ensuring that appropriate referrals for endometriosis are not delayed or blocked.

The GP Contract does not mandate the use of Advice and Guidance (A&G) in all circumstances. Instead, as per the Medium-Term Planning Framework published in October 2025, providers are expected to prioritise A&G prior to or in place of a planned care referral for at least ten specialties, selected locally for greatest overall benefit and to shape delivery of elective pathways. General practice should be involved in discussions to decide on which ten specialties are the most appropriate. This does not take away a GP’s right to refer, which remains a matter of clinical judgement. This reflects longstanding planned‑care referral practice and does not alter existing legal or professional accountability frameworks for GPs.A&G is designed to support quicker, clearer clinical decision making, by enabling GPs and specialists to discuss and agree the most appropriate next steps for a patient, including those with or suspected to have endometriosis. Where the outcome of advice is for care management in the community, we expect patients to be seen more quickly, closer to home, benefiting from earlier specialist input. In these cases, the GP may still subsequently refer their patient at any point if they have concerns.The Renewed Women’s Health Strategy commits to speeding up diagnosis and access to treatment for women with endometriosis. The strategy announces a new programme to improve education for girls about their menstrual health, investing an additional £1 million to support targeted work in schools and community settings to support girls’ knowledge about menstrual health and when to seek healthcare. This is an important factor to delays in diagnosis and treatment for endometriosis.

Whether his Department plans to introduce a modern service framework for the prevention, diagnosis and treatment of kidney disease.

The Government will consider long-term conditions for future waves of modern service frameworks (MSFs). The criteria for determining other conditions for future MSFs will be based on where there is potential for rapid and significant improvements in quality of care and productivity. After the initial wave of MSFs is complete, the National Quality Board will determine the conditions to prioritise for new MSFs as part of its work programme.

What discussions his Department has had with the Department of State for Education on the recognition of the Pathological Demand Avoidance profile within assessments for Autism Spectrum Disorder.

My Rt Hon. Friend, the Secretary of State for Health and Social Care, has regular discussions on a wide range of matters, including with other departments.Pathological Demand Avoidance (PDA) is most often understood as a characteristic of, or observed in, some autistic people, but professional consensus on its status is still required. PDA is not a recognised and ‘stand-alone’ diagnosis within the Diagnostic and Statistical Manual of Mental Disorders or the International Classification of Disease.It is the responsibility of integrated care boards to make available appropriate provision to meet the health and care needs of their local population, including assessment services for autistic people, in line with National Institute for Health and Care Excellence (NICE) guidelines.The NICE guideline Autism spectrum disorder in under 19s: recognition, referral and diagnosis, recommends that as part of autism assessments healthcare workers should consider PDA and carry out appropriate referrals.

What assessment he has made of the potential impact of increases in infant formula prices on families.

The Competition and Markets Authority (CMA) found that infant formula prices have risen significantly in recent years, and stakeholder evidence highlighted risks such as unsafe feeding practices and food insecurity among families struggling to afford formula. It is vital that families who cannot or choose not to breastfeed have access to infant formula that is affordable and high quality.Infant formula regulations set robust nutritional and compositional standards, which means that all infant formulas for sale in the United Kingdom are suitable for meeting the nutritional requirements of babies, regardless of price or brand. These regulations do not control or set the price of infant formula.In December 2025, the four governments of the UK published their joint response to the CMA’s market study on the infant and follow-on formula market, which is available at the following link:https://www.gov.uk/government/publications/infant-formula-government-response-to-cma-market-studyThis sets out a package of measures that will help give parents and carers the confidence to choose lower priced products, encourage manufacturers and retailers to compete more on price, and remove unnecessary barriers to affordability. Switching from the most expensive product to the cheapest could save up to £540 over the first year of an infant’s life.Measures include providing greater clarity on when and how vouchers, gift cards, and loyalty or reward schemes can be used to buy infant formula, and updated guidance on this point will be published shortly.Other measures to support families include the Government’s Healthy Start Scheme, which aims to encourage a healthy diet for pregnant women, babies, and young children under four years old from very low-income households. In April 2026 we will increase the value of Healthy Start weekly payments by 10% to £4.65, from £4.25, for pregnant women and children over one and under four years old, and to £9.30, from £8.50, for children under one years old. This will boost support for those families who need it the most. Healthy Start funding can be used to buy, or be put towards, the cost of fruit, vegetables, milk, and infant formula.

What assessment his Department has made of (a) the prevalence of respiratory disease and (b) the number of emergency hospital admissions for respiratory conditions in Chichester constituency compared with national averages; and what steps he is taking to ensure respiratory health is prioritised nationally, including through the introduction of a Modern Service Framework for respiratory care.

Data is available for emergency finished admission episodes (FAEs) where there was a primary diagnosis of 'respiratory conditions’. The following table shows the number of FAEs where there was a primary diagnosis of 'respiratory conditions’ for Chichester and England, for activity in English National Health Service hospitals and English NHS-commissioned activity in the independent sector, for 2024/25 and provisionally for 2025/26:Westminster Parliamentary Constituency of Residence2024/25 (August 2024 to March 2025)2025/26 (April 2025 to November 2025)Chichester1,305975England612,855511,558Source: Hospital Episode Statistics, NHS England. Available data on trends in respiratory conditions can be found on the Department’s Fingertips dataset. Data is not available by parliamentary constituency. Data is available at regional, county, unitary authority, and integrated care board level. Information for Chichester is available at the following link: https://fingertips.phe.org.uk/search/Respiratory#page/1/gid/1/pat/6/ati/501/are/E07000225/iid/40701/age/163/sex/4/cat/-1/ctp/-1/yrr/1/cid/4/tbm/1 The Government will consider long-term conditions for future waves of modern service frameworks (MSFs), including respiratory conditions. The criteria for determining other conditions for future MSFs will be based on where there is potential for rapid and significant improvements in the quality of care and productivity. After the initial wave of MSFs is complete, the National Quality Board will determine the conditions to prioritise for new MSFs as part of its work programme.

Whether his Department has reviewed the effects of device use, including tablets, amongst young children on speech and language development.

The Department of Health and Social Care and the Department for Education are working jointly to produce and publish new advice for parents and carers on the impacts of screen use on the health and development of children aged zero to five years old, including speech and language development. An expert group of child health and development specialists has been convened to review the evidence and produce a report for the Government. The Government’s advice for parents and carers will be informed by this report, our Call for Evidence, and direct engagement with parents and carers. The advice will be published by 1 April 2026.There is an emerging evidence base focusing on device use amongst children. However, many factors influence children’s development and there is limited evidence on the causal relationship between screen use and children’s health and development. We continue to learn from ongoing studies collecting data about young children, including the Department for Education’s Children of the 2020s longitudinal study, with further information available at the following link:https://children2020s.ipsos.com/This study found that higher screentime at two years old was independently associated with lower vocabulary development, and higher emotional and behaviour problems. However, other important factors such as economic circumstances and the child’s wider home learning environment also impact these outcomes and may influence why a family uses devices more.

Whether data on triple-negative breast cancer is used to identify variation in diagnosis, treatment and outcomes between i) regions and ii) NHS trusts.

The National Cancer Plan was published on 4 February 2026 and sets out how data will be collected and used to transform healthcare productivity, spot delays, and improve outcomes. This will build directly on the 10-Year Health Plan’s mission to make data the backbone of a modern, responsive National Health Service.The plan commits to improve cancer waiting times by providing trusts and Cancer Alliances with more granular and actionable data including disaggregated data for specific cancer types, real‑time pathway analytics via the Federated Data Platform, and streamlined cancer metrics to expose unwarranted variation. Trust boards will receive regular performance reports, and clearer public reporting, including more transparent league‑table style data, which will strengthen accountability and drive faster improvement.

Whether his Department is taking steps to increase the number of NHS posts available to doctors completing Foundation Year 2 in addition to the measures set out in the Medical Training (Prioritisation) Bill.

We set out in the 10-Year Health Plan for England that over the next three years we will create 1,000 new specialty training posts, with a focus on specialties where there is greatest need. We will set out next steps in due course.This Government is committed to training the staff we need, including doctors, to ensure patients are cared for by the right professional, when and where they need it. We will publish a 10 Year Workforce Plan to set out action to create a workforce ready to deliver the transformed services set out in the 10-Year Health Plan.

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.