Written questions by Brown-Fuller.

What assessment he has made of the potential implications for his policies of the report entitled World Breastfeeding Trends Initiative UK Report 2024, published in March 2025.

The Government is committed to giving children the best start in life, and infant feeding plays a crucial role in achieving this. We recognise the concerns raised in the World Breastfeeding Trends Initiative’s United Kingdom report and are considering the recommendations.We are already taking action to improve infant feeding support. We are strengthening the midwifery and health visiting workforce and building on these services by investing £18.5 million this year for infant feeding services through the Family Hubs and Start for Life programme in 75 local authorities in England. We are also investing in the National Breastfeeding Helpline which provides UK-wide support 24 hours a day, every day of the year, and are expanding Start for Life communications.

What steps his Department is taking to increase the availability of autism assessments in (a) England and (b) Chichester constituency.

The Government has recognised that, nationally, the demand for assessments for autism has grown significantly in recent years and that people are experiencing severe delays for accessing such assessments. The Government’s 10-Year Health Plan will make the National Health Service fit for the future, and it recognises the need for early intervention and support, without the need for diagnosis.It is the responsibility of integrated care boards (ICBs) to make available appropriate provision to meet the health and care needs of their local population, including provision of autism services, in line with relevant National Institute for Health and Care Excellence guidelines.On 5 April 2023, NHS England published a national framework and operational guidance to help ICBs and the NHS to deliver improved outcomes for children, young people, and adults referred to an autism assessment service. The guidance also sets out what support should be available before an assessment and what support should follow a recent diagnosis of autism, based on the available evidence. Since publication, NHS England has been supporting systems and services to identify where there are challenges for implementation and how they might overcome these.

What steps his Department is taking to improve NHS 111 response times.

The Government is committed to continuing to improve NHS 111 to ensure patients can access the right care the first time, only visiting accident and emergency when necessary.The latest published data shows that May 2025 saw the lowest average NHS 111 call answer time since records began in April 2021, 4 seconds faster than in April 2025, and 58 seconds faster than in May 2024. The average NHS 111 call answer time in the year to date is 46 seconds, compared to 157 seconds in the same period in 2024.Whilst NHS 111 response times have improved, we recognise there is more to do. On 6 June 2025, we published our Urgent and Emergency Care Plan for 2025/26, which includes the commitment to publish and implement the recommendations from the NHS 111 review to make the service quicker and simpler to navigate.

What assessment he has made of the adequacy of the availability of job opportunities for newly qualified nurses.

Decisions on the employment of newly qualified nurses are a matter for individual National Health Service trusts, which manage their recruitment at a local level, ensuring they have the right number of staff in place, with the right skill mix, to deliver safe and effective care.We are working closely with NHS England, employers, universities, and regional nursing leads to ensure support is in place to help graduating nurses find a role as soon as possible after qualification and transition into the workplace.

What steps his Department is taking to reduce waste in the NHS.

There are a range of initiatives in the National Health Service to tackle waste, ranging from locally managed walking aid refurbishment schemes to innovative projects on the reuse of surgical textiles. NHS England has also been working to reduce the wastage of medicines, as recommended in the National Overprescribing Review in 2020.In addition, in October 2024, the Department published the Design for Life roadmap, a new strategy to transition away from all avoidable single-use medical technology products towards a functioning circular system by 2045. The Design for life Roadmap is available at the following link:https://assets.publishing.service.gov.uk/media/679ca015a9ee53687470a2ed/design-for-life-roadmap.pdfSingle-use medical devices such as tourniquets and scissors, as well as high-tech electronic devices like harmonic shears, are often expensive and are thrown away after a single use. The programme is building on examples of where NHS organisations are already achieving cost, waste, and carbon savings.

What his planned timeline is for responding to the Competition and Markets Authorities recommendations in their report into the infant formula and follow-on formula market, published on 20 February 2024.

Infant feeding is critical to a baby’s healthy growth and development. The Government is committed to giving every child the best start in life, and that includes helping families to access support to feed their baby.Whilst breastfeeding has significant health benefits, we recognise that for those families that cannot or choose not to breastfeed, it is vital that they have access to infant formula that is affordable and high quality. Infant formula regulations ensure that all infant formula is suitable for meeting the nutritional needs of babies, regardless of the price or brand.The Government welcomes the Competition and Markets Authority’s market study into the United Kingdom’s infant formula and follow-on formula market. We are working closely with other Government departments and the devolved administrations to carefully consider its findings and recommendations, and will respond fully in due course.

If he will review the decision by NHS Hampshire and Isle of Wight Integrated Care Board to close Westbourne Surgery.

The Department understands that the general practice (GP) partners at Emsworth Medical Practice have arrived at the decision to propose the closure of the Westbourne Branch Surgery and that the proposed date of closure is 27 June 2025.There are no plans to review the decision by NHS Hampshire and Isle of Wight Integrated Care Board to close Westbourne Surgery. There is a high bar set out in guidance for intervention by my Rt. Hon. friend, the Secretary of State for Health and Social Care, in contested reconfiguration cases, who would expect all avenues of local resolution to be exhausted before a call-in request is made.Responsibility for the delivery, implementation, and funding decisions for services ultimately rests with the appropriate National Health Service commissioner, in this case, NHS Hampshire and Isle of Wight Integrated Care Board (ICB), rather than the Department. The closure of a GP surgery is an issue that is considered and decided upon by local commissioners following an application from a GP provider.Local health and care organisations are best placed to make decisions on commissioning services for their communities, working with local authorities, stakeholders, and local populations to meet people’s needs.When a practice does close, patients will be informed of the closure and advised to register at another local practice of their choice within their area. Commissioners must put in place appropriate measures to ensure that the affected patients have access to GP services.

What progress his Department has made on implementing the Immediate and Essential Actions of the Ockenden review, published on 30 March 2022.

All the recommendations made by Donna Ockenden in her review into maternity services at the Shrewsbury and Telford Hospital Trust in 2022 were accepted, including the requests made to the Government, the health system more widely, and the trust. Following publication of the Ockenden review, NHS England wrote to all trusts and systems asking them to deliver the recommendations and report to their public boards.To support this delivery, NHS England’s three-year delivery plan for maternity and neonatal services brought together the immediate and essential actions from the Ockenden review with those from other reports and guidance. The National Health Service’s operational planning guidance sets out the expectation that trusts should implement the key actions from the plan. In accordance with the NHS operating framework, it is for integrated care boards to oversee local progress with this. The technical guidance which accompanies the plan sets out how we are monitoring progress at a national level.The plan is in its final year of delivery, and progress has been made across the four themes to improve outcomes and experiences for women and their babies.The Shrewsbury and Telford Hospital Trust has seen a significant improvement in overall midwifery staffing levels. The trust has enhanced its senior and specialist midwifery teams to provide additional leadership, expert advice, and support for women and families, as well as the clinical teams. The Shrewsbury and Telford Hospital Trust now has in place robust training programmes that equip the maternity workforce with up-to-date skills, training, and development, including in the management of emergency scenarios.On 23 June 2025, my rt. Hon. Friend, the Secretary of State for Health and Social Care, announced the launch of an independent, national Investigation into NHS maternity and neonatal services to look at the systemic issues behind why so many women, babies and families experience unacceptable care. It will look at up to 10 maternity and neonatal units where there are specific issues, international evidence, adoption of best practice and a system-wide investigation of maternity and neonatal care. There have been several reviews, inquiries and national research into maternity and neonatal care in recent years, including Ockenden. The investigation will bring together lessons from past these reviews and will produce, by December 2025, one clear set of national recommendations to achieve high quality, safe care across maternity and neonatal services, and that women and families are listened to. The investigation will take previous recommendations, including the Immediate and Essentials actions from Ockenden, into consideration to ensure we are providing clarity to the system and effectively delivering the change needed.Alongside this, my rt. Hon. Friend, the Secretary of State for Health and Social Care, also announced we would be establishing a National Maternity and Neonatal Taskforce, which he would chair. It will use the recommendations from the investigation to develop a national plan to drive improvements across maternity and neonatal care, holding the system to account for delivering the actions and working closely with families to ensure their voices are central to this work.

Whether GP training includes a mandatory rotation on (a) obstetrics and (b) gynaecology.

The curricula for postgraduate medical specialty training are set by individual royal colleges and faculties. The General Medical Council approves curricula and assessment systems for each training programme. Curricula emphasise the skills and approaches that a doctor must develop in order to ensure accurate and timely diagnoses and treatment plans for their patients. The Royal College of General Practitioners (RCGP) sets the curriculum that all general practitioners (GPs) must cover before they are able to pass the examination to become a member of the RCGP and to work independently as a GP.Obstetrics and gynaecology are not mandatory specialties in a GP programme, and there are no mandatory jobs in GP specialty training. GP training is a balanced programme which allows the trainee to meet the outcomes of the curriculum. Women's health, including sexual and reproductive health, is a significant element of the General Practice and Community Placement elements of GP specialty training and of the curriculum.

What assessment he has made of the potential impact of US tariffs on the domestic supply of (a) methylphenidate and (b) pancreatic enzyme replacement therapy.

The Department is working closely with life sciences stakeholders and other Government departments to assess the potential impact of United States tariffs on global medicine supply chains. We have a range of well-established processes to mitigate risks to patients where there are shortages. We will continue to review the need to utilise these procedures as more information becomes available on the impact of tariffs on any specific products or companies.

What assessment he has made of the potential impact of US tariffs on the UK pharmaceutical industry.

The Department is working closely with United Kingdom pharmaceutical firms and trade associations to understand how United States tariffs may impact the sector and the trade of individual products. As this is an evolving situation, these assessments are ongoing, but we will continue to closely review the potential impact as more information becomes available.

What progress he has made on increasing the availability of (a) methylphenidate and (b) pancreatic enzyme replacement therapy.

As a result of intensive work, some issues with attention deficit hyperactivity disorder medicines have resolved. All strengths of lisdexamfetamine, atomoxetine capsules, atomoxetine oral solution, and guanfacine prolonged-release tablets are now available.However, whilst supply of methylphenidate prolonged-release tablets has greatly improved, some issues persist. We are continuing to work to resolve these remaining issues by engaging with all suppliers of methylphenidate prolonged-release tablets and capsules to assess the challenges faced and their actions to address them. We are also directing suppliers to secure additional stocks, expedite deliveries where possible, and review plans to build further capacity to support the continued growth in demand for the short and long-term. The Department is also working with new suppliers of methylphenidate prolonged-release tablets to improve supply and resiliency for the United Kingdom’s market.The Department is continuing to engage with all suppliers of pancreatic enzyme replacement therapy (PERT) to mitigate the supply issue that is affecting the whole of the UK. Through this, we have managed to secure additional volumes of PERT for 2025 for the UK. We are continuing to work with all suppliers to understand what more can be done to add further resilience to the market. The Department has also reached out to specialist importers who have sourced unlicensed stock to assist in covering the remaining gap in the market.In the longer term, the Department has had interest from non-UK suppliers wishing to bring their products to the UK and, along with colleagues in the Medicine and Healthcare products Regulatory Agency, we are working with these potential suppliers, and if authorised, these products could further diversify and strengthen the market.

Whether he has had discussions with Cabinet colleagues on the Competition and Markets Authority's infant formula and follow-on formula market study, published on 14 February 2025.

Infant feeding is critical to a baby’s healthy growth and development. The Government is committed to giving every child the best start in life and that includes helping families to access support to feed their baby. Whilst breastfeeding has significant health benefits, we recognise that for those families that cannot or choose not to breastfeed, it is vital that they have access to infant formula that is affordable and high quality. Infant formula regulations ensure that all infant formula is suitable for meeting the nutritional needs of babies, regardless of the price or brand.The Government welcomes the Competition and Markets Authority’s market study report on infant formula and follow-on formula. We are working with other Government Departments and the Devolved Governments to consider its recommendations, and relevant Ministers will also be consulted.The legislation which sets the general principles and requirements of overall food law places a statutory requirement to consult on potential changes to food law.

What steps his Department plans to take to consider the recommendations from the Competition and Markets Authority's infant formula and follow-on formula market study, published on 14 February 2025.

Infant feeding is critical to a baby’s healthy growth and development. The Government is committed to giving every child the best start in life and that includes helping families to access support to feed their baby. Whilst breastfeeding has significant health benefits, we recognise that for those families that cannot or choose not to breastfeed, it is vital that they have access to infant formula that is affordable and high quality. Infant formula regulations ensure that all infant formula is suitable for meeting the nutritional needs of babies, regardless of the price or brand.The Government welcomes the Competition and Markets Authority’s market study report on infant formula and follow-on formula. We are working with other Government Departments and the Devolved Governments to consider its recommendations, and relevant Ministers will also be consulted.The legislation which sets the general principles and requirements of overall food law places a statutory requirement to consult on potential changes to food law.

Whether the Government plans to implement the recommendations within the Competition and Markets Authority's infant formula and follow-on formula market study, published on 14 February 2025.

Infant feeding is critical to a baby’s healthy growth and development. The Government is committed to giving every child the best start in life and that includes helping families to access support to feed their baby. Whilst breastfeeding has significant health benefits, we recognise that for those families that cannot or choose not to breastfeed, it is vital that they have access to infant formula that is affordable and high quality. Infant formula regulations ensure that all infant formula is suitable for meeting the nutritional needs of babies, regardless of the price or brand.The Government welcomes the Competition and Markets Authority’s market study report on infant formula and follow-on formula. We are working with other Government Departments and the Devolved Governments to consider its recommendations, and relevant Ministers will also be consulted.The legislation which sets the general principles and requirements of overall food law places a statutory requirement to consult on potential changes to food law.

With reference to the Competition and Markets Authority's infant formula and follow-on formula market study, published on 14 February 2025, whether he has made an assessment of the potential merits of launching a public consultation on infant formula regulations.

Infant feeding is critical to a baby’s healthy growth and development. The Government is committed to giving every child the best start in life and that includes helping families to access support to feed their baby. Whilst breastfeeding has significant health benefits, we recognise that for those families that cannot or choose not to breastfeed, it is vital that they have access to infant formula that is affordable and high quality. Infant formula regulations ensure that all infant formula is suitable for meeting the nutritional needs of babies, regardless of the price or brand.The Government welcomes the Competition and Markets Authority’s market study report on infant formula and follow-on formula. We are working with other Government Departments and the Devolved Governments to consider its recommendations, and relevant Ministers will also be consulted.The legislation which sets the general principles and requirements of overall food law places a statutory requirement to consult on potential changes to food law.

If he will take steps to (a) improve diagnosis and care pathways for patients with peripheral arterial disease and (b) improve funding routes for the adoption of innovative technologies that will facilitate faster and safer diagnosis and treatment of the disease.

The Department is working with NHS England to take several steps to improve diagnosis, care and treatment for patients with peripheral arterial disease. For example, in 2022, NHS England commissioned a two-year Commissioning for Quality and Innovation (CQUIN) scheme, which incentivised the adoption of the Vascular Peripheral Arterial Disease Quality Improvement Framework, to support timely interventions for revascularisation. This measures the proportion of patients that have a diagnosis of chronic limb threatening ischaemia (CLTI) that undergo revascularisation within five days of a non-elective admission to vascular providers.As part of NHS England’s assessment on the adequacy of current diagnosis and treatment pathways, it commissions the National Vascular Registry (NVR) to provide information on the quality and outcomes of care for adults who have major vascular procedures. The NVR provides annual and quarterly reports for emergency and elective vascular procedures, including for those people with peripheral arterial disease who undergo either lower limb angioplasty/stent, lower limb bypass surgery, or major lower limb amputation.Following the introduction of these measures we can see that from over a two-year period from the first quarter of 2022 to the fourth quarter of 2024, NVR data demonstrated that vascular providers achieving the CQUIN had increased from 47% to 55%. During this period, the number of providers submitting data to the NVR had also increased by approximately 14% and every National Health Service region showed an improvement in CLTI revascularisation quality.Furthermore, NHS England has commissioned the NVR to facilitate an ‘outliers’ process in which vascular providers are monitored on several key performance metrics including CLTI revascularisation. NHS England continues to monitor all specialised vascular disease services via the NVR and working in collaboration with NHS England regional teams and integrated care boards.

What assessment he has made of the adequacy of current diagnosis and treatment pathways for patients with peripheral arterial disease.

The Department is working with NHS England to take several steps to improve diagnosis, care and treatment for patients with peripheral arterial disease. For example, in 2022, NHS England commissioned a two-year Commissioning for Quality and Innovation (CQUIN) scheme, which incentivised the adoption of the Vascular Peripheral Arterial Disease Quality Improvement Framework, to support timely interventions for revascularisation. This measures the proportion of patients that have a diagnosis of chronic limb threatening ischaemia (CLTI) that undergo revascularisation within five days of a non-elective admission to vascular providers.As part of NHS England’s assessment on the adequacy of current diagnosis and treatment pathways, it commissions the National Vascular Registry (NVR) to provide information on the quality and outcomes of care for adults who have major vascular procedures. The NVR provides annual and quarterly reports for emergency and elective vascular procedures, including for those people with peripheral arterial disease who undergo either lower limb angioplasty/stent, lower limb bypass surgery, or major lower limb amputation.Following the introduction of these measures we can see that from over a two-year period from the first quarter of 2022 to the fourth quarter of 2024, NVR data demonstrated that vascular providers achieving the CQUIN had increased from 47% to 55%. During this period, the number of providers submitting data to the NVR had also increased by approximately 14% and every National Health Service region showed an improvement in CLTI revascularisation quality.Furthermore, NHS England has commissioned the NVR to facilitate an ‘outliers’ process in which vascular providers are monitored on several key performance metrics including CLTI revascularisation. NHS England continues to monitor all specialised vascular disease services via the NVR and working in collaboration with NHS England regional teams and integrated care boards.

What plans his Department has to improve access to preventative intervention for patients at risk of lower-limb amputation.

For patients at risk of lower-limb amputation, including those diagnosed with peripheral arterial disease (PAD) or chronic limb threatening ischaemia (CLTI), timely interventions for revascularisation are crucial, along with preventative measures and early diagnosis.In 2022, NHS England commissioned a two-year Commissioning for Quality and Innovation (CQUIN) scheme, which incentivised the adoption of the Peripheral Arterial Disease Quality Improvement Framework (PAD-QIF), which aims to reduce delays in assessment, investigation, and revascularisation in patients with CLTI and in turn amputation rates.Alongside this, NHS England has implemented a range of initiatives aimed at improving prevention and early diagnosis of conditions which increase the risk of needing lower-limb amputations. These include NHS Health Checks for early detection of cardiovascular disease (CVD), the NHS Diabetes Prevention Programme, and expanding community diagnostic centres (CDCs) to improve early detection.The 10-Year Health Plan, once published, will set out the Government's overarching vision for delivering the critical shift from a focus on treating illness to preventing conditions such as CVD.

What discussions his Department has had with stakeholders on the potential merits of auto-enrolling all eligible families to the Healthy Start programme.

The Healthy Start scheme was introduced in 2006 to encourage a healthy diet for pregnant women, babies, and young children under four years old from very low-income households. It can be used to buy, or put towards the cost of, fruit, vegetables, pulses, milk, and infant formula. Those on the scheme have access to free Healthy Start Vitamins for pregnant women and children aged under four years old.The Department has been approached by, and engaged with, stakeholders regarding autoenrollment. The scheme is kept under review, and we remain open to all viable routes to improve uptake to ensure that as many eligible people as possible are accessing the scheme, to support their children with a healthy start in life. In January 2025, Healthy Start supported over 353,000 people.