Written questions by Toale.

What steps his Department is taking to ensure the renewed Women’s Health Strategy is supported by clear implementation plans, timelines and measurable outcomes.

Awaiting answer.

Whether Integrated Care Boards will be required to demonstrate alignment with the renewed Women's Health Strategy in annual delivery plans; and what consequences will apply where they do not comply.

Awaiting answer.

What the (a) start and (b) target completion date are for the redesign of clinical pathways for heavy menstrual bleeding, urogynaecology and menopause; and which body will be responsible for reporting progress.

Awaiting answer.

What criteria will govern allocation of the FemTech Challenge Fund; whether successful innovations will be required to demonstrate a clear adoption pathway into NHS services beyond pilot sites before receiving funding; and which organisation will administer the fund and be responsible for evaluating outcomes.

Awaiting answer.

Which Minister or senior official holds named personal accountability for delivery of each of the four core commitments in the renewed Women's Health Strategy; and whether those accountability arrangements will be published.

Awaiting answer.

What assessment he has made of the potential impact of the integration of NHS England functions into his Department on ring-fenced women's health funding being absorbed into wider NHS budgets; and what steps he is taking to mitigate that risk.

Awaiting answer.

What steps his Department has taken to ensure that dental practices are subject to effective regulation.

The Care Quality Commission (CQC) regulates all health and social care services, including dental services in England. The commission ensures quality and safety across a range of sectors that deliver health and care to people in England.The CQC carries out assessments of primary dental services to determine if they are compliant with regulations. The CQC does not rate dental practices in the same way that it rates other healthcare services. The inspections focus on compliance with regulations and result in a ‘regulations met’ or ‘regulations not met’ judgement. Further information can be found at the following link:https://www.cqc.org.uk/guidance-regulation/providers/assessment/assessing-quality-and-performance/services-we-do-not-rateThe General Dental Council (GDC) is the independent regulator of dentistry in the UK, with the primary role of protecting patient safety and maintaining public confidence. It fulfils this role by registering qualified dental professionals, setting standards for education, training, and conduct, and investigating serious complaints regarding professionals’ fitness to practise. The GDC’s Standards for the Dental Team set out professional standards of conduct, performance, and ethics, including principles for honest and transparent business practices.

What recent assessment his Department has made of trends in the level of Meningitis B cases among teenagers and university students; and what steps he is taking to help reduce that level.

The UK Health Security Agency continually monitors the incidence and profile of invasive meningococcal disease (IMD) in England across all age groups to provide information to the Joint Committee on Vaccination and Immunisation to help inform policy decisions.The United Kingdom has a world-leading meningococcal vaccine programme, and we were the first country to introduce a national Meningitis C (MenC) vaccine programme in 1999 and an infant programme targeting Meningitis B (MenB) disease in 2015, the year in which the teenage MenACWY vaccination was also introduced.Cases of IMD in England have fallen from over 2,500 in 1998/99, before the first routine meningococcal vaccination against MenC, was introduced, to 378 cases in 2024/225. The MenACWY vaccine also stops carriage and transmission. With this high population-level control of MenACWY disease, MenB disease accounted for 313 of the 378, or 83% of, cases in 2024/25.MenB remains rare but is now the leading cause of meningococcal disease in all age groups in England, including teenagers and young adults. Further information for the 2024 to 2025 epidemiological year, running from July 2024 to June 2025, is available at the following link:https://www.gov.uk/government/publications/meningococcal-disease-laboratory-confirmed-cases-in-england-2024-to-2025

When the Joint Committee on Vaccination and Immunisation last reviewed the cost-effectiveness model for providing the Meningitis B vaccine to teenagers; and whether his Department plans to commission an updated model.

In 2013, the Joint Committee on Vaccination and Immunisation (JCVI) advised that the cost-effectiveness of an adolescent Meningitis B (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.The sub-committee noted that when available, they would like to review a model evaluating the impact of MenB vaccine when given in a teenage programme in a two-dose schedule, including impact on meningococcal disease and gonorrhoea.

Whether his Department has made an assessment of the potential merits of extending routine NHS vaccination against Meningitis B to teenagers and first-year university students.

Policy regarding vaccination programmes is based on advice from the Joint Committee on Vaccination and Immunisation (JCVI). The JCVI keeps all vaccination programmes under review, and the meningococcal sub-committee have met a number of times over the past year to discuss the meningococcal vaccination programme. The minutes of all JCVI meetings are available at the following link:https://www.gov.uk/government/groups/joint-committee-on-vaccination-and-immunisation#sub-committee-membership-and-minutesIn 2013, the JCVI advised that the cost-effectiveness of an adolescent Meningitis B (MenB) vaccination programme would be dependent on the impact of the vaccine on protection against meningococcal carriage, which was uncertain at the time. Recent evidence considered by the meningococcal sub-committee indicates that MenB vaccines do not protect against carriage of meningococcus serogroup B in adolescents.The sub-committee noted that when available, they would like to review a model evaluating the impact of the MenB vaccine when given in a teenage programme in a two-dose schedule, including the impact on meningococcal disease and gonorrhoea.Adolescents remain eligible for the MenACWY vaccine until their 25th birthday.

Whether his Department plans to fund epidemiological research into the potential impact of diethylstilbestrol exposure on third generation people.

The Department invests over £1.6 billion each year on research through its research delivery arm, the National Institute for Health and Care Research (NIHR).While no research has been commissioned into the health outcomes of people exposed to diethylstilbestrol in utero via the NIHR since 2000, the NIHR would welcome high quality funding applications in this area. Further information on the scope of our research funding calls is available on the NIHR website.

What assessment he has made of the adequacy of NHS screening programmes for the detection of gynaecological cancers linked to diethylstilbestrol exposure.

The NHS Cervical Screening Programme is the only gynaecological screening programme offered by the National Health Service. On its own, it cannot provide comprehensive care to women exposed to diethylstilbestrol (DES) in utero. This is why the NHS Cervical Screening Programme’s guidance advises that local arrangements should be made for the follow up of individuals who have been exposed to DES and who have the stigmata of DES exposure. This is usually via annual colposcopy. The management of abnormal cytology falls outside of the NHS Cervical Screening Programme.

Whether diethylstilbestrol (DES) exposure is referenced in NHS training curricula for (a) obstetrics, (b) gynaecology and (c) general practice.

The standard of training for doctors is the responsibility of the General Medical Council (GMC), who set the outcome standards expected at undergraduate level and approve courses and medical schools to write and teach the curricula content that enables their students to meet the GMC’s outcome standards.The curricula for postgraduate training are set by the Academy of Medical Royal Colleges for foundation training, and by the relevant individual royal colleges and faculties for specialty training. The GMC approves curricula and assessment systems for each training programme.Whilst not all curricula may necessarily highlight a specific condition, they all nevertheless emphasise the skills and approaches a doctor must develop in order to ensure accurate and timely diagnoses and treatment plans for their patients, including for diethylstilbestrol exposure.

What discussions he has had with the (a) UK Health Security Agency and (b) National Institute for Health and Care Research on studies into diethylstilbestrol-related health risks.

Diethylstilbestrol is a synthetic non-steroidal estrogen medication, which does not fall within the UK Health Security Agency’s remit.Decisions on topics for new or updated guidance from the National Institute for Health and Care Excellence (NICE) are considered through an established NICE prioritisation process with decisions overseen by a prioritisation board, chaired by NICE’s Chief Medical Officer.

Whether his Department has considered the potential merits of a screening protocol for people exposed to diethylstilbestrol.

The UK National Screening Committee (UK NSC), which advises the Government on all aspects of screening, has never been asked to consider the evidence for a screening programme for people exposed to diethylstilbestrol in utero.Any individual or organisation can submit a topic to the UK NSC to consider a new screening programme via the UK NSC’s open call. As part of the open call process the committee will discuss whether this falls within its remit or whether it's more aligned with clinical care.Further information about the open call is available at the following link:https://www.gov.uk/government/publications/uk-nsc-annual-call-submitting-a-screening-proposal

Whether his Department has commissioned research since 2000 into the health outcomes of people exposed to diethylstilbestrol in utero.

The Department invests over £1.6 billion each year on research through its research delivery arm, the National Institute for Health and Care Research (NIHR).While no research has been commissioned into the health outcomes of people exposed to diethylstilbestrol in utero via the NIHR since 2000, the NIHR would welcome high quality funding applications in this area. Further information on the scope of our research funding calls is available on the NIHR website.

Whether women (a) known and (b) suspected to have exposure to diethylstilbestrol in utero are eligible for enhanced cancer screening.

Yes, women who believe they have been exposed to diethylstilbestrol (DES) in utero are eligible for enhanced cancer screening. The NHS Cervical Screening Programme guidance reminds providers that these women are eligible for routine cervical screening and states that local arrangements should be made for the follow up of women who have been exposed to DES and who have the stigmata of DES exposure. This is usually via annual colposcopy.

If his Department will make an assessment of the potential merits of launching a public information campaign to inform individuals born between 1940 and 1980 of the potential risks associated with in utero exposure to Diethylstilbestrol.

We recognise the consequences for those who were exposed to diethylstilbestrol (DES) and are sorry that women and their families have suffered for far too long.The Department has not made an assessment of the merits of launching a public information campaign relating to DES and has no plans to do so at this time.The Government will keep listening to all those who are affected through exposure to DES and consider what more we can do to improve the situation for them.The Government is committed to advancing patient safety and a learning culture within the National Health Service so that we can avoid harmful events happening to patients in the first place. This includes continued implementation of key measures under the NHS Patient Safety Strategy. The changes we are making as part of the 10-Year Health Plan and Dr Penny Dash’s report on the patient safety landscape will improve quality and safety by making it clear where responsibility and accountability sit at all levels of the system.

What discussions his Department has had with patient advocacy groups representing people affected by diethylstilbestrol exposure.

We recognise the consequences for those who were exposed to diethylstilbestrol (DES) and offer our sincere sympathies to those who continue to be affected.There have been no discussions between the Department and patient advocacy groups representing people affected by exposure to DES. However, we will consider what more can be done to improve the situation for these individuals.The Department has not assessed the feasibility of using historic medical records to identify and contact people who may have been exposed to DES. In the 1970’s, medicines vigilance was only in its infancy and there were no electronic records or systematic monitoring of prescriptions. There has been a step change in reporting and record-keeping since this time, and today’s regulatory frameworks are significantly different with much stricter post-authorisation monitoring, allowing for earlier identification and action on emerging safety issues. The Medicines and Healthcare products Regulatory Agency regulates medicines supplied in the United Kingdom and its activity spans the whole of a medicine’s lifecycle.

What guidance is available to clinicians for patients with a family history of diethylstilbestrol exposure.

The Government encourages all women, including those exposed to diethylstilbestrol (DES) in utero, to attend regular cervical screenings which test for human papillomavirus, the cause of most cervical cancers. Women who believe or know that they were exposed to DES in utero may also need regular colposcopy which falls outside the routine screening programme. We recommend that they should speak to their general practitioner about this as local arrangements should be made for the follow up of women who display evidence of DES exposure. Further information regarding individuals exposed to DES is contained within the cervical screening guidance for the National Health Service, at the following link:https://www.gov.uk/government/publications/cervical-screening-programme-and-colposcopy-management/5-screening-and-management-of-immunosuppressed-individualsMy Rt Hon. Friend, the Secretary of State for Health and Social Care, has asked NHS England to work with local cancer alliances to ensure that providers are aware of this existing screening and follow up guidance for individuals exposed to DES, and that those who could benefit from additional screening have access to this.The National Institute for Health and Care Excellence (NICE) is the national body that develops authoritative, evidence-based guidance for the NHS on best practice in the care and treatment of patients with defined conditions. NICE has not issued any guidance on the diagnosis and management of patients potentially exposed to DES and it currently has no plans to do so. Decisions on the development of new topics for NICE guidance are taken by the NICE prioritisation board, chaired by its Chief Medical Officer, in line with its published prioritisation framework.