Written questions by Toale.

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 assessment his Department has made of the potential impact of diethylstilbestrol exposure on the (a) long-term and (b) intergenerational health of people in the UK.

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 have the stigmata 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.Furthermore, where appropriate, my Rt Hon. Friend, the Secretary of State for Health and Social Care is considering how the Department may be able to share awareness of this issue with colleagues from across the Government who are responsible for related areas of chemical and environmental health policy, with a view to minimising future public health risks.There are no plans by the Department to undertake an assessment of the potential impact of DES exposure on the long-term or intergenerational health of people in the United Kingdom.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 DES in utero, the NIHR would welcome high quality funding applications in this area. Further information on the scope of research funding calls is available on the NIHR website.

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.

What assessment his Department has made of the potential third-generation health impacts of Diethylstilbestrol exposure; and whether specific research has been commissioned to examine those impacts on fertility, pregnancy outcomes, and cancer risk.

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 have the stigmata 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.Furthermore, where appropriate, my Rt Hon. Friend, the Secretary of State for Health and Social Care is considering how the Department may be able to share awareness of this issue with colleagues from across the Government who are responsible for related areas of chemical and environmental health policy, with a view to minimising future public health risks.There are no plans by the Department to undertake an assessment of the potential impact of DES exposure on the long-term or intergenerational health of people in the United Kingdom.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 DES in utero, the NIHR would welcome high quality funding applications in this area. Further information on the scope of research funding calls is available on the NIHR website.

Whether his Department plans to issue updated clinical guidance on diethylstilbestrol (DES) exposure to (a) general practitioners, (b) gynaecologists and (c) oncologists.

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.

What steps his Department is taking to raise awareness among healthcare professionals of the long-term health risks associated with in utero exposure to diethylstilbestrol.

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 have the stigmata 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.Furthermore, where appropriate, my Rt Hon. Friend, the Secretary of State for Health and Social Care is considering how the Department may be able to share awareness of this issue with colleagues from across the Government who are responsible for related areas of chemical and environmental health policy, with a view to minimising future public health risks.There are no plans by the Department to undertake an assessment of the potential impact of DES exposure on the long-term or intergenerational health of people in the United Kingdom.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 DES in utero, the NIHR would welcome high quality funding applications in this area. Further information on the scope of research funding calls is available on the NIHR website.

Whether his Department has made an assessment of the feasibility of using historic medical records to (a) identify and (b) contact people who may have been exposed to diethylstilbestrol.

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 plans his Department has to issue a official apology to those affected by the historical prescription of 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 assessment his Department has made of the potential implications for his policies of (a) the CDC guidance in the US and (b) other international models for management of Diethylstilbestrol exposure.

The Department has not undertaken any specific assessment of the potential implications for its policies of guidance by the Centers for Disease Control and Prevention of the United States or other international models for the management of exposure to diethylstilbestrol.The Department works closely with various expert United Kingdom bodies, recognised and widely respected internationally for their excellence, and bases policies on evidence provided by national authorities such as the National Institute for Health and Care Excellence.

What assessment his Department has made of the adequacy of NHS provision of medical equipment for families with disabled children.

Integrated care boards (ICBs) are responsible for commissioning services to meet the health needs of their local population, and responsibility for providing disabled children’s equipment would typically fall to the National Health Service and local authorities.We expect ICBs to follow guidance from the National Institute for Health and Care Excellence (NICE). In 2022 NICE published guidance on Disabled children and young people up to 25 with severe complex needs, which is available at the following link:https://www.nice.org.uk/guidance/ng213/chapter/Recommendations-on-service-organisation-integration-and-commissioningThe Children and Families Act 2014 requires that education, health, and social care services must work together to meet the needs of children and young people with special educational needs and disabilities (SEND). In May 2023, NHS England issued statutory guidance setting out the requirement for ICBs to have an executive lead for SEND, who will lead on supporting the chief executive and the board to ensure the ICB performs its functions effectively in the interests of children and young people with SEND.Local authorities are responsible for providing social care services for disabled children which can include specialist equipment. The guidance on supporting disabled children and their carers is available at the following link:https://assets.publishing.service.gov.uk/media/6849a7b67cba25f610c7db3f/Working_together_to_safeguard_children_2023_-_statutory_guidance.pdf

What steps his Department is taking to ensure that parents with disabled children are provided with appropriate medical equipment to support their child.

Integrated care boards (ICBs) are responsible for commissioning services to meet the health needs of their local population, and responsibility for providing disabled children’s equipment would typically fall to the National Health Service and local authorities.We expect ICBs to follow guidance from the National Institute for Health and Care Excellence (NICE). In 2022 NICE published guidance on Disabled children and young people up to 25 with severe complex needs, which is available at the following link:https://www.nice.org.uk/guidance/ng213/chapter/Recommendations-on-service-organisation-integration-and-commissioningThe Children and Families Act 2014 requires that education, health, and social care services must work together to meet the needs of children and young people with special educational needs and disabilities (SEND). In May 2023, NHS England issued statutory guidance setting out the requirement for ICBs to have an executive lead for SEND, who will lead on supporting the chief executive and the board to ensure the ICB performs its functions effectively in the interests of children and young people with SEND.Local authorities are responsible for providing social care services for disabled children which can include specialist equipment. The guidance on supporting disabled children and their carers is available at the following link:https://assets.publishing.service.gov.uk/media/6849a7b67cba25f610c7db3f/Working_together_to_safeguard_children_2023_-_statutory_guidance.pdf

What steps his Department is taking to improve public awareness of (a) HPV vaccination, (b) regular cervical screening and (c) other cervical cancer prevention measures.

On 19 June 2025, NHS England launched its first ever cervical cancer elimination creative campaign and communications toolkit for Cervical Screening Awareness Week, which took place between 19 and 24 June 2025. The campaign included digital resources that create a strong sense of shared responsibility and aim to increase awareness of the elimination goal, educate the public about human papillomavirus (HPV), and build confidence in the HPV vaccine and cervical screening.In March 2025, NHS England published its Cervical cancer elimination plan by 2040 – plan for England, setting out how the National Health Service will improve equitable uptake and coverage across HPV vaccination and cervical screening to meet the goal to eliminate cervical cancer by 2040. Further information on the Cervical cancer elimination plan by 2040 – plan for England is available at the following link:https://www.england.nhs.uk/publication/cervical-cancer-elimination-by-2040-plan-for-england/NHS England will build on what is already working well to drive vaccination and screening uptake and coverage, focussing on five cross-cutting themes:- increasing access;- raising awareness;- reducing inequalities;- improving digital capabilities; and- strengthening workforce capacity.Ensuring that people are aware of, and understand the benefits of, HPV vaccination and cervical screening is crucial for informed decision making. Creating effective, nuanced, and culturally sensitive health communications relies on collaborative work with third sector partners and local communities.NHS England will raise awareness of cervical cancer prevention offers through strategic, long-term and evidence-based communications.

What assessment his Department has made of the progress to meeting the World Health Organisation's 2030 strategy for (a) the elimination of cervical cancer, (b) 90 percent of girls vaccinated with HPV by age 15, (c) 70 percent of women screened by 35 years and again by 45 years and (d) 90 percent of women identified with cervical disease receiving treatment.

NHS England published the Cervical cancer elimination plan by 2040 – plan for England in March 2025, setting out how the National Health Service will improve equitable uptake and coverage across human papillomavirus (HPV) vaccination and cervical screening to meet the goal to eliminate cervical cancer by 2040. Further information on the Cervical cancer elimination plan by 2040 – plan for England is available at the following link:https://www.england.nhs.uk/publication/cervical-cancer-elimination-by-2040-plan-for-england/Progress has been made against meeting the World Health Organization’s targets and the 2030 milestones.76.7% of girls and 71.2% of boys aged 14 to 15 years old received the HPV vaccination by school Year 10 after catch-up, as of 2023/24. Although uptake is not currently where we would like it to be for cohorts affected by the pandemic, catch up opportunities will remain in place through School Aged Immunisation Service providers and general practices, until the age of 25 years old.76.9% of women aged 35 to 39 years old have a screening test recorded before their 35th birthday. 75.9% of women aged 40 to 44 years old have been screened in the previous five years, again as of 2023/24.88.3% of all cervical cancers received one or more forms of chemotherapy, radiotherapy, and tumour removal treatment. This rose to more than 96% for cervical cancer at stages 1 to 3, as of 2022/23.

What steps his Department is taking to increase (a) vaccination and (b) screening rates in areas with high health disparities.

The Department is working with NHS England and the UK Health Security Agency (UKHSA) to encourage high uptake of all immunisation and screening programmes, including in areas where coverage has historically been low.The National Health Service is building on what is already working well to drive vaccination and screening uptake and coverage, focussing on five cross-cutting themes: increasing access; raising awareness; reducing inequalities; improving digital capabilities; and strengthening workforce capacity.The NHS is also continuing to build on the understanding of barriers to and perceptions of vaccinations and screenings, identifying groups who may be at higher risk from diseases such as cervical cancer using national and local data, and developing inclusive material to better reach underserved communities through trusted voices.The rates of uptake for many of our pre-school programmes have either increased or stabilised in the period of January to March 2025, compared to the previous quarter. Most notably, maternal pertussis vaccination rates have increased from 59% in May 2024 to nearly 73% in March 2025, in England. Uptake rates for maternal pertussis are now higher than at the start of the programme in October 2012.However, while this is positive news that will provide more protection for our children in the future, there is clearly much more to do to stabilise and improve uptake. That is why we have set out actions to improve uptake in our 10-Year Health Plan for England and our strategy for Giving Every Child the Best Start in Life. The UKHSA is also refreshing its immunisation inequalities strategy to provide a framework for action to ensure improved uptake in under vaccinated and underserved populations Our Cervical cancer elimination plan by 2040 – plan for England, sets out how the NHS will improve equitable uptake and coverage across human papilloma virus vaccination and cervical screening, to meet the goal to eliminate cervical cancer by 2040. The NHS is also planning to publish a Breast Screening Programme Uptake Improvement Plan to help address inequalities. Further information on the Cervical cancer elimination plan by 2040 – plan for England is available at the following link:https://www.england.nhs.uk/publication/cervical-cancer-elimination-by-2040-plan-for-england/

What steps his Department is taking to deliver a cross-departmental indoor air quality strategy.

The Department engages with departments from across the Government on ways to reduce the health impacts of both indoor and outdoor air quality. This includes addressing damp and mould in homes through the Government’s action on social housing standards.

What discussions he has had with the Secretary of State for Environment, Food and Rural Affairs on cross-Government plans to help tackle air pollution.

The Department of Health and Social Care works closely with the Department for Environment, Food and Rural Affairs at both an official and ministerial level to tackle air pollution. Ministers from the Department of Health and Social Care and the Department for Environment, Food and Rural Affairs most recently met on air quality in May 2025.The Department for Environment, Food and Rural Affairs, with support from the UK Health Security Agency (UKHSA), a has undertaken an Air Quality Information Systems review, the final report of which was published in March 2025. This was a comprehensive review into the way air quality information is communicated to the public, including short-term and long-term exposure, indoor and outdoor air pollution, and provision of advice for the public on how to reduce their exposure and contribution to air pollution.Following this report, we will work with the UKHSA and the Department for Environment, Food and Rural Affairs to improve awareness of air pollution and the associated health impacts.

What assessment he has made with the Secretary of State for Environment, Food and Rural Affairs of the potential merits of a UK-wide public health clean air campaign on (a) (i) short-term and (ii) long-term air pollution exposure, (b) sources of (A) indoor and (B) outdoor air pollution and (c) practical advice to reduce personal exposure.

The Department of Health and Social Care works closely with the Department for Environment, Food and Rural Affairs at both an official and ministerial level to tackle air pollution. Ministers from the Department of Health and Social Care and the Department for Environment, Food and Rural Affairs most recently met on air quality in May 2025.The Department for Environment, Food and Rural Affairs, with support from the UK Health Security Agency (UKHSA), a has undertaken an Air Quality Information Systems review, the final report of which was published in March 2025. This was a comprehensive review into the way air quality information is communicated to the public, including short-term and long-term exposure, indoor and outdoor air pollution, and provision of advice for the public on how to reduce their exposure and contribution to air pollution.Following this report, we will work with the UKHSA and the Department for Environment, Food and Rural Affairs to improve awareness of air pollution and the associated health impacts.

What steps she plans to take in the National Cancer plan to improve diagnosis times for children and young people with cancer.

The Department is committed to getting the National Health Service diagnosing cancer earlier and treating it faster so that more patients survive this horrible set of diseases, including children and young people. To achieve this, the NHS has delivered an extra 40,000 operations, scans, and appointments each week as the first step to ensuring early diagnosis and faster treatment.To support timely and effective referrals, the National Institute for Health and Care Excellence has set out detailed guidance for general practitioners on the symptoms of cancer in children and young people, recommending referral within 48 hours for those presenting with a range of potential cancer symptoms.On 4 February 2025, the Department relaunched the Children and Young People Cancer Taskforce to identify tangible ways to improve outcomes and experiences for children and young people with cancer. The Taskforce is exploring opportunities for improvement across genomic testing and treatment, research and innovation, patient experience, and early detection and diagnosis.The forthcoming National Cancer Plan will include further details on improving outcomes for cancer patients, including for children and young people with cancer, and will highlight how the Department will support the NHS to improve diagnosis rates for people in all parts of England.

What assessment he has made of the effectiveness of the NHS Healthcare Travel Costs Scheme in providing support for young cancer patients' travel costs.

The Government knows that the cost of travel is an important issue for many young cancer patients and their families in England. NHS England and the integrated care boards are currently responsible for commissioning and ensuring the healthcare needs of local communities are met, including providing support for travel.The National Health Service runs schemes in England to provide financial assistance for travel to a hospital or other NHS premises for specialist NHS treatment or diagnostic tests, when referred by a doctor or other primary healthcare professional. The Healthcare Travel Costs Scheme (HTCS) provides financial assistance to patients in England who do not have a medical need for transport, but who require assistance with the costs of travelling to receive certain NHS services. Patients who do not qualify for the HTCS and who are on a low income may be able to claim the costs from the Department for Work and Pensions through Universal Credit or a Personal Independence Payment. The provision of disability benefits is also the responsibility of the Department for Work and Pensions.On 4 February 2025, the Department of Health and Social Care relaunched the Children and Young People Cancer Taskforce to identify tangible ways to improve outcomes and experiences for young cancer patients. The work of the taskforce is ongoing, and officials are exploring opportunities for improvement across a range of areas, including detection and diagnosis, genomic testing and treatment, research and innovation, and patient experience. The taskforce will also ensure that the unique needs of children and young people with cancer are carefully considered as part of the National Cancer Plan, which will include further details on how we will improve outcomes for children and young people with cancer across England, including Bournemouth and the South West region.The specific information requested is not held by the Department of Health and Social Care. Therefore, we cannot share how many children and young people with cancer receive treatment and care outside the region from Bournemouth and the South West, nor have we have not made a formal assessment of the cost of travel, the adequacy of financial support available, or the effectiveness of the NHS HTCS in providing support for young cancer patients' travel costs across specific localities in England. This information is not held centrally as it is held at individual NHS trust level.

How many children and young people with cancer receive (a) treatment and (b) care outside the region from (i) Bournemouth and (ii) the South West; and what assessment he has made if the (A) cost of travel and (B) the adequacy of financial support available.

The Government knows that the cost of travel is an important issue for many young cancer patients and their families in England. NHS England and the integrated care boards are currently responsible for commissioning and ensuring the healthcare needs of local communities are met, including providing support for travel.The National Health Service runs schemes in England to provide financial assistance for travel to a hospital or other NHS premises for specialist NHS treatment or diagnostic tests, when referred by a doctor or other primary healthcare professional. The Healthcare Travel Costs Scheme (HTCS) provides financial assistance to patients in England who do not have a medical need for transport, but who require assistance with the costs of travelling to receive certain NHS services. Patients who do not qualify for the HTCS and who are on a low income may be able to claim the costs from the Department for Work and Pensions through Universal Credit or a Personal Independence Payment. The provision of disability benefits is also the responsibility of the Department for Work and Pensions.On 4 February 2025, the Department of Health and Social Care relaunched the Children and Young People Cancer Taskforce to identify tangible ways to improve outcomes and experiences for young cancer patients. The work of the taskforce is ongoing, and officials are exploring opportunities for improvement across a range of areas, including detection and diagnosis, genomic testing and treatment, research and innovation, and patient experience. The taskforce will also ensure that the unique needs of children and young people with cancer are carefully considered as part of the National Cancer Plan, which will include further details on how we will improve outcomes for children and young people with cancer across England, including Bournemouth and the South West region.The specific information requested is not held by the Department of Health and Social Care. Therefore, we cannot share how many children and young people with cancer receive treatment and care outside the region from Bournemouth and the South West, nor have we have not made a formal assessment of the cost of travel, the adequacy of financial support available, or the effectiveness of the NHS HTCS in providing support for young cancer patients' travel costs across specific localities in England. This information is not held centrally as it is held at individual NHS trust level.