Written questions by Perteghella.

If he will undertake a review of the effectiveness of the Vaccine Damage Payment Scheme.

Our deepest sympathies are with those who have experienced harm following vaccination and with their families. Ministers recognise that concerns have been raised with the Vaccine Damage Payment Scheme (VDPS) and continue to consider potential reforms to the scheme.In parallel, the Department has been working with the NHS Business Services Authority (NHS BSA), the administrators of the VDPS, to process claims at a faster rate. The time it takes to process a claim depends on the complexity of the case and the length of time healthcare providers take to supply the requested medical records. The NHS BSA is engaging with healthcare providers to improve the return rate of these records, which is essential to assessing claims, including though submitting subject access requests.Information on COVID-19 claims to the VDPS is published on a quarterly basis by the NHS BSA. Further information is available at the following link:https://opendata.nhsbsa.net/dataset/vdps-covid-19

What recent assessment he has made of trends in the processing time for claims made under the Vaccine Damage Payment Scheme.

Our deepest sympathies are with those who have experienced harm following vaccination and with their families. Ministers recognise that concerns have been raised with the Vaccine Damage Payment Scheme (VDPS) and continue to consider potential reforms to the scheme.In parallel, the Department has been working with the NHS Business Services Authority (NHS BSA), the administrators of the VDPS, to process claims at a faster rate. The time it takes to process a claim depends on the complexity of the case and the length of time healthcare providers take to supply the requested medical records. The NHS BSA is engaging with healthcare providers to improve the return rate of these records, which is essential to assessing claims, including though submitting subject access requests.Information on COVID-19 claims to the VDPS is published on a quarterly basis by the NHS BSA. Further information is available at the following link:https://opendata.nhsbsa.net/dataset/vdps-covid-19

What steps he is taking to help address Creon shortages in the NHS.

The Department is aware of ongoing intermittent supply issues with pancreatic enzyme replacement therapy (PERT), including Creon capsules. Supplies of Creon and other licensed alternatives have improved in the past year, and specialist importers have sourced unlicensed stock to assist in covering the remaining gap in the market. We continue to work closely with the manufacturers to resolve the issues as soon as possible and to ensure patients have continuous access to medicines.We have widely disseminated comprehensive guidance to healthcare professionals about these supply issues, which provide advice on how to manage patients whilst there is disruption to supply. This includes serious shortage protocols to limit prescriptions to one month’s supply to ensure equitable distribution of available supplies and that Creon remains available for those patients who need it. The Department has issued additional management advice to healthcare professionals which directs clinicians to consider the unlicensed imports when licensed stock is unavailable and includes actions for integrated care boards to have local mitigation plans in place and implemented to ensure that no patient is left without PERT.The Department also routinely engages with the affected patient advocacy groups and charities, clinicians, and other relevant stakeholders to ensure they are kept informed on the latest supply picture and any communications issued.

What assessment has he made of the potential implications for his policies of regional variation in access to cognitive behavioural therapy for insomnia (CBTi) across England.

No such assessment has been made. It is for local integrated care boards to decide whether treatments such as cognitive behavioural therapy for insomnia should be offered to their local populations as a treatment for insomnia.NHS Talking Therapies for anxiety and depression offer low-intensity therapy which may include interventions around sleep hygiene. Individuals who are experiencing symptoms of anxiety and/or depression can be referred by their general practitioner, or can self-refer, to NHS Talking Therapies. People can also access helpful resources on sleep problems on the Every Mind Matters website at the following link:https://www.nhs.uk/every-mind-matters/mental-health-issues/sleep/

If he will make an assessment of the potential merits of providing NHS provision of scleral contact lenses for patients with complex corneal conditions.

Scleral contact lenses can be funded by the National Health Service for hospital eye service patients if there is a clinical need.

What assessment his Department has made of the potential impact of furniture poverty on health outcomes.

The links between material deprivation and poorer mental and physical health are well recognised. As highlighted by the campaign ‘End Furniture Poverty’, furniture can be one of the most expensive items people can purchase, and living without essential items can have an impact on health.We know everyday life poses greater health risks to the most disadvantaged in society, and that the current model of healthcare works least well for those who already experience disadvantage and are far more likely to have complex needs. This is why the 10-Year Health Plan for the National Health Service in England sets out a reimagined service designed to tackle inequalities in both access and outcomes.The Department of Health and Social Care is also working with the Ministry of Housing, Communities and Local Government on housing quality and homelessness issues, including the new Decent Homes Standard and implementation of Awaab’s Law to improve the quality of rented homes.The Ministry of Housing, Communities and Local Government has invested in the Household Support Fund to enable local authorities in England to provide discretionary support to vulnerable households in the most need with the cost of essentials. People in need may be able to get help for essential furniture from their local council through the Household Support Fund and other services available locally.

What steps his Department is taking to ensure that continuous NHS service is recognised across (a) primary, (b) secondary and (c) community care settings for the purposes of (i) redundancy pay and (ii) employment protections.

The Department understands the significance of recognising continuous service across different parts of the health system. Sections 12 and 16 of the National Health Service terms and conditions of service (Agenda for Change) handbook establish redundancy entitlements and employment protections for staff directly employed on Agenda for Change contracts in England, as well as employees whose contracts refer to Section 16. These arrangements are collectively agreed with NHS trade unions.Employers such as general practices within primary care operate as independent entities rather than NHS employers. Nevertheless, employers retain discretion to consider non-NHS service when calculating redundancy benefits, where this experience is relevant to NHS employment. NHS policy indicates that it may be reasonable, but is not obligatory, for employers to consider this previous service in the redundancy. These decisions should be mutually agreed upon by both the employer and employee at the point of joining or returning to the NHS.Collectively, sections 12 and 16 ensure that staff retain redundancy protections when moving between NHS organisations, while affording employers the flexibility to acknowledge any relevant external experience, which supports fairness and consistency in redundancy outcomes across the NHS. NHS Employers provides guidance to support the consistent implementation of NHS redundancy provisions across all settings. Ultimately, NHS organisations are responsible for administering the nationally agreed redundancy terms.

What assessment he has made of the potential impact of fragmented recognition of service across different NHS sectors on long-serving NHS staff during redundancy processes.

The Department has not made an assessment of how fragmented recognition of service across different National Health Service sectors might affect long-serving NHS staff who face redundancy.Redundancy entitlements for NHS staff are determined by Section 16 of the NHS Terms and Conditions of Service (Agenda for Change) handbook, which covers employees directly employed on Agenda for Change contracts in England and those whose contracts refer to Section 16. These arrangements are collectively agreed with NHS trade unions and also specify how previous NHS employment is defined and counted when determining redundancy pay.Local employers are responsible for confirming entitlement to a redundancy payment, and these terms will be stipulated in an employee’s contract of employment. The redundancy rules as described above apply to those employed by NHS employers in England as listed in Annex 1 of the Agenda for Change handbook. Employers must determine an individual’s redundancy entitlement in accordance with Section 16 as nationally agreed between employers and NHS trade unions. If someone has worked outside the NHS but in a role relevant to NHS employment, NHS policy recommends that it would be reasonable, but not a requirement, for employers to consider this service in any redundancy calculation. This consideration should be agreed between the employer and employee either upon joining or returning to the NHS.

What steps he is taking to prevent experienced women with non-linear NHS careers from being disproportionately excluded from leadership development opportunities during periods of (a) workforce restructuring and (b) redundancy.

NHS England actively promotes inclusion and accessibility in its formal leadership development programmes, including for experienced women with non-linear careers. Diversity data is monitored at every stage of selection to identify and address any risk of disproportionate exclusion.National leadership development programmes offered by NHS England are designed to assess potential, skills, and experience rather than continuous career progression. Entry routes are flexible and inclusive, enabling participation from colleagues working part-time, returning from career breaks, or with varied professional backgrounds.A wider programme of work is underway to support and develop National Health Service leaders including the commitment to establish a College of Executive and Clinical Leadership for the NHS. The college will provide access to development for all levels of managers and leaders, including those with non-linear career paths, to support them to succeed and progress in their NHS careers.

What assessment his Department has made of the potential impact of redundancy on access to levy-funded leadership development for experienced NHS staff; and whether he plans to introduce mitigations to prevent the loss of training opportunities following involuntary redundancy.

No assessment has been made of the potential impact of redundancy on access to levy-funded development for experienced National Health Service staff.The Department for Education issues guidance for all apprentices who are at risk of redundancy, which is available on their website. This sets out the terms for supporting apprentices at risk of redundancy and for continuing to fund their apprenticeships following redundancy.To further bolster training opportunities for experienced NHS staff, NHS England is expanding some national leadership and development offers, increasing flexible and mid-career offers, and widening access based on skills and potential rather than linear progression. Additional targeted outreach and career support are being used in places to encourage participation from experienced staff, including during periods of organisational change.

What steps he plans to take to increase (a) capacity of and (b) access to radiotherapy cancer treatment in (i) England and (ii) Stratford-upon-Avon.

Radiotherapy is crucial to cancer treatment, and it remains a key priority for the Government to reduce radiotherapy waiting times and provide high quality treatment for all patients, including those in Stratford-upon-Avon. This is why the Government has invested £70 million of central funding on 28 new LINAC radiotherapy machines across the country to replace older, less efficient radiotherapy machines. This crucial investment will boost treatment efficiency and productivity, freeing up capacity and reduce waiting times for patients. These new machines are currently being rolled out and have already started treating cancer patients across the country.The Coventry and Warwickshire NHS Trust received £2.3 million to replace ageing radiotherapy equipment from an underspend in the National Health Service’s capital settlement for 2024/25.

Whether the National Cancer Plan will address (a) access to and (b) capacity for radiotherapy services for cancer patients.

The National Cancer Plan will include further details on how we will improve outcomes for cancer patients, as well as how we will reduce waiting times for diagnosis and treatment.Improving access to all treatment services, including radiotherapy, remains a key priority for the Government. Our commitment to radiotherapy services is demonstrated by our £70 million investment in new LINAC radiotherapy machines to replace older, less efficient equipment. This crucial investment will boost treatment efficiency and productivity, freeing up capacity and reduce waiting times for patients. These new machines are currently being rolled out and have already started treating cancer patients across the country.

Whether the National Cancer Plan will address access to, and capacity for, radiotherapy services for cancer patients.

The National Cancer Plan will include further details on how we will improve outcomes for cancer patients, as well as how we will reduce waiting times for diagnosis and treatment.Improving access to all treatment services, including radiotherapy, remains a key priority for the Government. Our commitment to radiotherapy services is demonstrated by our £70 million investment in new LINAC radiotherapy machines to replace older, less efficient equipment. This crucial investment will boost treatment efficiency and productivity, freeing up capacity and reduce waiting times for patients. These new machines are currently being rolled out and have already started treating cancer patients across the country.

What alternative NHS roles are available to people who have completed accredited Physician Associate training but are unable to secure employment as Physician Associates.

Recruitment and retention of physician assistant, still legally known as physician associate (PA), roles into the National Health Service is the responsibility of individual employers in primary and secondary care as part of local and regional workforce planning. Decisions on alternative roles for newly qualified PAs rests with local employers, who will need to consider their workforce model, staffing numbers and skill mix as part of a wider workforce strategy aligned to service priorities.Nationally, NHS England continues to work closely with partners, supported by colleagues in the regions, to consider what guidance and support can be provided to employers to implement the Leng Review recommendations related to the employment of PAs.

What steps he is taking to (a) monitor and (b) regulate the cost of COVID-19 vaccinations offered by private providers for people who are not eligible for a free vaccination.

The availability of COVID-19 vaccines to supply the private market and the price charged for private COVID-19 vaccination is a matter for the companies concerned, not for the Government. All those eligible to receive a COVID-19 vaccination this autumn through the National Health Service, in line with advice by the independent expert Joint Committee on Vaccination and Immunisation, are encouraged to take up this offer. The national programme launched on 1 October 2025 and runs until 31 January 2026.

What assessment his Department has made of the potential impact of restricting eligibility for free covid-19 vaccinations on (a) infection rates, (b) hospital admissions and (c) mortality during winter 2025–26 on adults aged between 65 and 74 years old.

The primary aim of the national COVID-19 vaccination programme remains the prevention of serious illness, resulting in hospitalisations and deaths, arising from COVID-19.The JCVI is an independent expert committee which reviews the latest data on COVID-19 risks, vaccine safety, and effectiveness and advises the Government on eligibility for vaccination and immunisation programmes. The JCVI’s advice on COVID-19 vaccination for autumn 2025 is based on published analysis which considers the health impacts of vaccination against COVID-19 in various groups. This is available at the following link:https://www.sciencedirect.com/science/article/pii/S0264410X25002452The JCVI has advised that population immunity to COVID-19 has been increasing due to a combination of naturally acquired immunity following recovery from infection and vaccine-derived immunity. COVID-19 is now a relatively mild disease for most people, though it can still be unpleasant, with rates of hospitalisation and death from COVID-19 having reduced significantly since COVID-19 first emerged.The focus of the JCVI advised programme has moved towards targeted vaccination of the two groups who continue to be at higher risk of serious disease, including mortality. These are the oldest adults and individuals who are immunosuppressed.The Government has accepted the JCVI advice for autumn 2025 and in line with the advice, a COVID-19 vaccination is being offered to the following groups:adults aged 75 years old and over;residents in care homes for older adults; andindividuals aged six months old and over who are immunosuppressed, as defined in the ‘immunosuppression’ sections of tables 3 or 4 in the COVID-19 chapter of the UK Health Security Agency Green Book.The JCVI keeps all vaccination programmes under review.The UK Health Security Agency (UKHSA) continues to monitor COVID-19 through a variety of indicators and surveillance systems. Data are analysed and published by the UKHSA in weekly official statistics in the National Influenza and COVID-19 Surveillance Report. For the autumn 2025 campaign, this is available at the following link:https://www.gov.uk/government/statistics/national-flu-and-covid-19-surveillance-reports-2025-to-2026-season

What assessment his Department has made of the potential impact of restricting eligibility for free covid-19 vaccinations on (a) infection rates, (b) hospital admissions and (c) levels of mortality during winter 2025–26.

The primary aim of the national COVID-19 vaccination programme remains the prevention of serious illness, resulting in hospitalisations and deaths, arising from COVID-19.The JCVI is an independent expert committee which reviews the latest data on COVID-19 risks, vaccine safety, and effectiveness and advises the Government on eligibility for vaccination and immunisation programmes. The JCVI’s advice on COVID-19 vaccination for autumn 2025 is based on published analysis which considers the health impacts of vaccination against COVID-19 in various groups. This is available at the following link:https://www.sciencedirect.com/science/article/pii/S0264410X25002452The JCVI has advised that population immunity to COVID-19 has been increasing due to a combination of naturally acquired immunity following recovery from infection and vaccine-derived immunity. COVID-19 is now a relatively mild disease for most people, though it can still be unpleasant, with rates of hospitalisation and death from COVID-19 having reduced significantly since COVID-19 first emerged.The focus of the JCVI advised programme has moved towards targeted vaccination of the two groups who continue to be at higher risk of serious disease, including mortality. These are the oldest adults and individuals who are immunosuppressed.The Government has accepted the JCVI advice for autumn 2025 and in line with the advice, a COVID-19 vaccination is being offered to the following groups:adults aged 75 years old and over;residents in care homes for older adults; andindividuals aged six months old and over who are immunosuppressed, as defined in the ‘immunosuppression’ sections of tables 3 or 4 in the COVID-19 chapter of the UK Health Security Agency Green Book.The JCVI keeps all vaccination programmes under review.The UK Health Security Agency (UKHSA) continues to monitor COVID-19 through a variety of indicators and surveillance systems. Data are analysed and published by the UKHSA in weekly official statistics in the National Influenza and COVID-19 Surveillance Report. For the autumn 2025 campaign, this is available at the following link:https://www.gov.uk/government/statistics/national-flu-and-covid-19-surveillance-reports-2025-to-2026-season

What steps his Department is taking to utilise electronic health records indicating familial genetic predisposition to improve risk identification for men at increased risk of prostate cancer.

The NHS Retrospective Genetic Testing Programme is using electronic health records to identify people who have had a cancer diagnosis, between 2008 and 2018, making them eligible for inherited breast and ovarian cancer genetic testing on R208/R207 panels in line with the criteria set out in the National Genomic Test Directory, but who have not received testing. This will identify more people and their family members who have cancer susceptibility genes, including BRCA1/2 variants, enabling them to access relevant National Health Service screening and care pathways as appropriate.My Rt Hon. Friend, the Secretary of State for Health and Social Care will consider the final recommendation of the UK National Screening Committee (UK NSC) on screening for prostate cancer when it is received. He will make a decision on implementation, including any changes to the identification of men at risk of prostate cancer at that point.It is anticipated that the final recommendation will be provided in early 2026 after the conclusion of a 12 week consultation which opened on 28 November 2025. This seeks views on an evidence review and a draft recommendation to:- offer a targeted national prostate cancer screening programme to men with confirmed BRCA1/2 gene variants every two years, from 45 years old to 61 years old;- not recommend population screening;- not recommend targeted screening of black men;- not recommend targeted screening of men with family history; and- collaborate with the Transform trial team to answer outstanding questions on screening effectiveness for black men and men with a family history as soon as the trial data becomes available, and to await the results of the study to develop and trial a more accurate test than the prostate specific antigen test alone, to improve the balance of benefit and harm of screening.

What recent assessment he has made of the potential merits of improving systems to identify men with (a) BRCA1 and (b) BRCA2 gene variations who may be eligible for prostate cancer screening.

The National Inherited Cancer Predisposition Register (NICPR), launched 1 July 2025, captures data on all individuals with a likely pathogenic/pathogenic variant in a cancer susceptibility gene in England. This world-first national dataset of individuals at increased cancer risk provides significant opportunities for improved clinical care, audit, and research.The NICPR is part of the National Disease Registration Service and is a new initiative for NHS England. In view of the UK National Screening Committee’s (UK NSC) draft recommendations on screening men for prostate cancer, NHS England is working closely with colleagues in regional clinical genetics services to ensure that accurate data is gathered and can be applied effectively to inform future work.My Rt Hon. Friend, the Secretary of State for Health and Social Care will consider the final recommendation of the UK NSC on screening for prostate cancer when it is received. He will make a decision on implementation, including any changes to BRCA testing eligibility, at that point.It is anticipated that the final recommendation will be provided in early 2026 after the conclusion of a 12 week consultation which opened on 28 November 2025. This seeks views on an evidence review and a draft recommendation to:- offer a targeted national prostate cancer screening programme to men with confirmed BRCA1/2 gene variants every two years, from 45 years old to 61 years old;- not recommend population screening;- not recommend targeted screening of black men;- not recommend targeted screening of men with family history; and- collaborate with the Transform trial team to answer outstanding questions on screening effectiveness for black men and men with a family history as soon as the trial data becomes available, and to await the results of the study to develop and trial a more accurate test than the prostate specific antigen test alone, to improve the balance of benefit and harm of screening.

What steps he is taking to improve support for women’s menopausal health, including (a) training for GPs and (b) training for prescribing nurses.

The Government is committed to prioritising women’s health, including menopause, as we reform the National Health Service, and women’s equality will be at the heart of our health missions.That is why menopause will be added to the NHS Health Checks from 2026 for eligible women aged 40 to 55 years old who attend. This will support up to five million eligible women across England to access high quality information on menopause, including advice on managing symptoms and where to seek support.For new doctors starting their careers in the United Kingdom, the General Medical Council has introduced the Medical Licensing Assessment to encourage a better understanding of common women’s health problems. The content for this assessment includes several topics relating to women’s health, including menopause, and will encourage a better understanding of common women’s health problems.Additionally, for general practitioners and other primary healthcare professionals, the Royal College of General Practitioners (RCGP) has published a Women’s Health Library which brings together educational resources and guidelines on women’s health, including menopause, from the RCGP, the Royal College of Obstetricians and Gynaecologists, and the College of Sexual and Reproductive Healthcare.The National Institute for Health and Care Excellence has also developed a women’s and reproductive health topic suite, and updated guidelines on menopause in November 2024. The guideline recommends more treatment choices for menopause symptoms, and prescribers are encouraged to use these guidelines as best practice when making decisions relating to menopause.