Written questions by Duncan-Jordan.

What recent assessment has been made of the effectiveness of the 111 service in ensuring patients are referred to the correct place for treatment.

The Government is committed to continuing to improve NHS 111 to ensure patients can access the right care first time, only visiting accident and emergency when necessary.Our Urgent and Emergency Care Plan for 2025/26 committed to reviewing NHS 111 services and incorporating the recommendations from the review, to make the service more effective, quicker, and simpler to navigate.NHS England have now completed the NHS 111 review and is working with system partners to implement actions to improve service efficiency, consistency, and integrated delivery to reduce pressures this winter. We are also working with general practitioners and other healthcare providers to improve the patient referral process to primary care.

Whether he has made an assessment of the potential merits of introducing regulation of non-therapeutic male circumcision.

The Care Quality Commission (CQC) regulates male circumcisions including those performed for non-therapeutic reasons, when carried out by a healthcare professional. Circumcisions performed by regulated healthcare professionals are subject to CQC registration and oversight, ensuring consistent standards of safety and quality in those cases. Religious or cultural circumcisions by individuals who are not registered healthcare professionals remain outside the regulatory scope.The Department had made no recent assessment of the potential merits of introducing regulation of non-therapeutic circumcision when performed by those who are not healthcare professionals.

What will the NHS offline alternative consist of for people who are digitally excluded, in the context of NHS digitalisation.

Patients who prefer face-to-face appointments in physical settings will continue to access care through their local National Health Service provider. This is about expanding choice, not replacing traditional services.We will be working with marginalised groups, including through the Voluntary Community and Social Enterprise Health and Wellbeing Alliance that represents communities who share protected characteristics or that experience health inequalities. Inclusion will be a core priority as the organisation evolves.

What assessment he has made of the potential merits of providing dairy-free alternatives as part of the Nursery Milk Scheme.

Plant-based drinks are currently not covered by the legislation on the Nursery Milk Scheme, which only allows reimbursement to be made for cow’s milk and infant formula based on cow’s milk.The Scientific Advisory Committee on Nutrition and the Committee on Toxicity published an assessment on plant-based drinks in July 2025. This assessment made a number of recommendations to the Government and industry about plant-based drinks which may be considered suitable for children in terms of fortification and sweetening.The Government does not currently have plans to provide dairy-free alternatives as part of the Nursery Milk Scheme. However, the Department is considering the Committee’s recommendations.

What estimate his Department has made of the number of people who be unable to access NHS services after the move from analogue to digital.

The shift from analogue to digital services is not intended to entirely replace traditional access methods. Practices are required to maintain phone and in-person services for those who cannot or prefer not to use digital options.NHS Online will give patients more choice in how and when patients access specialist care. Digital services will always be optional and only offered when it is clinically appropriate and works for the patient. We’re working closely with community and patient groups to ensure inclusion is built into every stage of development. The experience of patients and how they access, understand, and feel about their care is central to the design and delivery of NHS Online.

If he will take steps to ensure that NHS bank shifts are paid at the same rate as contracted overtime.

National Health Service bank contracts are local contracts, the terms of which the employer has discretion over. The expectation is that the terms offered via a bank contract are agreed in partnership between employers and trade unions via local negotiating committees.Overtime payments for substantive staff on national contracts in England can only be paid to individuals once they have worked more than 37.5 hours per week, for Agenda for Change staff, or 40 hours per week for medical staff.Where an additional agreement exists between staff and their employing organisation on the payment of any additional hours, including hours worked in excess of 37.5 or 40 hours per week, for example via a bank contract, then this is considered a local matter.

How many and what proportion of (a) women and (b) people have had a HPV vaccination in Poole constituency in 2025.

Human papillomavirus (HPV) vaccine coverage is presented for England at a national, National Health Service commissioning region, and local authority level. Data is not gathered at constituency level.Vaccine coverage data for the routine school-aged HPV immunisation programme in England, including for the 2023 to 2024 academic year, is available at the following link:https://www.gov.uk/government/collections/vaccine-uptake#hpv-vaccine-uptake

If his Department will make an assessment of the number of people (a) with a respiratory disease, (b) who were hospitalised during winter 2024-25 and (c) who are not eligible to receive the covid-19 vaccination.

From November 2024 to March 2025 inclusive, 483,876 patients were admitted to hospital in England where the primary diagnosis was a respiratory disease. Data on COVID-19 vaccine eligibility is not linked to hospital admissions data.The UK Health Security Agency published further data on the prevalence of respiratory viruses in the population, and this data is available at the following link:https://ukhsa-dashboard.data.gov.uk/respiratory-viruses

What steps he is taking to ensure that the WHO target of 90% for the HPV vaccination programme is achieved in Poole constituency.

In March 2025, NHS England published the Cervical cancer elimination by 2040 – plan for England, which outlines how the National Health Service will improve uptake and coverage across human papillomavirus (HPV) vaccination and cervical screening, including in Poole constituency. The plan is available at the following link:https://www.england.nhs.uk/publication/cervical-cancer-elimination-by-2040-plan-for-england/For young people who may have missed out at the point of initial offer, the NHS-commissioned School Age Immunisation Service (SAIS) providers have robust catch-up plans in place for the adolescent HPV vaccination programme.NHS England has improved digital communications on vaccinations, including expanding the NHS app, and has improved access to the HPV vaccine outside of schools through community clinics at convenient times and locations.The UK Health Security Agency works closely with charities and academics to develop resources that can be used to raise awareness of HPV and the importance of vaccination.Poole constituency is covered by the Dorset SAIS Leads who, alongside their leadership team, remain fully engaged with NHS England to drive performance improvements. A summary of key developments during the 2024/25 academic year includes the launch of a new e-consent system in September 2025 and a named link nurse for every school: a dedicated nurse has been assigned to each school in Dorset, including Poole, to improve communication and foster stronger relationships.

What plans his department has to introduce type one diabetes testing for all infants.

The National Institute for Health and Care Excellence (NICE) is the independent body responsible for providing clinical guidelines for the diagnosis, treatment and care of children and young people with diabetes. NICE’s NG18 guideline for type 1 and 2 diabetes recommends that children and young people with suspected type 1 diabetes are referred immediately (on the same day) to a multidisciplinary paediatric diabetes team with the competencies needed to confirm diagnosis and provide immediate care.

What steps his Department is taking against PPE Medpro after their failure to repay £122m of public money by the 4pm deadline on 15 October 2025.

PPE Medpro Ltd went into administration prior to the court’s announcement on 1 October 2025. The Department has instructed lawyers who are engaged with all relevant parties regarding enforcement of the court decision, and this includes the administrators.Due to the sensitive and legally complex nature of recovery activity we are unable to offer a detailed commentary on the discussions as this would risk compromising the legal team’s efforts.

Whether his Department has made an assessment of the potential merits of appointing a Commissioner for Older People and Ageing for England, in the context of equivalent commissioners in (a) Wales and (b) Northern Ireland.

The Government is committed to improving the lives of older people in England, and we are progressing towards a National Care Service based on higher standards, greater choice and control, and better joined up care between services, with over £4 billion of additional funding available for adult social care by 2028.We have previously considered the merits of appointing a Commissioner for Older People and Ageing in England, similar to those in Wales and Northern Ireland. However, we believe that the duties such a role would cover are already addressed through existing structures and initiatives across the health and social care system.In England, local authorities have statutory responsibilities under the Care Act 2014 to promote individual wellbeing, prevent or delay the development of care needs, and ensure a sustainable and diverse care market, including for older people. This includes duties to assess needs, shape local provision, and support people to live independently for as long as possible. These responsibilities are reinforced by the Care Quality Commission’s assurance framework, which monitors how well councils are delivering these duties and which helps drive improvement across the system.

What steps he is taking to ensure that people seeking a potential diagnosis of multiple sclerosis are seen by a neurologist within 12 weeks.

Cutting waiting lists is a key priority for the Government. We have committed to achieving the NHS constitutional standard that 92% of patients should wait no longer than 18 weeks from Referral to Treatment by March 2029, including in neurology services.In January 2025, we published our Elective Reform Plan, which sets out our approach to hitting that target by the end of this Parliament.We surpassed our manifesto pledge to deliver an extra two million elective appointments; we have delivered 5.2 million additional appointments in our first year of government. Many of those appointments included appointments for treating multiple sclerosis.Waiting lists are coming down; they have fallen by over 206,000 since the Government came into office.

Whether he plans to make cognitive behavioural therapy for insomnia more widely available in England.

In its Clinical Knowledge Summary on insomnia, the National Institute for Health and Care Excellence (NICE) suggests that clinicians can offer cognitive behavioural therapy (CBT) for insomnia if sleep hygiene measures fail, daytime impairment is severe, causing significant distress, and the insomnia is not likely to resolve soon. It is for local integrated care boards to decide what treatments and support for insomnia are offered to their local populations. Further information on NICE’s Clinical Knowledge Summary on insomnia is available at the following link: https://cks.nice.org.uk/topics/insomnia/ In addition, NHS Talking Therapies services for anxiety and depression offer low-intensity therapy, including CBT, 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 via the following link: https://www.nhs.uk/mental-health/talking-therapies-medicine-treatments/talking-therapies-and-counselling/nhs-talking-therapies/ Individuals 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/NICE has also agreed to prioritise digital technologies that deliver CBT interventions for insomnia and insomnia symptoms as a topic for the development of HealthTech guidance.

What assessment he has made of the potential impact of cognitive behavioural therapy for insomnia.

In its Clinical Knowledge Summary on insomnia, the National Institute for Health and Care Excellence (NICE) suggests that clinicians can offer cognitive behavioural therapy (CBT) for insomnia if sleep hygiene measures fail, daytime impairment is severe, causing significant distress, and the insomnia is not likely to resolve soon. It is for local integrated care boards to decide what treatments and support for insomnia are offered to their local populations. Further information on NICE’s Clinical Knowledge Summary on insomnia is available at the following link: https://cks.nice.org.uk/topics/insomnia/ In addition, NHS Talking Therapies services for anxiety and depression offer low-intensity therapy, including CBT, 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 via the following link: https://www.nhs.uk/mental-health/talking-therapies-medicine-treatments/talking-therapies-and-counselling/nhs-talking-therapies/ Individuals 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/NICE has also agreed to prioritise digital technologies that deliver CBT interventions for insomnia and insomnia symptoms as a topic for the development of HealthTech guidance.

What assessment he has made of the potential impact of not giving people aged between 65 and 74 Covid-19 booster vaccinations on public health.

The Government’s policy on groups eligible for vaccination programmes is based on the advice of the independent expert body, the Joint Committee on Vaccination and Immunisation (JCVI). Over time, the risk from COVID-19 has reduced across the United Kingdom population, through exposure to the virus, changes in the virus and vaccination.The JCVI carefully considered the latest evidence on the risk of illness, serious disease in specific groups, as well as cost-effectiveness analysis, to provide the Government with advice on the autumn 2025 programme. The evidence indicates that whilst the risk from COVID-19 is now much lower for most people, adults aged 75 years old and over, residents in care homes for older adults, and those who are immunosuppressed are those at highest risk of serious COVID-19 disease. A more targeted vaccination programme, aimed at individuals, with a higher risk of developing serious disease, and where vaccination was considered potentially cost-effective, was advised for autumn 2025.Whilst current COVID-19 vaccines provide good protection against hospitalisation and/or death for those at highest risk, they provide very limited protection against acquiring COVID-19 infection or mild illness, meaning any potential public health benefit of reducing transmission is much less evident.Long term health consequences following COVID-19 infection, including post-COVID syndromes, such as long COVID, have been discussed at meetings of the JCVI. It remains uncertain whether getting extra COVID-19 vaccine doses has any effect on the chances of developing long COVID, how it progresses, or how it affects people.The JCVI has proactively published an updated list of Research Recommendations, encouraging future investigations on the exploration of data and evidence on the benefit of vaccination amongst post-COVID syndromes, and those with underlying medical conditions who are not currently eligible.The JCVI keeps all vaccination programmes under review. Accordingly, the Government will consider any additional advice from the JCVI in due course. Further information on the details of the modelling and analysis considered are within the 2025 and spring 2026 advice, on the GOV.UK website.Information is collected on hospital bed occupancy and on the reason for hospital admissions. It is, however, not possible to determine which admissions associated with COVID-19 were for individuals who were eligible for vaccination in autumn 2024 but no longer eligible in autumn 2025.

How many non-pandemic human vaccines have been licensed in the UK in the last 10 years that involved the use of beagles from MBR Acres; how many of those vaccines were later withdrawn or had contraindications added; and what contribution was made by the data from those beagles.

Answering this question would require Medicines and Healthcare products Regulatory Agency (MHRA) staff to go through a vast volume of data manually spanning 10 years. This is because the information is not held in such a way to be able to filter electronically by the requested category.The Guide to Parliamentary Work sets out that there is an advisory cost limit known as the disproportionate cost threshold which is the level above which departments can decide not to answer a written question. The current disproportionate cost threshold is £850.The Guide to Parliamentary Work is published online and is available at the following link:https://www.gov.uk/government/publications/guide-to-parliamentary-work

With reference to the MS Society’s report entitled A Different Path: Rethinking MS hospital care, published in September 2025, what assessment he has made of the potential impact of preventable unplanned hospital admissions for people with multiple sclerosis on (a) people with MS, (b) the NHS and (c) the economy.

As set out in our recently published 10-Year Health Plan, the Government is determined to shift more healthcare out of hospitals and into the community, to ensure patients and their families receive personalised care in the most appropriate setting, including patients with multiple sclerosis (MS).We recognise that preventable unplanned hospitals admissions for people with MS creates added pressure on acute services and are more costly for the National Health Service and the economy, when in fact most patients would prefer to be supported in the community.The 10-Year Health Plan sets out our vision for a Neighbourhood Health Service, which will embody our new preventative principle that care should happen as locally as it can, digitally by default, in a person’s home if possible, in a neighbourhood health centre when needed, and only in a hospital if necessary.The Neighbourhood Health Service will rebalance our health and care system so that it fits around peoples’ lives, not the other way round, moving away from a one-size-fits-all approach and giving people more power and choice over the care they receive.

If he will conduct a modelling exercise to determine how much the NHS should spend on the health elements of children’s palliative care.

I have tasked officials to look at how to improve the access, quality, and sustainability of all-age palliative care and end of life care in line with the 10 Year Health Plan.The Government and the National Health Service will closely monitor the shift towards the strategic commissioning of palliative care and end of life care services to ensure that the future state of services reduces variation in access and quality, although some variation may be appropriate to reflect both innovation and the needs of local populations.There are currently no plans at a national level to run a modelling exercise to determine how much the NHS should spend on the health elements of children’s palliative care.

If he will ensure that the National Cancer Plan for England includes targets to improve the diagnosis times of myeloma.

It is a priority for the Government to support the National Health Service to diagnose cancer, including blood cancers such as myeloma, as well as other unstageable cancers, as early and quickly as possible, and to treat it faster, in order to improve outcomes.To tackle late diagnoses of blood cancers, the NHS is implementing non-specific symptom pathways for patients who present with symptoms such as weight loss and fatigue, which do not clearly align to a tumour type. Blood cancers are one of the most common cancer types diagnosed through these pathways.We will get the NHS diagnosing blood cancer earlier and treating it faster, and we will support the NHS to increase capacity to meet the demand for diagnostic services through investment, including for magnetic resonance imaging and computed tomography scanners.The National Cancer Plan will include further details on how we will improve outcomes for cancer patients, including speeding up diagnosis and treatment, ensuring patients have access to the latest treatments and technology, and ultimately drive up this country’s cancer survival rates.