Written questions by Duncan-Jordan.

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.

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.

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.

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

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.

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.

Whether he plans to review the way children's palliative care is (a) planned and (b) funded.

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 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.

If he will make an assessment of the equity of access to the shingles vaccine.

Previously, the shingles vaccine was available to people turning 65 and 70 years old, up until their 80th birthday, and to severely immunosuppressed individuals aged 50 years old and over.As of 1 September 2025, approximately 300,000 more people have become eligible for shingles vaccination, with all severely immunosuppressed individuals aged 18 years old and over now being eligible for the shingles vaccine. Individuals who are severely immunosuppressed are most at risk of serious illness and complications from shingles, and so the decision has been made to follow the advice of the Joint Committee on Vaccination and Immunisation (JCVI), to lower the age of eligibility to protect the most vulnerable.For immunocompetent individuals, the current offering to adults aged 65 and 70 years old was agreed by the Department, the UK Health Security Agency, and NHS England. This decision was made following the JCVI’s advice, an assessment of the effective use of National Health Service resources, and careful consideration of individual risk and population benefit.Analysis shows that the difference in risk and vaccine effectiveness between an individual aged 66 to 69 years old and a 70-year-old is likely to be marginal. This was taken into consideration when planning the expansion of the vaccination programme for immunocompetent adults, which maintains the original offer for those turning 70 years old while also providing another cohort with the opportunity for vaccination.

What assessment he has made of the potential merits of funding (a) ICBs and (b) NHS trusts to purchase private hospitals.

The Government is committed to delivering an NHS that is fit for the future through our 10-Year Health Plan. We recognise that delivering high quality NHS healthcare services requires safe, sustainable, and effective infrastructure. That is why we prioritised investment in healthcare at the recent Spending Review, delivering the largest ever health capital budget.The New Hospital Programme is transforming the design and delivery of new hospital infrastructure and there are no plans for other national programmes of new hospital development or acquisition at this time. At a local level, integrated care boards (ICBs) and NHS Trusts are responsible for infrastructure planning, managing the operational capital allocations for their respective local areas, and acquiring new facilities.

What steps he is taking to help ensure that the views of (a) patients and (b) the public continue to be heard when the responsibilities of Healthwatch are moved to Integrated Care Boards.

The Department has accepted the recommendation of the Dash review of patient safety across the health and care landscape, to abolish Local Healthwatch.In future, integrated care boards will be responsible for seeking patient, user and wider community input for health along with their existing duties of patient involvement, and local authorities for social care, where it can feed directly into overall strategic planning and be more closely aligned with the commissioning and provision of care.The Dash review recommends that the strategic functions of Healthwatch England are transferred into a new patient experience directorate of the Department.The abolition of Healthwatch England and the transfer of its functions and the changes to Local Healthwatch will require primary legislation. Timing of this is subject to the will of parliament and will happen when parliamentary time allows.

What steps his Department is taking to promote the benefits of breast feeding to new mothers.

The Government is committed to raising the healthiest generation of children ever and to giving every child the best start in life. We want every parent to understand the benefits of breastfeeding so that they can make informed decisions about how to feed their baby. Through the Family Hubs and Start for Life programme, we are investing £18.5 million in 2025/26 to improve infant feeding support across 75 local authorities in England. This includes promoting the benefits of breastfeeding and supporting families to achieve their infant feeding goals. The Start for Life communications programme also promotes the benefits of breastfeeding via a website, email, and public awareness campaign.Most families will receive advice on the benefits of breastfeeding and support from midwives and health visitors. We are committed to strengthening these services and are already making progress.

What assessment he has made of the merits of allowing the adoption of Limited Liability Partnerships for GPs.

Currently, Limited Liability Partnerships cannot hold General Medical Services and Personal Medical Services contracts. However, general practice (GP) partners can take steps to reduce their personal liability and financial risk. For example, limited companies can be used to manage risks in the partnership. GP partnerships can also manage different liabilities through indemnities and different forms of insurance. As independent contractors and small business owners, these are decisions that GP partners make, with legal and accounting advice.

Whether he plans to review the rules that allow private companies working in the NHS to avoid paying VAT.

HM Treasury is committed to implementing the Public Sector Value Added Tax (VAT) reform which will remove the current disparity for VAT recovery between National Health Service trusts and private companies working in the NHS.

Whether he plans to issue new guidance to NHS Trusts advising them not to set up wholly owned subsidiary companies to avoid paying VAT.

The current NHS England guidance dated February 2024, titled Guidance for assuring and supporting complex change – subsidiaries guidance for trusts forming or changing a subsidiary, sets out the VAT position of wholly owned subsidiaries and confirms that “the commercial rationale is not dependent on the subsidiary enabling a VAT treatment that differs from the trust’s current arrangements”.There are no plans for this guidance to be updated.

Whether he plans to make an assessment of the potential merits of NHS Trusts setting up wholly owned subsidiary companies to avoid paying VAT.

The current NHS England guidance dated February 2024, titled Guidance for assuring and supporting complex change – subsidiaries guidance for trusts forming or changing a subsidiary, confirms that the Department “reminded all NHS provider finance directors in September 2017 of their responsibilities around tax, advising that tax avoidance arrangements should not be entered into under any circumstances. We expect all NHS providers to follow this guidance when considering any new arrangements or different ways of working”A perceived VAT advantage of setting up a wholly owned subsidiary cannot be the only reason for its creation. Subsidiary proposals should be driven by a robust commercial strategy that delivers clear financial, operational, and patient benefits.No assessment is planned or deemed necessary.