Written questions by Law.

What assessment his Department has made of the potential merits of widening the eligibility of COVID vaccines to people with Multiple Sclerosis.

The Government is committed to protecting those most vulnerable to COVID-19 through vaccination, as guided by the independent Joint Committee on Vaccination and Immunisation (JCVI). 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.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 is 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 spring 2026 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; and- individuals aged six months old and over who are immunosuppressed, as in the COVID-19 chapter of the UK Health Security Agency Green Book.The JCVI keeps all vaccination programmes under review.

What guidance or requirements exist for NHS trusts, GP practices and other health providers to ensure that medical records, appointment letters and other clinical correspondence about a child are sent to the correct parents or addresses, including where parental responsibility is shared.

NHS England has a range of guidance online relating to communicating with patients, and the sharing of medical records for direct care. NHS England continues to support the secure sharing of patient information to improve safety, reduce the duplication of tests, and support patient choice. Programmes such as Connecting Care Records are designed to enable appropriate access to patient information across organisational boundaries.In the Government’s 10-Year Health Plan there is a commitment to create a Single Patient Record (SPR). The SPR will provide a single, secure, and up to date record that brings together health and care information so clinicians can access the appropriate information they need, wherever a patient receives care. This will help reduce the delays caused by missing information, and clinicians working with incomplete histories. Subject to parliamentary timetables, the SPR will begin rolling out from 2028, starting with maternity and frailty.The National Health Service is taking a digital-first approach to patient communications, to ensure seamless and effective communications with patients and families. Further information is available at the following link:https://digital.nhs.uk/about-nhs-digital/digital-first-messagingThere is no specific guidance relating to ensuring correspondence relating to a child is sent to the correct addresses, as this relates to ensuring the accuracy of records which runs throughout the guidance both produced by NHS England, and the professional bodies.NHS England’s Policy and Guidance Manual for Primary Medical Services provide standard operating processes for general practice registration and include specific guidance when registering a child and the circumstances in which safeguarding guidance should be followed. This essentially underlines a “think family” approach and states an adult with parental responsibility should normally be registered at the practice with the child. Further information on NHS England’s Policy and Guidance Manual for Primary Medical Services is available at the following link:https://www.england.nhs.uk/long-read/primary-medical-services-policy-and-guidance-manual-pgm-2/

What assessment he has made of the potential merits of widening the eligibility of the NHS Low Income Scheme to include those who are on a state pension.

No such assessment has been made. People aged 60 years old and over are automatically entitled to free National Health Service prescriptions and free NHS eye tests.People on the state pension can apply for the NHS Low Income Scheme and depending on their income and requirements, may receive either full or partial help with health costs. Alternatively, they may be eligible for Pension Credit Guarantee Credit, which provides full help with health costs. Full help covers:- NHS prescription charges;- NHS dental treatment charges;- the cost of sight tests, glasses, and contact lenses;- the cost of travelling to receive NHS treatment; and- NHS wigs and fabric supports.

What steps he is taking to reduce burdens on NHS dentistry services, especially by ensuring dentists who are qualified to practice in other countries can be fast-tracked for qualification to practice in the UK.

The General Dental Council (GDC) regulates United Kingdom dentistry and sets the standards for all applicants to its registers. Routes to registration for overseas qualified dentists are set out in legislation.The Government is working with the GDC to increase the number of overseas-qualified dentists gaining registration to help address National Health Service workforce shortages.The GDC already offers priority booking to refugee dentists on its Overseas Registration Exam (ORE). Last year I asked the GDC to develop a plan to urgently cut the high ORE waiting list and in November received an update on their work. I have been assured that significant improvements to international registration are expected this year.I have also asked the GDC for an improved ORE booking system for the new ORE delivery contract, coming into effect from April 2026, and to explore prioritisation of UK resident candidates. I will meet the GDC again for an update on this work once the new contract is finalised.

What progress he has made on the (a) establishment and (b) delivery of the MHRA Early Access Service.

In July of this year the Medicines and Healthcare products Regulatory Agency (MHRA) published a statement of policy intent for the development and implementation of an Early Access Service for innovative medical devices. The statement of policy intent is available at the following link: https://www.gov.uk/government/publications/statement-of-policy-intent-early-access-to-innovative-medical-devices/statement-of-policy-intent-early-access-to-innovative-medical-devices#next-steps The service aims to speed up safe access to innovative medical devices for patients, supporting the Government’s Life Sciences Sector Plan. The statement set out our intention to work with stakeholders across the life science ecosystem to further develop the policy and to build the internal capability required to deliver the service throughout 2025. Further information on our plans will be provided in early 2026.

What steps his Department is taking to expedite the recruitment of newly qualified midwives (a) nationally and (b) within Cornwall.

On 11 August 2025, the Government announced the Graduate Guarantee for nurses and midwives. The guarantee will ensure that there are enough positions for every newly qualified midwife in England. Vacant maternity support worker posts will be temporarily converted to Band 5 midwifery roles, backed by £8 million to create new opportunities specifically for newly qualified midwives and to further ease the recruitment strain.Decisions about local recruitment are matters for individual National Health Service trusts. NHS trusts manage their recruitment at a local level, ensuring they have the right number of staff in place, with the right skill mix, to deliver safe and effective care.

What steps his Department has taken to ensure the delivery of 10,910 new dental appointments in Cornwall and the Isles of Scilly since February 2025 .

We have asked the integrated care boards (ICBs) to commission extra urgent dental appointments to make sure that patients with urgent dental needs can get the treatment they require. ICBs have been making extra appointments available since April 2025.ICBs have the flexibility to commission the additional activity in the way which best meets their local needs. Options include buying more appointments through new or recommissioned contracts, modification of existing contracts, or using flexible commissioning.National Health Service dentistry is delegated to the ICBs, who are accountable to NHS England for the delivery of urgent dental appointments.

Whether his Department has made an assessment of the potential impact of reclassifying the NHS ambulance service as an emergency service on (a) retirement age, (b) pension entitlements and (c) other areas.

National Health Service ambulance staff are entitled to NHS Pension Scheme membership. There are no plans to reclassify these staff as being entitled to Police or Firefighter’s Pension Scheme membership, or to a separate scheme with similar terms. This reclassification would significantly increase the pension contribution costs of these staff.NHS Pension Scheme members, including those in the ambulance service, do not have to work to the scheme’s normal pension age (NPA) to claim their retirement benefits. Flexible retirement options enable members to choose when to claim their benefits. Voluntary Early Retirement allows staff to fully retire up to ten years earlier than the NPA with an actuarially reduced pension due to the pension being in payment for longer. Alternatively, partial retirement allows members to draw down some or all of their pension while continuing to work and build up further pension benefits. Even when taken years before normal pension age, NHS Pension Scheme entitlements give exceptional value to staff and can provide for a comfortable living in retirement.

Whether his Department has made an assessment of the adequacy of the personal expenses allowance for residents in care homes to meet the cost of (a) transport, (b) health-related services and (c) social participation.

The rates of the personal expenses allowance (PEA) are reviewed annually, and local authorities also have the discretion to set higher rates for the PEA if they so choose.To allow people receiving means-tested support to keep more of their own income, the PEA was increased in line with consumer price index inflation for the present financial year, 2025/26.

What guidance his Department has provided to (a) local healthcare trusts and (b) ICBs on the specification for Neighbourhood Health Centres.

The Government has set out its vision for Neighbourhood Health Centres in the 10-Year Health Plan, co-locating National Health Service, local authority and voluntary sector services and bring historically hospital-based services into the community. These should be part of a broader offer that is defined locally to meet the local population needs holistically, rather than a one-size-fits-all approach. NHS England’s health building notes give best practice guidance on the design and planning of new healthcare buildings and on the adaption or extension of existing facilities, including for primary and community care services. These are available to both NHS trusts and integrated care boards, and are available at the following link: https://www.england.nhs.uk/estates/health-building-notes/

What assessment he has made of the potential merits of providing free covid vaccinations to unpaid carers.

The Government is committed to protecting those most vulnerable to COVID-19 through vaccination, as guided by the independent Joint Committee on Vaccination and Immunisation (JCVI). The primary aim of the national COVID-19 vaccination programme remains the prevention of severe illness, involving hospitalisation and/or death, arising from COVID-19.The JCVI’s advice for autumn 2024 noted that in the era of high population immunity to COVID-19, and with all cases due to highly transmissible omicron sub-variants, any protection offered by the vaccine against the transmission of infection from one person to another was expected to be extremely limited. On this basis, the JCVI did not advise offering vaccination to unpaid carers. The Government accepted the JCVI’s advice for autumn 2024, with both the advice and the Government’s response available at the following link:https://www.gov.uk/government/news/government-accepts-advice-on-2024-autumn-covid-vaccine-programmeOn 13 November 2024, the JCVI published advice on the COVID-19 vaccination programme covering vaccination in 2025 and spring 2026. In line with its advice for the autumn 2024 campaign, the JCVI does not advise COVID-19 vaccination for unpaid carers. This advice is available at the following link:https://www.gov.uk/government/publications/covid-19-vaccination-in-2025-and-spring-2026-jcvi-advice/jcvi-statement-on-covid-19-vaccination-in-2025-and-spring-2026#:~:text=the%20JCVI%20webpage.-,Advice%20on%20vaccination%20in%20spring%202025,care%20home%20for%20older%20adultsThe Government has accepted the JCVI’s advice on eligibility for the spring 2025 COVID-19 vaccination programme. The Government is considering the advice for autumn 2025 and spring 2026 carefully, and will respond in due course.

If he will have discussions with Cabinet colleagues on reforming student loan repayment rules to exempt nurses from repaying those loans while they are employed within the NHS.

The Government currently has no plans to exempt nurses from repaying student loans. The Government keeps the funding arrangements for all healthcare students under close review in order to balance the use of finite financial resources with the level of support students require.

Whether his Department is taking steps to hire more specialists in the diagnosis of adult ADHD.

NHS England has established an attention deficit hyperactivity disorder (ADHD) taskforce which is working to bring together those with lived experience with experts from the National Health Service, education, charity, and justice sectors. The taskforce is working to get a better understanding of the challenges affecting those with ADHD, including timely and equitable access to services and support, with the final report expected in the summer of 2025.In conjunction with the taskforce, NHS England has carried out detailed work to develop an ADHD data improvement plan, to inform future service planning. NHS England has also captured examples from integrated care boards who are trialling innovative ways of delivering ADHD services, and is using this information to support systems to tackle ADHD waiting lists and provide support to address people’s needs.We will publish a refreshed Long Term Workforce Plan to deliver the transformed health service we will build over the next decade, and treat patients on time again. We will ensure the NHS has the right people, in the right places, with the right skills to deliver the care patients need, when they need it.

What steps his Department is taking to ensure that GPs can support ADHD patients under the shared care plans through (a) reassessment, (b) re-prescription of ADHD medication and (c) other measures.

Shared care within the National Health Service refers to an arrangement whereby a specialist doctor formally transfers responsibility for all or some aspects of their patient’s care, such as the prescription of medication, over to the patient’s general practitioner (GP).The General Medical Council (GMC), which regulates and sets standards for doctors in the United Kingdom, has made it clear that GPs cannot be compelled to enter into a shared care agreement. Shared care is not part of the GP Contract and as such, participation is voluntary. GPs may decline such requests on clinical or capacity grounds. A GP who has previously agreed to a shared care agreement but who can no longer support it must provide a clear rationale for their decision. Both the GP and the specialist clinician share responsibility for ensuring continuity of care for the patient.The GMC has also issued guidance to help GPs decide whether to accept shared care responsibilities. In deciding whether to enter into a shared care agreement, a GP will need to consider a number of factors to determine whether it is within their sphere of competence, and therefore safe and suitable for their patient’s needs. This includes being satisfied that any prescriptions or referrals for treatment are clinically appropriate.If a shared care agreement is not in place, the responsibility for ongoing prescribing remains with the specialist clinician, which applies to both NHS and private medical care.

Whether his Department is taking steps to expand the number of organisations under the Right to Choose pathway that are able to have their ADHD prescriptions fulfilled by the NHS.

Shared care within the National Health Service refers to an arrangement whereby a specialist doctor formally transfers responsibility for all or some aspects of their patient’s care, such as the prescription of medication, over to the patient’s general practitioner (GP).The General Medical Council (GMC), which regulates and sets standards for doctors in the United Kingdom, has made it clear that GPs cannot be compelled to enter into a shared care agreement. Shared care is not part of the GP Contract and as such, participation is voluntary. GPs may decline such requests on clinical or capacity grounds. A GP who has previously agreed to a shared care agreement but who can no longer support it must provide a clear rationale for their decision. Both the GP and the specialist clinician share responsibility for ensuring continuity of care for the patient.The GMC has also issued guidance to help GPs decide whether to accept shared care responsibilities. In deciding whether to enter into a shared care agreement, a GP will need to consider a number of factors to determine whether it is within their sphere of competence, and therefore safe and suitable for their patient’s needs. This includes being satisfied that any prescriptions or referrals for treatment are clinically appropriate.If a shared care agreement is not in place, the responsibility for ongoing prescribing remains with the specialist clinician, which applies to both NHS and private medical care.

How many mental health workers will be recruited in Cornwall by 2029.

As part of our mission to build a National Health Service that is fit for the future and that is there when people need it, the Government will recruit an additional 8,500 mental health workers to reduce delays and provide faster treatment, which will also help ease pressure on busy mental health services. We are working with NHS England to consider options to deliver this commitment.Whilst we don’t have the breakdown of how many mental health workers will be recruited in specific constituencies, this summer we will publish a refreshed Long Term Workforce Plan to deliver the transformed health service we will build over the next decade and treat patients on time again. We will ensure the NHS has the right people, in the right places, with the right skills to deliver the care patients need when they need it.

If he will direct NICE to undertake an assessment of the potential merits of the use of hydrotherapy treatments in the NHS.

I have no plans to direct the National Institute for Health and Care Excellence (NICE) to assess hydrotherapy treatments, and it would not be appropriate for ministers to circumvent the NICE’s established process for prioritising topics for guidance development.When developing its guidelines, the NICE considers all the available evidence within the scope of the topic under consideration. Where good quality evidence supports the use of a therapy as clinically and cost effective, the NICE’s independent committee may recommend it for use in the National Health Service.Hydrotherapy is already recommended as a form of rehabilitation therapy following nerve injury in the NICE’s Rehabilitation after traumatic injury 2022 guideline. It is also recommended in the 2017 guideline Spondyloarthritis in over 16s: diagnosis and management, as an adjunctive therapy to manage pain and maintain or improve function for people with axial spondyloarthritis.

What steps his Department is taking to help put in place an effective workforce strategy for the neurology profession prior to the publication of the NHS Long Term Workforce Plan in summer 2025.

This summer, we will publish a refreshed Long Term Workforce Plan to deliver the transformed health service we will build over the next decade, and treat patients on time again. We will ensure the National Health Service has the right people, in the right places, with the right skills to deliver the care patients need when they need it, including in neurology.As of July 2024, there were over 1,800 full-time equivalent (FTE) doctors working in the specialty of neurology in NHS trusts and other organisations in England. This includes over 900 FTE consultant neurologists. In 2023, the fill rate for recruitment into the specialty of neurology in England was 94%.There are currently no plans for a specific workforce strategy for the neurology profession prior to the publication of the NHS Long Term Workforce Plan.The NHS workforce has been overworked for years, leading to staff becoming burnt out and demoralised. The NHS is broken but not beaten, and together we will turn it around. We have launched a 10-Year Health Plan to reform the NHS. The plan will set out a bold agenda to deliver on the three big shifts needed to move healthcare from hospital to the community, analogue to digital, and sickness to prevention.A central part of the 10-Year Health Plan will be our workforce and how we ensure we train and provide the staff, technology, and infrastructure the NHS needs to care for patients across our communities.

Whether he plans to bring forward legislative proposals on the provision of dental services.

We are currently reviewing the previous Government’s Dental Recovery Plan and what elements of that can be taken forward effectively and within National Health Service budgets. It is also clear that plan did not go far enough and so we are also working on further measures, prioritising initiatives that will see the biggest impact on access to NHS dental care.The Government is committed to tackling the challenges for patients trying to access NHS dental care with a rescue plan to provide 700,000 more urgent dental appointments and to recruit new dentists to areas that need them most. To rebuild dentistry in the long term, we will reform the dental contract, with a shift to focus on prevention and retaining NHS dentists. Not all improvements to the provision of NHS dental services may require legislative changes.