Written questions by Heylings.

What steps his Department is taking to work with other NHS bodies, such as local integrated care boards, on the development of the Modern Service Framework for Palliative and End of Life Care.

We have been engaging with a range of stakeholders, from around 70 organisations, to inform the development of the Modern Service Framework for Palliative Care and End of Life Care. This includes the Ambitions Partnership and NHS Alliance. We are also undertaking engagement with integrated care systems through National Health Service regional teams.

What assessment his Department has made of (a) trends in the level of complex post-traumatic stress disorder in England and (b) the adequacy of specialist support and treatment available for that condition.

Awaiting answer.

Whether his Department has made a recent assessment of the adequacy of the regulatory framework for liquid paracetamol products, including the quantity that can be purchased at one time.

The majority of patients use and take paracetamol responsibly. However, the Medicines and Healthcare products Regulatory Agency (MHRA) is aware that paracetamol can be a favoured drug of choice for impulsive or intentional overdose. The MHRA takes these issues seriously as patient safety is our priority. The MHRA monitors the safety of medicines, including the sale of paracetamol without prescription.In March 2025, the MHRA updated the voluntary Best Practice Guidance on the sale of medicines for pain relief, for general sales, to further highlight the risks of overdose, and to address public concerns and recognise current sales techniques. This guidance is available at the following link:https://assets.publishing.service.gov.uk/media/67e69e9e085277e9961b201b/Best_practice_guidance_on_the_sale_of_medicines_2025.pdfFurther risk mitigation measures are also being considered. These are voluntary guidelines concerning the sale of solid oral forms, both tablets or capsules, and have been agreed with retailers to minimise the risk of impulse buying and reduce the risk of overdose. While the guidance was for solid formulations, many retailers also apply the guidance to liquid formulations, with bars at their checkout to prevent the sale of more than two packs of medicines for pain. The guidance was to address the potential risk of overdose if a person chose to consume multiple tablets at once, which is likely to be more difficult with the syrup liquid formulations.The Human Medicines Regulations 2012 stipulate specific warnings for all paracetamol products to ensure that patients are warned of the risks of overuse. In addition, bottles should have child resistant caps to minimise the risk of access by the child.The MHRA undertook a review of paracetamol safety in 2024 to examine the pack size of the solid dose forms. A reduction in pack size was not considered to provide additional risk minimisation as individuals are able to buy more than one pack in a single transaction. The risk of overdose associated with the use of liquid paracetamol is less likely owing to the difficulty in swallowing a large volume of a viscous liquid. However, regulations also stipulate the maximum quantity that should be included in a container, whether it is in liquid or solid form.However, the MHRA is exploring legislative actions to address excessive sales and reduce the potential for harm, while remaining supportive of genuine patients.

What steps his Department is taking to reduce regional variation in IVF provision following publication of the updated NICE fertility guidelines.

Funding decisions for health services in England are made by integrated care boards (ICBs) and are based on the clinical needs of their local population.On 31 March, the National Institute for Health and Care Excellence (NICE) published its updated fertility guideline, which recommends that women under 40 years old who meet the clinical eligibility criteria should be offered up to three full cycles of in vitro fertilisation (IVF).There are no plans to introduce statutory duties on ICBs to deliver NICE fertility guidelines on IVF cycles. We expect ICBs to consider and reflect the updated NICE fertility guideline in their commissioning decisions, and we are working with NHS England to support greater consistency in provision.The Government published the Women's Health Strategy on 15 April which commits to ensuring that every woman can easily access fertility services, and we are currently working to assess the current provision of National Health Service commissioned fertility services as a baseline to inform supporting material for every ICB to implement the new NICE guidelines in full.

Whether he plans to introduce statutory duties on Integrated Care Boards to deliver NICE fertility guidelines on IVF cycles.

Funding decisions for health services in England are made by integrated care boards (ICBs) and are based on the clinical needs of their local population.On 31 March, the National Institute for Health and Care Excellence (NICE) published its updated fertility guideline, which recommends that women under 40 years old who meet the clinical eligibility criteria should be offered up to three full cycles of in vitro fertilisation (IVF).There are no plans to introduce statutory duties on ICBs to deliver NICE fertility guidelines on IVF cycles. We expect ICBs to consider and reflect the updated NICE fertility guideline in their commissioning decisions, and we are working with NHS England to support greater consistency in provision.The Government published the Women's Health Strategy on 15 April which commits to ensuring that every woman can easily access fertility services, and we are currently working to assess the current provision of National Health Service commissioned fertility services as a baseline to inform supporting material for every ICB to implement the new NICE guidelines in full.

What (i) steps his department is taking to address regional differences in funding for Mirena coil fitting and (ii) if he plans to ensure this service is available at GP surgeries.

The funding and provision of long-acting reversible contraception (LARC), such as the Mirena coil, is primarily a matter for local determination.Integrated care boards (ICBs) are responsible for commissioning contraception for both contraceptive and gynaecological purposes, including essential services under the GP Contract and LARC as a local arrangement.Contraception for contraceptive purposes, including LARC, is also a prescribed aspect of local authority sexual health commissioning. The Government has mandated local authorities in England to commission comprehensive open access to most sexual and reproductive health services through the Public Health Grant.It is for individual local authorities and ICBs to decide their spending priorities based on an assessment of local need, and to commission the blend of service access that best suits their population.The renewed Women’s Health Strategy, which was published on 15 April, sets out how we will ensure that women have straightforward access to the full range of contraception, including LARC, that meets their individual needs and preferences.We will include contraception in the upcoming sexual and reproductive health framework to clarify current commissioning arrangements and to share opportunities and best practice for closer working and improved pathways.

What discussions his Department has had with the General Medical Council on the (a) effectiveness and (b) adequacy of that organisation's guidance entitled Good practice in proposing, prescribing, providing and managing medicines and devices, published on 5 April 2021, on shared care agreements for people with ADHD.

Building on the work of the independent ADHD Taskforce, on 4 December 2025 my Rt Hon. Friend, the Secretary of State for Health and Social Care, announced an independent review into the prevalence and support for mental health conditions, attention deficit hyperactivity disorder (ADHD), and autism, which will inform our approach to ensuring appropriate support is in place.The independent review published an interim report on the 31 March 2026 which sets out key findings from the data and evidence reviewed so far, learning to date from discussions with people, including people with lived experience, and organisations as well as setting out plans for the next phase of the review and the key questions to address in more detail.The Department has made no specific assessment of the effectiveness of shared care agreements with independent sector providers for patients prescribed ADHD medication or held discussions with General Medical Council on their guidance.

When Section 16 of the NHS Staff Terms and Conditions (Agenda for Change) handbook was last reviewed in relation to the partial retirement scheme introduced in October 2023; and whether his Department has any plans to update this section to ensure fairness for staff who took partial retirement.

Section 16 of the NHS Terms and Conditions of Service handbook, also referred to as Agenda for Change, sets out the contractual redundancy provisions for staff covered by these terms and conditions. These contractual redundancy provisions for staff in England were agreed and ratified in partnership by the NHS Staff Council, the collective bargaining structure made up of trade union and employer representatives. Section 16 was last reviewed by the NHS Staff Council in 2015. No changes to the contractual redundancy provisions in England have been made since.Any future changes to the handbook, including changes to this section, would require the Department to issue a mandate to allow negotiations to be undertaken by the NHS Staff Council.

What steps his Department is taking to respond to feedback from frontline GPs to the NHS 10-Year Health Plan consultation; and whether this feedback will result in changes to its policy approach to general practice.

Participants shared their experiences of using and/or working in or with the National Health Service and their views on what it should look like in the future, which were used to shape the 10-Year Health Plan. A report detailing the views of members of the public and health and care staff as gathered through the Change NHS engagement process that contributed to the development of the 10-Year Health Plan for England is available at the following link:https://www.gov.uk/government/publications/engagement-insight-report-10-year-health-plan-for-englandThe Department currently has no plans to respond to specific individual feedback from frontline general practitioners (GPs).The 10-Year Health Plan, shaped by engagement, set out the need for reform within GPs. This includes increasing capacity, delivering on the recommendations of the Red Tape Challenge, and rolling out the technology to enable more appointments and better continuity of care for those with complex needs.As part of the shift from hospital to community, the plan also sets out more fundamental reform that will see GPs lead new neighbourhood providers that convene teams of skilled professionals to provide personalised care for groups of people with similar needs.We have now concluded the 2026/27 GP Contract consultation. The final package reflects commitments in the 10-Year Health Plan, including ending the 8:00am scramble, improving timely access to care, tackling GP unemployment, and supporting a shift towards prevention. Overwhelmingly, participants in the public deliberative events identified access to care, and prioritising GP access, as the most immediate priority the 10-Year Health Plan should address.We are investing an additional £485 million into GPs, taking total contract investment to over £13.8 billion in 2026/27. This builds on last year’s £1.1 billion of investment.

What assessment he has made of the impact of new online consultation requirements on patient access to GP care.

General practices (GPs) are independent businesses contracted by the National Health Service to deliver essential services, and as part of these contracts they are required to provide modern telephony systems, online consultation tools, and ensure that receptions are open during core hours. In the 2025 contract negotiations with the General Practitioners Committee England, an agreement was reached to ensure online consultation systems are available throughout core hours. These changes are designed to improve access to GPs, end the 8:00am scramble, and ensure parity across all access options. In January 2026, there has been an increase of 4.1 million online consultation submissions compared to January 2025. Office for National Statistics data from January 2026 shows that 76.8% of patients found it “easy” to contact their GP, up from 60.9% in July 2024. In the year to January 2026, including COVID-19 vaccinations, an additional six million appointments were delivered compared with the previous 12 months.

What steps he is taking to ensure that new neighbourhood health centres will be led by trusted local GPs.

General practice (GP) is the cornerstone of the Neighbourhood Health Service. GPs have a deep understanding and experience of their local population needs and a key role to play in maintaining the health and wellbeing of their neighbourhoods. We will encourage GPs to work over larger geographies by leading new neighbourhood providers. These providers will convene teams of skilled professionals, to provide truly personalised care for groups of people with similar needs. These teams of professionals and partners, nurses, doctors, social care workers, pharmacists, health visitors, employment support, children’s services, and more, will work together to support people and places to improve their health and wellbeing.We also envisage GPs playing an important role in supporting the shift of more planned care out of hospital, for example through working directly with consultants to support people with complex conditions closer to home, without the need for a hospital referral.

What plans his Department has to help resolve the shortage of bone cement in the NHS.

The Department is working closely with NHS England, professional bodies and industry partners and have implemented a range of measures to resolve the shortage of bone cement.The National Health Service has secured stock of an alternative bone cement product, which is now in the United Kingdom for onward distribution. There is sufficient supply to confidently resume elective procedures, and further deliveries are planned in the coming weeks.The NHS also issued immediate guidance to hospitals to ensure that trauma and urgent care could continue safely.We will keep our horizon-scanning processes under review and work specifically to identify future potential risks and safeguard continuity of future bone cement supplies.The Department has held regular discussions with NHS England on the supply position, operational impact, and plans to secure alternative products, including through established incident coordination structures.

What discussions he has had with (a) the Royal College of Paediatrics and Child Health, (b) the Children’s Commissioner, (c) the Local Government Association and (d) Adoption UK, on the waiting times faced by (i) looked-after children and (ii) previously looked-after children for neurodevelopmental assessment.

My Rt. Hon. Friend, the Secretary of State for Health and Social Care, has regular discussions on a wide range of matters including with stakeholders.The Government has recognised that, nationally, demand for assessments for neurodevelopmental conditions such as autism and attention deficit hyperactivity disorder (ADHD) has grown significantly in recent years and that people are experiencing severe delays for accessing such assessments. The Government’s 10-Year Health Plan will make the National Health Service fit for the future and recognises the need for early intervention and support.It is the responsibility of integrated care boards (ICBs) to make available appropriate provision to meet the health and care needs of their local population, including children and their access to neurodevelopmental assessments.NHS England issued advice to systems on ADHD service delivery and prioritisation on 7 October 2025. This advice includes guidance on managing service provision, reviewing waiting lists and providing support to patients waiting. The advice is available at the following link:https://www.england.nhs.uk/long-read/adhd-service-delivery-and-prioritisation-advice-to-systems/Through the Medium-Term Planning Framework, published 24 October, NHS England has set clear expectations for local ICBs and trusts to improve access, experience, and outcomes for autism and ADHD services over the next three years, focusing on improving quality and productivity.NHS England established an ADHD taskforce which brought together those with lived experience with experts from the NHS, education, charity, and justice sector to get a better understanding of the challenges affecting those with ADHD, including timely and equitable access to services and support. The final report was published on 6 November 2025 and we are carefully considering its recommendations.Building on the work of the Independent ADHD Taskforce, my Rt. Hon. Friend announced on 4 December 2025 the launch of an Independent Review into Prevalence and Support for Mental Health Conditions, ADHD and Autism. The review will inform our approach so that people with ADHD and autistic people have the right support in place to enable them to live well in their communities.

If he will make an assessment of the provision of NHS treatment for Functional Neurological Disorder; and what steps he will take to resolve the disparities that currently exist between regions for the treatment of this condition.

NHS England’s updated Specialised Neurology Service Specification, published in August 2025, includes specific reference to functional neurological disorder (FND). It states that all specialised neurology centres must include access to treatment services for FND. The updated Specialised Neurology Service Specification is available at the following link: https://www.england.nhs.uk/publication/specialised-neurology-services-adults/ There are a number of other national-level initiatives supporting service improvement and better care for patients with neurological conditions, including FND, such as the Getting It Right First Time Programme for Neurology and the Neurology Transformation Programme, which aim to improve care for people by reducing variation and delivering care more equitably across England. Additionally, we have set up a UK Neuro Forum facilitating formal, which are twice-yearly meetings across the Department, NHS England, the devolved administrations and health services, and the Neurological Alliances of all four nations. The new forum brings key stakeholders together, to share learning across the system and to discuss challenges, best practice examples, and potential solutions for improving the care of people with neurological conditions, including FND.

Whether NHS England holds data on the number of (i) current and (ii) previously looked-after children on waiting lists for (a) mental health services and (b) neurodevelopmental assessments.

NHS England holds data on the number of current looked-after children accessing or waiting for contact with secondary mental health services. We can identify individuals waiting for neurodevelopmental, autism, or mental health assessment via the indicated primary reason for referral or type of team they were referred to. NHS England does not hold specific data on the number of previously looked after children. If an individual is no longer a looked-after child, this would not be held within the dataset.

What discussions he has has with (i) the Royal College of Paediatrics and Child Health, (ii) the Children's Commissioner, (iii) the Local Government Association and (iv) Adoption UK on waiting times for current and previously looked-after children for mental health services.

The Minister of Care met with the Children’s Commissioner’s office and other stakeholders at the Care Leaver Ministerial Board in October 2025, where they discussed mental health support and ways to improve health outcomes for both current and previously looked after children. Officials have also engaged with the Local Government Association on similar issues.In addition, the Royal College of Paediatrics and Child Health took part in a care leavers advisory group meeting in October 2024, where conversations focused on care leavers’ health, their mental health needs, and waiting times for services.We have not engaged with Adoption UK on this particular issue.

When the review of the Carr-Hill formula will conclude; and when he plans to publish its findings.

The review of the Carr-Hill formula has been commissioned through the National Institute for Health and Care Research (NIHR) and commenced in October 2025. The first phase of the review is expected to conclude in March 2026. Subject to ministerial decision, further work would be undertaken to technically develop and model any proposed changes to the formula.Findings from the review will be published in due course by the NIHR. Members of Parliament will be updated once the review findings are available.Implementation of any new funding approach would be subject to ministerial decision and consultation with the General Practice Committee of England, of the British Medical Association, in the context of the available funding and our commitment to substantively reform the General Medical Services Contract within this Parliament.

What recent assessment he has made of the effectiveness of the points-based immigration system in the recruitment and retention of UK-trained newly qualified doctors.

No recent specific assessment has been made of the effectiveness of the points-based immigration system in the recruitment and retention of United Kingdom-trained newly qualified doctors.However, the number of applications to foundation and speciality training has increased over recent years, both from people graduating from UK medical schools, UK medical graduates, and from graduates of international medical schools, international medical graduates.For specialty training, the number of international medical graduates applying for places has significantly increased since 2020. Data from the General Medical Council (GMC) shows that the number of non-UK trained doctors applying for Core Training Year One and Specialty Training Year One places has increased from 5,326 in 2019 to 18,857 in 2024, a 254% increase. Over the same period, the number of UK trained applicants increased from 8,836 to 11,319, a 28% increase.Internationally trained doctors may also be seeking employment outside of medical specialty training posts and GMC data shows that the proportion of doctors taking up or returning to a GMC licence to practice who were trained outside of the UK was 57% in 2019, which has increased to 66% in 2024.

What steps he is taking to help ensure porcine insulin is available to users who are dependent on it.

The Department is aware of the global discontinuation of insulin porcine vials, including Hypurin Porcine Isophane, Hypurin Porcine Neutral, and Hypurin Porcine 30/70 Mix vials, by Wockhardt. We have issued comprehensive management guidance to the National Health Service, including all general practitioners (GPs) and community pharmacists, on 23 July 2025. This management guidance contains information on alternative licensed medicines including Hypurin Porcine cartridges.Hypurin Porcine Isophane and Hypurin Porcine Neutral cartridges remain available. Following a short-term supply issue from 1 January 2026, Hypurin Porcine 30/70 Mix cartridges will be available from the week closing on 19 January 2026.Patients and/or patient representatives should speak to their GP on the most appropriate treatment option.

What assessment he has made of racial inequalities in maternity care.

The Government recognises that there are stark inequalities for women and babies, and that they should receive the high-quality care they deserve, regardless of their background, location, or ethnicity.In England, maternal mortality rates are higher among women from Black and Asian ethnic groups. The risk of maternal death from Black ethnic backgrounds increased between 2022 and 2024 to nearly three times higher compared to white women, while Asian women had a slightly increased risk compared to white women.The Government is committed to setting an explicit target to close the maternal mortality gap. We are ensuring that we take an evidence-based approach to determining what targets are set, and that any targets set are women and baby-centred.Actions that have been taken to reduce inequalities includes the Perinatal Equity and Anti-Discrimination Programme, Equity and Equality action plans in the most deprived areas, and inequalities dashboard to identify areas where specific populations face the greatest disparities.To further target disparities in maternal care, Baroness Amos is chairing the National Independent Maternity and Neonatal Investigation. The investigation aims to identify the drivers and impact of inequalities faced by women, babies, and families from Black and Asian backgrounds, those from deprived groups, and those from other marginalised groups when receiving maternity and neonatal care.