Written questions by Al-Hassan.

Innovation and Technology, what discussions he has had with Cabinet colleagues on protecting children from the potential impacts of excessive use of smartphones.

Creating a safer online world is a priority for the government and we are focused on implementing the Online Safety Act so that children can benefit from its wide-reaching protections.The Government is reviewing the evidence base on children’s smartphone use, social media and their wellbeing.DSIT works closely with other government departments on a range of online safety matters with work on child online safety being a particular priority across government.

With reference to the draft regulations entitled The Human Medicines (Amendments Relating to Hub and Spoke Dispensing etc.) Regulations 2025, what the VAT status will be for any (a) fees and (b) other charges between hubs and spokes under model one.

The rate of VAT applicable to this supply will depend on the exact nature of the arrangements. If VAT charges apply to invoices issued by the hub, a spoke should be able to recover VAT costs if they are registered for VAT and if the final supply qualifies for VAT zero rating. VAT is a self-assessing tax and it is the responsibility of the supplier to charge, collect and pay to HM Revenue and Customs any VAT due on the supplies they make.

How many and what proportion of school nurses have received specialist training in (a) allergy and (b) anaphylaxis management.

Data is not held centrally on the number of school nurses who have received specialist training in allergy and anaphylaxis management. The Nursing and Midwifery Council (NMC) sets the standards for education preparation for school nurses, who are registered nurses that undertake a post-graduate Specialist Public Health Nurse qualification with an NMC-approved university. School nurses will then also undertake any mandatory training required by their employer, as appropriate to their role.Section 100 of the Children and Families Act 2014 places a duty on schools to make arrangements for supporting pupils with medical conditions. Schools should ensure they are aware of any pupils with medical conditions, and should have policies and processes in place to ensure that these can be well managed, including for allergies. The policy should also set out how staff will be supported in carrying out their role to support pupils, including how training needs are assessed and how training is commissioned and provided. Any member of school staff providing support to a pupil with medical needs should have received suitable training. NHS England has also produced the Health School Child e-learning programme, which is available at the following link:https://www.e-lfh.org.uk/programmes/healthy-school-child/This is designed for healthcare professionals, including school nurses, working with children aged five to 12 years old. Module 5 of the e-learning programme includes sessions on asthma, eczema, and other allergies.

Food and Rural Affairs, what steps his Department is taking to consult the (a) medical technology sector, (b) Department of Health and Social Care and (c) Medicines and Healthcare products Regulatory Agency when developing environmental policies.

The Government consults regularly with a range of stakeholders when developing environmental policies, both within and outside of Government.

Whether he plans to prevent spoke pharmacies from charging patients for additional services which are delivered by an outsourced hub partner.

For medicines prescribed as part of National Health Service primary care, patients either pay the standard NHS prescription charge or receive their prescriptions free of charge, depending on eligibility. Pharmacies are responsible for collecting these charges on behalf of the NHS and are not permitted to charge patients more than the set fee, even if the medicines have been assembled at the hub pharmacy.Pharmacies can offer private services to patients and charge additional fees to those who choose these services, for example, to have medicines delivered to their homes. Distance selling pharmacies are contractually required to deliver medicines to patients free of charge and this requirement will not be affected if a distance selling pharmacy engages a hub.

Pursuant to his Answer of 16 May 2025 to Question 51728, what steps he is taking to ensure that patients (a) improve and (b) protect their own health.

Whilst it is too early to say exactly what the 10-Year Health Plan will look like, what is certain is that delivering on prevention remains a priority as part of the plan’s three shifts, to get the health service and the nation’s health thriving once again. Through the 10-Year Health Plan, we want to take action to reduce the causes of the biggest killers and ensure the National Health Service uses its relationship with patients to help patients improve and protect their own health.We have already taken action. For example, the landmark Tobacco and Vapes Bill will gradually end the sale of tobacco products across the country and will ban vapes and other nicotine products from being deliberately branded and advertised to children.The NHS Health Check aims to detect people at risk of heart disease, stroke, type 2 diabetes, and kidney disease, as well as providing advice on reducing cardiovascular disease risk and referring people for support and treatment to improve their health. It is offered to eligible people aged between 40 and 74 years old once every five years. To improve access and engagement, we are developing a new online service that people can use at home to understand and act on their cardiovascular disease risk.We already have one of the most extensive vaccination programmes in the world, with vaccine confidence and uptake rates among the highest globally. The Department is working with the UK Health Security Agency and NHS England to take steps to promote uptake by providing diverse delivery methods to make getting vaccinated easier, increasing outreach efforts to under-served groups, and raising awareness of the dangers of vaccine preventable diseases.

What assessment he has made of the potential impact of NHS England’s criterion for eligibility for indication-specific pricing to demonstrate revenue loss on the UK’s international competitiveness in life sciences.

The Government is taking decisive steps to secure the future of life sciences research in the United Kingdom and to ensure we remain internationally competitive. The upcoming Life Sciences Sector Plan sets out a bold vision to strengthen our world-class research and development, attract global investment, and accelerate healthcare innovation.The National Health Service seeks the best value in its commercial deals for patients and taxpayers. The recent NHS Commercial Framework consultation clarified the circumstances in which indication specific pricing will be considered in England. The framework now provides further guidance relating to the time period over which revenue loss is considered and the components included in its calculation, referencing the potential to include future indications where there is a high degree of confidence of regulatory approval, a National Institute for Health and Care Excellence recommendation, and forecast volumes and prices. This will help companies better understand the circumstances in which indication specific pricing may be available to support patient access to new medicines.

How many commercial agreements NHS England has made with manufacturers of medicines which have r resulted in indication-specific pricing between January 2020 and March 2025; and what therapeutic area these have been for.

Information provided by NHS England shows that there have been 74 commercial agreements involving indication-specific pricing arrangements between January 2020 and March 2025. The following table shows the split by therapeutic areas:Cancer62Haematology5Other7Note: therapeutic areas with fewer than five commercial agreements have been grouped under Other to avoid identification of specific commercial deals.

Food and Rural Affairs, how the £360 million Fishing and Coastal Fund will be allocated.

The Fishing & Coastal Growth Fund will be investing £360 million over the next 12 years. We will work with industry to target investment where it matters most. For example, by considering investment in new technology and equipment to modernise our fishing fleet, training and skills to upskill the workforce and back the next generation of fishermen and promote the seafood sector to export our high-quality produce across the world.

Whether she plans to review the level of guaranteed support available to children with special educational needs in mainstream schools.

This government is committed to ensuring that all children and young people with special educational needs and disabilities (SEND) receive the right support to succeed and thrive in their education and as they move into adulthood.To enable high quality and inclusive practices within mainstream schools, the department is building a strong and credible evidence base on what works to drive inclusive education. The department has also created an Expert Advisory Group for Inclusion, who are using their expertise and drawing on that of wider stakeholders to advise government on how to best drive inclusive practice and improve the education experiences and outcomes of children and young people with SEND in mainstream schools.Additionally, the department is providing an increase of £1 billion for high needs budgets in England in the 2025/26 financial year. Total high needs funding for children and young people with complex SEND is over £12 billion in 2025/26. My right hon. Friend, the Secretary of State for Education has also announced £740 million for high needs capital in the 2025/26 financial year to support children and young people with SEND or who require alternative provision. This can be used to adapt classrooms to be more accessible for children with SEND, create specialist facilities within mainstream schools that can deliver more intensive support adapted to suit pupils’ needs and continue to provide places to support pupils in special schools with the most complex needs.

Whether he plans to include policies on self-care within the forthcoming 10-year Health Plan.

The 10-Year Health Plan will describe a shared vision for the health and care system in 2035, drawing directly from the extensive engagement that has been undertaken with the public, patients, and staff. The plan will set out how care models and pathways will need to change or evolve to better meet their needs, and the cultural and behavioural changes we want to see. The plan’s shift from sickness to prevention will help ensure the National Health Service uses its relationship with patients to help patients improve and protect their own health.

What discussions she has had with her counterparts in the Welsh Government on the potential impact of the £205 million subsidy for Cardiff Airport on the competitiveness of (a) Bristol Airport and (b) other nearby airports.

As aviation is devolved, decisions regarding any subsidies made to Cardiff Airport is a matter for the Welsh Government. While the Secretary of State has not had any conversations with counterparts in the Welsh Government, officials continue to engage the Welsh Government and nearby airports to understand the potential impacts.

What assessment his Department has made on the adequacy of access to (a) medicines and (b) controlled drugs in care homes in North Somerset.

Under the Enhanced health in care homes framework, every care home must be aligned to a primary care network (PCN) and must have established protocols between the PCN, the care home, and system partners, such as local general practices and pharmacies, for information sharing, shared care planning, use of shared care records, and clear clinical governance.Pharmacies are expected to maintain a reasonable stock holding to meet their legal obligations to dispense all prescriptions, including to patients in care homes, with reasonable promptness, recognising that it is not feasible for a pharmacy to maintain stock of every medicine. The Pharmacy Quality Scheme rewards community pharmacy contractors that deliver quality criteria, one of which is the Palliative and End of Life Care scheme. Participating pharmacy contractors must declare if they intend to routinely stock 16 critical end of life medicines, including controlled drugs such as morphine and midazolam and/or parenteral haloperidol, and must have an action plan in place to support local access. This enables palliative medicines to be quickly sourced when prescribed.Most care homes with nursing can hold stocks of controlled drugs and will not require a licence to access medicines containing controlled drugs for patients who need them. This is because care homes run by public authorities or charities are exempt from the need for a Home Office controlled drug licence. Care homes without nursing cannot store controlled drugs unless they are prescribed for individual residents.

What assessment his Department has made of the adequacy of regulation of access to controlled drugs in care homes in North Somerset.

Under the Enhanced health in care homes framework, every care home must be aligned to a primary care network (PCN) and must have established protocols between the PCN, the care home, and system partners, such as local general practices and pharmacies, for information sharing, shared care planning, use of shared care records, and clear clinical governance.Pharmacies are expected to maintain a reasonable stock holding to meet their legal obligations to dispense all prescriptions, including to patients in care homes, with reasonable promptness, recognising that it is not feasible for a pharmacy to maintain stock of every medicine. The Pharmacy Quality Scheme rewards community pharmacy contractors that deliver quality criteria, one of which is the Palliative and End of Life Care scheme. Participating pharmacy contractors must declare if they intend to routinely stock 16 critical end of life medicines, including controlled drugs such as morphine and midazolam and/or parenteral haloperidol, and must have an action plan in place to support local access. This enables palliative medicines to be quickly sourced when prescribed.Most care homes with nursing can hold stocks of controlled drugs and will not require a licence to access medicines containing controlled drugs for patients who need them. This is because care homes run by public authorities or charities are exempt from the need for a Home Office controlled drug licence. Care homes without nursing cannot store controlled drugs unless they are prescribed for individual residents.

Food and Rural Affairs, what progress has been made on turning Wainwright’s Coast to Coast route into a National Trail.

The proposal to designate Wainwright’s Coast to Coast route as a National Trail was approved in 2022. Natural England has been working with the Councils and National Park Authorities along the route to bring it up to National Trail quality standards. We have worked to make sure the route is permanently protected in law and have improved the surface to make it easier to use. This includes 5km of flagstones over Nine Standards Rigg and White Mossy Hill in the middle of the route which gets very boggy. This will help protect local habitats and preserve the route for walkers. We have also put up new signs that help people find their way and recognise Alfred Wainwright’s role in establishing the route. The route remains on track for completion with plans to officially launch it in spring 2026.

Innovation and Technology, what steps his Department is taking to help improve mobile network signal in North Somerset constituency.

I have asked Ofcom to check their figures, but according to them, 94% of the constituency has 4G geographic coverage from all four mobile operators, while 5G is available outside 96% of premises from at least one operator. The government’s ambition is for all populated areas, including rural communities, to have higher quality standalone 5G by 2030. We are working with industry and Ofcom to ensure we have the right policy and regulatory framework to support investment in this crucial infrastructure.

What steps he has taken to increase patient access to new and innovative treatments for Myasthenia Gravis.

The Government is committed to improving the lives of those living with rare diseases, such as myasthenia gravis. The UK Rare Diseases Framework sets out four priorities collaboratively developed with the rare disease community: these include improving access to specialist care, treatments, and drugs. We remain committed to delivering under the Framework and published the annual England action plan in February 2025.In the 2023 England Rare Disease Action Plan, action 25 was introduced to review the effectiveness of Innovative Medicines Fund (IMF), Early Access to Medicines Scheme (EAMS) and Innovative Licensing and Access Pathway (ILAP) in improving access to treatments for people living with rare diseases.NHS England, the National Institute for Health and Care Excellence and the Medicines and Healthcare products Regulatory Agency will meet annually to continue to discuss progress and the role of EAMS, ILAP and IMF in supporting access to treatments for people living with rare diseases. These meetings will include representatives from patient advocacy groups, industry and clinical researchers. Further progress on action 25 has been reported in the 2025 action plan, which is available at the following link:https://www.gov.uk/government/publications/england-rare-diseases-action-plan-2025

What his planned timetable is for when patients with Myasthenia Gravis will have access to recently licenced products.

On 7 March 2024, the Medicines and Healthcare products Regulatory Agency (MHRA) approved the medicine rozanolixizumab, marketed as Rystiggo, to treat adults with generalised myasthenia gravis.The National Institute for Health and Care Excellence (NICE) evaluates all new licensed medicines and makes recommendations for the National Health Service on whether they should be routinely funded by the NHS based on their clinical and cost effectiveness. NICE aims to publish guidance as close as possible to the time of licensing.NICE published draft guidance on the use of rozanolixizumab for consultation in September 2024 and was unable to recommend it as a clinically and cost-effective use of NHS resources due to uncertainties in the long-term effectiveness of the treatment, as well as uncertainties in the economic model and the cost-effectiveness at the price proposed by the company. NICE has not yet published final guidance, and it will keep stakeholders informed about next steps as soon as possible.

Whether the NHS 10 Year Plan will include steps to ensure healthcare professionals are adequately trained and supported in diagnosing and treating rare diseases like Myasthenia Gravis.

We have committed to develop a 10-Year Health Plan to deliver a National Health Service fit for the future. The plan, and the refreshed Long Term Workforce Plan that follows it, will ensure that we have the right number of staff, with the right skill mix so that patients, including those with rare diseases like myasthenia gravis, can be promptly diagnosed and treated.

If his Department will make an assessment of the potential impact of National Institute for Health and Care Excellence proposed changes to its Highly Specialised Technology routing criteria on access to medicines for people living with rare diseases.

Decisions on whether medicines should be evaluated by the National Institute for Health and Care Excellence (NICE) through its highly specialised technologies (HST) programme are taken by NICE itself against a set of published criteria that have been developed through public and stakeholder engagement.NICE is currently reviewing its HST criteria and has recently closed its public consultation on proposed changes. NICE will discuss the updated criteria at its Public Board Meeting on 19 March 2025. The purpose of the review is not to change the number or nature of the topics that are evaluated through the HST programme, but to ensure that the criteria are sufficiently clear and predictable for companies and patient groups and are aligned to the HST vision. The aims of the HST programme will remain unchanged. It is intended to: encourage research on, and innovation for, very rare conditions when there are challenges in generating an evidence base that is robust enough to bring the product to market; secure fairer and more equitable treatment access for very small populations with very rare diseases; and recognise that an approach that maximises health gain for the NHS may not always be acceptable; it could deliver results that are not equitable.Since 2022/23, NICE has been able to recommend 13 out of 14 medicines that it has appraised through its HST programme.