Written questions by Wilson.

What assessment his Department has made of the potential enforcement challenges associated with implementing the proposed generational smoking ban in Northern Ireland.

Measures in the Tobacco and Vapes Bill will strengthen enforcement and will help to ensure the successful implementation of the smoke-free generation policy. Age of sale restrictions for tobacco products are already in place in Northern Ireland, with enforcement led by district councils. The Department of Health in Northern Ireland, through the Public Health Agency, funds tobacco control officers to conduct test purchases and support retailer compliance. These arrangements are expected to continue under the new legislative framework and will include additional products. The Department of Health in Northern Ireland is working closely with councils in preparation for implementation of the smoke-free generation policy on 1 January 2027.The bill also gives ministers in Northern Ireland the ability to introduce a licensing scheme for the retail sale of tobacco, vaping, and nicotine products. This will strengthen enforcement, support legitimate businesses, and crack down on rogue retailers who breach the law. Once implemented, this will replace the existing retailer register for tobacco products in Northern Ireland.The Northern Ireland Assembly provided its legislative consent for the Tobacco and Vapes Bill on 10 February 2025.

Whether he has had recent discussions with his EU counterparts on the legality of the proposed generational smoking ban in Northern Ireland.

In preparation of the Tobacco and Vapes Bill, the Government has considered all its domestic and international obligations. The Government engages with the European Union and member states on a wide variety of issues, including matters relating to Northern Ireland. This engagement is confidential.

Whether his Department (a) sought and (b) received legal advice on the compatibility of the generational smoking ban proposed in the Tobacco and Vapes Bill with the Windsor Framework, particularly in relation to Northern Ireland's regulatory alignment obligations.

In preparation of the Tobacco and Vapes Bill, the Government has considered all its domestic and international obligations. The Government does not disclose whether it has sought or received legal advice.

What assessment he has made of the potential impact of family hubs on (a) neighbourhood health and (b) the delivery of integrated community-based health services.

The 10-Year Health Plan outlined proposals for a new Neighbourhood Health Service, which embodies our preventative principle, that care should happen as locally as it can. Neighbourhood health services will build on, and will coordinate with Best Start Family Hubs and Start for Life services to continue to integrate children’s services, National Health Services, and public health.The Neighbourhood Health Service will mean that millions of patients are treated and cared for closer to their home by new teams of health professionals, providing easier, more convenient access to a full range of healthcare services on people’s doorsteps.The impact of Family Hubs and Start for Life services will take time to be realised. The current Family Hubs and Start for Life programme is subject to two national, independent evaluations to understand its implementation and impact.

How many serious, non-fatal, adverse reactions associated with the use of misoprostol have been reported to the Medicines and Healthcare Products Regulatory Agency in each of the last ten years; and how many fatal adverse reactions associated with the use of misoprostol have been reported to the Medicines and Healthcare Products Regulatory Agency in that period.

The Medicines and Healthcare products Regulatory Agency (MHRA) is responsible for ensuring medicines, medical devices, and blood components for transfusion meet applicable standards of safety, quality, and efficacy. The MHRA rigorously assesses the available data, including from the Yellow Card scheme, and seeks advice from their independent advisory committee, the Commission on Human Medicines, where appropriate, to inform regulatory decisions.It is important to note that a reaction reported to the Yellow Card scheme does not necessarily mean it has been caused by the medicine, only that the reporter had a suspicion it may have. Underlying or concurrent illnesses may be responsible, or the events could be coincidental.The following table shows the number of Yellow Card reports classified as serious, excluding fatal outcomes, and those with a fatal outcome, received for misoprostol from initial licensing of the medicine up to 13 May 2025:YearSerious reportsReports with a fatal outcome2015100201611120172822018402019712020130202119120221912023922024210202580 Reports received via the Yellow Card scheme can contain more than one suspect medicine. It should be noted that misoprostol is used in combination with mifepristone, as such 60 of the serious reports and five reports with a fatal outcome include both products as the suspect drug.Misoprostol is licenced for a variety of indications, including gastroprotection in duodenal and gastric ulcers, termination of pregnancy, and induction of labour. Mifepristone is licenced for termination of pregnancy and induction of labour.A list of the possible side effects of mifepristone and misoprostol are provided in the product information document for healthcare professionals, the Summary of Product Characteristics, and in the UK Patient Information Leaflet.A Yellow Card report is considered serious according to two criteria. Firstly, a reported reaction can be considered serious according to our medical dictionary. Secondly, if the original reporter considers the report to be serious, they can select from the six serious criteria available, which are: patient died due to reaction; life threatening; resulted in hospitalisation or prolonged inpatient hospitalisation; congenital abnormality; involved persistent or significant disability or incapacity; or if the reaction was deemed medically significant.

How many (a) serious but non-fatal and (b) fatal adverse reactions associated with the use of mifepristone have been reported to the Medicines and Healthcare products Regulatory Agency in each of the last 10 years.

The Medicines and Healthcare products Regulatory Agency (MHRA) is responsible for ensuring medicines, medical devices, and blood components for transfusion meet applicable standards of safety, quality, and efficacy. The MHRA rigorously assesses available data, including from the Yellow Card scheme, and seeks advice from their independent advisory committee, the Commission on Human Medicines, where appropriate, to inform regulatory decisions.It is important to note that a reaction reported to the Yellow Card scheme does not necessarily mean it has been caused by the medicine, only that the reporter had a suspicion it may have. Underlying or concurrent illnesses may be responsible, or the events could be coincidental.The following table shows the number of Yellow Card reports classified as serious, excluding fatal outcomes, and those with a fatal outcome, received for mifepristone from the initial licensing of the medicine, up to 13 May 2025:YearSerious reportsReports with a fatal outcome20153020169120172512018902019612020802021502022502023222024100202560 Reports received via the Yellow Card scheme can contain more than one suspect medicine. It should be noted that mifepristone is used in combination with misoprostol, and as such 60 of the serious reports and five reports with a fatal outcome include both products as the suspect drug.Misoprostol is licenced for a variety of indications, including gastroprotection in duodenal and gastric ulcers, termination of pregnancy, and induction of labour. Mifepristone is licenced for termination of pregnancy and induction of labour.A list of the possible side effects of mifepristone and misoprostol are provided in the product information document for healthcare professionals, the Summary of Product Characteristics, and in the UK Patient Information Leaflet.A Yellow Card report is considered serious according to two criteria. Firstly, a reported reaction can be considered serious according to our medical dictionary. Secondly, if the original reporter considers the report to be serious, they can select from the six serious criteria available, which are: patient died due to reaction; life threatening; resulted in hospitalisation or prolonged inpatient hospitalisation; congenital abnormality; involved persistent or significant disability or incapacity; or if the reaction was deemed medically significant.

Whether his Department plans to make Omaveloxolone available through the NHS.

The National Institute for Health and Care Excellence (NICE) is the independent body responsible for developing evidence-based recommendations for the National Health Service on whether new, licensed medicines represent a clinically and cost-effective use of NHS resources.The NICE is unable to make a recommendation about the use of omaveloxolone for treating Friedreich's ataxia in people aged 16 years old and over, in the NHS. This is because the company, Biogen, withdrew its evidence submission. The NICE will review its decision if the company decides to make a new submission. Further information is available at the following link:www.nice.org.uk/guidance/indevelopment/gid-ta11431NHS England does not fund medicines where the company has not engaged with the NICE. This is to avoid a potential pathway for circumventing the NICE’s appraisal process.

With reference to the impact assessment for the Tobacco and Vapes Bill, published on 5 November 2024, whether the specified cost of retailer staff training (a) is a one-off cost and (b) reflects ongoing costs in relation to planned secondary legislation relating to that Bill.

The estimated familiarisation and staff training costs included in the Tobacco and Vapes Bill impact assessment are assumed to be one-off costs, and individual estimates are provided for each specific policy.The bill will gradually end the sale of tobacco products across the country, so an individual born on or after 1 January 2009 will never be legally sold these products, including through proxy purchasing. Although it will mean the legal age of sale effectively increases by one year each year, the regulations will not change every year. This means it will be a one-off cost for retailers in terms of training staff.Some indicative estimates for staff training are included for secondary legislation. This, however, will be subject to consultation and, where proportionate, further work will be completed to assess the costs and benefits of these measures.We will continue to work closely with retailers to support them in implementing the smoke-free generation policy in the future.

If he will make a comparative estimate of the costs of (a) implementing a one-time increase in the legal purchase age of tobacco and (b) introducing an age escalator, in the context of the Tobacco and Vapes Bill.

Smoking is the number one preventable cause of death, disability, and ill health. It causes approximately 80,000 deaths a year in the United Kingdom, one in four of all cancer deaths, and kills up to two-thirds of its users.Smoking also substantially increases the risk of many major health conditions throughout people’s lives, such as strokes, diabetes, heart disease, stillbirth, dementia, and asthma. Three quarters of smokers wish they had never started smoking but are unable to stop due to the addictive nature of tobacco.It is estimated that smoking costs the country £21.8 billion a year in England. This includes an annual £18.3 billion loss to productivity, through smoking related lost earnings, unemployment, and early death, as well as costs to the National Health Service and social care of over £2 billion.On 5 November 2024, the Department published an impact assessment on the Tobacco and Vapes Bill. This found that the introduction of the smoke-free generation policy, the progressive increase in the age of sale, will get smoking rates in England for 14 to 30 year olds to 0% as early as 2050. Over the next 50 years it will save tens of thousands of lives, and avoid up to 130,000 cases of cases of lung cancer, strokes, and heart disease.The impact assessment explored a one-time age increase, but this has been discounted as it does not achieve the policy objective to prevent future generations from ever taking up smoking and getting smoking prevalence to 0% to achieve a smoke-free United Kingdom. Simply raising the age of sale to one set year will only raise the age that people start smoking, and would not break the cycle of addiction and disadvantage.

Whether he plans to include steps to (a) grow and (b) upskill the Parkinson's specialist workforce in the (i) ten year and (ii) long-term workforce plan.

The 10-Year Health Plan will set out how we will deliver a National Health Service that is fit for the future, with a better service for everyone, regardless of condition or service area. We expect that the long-term workforce plan will need to be updated to reflect that plan, so that we train the staff we need to ensure that all patients are cared for by the right professional, when and where they need it.

What steps he is taking to reduce the time taken for patients diagnosed with a neurological condition to begin consultant-led treatment.

Tackling waiting lists, including for neurology, is a key part of our Health Mission. We are committed to getting back to the NHS Constitutional standard that at least 92% of patient wait no longer than 18 weeks from Referral to Treatment, within our first term.To reduce waiting times for neurological services, NHS England is working hard to improve the delivery of services for admitted patients with neurological disorders, including at a trust level, whilst also enhancing the use of advice and guidance to optimise referrals, and improving productivity in outpatient services through reducing the number of missed appointments and by optimising follow up systems.NHS England’s Neurology Transformation Programme is also working to develop guidance for health systems on all aspects of neurology pathway improvement in integrated care systems, including specialised services, secondary care, and community services. This work is focused on improving equity of access to, and timeliness of, care.Diagnostics, and in some cases surgical procedures, are key parts of the neurological pathways. At the 2024 Autumn Budget, my Rt. Hon. Friend, the Chancellor of the Exchequer announced £1.5 billion of capital funding for new surgical hubs and diagnostic scanners. This will build capacity for over 30,000 additional procedures and over 1.25 million diagnostic tests, as well as new beds, which will create more treatment space in emergency departments, reduce waiting times, and help shift more care into the community.