Written questions by Owen.

What assessment he has made of the level of his Department's role in SEND provision, especially for children with a) disabilities and life limiting-illnesses and b) children who need regular medication throughout the school day.

The Schools White Paper, Every child achieving and thriving, and the consultation on Special Educational Needs and Disabilities (SEND) reforms have now been published, as of 23 February. The White Paper and the consultation are available, respectively, at the following two links:https://www.gov.uk/government/publications/every-child-achieving-and-thrivinghttps://www.gov.uk/government/consultations/send-reform-putting-children-and-young-people-first/send-reform-putting-children-and-young-people-first-html-versionThese documents set out our ambitions to transform outcomes for children, young people, and their families who have been let down for far too long. The Department for Health and Social Care and NHS England have worked closely with the Department for Education on the reforms, and continued close partnership between health, social care, and education will be needed to realise the opportunity created by these crucial reforms.The Government is currently consulting on proposed updates to the statutory guidance on supporting pupils with medical conditions at school, with further information available at the following link:https://www.gov.uk/government/consultations/proposal-on-support-for-pupils-with-medical-conditions-at-schoolThe Government will publish non-statutory guidance to clarify the roles and responsibilities of health and education in supporting pupils with medical conditions in education settings. Schools are responsible for managing their resources and budgets. They must comply with their statutory duties, including those under the Equality Act and the duty under section 100 of the Children and Families Act 2014 to make arrangements for supporting pupils with medical conditions.Integrated care boards (ICBs) have various statutory duties under the Children and Families Act 2014 to work with local authorities, including on: identifying and notifying where a child or young person has potential SEND; joint commissioning; participating in education, health and care assessments and plans; and securing health provision. Reform proposals include the creation of New Specialist Provision Packages for children and young people with complex needs, which set out exactly what support and resources are required for specific needs. These will be developed and reviewed by an Independent Expert Panel with education and health co-chairs, and shaped through testing with parents. For children under five years old with complex needs, we will introduce a fast track for a Specialist Provision Package and Education, Health and Care Plan.The NHS Medium Term Planning Framework for 2026/27 to 2028/29, published October 2025, included, for the first time, a clear requirement for ICBs and providers to meet their statutory SEND duties and support the Government’s SEND reform plans. The framework is available at the following link:https://www.england.nhs.uk/wp-content/uploads/2025/10/medium-term-planning-framework-delivering-change-together-2026-27-to-2028-29.pdfEach ICB is also required to have an executive lead for children and young people with SEND. ICBs will need to work alongside local authorities to develop Local SEND Reform Plans, which will set out each local area’s approach to implementing SEND reforms, tailored to local context and need. These plans will lay the foundation for long-term reform, set how partners will work together, and enable ongoing monitoring of progress, including introduction of the new Experts at Hand service.

What work is being done with the Secretary of State for Education to address the additional workload of teaching assistants that are providing medical attention for disabled and severely ill children in SEND schools.

The Schools White Paper, Every child achieving and thriving, and the consultation on Special Educational Needs and Disabilities (SEND) reforms have now been published, as of 23 February. The White Paper and the consultation are available, respectively, at the following two links:https://www.gov.uk/government/publications/every-child-achieving-and-thrivinghttps://www.gov.uk/government/consultations/send-reform-putting-children-and-young-people-first/send-reform-putting-children-and-young-people-first-html-versionThese documents set out our ambitions to transform outcomes for children, young people, and their families who have been let down for far too long. The Department for Health and Social Care and NHS England have worked closely with the Department for Education on the reforms, and continued close partnership between health, social care, and education will be needed to realise the opportunity created by these crucial reforms.The Government is currently consulting on proposed updates to the statutory guidance on supporting pupils with medical conditions at school, with further information available at the following link:https://www.gov.uk/government/consultations/proposal-on-support-for-pupils-with-medical-conditions-at-schoolThe Government will publish non-statutory guidance to clarify the roles and responsibilities of health and education in supporting pupils with medical conditions in education settings. Schools are responsible for managing their resources and budgets. They must comply with their statutory duties, including those under the Equality Act and the duty under section 100 of the Children and Families Act 2014 to make arrangements for supporting pupils with medical conditions.Integrated care boards (ICBs) have various statutory duties under the Children and Families Act 2014 to work with local authorities, including on: identifying and notifying where a child or young person has potential SEND; joint commissioning; participating in education, health and care assessments and plans; and securing health provision. Reform proposals include the creation of New Specialist Provision Packages for children and young people with complex needs, which set out exactly what support and resources are required for specific needs. These will be developed and reviewed by an Independent Expert Panel with education and health co-chairs, and shaped through testing with parents. For children under five years old with complex needs, we will introduce a fast track for a Specialist Provision Package and Education, Health and Care Plan.The NHS Medium Term Planning Framework for 2026/27 to 2028/29, published October 2025, included, for the first time, a clear requirement for ICBs and providers to meet their statutory SEND duties and support the Government’s SEND reform plans. The framework is available at the following link:https://www.england.nhs.uk/wp-content/uploads/2025/10/medium-term-planning-framework-delivering-change-together-2026-27-to-2028-29.pdfEach ICB is also required to have an executive lead for children and young people with SEND. ICBs will need to work alongside local authorities to develop Local SEND Reform Plans, which will set out each local area’s approach to implementing SEND reforms, tailored to local context and need. These plans will lay the foundation for long-term reform, set how partners will work together, and enable ongoing monitoring of progress, including introduction of the new Experts at Hand service.

With reference to the Government response to the Women and Equalities Committee report on Tackling HIV transmission, HC 1663, what the basis is for the estimate that Cabotegravir injectable PrEP will impact 2,000 people; whether that figure is a cap on availability; and what steps his Department will take to ensure equitable access to injectable PrEP.

Cabotegravir pre-exposure prophylaxis (PrEP) was recommended by the National Institute for Health and Care Excellence (NICE) as a clinically and cost-effective use for people who cannot have oral PrEP on 5 November 2025.NICE estimated that up to 1,000 people would be eligible to receive cabotegravir injectable as PrEP but there is no cap on the number of people who may be eligible and therefore require and receive cabotegravir PrEP.The new HIV Action Plan, published on 1 December 2025, sets out how the Government will enable every level of the healthcare system to work together to engage everyone in prevention, testing and treatment, tackling stigma, and reaching our ambition to end new HIV transmissions by 2030.The Government will work with local authorities to expand alternative and digital delivery routes for injectable PrEP and audit current HIV technologies to identify gaps in provision. The UK Health Security Agency will publish local PrEP indicators to support action to reduce inequalities.

If he will publish a list of the research programmes that are underway on the safety of breast implants.

The Department commissions research through the National Institute for Health and Care Research (NIHR). The NIHR is not currently funding any specific research into the safety of breast implants but welcomes funding applications for research into any aspect of human health. Applications are subject to peer review and judged in open competition, with awards being made based on the importance of the topic to patients and health and care services, value for money, and scientific quality.The Department does not hold information related to breast implant safety research funded by other sources.

How many reports of BIA-ALCL there have been in the UK; and which manufacturers of breast implants those reports have been associated with.

As has been previously shared in evidence submitted to the Women and Equalities Select Committee in July 2025, with further information in the document attached, the Medicines and Healthcare product Regulatory Agency (MHRA) closely monitors Breast Implant Associated- Anaplastic Large Cell Lymphoma (BIA-ALCL), a cancer of the immune system, not a breast cancer, and publishes the output from this monitoring on the GOV.UK webpage, at the following link:https://www.gov.uk/guidance/breast-implants-and-anaplastic-large-cell-lymphoma-alclThe MHRA has developed, with advice from independent expert advisory group, a follow up strategy to collect further data on adverse incidents reporting BIA-ALCL. This has informed the information that is published on the MHRA webpage relating to BIA-ALCL which includes the most up to date number of confirmed reports of BIA-ALCL made to the MHRA, and the breakdown of the number of confirmed reports of primary BIA-ALCL cases by manufacturer of breast implant.Please note that the data on the GOV.UK webpage should be interpreted in the context of the ‘Notes and limitations to the data’ section also provided on the webpage.

How many (a) breast implants and (b) PIP breast implants have ruptured and had to be removed in the last 10 years; and how many of those ruptured implants were not listed on the breast and cosmetic implant registry when implanted.

The Breast and Cosmetic Implant Registry (BCIR), set up in 2016, collects all implant data, and explant data where possible.Practically, it is always difficult and often impossible to identify a model and product code on an explant. If explanted devices, or patients undergoing explant, cannot be linked to data collected at time of implant, then this often reduces explant data to 'patient, surgeon, location, date'. This in turn makes it impossible to monitor trends in explant/failure.NHS England is in the process of clarifying and mandating the detail required in the BCIR and other device-related collections.This will place a greater responsibility on trusts to either identify a device at the point of explant, or to identify the device from internal trust records created during the same patient's implant procedure. This will only be possible if the implant and explant are performed at the same trust. It is then the intention of NHS England to provide the same matching service for implant/explant where the trusts differ.This solution will, when implemented, give a full, proactive picture of device longevity/risk, for the purposes of research and surveillance, alongside the existing ability to identify patients affected by a device recall notice.

How many women in the UK have received Allergan breast implants.

The Breast and Cosmetic Implant Registry (BCIR), set up in 2016, collects all implant data, and explant data where possible.Practically, it is always difficult and often impossible to identify a model and product code on an explant. If explanted devices, or patients undergoing explant, cannot be linked to data collected at time of implant, then this often reduces explant data to 'patient, surgeon, location, date'. This in turn makes it impossible to monitor trends in explant/failure.NHS England is in the process of clarifying and mandating the detail required in the BCIR and other device-related collections.This will place a greater responsibility on trusts to either identify a device at the point of explant, or to identify the device from internal trust records created during the same patient's implant procedure. This will only be possible if the implant and explant are performed at the same trust. It is then the intention of NHS England to provide the same matching service for implant/explant where the trusts differ.This solution will, when implemented, give a full, proactive picture of device longevity/risk, for the purposes of research and surveillance, alongside the existing ability to identify patients affected by a device recall notice.

What discussions he has had with the Nursing and Midwifery Council on wait times for (a) general cases and (b) cases before the case examiner.

The Nursing and Midwifery Council (NMC) is the independent regulator of nurses and midwives in the United Kingdom, and nursing associates in England. The NMC is independent of Government, directly accountable to Parliament and is responsible for operational matters concerning the discharge of its statutory duties. The United Kingdom’s model of healthcare professional regulation is founded on the principle of regulators operating independently from the Government. The Professional Standards Authority for Health and Social Care oversees the bodies that regulate health and care professionals in the UK, which includes the NMC.As Minister of State for Health (Secondary Care), I monitor the NMC’s performance and meets with the organisation regularly, which includes discussion on the timeliness of the NMC’s fitness to practise processes. In line with the Ministerial Code, details of all ministerial meetings, including those with the NMC, are published quarterly on the GOV.UK website, at the following link:https://www.gov.uk/government/collections/ministerial-gifts-hospitality-overseas-travel-and-meetings

What steps he is taking to promote (a) culturally competent and (b) community-led prevention measures for older black men.

This Government recognises the evidence that men of Black ethnicity are at a higher risk of some diseases. Tackling these inequalities is a top priority for the Government.For example, black men are at higher risk of cardiovascular disease yet evidence shows that men in Black and Mixed ethnic groups are the least likely to receive lipid-lowering therapy or reach blood pressure targets. The National Health Service is tackling these inequalities through the Core20PLUS5 programme, a national approach to inform action to reduce healthcare inequalities in the most deprived areas. Hypertension and lipid management are one of the top clinical priorities for the framework, and the NHS is supporting systems where the burden of undiagnosed hypertension and untreated cholesterol is highest. Community based delivery models, such as pharmacy blood pressure checks and BP@Home, are also increasing access for underserved groups, including those in deprived and ethnically diverse communities.Prostate cancer is another example where incidence rates are higher among Black men. We are jointly delivering the £42 million TRANSFORM trial with Prostate Cancer UK, with £16 million from the Department, which aims to find better ways of detecting prostate cancer and address inequalities, ensuring at least 10% of those invited to participate are Black men. In November, the first men began receiving letters from their general practitioners, inviting them to join the landmark trial designed to make diagnosis earlier, safer, and more effective.There are around 17,000 people living with sickle cell disease in England. It is the fastest growing genetic condition in the country and is more common in people of Black African and Black Caribbean heritage (77% of patients) and in more deprived communities (47% of patients). NHS England, through the Sickle Cell and Thalassemia Quality Improvement programme, has stepped up a programme of work aligned to the Government’s 10-Year Health Plan particularly focusing on the shift to prevention, through a new education programme, that aims to develop a series of e-learning modules, training and communication material, which will focus on improving the knowledge and awareness about the condition, including for black men.

Whether he has had recent discussions with relevant stakeholders on pay for specialist community public health nurses.

Specialist community public health nurses in England are typically paid on the National Health Service’s Agenda for Change (AfC) pay system.Annual AfC pay awards are decided following recommendations from the independent NHS Pay Review Body (NHSPRB). We accepted the 2025/26 recommendations in full, and the Government has asked the NHSPRB to begin the 2026/27 pay round. Relevant stakeholders are invited to submit evidence to the NHSPRB to inform its deliberations.Officials and ministers continue to engage with AfC unions on pay and contractual matters via the NHS Staff Council.

Whether British citizens who receive undergraduate medical training overseas will be considered as part of plans to prioritise UK medical graduates for foundation postgraduate training.

As set out in our 10-Year Health Plan published on 3 July, we will work across Government to prioritise United Kingdom medical graduates for foundation training, and to prioritise UK medical graduates and other doctors who have worked in the National Health Service for a significant period for specialty training. We will set out next steps in due course.Internationally educated staff remain an important part of the NHS workforce, and we recognise the valuable role that British citizens who studied medicine abroad play in our NHS.

Whether he is taking steps to stop the use of paper forms for blood tests ordered by (a) GPs and (b) hospitals.

Pathology service transformation is critical to delivering the Government's ambitions for the National Health Service. The NHS has invested heavily in delivering digital transformation for pathology services to reduce reliance on paper-based processes; working closely with integrated care boards, pathology networks, and clinical IT suppliers to ensure interoperability between clinical systems to enable a fully digital, joined-up approach to pathology services.This includes implementing and expanding use of electronic test requesting systems and supporting efforts to standardise their use. These systems allow clinicians in general practice and hospital settings to request pathology tests digitally, improving efficiency, reducing transcription errors, and enhancing patient safety.

How much funding his Department has (a) allocated to and (b) spent on the treatment and care of individuals subject to female genital mutilation in each financial year since 2014-15.

Clinical services for women affected by female genital mutilation (FGM) are locally commissioned and include standard National Health Service delivery, for example in obstetrics and gynaecology, as well as maternity FGM clinics for pregnant women and FGM support clinics. The Department does not directly commission FGM support services and does not hold information on local spend on FGM services.

Whether his Department is taking steps to increase routine heart screening for young people participating in (a) school and (b) university sports.

The UK National Screening Committee (UK NSC) last reviewed screening for sudden cardiac death (SCD) in people under the age of 39 in 2019 and concluded that population screening should not be offered. More information on the recommendation is available at the following link:https://view-health-screening-recommendations.service.gov.uk/sudden-cardiac-death/The UK NSC received a submission via its 2024 annual call process to consider SCD screening in young people aged between 14 and 35 years old engaging in sport. The Committee decided to explore this proposal further and the next step will be an evidence-mapping process. Young people engaging in organised sport was one of the population groups included in the 2019 review, so the evidence map in this area will form part of the work to update the last review.

Whether his Department plans to work with the National Institute for Health and Care Excellence to expedite market access to the personalised immunotherapy developed to treat the malignant brain tumour glioblastoma DCVax-L via the NHS.

DCVax-L has not yet been licensed by the Medicines and Healthcare products Regulatory Agency (MHRA) for use in the United Kingdom. The manufacturer has confirmed that it has submitted an application, and it is fully engaged with the Marketing Authorisation process. The National Institute for Health and Care Excellence (NICE) makes recommendations for the National Health Service on whether all new licensed medicines should be routinely funded by the NHS based on an assessment of clinical and cost effectiveness. NICE aims, wherever possible, to issue recommendations on new medicines close to the time of licensing by the MHRA. The NHS is legally required to fund medicines recommended by NICE, normally within three months of the publication of final guidance. NICE is in discussions with the manufacturer of DCVax-L about a potential appraisal, subject to licensing.

When he expects the Medicines and Healthcare products Regulatory Agency will make public their decision on licensing the personalised immunotherapy developed to treat the malignant brain tumour glioblastoma, DCVax-L.

Northwest Biotherapeutics has submitted a Marketing Authorization Application to the United Kingdom’s Medicines and Healthcare Products Regulatory Agency (MHRA) for DCVax-L, an immunotherapy for glioblastoma. The MHRA is working with the applicant to reach a decision on this application, to ensure a thorough review that ensures quality, safety, and efficacy.

What steps his Department is taking to improve access to topical medication for prisoners.

People in prison are entitled to the same range and quality of health services as they would receive in the community.NHS England commissions healthcare services across the prison estate, ensuring that healthcare providers can prescribe all medications available to patients in community settings. As a result, topical medications that are prescribable on an NHS prescription are also available for individuals within the prison estate.

What steps his Department is taking to reduce waiting times for autism diagnoses.

It is the responsibility of the integrated care boards (ICBs) to make available appropriate provision to meet the health and care needs of their local population, including autism assessments and diagnosis, in line with relevant National Institute for Health and Care Excellence guidelines.On 5 April 2023, NHS England published a national framework and operational guidance to help ICBs and the National Health Service to deliver improved outcomes for children, young people and adults referred to an autism assessment service.In 2024/25, £4.3 million is available nationally to improve services for autistic children and young people, including autism assessment services.

What steps his Department is taking to ensure those diagnosed with coeliac disease receive timely and appropriate treatment.

The Government is committed to putting patients first. This means making sure that patients are seen on time and ensuring that people have the best possible experience during their care.We have made a commitment that 92% of patients should wait no longer than 18 weeks from Referral to Treatment within our first term. This includes those waiting for treatment for coeliac disease. As a first step to achieving this, following the Budget, we will deliver an additional two million operations, scans, and appointments across all specialities during our first year in Government, which is equivalent to 40,000 per week.The Royal College of General Practitioners has an e-learning module on the diagnosis and management of coeliac disease and its immunological comorbidities, which is designed to raise awareness and understanding of the symptoms of coeliac disease amongst general practitioners and primary care professionals and support early diagnosis. The e-learning module highlights that untreated coeliac disease can have important consequences, including small bowel lymphoma and osteoporosis.The NHS website is also a key awareness tool and contains useful information for the public about coeliac disease, its symptoms and how it is diagnosed and treated. This information is available at the following link:https://www.nhs.uk/conditions/coeliac-disease/The National Institute for Health and Care Excellence has guidance on the recognition, assessment and management of coeliac disease, which is available at the following link:https://www.nice.org.uk/guidance/ng20The guidance outlines a number of symptoms which are suggestive of coeliac disease and suggests that any person with these symptoms should be offered serological testing for coeliac disease. The guidance also states that first-degree relatives of people with coeliac disease should also be offered serological testing.

What (a) medical professionals, (b) charities, (c) organisations and (d) other groups the Commission on Human Medicines consulted on the provision of puberty blockers.

The Government’s response to the targeted consultation on proposed changes to the availability of puberty blockers was published on 11 December 2024, and details the individuals and organisations with which the Commission on Human Medicines consulted. It is available at the following link:https://www.gov.uk/government/consultations/proposed-changes-to-the-availability-of-puberty-blockers-for-under-18s/outcome/9702c8a7-3299-4a01-94dc-a63861786dd9