Written questions by Hodgson.

Whether the National Institute for Health and Care Excellence plans to publish updated guidance on the eight types of hernia mesh.

Topics for new or updated guidance from the National Institute for Health and Care Excellence (NICE) are considered through the NICE prioritisation process. Decisions as to whether NICE will create new, or update existing, guidance are overseen by an integrated, cross-organisational prioritisation board, chaired by NICE’s Chief Medical Officer. NICE’s prioritisation board is considering the use of hernia mesh in the treatment of ventral and inguinal hernias as a potential topic for guidance, and a decision will be taken in due course.

Pursuant to the Answer of 10 July 2025 to Question 63541 on Autism: Foetal Valproate Spectrum Disorder, if she will take steps to collate this information centrally.

Research already exists that shows evidence of an increased risk for children of neurodevelopmental disorders, such as autism, when exposed to Valproate during pregnancy. This includes the Medicines & Healthcare products Regulatory Agency’s publication, Valproate: review of safety data and expert advice on management of risks.As this link is already identified in the evidence and research available, NHS England has no plans to collate further information about the number of children with autism also diagnosed with foetal valproate syndrome.

Whether he has made an assessment of the potential merits of appointing a Government lead to establish a strategic mission for (a) rare and (b) less survivable cancers.

We will get the National Health Service diagnosing cancer earlier and treating it faster so more patients survive, and we will improve patients’ experience across the systemThe Government supports Scott Arthur’s Private Members Bill on rare cancers. The bill will make it easier for clinical trials into rare cancers to take place in England by ensuring the patient population can be easily contacted by researchers. The Government is committed to backing innovative clinical research ecosystem in the United Kingdom so that British patients can be among the first to benefit as we make the NHS fit for the future.Finally, the National Cancer Plan will include further details on how we will improve outcomes for patients with rare cancers, as well as speeding up diagnosis and treatment, ensuring patients have access to the latest treatments and technology.

For what reason the role of the Patient Safety Commissioner is now going to be hosted within the MHRA; and what assessment he has made of the potential impact of this on her ability to advocate for MHRA reform.

Dr Dash’s review of patient safety across the health and care landscape was published in July 2025. The review sets out a broad aim to streamline, simplify, and consolidate functions across the patient safety landscape. Dr Dash made nine recommendations which the Government has accepted in full and fed into the 10-Year Health Plan.The review specifically recommends that the patient safety commissioner is hosted by the Medicines and Healthcare Products Regulatory Agency. The office of the patient safety commissioner remains accountable to the Department, as it is now.The Patient Safety Commissioner will play an important role in holding the Medicines and Healthcare Products Regulatory Agency to account for its work on patient safety and in ensuring that patient safety and the voice of patients remains a core priority in the agency’s work.

What steps his Department is taking to ensure that the (a) experiences and (b) interests of (i) children with foetal valproate syndrome and (ii) their families are included in NHS reform.

As part of National Health Service reform, the Department has launched a transformation programme, led by a senior responsible officer. The Department is engaging with partners to ensure their experiences and interests are considered in shaping the future NHS. The valuable work done by the Patient Safety Commissioner and the resulting Hughes Report, which set out options for redress for those harmed by valproate and pelvic mesh, is being considered by the Government. This is a complex area of work, involving several Government departments, and it is important that we get this right. We will be providing an update to the Patient Safety Commissioner’s report at the earliest opportunity.

Whether he plans to respond to the Hughes Report before 23 July 2025.

The Government is carefully considering the work done by the Patient Safety Commissioner and her report, which set out options for redress for those harmed by valproate and pelvic mesh. This is a complex issue involving input from different Government departments. The Government will provide a further update to the Patient Safety Commissioner’s report.

How many children diagnosed with autistic spectrum disorders also have a diagnosis of foetal valproate syndrome.

Everyone who has been harmed from sodium valproate has our deepest sympathies. Information about the number of children diagnosed with an autistic spectrum disorder and a diagnosis of foetal valproate syndrome is not collected centrally.

For what reason (a) Valproate redress and (b) interim payments are delayed.

The Government is carefully considering the valuable work done by the Patient Safety Commissioner and the resulting Hughes Report, which set out options for redress for those harmed by valproate and pelvic mesh. This is a complex area of work, involving several Government departments. We will be providing an update to the Patient Safety Commissioner’s report at the earliest opportunity.

What assessment his Department has made of the adequacy of access to (a) palliative care medicines and (b) controlled drugs for patients in care homes.

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.The Government seeks to have a coordinated approach to prevent wastage as much as possible, to improve inefficiencies and reduce costs for the taxpayer. PCNs are required to ensure that Structured Medication Reviews (SMRs) for high-risk cohorts, such as care home patients, are implemented. SMRs are an evidence based comprehensive review of a person’s medication, their views, concerns, and safety. The use of SMRs can reduce harmful polypharmacy and medicine wastage.

What assessment his Department has made of the potential impact of controls on stocking (a) palliative care medicines and (b) controlled drugs on the (i) adequacy of access to medication for patients in care homes and (ii) levels of wastage.

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.The Government seeks to have a coordinated approach to prevent wastage as much as possible, to improve inefficiencies and reduce costs for the taxpayer. PCNs are required to ensure that Structured Medication Reviews (SMRs) for high-risk cohorts, such as care home patients, are implemented. SMRs are an evidence based comprehensive review of a person’s medication, their views, concerns, and safety. The use of SMRs can reduce harmful polypharmacy and medicine wastage.

What assessment his Department has made of the potential impact of misdiagnosis of women’s health symptoms on levels of diagnosis of ovarian cancer in (a) all women and (b) women under the age of 50.

The Government is committed to improving the diagnosis, treatment, and ongoing care of gynaecological conditions, including ovarian cancer. NHS England has taken urgent action to address gynaecology waiting lists through the Elective Recovery Plan, including support for innovative care models that bring services closer to patients, and the piloting of gynaecology pathways within community diagnostic centres.As a first step towards improving the diagnosis of ovarian cancer and reducing misdiagnosis, the National Health Service is now delivering an extra 40,000 operations, scans, and appointments each week. The NHS is also improving pathways to get people diagnosed once they are referred, including non-specific symptom pathways for patients who do not fit clearly into a single urgent cancer referral pathway. Combined, these interventions will help ensure early diagnosis and faster treatment, including for women with ovarian cancer, with further actions to be outlined in the forthcoming National Cancer Plan.The most recent data available from the National Disease Registration Service shows that in England in 2022, 3,151 people were diagnosed with ovarian cancer at stages 3 & 4, which is classed as advanced.

What estimate his Department has made on the number of patients diagnosed with ovarian cancer at an advanced stage.

The Government is committed to improving the diagnosis, treatment, and ongoing care of gynaecological conditions, including ovarian cancer. NHS England has taken urgent action to address gynaecology waiting lists through the Elective Recovery Plan, including support for innovative care models that bring services closer to patients, and the piloting of gynaecology pathways within community diagnostic centres.As a first step towards improving the diagnosis of ovarian cancer and reducing misdiagnosis, the National Health Service is now delivering an extra 40,000 operations, scans, and appointments each week. The NHS is also improving pathways to get people diagnosed once they are referred, including non-specific symptom pathways for patients who do not fit clearly into a single urgent cancer referral pathway. Combined, these interventions will help ensure early diagnosis and faster treatment, including for women with ovarian cancer, with further actions to be outlined in the forthcoming National Cancer Plan.The most recent data available from the National Disease Registration Service shows that in England in 2022, 3,151 people were diagnosed with ovarian cancer at stages 3 & 4, which is classed as advanced.

What assessment his Department has made of the potential impact of the removal of the target to increase the percentage of cancers diagnosed at stages 1 and 2 from the NHS Priorities and Operational Planning Guidance on women with ovarian cancer.

The Government is committed to improving the diagnosis, treatment, and ongoing care of gynaecological conditions, including ovarian cancer. NHS England has taken urgent action to address gynaecology waiting lists through the Elective Recovery Plan, including support for innovative care models that bring services closer to patients, and the piloting of gynaecology pathways within community diagnostic centres.As a first step towards improving the diagnosis of ovarian cancer and reducing misdiagnosis, the National Health Service is now delivering an extra 40,000 operations, scans, and appointments each week. The NHS is also improving pathways to get people diagnosed once they are referred, including non-specific symptom pathways for patients who do not fit clearly into a single urgent cancer referral pathway. Combined, these interventions will help ensure early diagnosis and faster treatment, including for women with ovarian cancer, with further actions to be outlined in the forthcoming National Cancer Plan.The most recent data available from the National Disease Registration Service shows that in England in 2022, 3,151 people were diagnosed with ovarian cancer at stages 3 & 4, which is classed as advanced.

Whether he has made an assessment of the potential merits of expanding the Family Nurse Partnership to include more than the existing 44 local authorities.

The Family Nurse Partnership Programme (FNP) is the Department’s current service for the most vulnerable first-time parents, for example, teenagers, care leavers, those known to the care system, or those who would otherwise have extremely poor clinical outcomes, affecting both themselves and their children. The FNP has been shown to improve vulnerable children’s development, school readiness and early educational attainment.Provision of the FNP is currently a choice for local authorities. The programme is currently available in 45 local authorities. Local authorities have a statutory duty for commissioning public health services for children and young people aged between zero and 19 years old. The Public Health Grant, from which various programmes for children and young people are funded, including FNP, has been uplifted for 2025/26 by 5.4%, a percentage equalling almost £200 million.

How many hernia mesh surgeries have taken place in each of the last 20 years; and what steps his Department is taking to ensure that patients are informed of the risks of mesh complications.

The following table shows the count of Finished Consultant Episodes (FCEs) where there was any procedure for 'hernia mesh surgeries', recorded for the years 2004/05 to 2023/24, in English National Health Service hospitals and English NHS commissioned activity in the independent sector:YearFCEs2004/0577,8492005/0679,7482006/0783,7892007/0889,0632008/0987,4012009/1085,5192010/1185,6972011/1290,5932012/1389,6762013/1495,6082014/1595,8542015/1692,1472016/1793,8872017/1889,0162018/1989,9512019/2081,7802020/2139,0342021/2270,8842022/2378,9172023/2483,045Source: Hospital Episode Statistics, NHS England.Clinicians are expected to inform patients about risks associated with recommended treatments, including reasonable alternatives, to enable informed consent and a balanced patient decision.

What steps he plans to take through the 10-year health plan to support children and young people with arthritis.

The 10-Year Health Plan will deliver the three big shifts our National Health Service needs to be fit for the future: from hospital to community; from analogue to digital; and from sickness to prevention. All of these are relevant to improving arthritis care for children and young people in all parts of the country. More tests and scans delivered in the community, better joint working between services, and greater use of apps and wearable technology will all support children, young people, and their families to manage their long-term conditions, including arthritis, closer to home.

With reference to NCEPOD's report entitled Joint Care? A review of the quality of care provided to children and young adults with juvenile idiopathic arthritis, published on 13 February 2025, whether he will take steps to implement the recommendations of that report as they relate to recognition of juvenile idiopathic arthritis by healthcare professionals.

The Department has not yet considered the recommendations of the report published by the National Confidential Enquiry into Patient Outcome and Death on 13 February 2025, Joint Care? A review of the quality of care provided to children and young adults with juvenile idiopathic arthritis. NHS England Specialised Commissioning has a Clinical Reference Group for specialised paediatric rheumatology, which has produced a service specification for these services. This service specification names juvenile idiopathic arthritis as one of the conditions that should be managed by a specialist paediatric rheumatology team. The service specification also sets out that specialised paediatric rheumatology teams will provide transitional care to facilitate transfer and ongoing care in adult rheumatology. Transitional care planning will involve paediatric rheumatology teams, adult rheumatology teams and local hospitals under a shared care arrangement. Specialised paediatric rheumatology services are expected to be commissioned in line with this service specification. In the NHS Long Term Plan, NHS England committed to delivering a service model for people aged between zero and 25 years old to improve young people’s experience and health outcomes. To aid implementation of this model, the Children and Young People’s Transformation Programme collaborated with key partners to develop national guidance on how the National Health Service can better support young people transfer into adolescent and adult services. The guidance is due to be published shortly and will be hosted on the NHS England website. The policy aligns with existing National Institute for Health and Care Excellence (NICE) guidelines and outlines the principles and steps of a service model for people aged between zero and 25 years old, along with best practice examples from across the country. NICE’s published guidance on the transition from children’s to adult services for young people includes recommendations on transition planning, support before and after transfer and the development of transition infrastructure. This guidance is available at the following link:https://www.nice.org.uk/guidance/ng43

What steps he is taking to support older children with arthritis as they transition to adult health and care services.

The Department has not yet considered the recommendations of the report published by the National Confidential Enquiry into Patient Outcome and Death on 13 February 2025, Joint Care? A review of the quality of care provided to children and young adults with juvenile idiopathic arthritis. NHS England Specialised Commissioning has a Clinical Reference Group for specialised paediatric rheumatology, which has produced a service specification for these services. This service specification names juvenile idiopathic arthritis as one of the conditions that should be managed by a specialist paediatric rheumatology team. The service specification also sets out that specialised paediatric rheumatology teams will provide transitional care to facilitate transfer and ongoing care in adult rheumatology. Transitional care planning will involve paediatric rheumatology teams, adult rheumatology teams and local hospitals under a shared care arrangement. Specialised paediatric rheumatology services are expected to be commissioned in line with this service specification. In the NHS Long Term Plan, NHS England committed to delivering a service model for people aged between zero and 25 years old to improve young people’s experience and health outcomes. To aid implementation of this model, the Children and Young People’s Transformation Programme collaborated with key partners to develop national guidance on how the National Health Service can better support young people transfer into adolescent and adult services. The guidance is due to be published shortly and will be hosted on the NHS England website. The policy aligns with existing National Institute for Health and Care Excellence (NICE) guidelines and outlines the principles and steps of a service model for people aged between zero and 25 years old, along with best practice examples from across the country. NICE’s published guidance on the transition from children’s to adult services for young people includes recommendations on transition planning, support before and after transfer and the development of transition infrastructure. This guidance is available at the following link:https://www.nice.org.uk/guidance/ng43

Whether the Children and Young People with Cancer Taskforce will recognise that cancer is different in (a) young people and (b) children.

The Department is committed to improving outcomes and patient experience for children, teenagers, and young adults with cancer, from birth to 24 years of age. That is why we have relaunched the Children and Young People Cancer Taskforce, which will identify tangible ways to drive improvements for cancer patients across this age range. The taskforce’s membership, which is currently being finalised, will reflect the diversity of needs across these patient groups.We recognise that cancer in teenagers and young people is different to cancer in adults and children, and so age-appropriate care is necessary, particularly regarding treatment, diagnosis, and wider support, as per the NHS England service specifications. Department officials are working with chairs of the taskforce to develop the Terms of Reference ahead of the first meeting, currently planned for March. The taskforce will consider the most appropriate dissemination routes or publication channels for taskforce materials in due course.

Whether the Children and Young People with Cancer Taskforce will recognise that teenagers and young adults with cancer have different needs to children.

The Department is committed to improving outcomes and patient experience for children, teenagers, and young adults with cancer, from birth to 24 years of age. That is why we have relaunched the Children and Young People Cancer Taskforce, which will identify tangible ways to drive improvements for cancer patients across this age range. The taskforce’s membership, which is currently being finalised, will reflect the diversity of needs across these patient groups.We recognise that cancer in teenagers and young people is different to cancer in adults and children, and so age-appropriate care is necessary, particularly regarding treatment, diagnosis, and wider support, as per the NHS England service specifications. Department officials are working with chairs of the taskforce to develop the Terms of Reference ahead of the first meeting, currently planned for March. The taskforce will consider the most appropriate dissemination routes or publication channels for taskforce materials in due course.