Written questions by Raja.

What role his Department played in the development, approval, or distribution of guidance to NHS midwives which stated that consanguineous marriage had “benefits” and that the prevalence of genetic defects among children born to consanguineous couples was “exaggerated”.

These phrases were not included in any guidance issued by the National Health Service. They were included in training materials which also made clear the genetic risk associated with close relative marriage.The Department had no role in the development, approval, or distribution of the training materials which included these phrases. The training materials were retired in 2025.We fully recognise the genetic risks of consanguineous relationships, and we offer referral to genetics services so individuals understand the risks and can make informed decisions.We are working with the NHS to look into how this training was developed, and to make sure it never happens again.

What steps his Department is taking to help improve influenza vaccination uptake in (a) Leicester and (b) the East Midlands.

The Department works closely with the UK Health Security Agency and NHS England to improve vaccination uptake. In Leicester, NHS England has advised that flu vaccination uptake has increased compared with last winter, with notable improvement in school‑age flu vaccination.Across the East Midlands, NHS England has advised that there has been an increase in uptake compared to this time last year for most cohorts, notably within two and three year olds and frontline healthcare worker cohorts, though lower uptake has been seen in over 65 year olds and care home cohorts.This year, NHS England has introduced, for the first time, an expansion to the two to three-year-old flu offer with appointments available via community pharmacy sites to support easier access.NHS England has been working closely with local integrated care boards (ICBs) and wider partners including acute and community hospitals, community pharmacies, and general practices, to take an integrated approach to improving influenza vaccination uptake across all eligible groups.Local ICBs are working together with community leaders and local partners to ensure that information is shared within communities about how, when, and where people can get vaccinated.

Whether he plans to bring forward proposals to require publicly funded bodies to ensure defibrillators are accessible to the public on a 24-hour basis.

It is for individual publicly funded bodies to determine appropriate arrangements for the defibrillators they maintain, taking account of relevant factors such as building operating hours and security. More broadly, local communities themselves are best placed to make decisions about location and access to defibrillators. The number has been increasing, with over 110,000 defibrillators now registered in the United Kingdom on The Circuit, the independent automated external defibrillators database. For these reasons, there are no plans to bring forward such proposals.

What steps his Department is taking to improve ambulance response times in (a) Leicester and (b) the East Midlands.

The Government recognises that in recent years ambulance response times have not met the high standards patients should expect.We are determined to turn things around. Our Urgent and Emergency Care Plan 2025/26, is backed by almost £450 million of capital investment, and commits to reducing category 2 ambulance response times to 30 minutes on average this year. The East Midlands Ambulance Service is investing over £4 million for additional clinicians in its control rooms to help patients with urgent care needs who call 999 to get signposted to the right care at the right time in the right place.The latest data from December 2025 for ambulance response times for East Midlands Ambulance Service shows progress, with category 2 incidents responded to in 44 minutes 19 seconds on average, which is 21 minutes and 56 seconds faster than the same period last year.

What steps his Department is taking to ensure that local NHS commissioning decisions use spare capacity in the independent sector to reduce NHS waiting lists.

Reducing waiting lists is a key part of the Government’s Health Mission, and we are committed to putting patients first by ensuring that they are seen on time and that they have the best possible experience of care. Since the Government came into office, the waiting list for routine appointments, operations, and procedures in England has now been cut by 312,369. This is despite 30.1 million referrals onto the waiting list.Fit for the Future: The 10-Year Health Plan for England and the Partnership Agreement between NHS England and the Independent Healthcare Providers Network reaffirmed our continued commitment to using independent sector capacity to improve access, reduce backlogs, and build a sustainable healthcare system.Between April 2025 and November 2025, the latest month for which data is available, over 1.1 million pathways have been taken off the waiting list by independent sector providers, with independent sector providers delivering 9.9% of all elective ordinary and day case procedures for the National Health Service.Commissioning decisions are for integrated care boards to make, who have a duty to arrange health services for the patients they are responsible for while living within their financial allocations. We expect decisions by local systems to support efforts achieving the goal of at least 65% of patients waiting no longer than 18 weeks for treatment by March 2026 whilst living within financial budgets set for 2025/26. NHS England has clearly set out that any decision to set activity management plans must not in any way restrict patient choice of provider.

What estimate he has made of the savings generated by reductions in NHS England staffing; and how are those savings being redirected into frontline patient care.

Creating a new joint organisation will streamline decision-making, reduce bureaucracy, and improve accountability. These changes are expected to generate significant efficiencies over time.The Department’s initial modelling demonstrate that the up-front investment in organisational change will be offset by long-term reductions in staffing and running costs, ensuring the programme delivers value for money and sustainable savings for the taxpayer. Current estimates expect that these changes will save £1 billion a year by the end of this Parliament, which is equivalent to 116,000 hip and knee operations.The Government is committed to transparency in how these figures are calculated. The methodology underpinning the £1 billion saving estimate will be set out through established mechanisms, including publication of supporting documentation where appropriate. This will ensure that both Parliament and the public are able to scrutinise the basis of the savings. Further detail will be brought forward over time, in line with our commitment to provide clear and timely information.The Department is committed to transparent, responsible, evidence-based policy making. We will publish proportionate assessments to support reforms. Assessments will be published to enable scrutiny and will be proportionate to the scale of reform.

Whether his Department has completed an impact assessment and cost-benefit analysis of the proposed reforms to NHS England; and if so, when it will be published.

Work is progressing at pace to develop the design and operating model for the new integrated organisation, and plan for the smooth transfer of people, functions and responsibilities.It is only right that with such significant reform, we commit to carefully assessing and understanding the potential impacts, as is due process. These ongoing assessments will inform our programme as appropriate.We are committed to transparency and will ensure that, following necessary appraisal, all relevant information is made accessible to Parliament. This includes the Impact Assessment that will accompany the primary legislation. Subject to the will of Parliament, the passage of the Bill is expected by March 2027.

I) what metrics his Department will use, and ii) over what timeframe, to judge whether the reforms to NHS England deliver (a) improved productivity, (b) reduced bureaucracy, and (c) better patient outcomes.

My Rt Hon. Friend, the Secretary of State for Health and Social Care, has set out his objectives for the wider health and care system through the 10-Year Health Plan which sets ambitious targets for the wider health and care sector to deliver the three big shifts: from hospital to community; from analogue to digital; and from sickness to prevention. The reforms to NHS England, and the wider health and care landscape, are a key component in delivering on this vision for a transformed National Health Service. As such, these reforms will be primarily judged and assessed against the extensive targets set out in this plan. Further information on the plan is available at the following link:https://assets.publishing.service.gov.uk/media/6888a0b1a11f859994409147/fit-for-the-future-10-year-health-plan-for-england.pdfWork is also continuing at pace to develop specific metrics and targets for the new Department of Health and Social Care that is being created. As is the case for any Government department, we will also develop specific metrics and targets for the new Department of Health and Social Care, which will be shared with Parliament and published.

What steps his Department is taking following the closure of NHS Commissioning Support Units to (a) support staff affected, and (b) ensure that functions previously delivered by those units continue to be provided safely and effectively.

As integrated care boards (ICBs) develop their strategic commissioning role and skills, commissioning support functions will be rationalised. This will result in commissioning support units (CSUs) being closed.Given wider changes in the system, including the larger geographical area of ICBs and the move to a more simplified operating model, for the National Health Service a whole, it is logical to integrate the work undertaken by CSUs into the other organisations that will make up the more streamlined, efficient NHS in future. The closure of CSUs will simplify the landscape and create efficiencies, and will strengthen the strategic commissioning skills in ICBs by giving them the freedom to develop these.A plan has been developed to ensure all services provided by CSUs and all CSU staff are mapped and destinations clarified, where function will continue, and workshops have been held with NHS England Regions to understand ICB intentions and timelines for the transfer of functions and staff and with the Department and NHS England on functions that may form part of the new Department. Governance arrangements are in place across NHS England and the CSUs to oversee the transition of functions and the safe closure of CSUs.Staff are being supported through this transition. The CSU Leadership Team hold regular all staff briefings where information on the abolition is cascaded. The CSUs are actively involving the trade unions. A voluntary redundancy scheme has been launched within the CSUs that mirrors that within NHS England. Staff are being actively informed about the scheme through the all-staff briefings.

What assessment the Department has made of the potential impact of reducing NHS-funded activity delivered by independent sector providers on local waiting times in (a) Leicester, (b) The East Midlands and (c) England.

Reducing waiting lists is a key part of the Government’s Health Mission, and we are committed to putting patients first by ensuring that they are seen on time and that they have the best possible experience of care. Since the Government came into office, the waiting list for routine appointments, operations, and procedures in England has now been cut by 312,369. This is despite 30.1 million referrals onto the waiting list.

If he will take steps to review NHS communications to ensure that language on (a) pregnancy and (b) breast feeding reflects biological sexes.

We are committed to working with NHS England to ensure health communications are as clear as possible and appropriately reflect sex as a protected characteristic in the Equality Act 2010. This includes communications about pregnancy and breast feeding. In April, in its judgment in the case of For Women Scotland Ltd v. The Scottish Ministers, the Supreme Court announced that it had reached a unanimous decision that the terms ‘man’, ‘woman’, and ‘sex’ in the Equality Act 2010 refer to biological sex. We welcome the clarity this brings. We recognise that there will be occasions when National Health Service providers want to specifically acknowledge patients with differing characteristics, including the transgender community. This may mean that trusts and providers decide to use additive language, for example “women and trans men”, to ensure health communications reach the largest audience.

What steps his Department is taking to ensure that NHS Blood and Transplant donor exclusion policies (a) reflect up-to-date medical evidence and (b) do not unnecessarily restrict donor participation.

NHS Blood and Transplant’s (NHSBT) donor selection criteria are based on advice provided by the Joint United Kingdom (UK) Blood Transfusion and Tissue Transplantation Services’ Professional Advisory Committee (JPAC). JPAC regularly reviews its guidelines to reflect the latest evidence. Their Whole Blood and Component Donor Selection Guidelines were last updated on 18 July 2025.Based on the recommendations of the For the Assessment of Individualised Risk Steering Group, the Government updated the blood donor selection criteria in 2021, thereby providing more opportunities for people to give blood.

If he will make an assessment of the potential merits of replacing the lifetime blood donation deferral for people who have used tanning injections with a fixed-term exclusion period similar to those in place for (a) tattoos and (b) piercings.

There are no plans to update the deferral policy for tanning injections. Unlike tattooing and piercing, tanning injections are not well regulated. Given injectable tanning products work internally, they do not meet the definition of a cosmetic product and are therefore not regulated via the UK Cosmetic Regulation. Regulation ensures safety standards are maintained to reduce the risk of transmitting a blood-borne infection.To protect the safety of the patient who receives the blood donation, the Blood Safety and Quality Regulations 2005 mandate permanent deferral from blood donation for anyone with a history of non-prescribed intravenous or intramuscular drug use, as per the Blood Safety and Quality Regulations 2005, with further information available at the following link:https://www.legislation.gov.uk/uksi/2005/50/schedule/part/3/paragraph/2n3

When his Department last reviewed NHS Blood and Transplant’s donor eligibility policy on the use of unlicensed injectable substances.

The safety of blood is of the upmost importance. The Blood Safety and Quality Regulations 2005 mandate permanent deferral from blood donation for anyone with a history of non-prescribed intravenous or intramuscular drug use, with further information available in the Blood Safety and Quality Regulations 2005, at the following link:https://www.legislation.gov.uk/uksi/2005/50/schedule/part/3/paragraph/2n3The Advisory Committee on the Safety of Blood, Tissues and Organs, which provides expert advice to all the United Kingdom’s governments, conducted a full review of the donor selection criteria in 2017. This includes the use of unlicensed injectable substances.The Joint United Kingdom (UK) Blood Transfusion and Tissue Transplantation Services’ Professional Advisory Committee provides expert guidance to the UK blood services. Their Whole Blood and Component Donor Selection Guidelines, which includes the guidance relating to injectable tanning agents, were last updated on 18 July 2025.

For what reason people who have used tanning injections are permanently unable to donate blood.

The safety of blood is of the upmost importance. Patients that receive blood donations can be particularly vulnerable to infections. In the United Kingdom, the Blood Safety and Quality Regulations 2005 mandate permanent deferral from blood donation for anyone with a history of non-prescribed intravenous or intramuscular drug use. The Blood Safety and Quality Regulations 2005 are available at the following link:https://www.legislation.gov.uk/uksi/2005/50/schedule/part/3/paragraph/2n3This is also reflected in the Joint United Kingdom (UK) Blood Transfusion and Tissue Transplantation Services Professional Advisory Committee (JPAC) guidelines, the Addiction and Drug Abuse guideline and the Blood Safety Entry guideline, which are available, respectively, at the following two links:https://transfusionguidelines.org/dsg/wb/guidelines/ad001-addiction-and-drug-abusehttps://www.transfusionguidelines.org/dsg/wb/guidelines/bl008-blood-safety-entryInjections can carry a risk of blood-borne illness. To preserve the safety of patients who receive blood donations, measures are taken to reduce the risk of transmitting blood-borne infections, including cleanliness and safety standards. However, as tanning injections are not well regulated, measures that would normally be used to prevent blood-borne infection cannot be assessed.

Whether NHS Blood and Transplant has made an assessment of the potential impact of the use of tanning injections more than (a) 12 months (b) three months prior to donating on blood safety.

The safety of blood is of the upmost importance. Patients that receive blood donations can be particularly vulnerable to infections. In the United Kingdom, the Blood Safety and Quality Regulations 2005 mandate permanent deferral from blood donation for anyone with a history of non-prescribed intravenous or intramuscular drug use. The Blood Safety and Quality Regulations 2005 are available at the following link:https://www.legislation.gov.uk/uksi/2005/50/schedule/part/3/paragraph/2n3This includes those in receipt of tanning injections, for any period prior to donation. NHS Blood and Transplant has provided guidance on blood safety by the Joint United Kingdom (UK) Blood Transfusion and Tissue Transplantation Services Professional Advisory Committee (JPAC). JPAC guidance reflects the Blood Safety and Quality Regulations 2005 in the Addiction and Drug Abuse guideline and the Blood Safety Entry guideline, which are available, respectively, at the following two links:https://transfusionguidelines.org/dsg/wb/guidelines/ad001-addiction-and-drug-abusehttps://www.transfusionguidelines.org/dsg/wb/guidelines/bl008-blood-safety-entryInjections can carry a risk of blood-borne illness. To preserve the safety of patients who receive blood donations, measures are taken to reduce the risk of transmitting blood-borne infections, including cleanliness and safety standards. However, as tanning injections are not well regulated, measures that would normally be used to prevent blood-borne infection cannot be assessed.

Whether the permanent exclusion of people who have used tanning injections is consistent with the current evidence base on the persistence of bloodborne infection risks.

The safety of blood is of the utmost importance. Donor exclusion policies are in place to maintain safety and are mandated in the Blood Safety and Quality Regulations 2005: The Blood Safety and Quality Regulations 2005, which are available at the following link:https://www.legislation.gov.uk/uksi/2005/50/schedule/part/3/paragraph/2n3Similarly to individuals with a history of Hepatitis B, Hepatitis C, and HIV, those with a history of non-prescribed intravenous or intramuscular drug use are permanently deferred from donating blood.The Joint United Kingdom (UK) Blood Transfusion and Tissue Transplantation Services’ Professional Advisory Committee produces guidance documents for UK blood services which outline the risks posed by tanning injections in the Addiction and Drug Abuse guideline and the Blood Safety Entry guideline, which are available, respectively, at the following two links:https://transfusionguidelines.org/dsg/wb/guidelines/ad001-addiction-and-drug-abusehttps://www.transfusionguidelines.org/dsg/wb/guidelines/bl008-blood-safety-entryTheir Whole Blood and Component Donor Selection Guidelines, which includes the guidance relating to injectable tanning agents, were last updated on 18 July 2025.

Whether he plans to delegate the commissioning of vaccination and immunisation services to integrated care boards from April 2026.

I refer the Hon. Member to the answer I gave on 29 September 2025 to Question PQ76374.

Whether he has made an assessment of the potential impact of not referencing biological sexes in some maternity care guidance on the safeguarding of patients.

The Department’s longstanding position is that health information should be as clear as possible and language should be used that appropriately reflects sex as defined in the Equality Act 2010.National maternity guidance and key documents, such as the Three-Year Delivery Plan for Maternity and Neonatal Services, reference women throughout.

Whether his Department has allocated funding to (a) initiatives and (b) organisations that promote the use of the term chestfeeding.

The Department funds infant feeding services and support through the National Health Service, local authorities, and the National Breastfeeding Helpline.We want all families to be able to achieve their infant feeding goals, regardless of their circumstances, and infant feeding support and advice should be available to anyone who needs it.