Written questions by Andrew.

Whether his Department uses international data when assessing evidence for rare diseases; and if he will make an assessment of the potential role of such data in relation to metachromatic leukodystrophy.

Last year, the 10-Year Health Plan was published following a national conversation to make the National Health Service work better for people.We know that significant unmet need remains for people living with rare diseases, and in February this year we published the England Rare Diseases Action Plan 2026 to highlight how delivery of the 10-Year Health Plan will address challenges for people living with rare diseases. The England Rare Diseases Action Plan 2026 is available at the following link:https://www.gov.uk/government/publications/england-rare-diseases-action-plan-2026/england-rare-diseases-action-plan-2026-main-reportThe Department invests over £1.7 billion each year on research through the National Institute for Health and Care Research (NIHR). This includes the NIHR funded RareCare study which aims to better understand what causes delays to diagnosis so we can take steps to address this. The research includes looking at how we can measure time to diagnosis for rare diseases which includes those that are covered by Newborn Blood Spot (NBS).Another example of NIHR funded research is the evaluation of test accuracy studies in NBS screening and rare disease settings. This project aims to provide guidance on the evidence needed to evaluate the accuracy of NBS screening to ultimately improve the quality of the available evidence base to support better decision making about new or modified screening programmes.For very rare conditions, it is difficult to generate robust evidence to demonstrate the value of screening, because so few babies are affected. The UK National Screening Committee (UK NSC), which advises the Government on all screening matters, is working with experts and partner organisations to look at how to make it easier to develop the evidence needed to make robust recommendations on the addition of more rare diseases to the NBS screening programme.Information about how the UK NSC makes screening recommendations, and how stakeholders and members of the public can be involved, is available at the following link:https://www.gov.uk/government/collections/uk-nsc-evidence-consultations-and-reviewsThe UK NSC’s terms of reference are available online and can be found via the following link:https://www.gov.uk/government/organisations/uk-national-screening-committee/about#terms-of-referenceThese were last reviewed and updated in 2022. The terms of reference are set by the four United Kingdom health departments and are signed off by the four chief medical officers.In the last few years, the UK NSC has recommended lung cancer screening, newborn screening for tyrosinaemia type 1, human papillomavirus self-sampling in under-screened women in the Cervical Screening Programme, research activity into rare diseases such as spinal muscular atrophy and severe combined immunodeficiency, the extension of intervals for diabetic eye screening, the use of DNA in the mother’s blood in the Fetal Anomaly Screening Programme, digital pathology in the cancer screening programmes, and extra tests for Edwards syndrome in pregnancy. It has also worked with partners to develop a very large trial on artificial intelligence in breast screening.The UK NSC uses international published evidence from all across the world. Some countries or regions reportedly screen for a condition when it is only at the pilot or research stage. Some ‘screening programmes’ just test for a condition rather than being end-to-end quality-assured programmes that include diagnosis, treatment, and care. And screening in some countries is delivered regionally, or even just by individual hospitals, rather than nationally. They are therefore not directly comparable to the national screening programmes offered in the UK.The UK NSC last reviewed screening for metachromatic leukodystrophy (MLD) in 2025. At the November 2025 UK NSC meeting, committee members concluded that there was not enough evidence to support newborn screening for MLD. However, members agreed that MLD would be a good candidate for inclusion in a multi-condition in-service evaluation (ISE) within the UK newborn blood spot screening programme, called EquipoISE. Full details of this review, including the evidence that was considered, are available at the following link:https://view-health-screening-recommendations.service.gov.uk/metachromatic-leukodystrophy/ EquipoISE is a proposed rolling, multi-condition ISE embedded within the NHS NBS screening programme that would help the UK NSC make timely evidence-based recommendations on multiple rare conditions. EquipoISE would evaluate multiple conditions simultaneously, sharing a single research infrastructure. This would significantly reduce costs and setup time, rather than conducting expensive, one-off studies for each individual rare condition. The UK NSC is using EquipoISE in its work with experts and partner organisations to look at how to make it easier to develop the evidence needed to make robust recommendations on the addition of more rare diseases to the NHS NBS screening programme. UK NSC members and Department officials met with stakeholders, including ArchAngel MLD Trust, the MPS Society, MLD Support UK, and the Newborn Screening Collaborative, in February this year.

How many children have been diagnosed with metachromatic leukodystrophy since 2022; how many of those were diagnosed in time to receive NHS-commissioned treatment; and whether he has made an assessment of the potential impact of the absence of newborn screening on the timing of diagnosis.

Last year, the 10-Year Health Plan was published following a national conversation to make the National Health Service work better for people.We know that significant unmet need remains for people living with rare diseases, and in February this year we published the England Rare Diseases Action Plan 2026 to highlight how delivery of the 10-Year Health Plan will address challenges for people living with rare diseases. The England Rare Diseases Action Plan 2026 is available at the following link:https://www.gov.uk/government/publications/england-rare-diseases-action-plan-2026/england-rare-diseases-action-plan-2026-main-reportThe Department invests over £1.7 billion each year on research through the National Institute for Health and Care Research (NIHR). This includes the NIHR funded RareCare study which aims to better understand what causes delays to diagnosis so we can take steps to address this. The research includes looking at how we can measure time to diagnosis for rare diseases which includes those that are covered by Newborn Blood Spot (NBS).Another example of NIHR funded research is the evaluation of test accuracy studies in NBS screening and rare disease settings. This project aims to provide guidance on the evidence needed to evaluate the accuracy of NBS screening to ultimately improve the quality of the available evidence base to support better decision making about new or modified screening programmes.For very rare conditions, it is difficult to generate robust evidence to demonstrate the value of screening, because so few babies are affected. The UK National Screening Committee (UK NSC), which advises the Government on all screening matters, is working with experts and partner organisations to look at how to make it easier to develop the evidence needed to make robust recommendations on the addition of more rare diseases to the NBS screening programme.Information about how the UK NSC makes screening recommendations, and how stakeholders and members of the public can be involved, is available at the following link:https://www.gov.uk/government/collections/uk-nsc-evidence-consultations-and-reviewsThe UK NSC’s terms of reference are available online and can be found via the following link:https://www.gov.uk/government/organisations/uk-national-screening-committee/about#terms-of-referenceThese were last reviewed and updated in 2022. The terms of reference are set by the four United Kingdom health departments and are signed off by the four chief medical officers.In the last few years, the UK NSC has recommended lung cancer screening, newborn screening for tyrosinaemia type 1, human papillomavirus self-sampling in under-screened women in the Cervical Screening Programme, research activity into rare diseases such as spinal muscular atrophy and severe combined immunodeficiency, the extension of intervals for diabetic eye screening, the use of DNA in the mother’s blood in the Fetal Anomaly Screening Programme, digital pathology in the cancer screening programmes, and extra tests for Edwards syndrome in pregnancy. It has also worked with partners to develop a very large trial on artificial intelligence in breast screening.The UK NSC uses international published evidence from all across the world. Some countries or regions reportedly screen for a condition when it is only at the pilot or research stage. Some ‘screening programmes’ just test for a condition rather than being end-to-end quality-assured programmes that include diagnosis, treatment, and care. And screening in some countries is delivered regionally, or even just by individual hospitals, rather than nationally. They are therefore not directly comparable to the national screening programmes offered in the UK.The UK NSC last reviewed screening for metachromatic leukodystrophy (MLD) in 2025. At the November 2025 UK NSC meeting, committee members concluded that there was not enough evidence to support newborn screening for MLD. However, members agreed that MLD would be a good candidate for inclusion in a multi-condition in-service evaluation (ISE) within the UK newborn blood spot screening programme, called EquipoISE. Full details of this review, including the evidence that was considered, are available at the following link:https://view-health-screening-recommendations.service.gov.uk/metachromatic-leukodystrophy/ EquipoISE is a proposed rolling, multi-condition ISE embedded within the NHS NBS screening programme that would help the UK NSC make timely evidence-based recommendations on multiple rare conditions. EquipoISE would evaluate multiple conditions simultaneously, sharing a single research infrastructure. This would significantly reduce costs and setup time, rather than conducting expensive, one-off studies for each individual rare condition. The UK NSC is using EquipoISE in its work with experts and partner organisations to look at how to make it easier to develop the evidence needed to make robust recommendations on the addition of more rare diseases to the NHS NBS screening programme. UK NSC members and Department officials met with stakeholders, including ArchAngel MLD Trust, the MPS Society, MLD Support UK, and the Newborn Screening Collaborative, in February this year.

What steps his Department is taking to ensure that patients affected by changes to services at St Andrew’s Hospital in Northampton are transferred safely to appropriate alternative mental health provision.

The failings exposed at St Andrew’s Hospital in Northampton site are completely unacceptable. The accounts of poor care, patient harm, and sustained risks to vulnerable people are deeply distressing, and the safety and wellbeing of patients remains our foremost priority throughout this process.NHS England has required commissioners to begin identifying alternative inpatient placements for patients at St Andrew’s Hospital in Northampton following ongoing concerns about patient safety. Transfers are being managed carefully and in phases, based on individual clinical assessments, and patients will only move when a suitable alternative placement has been identified that can safely meet their needs. Enhanced clinical oversight has been put in place at the site, and NHS England is working closely with placing commissioners and provider networks to ensure transfers prioritise patient safety, continuity of care and compliance with the Mental Health Act where applicable.We recognise that many patients at St Andrew’s will have limited capacity to advocate for themselves. Their voices, and those of their families and representatives, must be central to this process. Enhanced advocacy provision is already in place, and patient communications including accessible and Easy Read formats are being developed to support understanding and reduce anxiety.After discussing with the NHS, a patient’s placing commissioner will talk with them to explain the options being considered for the best place for them to go next. They will listen to each patient’s preferences and feed these back to the NHS so they can be taken into account when making plans. Advanced advocacy support for patients is also in place. However, the final decision will also depend on the care needs of each patient and what services are available.Where a patient is receiving care in an adult secure service, decisions will also need to consider risk and any requirements from the Ministry of Justice that may apply. These factors help the team decide the most appropriate place for ongoing care.

What assessment he has made of the adequacy of mental health crisis and inpatient provision in Northamptonshire following changes to services at St Andrew’s Hospital.

St Andrew’s site in Northampton provides care for a complex mix of patients on both an inpatient and outpatient basis. The decision by NHS England relates to inpatients at St Andrew’s Northampton site only. It is important to note that Care Quality Commission enforcement against St Andrew’s meant that no new patients have been admitted to the inpatient unit at Northampton for some time.Of the inpatients at St Andrew’s Northampton site, the majority are adult secure commissioned patients. Many of these patients are subject to Ministry of Justice restrictions. The decision will mean limitation upon the number of available adult secure beds in Northamptonshire, however alternative placements are being sought for patients in the region as well as in surrounding areas. The majority of other patients in St Andrew’s, Northamptonshire are patients placed by integrated care boards (ICB) into other core mental health services provided by St Andrew’s.NHS England is working with all placing commissioners, including Northamptonshire ICB, the East Midlands provider collaboratives and local providers, asking them to identify and transfer patients to alternative placements (within the community, other health or detained settings) in line with clinical need and informed by patient and family wishes. This approach is being informed by available capacity, impact across services and enabling the identification of specific additional requirements. This is a live situation; therefore, the assessment and response are evolving. An Ethics Framework has been used to guide decision making recognising that there are a range of risks which need to be carefully balanced. Recognising the wider health and economic context for the county, Northamptonshire ICB have also convened a local system response forum to ensure that local partners are informed and engaged.

What steps his Department is taking to ensure that families and carers of patients affected by changes to services at St Andrew’s Hospital in Northampton are involved in decisions about alternative care arrangements.

The failings exposed at St Andrew’s Hospital in Northampton site are completely unacceptable. The accounts of poor care, patient harm, and sustained risks to vulnerable people are deeply distressing, and the safety and wellbeing of patients remains our foremost priority throughout this process.NHS England has required commissioners to begin identifying alternative inpatient placements for patients at St Andrew’s Hospital in Northampton following ongoing concerns about patient safety. Transfers are being managed carefully and in phases, based on individual clinical assessments, and patients will only move when a suitable alternative placement has been identified that can safely meet their needs. Enhanced clinical oversight has been put in place at the site, and NHS England is working closely with placing commissioners and provider networks to ensure transfers prioritise patient safety, continuity of care and compliance with the Mental Health Act where applicable.We recognise that many patients at St Andrew’s will have limited capacity to advocate for themselves. Their voices, and those of their families and representatives, must be central to this process. Enhanced advocacy provision is already in place, and patient communications including accessible and Easy Read formats are being developed to support understanding and reduce anxiety.After discussing with the NHS, a patient’s placing commissioner will talk with them to explain the options being considered for the best place for them to go next. They will listen to each patient’s preferences and feed these back to the NHS so they can be taken into account when making plans. Advanced advocacy support for patients is also in place. However, the final decision will also depend on the care needs of each patient and what services are available.Where a patient is receiving care in an adult secure service, decisions will also need to consider risk and any requirements from the Ministry of Justice that may apply. These factors help the team decide the most appropriate place for ongoing care.

What steps his Department is taking, with NHS England and integrated care boards, to address systemic failings in inpatient mental health care.

Anyone receiving mental health treatment should be able to expect consistently safe, high‑quality care. Families, staff, and the public deserve answers when things go wrong in mental health settings and it is vitally important that, where care falls short, we learn from any mistakes made to improve care across the National Health Service and to protect patients in the future. To this end, the Department has announced a statutory inquiry into the Tees, Esk and Wear Valleys NHS Foundation Trust.The Department and NHS England are committed to ensuring we put in place a modernised legislative framework through the Mental Health Act 2025 which upholds patient rights and voice and that provides stronger oversight, higher standards, and a system that better protects and supports some of the most vulnerable people in society, whilst keeping patients and the public safe. We are also prioritising eliminating inappropriate out of area placements. The Medium Term Planning Framework set a new national expectation to end all integrated care board-commissioned inappropriate out of area placements and the commissioning of locked rehabilitation services by March 2028.

What steps his Department is taking to ensure that inpatient mental health services have sufficient staffing levels and the appropriate skill mix to provide safe and therapeutic care.

As part of our mission to build a National Health Service that is fit for the future and that is there when people need it, the Government is recruiting an additional 8,500 mental health workers by the end of this Parliament. Over 8,000 of these workers have been recruited since July 2024, which will help to ease pressure on busy mental health services. We will publish a 10 Year Workforce Plan later this year to ensure the NHS has the right people in the right places to care for patients when they need it.

What assessment he has made of whether NHS England’s projected PET-CT activity volumes for prostate cancer under the forthcoming commissioning arrangements align with current regional activity levels; and what assessment he has made of any variance between projected and existing provision.

NHS England is responsible for commissioning prostate‑specific membrane antigen (PSMA) radiotracers for positron emission tomography–computed tomography (PET‑CT) imaging for adults with high‑risk primary or recurrent prostate cancer. The commissioning policy, published in February 2025, sets out that PSMA PET‑CT should be available as a routinely commissioned imaging option within defined clinical criteria.NHS England undertook an assessment of current service provision, clinical evidence, and projected demand. This included reviewing existing PET‑CT activity across regions to identify variation and to ensure that projected activity volumes for prostate cancer aligned with current patterns of use and expected regional need. NHS England also considered evidence on current provision and expert advice when determining its recommended commissioning position.With respect to the modelling assumptions underpinning projected PSMA PET‑CT activity levels, NHS England’s assessment drew on a review of clinical evidence, expected diagnostic pathways, and forward‑looking estimates of the number of patients with high‑risk primary or recurrent prostate cancer who would meet the criteria for PSMA PET‑CT. The Clinical Panel and commissioning groups considered evidence on current provision, anticipated future utilisation, and the role of PSMA PET‑CT where conventional imaging leaves clinically important uncertainties. These assessments are reflected in the policy documentation and supporting evidence reviews published by NHS England.The commissioning policy documents including the Clinical Panel report, Evidence Review, and associated materials, are publicly available on the NHS England website at the following link:https://www.england.nhs.uk/publication/psma-radiotracers-in-petct-imaging-for-individuals-with-high-risk-primary-or-recurrent-prostate-cancer/

Whether he plans to publish the methodology used by NHS England to calculate projected PET-CT activity volumes, including any assumptions relating to future demand growth and pathway developments in prostate cancer.

NHS England is responsible for commissioning prostate‑specific membrane antigen (PSMA) radiotracers for positron emission tomography–computed tomography (PET‑CT) imaging for adults with high‑risk primary or recurrent prostate cancer. The commissioning policy, published in February 2025, sets out that PSMA PET‑CT should be available as a routinely commissioned imaging option within defined clinical criteria.NHS England undertook an assessment of current service provision, clinical evidence, and projected demand. This included reviewing existing PET‑CT activity across regions to identify variation and to ensure that projected activity volumes for prostate cancer aligned with current patterns of use and expected regional need. NHS England also considered evidence on current provision and expert advice when determining its recommended commissioning position.With respect to the modelling assumptions underpinning projected PSMA PET‑CT activity levels, NHS England’s assessment drew on a review of clinical evidence, expected diagnostic pathways, and forward‑looking estimates of the number of patients with high‑risk primary or recurrent prostate cancer who would meet the criteria for PSMA PET‑CT. The Clinical Panel and commissioning groups considered evidence on current provision, anticipated future utilisation, and the role of PSMA PET‑CT where conventional imaging leaves clinically important uncertainties. These assessments are reflected in the policy documentation and supporting evidence reviews published by NHS England.The commissioning policy documents including the Clinical Panel report, Evidence Review, and associated materials, are publicly available on the NHS England website at the following link:https://www.england.nhs.uk/publication/psma-radiotracers-in-petct-imaging-for-individuals-with-high-risk-primary-or-recurrent-prostate-cancer/

What assessment he has made of whether the modelling assumptions underpinning projected PSMA PET-CT activity volumes within the forthcoming PET-CT commissioning arrangements are (a) forward-looking and (b) reflect clinical demand.

NHS England is responsible for commissioning prostate‑specific membrane antigen (PSMA) radiotracers for positron emission tomography–computed tomography (PET‑CT) imaging for adults with high‑risk primary or recurrent prostate cancer. The commissioning policy, published in February 2025, sets out that PSMA PET‑CT should be available as a routinely commissioned imaging option within defined clinical criteria.NHS England undertook an assessment of current service provision, clinical evidence, and projected demand. This included reviewing existing PET‑CT activity across regions to identify variation and to ensure that projected activity volumes for prostate cancer aligned with current patterns of use and expected regional need. NHS England also considered evidence on current provision and expert advice when determining its recommended commissioning position.With respect to the modelling assumptions underpinning projected PSMA PET‑CT activity levels, NHS England’s assessment drew on a review of clinical evidence, expected diagnostic pathways, and forward‑looking estimates of the number of patients with high‑risk primary or recurrent prostate cancer who would meet the criteria for PSMA PET‑CT. The Clinical Panel and commissioning groups considered evidence on current provision, anticipated future utilisation, and the role of PSMA PET‑CT where conventional imaging leaves clinically important uncertainties. These assessments are reflected in the policy documentation and supporting evidence reviews published by NHS England.The commissioning policy documents including the Clinical Panel report, Evidence Review, and associated materials, are publicly available on the NHS England website at the following link:https://www.england.nhs.uk/publication/psma-radiotracers-in-petct-imaging-for-individuals-with-high-risk-primary-or-recurrent-prostate-cancer/

What assessment he has made of the potential impact of the cost of shipping and air freight following the conflict in the Middle East on the supply of generic medicines to the UK; and what steps he is taking to mitigate that impact.

We continue to monitor the impact of the Middle East conflict on the medical supply chain, including on generic medicines. While we understand that transport costs have risen, there are currently no reported shortages of medicines due to the conflict.If shortages do occur, we have a range of well-established processes and tools to mitigate risks to patients. These include close and regular engagement with suppliers, use of alternative strengths or forms of a medicine to allow patients to remain on the same product, expediting regulatory procedures, sourcing unlicensed imports from abroad, adding products to the restricted exports and hoarding list, use of Serious Shortage Protocols, and issuing National Health Service communications to provide management advice and information on the issue to healthcare professionals including pharmacists, so they can advise and support their patients.

What plans his Department has for non-specific symptom pathways for earlier diagnosis of leukaemia and other blood cancers.

Early diagnosis is a key focus of the National Cancer Plan. It is a priority for the Government to support the National Health Service to diagnose cancer, including blood cancers, as early and quickly as possible, and to treat it faster, to improve outcomes.To tackle the late diagnoses of blood cancers including leukaemia, the NHS is implementing non-specific symptom pathways for patients who present with symptoms such as weight loss and fatigue, which do not clearly align to a tumour type. Blood cancers, including leukaemia, are one of the most common cancer types diagnosed through these pathways.The NHS will improve early diagnosis and quicker treatment of blood cancers, including leukaemia, by expanding diagnostic services with investments in magnetic resonance imaging and computed tomography scanners. Furthermore, the 10-Year Health Plan’s commitment to putting digital health at the heart of the future health service and integrating that with a single patient record and neighbourhood health services, will mean that cancer patients will get the joined-up care they deserve.

Whether the Life Sciences Sector Plan includes provision to protect and promote the resilience of the UK’s medicines supply chain.

A thriving life sciences sector is key to supporting the United Kingdom’s resilience and securing our medicines supply chain. Through the Life Sciences Sector Plan, the Government is making the UK one of the best places in the world to develop and manufacture new and innovative medicines and build onshore manufacturing capabilities.The sector plan commits to delivery of the Life Sciences Innovative Manufacturing Fund (LSIMF), which is providing up to £520 million in grants to companies to improve the UK’s manufacturing capability and resilience. So far, LSIMF grants have supported five companies, unlocking over £560 million of investment in life sciences manufacturing, and research and development, with further announcements expected in the coming weeks and months.

What assessment his Department has made of current and projected workforce needs in interventional radiology; and what steps his Department is taking to support training and recruitment in this specialty.

We set out in the 10-Year Health Plan for England that over the next three years we will create 1,000 new specialty training posts, with a focus on specialties where there is the greatest need. We will set out next steps in due course.The Government is committed to training the staff we need, including doctors, to ensure patients are cared for by the right professional, when and where they need it. We will publish a 10 Year Workforce Plan to set out action to create a workforce ready to deliver the transformed services set out in the 10-Year Health Plan.

What steps his Department is taking to increase the availability of interventional radiology services in England.

The Elective Reform Plan, which was published in January 2025, committed to increasing surgical and diagnostic capacity for services such as interventional radiology. This is a step towards returning to the National Health Service constitutional standard that 92% of patients wait no longer than 18 weeks from referral to consultant-led treatment.As a result of spending reviews in 2021 and 2025, diagnostic interventional radiology received capital funding for four interventional radiology suites.The Government has also committed £2.3 billion across diagnostics for the next three financial years. Trusts and regions are currently going through a competitive bidding process for this diagnostic funding, which is expected to conclude in spring 2026.

Whether his Department has made an assessment of regional variation in access to 24/7 interventional radiology services in England.

The Elective Reform Plan, which was published in January 2025, committed to increasing surgical and diagnostic capacity for services such as interventional radiology. This is a step towards returning to the National Health Service constitutional standard that 92% of patients wait no longer than 18 weeks from referral to consultant-led treatment.As a result of spending reviews in 2021 and 2025, diagnostic interventional radiology received capital funding for four interventional radiology suites.The Government has also committed £2.3 billion across diagnostics for the next three financial years. Trusts and regions are currently going through a competitive bidding process for this diagnostic funding, which is expected to conclude in spring 2026.

Pursuant to the Answer of 15 January 2026 to Question UIN 82954, what payments NHS England has made for waiting list data validation exercises (a) since 1 September 2025 and (b) in 2025–26 to date.

It has not proved possible to respond to the hon. Member in the time available before Prorogation.

What estimate his Department has made of the number of patient pathways removed from referral-to-treatment waiting lists following data validation exercises since 2020.

It has not proved possible to respond to the hon. Member in the time available before Prorogation.

How many patient pathways from the net reduction in the referral-to-treatment waiting list reported since 1 September 2025 were removed as a result of (a) completion of treatment and (b) data validation exercises.

It has not proved possible to respond to the hon. Member in the time available before Prorogation.

If he will bring forward legislative proposals to restrict the sale of high sugar and high caffeine energy drinks to children aged 16 and under before the next King's Speech.

The Government has a commitment to ban the sale of energy drinks to children under 16 years old, which is subject to a consultation. We subsequently ran a 12-week consultation, which was open from 3 September 2025 to 26 November 2025.We are carefully considering the responses to the consultation. We will set out further information on next steps in due course when we publish the Government’s response to the consultation.Should legislation be proposed following the consultation outcome the final timing for introducing legislation would depend on ministerial decisions following the consultation, impact assessment requirements, and the necessary parliamentary scrutiny.