Written questions by Andrew.

What steps his Department is taking to increase access to specialist care for patients with Postural Orthostatic Tachycardia Syndrome, including reducing waiting times to see clinicians with relevant expertise.

Postural orthostatic tachycardia syndrome (PoTS) is diagnosed by a combination of general practitioners (GPs) and specialist clinicians. GPs can diagnose PoTS in many cases but, if they are unsure of symptoms or if symptoms are complex, they will refer patients to specialists for diagnosis, or where patients do not respond to initial treatment, patients may be referred to specialised cardiology or neurology services. The Royal College of General Practitioners’ Syncope Toolkit provides information to GPs, including the use of the active stand test, to rule out other conditions and potentially diagnose PoTS more quickly. Management of PoTS typically involves lifestyle changes and medications to help control symptoms, and can involve support from a multidisciplinary team.Where patients are referred to secondary care for diagnosis, we are investing in additional capacity to deliver appointments to help bring waiting lists and times down. The Elective Reform Plan, published in January 2025, sets out the specific productivity and reform efforts needed to return to the constitutional standard, that 92% of patients to wait no longer than 18 weeks from referral to treatment, by March 2029.By expanding community-based services for routine monitoring and follow up, employing artificial intelligence for productivity, and investing in digital tools and data, as outlined in the 10-Year Health Plan, we can ensure that consultants’ time is reserved for complex cases of PoTS, including specialist diagnostic assessments.Integrated care boards (ICBs), with oversight from NHS England, have a statutory responsibility to commission services which meet the needs of their local populations, including for those with PoTS. It is the responsibility of ICBs to work with clinicians, service users, and patient groups to develop services and care pathways that meet the needs of patients with PoTS. While the Department recognises the significant challenges of PoTS diagnoses, responsibility for specific clinical pathways and specialist training rests with local National Health Service bodies.The Department has made no assessment of the impact of NHS policies on private access for patients with PoTS seeking faster access to specialist care.

Whether his Department has made an assessment of the adequacy of NHS referral pathways for patients with Postural Orthostatic Tachycardia Syndrome, including the coordination of care between cardiology and neurology services.

Postural orthostatic tachycardia syndrome (PoTS) is diagnosed by a combination of general practitioners (GPs) and specialist clinicians. GPs can diagnose PoTS in many cases but, if they are unsure of symptoms or if symptoms are complex, they will refer patients to specialists for diagnosis, or where patients do not respond to initial treatment, patients may be referred to specialised cardiology or neurology services. The Royal College of General Practitioners’ Syncope Toolkit provides information to GPs, including the use of the active stand test, to rule out other conditions and potentially diagnose PoTS more quickly. Management of PoTS typically involves lifestyle changes and medications to help control symptoms, and can involve support from a multidisciplinary team.Where patients are referred to secondary care for diagnosis, we are investing in additional capacity to deliver appointments to help bring waiting lists and times down. The Elective Reform Plan, published in January 2025, sets out the specific productivity and reform efforts needed to return to the constitutional standard, that 92% of patients to wait no longer than 18 weeks from referral to treatment, by March 2029.By expanding community-based services for routine monitoring and follow up, employing artificial intelligence for productivity, and investing in digital tools and data, as outlined in the 10-Year Health Plan, we can ensure that consultants’ time is reserved for complex cases of PoTS, including specialist diagnostic assessments.Integrated care boards (ICBs), with oversight from NHS England, have a statutory responsibility to commission services which meet the needs of their local populations, including for those with PoTS. It is the responsibility of ICBs to work with clinicians, service users, and patient groups to develop services and care pathways that meet the needs of patients with PoTS. While the Department recognises the significant challenges of PoTS diagnoses, responsibility for specific clinical pathways and specialist training rests with local National Health Service bodies.The Department has made no assessment of the impact of NHS policies on private access for patients with PoTS seeking faster access to specialist care.

Whether the National Cancer Plan will include measures to improve cancer research capacity in hospitals in the North of England.

Research is crucial in tackling cancer, which is why the Department invests over £1.6 billion per year in research through the National Institute for Health and Care Research (NIHR). Cancer is a major area of NIHR spending at £141.6 million in 2024/25, reflecting its high priority. Research is a key focus of the National Cancer Plan. The plan will seek to ensure advances in cancer research benefit patients across the country, including the North of England.The Department is committed to funding health and care research via the NIHR across England, to ensure that the research we support is inclusive and representative of the populations we serve.NIHR research infrastructure has national coverage across the whole of England across all geographies and settings. Our infrastructure schemes aim to build research capacity and capability across the country across all geographies and settings. In line with prior commitments, the Department has increased funding for research infrastructure schemes delivering cancer research in northern regions, including Biomedical Research Centres, Clinical Research Facilities, and HealthTech Research Centres.Through the NIHR Research Delivery Network, the NIHR provides funding and support to the National Health Service and other providers to deliver research, operating across 12 regions throughout the country. The North West, North East and North Cumbria, and Yorkshire and Humber Regional Research Delivery Networks operate in all NHS trusts that span the north of England, giving researchers and delivery teams the practical support they need locally so that more research can take place, and more people can take part.

Whether he plans to provide financial support to redress schemes relating to pelvic mesh and valproate proposed by devolved governments.

The Government is carefully considering the work 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. To progress this, I met with the patient safety commissioner late last year and we continue to work closely together. Should a decision be made for any United Kingdom-wide scheme, appropriate steps would also be taken to engage across the UK at the earliest opportunity. I am also in contact with ministers within the devolved administrations, with engagement between officials across the UK occurring regularly.

Whether his Department plans to involve cancer charities in the delivery and governance of the forthcoming National Cancer Plan.

The National Cancer Plan will build on the shift from hospital to community set out by the 10-Year Health Plan and will seek to foster improved collaboration with the voluntary and community sector to deliver this.Governance mechanisms for monitoring implementation and ensuring accountability for delivery will be established as part of the development of the National Cancer Plan, which will be published in the new year.

What consideration he has given to including prehabilitation and rehabilitation as core elements of cancer treatment in the forthcoming National Cancer Plan.

The Department is working with NHS England to support local systems to deliver effective rehabilitation and prehabilitation services. The National Cancer Plan will aim to improve how the physical and psychosocial needs of people with cancer can be met, with a focus on personalised care to improve quality of life. It will address how the experience of care can be improved for those diagnosed, treated, and living with and beyond cancer.

Whether his Department has made an assessment of the potential impact of NHS policies on private access for patients with Postural Orthostatic Tachycardia Syndrome seeking faster access to specialist care.

Postural orthostatic tachycardia syndrome (PoTS) is diagnosed by a combination of general practitioners (GPs) and specialist clinicians. GPs can diagnose PoTS in many cases but, if they are unsure of symptoms or if symptoms are complex, they will refer patients to specialists for diagnosis, or where patients do not respond to initial treatment, patients may be referred to specialised cardiology or neurology services. The Royal College of General Practitioners’ Syncope Toolkit provides information to GPs, including the use of the active stand test, to rule out other conditions and potentially diagnose PoTS more quickly. Management of PoTS typically involves lifestyle changes and medications to help control symptoms, and can involve support from a multidisciplinary team.Where patients are referred to secondary care for diagnosis, we are investing in additional capacity to deliver appointments to help bring waiting lists and times down. The Elective Reform Plan, published in January 2025, sets out the specific productivity and reform efforts needed to return to the constitutional standard, that 92% of patients to wait no longer than 18 weeks from referral to treatment, by March 2029.By expanding community-based services for routine monitoring and follow up, employing artificial intelligence for productivity, and investing in digital tools and data, as outlined in the 10-Year Health Plan, we can ensure that consultants’ time is reserved for complex cases of PoTS, including specialist diagnostic assessments.Integrated care boards (ICBs), with oversight from NHS England, have a statutory responsibility to commission services which meet the needs of their local populations, including for those with PoTS. It is the responsibility of ICBs to work with clinicians, service users, and patient groups to develop services and care pathways that meet the needs of patients with PoTS. While the Department recognises the significant challenges of PoTS diagnoses, responsibility for specific clinical pathways and specialist training rests with local National Health Service bodies.The Department has made no assessment of the impact of NHS policies on private access for patients with PoTS seeking faster access to specialist care.

Whether his Department has held recent discussions with the Scottish Government on the inclusion of data from NHS Scotland in the UK Pelvic Floor Registry; and what his expected timescale is for full UK-wide data integration.

As a Government department, the Department of Health and Social Care engages constructively and works collaboratively with the devolved administrations on areas of shared interest, including information sharing, coordination, and issues that have United Kingdom wide or cross-border implications.The NHS England Outcomes and Registries Programme invites relevant health professionals from the devolved nations to participate in monthly clinical steering groups across several clinical registries to foster collaboration and alignment of working practices. Wales and Northern Ireland have participated fully in the Pelvic Organ Prolapse and Stress Urinary Incontinence Clinical Steering Group. Scottish representatives last participated in November 2024, though they continue to be sent minutes of the progress of the NHS England-led Group.The registry is due to be launched across 50% of English providers in February, with a second wave covering the remaining English providers planned for summer 2026.

Whether he has considered including emergency presentation as a metric for tracking early cancer diagnosis across all tumour types, including non-stageable cancers such as leukaemia, in the forthcoming National Cancer Plan.

The National Cancer Plan will seek to improve outcomes for all cancers, including non-stageable cancers such as leukaemia. The Department remains committed to the early diagnosis of cancer and to improving outcomes for patients. However, we recognise that there is more to be done to ensure that patients with harder to stage cancers, such as blood cancer, receive fast and early diagnoses.The National Health Service 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 are one of the most common cancer types diagnosed through these pathways.We have engaged extensively with Cancer 52 and other cancer charities, including Leukaemia UK to inform development of the National Cancer Plan, which will be published shortly. We have listened to concerns about existing early diagnosis targets and considered the feasibility of adopting new metrics to track progress, including suggestions from stakeholders that we track emergency presentation. Further details on our approach to early diagnosis, including how we can improve outcomes for rarer cancers, will be set out in due course.

What assessment he has made of the adequacy of the time taken for leukaemia diagnosis; and whether his Department has made an assessment of the potential implications for its policies of the findings of Leukaemia UK’s Count Us In campaign.

The National Cancer Plan will seek to improve outcomes for all cancers, including non-stageable cancers such as leukaemia. The Department remains committed to the early diagnosis of cancer and to improving outcomes for patients. However, we recognise that there is more to be done to ensure that patients with harder to stage cancers, such as blood cancer, receive fast and early diagnoses.The National Health Service 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 are one of the most common cancer types diagnosed through these pathways.We have engaged extensively with Cancer 52 and other cancer charities, including Leukaemia UK to inform development of the National Cancer Plan, which will be published shortly. We have listened to concerns about existing early diagnosis targets and considered the feasibility of adopting new metrics to track progress, including suggestions from stakeholders that we track emergency presentation. Further details on our approach to early diagnosis, including how we can improve outcomes for rarer cancers, will be set out in due course.

Pursuant to the Answer of 2 December 2025 to Question 93696, what recent steps he has taken to implement the UK Rare Diseases Framework commitment to faster diagnosis; and how this is reflected in changes to the newborn screening programme.

The Government is committed to improving the lives of those living with rare diseases. Helping patients get a final diagnosis faster is one of the four priorities of the UK Rare Diseases Framework. We published the annual England action plan in February 2025, where we report on the steps we have taken to advance this priority. This year's plan updated on research we have commissioned to better understand what causes delays in diagnosis; the Generation Study to pilot whole genome sequencing of newborns in the National Health Service; and the work of the NHS Genomic Medicine Service.The current NHS Newborn Blood Spot Screening Programme enables early identification, referral and treatment of babies with 10 rare but serious conditions. In the United Kingdom, new screening programmes and modifications to existing screening programmes are recommended by the UK National Screening Committee (UK NSC). The UK NSC recommended newborn screening for hereditary tyrosinaemia type 1 in June 2022. The NHS began to offer it routinely in October 2025. An in-service evaluation (ISE) of screening for Severe Combined Immunodeficiency was launched in 2021 and closed on 27 October 2025. At the June 2023 UK NSC meeting, the Committee supported the need for a new independent model for spinal muscular atrophy (SMA) and agreed to plan for the SMA ISE. Evidence was published in August 2025, and is available at the following link: https://nationalscreening.blog.gov.uk/2025/08/07/uk-nsc-publishes-sma-screening-evidence-documents/ Planning and development work to shape the ISE of newborn screening for SMA is ongoing.

Whether he has made an assessment of the adequacy of therapeutic radiography apprenticeship provision; and what steps she is taking to support the long-term viability of those courses.

The department works closely with the Department for Health and Social Care to support the availability of a diverse range of training routes into health and care careers. We have worked with the health and care sector to design the Level 6 prosthetics and orthotics and Level 6 therapeutic radiography standards. These are approved for delivery and information about these standards, including funding bands, is published here and here. Apprenticeship providers are independent bodies responsible for making their own decisions about which courses they deliver.

Whether he has made an assessment of the sustainability of prosthetics and orthotics apprenticeship provision in England; and what steps she is taking to support its continuation.

The department works closely with the Department for Health and Social Care to support the availability of a diverse range of training routes into health and care careers. We have worked with the health and care sector to design the Level 6 prosthetics and orthotics and Level 6 therapeutic radiography standards. These are approved for delivery and information about these standards, including funding bands, is published here and here. Apprenticeship providers are independent bodies responsible for making their own decisions about which courses they deliver.

What discussions his Department has had with the Department for Education on supporting small healthcare professions whose training courses may be financially unviable despite being essential to NHS and community healthcare delivery.

The Department of Health and Social Care works closely with the Department for Education to support the availability of a diverse range of training routes into health and care careers. While the Government is committed to ensuring sustainable training pathways for small and vulnerable healthcare professions, higher education institutions are independent providers and are responsible for making their own decisions about course delivery and viability.

Pursuant to the Answer of 2 December 2025 to Question 93697, if he will meet with representatives of ArchAngel MLD Trust, the MPS Society, MLD Support UK, the LSD Collaborative, and Alex – The Leukodystrophy Charity before responding to the UK National Screening Committee’s forthcoming recommendation on Metachromatic Leukodystrophy.

My rt. Hon. Friend, the Secretary of State for Health and Social Care, will carefully consider a UK National Screening Committee (UK NSC) recommendation on metachromatic leukodystrophy when it is presented to him, before making a decision. The Secretary of State will ask officials to meet with representatives of ArchAngel MLD Trust, the MPS Society, MLD Support UK, the LSD Collaborative, and Alex – The Leukodystrophy Charity.

What assessment he has made of the potential impact on child development outcomes of not matching Start for Life funding with the expansion of Best Start Family Hubs.

We are committed to delivering the 10-Year Health Plan ambition to match Healthy Babies, formerly Start for Life, to Best Start Family Hubs over the next decade.There is strong evidence that the 1,001 days from pregnancy to the age of two years old set the foundations for our cognitive, emotional, and physical development. Supporting babies and their families in this period provides an opportunity to improve health and education outcomes and reduce inequalities, including on Early Years Foundation Stage domains.We have already started to deliver the shift from treatment to prevention by providing funding to 75 areas to deliver universal, prevention-focussed Healthy Babies services. From April, the Government is rolling out Best Start Family Hubs to all local authorities, backed by over £500 million to reach up to half a million more children and families. This funding will help embed hubs within a wider support system, including integrated child health services, and will enable proactive identification and support for health issues and early developmental delays.

Pursuant to the Answer of 2 December 2025 to Question 93697, whether he has made an estimate of the differences in the number of conditions screened for in newborns between the UK and other countries such as Norway, Australia, Italy, Poland, and the Netherlands; and how those differences relate to the internationally recognised criteria used by the UK National Screening Committee.

Screening programmes in the United Kingdom have a more rigorous approach towards evaluating the benefits and harms of screening compared to many other countries such as the United States of America and Italy.The independent UK National Screening Committee (UK NSC), which is made up of leading medical and screening experts, advises Ministers in all four nations of the UK on the evidence on screening. Where the Committee is confident that screening provides more good than harm, they recommend a screening programme.Some countries often cited as screening more conditions than the UK are not always running national programmes. Some countries or regions 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.

Whether his Department is undertaking a review into the prevalence and overdiagnosis of mental health conditions and neurodivergence.

On 4 December 2025, we launched an independent review into the prevalence and support for mental health conditions, attention deficit hyperactivity disorder (ADHD), and autism. The review will look to understand the similarities and differences between mental health conditions, ADHD, and autism. It will look at the prevalence, early intervention and treatment, and the current challenges facing clinical services. It will also examine the extent to which diagnosis, medicalisation, and treatment improve outcomes for individuals. This will include exploring the evidence around clinical practice and the risks and benefits of medicalisation.

What recent assessment he has made of trends in the level of diagnosis rates for mental health conditions in England.

On 4 December 2025, we launched an independent review into the prevalence and support for mental health conditions, attention deficit hyperactivity disorder (ADHD), and autism. The review will look to understand the similarities and differences between mental health conditions, ADHD, and autism. It will look at the prevalence, early intervention and treatment, and the current challenges facing clinical services. It will also examine the extent to which diagnosis, medicalisation, and treatment improve outcomes for individuals. This will include exploring the evidence around clinical practice and the risks and benefits of medicalisation.

Who his Department plans to consult as part of any review into the prevalence and overdiagnosis of mental health conditions and neurodivergence.

The independent review into prevalence and support for mental health conditions, attention deficit hyperactivity disorder (ADHD), and autism will appoint an advisory working group. This will be a multidisciplinary group of leading academics, clinicians, epidemiological experts, charities and people with lived experience to directly shape the recommendations and scrutinise the evidence.Ahead of launching the independent review, my Rt Hon. Friend, the Secretary of State for Health and Social Care, held discussions with a range of mental health, ADHD, and autism stakeholders on the scope of the review.As this is an independent review, it is therefore for the Chair and vice-chairs to consider who to consult and the relevant forums for engagement, that are relevant to deliver the terms of reference set by the Department.