Written questions by Collins.

What steps the MHRA is taking to address circumstances in which a previously used GMDN Level 2 code has been obsoleted or materially amended at the point of mandatory device registration renewal.

Global Medical Device Nomenclature (GMDN) Codes and Categories are managed by the GMDN Agency. The GMDN Agency may obsolete GMDN Codes within a hierarchy of GMDN Categories. If a GMDN Code is obsoleted, the Medicine and Healthcare products Regulatory Agency (MHRA) will receive a feed notifying it of the GMDN Code obsolescence. When a GMDN Code becomes obsolete, the MHRA notifies all registrants that are impacted by the obsolescence. Applicants are notified within the MHRA Device Online Registration System (DORS). The applicant can then update the obsolete GMDN Code to an active GMDN Code within DORS.If a newly selected active GMDN Code falls within a different GMDN Level 2 Category, or Level 1 Category where no Level 2 Category exists, an annual fee may become payable from 1 April of the following year at the time of renewal. The fee will be charged if the newly selected GMDN Code is the only device within the chargeable category.

What recent steps he has taken to increase access to GP appointments.

This government has invested an extra £1.6 billion into general practice since coming into office, recruited over 2000 GPs, and extended access to online services throughout core hours, delivering 6.8 million more appointments, 46,000 more benefiting your constituents in the last year. Thanks to the steps the government has taken, 75% of patients now say it is easy to contact their GP, up a sizeable 14 percentage points since July 2024, a very positive development that I’m sure the honourable lady would wish to welcome. In our manifesto we pledged to end the 8am scramble - and that is precisely what we are doing.

With reference to the National Institute for Health and Care Research's news story entitled NIHR launches £13.7 million investment into brain tumour research, published on 19 December 2025, whether the funding allocated to brain tumour research through the NIHR Brain Tumour Research Consortium includes specific funding to increase tissue freezing capacity and standardise access to tumour storage across NHS trusts and health boards to allow all eligible brain cancer patients to have genomic sequencing, clinical trials, and advanced diagnostics.

The Department invests over £1.6 billion each year in research through the National Institute of Health and Care Research (NIHR).In January 2026, the NIHR announced increased investment of over £25 million in the NIHR Brain Tumour Research Consortium. The world-leading consortium aims to transform outcomes for adults and children and their families who are living with brain tumours, ultimately reducing lives lost to cancer. Its activities will include:enrolling patients to a ‘Real World’ study tracking their progress in everyday medical settings, before matching them to new clinical trials based on their cancer subtype;developing pioneering new clinical trials, including platform trials, to test medicines and radiotherapy technologies, immunotherapies, and novel gene therapies. This includes targeted precision medicine; anddeveloping new training programmes for those working in brain cancer research to build capacity and increase skills among the next generation of researchers.It is anticipated that this funding will include costs associated with freezer capacity to house frozen tissue and liquid biopsy samples specifically to support the consortium’s activities. The consortium will also engage with partners on the standardised pathways for tissue storage and whole genome sequencing for all patients for stratification into clinical trials.In addition, the NIHR’s investments for capital equipment, technology, and modular buildings support National Health Service trusts across England to deliver high-quality research to improve the health of the population. This investment includes cutting edge research equipment and fixed assets such as ultra-low and cryogenic freezers, to strengthen research capacity and improve access to samples for research.

With reference to the National Institute for Health and Care Research's news story entitled NIHR launches £13.7 million investment into brain tumour research, published on 19 December 2025, what assessment his Department has made of the potential impact of funding the NIHR Brain Tumour Research Consortium and Brain Tumour Research Centres of Excellence on the level of patient access to tumour tissue freezing within routine NHS neuro-oncology pathways, including access for patients treated outside specialist centres to sequencing, research, and clinical trials.

The Department invests over £1.6 billion each year in research through the National Institute of Health and Care Research (NIHR).In January 2026, the NIHR announced increased investment of over £25 million in the NIHR Brain Tumour Research Consortium. The world-leading consortium aims to transform outcomes for adults and children and their families who are living with brain tumours, ultimately reducing lives lost to cancer. Its activities will include:enrolling patients to a ‘Real World’ study tracking their progress in everyday medical settings, before matching them to new clinical trials based on their cancer subtype;developing pioneering new clinical trials, including platform trials, to test medicines and radiotherapy technologies, immunotherapies, and novel gene therapies. This includes targeted precision medicine; anddeveloping new training programmes for those working in brain cancer research to build capacity and increase skills among the next generation of researchers.It is anticipated that this funding will include costs associated with freezer capacity to house frozen tissue and liquid biopsy samples specifically to support the consortium’s activities. The consortium will also engage with partners on the standardised pathways for tissue storage and whole genome sequencing for all patients for stratification into clinical trials.In addition, the NIHR’s investments for capital equipment, technology, and modular buildings support National Health Service trusts across England to deliver high-quality research to improve the health of the population. This investment includes cutting edge research equipment and fixed assets such as ultra-low and cryogenic freezers, to strengthen research capacity and improve access to samples for research.

What assessment his Department has made of the potential merits of funding the full cost of specialist palliative care delivered by hospices.

Integrated care boards (ICBs) are responsible for commissioning palliative care services to meet the reasonable needs of their population, which can include hospice services available within the ICB catchment. To support ICBs in this duty, NHS England has published statutory guidance and a service specification. The Government is developing a Palliative Care and End-of-Life Care Modern Service Framework (MSF) for England. The MSF will drive improvements in the services that patients and their families receive at the end of life and will enable ICBs to address challenges in access, quality, and sustainability through the delivery of high-quality, personalised care. Through our MSF, we will closely monitor the shift towards the strategic commissioning of palliative care and end-of-life care services to ensure that services reduce variation in access and quality. We will consider contracting and commissioning arrangements as part of our MSF. We recognise that there is currently a mix of contracting models in the hospice sector. By supporting ICBs to commission more strategically, we can move away from grant and block contract models. In the long term, this will aid sustainability and help hospices’ ability to plan ahead. The recently published Strategic Commissioning Framework and Medium-Term Planning Guidance also make clear the expectations that ICBs should understand current and projected total service utilisation and costs for those at the end of life, creating an overall plan to more effectively meet these needs through neighbourhood health. Hospices provide both core and specialist palliative care. Whilst acknowledging that not everyone will need specialist palliative care, we must ensure is that there is equitable and timely access to these services, whether they are provided by hospices or the National Health Service. While no specific assessment has been made of the cost of changes in the levels of funding to hospices on the wider healthcare system, as part of our 10-Year Health Plan, the Government will shift the focus of healthcare out of the hospital and into the community. We recognise that it is vital to include palliative care and end-of-life care, including hospices, in this shift.

What assessment his Department has made of the cost of changes in the levels of funding to hospices on the wider healthcare system.

Integrated care boards (ICBs) are responsible for commissioning palliative care services to meet the reasonable needs of their population, which can include hospice services available within the ICB catchment. To support ICBs in this duty, NHS England has published statutory guidance and a service specification. The Government is developing a Palliative Care and End-of-Life Care Modern Service Framework (MSF) for England. The MSF will drive improvements in the services that patients and their families receive at the end of life and will enable ICBs to address challenges in access, quality, and sustainability through the delivery of high-quality, personalised care. Through our MSF, we will closely monitor the shift towards the strategic commissioning of palliative care and end-of-life care services to ensure that services reduce variation in access and quality. We will consider contracting and commissioning arrangements as part of our MSF. We recognise that there is currently a mix of contracting models in the hospice sector. By supporting ICBs to commission more strategically, we can move away from grant and block contract models. In the long term, this will aid sustainability and help hospices’ ability to plan ahead. The recently published Strategic Commissioning Framework and Medium-Term Planning Guidance also make clear the expectations that ICBs should understand current and projected total service utilisation and costs for those at the end of life, creating an overall plan to more effectively meet these needs through neighbourhood health. Hospices provide both core and specialist palliative care. Whilst acknowledging that not everyone will need specialist palliative care, we must ensure is that there is equitable and timely access to these services, whether they are provided by hospices or the National Health Service. While no specific assessment has been made of the cost of changes in the levels of funding to hospices on the wider healthcare system, as part of our 10-Year Health Plan, the Government will shift the focus of healthcare out of the hospital and into the community. We recognise that it is vital to include palliative care and end-of-life care, including hospices, in this shift.

For what reason business rates treatment is different for community pharmacies and (a) GP and (b) NHS dentist surgeries; and whether his Department plans to extend business rate reimbursements to community pharmacies.

Community pharmacy, general practice and National Health Service dental surgeries all play a vital role in delivering our Neighbourhood Health Service offer for communities across the country. They are treated differently in relation to business rates because GP practices and most NHS dental services have their premises costs reimbursed under NHS contracts, whereas community pharmacies are treated as retail businesses and do not have a comparable, automatic reimbursement mechanism for business rates.That difference in this treatment is rooted in how each service is commissioned, contracted, and classified. Community pharmacy have been afforded support through the business rates relief for retail, hospitality or leisure which is not provided for general practice or dental surgeries. From 2026, this relief is being replaced by two lower business rates multipliers for properties with a rateable value below £500,000.

What assessment his Department has made of the potential impact of reductions in local authority public health nursing contracts on prevention and community-based care.

Decisions related to public health nursing contracts are taken at a local level.Public health nursing has been funded by local authorities since 2015 through the Public Health Grant. We increased the Public Health Grant by £224 million this year, 2025/26, to support local authorities to deliver public health services. We will continue to invest in local authorities' vital public health work, providing over £13.4 billion, a 5.6% cash increase, over the next three years through a consolidated ringfenced Public Health Grant. This is the first three-year public health settlement in a decade, giving local authorities far greater certainty over their future funding and supporting their ability to plan ahead. We have refreshed guidance for the Healthy Child Programme to strengthen service delivery and promote consistency in the quality of public health nursing across the country. This guidance is due for publication in early 2026.

Whether his Department plans to introduce a statutory right to access free period products.

The Government recognises the importance of women and girls being able to access the care they need for their reproductive health, including period products.We know that poverty doesn’t recognise gender, and that women and girls may suffer given the cost of period products. However, we know that period poverty reflects wider cost-of-living pressures, which is why the Government is tackling the root causes of poverty, through measures to make work pay, boosting the living wage, and investing in public services, so no one has to go without the essentials.There are a number of schemes across the Government which ensure that those who are most vulnerable can access the products they need. The Department for Education’s Period Products scheme launched in 2020 and provides free period products to girls and women in their place of study so that nobody misses out on education because of their period. Similarly, all women and girls being cared for by the National Health Service are entitled to be given, upon request, appropriate period products free of charge.We are also taking steps to ensure that products are as affordable as possible, as the tax on period products has been zero-rated since 2021, and in 2023 this was extended to include reusable period underwear.

What assessment his Department has made of the potential impact of Agenda for Change mileage reimbursement rates, including the change to the rate for travelling over 3,500 miles annually, on the (a) recruitment and (b) retention of community-based NHS staff.

This specific assessment has not been made. As set out in the NHS Terms and Conditions of Service Handbook, which is maintained by the NHS Staff Council, mileage reimbursement rates are reviewed twice a year in April and November.The outcome of the November 2025 review resulted in reimbursement rates reducing due to sustained decreases in fuel prices for the 12-month period ending in October 2025. Reimbursement rates dropped to 56 pence per mile for the first 3,500 miles claimed before dropping to 21 pence per mile thereafter. The revised rates apply to mileage incurred from 1 January 2026 onwards.These changes apply to all staff directly employed in England under Agenda for Change terms and conditions and Resident Doctors. There are no specific rates for community staff.

What assessment his Department has made of the potential merits of enabling children waiting over 26 weeks for a paediatric appointment to be seen by alternative NHS-commissioned providers.

Patients in England have a right to request their local integrated care board (ICB) find an alternative provider when they have been waiting, or expect to wait, over 18 weeks to begin treatment for consultant-led care.ICBs are required to take all reasonable steps to ensure the patient is offered an appointment with a clinically appropriate alternative provider with whom an ICB or NHS England has an NHS Standard Contract for the relevant service, who can start their treatment more quickly. Further information is available on the NHS Choice Framework at the following link:https://www.gov.uk/government/publications/the-nhs-choice-framework/

How many children have waited more than (a) 26 and (b) 40 weeks for an initial paediatric referral triage in the most recent 12-month period for which data is available.

We do not hold data on how many children have waited more than 26 and 40 weeks for an initial paediatric referral triage in the most recent 12-month period.Published referral to treatment data covers the period on waiting time from referral to first definitive treatment.

What guidance his Department has issued to Integrated Care Boards on clinically prioritising children whose symptoms are deteriorating while awaiting paediatric referral allocation.

The Government is committed to ensuring that patient outcomes will be at the heart of building a National Health Service that is fit for the future.National planning guidance sets expectations for systems to prioritise clinically urgent cases and those at risk of deterioration. The NHS triages patients waiting for elective care at a local level, ensuring the order in which patients are seen reflects clinical judgement on need as well as taking into account overall wait time.We have committed to ensuring that integrated care boards and providers have interventions in place to reduce disparities for groups who face additional waiting list challenges, and primary and secondary care clinicians are to improve e-RS functionality, a national digital platform for referring patients into elective care, by including data to enable better prioritisation of children and young people.The clinically led Getting It Right First Time children and young people programme continue to work with providers to ensure they are implementing best practice to improve children’s outcomes and waiting times across all medical and surgical specialities.

What steps his Department is taking to provide support or funding to NHS Trusts with paediatric waiting times exceeding 26 weeks.

The Government’s ambition is to restore performance against the NHS Constitutional standard, which requires 92% of patients to start consultant-led treatment within 18 weeks.All waiting lists are subject to clinical prioritisation at a local level. The National Health Service triages patients waiting for elective care, including surgeries, ensuring the order in which patients are seen reflects clinical judgement on need as well as taking into account overall wait time.The Spending Review 2025 has prioritised health, with record investment in the health and social care system, including investment in elective services. Through the Spending Review, the Government announced that NHS day to day spending will increase by £29 billion in real terms by 2028/29 compared to 2023/24.The Department recognises the impact of long waits on children and young people and is committed to reducing paediatric waiting times.Through the Elective Recovery Plan, we have invested in additional capacity, including surgical hubs, community diagnostic centres, and increased use of the independent sector to support challenged trusts.Targeted support is provided via Getting It Right First Time and specialty-specific improvement programmes, including paediatric ear, nose, and throat, and ophthalmology. National planning guidance sets expectations for systems to prioritise clinically urgent cases and those at risk of deterioration.

What the average waiting time is for paediatric referrals in (a) East and North Hertfordshire NHS Trust, (b) Hertfordshire and West Essex ICB and (c) England; and what steps his Department is taking to reduce paediatric referral backlogs.

The median average waiting time for paediatric referrals for those that are currently on the referral to treatment waiting list is:- 8.7 weeks for the East and North Hertfordshire NHS Trust;- 8.7 weeks for the Hertfordshire and West Essex Integrated Care Board (ICB); and- 9.9 weeks for England.Our Elective Reform Plan (ERP), published in January 2025, sets out how the National Health Service will reform elective care services and meet the 18-week referral to treatment standard for all patients, including children and young people, by March 2029. As a first step to achieving this, we exceeded our pledge to deliver an extra two million operations, scans, and appointments in our first year of Government, delivering 5.2 million more appointments.We have made it easier to monitor elective waiting times for children and young people by publishing new demographic data as part of monthly inequalities statistical releases. This is a big step forward in improving the transparency of waiting times and will provide accountability for children’s elective waiting lists.The ERP outlined several commitments specifically in relation to children and young people including that ICBs and providers should ensure interventions are in place to reduce disparities for groups who face additional waiting list challenges, and that primary and secondary care clinicians are encouraged to improve digital referral functionality by including data that enables better prioritisation.In addition, the clinically led Getting It Right First Time Children and Young people programme continues to work with providers to ensure they are implementing best practice to improve children’s outcomes and waiting times across all medical and surgical specialities.Lastly, dedicated paediatric surgery days are being introduced across England, using existing NHS estate in day surgery or hub settings, to boost surgical activity for children and young people. We are also making the most of surgical hubs to deliver better outcomes for children, through promoting greater paediatric ear, nose, and throat access. Surgical hubs will play a key role in delivering this increased activity and ensuring timely access to planned care.

What assessment he has made of the potential impact of the Medicines and Healthcare products Regulatory Agency’s proposed annual registration fees for medical devices under the Device Online Registration System on (a) small and (b) micro medical device manufacturers; and what steps he is taking to ensure that those fees do not disproportionately affect family-run and other niche low-volume manufacturers.

The new medical devices registration fee is designed to be proportionate to the breadth of presence of each manufacturer across the medical device market in Great Britain. In response to consultation feedback, the fee has been set at the minimum number of Global Medical Device Nomenclature (GMDN) Level 2 Categories that cover a manufacturer’s registered products. GMDN Level 2 Categories are sufficiently broad to cover the product range of a typical small or micro company. Based on the registration data held in November 2025, 55% of manufacturers will only pay a single fee of £300. The Medicines and Healthcare products Regulatory Agency (MHRA) is currently contacting all manufacturers individually, setting out the number of GMDN Level 2 Categories they would be charged for, based on their registrations in November 2025. This is part of an ongoing MHRA campaign to ask manufacturers to review their registrations before 31 March 2026, to ensure that they have only registered products they manufacture and place on the market. This exercise is likely to increase the number of manufacturers only paying one fee of £300. The MHRA has strengthened the safety and surveillance system for medical devices following the post-market surveillance legislation, SI 2024 No. 1368, that came into force on 16 June 2025. In addition to the clear benefits to patient safety, the new legislation and resulting increased post-market surveillance requirements are a critical enabler of the MHRA’s more risk-proportionate, pro-innovation approach to regulation that is heralded in the NHS 10-year plan as the MHRA can be more confident in picking up safety issues in real world data.

What steps he is taking to (a) ensure that medical device manufacturers can verify the General Medical Device Nomenclature categories and associated charges used to calculate their annual registration fees under the Device Online Registration System and (b) minimise duplicative regulatory and registration costs for UK-based manufacturers arising from divergence between the UK regime and the EU’s EUDAMED system.

When the registration system updates for collecting the new medical device registration fee go live on 1 April 2026, the system will have the functionality to show manufacturers the Global Medical Device Nomenclature (GMDN) Level 2 Categories they are being charged for. In the meantime, the Medicines and Healthcare products Regulatory Agency (MHRA) will make available, to customers who specifically request this, the breakdown of GMDN Level 2 Categories they would be charged for, based on their registrations this November. The MHRA has made it clear to customers that these are estimates only. This is part of an ongoing MHRA campaign to ask manufacturers to review their registrations before 31 March 2026, to ensure that they have only registered the products they place on the market. Another round of more accurate fee estimates in late February/early March 2026 is planned. The MHRA has strengthened the safety and surveillance system for medical devices following the post-market surveillance legislation, SI 2024 No. 1368, that came into force on 16 June 2025. In addition to the clear benefits to patient safety, the new legislation and resulting increased post-market surveillance requirements are a critical enabler of the MHRA’s more risk-proportionate, pro-innovation approach to regulation that is heralded in the NHS 10-year plan as the MHRA can be more confident in picking up safety issues in real world data. The MHRA post market surveillance depends on the registration of all medical devices in the United Kingdom. The UK is not involved in the European database on medical devices, or EUDAMED, and the market surveillance mechanisms it supports.

What steps his Department is taking to develop national guidelines and quality standards for vision rehabilitation services; and if he will commission the National Institute for Health and Care Excellence to develop evidence-based standards in this area.

The National Institute for Health and Care Excellence (NICE) is the independent body that develops authoritative, evidence-based guidelines and quality standards for the health and care system on best practice. Topics for the development of NICE guidelines and quality standards are identified by the NICE prioritisation board, chaired by the NICE Chief Medical Officer, in line with its published prioritisation framework. NICE does not currently have any plans to develop a guideline or quality standard on vision rehabilitation. The NICE prioritisation board considered vision rehabilitation as a potential topic for the development of guidance in August 2024 and concluded that there is insufficient evidence in this area to develop useful guidance.

If he will bring vision rehabilitation services under the same regulatory and monitoring framework as other adult social care services; and what assessment he has made of the potential merits of doing so.

Under the Care Act 2014, local authorities have the duty to shape their care market and to commission a range of high-quality, sustainable, and person-centred care and support services to meet the diverse needs of all local people. This includes encouraging a wide range of service provision to ensure that people, including those with sight loss, have a choice of appropriate services and equipment that maximises independence.Although the Care Quality Commission (CQC) is not currently required to assess vision rehabilitation services, as regulated activities under the Health and Social Care Act 2008, sensory services, including vision rehabilitation, do form part of CQC’s overall assessment of local authorities’ delivery of adult social care.CQC assessments identify local authorities’ strengths and areas for development, in their delivery of their duties under part 1 of the Care Act. This facilitates the sharing of good practice and helps us to target support where it is most needed. It may be helpful to know that the CQC will report on sensory services when there is something important to highlight, for example, something being done well, innovative practice, or an area for improvement.

What steps his Department is taking to support clinical trials for multi-compound cannabis-based medicinal products for the treatment of drug-resistant epilepsy in children.

The Department commissions research through the National Institute for Health and Care Research (NIHR). The NIHR is funding two trials to investigate the safety and efficacy of cannabinoid treatments for drug-resistant epilepsy in both adults and children. Further detail on the trials can be found on the NIHR’s website, at the following link:https://fundingawards.nihr.ac.uk/award/NIHR131309The Department is committed to ensuring that all patients, including those with epilepsy, have access to cutting-edge clinical trials and innovative, lifesaving treatments. We are working to fast-track clinical trials to drive global investment into life sciences, improve health outcomes, and accelerate the development of the medicines and therapies of the future, including treatments for epilepsy.