Written questions by Collins.

What discussions he has had with NHS England on including postural orthostatic tachycardia syndrome training in junior doctor specialty training programmes.

No discussions have been held. The curricula for postgraduate training are set by the Academy of Medical Royal Colleges for foundation training, and by individual royal colleges and faculties for specialty training. The General Medical Council approves curricula and assessment systems for each training programme. Whilst not all curricula may necessarily highlight a specific condition, they all nevertheless emphasize the skills and approaches a doctor must develop in order to ensure accurate and timely diagnoses and treatment plans for their patients.

What steps his Department is taking to tackle ensure that children have access to health play services in (a) children's hospitals and (b) children's wards in district general hospitals.

The Department recognises the importance of supporting and maintaining children’s right to play in healthcare settings, because games and active play in all settings build social skills and promote children’s well-being.To support this, in June 2025 NHS England and Starlight, a national charity for children’s play in healthcare, co-published the Play Well Toolkit. The toolkit provides guidance on best practice, and includes a checklist to support the auditing, monitoring, and evaluation of services. NHS England is promoting the Play Well toolkit to managers of health play services across a wide range of settings, including community clinics, emergency departments, children’s hospices, and acute paediatric wards.

What steps his Department is taking to ensure that patients with postural orthostatic tachycardia syndrome have access to (a) specialist (i) clinicians, (ii) nurses, (iii) physiotherapists, (iv) occupational therapists, (v) dieticians and (vi) clinical psychologists and (b) (A) equipment and (B) clinic space in Harpenden and Berkhamsted constituency.

Services for people with postural tachycardia syndrome (PoTS) are commissioned locally by integrated care boards (ICBs). ICBs have a statutory responsibility to provide a health service to the local population, subject to local prioritisation and funding, which includes access to specialist medical services for people with PoTS as appropriate.The treatment of patients with PoTS in the Harpenden and Berkhamsted constituency area is managed on an individual, case-by-case basis. A multi-disciplinary team approach has been adopted, involving specialists such as physiotherapists, cardiologists, and neurologists. Patients are referred into specialist centres in London if their diagnosis or treatment requires a more specialist approach or facilities.More widely, the Government is committed to publishing a 10 Year Workforce Plan which will ensure that the National Health Service has the right people in the right places, with the right skills to care for patients, when they need it, including for patients with PoTS.

What steps his Department is taking to ensure that the NHS Cancer Vaccine Launch Pad includes clinical trials for brain cancer.

The NHS Cancer Vaccine Launch Pad (CVLP) is a platform set up to accelerate the development of cancer vaccines and speed up access to mRNA personalised cancer vaccine clinical trials for cancer patients. The CVLP has been instrumental in accelerating trial activity in cancer research, with CVLP sites driving faster activation and enrolment timelines. The platform is designed to be company and clinical trial type agnostic, and so any company that wishes to deliver trials via the platform, including those developing vaccines for brain tumours, can contact the CVLP to explore how the platform can support their research.

What recent discussions he has had with (a) National Institute for Health and Care Excellence, (b) NHS England, (c) the Medicines and Healthcare products Regulatory Agency, (d) the National Institute for Health and Care Research and (e) the Medical Research Council on (i) expediting and (ii) improving access to (A) novel treatments, (B) therapeutics and (C) technologies for brain cancer patients.

The Department recognises that there are currently limited treatment options available for people who have been diagnosed with brain tumours, and the significant impact that rarer forms of cancer can have on patients, carers, and their families. That is why the Department is committed to working closely with partners and patient groups to shape the long-term vision for cancer.The Department has regular discussions with system partners on a number of topics, including access to novel treatments, therapeutics, and technologies for brain cancer patients. The National Institute for Health and Care Excellence evaluates the clinical and cost effectiveness of all new licensed medicines, including for the treatment of brain cancer, and aims to issue guidance on whether they should be routinely funded by the National Health Service in England as close as possible to licensing.The Department has engaged widely with stakeholders as part of the development of the National Cancer Plan, which will include further details on how the Government will improve outcomes for cancer patients, as well as speeding up diagnosis and treatment, ensuring patients have access to the latest treatments and technology.Furthermore, a new national Brain Tumour Research Consortium was established in December 2024, funded by the National Institute for Health and Care Research, to bring together researchers from a range of different disciplines and institutions with the aim of driving scientific advancements in how to prevent, detect, manage, and treat cancers in adults and children. The work being undertaken by the consortium aims to ensure that patients have access to the latest treatments and technology and to clinical trials.The Government also supports the Rare Cancers Private Members Bill. The bill will make it easier for clinical trials on brain cancer to take place in England, by ensuring the patient population can be more easily contacted by researchers.The Medicines and Healthcare products Regulatory Agency is engaging with industry and patient stakeholder groups to see how the agency can encourage research and product licencing in this area. It remains focused on enabling safe access to innovative treatment as rapidly as possible.

If he will make it his policy to renew the National Maternity Safety Ambition at the end of 2025.

Our commitment to set an explicit target to close the black and Asian maternal mortality gaps has not wavered. Addressing the shocking inequalities that exist across maternity and neonatal services is fundamental to ensuring that all women and babies receive safe, personalised, and compassionate care.We are working closely with NHS England, and the wider sector, to identify the right actions and interventions to tackle the stark inequalities that exist. The Government is committed to setting an explicit target to close the black and Asian maternal mortality gap. We are ensuring that we take an evidence-based approach, and that any targets set are women and baby centred.It is vital that the system is supported with the right actions to meet any target or ambition set. This is why, through the national investigation and taskforce, we will work with families and stakeholders to develop further actions to meet our ambitions.

If his Department will consider adopting new National Maternity Safety Ambitions to eliminate inequalities in maternal and neonatal outcomes based on ethnicity and deprivation.

Our commitment to set an explicit target to close the black and Asian maternal mortality gaps has not wavered. Addressing the shocking inequalities that exist across maternity and neonatal services is fundamental to ensuring that all women and babies receive safe, personalised, and compassionate care.We are working closely with NHS England, and the wider sector, to identify the right actions and interventions to tackle the stark inequalities that exist. The Government is committed to setting an explicit target to close the black and Asian maternal mortality gap. We are ensuring that we take an evidence-based approach, and that any targets set are women and baby centred.It is vital that the system is supported with the right actions to meet any target or ambition set. This is why, through the national investigation and taskforce, we will work with families and stakeholders to develop further actions to meet our ambitions.

What assessment his Department has made of the adequacy of the steps taken by NHS England to ensure (a) transparency when maternal and neonatal care goes wrong and (b) that bereaved parents receive full answers on (i) their and (ii) their babies’ care.

In June 2025, the Secretary of State for Health and Social Care announced measures to hold National Health Service maternity and neonatal services to greater account and improve transparency. This included the introduction of a new early warning system, powered by a real-time data tool, to detect safety issues earlier and allow action to be taken more swiftly to improve outcomes. Since the announcement, the NHSE Chief Executive has met with leaders of the four trusts of greatest concern in maternity and neonatal care. He set out the priority they need to give to turning around their services in Leeds, Gloucester, Mid and South Essex, and Sussex, with ongoing oversight and support being led by Regional Directors. As set out in the terms of reference for the independent national Investigation into NHS maternity and neonatal services announced by the Secretary of State, the Investigation will assess the quality of the response of NHS trusts and integrated care boards (ICBs) when things go wrong or harm occurs, including investigating and learning from incidents and promoting honesty, transparency and candour. The Investigation, chaired by Baroness Amos, will develop and publish one set of national recommendations. These recommendations will be taken forward by the National Maternity and Neonatal Taskforce, chaired by Secretary of State for Health, and formed into a national action plan to help bereaved and harmed families to receive justice and accountability.

Whether he has made a comparative assessment of neonatal death rates in (a) the UK and (b) other European countries in the last ten years.

The United Kingdom neonatal mortality rate for babies after at least 24 weeks of pregnancy decreased between 2013 and 2020, before rising in 2021 and 2022 and falling slightly in 2023.This is similar to the trend across Europe, where rates generally decreased or fluctuated about a similar level between 2015 to 2019.In 2019, the UK neonatal mortality rate was slightly higher than the median across Europe.

What steps his Department is taking to establish routine data collection on miscarriages.

An update to digital record standards on maternity means that the National Health Service is now able to record the pregnancy outcome for any woman, including miscarriage, where they have been in contact with NHS maternity services.

What steps his Department is taking to support families who have experienced baby loss in Harpenden and Berkhamsted constituency.

East and North Hertfordshire NHS Trust, the Princess Alexandra Hospital NHS Trust and West Hertfordshire Teaching Hospitals NHS Trust all provide seven-day maternity bereavement care, meaning women and families can access support from a maternity professional trained in specialist bereavement care.Watford General Hospital has a team of midwives who provide families with individualised support and specialist bereavement care when faced with the death of their baby. The hospital has also opened the Rose Room, a special space for families who experience the loss of a baby to spend time with their baby and begin to process their grief. There are facilities for families and siblings, including hand and foot casting services, to provide lasting memories.The Hertfordshire Perinatal Trauma and Loss Care service is a psychology-led, county-wide specialist service for people who are experiencing moderate to severe mental health difficulties as a direct result of a perinatal loss of any kind, including loss by separation through safeguarding processes.The charity Petals is also now able to provide specialist counselling support to bereaved parents who are Hertfordshire residents, no matter where their maternity care was delivered.

What assessment his Department has made of the adequacy of mandatory training requirements for food handlers in businesses serving the public on increasing awareness of (a) allergens, (b) gluten-free diets and (b) other food hygiene regulations for people with coeliac disease.

Under United Kingdom law, food business operators must ensure that staff training is appropriate to the type of food handled, including high-risk foods such as those containing allergens or gluten. While there is no standalone legal requirement for allergen-specific training, the Food Standards Agency provides free online allergy training, allergen guidance for food businesses, and technical guidance on food allergen labelling, which includes gluten-free considerations.While food allergen training is the responsibility of the food business operator, local authorities assess its adequacy during inspections to ensure compliance with allergen management requirements.

Whether his Department plans to update information on the commissioning framework within the NHS England guidance entitled Prescribing Gluten Free Foods in Primary Care: Guidance for CCGs, published on 28 November 2018.

No recent assessment has been made by the Department. However, a review was undertaken in 2019, which confirmed that the position in England remains that gluten free (GF) bread and mixes can be provided to all eligible coeliac patients on a National Health Service prescription. A wide range of these items continues to be listed in Part XV of the Drug Tariff.NHS England developed guidance on Prescribing Gluten Free Foods in Primary Care in 2018 which states that NHS commissioners can restrict the prescribing of GF foods to bread and mixes only. Under the current legislation, integrated care boards may choose to further restrict product choice, or end prescribing of GF foods altogether, if they feel this is appropriate for their population, whilst taking account of their legal duties to advance equality and having regard to reducing health inequalities. NHS England currently has no plans to update the guidance.

What assessment he has made of the adequacy of access to specialist psychological support for parents following pregnancy or baby loss in each region; and what steps his Department is taking to ensure that all bereaved parents can access such support through the NHS regardless of where they live.

The Government is determined to ensure all women and babies receive the high-quality care they deserve, regardless of their background, location or ethnicity. That is why the Secretary of State has set up a rapid, national, independent Investigation into National Health Service maternity and neonatal services to understand the systemic issues behind why so many women, babies and families experience unacceptable care. The Investigation will deliver interim recommendations in December 2025, ahead of further findings in spring 2026. The Secretary of State will chair a Maternity and Neonatal Taskforce that will develop an action plan based on the Investigation recommendations and oversee implementation and improvement in outcomes. Bereavement services that are available seven days a week are also being set up in every area in England to support women and families who experience pregnancy loss or neonatal death.  These services are in place in 115 out of 120 trusts with maternity services in England. All NHS trusts in England are also signed up to the National Bereavement Care Pathway which is designed to improve the quality and consistency of bereavement care for parents and families experiencing pregnancy or baby loss.

If he will make an assessment of the potential impact of recent (a) disability benefit and (b) social care policy changes on (i) polio survivors and (ii) people with post-polio syndrome.

Any changes to Personal Independence Payment eligibility will come after the Timms Review, an ambitious and inclusive review that aims to ensure we have a system that supports disabled people to achieve better health, higher living standards and greater independence, including through employment.To ensure lived experience is at the heart of its work, the review will be co-produced by disabled people, the organisations that represent them, and other experts. We are committed to concluding the review by autumn 2026, when it will report to the Secretary of State for Work and Pensions for a final decision.Under Section 18 the 2014 Care Act, local authorities are required to meet the needs of adults in their area who meet the eligibility criteria, which would include polio survivors and people with post-polio syndrome with eligible needs. The Care Quality Commission is assessing how well local authorities are meeting their duties under Part 1 of the Care Act.

What assessment his Department has made of the potential merits of reviewing the regional disparities of access to (a) therapy and (b) rehabilitation services for people living with (i) the long-term effects of polio and post-polio syndrome and (ii) the long-term effects of polio.

Although there is currently no cure for post-polio syndrome, a range of treatments and support is available to help manage the symptoms and improve quality of life. Treatment will depend on the severity of a patient’s condition, but care may involve pain-relieving medication, physiotherapy, dietary and exercise advice, and/or counselling or cognitive behavioural therapy. It is for commissioners, providers, and clinicians, supported by relevant clinical practice, to determine the best treatment for people with post-polio syndrome.Ongoing rehabilitation for polio survivors is commissioned at a local level by integrated care boards (ICBs) as it is unlikely they would require the complex rehabilitation services commissioned by NHS England.It is the responsibility of ICBs to make available appropriate provision to meet the health and care needs of their local population, including services for people with polio and post-polio syndrome, as they are best placed to make decisions according to local need.The 10-Year Health Plan commits to a health system that is inclusive and equitable. While polio survivors are not named explicitly, the plan’s shift from hospital to community care is particularly relevant for polio survivors, many of whom require ongoing rehabilitation and support to live independently. The 10-Year Health Plan outlines the expansion of community-based services and neighbourhood health models, which will bring care closer to home and reduce reliance on hospital-based services, and investment in digital tools and assistive technologies, which can enhance independence and access to services for those with mobility challenges.While the Department has not made a specific assessment of the potential merits of reviewing the regional disparities of access to therapy and rehabilitation services for people living with the long-term effects of polio and post-polio syndrome, addressing healthcare inequity is a core focus of the 10-Year Health Plan, to ensure the National Health Service is there for anyone who needs it whenever they need it, including people with polio and post-polio syndrome.

What steps his Department is taking to ensure that post-polio syndrome is (a) recognised, (b) diagnosed, and (c) treated though (i) access to specialist neuromuscular clinics, (ii) appropriate care pathways and (iii) other means.

Although there is currently no cure for post-polio syndrome, a range of treatments and support is available to help manage the symptoms and improve quality of life. Treatment will depend on the severity of a patient’s condition, but care may involve pain-relieving medication, physiotherapy, dietary and exercise advice, and/or counselling or cognitive behavioural therapy. It is for commissioners, providers, and clinicians, supported by relevant clinical practice, to determine the best treatment for people with post-polio syndrome.Ongoing rehabilitation for polio survivors is commissioned at a local level by integrated care boards (ICBs) as it is unlikely they would require the complex rehabilitation services commissioned by NHS England.It is the responsibility of ICBs to make available appropriate provision to meet the health and care needs of their local population, including services for people with polio and post-polio syndrome, as they are best placed to make decisions according to local need.The 10-Year Health Plan commits to a health system that is inclusive and equitable. While polio survivors are not named explicitly, the plan’s shift from hospital to community care is particularly relevant for polio survivors, many of whom require ongoing rehabilitation and support to live independently. The 10-Year Health Plan outlines the expansion of community-based services and neighbourhood health models, which will bring care closer to home and reduce reliance on hospital-based services, and investment in digital tools and assistive technologies, which can enhance independence and access to services for those with mobility challenges.While the Department has not made a specific assessment of the potential merits of reviewing the regional disparities of access to therapy and rehabilitation services for people living with the long-term effects of polio and post-polio syndrome, addressing healthcare inequity is a core focus of the 10-Year Health Plan, to ensure the National Health Service is there for anyone who needs it whenever they need it, including people with polio and post-polio syndrome.

What steps his Department is taking to ensure (a) polio survivors with post-polio syndrome and (b) other polio survivors have equitable access to specialist treatment centres providing (i) physiotherapy, (ii) hydrotherapy, (iii) pain management and (iv) rehabilitation across the country.

Although there is currently no cure for post-polio syndrome, a range of treatments and support is available to help manage the symptoms and improve quality of life. Treatment will depend on the severity of a patient’s condition, but care may involve pain-relieving medication, physiotherapy, dietary and exercise advice, and/or counselling or cognitive behavioural therapy. It is for commissioners, providers, and clinicians, supported by relevant clinical practice, to determine the best treatment for people with post-polio syndrome.Ongoing rehabilitation for polio survivors is commissioned at a local level by integrated care boards (ICBs) as it is unlikely they would require the complex rehabilitation services commissioned by NHS England.It is the responsibility of ICBs to make available appropriate provision to meet the health and care needs of their local population, including services for people with polio and post-polio syndrome, as they are best placed to make decisions according to local need.The 10-Year Health Plan commits to a health system that is inclusive and equitable. While polio survivors are not named explicitly, the plan’s shift from hospital to community care is particularly relevant for polio survivors, many of whom require ongoing rehabilitation and support to live independently. The 10-Year Health Plan outlines the expansion of community-based services and neighbourhood health models, which will bring care closer to home and reduce reliance on hospital-based services, and investment in digital tools and assistive technologies, which can enhance independence and access to services for those with mobility challenges.While the Department has not made a specific assessment of the potential merits of reviewing the regional disparities of access to therapy and rehabilitation services for people living with the long-term effects of polio and post-polio syndrome, addressing healthcare inequity is a core focus of the 10-Year Health Plan, to ensure the National Health Service is there for anyone who needs it whenever they need it, including people with polio and post-polio syndrome.

What steps his Department is taking to help tackle regional inequalities in access to gluten free prescriptions for patients with coeliac disease.

Decisions about the commissioning and funding of local health services are the responsibility of local integrated care boards (ICBs). It is the responsibility of ICBs, working with clinicians, service users, and patient groups, to develop local services and care pathways that meet patients’ needs.NHS England guidance on Prescribing Gluten-Free foods in Primary Care states that commissioners should restrict the prescribing of gluten-free (GF) foods to bread and mixes only. Under the current legislation, ICBs may choose to further restrict product choice, or end prescribing of GF foods altogether, if they feel that this is appropriate for their population, whilst taking account of their legal duties to advance equality and having regard to reducing health inequalities.The national prescribing position in England remains that GF bread and mixes can be provided to coeliac patients on an NHS prescription, and a wide range of these items continue to be listed in Part XV of the Drug Tariff. This means that prescribers can issue NHS prescriptions, based on a shared decision between prescriber and patient, while also being mindful of local and national guidance. Health is largely a devolved matter and local health arrangements for GF prescribing in Scotland and Wales are a matter for the devolved administrations.

If his Department will take steps to ensure that people no longer eligible for covid-19 vaccines under the the Flu and Covid-19 Seasonal Vaccination Programme are able to receive them if they wish; and whether his Department plans to make covid-19 vaccinations available privately for people not eligible through the NHS.

The Joint Committee on Vaccination and Immunisation (JCVI) is the independent expert committee which reviews the latest data on COVID-19 risks, vaccine safety, and effectiveness and advises the department on the approach to vaccination and immunisation programmes.The aim of the COVID-19 immunisation programme is to prevent serious disease, namely hospitalisation and/or mortality, arising from COVID-19. Population immunity to COVID-19 has been increasing due to a combination of naturally acquired immunity following recovery from infection and vaccine-derived immunity. COVID-19 is now a relatively mild disease for most people, though it can still be unpleasant, with rates of hospitalisation and death from COVID-19 having reduced significantly since COVID-19 first emerged. The focus of the JCVI-advised programme has moved towards targeted vaccination of the oldest adults and individuals who are immunosuppressed. These are the two groups who continue to be at higher risk of serious disease, including mortality.On 13 November 2024, the JCVI published advice on who should be offered vaccination in autumn 2025. On 26 June 2025, the Government decided, in line with this advice, that a COVID-19 vaccine should be offered in autumn 2025 to the following groups:- adults aged 75 years and over;- residents in a care home for older adults; and- individuals aged 6 months and over who are immunosuppressed, as defined in the UK Health Security Agency Green Book.There are no plans to offer vaccination through the national programme outside these JCVI-advised groups for autumn 2025. Some private providers currently offer COVID-19 vaccination, and whether to provide vaccination privately is a matter for the companies concerned.