Written questions by Collins.

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.

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.

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.

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.

Whether his Department plans to update regulations on the (a) composition, (b) marketing and (c) labelling of commercial (i) infant and (ii) toddler foods.

Children’s early years provide an important foundation for their future health and strongly influence many aspects of wellbeing in later life. The Government has published voluntary industry baby food guidelines as part of our comprehensive strategy to give children the best start in life. The guidelines challenge businesses to reduce the levels of salt and sugar in commercial baby food and drink products aimed at those aged up to 36 months. The guidelines also set out voluntary labelling actions for industry, in addition to reinforcing legislative requirements around labelling and health and nutrition claims. This will help to support parents and carers to make informed choices about what to feed their children. Businesses have 18 months from the publication of these guidelines, therefore by February 2027, to deliver the required changes. We will monitor industry progress towards implementing the sugar, salt, and labelling guidelines. It is vital that we maintain the highest standards for foods consumed by babies and infants, which is why we also have regulations in place that set nutritional, compositional, and labelling standards for commercial baby food. These ensure that commercial baby foods are suitable for infants and young children and require businesses to ensure labelling is clear and not misleading. The regulations also set labelling standards to ensure consumers have clear and accurate information about the products they buy. The Best Start in Life health website has advice for parents and carers on successful weaning of infants to introduce healthy solid foods, and is available at the following link: https://www.nhs.uk/start-for-life/ It has been updated to provide new advice on shop-bought baby food and healthy weaning practices. The update has been made in light of the increased availability and range of commercial baby food products, highlighting the need for clear and consistent advice for parents and carers. We continue to keep these regulations under review to ensure that the composition of infant food and drinks reflects the latest scientific advice and dietary guidelines. The voluntary industry baby food guidelines should support improvements in this area.

What steps his Department is taking to provide support for people with postural tachycardia syndrome in Harpenden and Berkhamsted constituency.

Improving health outcomes for everyone living with a long-term condition, including postural tachycardia syndrome (PoTS), is a key part of the Government's mission to build an NHS fit for the future.People with PoTS can access a variety of NHS services, which are locally commissioned by integrated care boards (ICBs). ICBs are responsible for ensuring that their local area has appropriate services in place to meet the needs of their population, including those in the Harpenden and Berkhamsted constituency.Many patients can be diagnosed and managed effectively within primary care. In complex cases, or where patients do not respond to initial treatment, patients may be referred to specialised cardiology or neurology services.At a national level, NHS England has made available additional support. This includes a focus on healthy working environments, tools and resources to support line managers to hold meaningful conversations with staff to discuss their wellbeing, and emotional and psychological health and wellbeing support.The three shifts outlined in the recently published 10-Year Health Plan will support people with long-term conditions, including those with PoTS, to better manage their condition and access services closer to home. For example, it will empower them to access their medical history and allow them to book and manage their appointments and medication.

Whether his Department plans to increase funding for newly qualified nurse positions in Harpenden and Berkhamsted constituency.

On 11 August 2025, the Government announced the Graduate Guarantee for nurses and midwives. The guarantee will ensure that there are enough positions for every newly qualified nurse in England. The package of measures will unlock thousands of jobs and will ensure that thousands of new posts are easier to access by removing barriers for National Health Service trusts, creating opportunities for graduates and ensuring a seamless transition from training to employment.These new measures aim to tackle graduates’ concerns about job availability and ensure the NHS has the right staff to provide the best possible care to patients everywhere.

Whether his Department has made an assessment of the potential merits of conducting a national safeguarding review into the protection of disabled dependents when their sole carer is incapacitated.

Any form of abuse or neglect is unacceptable, and the Government is committed to ensuring that families have the support that they need.Under the Care Act 2014, local authorities have a statutory duty to make enquiries about safeguarding concerns and support people caring for their family and friends. The Care Act 2014 also requires local authorities to deliver a wide range of sustainable, high-quality care and support services, including support for unpaid carers.The Carer Contingency Campaign Pack: Supporting Carers and Strengthening Local Care Systems, developed by the Carers Trust with NHS England and the Health and Wellbeing Alliance, helps local carer organisations to implement Carer Contingency Plans, which are structured protocols ensuring care continuity when the carer is unexpectedly unavailable. Unpaid carers can be supported to create contingency plans to ensure the person they care for continues receiving support if they are suddenly unavailable. It includes practical tools, good practice examples, and guidance on emergency planning.We have launched an independent commission into adult social care, chaired by Baroness Casey. The Commission will start a national conversation about what care and support working age adults, older people, and their families expect from adult social care, including exploring the needs of unpaid carers who provide vital care and support.The Commission's Terms of Reference are sufficiently broad to enable Baroness Casey to define its remit to independently consider how to build a social care system fit for the future, including the safeguarding of those receiving care if the Commission sees fit.

What estimate his Department has made of the number of deaths as a result of out-of-hospital cardiac arrests in (a) 2020, (b) 2021, (c) 2022, (d) 2023 and (e) 2024.

NHS England has published the national service specification Inherited Cardiac Conditions (All Ages), that covers patients who often present as young adults with previously undiagnosed cardiac disease and families requiring follow up due to a death from this cause. This describes the service model and mandated guidelines and guidance that should be followed to support the diagnosis and treatment of patients or family members. It also includes the requirement for inherited cardiac conditions services to investigate suspected cases. Further information on the Inherited Cardiac Conditions (All Ages) service specification is available at the following link: https://www.england.nhs.uk/wp-content/uploads/2017/11/cardiology-inherited-cardiac-conditions.pdf NHS England has published a suite of national service specifications and standards for congenital heart disease, which define the standards of care expected from all organisations funded by NHS England, to support and improve the diagnosis and treatment of patients with congenital cardiac problems. There are no plans to publish further specific information on people under the age of 35 years old with cardiac abnormalities, over and above those who would be covered by the service specifications referenced above. Data shows that in 2022, there were 939 people under the age of 35 years old who died due to heart and circulatory conditions. Further information, including historic data and a breakdown of death by high level condition, is available on the British Heart Failure website, at the following link: https://www.bhf.org.uk/-/media/files/for-professionals/research/heart-statistics/bhf-cvd-statistics-compendium-2024-v3.pdf?rev=c72e2593b0ac4f2b999ad2f5999d8c07&hash=7DCC7E6832AA9495B0F5E720357DB9FB NHS England does not hold the data for the number of deaths following out of hospital cardiac arrests (OHCAs). The following table shows the number of cardiac arrest patients in England receiving an organised emergency medical services response, whether resuscitation was attempted, continued, terminated, or not attempted, the number where resuscitation was commenced or continued by an ambulance service, and the number of those with survival at 30 days, from 2020 to 2024: 20202021202220232024Cardiac arrest patients in England receiving an organised emergency medical services response, whether resuscitation was attempted, continued, terminated, or not attempted93,92095,09399,11195,22796,049Number where resuscitation was commenced or continued by an Ambulance Service30,84132,48634,19532,03132,932Number of those with survival at 30 days2,4972,7832,6602,9433,144Source: NHS England’s Ambulance Quality Indicators, available at the following link: https://www.england.nhs.uk/statistics/statistical-work-areas/ambulance-quality-indicators/Notes:the 2020 figure is survival to discharge from hospital rather than survival at 30 days, and may be incomplete;during the COVID-19 pandemic, data suppliers in some hospitals were moved to other duties, making data on survival harder to obtain than data on deaths; anddue to a trust-wide outage of the Electronic Patient Clinical Record, data is unavailable from 1 April to 30 September 2023 for the Isle of Wight, and incomplete for the South Central Ambulance Service from July to September 2023. Publicly available data on OHCAs can also be found on the University of Warwick’s out-of-hospital cardiac arrest outcomes website, at the following link: https://warwick.ac.uk/fac/sci/med/research/ctu/trials/ohcao/

Whether he plans to review the (a) scope, (b) eligibility, (c) criteria and (d) compensation level of the Vaccine Damage Payment Scheme.

I would like to express my deepest sympathies to those individuals who have experienced harm following vaccination, and to their families.Ministers continue to consider options for reforming the Vaccine Damage Payment Scheme.In parallel, the Department has been working with the NHS Business Services Authority, the administrators of the scheme, to take steps to improve the Vaccine Damage Payment Scheme, including through processing claims at a faster rate.

What assessment he has made of the effectiveness of Crawford & Company in administering the Vaccine Damage Payment Scheme; and for what reason that company was selected to manage the process.

The NHS Business Services Authority is the administrator of the Vaccine Damage Payment Scheme (VDPS). Crawford and Company provides a medical assessment service for the VDPS. Crawford and Company were awarded this contract following a formal procurement process under the Public Contracts Regulations 2015 (as amended). The procurement process was open, fair, and transparent. Crawford and Company emerged as the successful bidder following an evaluation of their bid, and the contract started in March 2022, following their successful bid.Key performance indicators are in place to ensure the effectiveness of the medical assessment service, and are closely monitored via the contract. This includes a target that 95% of medical assessments are returned to the NHS Business Services Authority within 15 working days. The supplier has achieved this target since August 2023.

What training is provided to NHS continuing healthcare assessors on health needs associated with (a) progressive supranuclear palsy and (b) corticobasal degeneration.

The National Framework for NHS Continuing Healthcare and NHS-funded Nursing Care sets out the process for determining eligibility for NHS Continuing Healthcare (CHC). This statutory guidance is clear that the assessment process should include someone with specialist knowledge of the individual’s condition, such as progressive supranuclear palsy or corticobasal degeneration, or have information available to them from the relevant specialists.It is important that those contributing to the assessment process have the relevant skills and knowledge. To support staff working in health and social care to apply the principles of the national framework, NHS England has developed and published a comprehensive set of online learning resources.Eligibility for CHC is not determined by diagnosis or clinical condition. It is assessed on a case-by-case basis, taking into account an individual’s needs, including ways in which these needs interact with one another.

What steps his Department is taking to support (a) research and (b) development into medical treatments for people affected by COVID-19 vaccine injury.

The Department commissions research through the National Institute for Health and Care Research (NIHR), and continues to welcome funding applications for research into any aspect of human health, including treatments for vaccine side effects. Since the start of the pandemic, the NIHR has allocated more than £110 million of funding for COVID-19 vaccine research, including consideration of issues around vaccine safety. As part of this, the Department commissioned a £1.6 million programme of work through the NIHR, to understand the mechanisms underlying the occurrence of COVID-19 vaccine-induced thrombotic thrombocytopenia syndrome, a rare condition of blood clotting with low platelets following vaccination for COVID-19. This research was published in July 2025.In the very rare event where an individual may have suffered a severe adverse reaction to a COVID-19 vaccine, care and treatment will be best met and managed by National Health Service local specialist services, augmented as appropriate by national specialist advice.

Whether his Department has made an assessment of the potential merits of improving continuing healthcare assessments for (a) progressive supranuclear palsy and (b) corticobasal degeneration.

The Department has not made an assessment of the potential merits of improving NHS Continuing Healthcare (CHC) assessments at this time, in relation to individuals with supranuclear palsy and corticobasal degeneration.Eligibility for CHC is not determined by age, diagnosis or condition, or financial means, instead it is assessed on a case-by-case basis, taking into account the totality of an individual’s needs. This ensures a person-centred approach to CHC, whereby the individual is placed at the centre of the assessment and care-planning process, and should be supported to access and follow these. We continue to work with our partners, including: NHS England, who is responsible for oversight of CHC delivery; external organisations; and people with lived experience, to seek feedback on CHC policy and implementation.