Written questions by Collins.

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 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.

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 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.

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.

How many children with drug-resistant epilepsy have been prescribed cannabis-based medicinal products through private prescriptions in each of the last three years; and what assessment his Department has made of trends in the level of access to cannabis-based medicinal products for children with severe epilepsy unable to afford private prescriptions.

The NHS Business Services Authority does not hold the information in the form requested. National Health Service or private controlled drug prescription forms to do contain information on the condition being treated, or why a medicine has been prescribed.No assessment has been made of trends in the level of access to cannabis-based medicinal products for children with severe epilepsy unable to afford private prescriptions.The Department does not make provision for the funding of medicines outside of the NHS’ commissioning systems and it remains that the cost of treatments sought privately are the responsibility of patients.

Whether his Department has made an assessment of the potential impact of restrictions on television and online advertising of products high in fat, salt and sugar on levels of marketing through outdoor and brand-based advertising; and if he will consider extending restrictions to cover such advertising.

As set out in our 10-Year Health Plan for England, we will take decisive action on the obesity crisis to ease the strain on our National Health Service and create the healthiest generation of children ever. We are already delivering the biggest public health reforms in a generation, including implementing restrictions on the advertising of less healthy food and drink before 9:00pm on television and at all times online from 5 January 2026.Last year, the Government published the revised National Planning Policy Framework for local government, giving local authorities stronger, clearer powers to block new fast-food outlets near schools and where young people congregate. This will stop the relentless targeting of children and young people by the fast-food industry.We also welcome the work by the metropolitan mayors to support the action to ban junk food marketing across public transport networks and public spaces that are controlled locally.An impact assessment on the advertising restrictions was published on the GOV.UK website, which considered the impact of the restrictions on brand advertising and alternative media, including outdoor advertising, from the perspective of actions that advertisers of products that are high in fat, sugar or salt (HFSS) may take to mitigate the loss of revenue from the restrictions on television and online. The impact assessment made an assumption that approximately £14 million of lost revenue may be mitigated if HFSS advertisers took these actions.We continue to review evidence of the impacts on children of advertising for less healthy food and drink products and will consider if and where further action is needed.

Whether he plans to introduce national waiting-time standards for ADHD and autism assessments for under-18s; and what progress NHS England has made in improving the (a) collection and (b) publication of data on waiting times for (i) ADHD and (ii) autism assessments.

The National Institute for Health and Care Excellence (NICE) recommends a maximum waiting time of 13 weeks between a referral for an autism assessment and a first appointment. There is no wait standard for referral for an autism assessment to receiving a diagnosis of autism, and NICE guidelines for attention deficit hyperactivity disorder (ADHD) diagnosis and management do not recommend a maximum waiting time standard from referral for an assessment of ADHD to the assessment being provided.NICE guidelines are developed by experts based on a thorough assessment of the available evidence and through extensive engagement with stakeholders. They are not mandatory, but National Health Service commissioners are expected to take them fully into account in designing services to meet the needs of their local populations.The Medium-Term Planning Framework, published 24 October, was explicit that integrated care boards (ICBs) and providers are expected to optimise existing resources to reduce long waits for autism and ADHD assessments and improve the quality of assessments by implementing existing and new guidance, as published.NHS England publishes quarterly statistical data on waiting times within autism diagnostic pathways, which remain under constant review. This data is available at the following link:https://digital.nhs.uk/data-and-information/publications/statistical/autism-statisticsFor the first time, NHS England published management information on ADHD assessment waiting times at a national level on 29 May 2025 as part of its ADHD data improvement plan, and it has also released technical guidance to ICBs to improve the recording of ADHD data, with a view to improving the quality of ADHD waits and diagnosis data as well as publishing more localised data in future.The most recent data, published in August 2025 and is available on the NHS England website, at the following link:https://digital.nhs.uk/data-and-information/publications/statistical/mi-adhd/august-2025Data in this publication is sourced from a number of existing NHS England datasets, and the publication is known to contain a number of data quality issues, further details of which can be found at the following link:https://digital.nhs.uk/data-and-information/publications/statistical/mi-adhd/supporting-information

What steps he is taking to ensure that Integrated Care Boards prioritise ADHD and autism assessments for children and young people approaching (a) key educational stages, (b) GCSEs and (c) post-16 transition points.

We recognise that transitions between life stages can be particularly challenging for those who find change difficult, including many autistic people and people with attention deficit hyperactivity disorder (ADHD).The Medium-Term Planning Framework, published 24 October, was explicit that integrated care boards (ICBs) and providers are expected to optimise existing resources to reduce long waits for autism and ADHD assessments and improve the quality of assessments by implementing existing and new guidance, as published.On 5 April 2023, NHS England published a national framework and operational guidance to help ICBs and the National Health Service to deliver improved outcomes for people referred to an autism assessment service. The guidance also sets out what support should be available before an assessment and following a recent diagnosis of autism. They make clear that autism assessment provision is needed throughout the lifespan and that ICBs should ensure that people of all ages can access an autism assessment locally.NHS England established an ADHD taskforce which brought together those with lived experience with experts from the NHS, education, charity, and justice sectors to get a better understanding of the challenges affecting those with ADHD, including in accessing timely and equitable access to services and support. We are pleased that the final report was published on 6 November, and we are carefully considering its recommendations.

What steps his Department is taking to improve support for adults with cerebral palsy.

The Government is committed to ensuring that people living with cerebral palsy have access to appropriate support and services throughout their lives, enabling them to fulfil their potential and lead healthy, productive lives.The National Institute for Health and Care Excellence (NICE) has published a guideline for adults with cerebral palsy, code NG119. The guideline recommends regular reviews of clinical and functional needs, clear care pathways, and access to multi-disciplinary teams and specialist neurology services. The guideline is available at the following link:https://www.nice.org.uk/guidance/ng119The 10-Year Health Plan sets out a vision for a health and care system that delivers more personalised, integrated, and proactive care for people with long-term and complex conditions, including cerebral palsy. By 2027, 95% of people with complex needs should have an agreed personal care plan. These will promote shared decision-making and access to personal health budgets, giving individuals more choice and control over therapies, equipment, and support tailored to their needs. Additionally, integrated neighbourhood health teams will bring together professionals across disciplines to deliver joined-up care for people with cerebral palsy.

What steps his Department is taking to reduce waiting times for neurology outpatient appointments; and what plans are in place to ensure timely access to neurological care for all patients.

The Government is committed to delivering the National Health Service constitutional standard that 92% of patients to wait no longer than 18 weeks from referral to treatment by March 2029. This includes patients waiting for neurology care.As of August 2025, the neurology waiting list stands at 226,432, a reduction of 4.3% since August 2024. Since coming into office we have delivered 5.2 million additional appointments, including for neurology care, in part by rolling out reforms outlined in the Elective Reform Plan (ERP). These reforms include broadening access to outpatient care, through virtual and group consultations, and minimising missed appointments. We have also expanded the Advice and Guidance scheme, which helps to ensure that patients get care in the right place and only see a specialist if it’s really necessary, freeing up capacity in secondary care for those who need it, including certain patients with neurology conditions or symptoms. The latest data, which is subject to change, shows this has resulted in 589,336 requests being “diverted” since April 2025, a 4.3% increase compared to the same period in 2024. The 10-Year Health Plan builds on the ERP with a more sustainable vision for elective care where two-thirds of outpatient care is moved to community settings or delivered remotely, rather than in hospitals. Patients' access to specialists, including neurologists, will be improved by providing this specialist care in the community where possible and increasing digital access to specialists through the NHS app where it’s more convenient for patients. The recently published Medium Term Planning Framework outlines targets for the NHS from 2026/27 to 2028/29 to deliver the 10-Year Health Plan’s ambitions, including giving patients more control over their follow up care to reduce unnecessary appointments and expanding Advice and Guidance, thereby freeing up appointments and reducing long waits, including for neurology care.

What steps he is taking to ensure that people who need it have access to palliative care services in Harpenden and Berkhamsted constituency.

Palliative care services are included in the list of services an integrated care board (ICB) must commission. To support ICBs in this duty, NHS England has published statutory guidance and service specifications.  The statutory guidance states that ICBs, including the Hertfordshire and West Essex ICB, the Surrey Heartlands ICB, and the Frimley ICB, must work to ensure that there is sufficient provision of care services to meet the needs of their local populations.NHS England has also developed a palliative care and end of life care dashboard. The dashboard helps commissioners understand the palliative care and end of life care needs of their local population, including the ability to filter the available information, such as by deprivation or ethnicity, enabling ICBs to put plans in place to address and track the improvement of health inequalities, and ensure that funding is distributed fairly, based on prevalence.The Department and NHS England are currently working at pace to develop plans on how best to improve the access, quality, and sustainability of all-age palliative care and end of life care in line with the 10-Year Health Plan.Additionally, through the National Institute for Health and Care Research, the Department has invested £3 million in a Policy Research Unit in Palliative and End of Life Care. This unit is building the evidence base on palliative care and end of life care, with a specific focus on inequalities.

What plans he has to ensure adequate financial support for the full range of specialist palliative care services provided by hospices.

Integrated care boards (ICBs) are responsible for the commissioning of palliative care and end of life care services, to meet the needs of their local populations. To support ICBs, including the NHS Hertfordshire and West Essex ICB, which covers the Harpenden and Berkhamsted constituency, in this duty, NHS England has published statutory guidance and service specifications. NHS England has also developed a palliative care and end of life care dashboard, which brings together all relevant local data in one place.Whilst the majority of palliative care and end of life care is provided by National Health Service staff and services, we recognise the vital part that voluntary sector organisations also play.The amount of funding charitable hospices receive varies by ICB area, and will, in part, be dependent on the breadth of palliative care, including specialist palliative care, and end of life care provision within each ICB catchment area. It is important to note that hospices, like the NHS, provide both specialist and generalist palliative care and end of life care. Not all patients will require specialist palliative care. The Department and NHS England are currently looking at how to improve the access, quality, and sustainability of all-age palliative care and end of life care in line with the 10- Year Health Plan. Additionally, we are supporting the hospice sector with a £100 million capital funding boost for eligible adult and children’s hospices in England to ensure they have the best physical environment for care.We are also providing £26 million in revenue funding to support children and young people’s hospices for 2025/26. I am pleased to confirm the continuation of circa £26 million, adjusted for inflation, for the next three financial years, 2026/27 to 2028/29 inclusive, to be distributed again via ICBs. This amounts to approximately £80 million over the next three years.

What steps he is taking to ensure that hospice contracts reflect the (a) cost of the services they provide and (b) needs of the local population in Harpenden and Berkhamsted constituency.

Integrated care boards (ICBs) are responsible for the commissioning of palliative care and end of life care services, to meet the needs of their local populations. To support ICBs, including the NHS Hertfordshire and West Essex ICB, which covers the Harpenden and Berkhamsted constituency, in this duty, NHS England has published statutory guidance and service specifications. NHS England has also developed a palliative care and end of life care dashboard, which brings together all relevant local data in one place.Whilst the majority of palliative care and end of life care is provided by National Health Service staff and services, we recognise the vital part that voluntary sector organisations also play.The amount of funding charitable hospices receive varies by ICB area, and will, in part, be dependent on the breadth of palliative care, including specialist palliative care, and end of life care provision within each ICB catchment area. It is important to note that hospices, like the NHS, provide both specialist and generalist palliative care and end of life care. Not all patients will require specialist palliative care. The Department and NHS England are currently looking at how to improve the access, quality, and sustainability of all-age palliative care and end of life care in line with the 10- Year Health Plan. Additionally, we are supporting the hospice sector with a £100 million capital funding boost for eligible adult and children’s hospices in England to ensure they have the best physical environment for care.We are also providing £26 million in revenue funding to support children and young people’s hospices for 2025/26. I am pleased to confirm the continuation of circa £26 million, adjusted for inflation, for the next three financial years, 2026/27 to 2028/29 inclusive, to be distributed again via ICBs. This amounts to approximately £80 million over the next three years.

What steps his Department is taking to ensure the availability of health play (a) services and (b) professionals for children.

The Government is committed to raising the healthiest generation of children ever, which includes ensuring that children receive the appropriate care and support whenever they need it.In support of this commitment, NHS England and Starlight, a national charity for children’s play in healthcare, co-published the Play Well Toolkit in June 2025. The toolkit recognises the important role of health play teams and provides important guidance on best practice, enabling these teams to deliver child-friendly care. 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 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 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 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.