Written questions by Collins.

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.

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.

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.

What assessment his Department has made of the potential merits of permitting GPs to prescribe cannabis-based medicinal products; and what plans he has to ensure NHS access to full-spectrum cannabinoid treatments for treatment-resistant epilepsy.

The conditions attached to a medicine’s marketing authorisation determine who it can be prescribed by. This may include restricting the initiation of treatments to specialist doctors, as is the case for the licensed cannabis-based medicines Sativex and Epidyolex. These are not first line treatments, and patients will be at a stage in their treatment pathway where they will be under the care of a specialist doctor before accessing these medicines.General practitioners (GPs) cannot independently prescribe unlicensed cannabis-based products for medicinal use. The law allows GPs to prescribe these products under the direction of a specialist as part of a shared care arrangement. A GP can accept ongoing shared care responsibilities once a specialist has initiated a prescription, and a patient’s clinical condition is stable. In doing so, they must accept the enhanced legal and professional responsibilities associated with prescribing an unlicensed product, and this includes accountability for the quality of the product prescribed.This restriction forms part of the checks and balances that the Advisory Council on the Misuse of Drugs recommended the Government put in place when rescheduling cannabis-based products for medicinal use, to minimise the risk of misuse and diversion.Clinical guidelines from the National Institute for Health and Care Excellence (NICE) state that there is insufficient evidence to make population level recommendations for the use of unlicensed cannabis-based products for medicinal use in the treatment of patients with refractory epilepsy. NICE recommends that further research is carried out to inform future commissioning decisions in the National Health Service.Like any medicine, manufacturers of unlicensed cannabinoid treatments need to invest in research and clinical trials to prove that their products are safe and effective. In the absence of action from manufacturers, NHS England and the National Institute for Health and Care Research have agreed to over £8.5 million in funding for two world first clinical trials relating to the use of cannabis-based products for medicinal use for the treatment of drug-resistant epilepsies and neuropathic pain due to chemotherapy. Further information on the trial of medicinal cannabis for refractory epilepsies, and the trial of oral cannabinoids for the treatment of chemotherapy induced peripheral neuropathic pain is available, respectively, at the following two links:https://www.fundingawards.nihr.ac.uk/award/NIHR131309https://www.fundingawards.nihr.ac.uk/award/NIHR151052

What steps his Department is taking to improve timely access to innovative treatments for women with ovarian cancer.

The Department is committed to improving cancer care for patients across England, including those with ovarian cancer. The National Cancer Plan will include further details on how we will improve outcomes for cancer patients across the country, including patients with ovarian cancer, as well as speeding up diagnosis and access to treatment. It will ensure that more patients have access to the latest treatments and technology, and to clinical trials. These actions will help bring this country’s cancer survival rates back up to the standards of the best in the world.The Government is supporting Scott Arthur’s Private Members Bill on rare cancers. The bill will make it easier for clinical trials into rare cancers, such as ovarian cancer, to take place in England by ensuring the patient population can be easily contacted by researchers.

Whether he plans to include targets on improving survival for (a) ovarian cancer and (b) other rare and less common cancers in the upcoming national cancer plan.

The Department is committed to improving survival outcomes for all cancer types, including ovarian cancer and other rare and less common cancers, by catching it early, and treating it faster and more effectively. As a first step, the National Health Service is now delivering an extra 40,000 operations, scans, and appointments each week, to support early diagnosis and faster treatment.NHS England is continuing the roll out of community diagnostic centres to ensure that patients can access the diagnostic tests they need as quickly as possible. The NHS is also improving pathways to get people diagnosed faster once they are referred, including non-specific symptom pathways for patients who do not fit clearly into a single urgent cancer referral pathway.To ensure patients have access to the best treatment for ovarian cancer, NHS England commissioned an audit on ovarian cancer. Using routine data collected on patients diagnosed with ovarian cancer in an NHS setting as part of their care and treatment, the audits bring together information to look at what is being done well, where it’s being done well, and what needs to be improved. The audit published its report in September 2024 and officials across NHS England and the Department are considering its findings.Further actions on improving the survival of all cancers, including ovarian cancer and other rare and less common cancers, will be outlined in the forthcoming National Cancer Plan, which will be published later this year. It will seek to improve every aspect of cancer care to better the experience and outcomes for people with cancer. The goal is to reduce the number of lives lost to cancer over the next ten years, and the ambition will be set out as part of the National Cancer Plan.

What steps his Department is taking to help improve survival outcomes for patients diagnosed with (a) ovarian cancer and (b) other rare and less common cancers.

The Department is committed to improving survival outcomes for all cancer types, including ovarian cancer and other rare and less common cancers, by catching it early, and treating it faster and more effectively. As a first step, the National Health Service is now delivering an extra 40,000 operations, scans, and appointments each week, to support early diagnosis and faster treatment.NHS England is continuing the roll out of community diagnostic centres to ensure that patients can access the diagnostic tests they need as quickly as possible. The NHS is also improving pathways to get people diagnosed faster once they are referred, including non-specific symptom pathways for patients who do not fit clearly into a single urgent cancer referral pathway.To ensure patients have access to the best treatment for ovarian cancer, NHS England commissioned an audit on ovarian cancer. Using routine data collected on patients diagnosed with ovarian cancer in an NHS setting as part of their care and treatment, the audits bring together information to look at what is being done well, where it’s being done well, and what needs to be improved. The audit published its report in September 2024 and officials across NHS England and the Department are considering its findings.Further actions on improving the survival of all cancers, including ovarian cancer and other rare and less common cancers, will be outlined in the forthcoming National Cancer Plan, which will be published later this year. It will seek to improve every aspect of cancer care to better the experience and outcomes for people with cancer. The goal is to reduce the number of lives lost to cancer over the next ten years, and the ambition will be set out as part of the National Cancer Plan.

What plans his Department has to improve access to effective (a) symptom management and (b) pain relief for people with chronic urinary tract infections in Harpenden and Berkhamsted constituency.

The Harpenden and Berkhamsted constituency is served by the Hertfordshire and West Essex Integrated Care Board (ICB). The ICB applies the National Institute for Health and Care Excellence’s guidelines for the treatment of urinary tract infections (UTIs) to the treatment of chronic UTIs. The ICB has a defined care pathway which ensures that if primary care management is not sufficient, then patients are swiftly referred to specialist care for more intensive support, including further investigations and management of their symptoms and their pain.Appropriate treatment and support for people with chronic UTIs are dependent on receiving an accurate diagnosis. Diagnostic tests for chronic UTIs, such as urinalysis and urine culture, are widely available across all pathology networks in England, including Hertfordshire and West Essex. Ensuring accurate diagnostic testing not only aids more effective identification of infection but can also reduce unnecessary prescribing and overprescribing of broad-spectrum antimicrobials, and directly benefit patients in Harpenden and Berkhamsted, who will get the right treatment sooner.General practitioners can request testing for chronic UTIs via several pathways, including at point-of-care, via community diagnostic centres, or via laboratories. Laboratories across England adhere to stringent quality standards for diagnostic tests, including the UK Accreditation Standard ISO 15189, and implement robust internal and external quality assurance schemes. Together, these measures ensure the accuracy and reliability of diagnostic testing.Through the National Institute for Health and Care Research, the Department is supporting work to understand the research gaps on UTIs that matter most to patients, carers, and clinicians. This is through a James Lind Alliance Priority Setting Partnership (PSP), led by Antibiotic Research UK, Bladder Health UK, and The Urology Foundation. This partnership will publish its findings in spring 2026. The aim of the Chronic and Recurrent UTI PSP is to identify the unanswered questions about chronic and recurrent UTIs from patient, carer, and clinical perspectives and then to prioritise those that patients, carers, and clinicians agree are the most important for research to address.NHS England is also supporting research into newer, more accurate point-of-care tests for UTIs, such as via the Toucan study. Further information on the study is available at the following link:https://www.phctrials.ox.ac.uk/recruiting-trials/toucan-platform-for-uti-diagnostic-evaluation

When his Department plans to include Parkinson’s disease in the Quality and Outcomes Framework.

There are currently no plans to include Parkinson’s disease in the Quality and Outcomes Framework (QOF).The indicators included in QOF are developed in accordance with National Institute for Health and Care Excellence (NICE) guidelines, and are underpinned by a robust evidence base. The QOF is reviewed annually to ensure it remains aligned with NICE guidelines.For the 2025/26 contract year, 32 out of 76 QOF indicators were retired to streamline the scheme and reduce the administrative burden on general practice.

What assessment his Department has made of the difference in patient care outcomes between (a) assigning a named GP for accountability and (b) ensuring continuity of care through an own doctor system for patients with long-term conditions.

The Government is bringing back the family general practitioner (GP) because we know that continuity of care is essential to person-centred healthcare. While all patients have the legal right to choose their GP practice and must be assigned a named GP, the current system does not guarantee that they will see the same doctor at each visit. Although practices must make reasonable efforts to accommodate patient preferences, there is currently no formal assessment of the impact of assigning a named GP on outcomes.That is why we are going further, by improving continuity of care, we aim to make it easier for patients to see the same doctor at each appointment, which is key to managing and supporting patients with long-term conditions.

If he will take steps to ensure that total triage systems in primary care do not compromise the continuity of care for patients with (a) Parkinson’s disease and (b) other chronic neurological conditions.

The triage process is designed to direct patients to the most appropriate healthcare professional based on their individual needs. This includes those who request or require continuity of care with the same general practitioner (GP), such as patients with Parkinson’s or other neurological conditions, as well as those who may be more appropriately supported by accident and emergency or pharmacy services. The system aims to accommodate a wide range of patient needs and enhance access across the broader healthcare network.To prevent digital exclusion, the GP contract clearly states that patients must always have the option to telephone or visit their practice in person. Online tools that are utilised to support ‘total triage’ should complement, not replace, traditional methods of access. Practice receptions must remain open to ensure that patients without access to telephone or digital services are not disadvantaged, especially those with conditions that require in-person support.

What plans his Department has to increase (a) awareness and (b) availability of Parkinson’s specialist nurses in primary care; and what proportion of GP surgeries have established referral pathways to such specialist support.

The Government is committed to improving care for people with neurological conditions, including those with Parkinson’s disease, and ensuring they receive the support that they need. With one in six people suffering from neurological conditions that can severely impact every aspect of their lives, it is vital we ensure that they, along with their families and carers, receive high-quality, compassionate care and access to the latest services and treatments. Having a better understanding of diseases like Parkinson’s is vital in making sure we can provide the right care at the right time.Integrated care boards (ICBs) commission secondary care neurology services and interface with primary care to ensure there is access to specialist services. Parkinson’s specialist nurses are generally based in secondary and community care settings, depending on where the ICB determines is the best service provision for their locality.All general practitioners should follow the National Institute for Health and Care Excellence (NICE) clinical guideline 127 on the recognition and referral of people with suspected neurological conditions, including Parkinson’s disease. Further information on NICE clinical guideline 127 is available at the following link:https://www.nice.org.uk/guidance/ng127Regular support with a Parkinson’s disease nurse specialist is highlighted as a key intervention in NICE guideline 71, Parkinson’s disease in adults, which is available at the following link:https://www.nice.org.uk/guidance/ng71/

What steps his Department is taking to (a) help tackle midwifery shortages and (b) improve recruitment and retention in the NHS in (i) Harpenden and Berkhamsted constituency, (ii) Hertfordshire and (c) England.

The Government is committed to tackling the issues facing the maternity workforce, to make sure we have the right people in the right place at the right time. NHS England is leading a range of initiatives to boost retention of existing staff and to ensure that the National Health Service remains an attractive career choice for new recruits. This includes building a compassionate and inclusive culture, supporting staff wellbeing, and promoting flexible working opportunities.NHS England has invested in a range of measures, such as unit-based retention leads, a midwifery and nursing retention self-assessment tool, mentoring schemes, and investment in workforce capacity. This has resulted in an increase in retention and a reduction in vacancy, leaver, and turnover rates. As of March 2025, there are a record 25,000 full time equivalent midwives in post, which is over 1,400, or 6.1%, more full-time equivalent midwives in the maternity.

What steps her Department is taking to ensure people in mental health crises receive adequate support in emergency services in (a) Harpenden and Berkhamsted constituency and (b) Hertfordshire.

The Hertfordshire and West Essex Integrated Care Board commissions mental health services to meet the needs of its population, including for people living in Harpenden and Berkhamsted. The integrated care board continues to monitor the effectiveness and quality of these services.The National Health Service, local councils, police, and experts by experience continue to work together through Hertfordshire’s Crisis Care Concordat, to implement service and pathway improvements to ensure that people experiencing a mental health crisis receive timely, effective, and appropriate support.This includes implementing the Right Care, Right Person approach which minimises the involvement of police in the care of people with mental health needs, where this is appropriate.The integrated care board has developed a range of services to support people in mental health crisis. A new mental health urgent care centre has opened in Stevenage, which offers a safe space and a multidisciplinary team to provide support. Options for a similar model in West Hertfordshire are being explored. Nightlight services, delivered by the Herts Mind Network, provide emotional support, advice, and sanctuary space for those experiencing a mental health crisis.Additionally, mental health response vehicles are being rolled out across the country. Each vehicle is staffed by a paramedic with enhanced medical training and a registered mental health practitioner, enabling expert care to be delivered directly at the scene.People of all ages in England who are experiencing a mental health crisis can speak to a trained NHS professional at any time of the day via the NHS 111 service. This service gives people the chance to be listened to by a trained member of staff who can help direct them to the right place.

What funding has been allocated by his Department for research into the (a) causes, (b) treatment, and (c) long-term effects of long covid in children and young people.

The Department funds research on health and social care through the National Institute for Health and Care Research (NIHR). Between 2019/20 and 2023/24, the NIHR and the Medical Research Council (MRC), part of UK Research and Innovation, have jointly invested over £57 million into long COVID research with the aim of improving diagnosis and our understanding of the underlying mechanisms of the disease, evaluating the effectiveness of pharmacological and non-pharmacological therapies and interventions, and clinical care. This research will support the treatment of long COVID in children and young people, as well as adults. We have also funded research specifically focused on long COVID in children and young people, including the approximately £1.9 million CLoCk study jointly funded by the NIHR and MRC. The study developed an agreed definition of long COVID in children and young people and associated symptoms, to improve understanding of the condition and help harmonise research. The NIHR and MRC remain committed to funding high-quality research into the causes, treatments and long-term effects of long COVID. The NIHR welcomes funding applications for research into any aspect of human health and care including long COVID in children and young people. These applications are subject to peer review and judged in open competition, with awards being made based on the importance of the topic to patients and health and care services, value for money and scientific quality.

What recent assessment he has made of the prevalence of long covid in children and young people in (a) England and (b) Hertfordshire; and if he will publish estimates of the number of affected individuals by age group.

The most recent data from the Winter COVID-19 Infection Study, a joint study carried out by the Office for National Statistics (ONS) and the UK Health Security Agency, shows that, for the period 6 February 2024 to 7 March 2024, an estimated two million people, or 3.3% of the population, in private households in England and Scotland, self-reported experiencing long COVID symptoms more than four weeks after a COVID-19 infection. The following table shows a breakdown by age group of the number of people with self-reported long COVID symptoms, more than four weeks after a COVID-19 infection:Age groupEstimate3 to 17 years old111,81618 to 34 years old406,53835 to 44 years old294,09945 to 54 years old397,80255 to 64 years old389,97765 to 74 years old271,37475 years old and over113,467 While no estimate has been made specifically for Hertfordshire, the same dataset from the ONS estimated that 202,852 people self-reported experiencing long COVID symptoms in the East of England region in that same time period.NHS England has invested £314 million since the start of the pandemic to provide care and support for people with long COVID. This includes establishing specialist clinics throughout England to assess children and young people who are experiencing the long-term effects of COVID-19 infection. A further £86.7 million of funding was included in integrated care board (ICB) core allocations for 2024/25, and specific regional funding was also allocated for assurance and system support.As of 1 April 2024, there were over 90 adult post-COVID services across England, along with an additional 10 children and young people’s hubs. Since April 2024, commissioning of long COVID services has been the responsibility of local ICBs, following the closure of the national programme.The National Institute for Health and Care Excellence (NICE) is responsible for keeping its published guidelines up to date and under active surveillance, to ensure that they reflect developments in the evidence base and its recommendations on new medicines.The NICE is changing the way that it develops guidelines to ensure that they respond more rapidly to the latest evidence and newly recommended technologies, to help speed up access for patients.

What steps his Department is taking to ensure that children and young people with long covid have access to age-appropriate care and treatment.

The most recent data from the Winter COVID-19 Infection Study, a joint study carried out by the Office for National Statistics (ONS) and the UK Health Security Agency, shows that, for the period 6 February 2024 to 7 March 2024, an estimated two million people, or 3.3% of the population, in private households in England and Scotland, self-reported experiencing long COVID symptoms more than four weeks after a COVID-19 infection. The following table shows a breakdown by age group of the number of people with self-reported long COVID symptoms, more than four weeks after a COVID-19 infection:Age groupEstimate3 to 17 years old111,81618 to 34 years old406,53835 to 44 years old294,09945 to 54 years old397,80255 to 64 years old389,97765 to 74 years old271,37475 years old and over113,467 While no estimate has been made specifically for Hertfordshire, the same dataset from the ONS estimated that 202,852 people self-reported experiencing long COVID symptoms in the East of England region in that same time period.NHS England has invested £314 million since the start of the pandemic to provide care and support for people with long COVID. This includes establishing specialist clinics throughout England to assess children and young people who are experiencing the long-term effects of COVID-19 infection. A further £86.7 million of funding was included in integrated care board (ICB) core allocations for 2024/25, and specific regional funding was also allocated for assurance and system support.As of 1 April 2024, there were over 90 adult post-COVID services across England, along with an additional 10 children and young people’s hubs. Since April 2024, commissioning of long COVID services has been the responsibility of local ICBs, following the closure of the national programme.The National Institute for Health and Care Excellence (NICE) is responsible for keeping its published guidelines up to date and under active surveillance, to ensure that they reflect developments in the evidence base and its recommendations on new medicines.The NICE is changing the way that it develops guidelines to ensure that they respond more rapidly to the latest evidence and newly recommended technologies, to help speed up access for patients.

What assessment his Department has made of the potential merits of a national register of children and young people diagnosed with long covid.

The most recent data from the Winter COVID-19 Infection Study, a joint study carried out by the Office for National Statistics (ONS) and the UK Health Security Agency, shows that, for the period 6 February 2024 to 7 March 2024, an estimated two million people, or 3.3% of the population, in private households in England and Scotland, self-reported experiencing long COVID symptoms more than four weeks after a COVID-19 infection. The following table shows a breakdown by age group of the number of people with self-reported long COVID symptoms, more than four weeks after a COVID-19 infection:Age groupEstimate3 to 17 years old111,81618 to 34 years old406,53835 to 44 years old294,09945 to 54 years old397,80255 to 64 years old389,97765 to 74 years old271,37475 years old and over113,467 While no estimate has been made specifically for Hertfordshire, the same dataset from the ONS estimated that 202,852 people self-reported experiencing long COVID symptoms in the East of England region in that same time period.NHS England has invested £314 million since the start of the pandemic to provide care and support for people with long COVID. This includes establishing specialist clinics throughout England to assess children and young people who are experiencing the long-term effects of COVID-19 infection. A further £86.7 million of funding was included in integrated care board (ICB) core allocations for 2024/25, and specific regional funding was also allocated for assurance and system support.As of 1 April 2024, there were over 90 adult post-COVID services across England, along with an additional 10 children and young people’s hubs. Since April 2024, commissioning of long COVID services has been the responsibility of local ICBs, following the closure of the national programme.The National Institute for Health and Care Excellence (NICE) is responsible for keeping its published guidelines up to date and under active surveillance, to ensure that they reflect developments in the evidence base and its recommendations on new medicines.The NICE is changing the way that it develops guidelines to ensure that they respond more rapidly to the latest evidence and newly recommended technologies, to help speed up access for patients.