Asked by: Ian Sollom (Liberal Democrat - St Neots and Mid Cambridgeshire)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health and Social Care, what steps his Department is taking to reverse the long-term decline in the amount spent on medicines as a percentage of the NHS budget.
Answered by Zubir Ahmed - Parliamentary Under-Secretary (Department of Health and Social Care)
We continue to support the United Kingdom’s world leading life sciences sector through investment, innovation and reform as set out in our Life Sciences Sector Plan and 10-Year Health Plan, through which we committed to accelerating growth in net spend on innovative medicines to unlock the potential for patients.
As announced as part of our world-leading agreement with the United States, we will increase the amount which the UK pays for life-changing medicines by 25% through changes to the way that medicines are evaluated by the National Institute for Health and Care Excellence (NICE), including an increase to the NICE cost-effectiveness threshold. In this way, we are increasing the value that we place on innovations that deliver improvements to patient health, ensuring faster patient access for vital medicines for cancer, rare diseases and other conditions.
We are giving a clear signal that we want to bring innovative medicines to National Health Service patients, encouraging the life sciences industry to prioritise the UK as an early launch market, and help get the newest available treatments to those who need them.
Asked by: Paul Holmes (Conservative - Hamble Valley)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health and Social Care, whether his Department has made an assessment of the potential impact of people being held in Accident and Emergency departments due to unavailability of local NHS mental health beds on patients.
Answered by Zubir Ahmed - Parliamentary Under-Secretary (Department of Health and Social Care)
While no such specific assessment has been made, we know that in some local areas there is a need for more beds. This is being addressed in part through investment in new units, although this should be considered as part of a whole system transformation approach.
Investment of £75 million of capital funding this year aims to improve inpatient care and help stop mental health patients being sent far from home for treatment. Our neighbourhood mental health centres will also improve continuity of care, drive down waits, and reduce inpatient admissions. These centres provide round the clock, open-access to treatment and support for adults with severe mental health needs. We have opened the first of six 24/7 neighbourhood mental health centres in England, in Tower Hamlets, and other local areas are looking to rollout the model more widely.
We also know that pressures in accident and emergency are best addressed by clear, efficient, and adequately resourced routes to appropriate crisis care. NHS Operational and Planning Guidance for 2025/26 tasks local health systems to improve patient flow through mental health crisis pathways and reduce waits longer than 12 hours in accident and emergency departments. Systems should do this by maximising the use of crisis alternatives and through robust system oversight.
Substantial progress has been achieved in building more robust crisis care pathways across all ages ensuring that people in mental health crisis have access to timely and appropriate support. Key developments include the introduction of the NHS 111 ‘select mental health’ option, investment in alternative crisis services, roll-out of the Mental Health Response Vehicles programme, and full national coverage of 24/7 liaison mental health teams in general acute hospitals. We are also investing up to £120 million to bring the number of mental health emergency departments up to approximately 85. Mental health emergency departments provide rapid assessment and support in a therapeutic setting, helping those with mental health needs get the right care quickly and reducing reliance on emergency departments.
Asked by: Julia Lopez (Conservative - Hornchurch and Upminster)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health and Social Care, whether the capped VPAG rate referred to in the UK-US Economic Prosperity Deal will only apply to pharmaceutical products of US origin.
Answered by Zubir Ahmed - Parliamentary Under-Secretary (Department of Health and Social Care)
The capped rate applies to all newer medicines, not just pharmaceutical products originating from the United States.
Asked by: Rupert Lowe (Independent - Great Yarmouth)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health and Social Care, what aggregated safety data, including adverse-event summaries, the MHRA has recorded relating to the use of puberty blockers in under-18s since 2010; and whether the Department has been informed of any safety signals during that period.
Answered by Zubir Ahmed - Parliamentary Under-Secretary (Department of Health and Social Care)
The Medicines and Healthcare products Regulatory Agency (MHRA) is responsible for ensuring medicines, medical devices, and blood components for transfusion meet applicable standards of safety, quality, and efficacy. The MHRA rigorously assesses available data, including from the Yellow Card scheme, and seeks advice from their independent advisory committee, the Commission on Human Medicines, where appropriate to inform regulatory decisions.
Puberty blockers are also known as gonadotrophin-releasing hormone (GnRH) analogues. These medicines are licenced for conditions such as young children who enter puberty too early, also known as precocious puberty, prostate cancer, and endometriosis. The use of GnRH analogues to suppress puberty in children and young people with gender dysphoria is off-label prescribing. This means that the use of these medicines for this purpose is outside of the licensed uses, and as such the benefits and risks of the medicine for use in this specific population have not been assessed. The MHRA does not regulate off-label use.
The MHRA has received three United Kingdom suspected adverse drug reaction reports in which a GnRH analogue has been reported as being used in a child or young person for the purpose of puberty suppression in gender dysphoria. The GnRH analogues included in this search were buserelin, leuprorelin, goserelin, gonadorelin, nafarelin, and triptorelin. Please note it is not mandatory to provide information on indication when submitting an adverse drug reaction report.
It is important to note that a reaction reported to the Yellow Card scheme does not necessarily mean it has been caused by the medicine, only that the reporter had a suspicion it may have. Underlying or concurrent illnesses may be responsible, or the events could be coincidental.
The MHRA has not identified any safety signals which concern the off-label use of the GnRH analogues for the purpose of puberty suppression in gender dysphoria. However, we acknowledge that there is a clear lack of clinical evidence for the safety and efficacy of using these medicines for gender incongruence and/or dysphoria in those aged 18 years old and under. That is why NHS England and the National Institute for Health and Care Research have commissioned a carefully designed clinical trial to assess the relative benefits and harms of puberty suppressing hormones on young people’s physical, social, and emotional well-being.
Asked by: Rupert Lowe (Independent - Great Yarmouth)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health and Social Care, what evidence NICE has identified as the basis for its clinical assessment of puberty blockers for gender dysphoria; and whether NICE has undertaken (a) scoping and (b) evaluation exercises since 2015.
Answered by Zubir Ahmed - Parliamentary Under-Secretary (Department of Health and Social Care)
The National Institute for Health and Care Excellence (NICE) has not developed guidance on, or made a clinical assessment of, puberty blockers for gender dysphoria. In 2020, NICE developed two evidence summaries:
These summaries were commissioned by NHS England and developed by NICE to an NHS England process. They helped inform the Cass review.
Asked by: Lord Harper (Conservative - Life peer)
Question to the Department of Health and Social Care:
To ask His Majesty's Government on the basis of what evidence they have estimated that the extension of the soft drinks industry levy, announced on 25 November, could prevent almost 14,000 cases of adult obesity and nearly 1,000 cases of childhood obesity.
Answered by Baroness Merron - Parliamentary Under-Secretary (Department of Health and Social Care)
The changes to the Soft Drinks Industry Levy announced in the 2025 Autumn Budget are:
These changes will apply from 1 January 2028. They are designed to encourage producers to reformulate their products to reduce sugar levels and avoid paying the levy, thus reducing calories consumed from the drinks in scope.
Evidence shows that energy dense diets such as those that are high in sugar can contribute to excess calorie intake, which if sustained leads to weight gain and obesity. Population-level policies therefore aim to create a healthier food environment to reduce excess calories and obesity prevalence across the entire population.
The Department carried out a health benefit assessment to estimate the calorie reduction from these changes through reformulation and substitution to alternative drinks. Together, these changes reduce sugar and calorie intake from drinks across all age groups.
The analysis used nutrition data from the National Diet and Nutrition Survey, sales data from Worldpanel by Numerator, formerly Kantar WorldPanel, and a series of assumptions to estimate the sugar and calories removed from diets due to the changes. The approach, data sources, and assumptions are set out in detail in the published assessment.
This analysis estimates per person per day calorie reductions of 0.3 kcal in five to 10 year olds, 0.4 kcal in 11 to 18 year olds, 0.3 kcal in 19 to 64 year olds, and 0.2 kcal in those aged 65 years old and over.
The BMI Prevalence Model was then used to simulate the change in obesity prevalence from the estimated change in calorie intake at a population level. This model is based on weight loss equations by Henry (2005), a sample of height and weight data from Health Survey for England, and population data from Office for National Statistics.
This modelling estimates that a calorie reduction of this scale could translate into reducing cases of adult obesity by almost 14,000 and childhood obesity by almost 1,000.
Asked by: Lord McCrea of Magherafelt and Cookstown (Democratic Unionist Party - Life peer)
Question to the Department of Health and Social Care:
To ask His Majesty's Government what is the estimated cost of strikes within the NHS in the past six months; and what new proposals are being considered to protect patient services during any further strikes.
Answered by Baroness Merron - Parliamentary Under-Secretary (Department of Health and Social Care)
The five-day resident doctor strike in July 2025 had an estimated cost to the National Health Service of approximately £240 million, and this is a starting estimate for the planned November strike. The costs were lower than in July 2024 as a result of lower turnout. We continue to update estimates as new data becomes available, in line with receiving business as usual financial data from NHS systems.
The NHS has tried and tested plans in place to minimise disruption and will work with partners to ensure that safe care for patients continues to be available and emergency services continue to operate. Data published on 23 November shows that the NHS met its ambitious goal to maintain 95% of planned care during the November round of strike action, surpassing the 93% protected during action in July, while still maintaining critical services, including maternity services and urgent cancer care.
Asked by: Olivia Blake (Labour - Sheffield Hallam)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health and Social Care, whether the Cancer Plan will specifically address the availability of products containing Melanotan II.
Answered by Zubir Ahmed - Parliamentary Under-Secretary (Department of Health and Social Care)
The Government is taking steps to prevent, diagnose, and treat cancers more quickly, including skin cancers. The forthcoming National Cancer Plan will cover the entirety of the cancer pathway from referral and diagnosis to treatment and ongoing care. It will set out how we will improve outcomes for cancer patients, including by speeding up diagnosis and treatment, ensuring patients have access to the latest treatments and technology, and ultimately driving up this country’s cancer survival rates. We will publish the National Cancer Plan in the new year to reduce the number of lives lost to cancer over the next 10 years.
We received over 11,000 responses to our call for evidence from individuals, professionals, and organisations, and we are reviewing the submissions from skin cancer partners. While no formal assessment has been made of the availability and levels of the use of tan-enhancing products containing Melanotan II, respondents shared concerns about tanning products and their potential links to cancer, particularly melanoma. Our expansive engagement will allow the National Cancer Plan to have patients at its heart.
The Medicines and Healthcare products Regulatory Agency (MHRA) is responsible for the regulation of medicinal products and medical devices in the United Kingdom.
Although tanning is not considered to be a medical purpose, injectable products containing Melanotan I or Melanotan II have been determined as medicinal products due to their similarity to the authorised medicine Scenesse.
In relation to nasal sprays containing Melanotan I or Melanotan II, there are no equivalent authorised medicines, and in the absence of medicinal claims, they are not regarded as medicinal products.
Medicinal products must hold a relevant Marketing Authorisation to be legally sold and supplied in the United Kingdom. This also guarantees that the medicines have been tested for conformity with strict standards of quality, safety, and efficacy. The MHRA takes action when a medicinal product without appropriate authorisations is identified.
Asked by: Andrew Snowden (Conservative - Fylde)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health and Social Care, whether (a) families and (b) attorneys holding Power of Attorney are notified immediately when a DNR notice is added to a vulnerable adult’s medical record.
Answered by Zubir Ahmed - Parliamentary Under-Secretary (Department of Health and Social Care)
The Department remains clear that it is unacceptable for Do Not Attempt Cardiopulmonary Resuscitation (DNACPR) decisions to be applied in a blanket fashion to any group of people and should be fully discussed with the individual and their family where possible and appropriate. NHS England clinical leaders have issued a number of statements and letters to health and care providers which emphasise personalised approaches to care and treatment and which reiterate that there has never been an instruction or directive issued by the National Health Service to put in place a DNACPR solely on the basis of disability, learning disability, or special needs.
Agreement to a DNACPR is an individual decision and should involve the person concerned or, where the person lacks capacity, their families, carers, guardians, or other legally recognised advocates. Guidance from clinical bodies such as the British Medical Association, the Resuscitation Council UK, and Royal College of Nursing reflects this. These decisions should take into account the patient’s wishes, or those of people close to the patient, informed by a sensitive explanation of the risks and burdens associated with giving cardiopulmonary resuscitation. The treating doctor should try to reach agreement with the patient or those close to the patient. If, after discussion, the doctor remains of the view that cardiopulmonary resuscitation would not be clinically appropriate, there is not an obligation to attempt it. However, the rationale for not doing so should be clearly articulated. NHS England has published public-facing guidance on DNACPR decisions on the NHS.UK website. This includes advice on asking for a second opinion or review if patients, or their families, disagree with a DNACPR decision.
The Department has not received any complaints regarding DNACPR decisions being applied without consent in the last five years.
Asked by: Andrew Snowden (Conservative - Fylde)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health and Social Care, whether guidance has been issued to NHS Trusts to ensure that DNR decisions are never made solely on the basis of disability, learning disability and special needs.
Answered by Zubir Ahmed - Parliamentary Under-Secretary (Department of Health and Social Care)
The Department remains clear that it is unacceptable for Do Not Attempt Cardiopulmonary Resuscitation (DNACPR) decisions to be applied in a blanket fashion to any group of people and should be fully discussed with the individual and their family where possible and appropriate. NHS England clinical leaders have issued a number of statements and letters to health and care providers which emphasise personalised approaches to care and treatment and which reiterate that there has never been an instruction or directive issued by the National Health Service to put in place a DNACPR solely on the basis of disability, learning disability, or special needs.
Agreement to a DNACPR is an individual decision and should involve the person concerned or, where the person lacks capacity, their families, carers, guardians, or other legally recognised advocates. Guidance from clinical bodies such as the British Medical Association, the Resuscitation Council UK, and Royal College of Nursing reflects this. These decisions should take into account the patient’s wishes, or those of people close to the patient, informed by a sensitive explanation of the risks and burdens associated with giving cardiopulmonary resuscitation. The treating doctor should try to reach agreement with the patient or those close to the patient. If, after discussion, the doctor remains of the view that cardiopulmonary resuscitation would not be clinically appropriate, there is not an obligation to attempt it. However, the rationale for not doing so should be clearly articulated. NHS England has published public-facing guidance on DNACPR decisions on the NHS.UK website. This includes advice on asking for a second opinion or review if patients, or their families, disagree with a DNACPR decision.
The Department has not received any complaints regarding DNACPR decisions being applied without consent in the last five years.