Found: Letter from Lord Carlile of Berriew to Baroness Merron (Dept of Health and Social Care) re: Tobacco and

Question to the Department of Health and Social Care:

To ask His Majesty's Government, further to the Written Answer by Baroness Merron on 10 March (HL14737), when they plan to implement each of the immediate priorities for improving adult gender services in that answer.

Answered by Baroness Merron - Parliamentary Under-Secretary (Department of Health and Social Care)

Further to the written answer given on 10 March 2026 to Question HL14737, NHS England’s immediate priorities for improving adult gender services and their planned timeframes are as follows:

• the creation of a new single, national waiting list for adult gender services, with plans for a phased transfer of patients from May 2026;
• raising the referral threshold to 18 years old to align with the age of discharge from the NHS Children and Young People’s Service, which was enacted in December 2025;
• bringing an end to self-referrals into the service and, in parallel, providing advice and guidance for those finding it difficult to secure a referral, which will be enacted through the new service specification for adult gender services, which is planned to be operational for the 2027/28 financial year; and
• establishing productivity goals for every service which can then guide and inform the commissioning of additional services, underpinned by a clear understanding of the regional demand through the national waiting list, with plans for this to be in place by the autumn of 2026.

Question to the Department of Health and Social Care:

To ask His Majesty's Government, further to the Written Answer by Baroness Merron on 10 March (HL14735), when they expect the national minimum dataset for adult gender dysphoria clinics to be completed and in use.

Answered by Baroness Merron - Parliamentary Under-Secretary (Department of Health and Social Care)

NHS England plans for the national minimum dataset for adult gender dysphoria services to be operational in the next financial year, 2027/28.

Question to the Department of Health and Social Care:

To ask His Majesty's Government, further to the Written Answer by Baroness Merron on 4 March (HL14724), whether NHS England has provided guidance to integrated care boards in the current planning round to include robotic assisted surgery adoption trajectories in their operational plans; what monitoring arrangements are in place to assess uptake and implementation by NHS trusts of the guidance Implementation of robotic assisted surgery in England, published in July 2025; and what is meant by "regional alliances" in the context of robotic assisted surgery expansion.

Answered by Baroness Merron - Parliamentary Under-Secretary (Department of Health and Social Care)

The Department and NHS England are working with senior leaders across the health system, including integrated care boards (ICBs), to make sure that procurement of surgical robotic platforms supports innovation, transparency and long-term value.

No guidance has been provided to ICBs at this stage, but equity of access remains a key consideration. The Department and NHS England are working with regional partners to understand how robotics can be deployed in a way that supports equity, productivity and population need. Regional alliances refer to Cancer Alliances, which look at the care and support patients should expect to receive from diagnosis to follow-up across their whole area, so they can address variation and implement best practice. NHS England provides Cancer Alliances with funding for cancer to assist in their work.

Decisions on the procurement of robotic-assisted surgery are made locally by National Health Service trusts and ICBs, in line with local need and national guidance. No specific targets or monitoring arrangements have been set in relation to uptake or implementation of the July 2025 Getting It Right First Time (GIRFT) guidance. However, a baseline assessment is being undertaken to understand the current provision of robotic assisted surgery and the increase in activity needed to begin to close the gaps. NHS England has funding in place for a national robotic surgery registry, which, once established will provide near real-time data on this aspect.

Question to the Department of Health and Social Care:

To ask His Majesty's Government, further to the Written Answer by Baroness Merron on 30 March (HL15723), whether the interim leadership cover for the South Yorkshire Integrated Care Board carries out the same statutory duties as the redundant Chief Executive role; and if so, what assessment they have made of the compliance of this redundancy with the HM Treasury guidance on Public Sector Exit Payments and value for money protocols.

Answered by Baroness Merron - Parliamentary Under-Secretary (Department of Health and Social Care)

It has not proved possible to respond to this question in the time available before Prorogation. Ministers will correspond directly with the Member.

Question to the Department of Health and Social Care:

To ask His Majesty's Government, further to the Written Answer by Baroness Merron on 30 March (HL15724), whether the post of the previous chief executive of the South Yorkshire Integrated Care Board was identified for the redundancy pool as a direct result of a legal merger or abolition of that ICB as part of the reduction of ICBs from 42 to 26; and if no such merger or abolition was formally proposed for South Yorkshire ICB, on what basis that post was identified for redundancy under that framework.

Answered by Baroness Merron - Parliamentary Under-Secretary (Department of Health and Social Care)

It has not proved possible to respond to this question in the time available before Prorogation. Ministers will correspond directly with the Member.

Question to the Department of Health and Social Care:

To ask His Majesty's Government, further to the Written Answer by Baroness Merron on 12 March (HL13897), what are the health disparities of Gypsy, Traveller and Roma ethnic groups in the areas in that Answer, in particular (1) maternal mortality outcomes, (2) mental health provision, (3) cancer outcomes, and (4) cardiovascular disease; and what action they are taking to reduce those disparities.

Answered by Baroness Merron - Parliamentary Under-Secretary (Department of Health and Social Care)

It is a priority for the Government to increase the amount of time people spend in good health and prevent premature deaths. Our 10-Year Health Plan for England sets out a reimagined service designed to tackle inequalities in both access and outcomes, including our ambitious commitment to halve the healthy life expectancy gap between the richest and poorest regions.

NHS England has launched a Maternity and Neonatal Equalities dashboard that brings together key information to address health inequalities in maternity and neonatal care services from a range of data sources, with breakdowns by ethnicity and deprivation to make health inequalities visible, measurable, and actionable in maternity and neonatal services.

NHS England is implementing a new anti-discrimination programme, which aims to ensure all service users and their families will receive care free from discrimination and racism, and all staff will experience a work environment free from discrimination and racism. All trusts are expected to have completed the programme by 2027.

We have legislated to modernise the Mental Health Act to strengthen choice, autonomy and rights, and ensure people are treated with dignity and respect. The Government is also committed to delivering the cross-sector Suicide Prevention Strategy for England (2023 to 2028), including its ambition to improve evidence and better understand national trends and suicide rates in particular groups, including people who are Gypsy, Roma or Travellers.

The Government and NHS England have announced a three-year Neighbourhood Early Diagnosis Fund as part of £200 million investment for Cancer Alliances to tackle inequalities in screening and early diagnosis in deprived and underserved areas. Core20PLUS5 also includes early cancer diagnosis as a priority area for accelerated improvement.

The Department recognises inequalities exist across the cardiovascular disease (CVD) pathway. The Department and NHS England are working together to develop a CVD Modern Service Framework which will support, evidence-led consistent, high quality and equitable care.

Question to the Department of Health and Social Care:

To ask His Majesty's Government, further to the Written Answer by Baroness Merron on 10 March (HL14740), how the Cass Review recommendations will be implemented and monitored across NHS children and young people gender services.

Answered by Baroness Merron - Parliamentary Under-Secretary (Department of Health and Social Care)

On 1 April 2026, NHS England published a final service specification for National Health Service children and young people's gender services, which incorporates the findings and recommendations of the final report of the Cass Review, including adoption of the new Holistic Assessment Framework.

NHS England continues to have oversight of implementation of the various Cass Review recommendations in 2026/27, in line with the implementation plan published in August 2024. NHS England chairs a National Portfolio Board for NHS Children and Young People’s Gender Services, which is the vehicle for monitoring progress for implementing recommendations from the Cass Review. Membership of the board includes officials from the Department of Health and Social Care, Baroness Cass, the independent Chair of the National Provider Network, representatives of the royal colleges of medicine, senior clinicians, the NHS National Medical Director for Specialised Services, and the NHS National Director for Specialised Services.

Question to the Department of Health and Social Care:

To ask His Majesty's Government, further to the Written Answer by Baroness Merron on 11 March (HL15021), how many patients are treated for non-Hodgkin lymphoma by the NHS each year.

Answered by Baroness Merron - Parliamentary Under-Secretary (Department of Health and Social Care)

The National Health Service provides a range of treatments for non-Hodgkin lymphoma, including chemotherapy as a first treatment, immunotherapy, radiotherapy, targeted therapies, and stem cell transplantation for eligible patients.

Effectiveness of treatments is assessed by clinicians for individual patients using data on measures such as the responsiveness of the cancer to treatment, remission, overall survival, and quality of life. The most appropriate treatment depends on the type and stage of lymphoma and the patient’s individual circumstances, and decisions are made by specialist multidisciplinary teams.

The National Institute for Health and Care Excellence (NICE) has evaluated and recommended several Chimeric Antigen Receptor T Cell (CAR-T) Therapy treatments for use within the Cancer Drugs Fund for the treatment of various cancers, including for large B-cell lymphoma a sub type of non-Hodgkin lymphoma, which are now available to NHS patients in line with NICE’s recommendations. In November 2025, NHS England published commissioning guidance to support the implementation of CAR-T therapies for blood cancer.

Furthermore, the National Cancer Plan commits to ensuring rare cancer patients, including blood cancer, have improved access to targeted and personalised treatments where genomics identifies suitable options. The plan aims is to improve survival rates for rare cancers, including blood cancers by exploring novel procurement routes for diagnostics and treatments. Genomics will support the development of new treatments to improve outcomes for those with cancer.

The following table shows, from latest data available, the number of patients treated for non-Hodkin lymphoma receiving radiotherapy, systemic anti-cancer treatment (SACT), and tumour resections for their tumour, each year from 2019 to 2022:

Question to the Department of Health and Social Care:

To ask His Majesty's Government, further to the remarks by Baroness Merron on 24 November 2025 (HL Deb col 1107), when they intend to launch the consultation on emergency police powers of detention.

Answered by Baroness Merron - Parliamentary Under-Secretary (Department of Health and Social Care)

On 24 November, the Department announced its commitment to consult on the powers available to different professionals in different situations and settings, in particular, but not limited to, the operation of the emergency powers in sections 135 and 136. The consultation will seek views on powers and joint working approaches to ensure that health and social care professionals and police have the appropriate powers to act in order to prevent people harming themselves and others when in a mental health crisis.

The Department also set out plans to work closely with a range of stakeholders to shape the scope of that consultation. Officials at the Department of Health and Social Care have started engagement with Home Office officials and stakeholders from the police, health, and social care to consider the options to consult on that support better outcomes for patients and services, and we will set out further detail on the timing of the consultation in due course.

Question to the Department of Health and Social Care:

To ask His Majesty's Government, further to the Written Answer by Baroness Merron on 4 March (HL14721) indicating a substantial underspend in the Innovative Medicines Fund, what steps they are taking to expand managed access pathways for innovative medicines, including disease-modifying treatments for Alzheimer’s disease such as Lecanemab and Donanemab.

Answered by Baroness Merron - Parliamentary Under-Secretary (Department of Health and Social Care)

NHS England cannot comment on the proportion of the Innovative Medicines Fund’s budget that has been spent on medicines made available through managed access agreements. Due to the low numbers of patients who receive these highly specialised treatments, publishing this information risks confidentiality of pricing.

The National Institute for Health and Care Excellence (NICE) is able to recommend any medicine, including for the treatment of Alzheimer’s disease, for a period of managed access through the Innovative Medicines Fund where it concludes that it is plausibly cost effective and the collection of real-world evidence may resolve clinical uncertainty. NICE concluded in its draft guidance on lecanemab and donanemab that neither treatment was suitable for a period of managed access but has not yet published its final guidance. There are no current plans to expand the circumstances in which NICE is able recommend medicines for managed access.

Question to the Department of Health and Social Care:

To ask His Majesty's Government, further to the Written Answer by Baroness Merron on 4 March (HL14721), what proportion of the Innovative Medicines Fund budget has been spent on medicines made available through managed access agreements.

Answered by Baroness Merron - Parliamentary Under-Secretary (Department of Health and Social Care)

NHS England cannot comment on the proportion of the Innovative Medicines Fund’s budget that has been spent on medicines made available through managed access agreements. Due to the low numbers of patients who receive these highly specialised treatments, publishing this information risks confidentiality of pricing.

The National Institute for Health and Care Excellence (NICE) is able to recommend any medicine, including for the treatment of Alzheimer’s disease, for a period of managed access through the Innovative Medicines Fund where it concludes that it is plausibly cost effective and the collection of real-world evidence may resolve clinical uncertainty. NICE concluded in its draft guidance on lecanemab and donanemab that neither treatment was suitable for a period of managed access but has not yet published its final guidance. There are no current plans to expand the circumstances in which NICE is able recommend medicines for managed access.

Question to the Department of Health and Social Care:

To ask His Majesty's Government, further to the Written Answer by Baroness Merron on 3 February (HL14030), whether they have made a decision on whether the increased cost-effectiveness threshold will apply to medical technologies that are evaluated by the National Institute for Health and Care Excellent through its HealthTech programme.

Answered by Baroness Merron - Parliamentary Under-Secretary (Department of Health and Social Care)

Pursuant to the to the answer of 3 February, the Government is actively considering whether the increased cost-effectiveness threshold will apply to medical technologies that are evaluated by the National Institute for Health and Care Excellence through its HealthTech programme and will set out its position in due course.

Found: Letter from Baroness Merron to Baroness O'Loan regarding the question on the supply of approved substances

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Found: Letter dated 23/04/2026 from Baroness Merron to Baroness Coffey regarding issues raised during the Committee