Question to the Department for Transport:

To ask His Majesty's Government what estimate they have made of the capital and ongoing operating costs of developing, launching and maintaining the proposed Great British Railways ticketing website and mobile application.

Answered by Lord Hendy of Richmond Hill - Minister of State (Department for Transport)

Officials continue to develop the proposition for the Great British Railways app and website. We are engaging with industry on this project and will provide updates in due course.

Question to the Department of Health and Social Care:

To ask His Majesty's Government what assessment they have made of the impact on patients of withdrawing access to an existing cancer treatment, namely CAR-T therapy for relapsed or refractory mantle cell lymphoma, which has been available on the NHS since 2021.

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

202 patients have received brexucabtagene autoleucel, a form of CAR-T therapy, for the treatment of mantle cell lymphoma via the Cancer Drugs Fund (CDF). This data is taken from NHS England’s prior approval system. The National Institute for Health and Care Excellence (NICE) is currently re-evaluating the evidence on clinical outcomes collected through its use in the CDF in its ongoing re-evaluation of brexucabtagene autoleucel.

NICE published final draft guidance on 24 December 2025 in which it was not able to recommend brexucabtagene autoleucel for the treatment of relapsed or refractory mantle cell lymphoma in adults who have had two or more lines of systemic treatment that included a Bruton's tyrosine kinase inhibitor. This is because the extent of brexucabtagene autoleucel’s clinical benefit is uncertain. There are also uncertainties in the economic model because there is not enough evidence to tell if the cancer can be ‘cured’ in people having brexucabtagene autoleucel and it is not known how long people live after having brexucabtagene autoleucel. The cost-effectiveness estimates are also substantially above the range that NICE considers an acceptable use of National Health Service resources. NICE has not yet published final guidance and stakeholders have recently had an opportunity to appeal NICE’s recommendations.

The Government recognises that the potential withdrawal of brexucabtagene autoleucel as a treatment for future patients will be concerning for patients and their families, but it is right that these decisions are taken independently and on the basis of the available evidence. In line with an arrangement between NHS England and the company, if NICE’s final guidance does not recommend use, patients who started treatment during the managed access period can continue their treatment.

Question to the Department of Health and Social Care:

To ask His Majesty's Government how many patients have received CAR-T therapy for mantle cell lymphoma via the Cancer Drugs Fund; and what assessment has been made of the clinical outcomes for those patients.

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

202 patients have received brexucabtagene autoleucel, a form of CAR-T therapy, for the treatment of mantle cell lymphoma via the Cancer Drugs Fund (CDF). This data is taken from NHS England’s prior approval system. The National Institute for Health and Care Excellence (NICE) is currently re-evaluating the evidence on clinical outcomes collected through its use in the CDF in its ongoing re-evaluation of brexucabtagene autoleucel.

NICE published final draft guidance on 24 December 2025 in which it was not able to recommend brexucabtagene autoleucel for the treatment of relapsed or refractory mantle cell lymphoma in adults who have had two or more lines of systemic treatment that included a Bruton's tyrosine kinase inhibitor. This is because the extent of brexucabtagene autoleucel’s clinical benefit is uncertain. There are also uncertainties in the economic model because there is not enough evidence to tell if the cancer can be ‘cured’ in people having brexucabtagene autoleucel and it is not known how long people live after having brexucabtagene autoleucel. The cost-effectiveness estimates are also substantially above the range that NICE considers an acceptable use of National Health Service resources. NICE has not yet published final guidance and stakeholders have recently had an opportunity to appeal NICE’s recommendations.

The Government recognises that the potential withdrawal of brexucabtagene autoleucel as a treatment for future patients will be concerning for patients and their families, but it is right that these decisions are taken independently and on the basis of the available evidence. In line with an arrangement between NHS England and the company, if NICE’s final guidance does not recommend use, patients who started treatment during the managed access period can continue their treatment.

Question to the Department for Transport:

To ask His Majesty's Government what assessment they have made of the availability of specialist rail plant used in the maintenance of the rail network.

Answered by Lord Hendy of Richmond Hill - Minister of State (Department for Transport)

Network Rail is responsible for assessing the availability of specialist rail plant used in maintaining the rail network. It is currently reviewing its long-term equipment requirements for track maintenance and renewals, to ensure that it has the capacity, flexibility, and technology it needs to meet future demand efficiently.