Asked by: Lord Harper (Conservative - Life peer)
Question to the Department of Health and Social Care:
To ask His Majesty's Government what is the expected (1) total and (2) per capita reduction in daily calorie intake for (1) adults and (2) children in England as a result of the extension of the soft drinks industry levy announced on 25 November.
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 the calories consumed from the drinks in scope.
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. This is equivalent to approximately four million kcal per day in children and 13 million kcal per day in adults.
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 Harper (Conservative - Life peer)
Question to the Department of Health and Social Care:
To ask His Majesty's Government how many members will be on the Independent Commission on Adult Social Care, how many have been appointed to date, and what are the names and backgrounds of those appointed.
Answered by Baroness Merron - Parliamentary Under-Secretary (Department of Health and Social Care)
Baroness Louise Casey of Blackstock chairs the independent commission into adult social care (the Commission) alongside a dedicated secretariat team. No commissioners have been appointed.
Baroness Casey and the Commission’s secretariat are based in the Cabinet Office. The secretariat has a total of 11 officials, nine are employed by the Department of Health and Social Care, and two by the Cabinet Office. One external individual has been hired as contingent labour to support the work of the Commission’s secretariat. There are a further four officials working in the Commission’s sponsorship function based in the Department of Health and Social Care.
As the Commission is independent, the secretariat may expand as it carries out its work and as Baroness Casey considers what further skills and expertise she needs.
Asked by: Lord Harper (Conservative - Life peer)
Question to the Department of Health and Social Care:
To ask His Majesty's Government whether any civil servants are working on the implementation of the Terminally Ill Adults (End of Life) Bill beyond the work necessary to improve the workability of the legislative drafting.
Answered by Baroness Merron - Parliamentary Under-Secretary (Department of Health and Social Care)
The function of the team working within the Department is to fulfil the Government’s duty to the statute book, with regard to the legal and technical coherence of the bill.
Matters of policy have remained solely for the sponsoring members, the Hon. Member Kim Leadbeater in the Commons and the Rt Hon. Lord Falconer of Thoroton in the Lords, to determine.
None of this work to date has been done with the objective of implementing assisting dying. Should the bill gain Royal Assent, this work would form the basis of an implementation programme.
Asked by: Lord Harper (Conservative - Life peer)
Question to the Department of Health and Social Care:
To ask His Majesty's Government, in the light of the King’s College London report Learning from lives and deaths: people with a learning disability and autistic people, published in September, what steps they are taking to ensure that the impact on people with learning disabilities is considered when the policy for vaccine eligibility is decided this year, including when initially making the decision to accept JCVI recommendations.
Answered by Baroness Merron - Parliamentary Under-Secretary (Department of Health and Social Care)
The Government is committed to protecting those most vulnerable to COVID-19 through vaccination, as guided by the independent Joint Committee on Vaccination and Immunisation (JCVI). The primary aim of the national COVID-19 vaccination programme remains the prevention of serious illness, resulting in hospitalisations and deaths, arising from COVID-19.
The JCVI has advised that population immunity to COVID-19 has been increasing due to a combination of naturally acquired immunity following recovery from infection and vaccine-derived immunity. COVID-19 is now a relatively mild disease for most people, though it can still be unpleasant, with rates of hospitalisation and death from COVID-19 having reduced significantly since COVID-19 first emerged.
The focus of the JCVI advised programme has therefore moved towards targeted vaccination of the two groups who continue to be at higher risk of serious disease and mortality. These are the oldest adults and individuals who are immunosuppressed. The JCVI’s full advice for autumn 2025 is available on the GOV.UK website, in an online only format. The Government has accepted the JCVI’s advice for autumn 2025 and in line with the advice a COVID-19 vaccination is being offered to the following groups in autumn 2025:
As with other United Kingdom vaccination programmes, the JCVI’s advice on eligibility carefully considered the evidence on the risk of illness, serious disease, or death as a consequence of infection, in specific groups, as well as a cost-effectiveness analysis. The JCVI has engaged a number of organisations representing adults with learning disabilities to discuss the COVID-19 vaccine eligibility criteria.
The most recent Learning from Lives and Deaths: People with a Learning Disability and Autistic People Annual Report, based on 2023 data and published in September 2025, highlights how COVID-19 has fallen significantly as a cause of death in people with learning disabilities since the pandemic in 2021. Although it is important to caveat that the data in this report may not be complete for 2023 due to data collection issues, the trend observed provides reassurance that the risk of severe COVID-19 is much lower now than previously, including for people with a learning disability and autistic people.
As for all vaccines, the JCVI keeps the evidence under regular review.
Asked by: Lord Harper (Conservative - Life peer)
Question to the Department of Health and Social Care:
To ask His Majesty's Government what assessment they have made of the impact of removing eligibility for the COVID-19 booster vaccine on people with learning disabilities.
Answered by Baroness Merron - Parliamentary Under-Secretary (Department of Health and Social Care)
The Government is committed to protecting those most vulnerable to COVID-19 through vaccination, as guided by the independent Joint Committee on Vaccination and Immunisation (JCVI). The primary aim of the national COVID-19 vaccination programme remains the prevention of serious illness, resulting in hospitalisations and deaths, arising from COVID-19.
The JCVI has advised that population immunity to COVID-19 has been increasing due to a combination of naturally acquired immunity following recovery from infection and vaccine-derived immunity. COVID-19 is now a relatively mild disease for most people, though it can still be unpleasant, with rates of hospitalisation and death from COVID-19 having reduced significantly since COVID-19 first emerged.
The focus of the JCVI advised programme has therefore moved towards targeted vaccination of the two groups who continue to be at higher risk of serious disease and mortality. These are the oldest adults and individuals who are immunosuppressed. The JCVI’s full advice for autumn 2025 is available on the GOV.UK website, in an online only format. The Government has accepted the JCVI’s advice for autumn 2025 and in line with the advice a COVID-19 vaccination is being offered to the following groups in autumn 2025:
As with other United Kingdom vaccination programmes, the JCVI’s advice on eligibility carefully considered the evidence on the risk of illness, serious disease, or death as a consequence of infection, in specific groups, as well as a cost-effectiveness analysis. The JCVI has engaged a number of organisations representing adults with learning disabilities to discuss the COVID-19 vaccine eligibility criteria.
The most recent Learning from Lives and Deaths: People with a Learning Disability and Autistic People Annual Report, based on 2023 data and published in September 2025, highlights how COVID-19 has fallen significantly as a cause of death in people with learning disabilities since the pandemic in 2021. Although it is important to caveat that the data in this report may not be complete for 2023 due to data collection issues, the trend observed provides reassurance that the risk of severe COVID-19 is much lower now than previously, including for people with a learning disability and autistic people.
As for all vaccines, the JCVI keeps the evidence under regular review.
Asked by: Lord Harper (Conservative - Life peer)
Question to the Department of Health and Social Care:
To ask His Majesty's Government what assessment they have made of the current level of risk from COVID-19 to people with learning disabilities.
Answered by Baroness Merron - Parliamentary Under-Secretary (Department of Health and Social Care)
The Government is committed to protecting those most vulnerable to COVID-19 through vaccination, as guided by the independent Joint Committee on Vaccination and Immunisation (JCVI). The primary aim of the national COVID-19 vaccination programme remains the prevention of serious illness, resulting in hospitalisations and deaths, arising from COVID-19.
The JCVI has advised that population immunity to COVID-19 has been increasing due to a combination of naturally acquired immunity following recovery from infection and vaccine-derived immunity. COVID-19 is now a relatively mild disease for most people, though it can still be unpleasant, with rates of hospitalisation and death from COVID-19 having reduced significantly since COVID-19 first emerged.
The focus of the JCVI advised programme has therefore moved towards targeted vaccination of the two groups who continue to be at higher risk of serious disease and mortality. These are the oldest adults and individuals who are immunosuppressed. The JCVI’s full advice for autumn 2025 is available on the GOV.UK website, in an online only format. The Government has accepted the JCVI’s advice for autumn 2025 and in line with the advice a COVID-19 vaccination is being offered to the following groups in autumn 2025:
As with other United Kingdom vaccination programmes, the JCVI’s advice on eligibility carefully considered the evidence on the risk of illness, serious disease, or death as a consequence of infection, in specific groups, as well as a cost-effectiveness analysis. The JCVI has engaged a number of organisations representing adults with learning disabilities to discuss the COVID-19 vaccine eligibility criteria.
The most recent Learning from Lives and Deaths: People with a Learning Disability and Autistic People Annual Report, based on 2023 data and published in September 2025, highlights how COVID-19 has fallen significantly as a cause of death in people with learning disabilities since the pandemic in 2021. Although it is important to caveat that the data in this report may not be complete for 2023 due to data collection issues, the trend observed provides reassurance that the risk of severe COVID-19 is much lower now than previously, including for people with a learning disability and autistic people.
As for all vaccines, the JCVI keeps the evidence under regular review.
Asked by: Lord Harper (Conservative - Life peer)
Question to the Department of Health and Social Care:
To ask His Majesty's Government what assessment they have made of (1) the extent, and (2) the quality, of specialist palliative care commissioning of (a) in-patient beds, (b) community support teams, (c) hospital support teams, and (d) 24/7 advice.
Answered by Baroness Merron - Parliamentary Under-Secretary (Department of Health and Social Care)
Palliative care services are included in the list of services an integrated care board (ICB) must commission. This promotes a more consistent national approach and supports commissioners in prioritising palliative care and end of life care. To support ICBs in this duty, NHS England has published statutory guidance and service specifications.
As set out in that guidance, this could be through universal services, for example general practitioners and community nursing services, or via specialist services where appropriate. However, not all patients will require specialist palliative or end of life care.
This guidance also makes specific reference to commissioners defining how their services will meet population needs 24/7 and includes a priority action for ensuring that staff, patients, and carers can access the care and advice they need, whatever time of day.
NHS England has developed a palliative care and end of life care dashboard, which brings together all relevant local data in one place. The dashboard helps commissioners understand the palliative care and end of life care needs of their local population.
Additionally, NHS England has a legal duty to annually assess the performance of each ICB in respect of each financial year and to publish a summary of its findings. This assessment must assess how well the ICB has discharged its functions.
Asked by: Lord Harper (Conservative - Life peer)
Question to the Department of Health and Social Care:
To ask His Majesty's Government, further to the remarks by Baroness Merron on 20 October (HL Deb col 480), in what way is the Mental Health Act "very significant" in supporting people with learning disabilities to access NHS services.
Answered by Baroness Merron - Parliamentary Under-Secretary (Department of Health and Social Care)
The Government’s 10-Year Health Plan sets out to tackle health inequalities and people with disabilities are a priority for care from a neighbourhood team with more holistic, on-going support. Ahead of this, action is underway to improve access and support through staff training, proactive health checks and plans, and the Mental Health Act reforms.
The Government knows that people with a learning disability and autistic people have poorer health outcomes than the general population, including, on average, dying younger. They continue to experience disparities in the quality of care they receive, which may include barriers to accessing the right support.
The Government is rolling out the Oliver McGowan Mandatory Training on Learning Disability and Autism to the health and adult social care workforce to ensure staff have the right knowledge and skills to provide safe, informed care. Oliver’s Training is the Government’s preferred package for providers registered with the Care Quality Commission to meet the statutory training requirement under the Health and Care Act 2022. Over three million people have completed the e-learning package, the first part of this training, and more than 2,700 people have been trained to deliver the interactive second part nationwide.
Annual health checks for people with a learning disability are a crucial way to identify undetected conditions early and ensure the appropriateness of ongoing treatments. NHS England is working with people with lived experience, clinical professionals, and commissioners to produce a quality framework to ensure that these vital checks are high-quality. NHS England is also taking forward a range of work to improve the quality of the services accessed by people with a learning disability, including rollout of the Reasonable Adjustment Digital Flag across health and care services which enables health and publicly funded care professionals to record, share, and view details of the reasonable adjustments which individuals need to support their care and treatment.
The number of people with a learning disability and autistic people in mental health hospitals is unacceptable, and there are still too many people being detained who could be supported to live well in their communities. The Mental Health Bill currently before Parliament limits the scope of the ability to detain people with a learning disability and autistic people so that they can only be detained under Part 2, section 3 if they have a co-occurring mental disorder that requires hospital treatment. It also introduces measures to improve community support, including putting Care (Education) and Treatment Reviews and Dynamic Support Registers on a statutory footing, and placing certain duties on integrated care boards and local authorities when exercising existing commissioning duties.
Asked by: Lord Harper (Conservative - Life peer)
Question to the Department of Health and Social Care:
To ask His Majesty's Government what assessment they have made of the issues faced by people with learning disabilities in accessing NHS services; and what plans they have to address those issues.
Answered by Baroness Merron - Parliamentary Under-Secretary (Department of Health and Social Care)
The Government’s 10-Year Health Plan sets out to tackle health inequalities and people with disabilities are a priority for care from a neighbourhood team with more holistic, on-going support. Ahead of this, action is underway to improve access and support through staff training, proactive health checks and plans, and the Mental Health Act reforms.
The Government knows that people with a learning disability and autistic people have poorer health outcomes than the general population, including, on average, dying younger. They continue to experience disparities in the quality of care they receive, which may include barriers to accessing the right support.
The Government is rolling out the Oliver McGowan Mandatory Training on Learning Disability and Autism to the health and adult social care workforce to ensure staff have the right knowledge and skills to provide safe, informed care. Oliver’s Training is the Government’s preferred package for providers registered with the Care Quality Commission to meet the statutory training requirement under the Health and Care Act 2022. Over three million people have completed the e-learning package, the first part of this training, and more than 2,700 people have been trained to deliver the interactive second part nationwide.
Annual health checks for people with a learning disability are a crucial way to identify undetected conditions early and ensure the appropriateness of ongoing treatments. NHS England is working with people with lived experience, clinical professionals, and commissioners to produce a quality framework to ensure that these vital checks are high-quality. NHS England is also taking forward a range of work to improve the quality of the services accessed by people with a learning disability, including rollout of the Reasonable Adjustment Digital Flag across health and care services which enables health and publicly funded care professionals to record, share, and view details of the reasonable adjustments which individuals need to support their care and treatment.
The number of people with a learning disability and autistic people in mental health hospitals is unacceptable, and there are still too many people being detained who could be supported to live well in their communities. The Mental Health Bill currently before Parliament limits the scope of the ability to detain people with a learning disability and autistic people so that they can only be detained under Part 2, section 3 if they have a co-occurring mental disorder that requires hospital treatment. It also introduces measures to improve community support, including putting Care (Education) and Treatment Reviews and Dynamic Support Registers on a statutory footing, and placing certain duties on integrated care boards and local authorities when exercising existing commissioning duties.