Asked by: Lord Harper (Conservative - Life peer)
Question to the Department of Health and Social Care:
To ask His Majesty's Government how much revenue was received as a result of the work of overseas visitor managers in the NHS (1) in total, and (2) in each NHS Trust, in each of the last five years.
Answered by Baroness Merron - Parliamentary Under-Secretary (Department of Health and Social Care)
The Department does not hold the data requested on the number of overseas visitor managers that are employed by the National Health Service.
NHS England publishes Hospital and Community Health Services workforce statistics for England. The data is drawn from the Electronic Staff Record, the Human Resources system for the NHS. The level of detail available in the dataset is insufficient to identify staff who are employed in roles described as ‘Overseas Visitor Managers’ or similar.
The Department and NHS England publish annual data on the income identified and recovered from chargeable overseas visitors in England in the Department’s Annual Report and Accounts and in NHS England’s consolidated NHS provider accounts.
The following table shows aggregate income identified and cash payments received between 2020 and 2025:
Year | Aggregate income identified | Cash payments received in-year |
2020/21 | £61,000,000 | £21,000,000 |
2021/22 | £67,000,000 | £25,000,000 |
2022/23 | £100,000,000 | £32,000,000 |
2023/24 | £123,000,000 | £42,000,000 |
2024/25 | £142,000,000 | £43,000,000 |
Source: The Department of Health and Social Care Annual Report and Accounts and Consolidated NHS provider accounts.
Neither the Department nor NHS England hold a breakdown of this information by NHS trust.
NHS charges can be recovered up to six years from the date of invoice, and therefore the amount recovered in a year does not necessarily mean it was identified in the same financial year.
Asked by: Lord Harper (Conservative - Life peer)
Question to the Department of Health and Social Care:
To ask His Majesty's Government how many Overseas Visitor Managers are employed by the NHS (1) in total, and (2) in each NHS Trust.
Answered by Baroness Merron - Parliamentary Under-Secretary (Department of Health and Social Care)
The Department does not hold the data requested on the number of overseas visitor managers that are employed by the National Health Service.
NHS England publishes Hospital and Community Health Services workforce statistics for England. The data is drawn from the Electronic Staff Record, the Human Resources system for the NHS. The level of detail available in the dataset is insufficient to identify staff who are employed in roles described as ‘Overseas Visitor Managers’ or similar.
The Department and NHS England publish annual data on the income identified and recovered from chargeable overseas visitors in England in the Department’s Annual Report and Accounts and in NHS England’s consolidated NHS provider accounts.
The following table shows aggregate income identified and cash payments received between 2020 and 2025:
Year | Aggregate income identified | Cash payments received in-year |
2020/21 | £61,000,000 | £21,000,000 |
2021/22 | £67,000,000 | £25,000,000 |
2022/23 | £100,000,000 | £32,000,000 |
2023/24 | £123,000,000 | £42,000,000 |
2024/25 | £142,000,000 | £43,000,000 |
Source: The Department of Health and Social Care Annual Report and Accounts and Consolidated NHS provider accounts.
Neither the Department nor NHS England hold a breakdown of this information by NHS trust.
NHS charges can be recovered up to six years from the date of invoice, and therefore the amount recovered in a year does not necessarily mean it was identified in the same financial year.
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 answer by Baroness Merron on 16 December (HL Deb Col 661), what research has been carried out by, or on behalf of, the NHS to identify the reasons for vaccine hesitancy among NHS staff.
Answered by Baroness Merron - Parliamentary Under-Secretary (Department of Health and Social Care)
The Department invests over £1.6 billion each year on research through its research delivery arm, the National Institute for Health and Care Research (NIHR). It is funding research into the causes of vaccine hesitancy and ways to improve vaccine uptake in all adults and children, and to reduce inequalities in coverage.
The NIHR has funded a specific study aimed at improving the uptake rate of vaccination in the National Health Service for seasonal influenza. The results are published in Improving uptake of seasonal influenza vaccination by healthcare workers: Implementation differences between higher and lower uptake NHS trusts in England, from Infection, Disease and Health, volume 24, issue 1, published February 2019.
The NIHR has also funded research addressing factors associated with vaccine intention during COVID-19, which included health and social care workers. These results are published in Human Vaccines and Immunotherapeutics, in volume 17 in 2021, and volume 18 in 2022.
Other ongoing research to address the decline in immunisation rates is carried out by the NIHR Health Protection Research Unit in Vaccines and Immunisation and the NIHR Health Protection Research Unit on Evaluation and Behavioural Science. Both have received funding of £5.5 million over five years.
The NIHR continues to welcome funding applications for research into any aspect of human health, including vaccine hesitancy among National Health Service staff.
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.