David Smith

I hold regular discussions with National Highways on matters related to the Strategic Road Network. I am aware that National Highways is undertaking a safety study on the A1 through Northumberland which focuses on how it can improve the route’s safety rating. The study will identify specific locations where safety performance can be enhanced. These locations can then be considered for funding as part of the future Road Investment Strategies.

National Highways has considered the safety record of the A1 through North Northumberland, along with other priorities for this section of the route, as part of its London to Scotland (East) Route Strategy. The outputs of this work will be considered as part of final decisions on investment in the third Road Investment Strategy.

As the Chancellor of the Exchequer announced on 11 June, this Government will deliver improvements to people’s everyday travel by providing £24 billion of capital funding between 2026-27 and 2029-30 to maintain and improve national and local roads across the country. We will confirm funding for the third Road Investment Strategy in due course.

The Department for Transport will confirm the enhancement schemes and large-scale renewals to be delivered in the next road period when the third Road Investment Strategy is published in early 2026. National Highways will then publish further details in its Delivery Plan.

The Government does not believe the current access is working in the best interests of passengers and taxpayers. Our consultation set out proposals for fundamental reform of the access and charging framework under Great British railways, a single directing mind, able to take decisions on access in the public interest and make the best use of expensive national infrastructure.

The Government has been very clear that where it adds value and opens up new markets, with better outcomes for passengers, and where the levels of abstraction and service reliability impacts are acceptable, there will remain a place for open access on the Great British Railways managed railway. Great British Railways will be held to account by the ORR through a robust and independent appeals function which will ensure access decisions are fair and non-discriminatory with the ability to direct appropriate remedies.

The Department is working closely with the Inter-Ministerial Group on Homelessness and Rough Sleeping, to get the country back on track to ending homelessness.

As I made clear in my statement to the House, Hansard, 1 July, col 219, any changes to PIP eligibility will come after a comprehensive review of the benefit, which I am leading, and which will be co-produced with disabled people, the organisations that represent them, clinicians, experts, MPs and other stakeholders, so a wide range of views and voices are heard. This review aims to ensure that the PIP assessment is fair and fit for the future. The review is expected to conclude in autumn 2026.

Personal Independence Payment (PIP) is there to help people, now and into the future, with the extra costs of living with a disability.

PIP is not intended to cover housing costs, which are paid through Universal Credit or Housing Benefit, but my department is committed to identifying and preventing homelessness amongst all customers.

Tailored support is available to those at risk of and experiencing homelessness. This includes easements for those with work-related requirements, to give the space to resolve housing issues; referrals to local authority housing teams under ‘duty to refer’ legislation; and signposting to money advice services.

We are continuing funding this year for local authorities to provide additional financial support for people struggling with housing and other essential living costs through the Household Support Fund and Discretionary Housing Payments. Through the Spending Review, we announced £1bn a year including Barnett consequentials from 2026 to reform crisis support in England.

The Pathways to Work Green Paper announced a broad package of plans and proposals to reform health and disability benefits and employment support. Our reforms will ensure the most vulnerable and severely disabled people are protected, so they can live with dignity and security, while supporting those who can work to do so. As we develop detailed proposals for change, we will continue to consider the potential impacts of reforms.

Ending all forms of homelessness is a priority for this Government. £1 billion has been invested in homelessness and rough sleeping services this year. DWP is fully committed to playing its part in homelessness prevention and supporting MHCLG to develop a new cross-government strategy to get us back on track to ending homelessness.

We strongly value the input of disabled people and people with health conditions, in addition to representative organisations that support them, and that is why we have brought forward this Green Paper and the consultation.

The consultation welcomes the views of voluntary organisations, and we hope many will respond before the consultation closes on the 30 June 2025. Our programme of accessible public events will further facilitate input, including in-person and online, and will help us hear from disabled people and representative organisations directly.

We are also exploring other ways to facilitate the involvement of stakeholders in our reforms. In addition to the consultation, we will establish ‘collaboration committees’ that bring groups of people together for specific policy development areas and our wider review of the PIP assessment will bring together a range of experts, stakeholders and people with lived experience.

As we develop proposals further, we will consider how to best to involve voluntary and community organisations in the planning and implementation of reforms, including in our employment support package.

We announced in the Pathways to Work Green Paper that we would establish a new guarantee of support for all disabled people and people with health conditions claiming out of work benefits who want help to get into or return to work, backed up by £1 billion of new funding

As the Green Paper notes, we are keen to engage widely on the design of this guarantee and the components needed to deliver it. To get this right, we will be seeking input from a wide range of stakeholders including devolved governments, local health systems, local government and Mayoral Strategic Authorities, organisations in the private, voluntary and charitable sectors, employers and potential users. We will confirm further details in due course after we have completed our consultation process.  We expect voluntary and charitable organisations to play a significant role in delivering employment support.

Universal Credit treats all forms and sectors of self-employment in the same way, focusing on the level of a customer’s earnings rather than the sector in which they work. The Minimum Income Floor (MIF) encourages self-employed customers to progress in work and grow their earnings to a sustainable level.

The Government is committed to reviewing Universal Credit. Further details will be provided in due course.

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 (hospitalisations and deaths) arising from COVID-19. 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, including mortality. These are the oldest adults and individuals who are immunosuppressed.

On 13 November 2024, JCVI published advice on who should be offered vaccination in autumn 2025. On 26 June 2025, the Government accepted the JCVI’s advice that in autumn 2025, a COVID-19 vaccination should be offered to the following groups:

• adults aged 75 years and over;

• residents in care homes for older adults;

• individuals aged 6 months and over who are immunosuppressed (as defined in the ‘immunosuppression’ sections of tables 3 or 4 in the COVID-19 chapter of the UK Health Security Agency Green Book).

The Government has no plans to change eligibility for autumn 2025. It has accepted the JCVI advice for this campaign in full. As for all vaccines, the JCVI keeps the evidence under regular review.

Semaglutide, brand name Wegovy, tirzepatide, brand name Mounjaro, and liraglutide, brand name Saxenda, are approved for the management of obesity. They are recommended as cost-effective for use on the National Health Service for people who have a body mass index (BMI) over a certain threshold, and one or more weight-related comorbidities.

The marketing authorisations for tirzepatide and other weight loss medicines do not include an exhaustive list of qualifying comorbidities, and it is for the prescriber to apply their clinical judgement in determining whether a patient meets the eligibility criteria.

The exact causes of lipoedema are not clear, and the NHS.UK website states that it’s not caused by being overweight, and that it is a separate condition to obesity.

The NHS is currently rolling out tirzepatide in primary care, using a phased approach based on clinical need. Approximately 220,000 individuals are expected to be eligible over the next three years. NHS England worked with clinical experts, NHS integrated care boards, patient and public representatives, healthcare professionals, charities, and royal colleges on its prioritisation approach, which it set out in its interim commissioning guidance, at the following link:

https://www.england.nhs.uk/publication/interim-commissioning-guidance-implementation-of-the-nice-technology-appraisal-ta1026-and-the-nice-funding-variation-for-tirzepatide-mounjaro-for-the-management-of-obesity/

At the current time, patients will be eligible for treatment in primary care if they have a BMI of at least forty, and four or more out of five ‘qualifying' conditions. The qualifying conditions for tirzepatide treatment are cardiovascular disease, hypertension, dyslipidaemia, obstructive sleep apnoea, and type 2 diabetes mellitus.

Improving outcomes and experiences of cancer treatment, including lobular breast cancer and other rare cancers, is a priority for the Government. Engagement with campaigners and partners is vital to achieving this.

My rt. Hon. Friend, the Secretary of State for Health and Social Care, accompanied by my hon. Friend, the Minister of State for Health, met with representatives of the Lobular Moonshot Project on 14 July 2025 to discuss their work. Following this meeting, the Chief Scientific Adviser and officials from the Department and the Medical Research Council (MRC) met again with the Lobular Moonshot Project to provide advice on existing funding options. Both the MRC and the National Institute for Health and Care Research have committed to continuing to work with the Lobular Moonshot Campaign team to support the development of fundable research proposals in this area and help drive our collective ambition to increase understanding and effective management of this disease.

In April 2025, I attended an event with Cancer Research UK, Macmillan, and Cancer52. The was followed by a roundtable in May 2025, in which I met with Cancer52 members, representing a wide range of cancer types, to discuss how the National Cancer Plan can prioritise rare cancers, to make a meaningful difference to how patients experience cancer treatment, and to bring cancer survivability back up to the standards of the best in the world. I have also met with brain cancer campaigners and All-Party Parliamentary Group members on several occasions since taking up post.

The National Cancer Plan will include more details about improving treatments for all tumour types, including lobular breast cancer. The Department continues to engage with a wide range of cancer partners on the Plan, including charities and patient representative bodies.

While the Department has made no assessment, approximately 89% of prescription items are dispensed free of charge in the community in England, and there is a wide range of exemptions from prescription charges already in place for which those with ulcerative colitis and Crohn’s disease may be eligible. Eligibility depends on the patient’s age, whether they are in qualifying full-time education, whether they are pregnant or have recently given birth, whether they have a qualifying medical condition, or whether they are in receipt of certain benefits or a war pension.

People on low incomes can apply for help with their health costs through the NHS Low Income Scheme. Prescription prepayment certificates (PPCs) are also available. PPCs allow people to claim as many prescriptions as they need for a set cost, with three-month and 12-month certificates available. The 12-month PPC can be paid for in instalments.

The 10-Year Health Plan sets out our plan to get the National Health Service back on track and make it fit for the future through delivering three big shifts in how the NHS works. By moving more care from hospital to community, shifting from analogue to digital, and reaching patients earlier by shifting from sickness to prevention, the NHS will be better enabled to meet future demographic changes.

Integrated care boards are expected to have a deep understanding of their population’s needs and will engage with the public to develop long-term plans that meet these needs.