Asked by: Joshua Reynolds (Liberal Democrat - Maidenhead)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health and Social Care, whether he plans to allow inhalers to be sold over the counter without a prescription.
Answered by Zubir Ahmed - Parliamentary Under-Secretary (Department of Health and Social Care)
At present, inhalers used for conditions such as asthma and chronic obstructive pulmonary disease are authorised as prescription-only medicines (POM). This classification reflects the clinical need for a healthcare professional to confirm diagnosis, advise on correct inhaler technique, determine appropriate dosing, monitor treatment response, and detect any adverse reactions. The prescription requirement also supports the systematic recording of use and helps prevent inappropriate or excessive use.
It is also important to note that inhalers themselves are not a class of medicine per se but a delivery device for a range of medicines.
If a manufacturer or marketing authorisation holder wishes to pursue POM to pharmacy medicine reclassification for any type of medicine or their mode of delivery, the appropriate route is to submit a major reclassification application to the Medicines and Healthcare products Regulatory Agency (MHRA). This is a formal dossier that must present a robust evidential case in support of reclassification.
The MHRA publishes guidance on the requirements for reclassification applications, including what constitutes a “major” reclassification. The MHRA is open to early dialogue with sponsors to clarify expectations and help focus application efforts via the provision of scientific advice. Until such an application is received and assessed under the statutory framework, the prescription requirement remains in place.
Should a comprehensive dossier be submitted, the MHRA will consider it in line with its public-health mandate. The MHRA remains open to innovations that improve patient access and convenience, provided they uphold safety, clinical outcomes, and quality of care.
Asked by: Joshua Reynolds (Liberal Democrat - Maidenhead)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health and Social Care, whether his Department plans to examine options for a separate evaluation process for orphan medicines claiming significant benefit over existing treatments.
Answered by Zubir Ahmed - Parliamentary Under-Secretary (Department of Health and Social Care)
There are no plans to introduce a separate evaluation process for orphan medicines. The National Institute for Health and Care Excellence (NICE) makes recommendations for the National Health Service on whether all new licensed medicines, including medicines for rare diseases, should be routinely funded by the NHS based on an assessment of their costs and benefits. NICE operates a separate highly specialised technologies programme for the evaluation of a small number of treatments for very rare, very severe diseases which uses a much higher cost-effectiveness threshold that recognises the challenges of bringing treatments for very rare diseases to market.
NICE’s methods have been proven to be suitable for the evaluation of rare disease medicines, where companies are willing to price their medicines fairly. NICE’s approval rate for medicines for rare diseases is in line with its overall approval rate for new medicines, and from April 2024 to April 2025, NICE recommended all 15 of the rare disease drugs that it evaluated through its standard technology appraisal programme.
Asked by: Joshua Reynolds (Liberal Democrat - Maidenhead)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health and Social Care, what assessment his Department has made of the potential impact of the National Institute for Health and Care Excellence not having updated its methods on evaluating the wider societal costs of rare diseases since 2017.
Answered by Zubir Ahmed - Parliamentary Under-Secretary (Department of Health and Social Care)
There are no plans to introduce a separate evaluation process for orphan medicines. The National Institute for Health and Care Excellence (NICE) makes recommendations for the National Health Service on whether all new licensed medicines, including medicines for rare diseases, should be routinely funded by the NHS based on an assessment of their costs and benefits. NICE operates a separate highly specialised technologies programme for the evaluation of a small number of treatments for very rare, very severe diseases which uses a much higher cost-effectiveness threshold that recognises the challenges of bringing treatments for very rare diseases to market.
NICE’s methods have been proven to be suitable for the evaluation of rare disease medicines, where companies are willing to price their medicines fairly. NICE’s approval rate for medicines for rare diseases is in line with its overall approval rate for new medicines, and from April 2024 to April 2025, NICE recommended all 15 of the rare disease drugs that it evaluated through its standard technology appraisal programme.
Asked by: Joshua Reynolds (Liberal Democrat - Maidenhead)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health and Social Care, whether his Department is taking steps to introduce an (a) diagnostic protocol for bowel cancer in patients under 50 and (b) a mandatory referral for colonoscopy after two presentations of unresolved rectal bleeding.
Answered by Ashley Dalton - Parliamentary Under-Secretary (Department of Health and Social Care)
The Department is committed to ensuring that people of all ages with symptoms of bowel cancer are diagnosed as quickly as possible. Clinicians should use their judgment in line with National Institute for Health and Care Excellence (NICE) guidance to ensure that every patient receives timely and appropriate investigation for bowel cancer, including patients aged under 50 years old presenting with unresolved rectal bleeding.
Guidance on referral for suspected cancer is developed and maintained by NICE. The guideline NG12 sets out the symptoms which should prompt referral for urgent investigation. For lower gastrointestinal cancer, there are several indications for patients aged under 50 years old which would be expected to result in referral. Further information can be found on the NICE website at the following link:
Asked by: Joshua Reynolds (Liberal Democrat - Maidenhead)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health and Social Care, what steps the Medicines and Healthcare products Regulatory Agency is taking to ensure transparency in the (a) operation and (b) maintenance of the UK orphan medicines register.
Answered by Zubir Ahmed - Parliamentary Under-Secretary (Department of Health and Social Care)
The Medicines and Healthcare Products Regulatory Agency (MHRA) is an executive agency of the Department of Health and Social Care and regulates medicine, medical devices and blood components for transfusion in the UK, with responsibility for ensuring medicines meet appropriate standards of safety, quality and efficacy.
The United Kingdom Orphan Register is publicly available at the following link:
https://www.gov.uk/government/publications/orphan-registered-medicinal-products/orphan-register
The register is updated by the MHRA when a new orphan medicinal product or new orphan indication is authorised or their market protection expires. A process of checks to be carried out on the register on a periodic basis has been implemented to ensure that accuracy of the website is maintained.
Asked by: Joshua Reynolds (Liberal Democrat - Maidenhead)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health and Social Care, what structures are in place within the NHS to (a) oversee and (b) manage financial efficiency in healthcare settings; and whether his Department has considered establishing a dedicated executive function to support this work.
Answered by Karin Smyth - Minister of State (Department of Health and Social Care)
Financial efficiency within the National Health Service is managed primarily by integrated care boards (ICBs) and NHS trusts, which are responsible for local financial planning, budget control, and delivery of efficiency savings. Progress is monitored and supported by both NHS England regional and national teams including as part of the new Financial Performance and Improvement Programme. For example, as part of 2025/2026 planning, NHS England provided every provider and system with a tailored and benchmarked productivity and efficiency data pack setting out opportunities to support the development of efficiency and savings schemes.
NHS England have also established an executive chaired group to oversee the development of a coherent, organisation-wide strategy and associated policies for delivering programmes to improve productivity and efficiency across the NHS.
Asked by: Joshua Reynolds (Liberal Democrat - Maidenhead)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health and Social Care, what his Department’s policy is on the use of cash for food vendor payments in NHS hospitals.
Answered by Karin Smyth - Minister of State (Department of Health and Social Care)
The Department does not have a policy on the use of cash for the payment of food vendors in National Health Service hospitals. These decisions are taken locally by NHS organisations.
Asked by: Joshua Reynolds (Liberal Democrat - Maidenhead)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health and Social Care, what recent assessment his Department has made of the potential impact of midwifery recruitment freezes on maternal health outcomes in England; and what steps his Department is taking to reduce staffing shortages in maternity services in areas where (a) hospital access times are longer and (b) home birth provision has declined.
Answered by Karin Smyth - Minister of State (Department of Health and Social Care)
The Government is committed to tackling the retention and recruitment challenges that face the National Health Service.
NHS England is leading a range of initiatives to boost the retention of existing staff. This includes building a compassionate and inclusive culture, supporting staff wellbeing, and promoting flexible working opportunities.
On 11 August, we announced the Graduate Guarantee for nurses and midwives. The Graduate Guarantee will ensure that there are enough positions for every newly qualified midwife in England. The package of measures will unlock thousands of jobs and will ensure thousands of new posts are easier to access by removing barriers for NHS trusts, creating opportunities for graduates and ensuring a seamless transition from training to employment.
Vacant maternity support worker posts will be temporarily converted to band 5 midwifery roles, backed by £8 million to create new opportunities specifically for newly qualified midwives and to further ease the recruitment strain.
These new measures aim to tackle graduates’ concerns about job availability and ensure the NHS has the right staff to provide the best possible care to patients everywhere.
Targeted retention work for midwives is being undertaken by NHS England, led by the Chief Nursing Officer for England. This work contains a range of measures, including creation of a midwifery and nursing retention self-assessment tool, mentoring schemes, strengthened advice and support on pensions, and embedding flexible retirement options. NHS England has also invested in unit-based retention leads which, alongside investment in workforce capacity, has seen a reduction in vacancy, leaver and turnover rates.
There are four nationally run programmes to develop midwifery staff, at bands 6 and above, from ethnic minority groups to better support patients, in addition to local initiatives to better reflect the community of the women and babies they support.
Responsibility for the delivery, implementation and funding decisions for services ultimately rests with the appropriate NHS commissioner. This includes waiting times and homebirth provisions.
NHS commissioners are expected to develop clear plans for reverting temporary service changes or developing plans for the permanent reconfiguration of the service. All service changes should be based on clear evidence that they will deliver better outcomes for patients.
Asked by: Joshua Reynolds (Liberal Democrat - Maidenhead)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health and Social Care, what his planned timeline is for publishing a Government response to the Hughes Report, published on 7 February 2024.
Answered by Karin Smyth - Minister of State (Department of Health and Social Care)
The Government is carefully considering the work by the Patient Safety Commissioner and her Report, which set out options for redress for those harmed by valproate and pelvic mesh. This is a complex issue involving input from different Government Departments. The Government will provide a further update to the Patient Safety Commissioner’s Report.
Asked by: Joshua Reynolds (Liberal Democrat - Maidenhead)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health and Social Care, what steps his Department is taking to expand access to degree apprenticeships in midwifery for (a) mature students, (b) career changers and (c) other people who face (i) financial and (ii) practical barriers to undertaking traditional university training routes.
Answered by Karin Smyth - Minister of State (Department of Health and Social Care)
We will publish a new workforce plan to deliver the transformed health service we will build over the next decade, and will treat patients on time again. This will include how we ensure we train healthcare staff, through all training routes including apprenticeships, to support patients in all of our communities.