Asked by: Liz Jarvis (Liberal Democrat - Eastleigh)
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 improve early diagnosis of foetal alcohol spectrum disorder.
Answered by Ashley Dalton - Parliamentary Under-Secretary (Department of Health and Social Care)
The Government recognises that foetal alcohol spectrum disorders (FASD) can have a significant impact on the early years of development for children. As a result, it is crucial to diagnose FASD as early as possible. As part of the prevention efforts around FASD, the Department promotes a precautionary approach by advising that the safest option during pregnancy is to avoid alcohol altogether.
The Department asked the National Institute for Health and Care Excellence (NICE) to produce a quality standard in England for FASD, to help the health care system improve both diagnosis and support for individuals affects by FASD. This was published in March 2022 and is available at the following link:
https://www.nice.org.uk/guidance/qs204
Healthcare providers continue to advise pregnant women about the risks of alcohol consumption, document alcohol use, and refer children with probable prenatal alcohol exposure for assessment.
Asked by: Liz Jarvis (Liberal Democrat - Eastleigh)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health and Social Care, whether the NHS plans to fund abiraterone for patients with high-risk non-metastatic prostate cancer.
Answered by Karin Smyth - Minister of State (Department of Health and Social Care)
The Department has had no such discussions. Abiraterone does not have a marketing authorisation for use in the treatment of high-risk, non-metastatic prostate cancer and has not been evaluated for that indication by the National Institute for Health and Care Excellence (NICE). The NICE makes recommendations for the National Health Service in England on the vast majority of new and significant licence indications, but does not evaluate medicines that are used outside their marketing authorisations or “off-label”.
NHS England considered abiraterone as an off-label treatment for the treatment of hormone sensitive, non-metastatic prostate cancer through its clinical policy development process in 2024/25. Through this process NHS England confirmed that there was sufficient supporting evidence to support the routine commissioning of abiraterone in this indication, but it has not been possible to identify the necessary recurrent funding to support the commissioning of abiraterone for this purpose, or any other treatments within the prioritisation round. Should the funding position change and a further prioritisation round take place, abiraterone for the treatment of hormone sensitive, non-metastatic prostate cancer will be reconsidered.
Asked by: Liz Jarvis (Liberal Democrat - Eastleigh)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health and Social Care, what steps he is taking to provide diagnostic training for GPs to recognise the symptoms of hyperemesis gravidarum.
Answered by Stephen Kinnock - Minister of State (Department of Health and Social Care)
We recognise that hyperemesis gravidarum is a debilitating condition that can have a devastating impact on women and their families.
The standard of medical training is the responsibility of the General Medical Council (GMC), which is an independent statutory body. The GMC has the general function of promoting high standards of education and co-ordinating all stages of education to ensure that medical students and newly qualified doctors are equipped with the knowledge, skills, and attitudes essential for professional practice.
The curriculum for general practice (GP) specialty training is set by the Royal College of General Practitioners (RCGP), and must meet the standards set by the GMC and be formally approved by them. The curriculum emphasises the skills and approaches a GP must develop in order to ensure accurate and timely diagnoses and treatment plans for their patients. This is assessed by the Membership of the Royal College of General Practitioners Examination. The RCGP GP training curriculum includes “emesis” as a symptom of concern during pregnancy.
Qualified GPs are responsible for ensuring their own clinical knowledge remains up-to-date, and for identifying learning needs across their whole scope of practice, as part of their continuing professional development and professional evaluation by the GMC.
Asked by: Liz Jarvis (Liberal Democrat - Eastleigh)
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 support parents caring for children with long covid; and whether his Department plans to develop a long-term strategy to fund (a) biomedical research and (b) treatment for long covid in (i) adults and (ii) children.
Answered by Ashley Dalton - Parliamentary Under-Secretary (Department of Health and Social Care)
The Government is committed to ensuring that families have the support that they need. The Care Act 2014 requires local authorities to deliver a wide range of sustainable, high-quality care and support services, including support for carers, which can include parents.
Across the National Health Service in England, there are services supporting people with post-COVID syndrome, often described as long COVID. These services offer physical, cognitive, and psychological assessment, and, where appropriate, refer patients onto existing services for treatment and rehabilitation. Further information can be found via the NHS website, at the following link:
https://www.england.nhs.uk/coronavirus/post-covid-syndrome-long-covid/
The National Institute for Health and Care Research (NIHR) and the Medical Research Council (MRC) remain committed to funding high-quality research to understand the causes, consequences, and treatment for long COVID. We are actively exploring next steps for research in this area.
Between 2019/20 and 2023/24, through the NIHR and MRC, we have invested over £57 million on research into long COVID, with almost £40 million of this through two specific research calls on long COVID. The funded projects aim to improve our understanding of the diagnosis and underlying mechanisms of the disease and the effectiveness of both pharmacological and non-pharmacological therapies and interventions, as well as to evaluate the effectiveness of clinical care.
This includes funded clinical trials to test and compare different treatments such as antihistamines, anticoagulants, and anti-inflammatory medicines, as well as trials such as the approximately £1.5 million REGAIN trial funded through the NIHR. REGAIN is the first randomised trial to show a benefit from rehabilitation for people with long COVID, and the first high-quality evidence confirming the sustained clinical benefit and lack of harm with rehabilitation programmes for long COVID which combine exercise with behavioural support, to measure their effects on symptoms, health, and other outcomes.
The approximately £1.9 million CLoCk study, co-funded by the NIHR and the MRC, developed an agreed definition of long COVID in children and young people as well as the associated symptoms, which will help harmonise research and improve understanding of the condition.
Funding is available and we welcome funding applications for research into long COVID in both adults and children. These applications are subject to peer review and judged in open competition, with awards being made on the basis of the importance of the topic to patients and health and care services, value for money, and scientific quality.
To support clinical leadership in this area, NHS England has worked in partnership with the British Society of Physical and Rehabilitation Medicine to develop a new Clinical Post-COVID Society to facilitate the ongoing sharing of best practice and to support people affected by long COVID. Further information about the society can be found at the following link:
https://www.clinicalpcs.org.uk
Asked by: Liz Jarvis (Liberal Democrat - Eastleigh)
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 ensure proactive management of medicine shortages.
Answered by Karin Smyth - Minister of State (Department of Health and Social Care)
There are approximately 14,000 licensed medicines and the overwhelming majority are in good supply. Where supply issues do arise, we know how frustrating and distressing these can be for patients, and we work closely with industry, the National Health Service, and the Medicines and Healthcare products Regulatory Agency to resolve the issues as quickly as possible, to ensure patients can access the medicines they need.
Medicine supply chains are complex, global, and highly regulated and there are a number of reasons why supply can be disrupted, many of which are not specific to the United Kingdom and outside of Government control, including manufacturing difficulties, access to raw materials, sudden demand spikes or distribution issues, and regulatory issues.
While we can’t always prevent supply issues from occurring, we have a range of well-established processes and tools to manage them when they arise and mitigate risks to patients. These include close and regular engagement with suppliers, use of alternative strengths or forms of a medicine to allow patients to remain on the same product, expediting regulatory procedures, sourcing unlicensed imports from abroad, adding products to the restricted exports and hoarding list, and use of Serious Shortage Protocols. In addition, we will issue communications to the NHS which provides management advice and information on the issue to healthcare professionals, including pharmacists, so they can advise and support their patients.
The resilience of UK supply chains is a key priority, and we are committed to helping to build long term supply chain resilience for medicines. We are continually learning and seeking to improve the way we work to both manage and help prevent supply issues and avoid shortages. The Department, working closely with NHS England, is taking forward a range of actions to improve our ability to mitigate and manage shortages and to strengthen our resilience.
Asked by: Liz Jarvis (Liberal Democrat - Eastleigh)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health and Social Care, what recent assessment he has made of trends in the level of maternity unit closures; and what steps he is taking to prevent the closure of maternity units.
Answered by Karin Smyth - Minister of State (Department of Health and Social Care)
There are real issues in maternity care, but also outstanding examples of care. It will not be an overnight recovery, but we will be making steady improvements to ensure all women receive safe, personalised, and compassionate care.
The Government continues to work with the National Health Service as it delivers its three-year maternity and neonatal plan to improve maternity and neonatal services.
The reconfiguration of services is a local decision that should be informed by clinical best practice, following appropriate engagement with patients and stakeholders. All service changes should be based on clear evidence that they will deliver better outcomes for patients.
Responsibility for the delivery, implementation, and funding decisions for services ultimately rests with the appropriate NHS commissioner. Substantial planned service change should be subject to a full public consultation and should meet the Government and NHS England’s ‘tests’ to ensure good decision-making. The Government has not made an assessment of the closures to maternity services, as these are decisions best made locally.
It is right that NHS services reflect changing demographics and birth rates, to ensure resources are used efficiently. At the same time, we expect maternity providers to listen to women and ensure they are given a choice at all stages of their pregnancy.
Asked by: Liz Jarvis (Liberal Democrat - Eastleigh)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health and Social Care, what steps he is taking to ensure that integrated care boards provide gluten free bread prescriptions for patients with coeliac disease.
Answered by Karin Smyth - Minister of State (Department of Health and Social Care)
The Department has undertaken two national consultations in recent years on the prescribing of gluten-free foods in primary care. The rationale for this was the increased availability of these products in supermarkets and other food outlets at a time when the annual cost to the National Health Service of prescribing such items was £15.7 million. The first of these proposed changes to prescribing arrangements resulted in the Government’s decision to restrict such foods to bread and mixes.
NHS England’s guidance, Prescribing Gluten-Free Foods in Primary Care, was developed to communicate to local commissioners, now integrated care boards (ICBs), the changes in legislation. Wording is included in the guidance which states that commissioners may further restrict the prescribing of gluten-free foods by selecting bread only, mixes only, or may choose to end the prescribing of gluten-free foods altogether, if they feel this is appropriate for their population, and whilst taking account of their legal duties to advance equality and have regard to reducing health inequalities. In NHS England’s guidance, there are no limits on the amount of bread or mixes that can be prescribed.
Decisions about the commissioning and funding of local health services are the responsibility of local ICBs. NHS England’s guidance should be taken into account when ICBs formulate local policies, and prescribers are expected to reflect local policies in their prescribing practice. The guidance does not remove the clinical discretion of prescribers in accordance with their professional duties.
Asked by: Liz Jarvis (Liberal Democrat - Eastleigh)
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 side effects of the anti-malarial drug Lariam on civilian patients prescribed it in the UK.
Answered by Karin Smyth - Minister of State (Department of Health and Social Care)
The Medicines and Healthcare products Regulatory Agency (MHRA) is responsible for ensuring that medicines, medical devices, and blood components for transfusion meet applicable standards of safety, quality, and efficacy. The MHRA rigorously assesses the available data, including from the Yellow Card scheme, and seeks advice from the Commission on Human Medicines, the MHRA’s independent advisory committee, where appropriate, to inform regulatory decisions, including amending the product information.
Mefloquine, commercially known as Lariam, is effective in the prevention and treatment of malaria, and is licensed for use by the MHRA in the United Kingdom. The current product information for mefloquine states that neuropsychiatric adverse reactions may occur during treatment, and includes warnings and precautions to minimise these risks. It also states that such adverse reactions may persist for months, or longer, even after discontinuation of the drug. It has not been established, however, that such adverse reactions may be permanent.
Patient safety is our top priority, and no medicine would be approved unless it met our expected standards of safety, quality, and effectiveness. Our role is to continually monitor the safety of medicines during their use, including Larium. We have robust, safety monitoring and surveillance systems in place for all healthcare products. When a safety issue is confirmed, we always act promptly to inform patients and healthcare professionals and take appropriate steps to mitigate any identified risk.
Asked by: Liz Jarvis (Liberal Democrat - Eastleigh)
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 review the (a) licensing and (b) prescribing guidelines for the anti-malarial drug Lariam.
Answered by Karin Smyth - Minister of State (Department of Health and Social Care)
The Medicines and Healthcare products Regulatory Agency (MHRA) is responsible for ensuring that medicines, medical devices, and blood components for transfusion meet applicable standards of safety, quality, and efficacy. The MHRA rigorously assesses the available data, including from the Yellow Card scheme, and seeks advice from the Commission on Human Medicines, the MHRA’s independent advisory committee, where appropriate, to inform regulatory decisions, including amending the product information.
Mefloquine, commercially known as Lariam, is effective in the prevention and treatment of malaria and is licensed for use by the MHRA in the United Kingdom. The current product information for mefloquine states that neuropsychiatric adverse reactions may occur during treatment and includes warnings and precautions to minimise these risks. It also states that such adverse reactions may persist for months, or longer, even after discontinuation of the drug. It has not been established, however, that such adverse reactions may be permanent.
Patient safety is our top priority, and no medicine would be approved unless it met our expected standards of safety, quality, and effectiveness. Our role is to continually monitor the safety of medicines during their use, including Larium. We have robust, safety monitoring and surveillance systems in place for all healthcare products. When a safety issue is confirmed, we always act promptly to inform patients and healthcare professionals and take appropriate steps to mitigate any identified risk.
As with any medicine, clinicians are responsible for making prescribing decisions for their patients, taking into account best prescribing practice and the local commissioning decisions of their respective integrated care board.
Clinicians are also expected to take account of appropriate national guidance on clinical effectiveness and safety, and are accountable for their prescribing decisions, both professionally and to their service commissioners. The national guidance for mefloquine is available at the following link:
https://cks.nice.org.uk/topics/malaria-prophylaxis/prescribing-information/mefloquine/
Prescribers are responsible for ensuring that any side effects experienced by their patients are addressed promptly, they should work with their patient to decide on the most suitable management plan, with the provision of the most clinically appropriate care for the individual always being the primary consideration.
Asked by: Liz Jarvis (Liberal Democrat - Eastleigh)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health and Social Care, whether he plans to increase the provision of pacemakers and implanted defibrillators.
Answered by Karin Smyth - Minister of State (Department of Health and Social Care)
The volume of implantable devices purchased by cardiac providers has increased by 22% in 2024/25, when compared with the same period in 2023/24. Commissioned providers determine the need for cardiac implantable electronic device (CIED) implantation using a multi-disciplinary team approach, which considers the needs of the individual patient and clinical guidelines.
In 2023/24, approximately 60,000 CIEDs, which includes implantable cardioverter defibrillators and pacemakers, were implanted by National Health Service providers, as per the National Audit of Cardiac Rhythm Management report 2025.