Asked by: Nadia Whittome (Labour - Nottingham East)
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 the safety and appropriate care of patients with suspected craniocervical instability; what plans he has to improve access to appropriate imaging and specialist clinical review for such patients, including those with Ehlers-Danlos syndrome; and what assessment he has made of the potential merits of using patients’ lived experience to inform future policy development and service provision in this area.
Answered by Sharon Hodgson - Parliamentary Under-Secretary (Department of Health and Social Care)
Decisions on the assessment, diagnosis, and management of suspected craniocervical instability (CCI) are made by National Health Service clinicians on a case‑by‑case basis, drawing on established neurological, neurosurgical, rheumatology, and pain pathways. The Department has not issued specific national guidance on CCI, including in patients with Ehlers–Danlos syndromes (EDS). Responsibility for designing and commissioning pathways for rare or complex conditions rests with integrated care boards (ICBs), which are best placed to plan services that reflect local needs and available specialist expertise.
Patients with symptoms suggestive of CCI may be referred for appropriate diagnostic imaging, such as magnetic resonance imaging or computed tomography scanning, where clinically indicated. Access to imaging continues to expand through the Government’s programme of community diagnostic centres, which is increasing diagnostic capacity and supporting earlier identification of complex conditions as part of the wider 10‑Year Health Plan.
Where specialist clinical review is required, referral decisions are made by NHS clinicians, who can access expertise across neurology, neurosurgery, and associated sub-specialties. ICBs are responsible for ensuring that local pathways support timely referral to the most appropriate service.
The Department recognises the value of patients’ lived experience in improving the design of services for complex conditions. Department officials are working with patient groups to identify service gaps, improve equity of access, and inform future service development. This approach helps ensure that the needs and experiences of patients with suspected CCI, including those with EDS, are reflected in wider policy work.
Asked by: Nadia Whittome (Labour - Nottingham East)
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 people with substance use issues can access specialist inpatient detox treatment.
Answered by Sharon Hodgson - Parliamentary Under-Secretary (Department of Health and Social Care)
Local authorities are responsible for commissioning drug and alcohol treatment services according to local need as part of their public health responsibilities, and this includes the provision of inpatient detoxification services.
In line with recommendations in Dame Carol Black’s independent review of drug treatment and recovery, the Department created a distinct grant to support and expand inpatient detoxification for people who use drugs and alcohol. The £10 million a year grant ran between 2022/23 and 2024/25, before being consolidated into the Drug and Alcohol Treatment and Recovery Improvement Grant in 2025/26. Investment in inpatient detoxification services will continue beyond 2026. The Government has committed over £13.45 billion across three years through the Public Health Grant, including £3.4 billion ringfenced for drug and alcohol prevention, treatment, and recovery, which includes funding for inpatient detoxification. This multi-year funding provides greater certainty for local areas as they plan and sustain services.
Asked by: Nadia Whittome (Labour - Nottingham East)
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 availability of NHS provision on the number of patients with Cranio-Cervical Instability who are seeking (a) diagnosis and (b) surgical treatment overseas.
Answered by Ashley Dalton
The Department recognises that Ehlers–Danlos syndromes (EDS) and associated cranio‑cervical instability (CCI) are complex conditions that can be challenging to diagnose and manage, and we acknowledge the concerns raised by patients and clinicians about variation in expertise and access to appropriate care.
Care for CCI is managed within existing specialised neurology and spinal pathways, delivered in centres with the appropriate expertise. NHS England works with clinical experts and integrated care boards to ensure that provision reflects the best available evidence and supports patients with complex connective‑tissue and neurological presentations. Decisions on surgical interventions for CCI must be based on individual clinical assessment, the strength of available evidence for benefit, and consideration of potential risks.
Once qualified, healthcare professionals are responsible for ensuring their own clinical knowledge remains up to date, and for identifying learning needs as part of their continuing professional development. Clinical teams are expected to use the best available evidence and follow national guidance when assessing and managing patients with complex connective tissue disorders.
The Department continues to engage with patient groups, charities, and Members of Parliament on the issues facing people with EDS and CCI. Insights from this engagement, including on the barriers patients encounter in accessing National Health Services, are informing our ongoing consideration of what further action may be needed to strengthen referral routes, support the dissemination of clinical resources, and consider where further system support may improve diagnostic confidence and care coordination.
The Department is aware of a number of individual cases where patients with suspected CCI have travelled overseas for imaging or surgery not routinely available in the NHS.
Asked by: Nadia Whittome (Labour - Nottingham East)
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 a) (a) the diagnosis of, (b) clinician training on and (c) access to treatment for patients with Ehlers-Danlos Syndromes and associated Cranio-Cervical Instability.
Answered by Ashley Dalton
The Department recognises that Ehlers–Danlos syndromes (EDS) and associated cranio‑cervical instability (CCI) are complex conditions that can be challenging to diagnose and manage, and we acknowledge the concerns raised by patients and clinicians about variation in expertise and access to appropriate care.
Care for CCI is managed within existing specialised neurology and spinal pathways, delivered in centres with the appropriate expertise. NHS England works with clinical experts and integrated care boards to ensure that provision reflects the best available evidence and supports patients with complex connective‑tissue and neurological presentations. Decisions on surgical interventions for CCI must be based on individual clinical assessment, the strength of available evidence for benefit, and consideration of potential risks.
Once qualified, healthcare professionals are responsible for ensuring their own clinical knowledge remains up to date, and for identifying learning needs as part of their continuing professional development. Clinical teams are expected to use the best available evidence and follow national guidance when assessing and managing patients with complex connective tissue disorders.
The Department continues to engage with patient groups, charities, and Members of Parliament on the issues facing people with EDS and CCI. Insights from this engagement, including on the barriers patients encounter in accessing National Health Services, are informing our ongoing consideration of what further action may be needed to strengthen referral routes, support the dissemination of clinical resources, and consider where further system support may improve diagnostic confidence and care coordination.
The Department is aware of a number of individual cases where patients with suspected CCI have travelled overseas for imaging or surgery not routinely available in the NHS.
Asked by: Nadia Whittome (Labour - Nottingham East)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health and Social Care, if his Department will make an assessment of the potential merits of including international medical graduates who are GMC-registered and who have at least two years’ NHS experience by 5 March 2026 in the prioritisation for specialty training.
Answered by Karin Smyth - Minister of State (Department of Health and Social Care)
The Medical Training (Prioritisation) Act 2026, which received Royal Assent on 5 March 2026, prioritises United Kingdom medical graduates and other doctors with significant National Health Service experience for specialty training places.
For specialty training places starting in 2026, immigration statuses are being used as a practical proxy to capture applicants who are most likely to have significant experience working in the health service in the UK.
From 2027, immigration status will no longer automatically determine priority for specialty training. Instead, we are able to make regulations to specify any additional groups who will be prioritised by reference to criteria indicating significant experience as a doctor in the health service, or by reference to immigration status. The Department will work with NHS England, the devolved administrations, and other partners on how best to define and evidence significant NHS experience as part of the development of those regulations.
Asked by: Nadia Whittome (Labour - Nottingham East)
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 patient experience data and intelligence is independently aggregated and analysed following the abolition of local Healthwatch.
Answered by Zubir Ahmed - Parliamentary Under-Secretary (Department of Health and Social Care)
Following the abolition of local Healthwatch, our proposals are that integrated care boards (ICBs) and local authorities (LAs) will have the responsibility for gathering views, and feedback from local people about health and social care services respectively in their area.
ICBs and LAs will be required to take these views into account when looking at their commissioning strategies to ensure these meet the needs of local people. They will also be required to demonstrate that they have done so.
However, these proposals require primary legislation. The timing of this is subject to the will of Parliament and will happen when parliamentary time allows.
Asked by: Nadia Whittome (Labour - Nottingham East)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health and Social Care, if he will ensure that human, qualitative patient insight is not displaced by digital, survey-based and institution-led feedback once local Healthwatch is abolished.
Answered by Zubir Ahmed - Parliamentary Under-Secretary (Department of Health and Social Care)
As set out in the Dash Review of the patient safety landscape published in July 2025, and in the 10-Year Health Plan, the statutory functions of local Healthwatch bodies will be transferred to integrated care boards (ICBs) for health, and to local authorities (LAs) for social care.
Both ICBs and LAs will be required to demonstrate how they have gathered patient and user feedback from local people including those who do not have access to digital platforms, those who are less proficient with technology, and people for whom English is a second language.
Asked by: Nadia Whittome (Labour - Nottingham East)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health and Social Care, what assessment he has made of the potential merits of a) waiving and b) subsidising the cost of the first six to eight (i) preliminary and (ii) core examinations for junior doctors.
Answered by Karin Smyth - Minister of State (Department of Health and Social Care)
The Department has not made a specific assessment of the potential merits of waiving or subsidising the cost of the first six to eight preliminary and/or core examinations for resident, previously “junior”, doctors.
My Rt Hon. Friend, the Secretary of State for Health and Social Care, made two offers to the British Medical Association (BMA) Resident Doctors Committee in 2025 to try to resolve its ongoing industrial disputes. These including provisions to reimburse fees for mandatory royal college examinations to resident doctors in England. However, the BMA rejected these offers.
The Government remains determined to put an end to the damaging cycles of disruption caused by strike action and is holding talks with the BMA to resolve the disputes.
Asked by: Nadia Whittome (Labour - Nottingham East)
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 Medical Training (Prioritisation) Bill on British citizens who have already commenced undergraduate medical degrees overseas on the understanding that they would be able to return to the UK to complete their Foundation Programme; and what plans he has to implement transitional protections and assurances to safeguard their training prospects and future careers in the NHS.
Answered by Karin Smyth - Minister of State (Department of Health and Social Care)
Subject to the parliamentary passage of the bill, British citizens who have graduated from medical schools outside of the United Kingdom will not be prioritised for foundation training places if they spent the majority of their time studying outside the British Islands.
The Government does not plan to implement transitional protections or assurances in relation to these applicants. Prioritisation does not mean exclusion. Non-prioritised graduates will still be able to apply for foundation training places, and they will be offered places if vacancies remain after prioritised applicants have received offers.
Asked by: Nadia Whittome (Labour - Nottingham East)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health and Social Care, what consideration his Department has given to introducing transitional arrangements for the implementation of UK graduate prioritisation in medical specialty recruitment for the 2025–26 recruitment cycle; and whether he will review the decision to assess applicants’ immigration or settlement status at the point of application rather than at the point of job offer, in cases where applicants will have Indefinite Leave to Remain by the time offers are made.
Answered by Karin Smyth - Minister of State (Department of Health and Social Care)
The Government does not plan to introduce transitional arrangements for the implementation of the Medical Training (Prioritisation) Bill.
For 2026 specialty training posts we have used immigration status as a reasonable proxy for National Health Service experience. Subject to parliamentary passage, the bill prioritises applicants at offer stage based on their immigration status at that point. Applicants will be able to update their application status where it has changed since they made their application. For specialty training posts starting from 2027 onwards, the immigration status category will not apply automatically. Instead, we will be able to make regulations to specify any additional groups who will be prioritised by reference to criteria indicating significant experience as a doctor in the health service, or by reference to immigration status. We will set out next steps on these regulations in due course.