Eating Disorders Awareness Week
Zubir Ahmed Excerpts(1 day, 19 hours ago)
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The Parliamentary Under-Secretary of State for Health and Social Care (Dr Zubir Ahmed)
It is an honour and a pleasure to serve under your chairmanship, Ms Vaz. I congratulate the hon. Member for Bath (Wera Hobhouse) on securing today’s debate and raising this important topic—as she always does. I also pay tribute to her for her long-standing advocacy on this topic and for all the work she does in the eating disorders all-party parliamentary group. She is joined today by a number of hon. Members from across the House, who have made thoughtful contributions.
One hon. Member who is conspicuous by his absence—he has already been mentioned, and I informed him in advance that I would mention him too, Ms Vaz—is my hon. Friend the Member for Isle of Wight West (Mr Quigley). He is my friend, and he is conspicuous because of the tireless work he does and the way he advocates for persons with eating disorders. I know that that is born out of personal interest and pain. We miss his presence here today and send him our good wishes from across the House.
It is important that we are having this debate today to note Eating Disorders Awareness Week. This year’s theme rightly places the focus on the power of community, which speaks to a simple but profound truth: no one should face an eating disorder alone. Recovery is not only about clinical treatment, vital though that is; it is also about the networks of support that surround that individual—not only health professionals, but mums, dads, grandparents, siblings, friends, teachers, colleagues and many others.
Wera Hobhouse
One of the most harrowing things that we hear again and again when taking evidence in the APPG is how families feel completely abandoned. People have to give up work, often over years, because they are meant to care for someone with a severe condition and they do not have the capacity to do so by themselves. It is only when that condition is finally so bad that the loved one is then readmitted to hospital. That revolving door must end. The human cost to that tragedy—apart from the cost to the NHS—must end. It is absolutely tragic and wrong.
Dr Ahmed
I wholeheartedly agree. The Government are committed to ending the revolving door for many conditions—this is an exemplar, in many ways—by joining up care and the streams of information that underpin it. One of our main commitments in our 10-year health plan is to have more joined-up care, to move it from sickness to prevention and to move from hospital into community, where that join-up can happen.
This community can thrive only when it is built on a foundation of timely, effective care. That is why we are focused on reforming eating disorder services so that people can access help when they need it, not after their condition has escalated. That approach underpins the new NHS guidance for children and young people’s eating disorder services, published last month, which is clear that care should be timely, joined up and delivered as close to home as possible.
As many here know, demand for mental health support, including eating disorder services, rose sharply during the pandemic, and the rise has been sustained thereafter. Although services remain under significant pressure, as a result of the additional investment there are some green shoots in system capacity and capability to better meet rising demand and reduce the waits that hon. Members have described.
In December 2025, 83.3% of routine referrals to children and young people’s community eating disorder services and 78.8% of urgent referrals started treatment within four weeks and one week respectively. That is a marked improvement in performance, compared with the situation six months earlier. In June last year, only 72.2% of routine referrals and 63.7% of urgent referrals were seen within four weeks and one week respectively. Although those are encouraging signs, I am under no illusion: too many children and young people are still waiting far too long for support. That is exactly why further reform and delivery are needed.
The Government’s long-term approach to mental health reform is set out in the 10-year health plan, which is clear in its direction. It shifts care from hospital to community, from sickness to prevention and, of course, from analogue to digital, which will be so important when it comes to having joined-up care. I assure hon. Members that those shifts are not abstract principles, but practical changes that are already being embedded. I know that they matter deeply for people living with eating disorders, and the families and loved ones who support them.
But I recognise that plans alone do not deliver care. Delivery depends on people and having the right workforce with the right skills in the right places. That is why, on top of the workforce plan that will come to fruition in late spring or early summer, we are investing in the workforce. We are committed to providing an additional 8,500 new mental health professionals across child and adult mental health services, to cutting waiting times and to ensuring that people access treatment and support earlier than ever before.
We are also working to strengthen skills and capability across the system. NHS England has introduced comprehensive training to ensure that staff across mental and physical health services can recognise eating disorders early and respond safely and effectively. That training supports clinicians working not only in the community but in primary and, crucially, acute care settings, where I used to work. I often saw such patients on my acute general surgical receiving ward rounds. The training includes specialist programmes, including the Royal College of Psychiatrists’ eating disorders credential, expanded access to family-based therapies, cognitive behavioural therapy for eating disorders, and dedicated training on ARFID, which the hon. Member for Sleaford and North Hykeham (Dr Johnson) mentioned. That work is about giving staff the skills, confidence and, crucially, clarity they need to deliver safe, high-quality care and reduce some of the avoidable harm that we have discussed today.
I am pleased to say that funding for children and young people’s eating disorder services has increased significantly, from £46.7 million in 2017-18 to an actual spend of £106.3 million in 2024-25. With that extra funding, we have focused on enhancing the capacity of community eating disorder teams across the country, because we know that timely, effective care leads to better outcomes, supports recovery and helps to prevent conditions escalating to the point at which hospital admission becomes inevitable.
When admission is necessary, stronger community care can reduce length of stay when it is safe. We recognise the concerns that in-patient capacity remains under pressure in some parts of our country. There are reports of individuals being discharged at very low body mass due to bed availability, as the hon. Member for Bath highlighted. Discharge decisions must always be about clinical judgment and patient safety, not capacity constraints. NHS England reassures me and continues to work with providers and integrated care boards to ensure that sufficient specialist provision and safe step-down pathways will be in place.
Dr Caroline Johnson
The Minister’s speech is very interesting. He talks about an increase in capacity, much of which will require workforce. I noticed that when he mentioned the workforce plan, he said “spring or early summer”, which is a change from his previous wording, which was always “spring”. Is that a sign that it is being delayed further?
Dr Ahmed
As always, the hon. Lady reads too much into my words. I am a Scot, so for me, spring and summer sometimes mean the same thing—and indeed winter. I can reassure her that there was no subtext to that nuance earlier in my speech. We remain committed and are on track to deliver on the workforce plan.
We recognise concerns, of course, and NHS England is addressing them. Prevention must be central to how we respond to eating disorders, particularly for children and young people. That is why we are also providing £13 million to strengthen the role of mental health support teams in schools and colleges through enhancements, so that concerns about disordered eating and body image can be identified and addressed much earlier. Acting sooner improves outcomes, reduces the need for more intensive treatment later and helps to ensure that our young people get the support they need, at the right time.
We are encouraged by the progress being made, but I am under no illusions. I know that sustained improvement depends on clear, consistent expectations for high-quality care across the whole pathway. That is why, alongside the 10-year health plan, we are developing a modern service framework for severe mental illness, which I can reassure the House will include eating disorders, to help to reduce avoidable harm from them and improve outcomes for persons affected by them. However, to get it right, we need expert input across the system, so my noble Friend Baroness Merron, the Minister responsible for mental health, will be hosting a roundtable discussion with eating disorder charities, clinicians and those with lived experience, to ensure that the modern service framework delivers meaningful improvements for people with eating disorders, with lived experience at the heart of it.
We have spoken, rightly, about online safety issues as they intersect with mental illness and eating disorders. As a parent, I of course remain deeply concerned about the widespread availability online of harmful material promoting eating disorders, suicide and self-harm, which can be far too easily accessed by people, including young people, who may be vulnerable. The UK’s Online Safety Act 2023 makes platforms—including social media, search and pornography services—legally responsible for keeping people, especially children, safe online. All providers must mitigate the risks of illegal harm on their services, and all providers of services likely to be accessed by children must take steps to mitigate their risks to children, especially as regards content related to eating disorders.
Wera Hobhouse
The Minister is very generous with his time. I mentioned this issue in my speech and I see it across the board, not just with regard to eating disorders. The Online Safety Act provides that Ofcom can intervene, but only if the content is reported, so we are relying on often very vulnerable people to report something before Ofcom intervenes. That cannot be right. There has to be a stronger emphasis on the social media platforms actually taking down accounts very quickly and, as I have also said, ensuring that they do not just reappear under a different name.
Dr Ahmed
The hon. Lady makes a really valid point. She will know, as I do, that the regulation of these platforms in relation to children’s access is a live issue at the heart of Government at the moment. She is right: the current provisions are not strong enough to be adequate safeguards. We do need more proactive intervention from our technology partners. My right hon. Friend the Secretary of State for Science, Innovation and Technology takes that very seriously and is pushing very hard on it in relation to not only harm in this space, but harm in general, for children online.
Ofcom ensures that services uphold these duties, including for smaller online sites. Its small but risky services taskforce has assessed 20 services relating to this harm, over half of which have been at high risk for eating disorder content. I am happy to write to my colleagues in the Department for Science, Innovation and Technology, on the back of this debate, to learn from them what further action specific to eating disorders is coming down the pipeline, and I can relay that information to hon. Members assembled in this Chamber today.
I also share the deep concern about reports of people with eating disorders being offered end-of-life care.
Dr Arthur
Before we move on to end-of-life care, I welcome the great offer that the Minister has given to reach out to the Department for Science, Innovation and Technology to better understand what they are doing on digital platforms. I expect that many of the people who are going to respond to the consultation around the banning of social media for under-16s will come from the healthcare profession, because of the connections between mental health and eating disorders and the use of these platforms. Will he be proactively asking for action to make sure that young people are protected? That would also mean more resources for people who have eating disorders, because hopefully fewer people would be coming forward.
Dr Ahmed
My hon. Friend is absolutely right. Being proactive and following the evidence should be our north star when we are formulating policy; I know that is true of my right hon. Friend the Secretary of State for Science, Innovation and Technology.
The Royal College of Psychiatrists has been explicit about eating disorders and end-of-life care. Anorexia nervosa is not a terminal illness in its own right. The college’s guidance on medical emergencies in eating disorders was developed precisely to ensure that preventable deaths become a thing of the past. NHS England is clear that no patient with an eating disorder should routinely be placed in palliative care. Our focus must always be on treatment and recovery, and underpinned by the hope of recovery.
We also share concerns about the accurate recordings of deaths where eating disorders may have been a contributing factor. The hon. Member for Bath outlined some of her frustrations regarding correspondence with the Ministry of Justice and I would be happy to take up that call on her behalf to make sure that she gets the correspondence that she is entitled to. The statutory medical examiner and coroner system provides a clear framework to ensure that deaths are properly investigated and recorded so that lessons are identified and patient safety is strengthened.
Although it is for the coroner to exercise independent judicial discretion to determine what is recorded as the medical cause of death, I can reassure hon. Members that the coroner’s office has been undergoing training to ensure that the recording of deaths associated with eating disorders is done more accurately and proactively. Accurate recording matters, and we will continue to work with our partners, including colleagues in the Ministry of Justice and clinicians, to ensure that not only are the statistics captured, but the learning underpinning those statistics is reflected in genuine improvements to care.
Eating disorders are serious and complex mental illnesses that can affect anyone at any age and in any community or family. They require timely treatment, skilled professionals and sustained support thereafter.
Helen Morgan
The Minister is probably about to draw his remarks to a close, but can I press him again on the mental health investment standard, which should ensure that the proportion of NHS spending on mental health goes up every year? In the last year for which we have numbers, it had gone up as a proportion of ICB spend, but had fallen as a proportion of overall NHS spend. Can the Minister commit that the Department will not be abandoning that standard, and that we will see mental health spending go up each year?
Dr Ahmed
I can certainly commit to the hon. Lady that mental health spending in real terms will go up every single year. It went up by £688 million in real terms this year. The good nature of this debate permits me to push back only gently against the hon. Member for Sleaford and North Hykeham, who talked about spending in the NHS, but I do feel I need to push back a little: one of the reasons why that percentage in statistical terms is lower, but the spend in real terms is higher is because we had to spend so much more money—the record £26 billion that was afforded in additional spend by the Chancellor in the Budget—in other parts of the health service to compensate for the decay and decline in the NHS over the last 14 years. But the hon. Member for North Shropshire (Helen Morgan) has my commitment to the overall philosophy that mental health spending will increase year on year.
As I was saying, eating disorders are serious and complex; over and above skilled professionals, they also require compassion, understanding and collective responsibility. Through the 10-year health plan, we are shifting care closer to home; strengthening early intervention; expanding the workforce where necessary, such as with community mental health workers; improving standards and investing in the community services that make recovery possible. We are also equipping staff with the right training, protecting young people online—while continuing to improve and explore the mechanisms through which we can do that—and working with experts and those with lived experience to ensure that the reform we are choosing to pursue delivers real and lasting change.
We know that the policy framework alone is never enough. Change also depends on the voices of campaigners, including many who join us here today, clinicians, families and those who have shared their lived experience. I can assure everyone that their advocacy continues to shape this Government’s approach, and it will continue to do so.
To those living with an eating disorder, and to the families supporting them, I want to say this: “You are not invisible. You are not alone.” This Government are committed to building a system that responds with urgency, expertise and compassion. Our task—across this House and beyond it—is to ensure that when someone reaches out for help, the system we create is ready to respond with urgency, expertise and, crucially, hope. I once again thank hon. Members for contributing to this debate and I look forward to continuing this work with colleagues from across the House.
Oral Answers to Questions
Zubir Ahmed Excerpts(3 days, 19 hours ago)
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Dame Meg Hillier (Hackney South and Shoreditch) (Lab/Co-op)
The Parliamentary Under-Secretary of State for Health and Social Care (Dr Zubir Ahmed)
Mental health issues affect all ages, and the support is not always there. We are determined to change that. We have hired almost 8,000 extra mental health workers since we came into office and increased investment in mental health by an additional £688 million this year. We are also transforming services through community-based 24/7 mental health centres, providing open access to treatment and support for adults with severe mental health needs, expanding NHS talking therapies, and rolling out mental health support teams in more schools.
Dame Meg Hillier
The NHS’s work on this is vital, but I also draw the Minister’s attention to Mind in Hackney, which is pioneering a new approach to make sure that people get two sessions of mental health support within two weeks. They can get more later on, but that is what they get, rather than waiting in a queue for six months for long-term support. For many people, that, along with a long-term treatment plan, is enough. May I urge the Minister to come and visit? It is only half an hour up the road from Westminster; he could fit it in before Prime Minister’s questions.
Dr Ahmed
I am grateful for my hon. Friend’s invitation. She is right: we need to think of innovative ways of attacking the mental health issues that face our country, and particularly our young people. Those include digital and face-to-face therapies, both of which we are expanding at a rapid pace. I am delighted to pass on her invitation to the Minister for Mental Health.
Sir Julian Lewis (New Forest East) (Con)
Has the Minister had any opportunity to form conclusions about whether excessive involvement with social media and other online potential harms has contributed to an apparent significant increase in the levels of mental health disorders?
Dr Ahmed
The right hon. Gentleman is right to highlight this very live issue. As a doctor, a parent and a Minister, it is live in my mind, as it is in the minds of hon. Members across the House. It is important that we follow the evidence, and act safely and proportionately in response to that evidence. The right hon. Gentleman will know this Government’s ambition, and the direction that we want to set to ensure that young people are kept safe online.
Lewis Atkinson (Sunderland Central) (Lab)
Analysis by Rethink Mental Illness of the latest NHS waiting time statistics shows that people are eight times more likely to wait over 18 months for mental health treatment than physical health treatment. Does the Minister agree that waiting 18 months for such treatment is totally unacceptable? What steps will the Government take to cut adult mental health waiting times?
Dr Ahmed
Absolutely; it is unacceptable that there is still a disparity between mental and physical health when it comes to investigation, diagnosis and treatment. That is why this Government are proud to put record amounts of funding for mental health into the NHS. We are also making available £473 million of capital funding for encouraging and establishing 24/7 mental health centres, alongside other capital priorities, so that people can get the right support at the right time, closer to home.
Jess Brown-Fuller (Chichester) (LD)
After my young constituent was left in limbo between child and adolescent mental health services, health services and neurodevelopment pathways, with nobody claiming responsibility for her healthcare needs, her mum called 111 to get some advice. The advice she was given was, “If you’re not happy with the service, contact your MP.” With all mental health and emergency services stretched to breaking point, what tangible action are this Government taking to address the mental health crisis in our neurodiverse population, so that nobody else in my constituency is failed like this young lady?
Dr Ahmed
I think we are all distressed to hear stories like that. It is what motivates us to keep going and ensure that the NHS becomes a match-fit service for the 21st century. To reassure the hon. Lady, in addition to the investments I have already highlighted, we are also investing £13 million to pilot enhanced training for staff, so that they can offer more support to young people with complex needs, such as those she has described.
Ruth Cadbury (Brentford and Isleworth) (Lab)
Dr Al Pinkerton (Surrey Heath) (LD)
The Parliamentary Under-Secretary of State for Health and Social Care (Dr Zubir Ahmed)
Every child with a disability should have the opportunity to reap the health and wellbeing benefits of being active. We are working across health, education and sports to break down barriers to physical activity, including for children with Down’s syndrome. That includes ensuring that they have access to inclusive, sensory-rich activities that they can enjoy with friends, families and carers.
Dr Pinkerton
I recently had a meeting with British Gymnastics, the charity Stepping Stones, and Prime Acrobatics, a wonderful and inclusive gymnastics centre in my Surrey Heath constituency. They told me that young people with Down’s syndrome are routinely prevented from taking part in physical activity and sport because of concerns about neck stability. Might the Minister be willing to take this case on, work with GPs, the NHS and other relevant bodies to review guidance in that area, and remove the barriers that can all too often prevent young people from engaging with the physical and sporting activities that are so vital to their physical and mental wellbeing?
Dr Ahmed
The hon. Member is not the first colleague to raise that issue. Clearly, the safety of patients and children is paramount, but it must be proportionate and led by evidence. I would be very happy to explore this further with him.
Dr Marie Tidball (Penistone and Stocksbridge) (Lab)
The Parliamentary Under-Secretary of State for Health and Social Care (Dr Zubir Ahmed)
I am grateful to my hon. Friend for her work on raising the profile of this underserved area. It is simply unacceptable that disabled women are at higher risk of neonatal and perinatal mortality and stillbirth, and that they continue to experience adverse outcomes relative to the general population. That is why my right hon. Friend the Secretary of State has launched an independent maternity investigation, which will help us to understand the systemic issues behind why so many families, including disabled women, experience unacceptable care.
Dr Tidball
Too often, disabled women’s bodies are deemed not to count. In the last year, I have met two incredible disabled women: Carly, a Paralympian, and Sarah, an occupational therapist. Neither found out that they were pregnant until their second and third trimesters respectively because none of their clinicians considered that they might be pregnant. But we are making babies, we are having babies—against the odds; we have a 44% higher likelihood of stillbirth—and we are being brilliant mothers. Will the Secretary of State meet me to discuss ensuring that inclusive maternity care for disabled women is at the heart of our women’s health strategy so that our womanhood is no longer invisible?
Dr Ahmed
We are so lucky to have my hon. Friend in this place, challenging us to be better—and we can be better. We need to be bolder, and we need to take decisive action to close the gap on inequalities to ensure that all women receive safe, personalised and compassionate care. We know how important inclusive maternity care is for disabled women. I note that my hon. Friend has previously had meetings with the Minister for maternity, and my right hon. Friend the Secretary of State would be delighted to meet her.
Josh Babarinde (Eastbourne) (LD)
A matter of weeks ago, a power cut plunged parts of Eastbourne district general hospital, where I was born, into darkness and forced our maternity unit to temporarily close, particularly affecting disabled women. People had to use their iPhone torches to see. Despite that power infrastructure failure, we are way at the back of the queue for new hospital funding. Will the Minister commit to accelerating the unlocking of that cash, so that women can have the services they deserve—
Gregory Stafford (Farnham and Bordon) (Con)
Thank you very much, Mr Speaker.
Seven months ago, the NHS 10-year plan promised a maternity taskforce. May I ask the Minister how many times it has met?
Dr Ahmed
I welcome the hon. Gentleman to his place. I am informed by my right hon. Friend the Secretary of State that it has not met yet, but we are establishing it and it will be meeting soon.
Gregory Stafford
The fact that the taskforce has not even met, seven months later, tells us everything we need to know about how urgent and important the Government consider this issue. In Leeds, families are losing faith in the failing maternity services. The Secretary of State said that he takes the matter “extremely seriously”, yet Donna Ockenden—who exposed the failings in Nottingham, has the support of families, and has said that she is ready and willing to lead the inquiry—has not been appointed. If the Minister and the Secretary of State take this issue extremely seriously, why have they not appointed a chair yet?
Dr Ahmed
I see that the brass neck of the hon. Gentlemen’s predecessor has been transplanted to him. He talks about seven months, but what about the last 14 years, through which the Conservatives presided over the decay and decline of our NHS? They failed our patients and the clinicians who serve them. My right hon. Friend the Secretary of State is in regular contact with maternity families and, like me, he takes the matter extremely seriously. He will report to this House on the outcome of his deliberations on a regular basis.
Alison Griffiths (Bognor Regis and Littlehampton) (Con)
Euan Stainbank (Falkirk) (Lab)
The Parliamentary Under-Secretary of State for Health and Social Care (Dr Zubir Ahmed)
This UK Labour Government, at least, are spending billions of pounds upgrading the digital architecture of the NHS in England. That means that over 90% of GPs now offer appointments online, and by 2029 we will have a single patient record for patients and their clinicians to access all their information. That is in contrast with the digital desert that exists in Scotland, which is why it is time for Analogue John to move over and make way for Anas Sarwar as First Minster to save Scotland’s NHS.
Tessa Munt (Wells and Mendip Hills) (LD)
Ms Julie Minns (Carlisle) (Lab)
Dr Ahmed
Glasgow is a great place to get medical care—I can attest to that—but people should not have to travel 200 miles to get medical care. My hon. Friend and I have had many discussions on this topic, and I am very glad to continue those discussions. She knows that treatment along the border is subject to service-level agreements in both English trusts and Scottish health boards, but it should be much more porous and accommodating than it is. I am happy to take these discussions with her further later.
Victoria Collins (Harpenden and Berkhamsted) (LD)
Catherine from Redbourn has shared that she has to wait weeks for a GP appointment, yet her village faces an increase in residents of up to 70%, which means thousands of new patients. Some of that is through speculative developments. Does the Minister agree that councils should have the powers to ensure that planning approvals are dependent on first securing healthcare to serve those new residents? Will he commit to ensuring that NHS planning cycles are aligned with housing developments to ensure that communities do not have to wait for weeks, months or years?
Peter Swallow (Bracknell) (Lab)
Dr Ahmed
Mental health support teams provide innovative early support for children and young people in schools and colleges, and I am pleased that these are working well in Bracknell Forest, too. Up to 900,000 additional pupils will have access to that support by the spring, and we are accelerating the roll-out to reach full national coverage by 2029.
Bradley Thomas (Bromsgrove) (Con)
Several weeks ago, I received a jaw-dropping email from a local Bromsgrove GP, who told me that a 10-month-old child nearly died after ambulance delays. Worse, the same day, another patient—a 66-year-old driving instructor—suffered a cardiac arrest during a driving lesson and died while being driven to the hospital by his wife. My constituents demand a better service and better response times. What are the Government going to do about this, and will the Secretary of State meet me and the concerned GP who wrote to me to address this issue?
Lola McEvoy (Darlington) (Lab)
As the Secretary of State knows, Darlington Memorial hospital is part of the County Durham and Darlington NHS foundation trust, which has recently been marred by the scandal of over-operation in breast services. We know that many women came to harm as a result of those failures, but we are yet to find out how many and the full extent of the harm because the trust has not completed the comprehensive look-back. Will the Minister meet me to ensure that our trust has all the resources it needs to learn the lessons necessary to ensure that no women—whether in my area or across the country—have invasive and painful clinical procedures that they do not need?
Dr Ahmed
My hon. Friend and I have had discussions regarding this matter before. Patient safety is of paramount importance, especially when it comes to surgery, including breast surgery. I am happy to meet her to discuss this further at a ministerial surgery.
Pharmacy First: Withholding Payments
Zubir Ahmed Excerpts(2 weeks, 1 day ago)
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Dr Luke Evans (Hinckley and Bosworth) (Con)
(Urgent Question): To ask the Secretary of State for Health and Social Care if he will make a statement on the withholding of Pharmacy First payments to pharmacies.
The Parliamentary Under-Secretary of State for Health and Social Care (Dr Zubir Ahmed)
It is a pleasure to take the traditional Department of Health and Social Care urgent question before recess—I would not miss it for the world.
Since coming into office, we have reversed the decade of cuts to community pharmacy with the biggest uplift for the sector in years and frozen prescription charges to help our constituents with the cost of living, and women can now get the morning-after pill free of charge across the country. Earlier this week, I spoke to the National Pharmacy Association’s winter reception to pay tribute to its members for their work and to assure them that I have their back, as does the Minister for Care.
The hon. Member for Hinckley and Bosworth (Dr Evans) raises the important issue of payments made via Pharmacy First. As he knows, pharmacy contractors receive a monthly fixed payment if they meet certain requirements. We agreed to reduce the claim window, in conjunction with Community Pharmacy England, as part of our deal for 2025-26 to introduce a new Pharmacy First fixed first payment of £500. That has supported a broader range of pharmacies and has meant that more pharmacies have become eligible for payments. We are in discussions with Community Pharmacy England to consider where improvements to the claiming process can be made, address concerns raised by contractors and aim for a more consistent approach to remuneration. We will also consult with Community Pharmacy England shortly on the contractual framework for next year.
There are issues relating to contractors being suspended from providing Pharmacy First that are for separate consideration. When concerns are raised, NHS England can suspend individual contractors from providing the service pending a full investigation. There are a number of reasons why that might be necessary, but the measures are there, first and foremost, as the House will appreciate, to protect patient safety. I am a clinician, as is the hon. Member for Hinckley and Bosworth, and I am sure that he will agree that patient safety should be at the forefront of everything we do.
Finally, funding for the core community pharmacy contractual framework has been increased to over £3 billion—the largest uplift of any part of the NHS in the last two years. As part of this year’s contractual framework, we have agreed to keep the current cost control mechanism linked to Pharmacy First that we inherited from the previous Government to ensure that the money is spent within that envelope. I thank the hon. Gentleman for his question.
Dr Evans
It is a regret that I have had to summon the Minister here to answer questions, and surprise, surprise—
Dr Evans
I of course withdraw that remark, Mr Speaker, and I thank you for summoning the Minister on my behalf. It seems to have had the desired effect, because the outstanding parliamentary questions have, strangely enough, been answered this morning. I hope to get some clarity as this is really important.
The issue has been explained simply by the chair of the National Pharmacy Association:
“The work was done. Patients were treated. The NHS benefited. Yet payments are being withheld on a technicality.”
What makes that worse is that many pharmacies do not even realise that some of the money is missing. He goes on:
“Statements appear ‘successful’, yet Pharmacy First payments are absent. Contractors are only discovering the issue long after the window has closed, when it’s already too late.”
Will the Minister tell the House how many pharmacies the Government think are impacted? What is the total value of the outstanding payments? What steps are the Government taking to rectify this, and would they consider a late payment mechanism to help solve the issue?
There is a wider concern. Payments are administered by the NHS Business Services Authority. The chair of the NPA labelled the behaviour of NHSBSA “outrageous”. That already follows repeat concerns about NHSBSA’s performance, including multiple serious delays in NHS pension processing and several urgent questions on the Floor of the House. Does the Minister still retain confidence in NHSBSA? Given the ongoing concerns from multiple fields, will he commission a review of the operational performance of the entire NHSBSA?
Community pharmacies are already under intense pressure from this Government, with tax rises on employment and business rates and with increases in costs, and now they appear not to be being paid for work already done. I hope the Minister will act quickly to put this right.
Dr Ahmed
As the hon. Gentleman will know—or should know—the current remuneration method was agreed in conjunction with the sector. The adjustment was agreed with the sector’s representative body, Community Pharmacy England. Advance notice of the change was provided to those contractors by letter and in an article published by the NHS Business Services Authority in May 2025. In addition, Community Pharmacy England knows that, should this be a priority issue for it to negotiate in the next contract, we will take that on board and use it as an option.
There are of course always extenuating circumstances, such as IT not working. Officials have reassured me that, following discussions with Community Pharmacy England, we have introduced specific provisions in the drug tariff that will allow pharmacy contractors to receive payment for claims that were delayed due to IT issues outside of its control.
I can appreciate why the hon. Gentleman wants to expand the remit of the urgent question across primary care—well, let me tell him. I know he had neck surgery recently; I did not realise they put a brass neck in him as well when they did it. He knows what kind of NHS decline and decay over which he and his Government presided over the past 15 years: primary care where people are left wandering around asking for GPs, and the Conservatives left GPs on the scrapheap, unemployed. This Government ensured, when they came into office, that—
Mr Speaker
Order. Minister, one of us is going to sit down, and it is not going to be me. Please can we have a little bit more calm? You have come in as the supporting Minister to the Secretary of State. I want you to set the example and not be the naughty one.
Mr Speaker
Order. We are going to learn the rules between us, Minister. Dr Luke Evans, I have granted you this urgent question. Quite rightly, I wanted your question to be heard by the Minister; I did not want any interruption. I expect you to listen to the answer without interruption.
Dr Ahmed
This Government take our responsibilities seriously in providing an effective 21st-century primary-care NHS, free at the point of care. That is why when we came into power we ensured that the pharmacy sector had the largest uplift of any part of the NHS in the past two years—£3.1 billion. To support primary care further, we ensured that GPs who could not find employment found it under this Labour Government. It is only this Government that can modernise the NHS, make it free at the point of care and ensure that it is a high-quality service going forward.
Liam Conlon (Beckenham and Penge) (Lab)
My constituent Raj Matharu runs the brilliant Westchem pharmacy in West Wickham, is CEO of Community Pharmacy South East London, and last year was shortlisted for community pharmacist of the year. I have heard from residents across West Wickham how his pharmacy provides trusted and frictionless access to healthcare and advice across a range of issues. Pharmacy First can both provide a quicker, easier service for patients and relieve pressure on primary care. What support have the Government put in place for community pharmacies, especially in relation to funding?
Dr Ahmed
As I have stated, we have given pharmacies a record £3.1 billion settlement. We absolutely endorse the need for pharmacies to do more in our communities. We are enabling pharmacists up and down the country to expand their repertoire, and we are ensuring that Pharmacy First remuneration is a dynamic process, month on month, that reflects the activity that each pharmacy is doing.
Helen Morgan (North Shropshire) (LD)
Pharmacists play a crucial role in supporting the health service by reducing the pressure on overcrowded hospitals and GP surgeries. They also play a crucial role in local communities by providing access to treatment when appointments remain hard to come by elsewhere. But pressure on pharmacists is severe and has been getting worse, as shown by closures in my constituency and across the country. Those closures hit hardest in rural and coastal areas and in the most deprived areas, where they are most needed. This vital service needs to be supported and not undermined so that our constituents can rely on being able to access the medicines and treatment they need.
Has the Minister considered a new late payment mechanism to ensure that if contractors miss the deadline, they can still receive compensation for the work they have undertaken, especially in the interim as pharmacists adapt to the changes that have been introduced? What discussions has he had with NHSBSA to resolve the technical difficulties being experienced?
Dr Ahmed
I can assure the hon. Lady of our commitment to an effective primary care system up and down the country, in both rural and coastal communities. My hon. Friend the Minister for Care, whose portfolio includes pharmacy, takes his responsibilities seriously and is exploring all avenues to ensure equity of access and funding, including through the Carr-Hill formula.
The hon. Lady asks what mitigations can be employed to ensure that payments are made in extraordinary circumstances. I can assure her that I have had those discussions with my officials this morning, and they reassured me that there will be a degree of flexibility, particularly in circumstances outwith the control of individual pharmacies.
James Naish (Rushcliffe) (Lab)
I am very grateful for the fact that this urgent question was granted, because pharmacies have been in touch with me about their concerns. I must put another thing on the Minister’s to-do list: independent prescribing. Evans Pharmacy in my constituency has been part of the independent prescribing pathfinder programme, and only 5% of patients seen by the prescribers subsequently require GP prescribing. However, no clear funding or arrangement will be in place after March this year. Will he provide Evans Pharmacy and similar prescribers with clarity about what will happen next?
Dr Ahmed
My hon. Friend is absolutely right. Independent prescribers are a key and expanding part of our workforce, providing a sustainable primary care service. I am very happy for the Minister for Care to write to him with the exact funding plans for the next financial year.
Mr Gagan Mohindra (South West Hertfordshire) (Con)
In the past year, I have spent time visiting pharmacies across my constituency, undertaken work experience at Riverside pharmacy in Rickmansworth, and communicated regularly with Community Pharmacy Hertfordshire. It is clear that our pharmacies are under unsustainable pressure from rising costs, especially following the Government’s increase to employer national insurance contributions. Pharmacy First was a great Conservative initiative to reduce pressure on our GPs. Why are this Government hurting pharmacies and patients by delaying payments?
Dr Ahmed
Pharmacy First is indeed a great initiative. It is not the first in this country; it has been developed in other parts of the country. When we came into office, we worked with the sector and stakeholders, and agreements on remuneration and pricing were reached in conjunction with the sector. What is more, we are addressing the pricing structures and payment mechanisms that are not working and need improvement with a dynamism that was lacking under the previous Government.
Lincoln Jopp (Spelthorne) (Con)
The Trio Pharmacy in Shepperton told me that there are two problems with Pharmacy First. The first is that pharmacies are simply not getting the referrals that they should from GPs. The second is that remuneration for their services does not take into account the amount of time needed for examination, diagnosis and prescription. The Nebel Pharmacy in Sunbury, near where I live, says that the work needs to be looked at as a vocation, because it simply makes no money. That is not sustainable, is it?
Dr Ahmed
The hon. Gentleman is absolutely right: we need to unblock the referral pathways. The neighbourhood health service is all about ensuring that the process between general practitioner and pharmacist feels seamless. On payments, we are cognisant of the fact that as demographics change, population needs in different parts of the country vary, so different payment mechanisms must apply. We are closely working with colleagues and stakeholders in the sector to ensure that we get that right.
Mr Will Forster (Woking) (LD)
Residents of West Byfleet are frustrated that a new pharmacy that wants to open in their area is not allowed to do so. Be it that unreasonable restriction, the increase in NICs or a lack of funding, this Government’s every action seems to undermine the pharmacy sector. Will the Minister explain why the Government are withholding funding from pharmacies that have signed up in good faith to Pharmacy First, and why they have not introduced a late-payment mechanism?
Dr Ahmed
I am reminded that Liberal Democrat Front Benchers always welcome funding for the NHS, but can never explain where the money should come from. I have already mentioned the record funding that we are putting into pharmacy. I have reiterated that there is ministerial engagement with the pharmacy sector—not just through the Minister with responsibility for pharmacy, but through me, as Minister with responsibility for health innovation. Our relationship with the pharmacy sector is in a good place, and we continue to develop it.
Greg Smith (Mid Buckinghamshire) (Con)
Pharmacy First was undoubtedly game changing. When I visit pharmacies around my constituency, many of them are keen to expand Pharmacy First and to offer more lines. However, I can give an example similar to the one that my hon. Friend the Member for Spelthorne (Lincoln Jopp) gave. The people at Wendover Pharmacy took me through their books, and on many of the services that they offer, they either barely make any money or make a loss. The Minister said in answer to my hon. Friend the Member for South West Hertfordshire (Mr Mohindra) that pricing was set with the sector, so clearly something is going wrong, because the experience of Wendover Pharmacy is quite different.
Dr Ahmed
The hon. Member is right that under the Pharmacy First programme, contractors receive a monthly fixed payment upon delivering a minimum number of consultations, as per the 2025-26 agreement. That can go up and down month to month, in a dynamic process, depending on how many patients are seen in pharmacies. I completely take his point that we are evolving our care system, and ensuring a move from hospital to community, but are not quite there yet; however, I think we are on the road. Through our neighbourhood health programme, we are solidifying the relationships between general practice, pharmacies, opticians and other allied health professionals in primary care.
Claire Young (Thornbury and Yate) (LD)
Not only are community pharmacies in my constituency facing problems with Pharmacy First payments, but pharmacies like Abbotswood Pharmacy tell me that they are not seeing the referrals that GPs are supposedly making. Pharmacies can take pressure off the NHS. Does the Minister agree that this combination of referral failures and payment delays is forcing patients to wait longer for care, and what steps will he take to ensure that both referrals and payments are successfully made?
Dr Ahmed
The hon. Member is absolutely right: we need to unblock some of the referral pipelines between GPs and pharmacies. We are absolutely clear in our instructions to the system that pharmacies are an integral and growing component of primary care provision, and that premise underlies all our discussions with pharmacies and GPs.
Richard Foord (Honiton and Sidmouth) (LD)
Allied Pharmacies has taken over a couple of failing Jhoots Pharmacy branches in my area since Pharmacy First was introduced, which is very welcome. The chief executive said this week that the outlook for elderly people and those without a car in rural areas was stark. Between 2015 and 2025, community pharmacies have seen a real-terms funding cut of about 30%—that is £1 billion less in real terms—and rural Devon and Cornwall have seen a reduction of 90,000 hours of pharmacy time in two years. In that context, will the Minister ensure that full compensation is given to dispensing doctors in rural areas for the cost of medicines?
Dr Ahmed
I am grateful to the hon. Gentleman for adumbrating how 14 years of Tory Government have led to significant decay in the provision of primary care services in some of our communities. He is right to mention dispensing doctors, who are a vital part of the mixture in hard-to-reach and coastal communities. I had many meetings with them prior to my appointment, and my colleague the Minister for Care will continue to meet them to ensure that they continue to be part of the mix of care provision in those communities.
Freddie van Mierlo (Henley and Thame) (LD)
Last year, I visited a pharmacy in Benson in my constituency, where Vik Patel described to me how the pharmacy’s being rural disadvantages it in the Pharmacy First scheme. His pharmacy never meets the threshold to qualify for payment, and that threshold has gone up over and over again, from five patients a month in April last year to 30 in March 2025, so the pharmacy is effectively delivering a service for free. Vik is a lovely chap, and he is happy to do that, but it is not a sustainable business model. What will the Minister do to help rural pharmacies like mine in Benson?
Dr Ahmed
I can reassure the hon. Member that my hon. Friend the Minister for Care is looking at funding and primary care provision in the round in coastal and poorer communities, and I would be delighted to take back his representations about Pharmacy First in rural settings.
Jim Shannon (Strangford) (DUP)
I thank the Minister for his answers. I want to give a helpful suggestion from a Northern Ireland perspective. He will agree that a rural pharmacy will find it more difficult to meet the ever increasing threshold, and that the point of these payments is to take pressure off GPs, not to provide a back-door way of underpaying earned compensation. In Northern Ireland, we have a slightly different system that involves payment per consultation, which I ask the Minister to consider. Perhaps that would be more appropriate, and would give pharmacies, GPs and their patients what they are looking for.
Dr Ahmed
I am always grateful for the hon. Gentleman’s wise counsel. He will know that I have regular meetings with my counterparts in the devolved nations. I am well aware of some of the remuneration schemes in Northern Ireland, and I am following them with interest.
Brain Tumour Survival Rates
Zubir Ahmed Excerpts(2 weeks, 4 days ago)
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The Parliamentary Under-Secretary of State for Health and Social Care (Dr Zubir Ahmed)
I start by thanking my hon. Friend the Member for Mitcham and Morden (Dame Siobhain McDonagh), and the hon. Members for Witney (Charlie Maynard) and for Kingswinford and South Staffordshire (Mike Wood) for supporting this important debate. I would like to take a few moments to acknowledge the contributions of all hon. Members across this House—from personal experience, I know how hard it is to talk about these issues when people close to your family are lost to brain tumours. They include my aunt, who was instrumental in my pursuing a career in medicine. She passed away in 1997, only four months after a diagnosis of glioblastoma.
The hon. Member for Witney asked about consent in relation to tumour tissue research, which is a really important and pertinent topic. I am very happy to go away and consult with the Human Tissue Authority regarding the facility we have at the moment, which is quite sizeable, for securing consent to research on tissue from living persons and deceased persons. As a transplant surgeon, I am relatively au fait with some of the consent issues that can arise in using tissue from deceased persons, and I am always very happy to encourage consideration of those issues wherever possible. The hon. Member rightly challenged us to improve our architecture for digital consent. We continue to do so through our “analogue to digital” platform, on which the 10-year health plan is based, not only for care but for research.
I thank my hon. Friend the Member for Colne Valley (Paul Davies) and the hon. Member for Mid Dunbartonshire (Susan Murray) for their thought-provoking contributions to this debate, as well as my hon. Friend the Member for Edinburgh South West (Dr Arthur), who talked so passionately about these issues. I thank him once again for bringing forward his private Member’s Bill, which will do so much to move the dial on research, not only on brain tumours but on rare cancers more generally. He had a specific ask about visa costs for talent coming from elsewhere in the world, and I assure him that we are looking seriously into these issues. Only today, I was chairing a session of the Life Sciences Council, where we talked about the global talent fund. That is pertinent to the discussions that my hon. Friend is having, and I am happy to put the council in touch with him to further those discussions regarding how we attract the brightest and the best to our country to advance the cause of life sciences generally, as well as the cause of researching rare cancers.
The hon. Member for Wokingham (Clive Jones) talked more specifically about referral targets. I can reassure him that we are totally committed as a Government to hitting those national standards on 62-day waits. He challenged us to go to 100%. I caution him that although 85% is possible, 100% is not, usually for clinical reasons. There may be genuine clinical reasons why patients cannot access treatment within 62 days in terms of planning and specialist access.
My right hon. Friend the Member for Hayes and Harlington (John McDonnell) talked about diagnostics. That issue is close to my heart, and I reassure him that through the continued opening of community diagnostic centres up and down the country and £2 billion of funding, I am determined to ensure that diagnostics is improved and available closer to home wherever possible.
The hon. Member for North East Hampshire (Alex Brewer) talked about her friend being diagnosed with a brain tumour in A&E. As someone who was a young casualty officer many years ago, that resonated strongly with me. The A&E department is the last place where any tumour should be diagnosed, but I remember it happening far too frequently as a young casualty officer. One litmus test of the success of our cancer plan will be that much fewer of those diagnoses will be undertaken in an unplanned fashion in A&Es up and down our country.
I am always grateful for the learned remarks of my hon. Friend the Member for Bury St Edmunds and Stowmarket (Peter Prinsley). I always feel like I learn so much from him. In fact, I learned so much tonight that I might add his contribution to my portfolio of continuing professional development when I submit myself back to the General Medical Council to extend my licence.
The hon. Member for Strangford (Jim Shannon) always raises thought-provoking issues about four-nation working. I assure him that I continually and frequently discuss many matters pertaining to the health of our four nations with the Minister of Health in Northern Ireland. I can also reassure him of our UK-wide commitment to the life sciences sector plan and life sciences project. On that note, it was my great pleasure to meet academics from Queen’s University Belfast in this place only a few months ago, where I reaffirmed my commitment as life sciences Minister to the life sciences sector plan being a true four-nation project. That of course includes Northern Ireland, and I know from my own academic interests that much expertise resides in Northern Ireland.
The hon. Member for Epsom and Ewell (Helen Maguire) talked about benign tumours not being forgotten, and she is absolutely right. Those of us from a medical background know that it is a spectrum between benign and malignant tumours. Many benign tumours can evolve into malignant tumours, and they must be captured by plans such as the national cancer plan. She challenged me about publishing regular outcomes from the national cancer plan, and I can certainly commit to that. Those can be scrutinised in the normal way by the Health and Social Care Committee.
The shadow Minister, the hon. Member for Sleaford and North Hykeham (Dr Johnson) talked about screening. She will know, as I do, that screening is important when it is evidence-based and where the benefits outweigh the harms. Screening is never harm-free, so it is important to ensure we are calculating these things based on expert evidence. Neither she nor I are experts in screening, so we always defer to the UK National Screening Committee and its deliberations and opinions on these matters.
The shadow Minister asked me about the workforce plan. I can assure her that that is in play and will be published shortly, in the spring or very early summer. She asked how that might interact with diagnostic capacity, and I can assure her that we are working at great speed to ramp up diagnostic capacity through the funding envelope that I mentioned. She will know that it is important, when we plan both for workforce and diagnostic capacity, to take account of AI moving at a rapid pace. We have already been able to eliminate one radiologist from breast cancer diagnoses, and it is entirely possible that we will be able to have a similar impact with technology on the rates of other cancers and, for example, lung cancer diagnostics. It is important that, as we work through the workforce plan, we take account of what the future will look like in that context.
When we came to the topic of the potential association between traumatic brain injury and brain tumours and my hon. Friend the Member for Bury St Edmunds and Stowmarket intervened on the hon. Member for Sleaford and North Hykeham, the medical man in me could not help himself. I looked at PubMed quickly to check whether there was indeed an association, and I picked out a paper that may be of interest to the medical people in this place. Following 24 years’ worth of data from Mass General Brigham hospital, with 75,000 patients on each arm looked at retrospectively, there would seem to be a mild association between severe traumatic brain injury and the diagnosis of malignant brain tumours.
Sir John Hayes
As the Minister is now referring to my specialist subject, I thought that I had better intervene. Although I defer, of course, to the immense experience of the hon. Member for Bury St Edmunds and Stowmarket (Peter Prinsley) in these matters, I think that this is associated with lesions and scarring, and that is why, as the Minister said, there is a mild association. As the hon. Member said, there is a much more profound association with other neurological conditions, particularly dementia.
While I am on my feet, may I ask the Minister to address the issue of research? The hon. Member for Bury St Edmunds and Stowmarket is right: diagnostics are terribly difficult, but 1% of the expenditure on cancer research currently goes towards brain tumour research. Can we increase that?
Dr Ahmed
I am grateful to the right hon. Member for his remarks. At the risk of turning this into some sort of medical journal club—I will move on quite swiftly, Madam Deputy Speaker—let me point out that the association is based on retrospective data, and we all know that we have to be a little bit cautious with retrospective data. As for the question of research, I can assure the right hon. Member that we are committed to spending more of the £2 billion NIHR budget on rare cancer research, some of which is ringfenced.
The hon. Member for Sleaford and North Hykeham asked about rural areas. In the workforce plan, we are committed to ensuring—
Sarah Owen
May I take up the point about funding? I apologise for not having been here at the beginning of the debate, but I want to pay tribute to my two incredible constituents Khuram and Yasmin. Their daughter Amani was diagnosed with glioblastoma, and tragically passed away in February 2022 at just 23 years old. Amani’s parents devoted themselves to taking care of her 24/7 as the cancer progressed, but they had to fundraise £100,000. Does the Minister not agree that parents and others should be spending their time with their loved ones, not spending their time fundraising for experimental drugs?
Dr Ahmed
I thank my hon. Friend for all her advocacy on behalf of all her constituents, but particularly Amani’s family. This is a story with which I am very familiar, and I can reassure my hon. Friend that I am committed to ensuring that medical research is properly funded so that, indeed, it is not the duty of bereaved parents or parents to raise the money.
Dame Siobhain McDonagh
We all know that, while money is important, if the institutions that are given money do not spend it, we are all left frustrated and wondering what will happen. I have met cancer Ministers in both the last Conservative Government and this Government, all of whom have been well-intentioned and meaning to bring progress, but it requires intervention with those organisations to ensure that the money that is made available is spent.
Dr Ahmed
I am hearing my hon. Friend’s call to action loud and clear. I can report to her that—this is in addition to the other ongoing clinical trials in the area of brain tumour and glioma research—in October 2025, RECURRENT-GB opened for recruitment. This is a new UK multi-centre randomised controlled trial, supported by nearly £2 million of NIHR funding, which will explore, for instance, whether surgery can improve the quality of life for patients with glioblastoma when the glioblastoma comes back after treatment. I know that my hon. Friend will hold our feet to the fire when it comes to recruitment and the money being used appropriately, and I am delighted to continue working with her in that regard.
Since this Government took office, over 213,000 more people are getting a cancer diagnosis on time, over 36,000 more people are starting treatment on time, and rates of early diagnosis are hitting record highs. Despite these vital signs of recovery, we know that our NHS is still failing far too many cancer patients and their families, as Members from across the House have highlighted this evening. We know that brain tumours remain one of the hardest cancers to treat, and it remains a challenging and underserved area of research.
Last week, the Government published our national cancer plan. We now have a blueprint to shift the dial on rare and challenging cancers, underpinned by three key targets. First, we aim to save 330,000 more lives by 2035 by ensuring that three in every four people diagnosed in 2035 will be cancer-free or living well with cancer five years after diagnosis. Secondly, we will achieve the three cancer performance targets, which I mentioned earlier, by the end of March 2029. Finally, we will improve the quality of life for people living with cancer.
Rare and less common cancers are a priority for the Government, and this is the first ever cancer plan with a whole chapter dedicated to rare cancers. We aim to be in the top quartile of European countries for 14 rare cancers, including brain tumours, where we currently rank 22nd out of 24. We will pull every lever available to drive improvements for these cancer types. We know that one of the most effective ways to improve survival from cancer, including brain cancer, is to catch it and treat it early, so we have committed to reducing the number of rare cancers diagnosed in emergency settings, including brain tumours, which cannot be staged like other cancers and have therefore not been previously captured by early diagnosis measures.
Dr Arthur
This is about equality. There is a fantastic charity called The Eve Appeal, which is focused on gynaecological cancers. It makes the point that a disproportionate number of people with these cancers end up being diagnosed in A&E, by which time it is too late. Through a meeting I had with Blood Cancer UK, I know that ethnic minorities are much more likely to face a diagnosis in A&E than in a doctor’s surgery. This is something that we should do, not just because it is the right thing to do but because it is a matter of equality.
Dr Ahmed
I could not agree more with my hon. Friend, and that is why NIHR funding has been specifically allocated. One of the tests for a grant is the diversity of the population it will serve.
We recognise the challenges presented by brain tumours. By publishing regular performance data at a more granular level and adding diagnosis in emergency settings to our basket of early diagnosis metrics, we are committed to moving the dial on these issues. For all patients diagnosed with rare cancers, we will prioritise access to specialist treatment and multidisciplinary teams to ensure that they benefit from the best of evidence-based care. We will work with charities to support rare cancer patients, and to ensure that they have access to the right information to manage their cancer care. We wish to be held accountable on these commitments and to drive forward progress for rare cancer patients, and we will therefore appoint a national clinical lead for rare cancers, who will provide independent arbitration.
The actions I have listed make up just a small part of our plan. It will turn cancer, which is one of the country’s biggest killers, into a treatable chronic condition. We have developed our plans with patients, charities, families and clinicians, and have heard from many Members today. We are grateful for the continued campaigning on rare cancers and brain tumours.
Dame Siobhain McDonagh
The chapter on rare cancers says that a named individual at NIHR will be responsible for progress in rare cancers. If there is no progress, will they get the sack?
Dr Ahmed
Sacking people is above my pay grade, so I will revert to the Secretary of State’s opinion on that, but my hon. Friend can certainly be reassured that we will hold them accountable, just as she will hold me accountable. She might give me the sack at this rate, so I had better be careful.
We are grateful for the continued campaigning on rare cancers. We look forward to working further with partners to deliver improvements in outcomes for brain cancer patients, and we know that the improvements promised through this plan rely on good research.
That research has already begun, with over £25 million invested in the NIHR brain tumour research consortium, which aims to transform outcomes for adults and children —and their families—who are living with brain tumours, ultimately reducing the number of lives lost to cancer. Furthermore, we are partnering with Cancer Research UK to provide £3 million to co-fund the CRUK brain tumour centres of excellence. This will ensure that we accelerate the move from foundational research to delivering innovative treatments for patients. These investments have the potential to shift the dial and the UK’s position as a leading location for brain tumour treatment research.
As reaffirmed in the national cancer plan, this Government are proud to support the Rare Cancers Bill, introduced by my hon. Friend the Member for Edinburgh South West, which passed its Second Reading in the other place last month. I thank my hon. Friend the Member for Mitcham and Morden and other hon. Members for their support and their moving contributions to the debates on the Bill. This important legislation will make it easier for researchers to connect with patients living with rare cancers, including brain tumours; streamline recruitment into clinical trials; and ensure that our regulatory system delivers for patients. As set out in our 10-year health plan, we will ensure that the UK is a global leader in clinical research. This Bill will accelerate the clinical trials needed to deliver the most effective cutting-edge treatments and the highest-quality care for patients facing a rare cancer diagnosis. I look forward to seeing it progress towards Royal Assent.
I once again thank hon. Members for giving me the chance to set out our plans on rare cancers. I hope I have reassured them that we are determined to improve survival rates for patients, and ensuring that everyone has access to the highest-quality care and the highest-quality research. The national cancer plan embodies these ambitions and sets out how we will achieve them. Through our significant research investments and our support of the private Member’s Bill on rare cancers, in 2026 we will begin to shift the dial on outcomes for brain tumour patients.
Madam Deputy Speaker (Caroline Nokes)
I call Dame Siobhain McDonagh to wind up.
Pandemic Agreement: Pathogen Access and Benefit Sharing System
Zubir Ahmed Excerpts(3 weeks, 4 days ago)
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The Parliamentary Under-Secretary of State for Health and Social Care (Dr Zubir Ahmed)
I would like to update the House regarding the follow-up negotiations to the pandemic agreement to develop and agree a new pathogen access and benefit sharing (PABS) system in the form of an annex to the agreement.
The PABS system will be a new, voluntary system for life sciences companies to sign up to in order to gain faster access, with less red tape, to the pathogens they need to create new vaccines, treatments and diagnostics (VTDs) for in the event of a pandemic. These negotiations are currently ongoing via the World Health Organisation’s member state-led intergovernmental working group (IGWG), which was established to facilitate this process.
Since my last update to the House on 22 October 2025, the IGWG has convened in from 3 to 7 November and from 1 to 5 December and held a resumed session from 20 to 22 January. So far, technical discussions have centred around the scope of pathogen materials and sequence information covered by the PABS system; how they will be shared through laboratory networks and databases to ensure timely access; benefit sharing provisions for manufacturers who sign up to the system; the links between PABS and other international access and benefit sharing frameworks; the links between domestic access and benefit sharing legislation and the PABS system; and provisions regarding traceability and open access to data.
The most recent round of negotiations saw some progress made on issues including the use of terms for the PABS system, but differences remain on a range of issues. The UK Government remain committed to continuing work with other member states to find consensus and to deliver an effective, implementable, and equitable PABS system.
Member states have agreed to report on the outcome of negotiations by the next World Health Assembly in May 2026. Only once the negotiations on the PABS annex have concluded, and the annex has been adopted by the WHA, will the pandemic agreement, including the PABS annex, be open for signature and ratification by member states.
Two further negotiating weeks are scheduled for 9-13 February and 23-27 March and I will update the House further as negotiations continue.
[HCWS1296]
People with a Learning Disability and Autistic People: Eighth Annual Report
Zubir Ahmed Excerpts(1 month ago)
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The Parliamentary Under-Secretary of State for Health and Social Care (Dr Zubir Ahmed)
I would like to acknowledge today the publication of the updated eighth report on “Learning from lives and deaths—People with a learning disability and autistic people” (LeDeR) produced by King’s College London. This replaces a previous version of the report which was retracted in December 2025 due to a technical issue with the LeDeR data. I will place a copy of the revised report in the Library of both Houses.
This Government are committed to improving care and reducing health inequalities for people with a learning disability and autistic people. We understand how important the timely and accurate release of information on LeDeR is in achieving this goal.
Following urgent investigation, the errors were found to be caused by an automated data-processing issue, which meant that some data on causes of death was missing at the time of analysis. This affected the conclusions originally published. I recognise how concerning the retraction will have been for bereaved families and stakeholders who place great trust in the LeDeR process. NHS England has worked with its data processor to correct the automated processing error so that it cannot recur. King’s College London has also strengthened its data checking protocols to prevent similar issues in the future. I am assured that this issue has now been resolved, and these improvements have been applied to the revised report published today.
The headline findings of the updated 2023 LeDeR report remain consistent with those previously published. The updated analysis reaffirms that people with a learning disability continue to experience significant health inequalities: on average, they die 19.5 years younger than the general population and are almost twice as likely to die from an avoidable cause of death. This remains unacceptable, and tackling these disparities continues to be a priority for this Government.
NHS England sets clear expectations for local systems, requiring integrated care boards to prioritise LeDeR reviews in their delivery plans and produce an annual report demonstrating how learning from those reviews has driven action. In addition, there is wider, significant work under way to reduce health inequalities for people with a learning disability and autistic people—including mandatory training on learning disability and autism for health and care staff, continued uptake of annual health checks, and roll out of a reasonable adjustment digital flag.
The updated report contains the following specific changes:
Review of lives and deaths (2021-23)
The proportion of deaths classed as avoidable is now higher than originally reported, particularly in 2023 (40.2% v. 38.8%), although the downward trend over time remains. Influenza and pneumonia remain the leading avoidable cause but account for a smaller share, while ischaemic heart disease contributes a larger share. Cerebrovascular disease replaces digestive cancers among the leading avoidable causes. The ranking of overall causes of death has also changed, with diseases of the circulatory system now the most common cause.
Ethnicity
There are small changes in the proportion of deaths classified as avoidable by ethnic group, with slightly lower percentages among ethnic minority groups and a slightly higher percentage among white adults. There are small shifts in the relative contribution of leading causes of death by ethnic group. These changes do not alter the overall conclusions, with avoidable mortality remaining higher among several ethnic minority groups than white adults and the general population.
Level of learning disability
Avoidable mortality is higher than originally reported for both adults with a mild or moderate learning disability and those with a severe or profound learning disability. The difference between these groups is now considerable. While there are small changes in the proportions of overall and avoidable causes of death, the ordering of causes remains unchanged, and the overall interpretation of differing mortality patterns by level of learning disability is not altered.
Autistic adults
There are small changes in the proportions of causes of death among autistic adults without a learning disability. The largest shift is in deaths by suicide, which increase from 29.1% to 31.5%. This does not alter the overall interpretation of findings. Evidence on causes of death for autistic adults without a learning disability is emerging. The number of deaths notified to LeDeR remains small, meaning findings are unlikely to be fully representative of the population of people who are autistic.
[HCWS1276]
Draft Medical Devices (Fees Amendment) Regulations 2026
Zubir Ahmed Excerpts(1 month ago)
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The Parliamentary Under-Secretary of State for Health and Social Care (Dr Zubir Ahmed)
I beg to move,
That the Committee has considered the draft Medical Devices (Fees Amendment) Regulations 2026.
It is a pleasure to serve under your chairship, Ms Jardine. I am grateful for the opportunity to open the debate on these regulations, which were laid before Parliament on 16 December 2025 and are due to come into force on 1 April 2026. The purpose of the regulations is to amend the Medical Devices Regulations 2002 and the Medical Devices (Northern Ireland Protocol) Regulations 2021 to update their fee structure. They do that by introducing a new medical devices registration fee, which provides additional funding for the Medicines and Healthcare products Regulatory Agency’s strengthened post-market surveillance of medical devices.
From 1 April 2026, the new annual fee will apportion the MHRA’s PMS costs more fairly across the sector and will replace the current per-application fee, which is insufficient to cover the costs of the post-market surveillance we wish to see in future. In 2026-27, the fee will be part-subsidised by the Department of Health and Social Care, with the intention that, subject to further ministerial and parliamentary approval, we will move to a fully cost-recovering annual fee model from 2027-28.
As to why the regulations are necessary in a modern MHRA regulatory framework, PMS refers to the work that the MHRA does to collect, review and act on safety and performance issues relating to medical devices on the market. The independent medicines and medical devices safety review highlighted the need for a higher-quality medical devices PMS framework. The Medical Devices (Post-market Surveillance Requirements) (Amendment) (Great Britain) Regulations 2024, which came into force on 16 June 2025, were a key part of the wider reforms developed in response to the recommendations in that review. The 2024 regulations strengthen the medical devices safety and surveillance framework, improve patient safety and support the MHRA’s more risk-proportionate and innovation-friendly approach to regulation. However, they are also estimated to increase PMS workload by 60% to 70%, at an annual cost of around £17 million, so finding a sustainable funding model is vital.
Historically, the PMS of MHRA devices has been funded mainly by subsidy from the Department of Health and Social Care, and partly by the current per-application fee model. Subsidising ongoing regulatory activity through general taxation is not the MHRA’s usual approach to fees and services. The usual approach is based on His Majesty’s Treasury’s “Managing Public Money” guidance, which states that fees should be set on a full cost-recovery basis. Therefore, the regulations reduce subsidy by introducing a direct annual registration fee, so that those who benefit from access to the market fund the regulatory activity that underpins it.
On the intended operation of the regulations in practice, the new annual fee apportions the overall cost of the MHRA’s PMS activities by using the global medical device nomenclature system, which is a globally recognised system for naming and classifying medical devices. It is hierarchical, with broader groupings at higher levels and more granular entries at lower levels—for example, level 2 is a “category” and level 5 is an individual GMDN “term”.
Medical devices are registered with the MHRA using a GMDN code. Prior to placing devices on the market for use, the MHRA hosts a register of them called the device online registration system, or DORS—I am sorry, Ms Jardine, it is another acronym. The register is a valuable resource to monitor devices in circulation and to know when there are concerns about their uses. The proposed fee will be calculated using information from DORS; in practice, the MHRA will charge based on the number of chargeable GMDN level 2 categories that the manufacturer’s registrations fall into. It is important to note that if a manufacturer has multiple devices in the level 2 category, they will be charged only once a year for that category.
As the GMDN system is already in use for device registration, this approach also limits the administrative burden because fees can be calculated from existing data, rather than requiring additional information from the manufacturer, and is therefore less onerous. The MHRA consulted widely on the fee as part of its last statutory fees uplift and updated its approach based on stakeholder feedback. The consultation ran for two months, from August to October 2024, and was widely promoted and was supported by a small and medium-sized enterprise webinar.
The annual fee proposed in the consultation was £210 per GMDN level 5 term, using the most granular, fifth level of the GMDN structure. Most respondents did not support the proposal: 72% were opposed, 18% had no opinion and 10% supported it. Their concerns focused on the introduction of a new annual cost at short notice and the risk of a disproportionate impact on SMEs and areas that attract more GMDN registrations, such as in vitro diagnostics and—something that is close to my heart—surgical instruments.
In response to feedback, several changes were made. The MHRA set up a confidential, trusted advisory group of industry representatives to discuss the approach and seek further advice on implementation. That was welcomed by the members and provided useful feedback and assurance. The fee is being rolled out in a phased way to give the sector time to adapt and respond to its needs. The costs have been fully subsidised in 2025-26, and this instrument introduces a part-subsidised annual fee from 2026-27, with the intention to move to a fully cost-recovering annual fee model from 2027-28, subject, as I have said, to further ministerial review and parliamentary approval. The fee was remodelled to be charged at GMDN category level 2, rather than level 5, which is a higher, more general level, which will result in the costs being more equitably spread.
Overall, the MHRA estimates that, crucially, 56% of manufacturers will pay only £300 a year, and that 82% of manufacturers will pay no more than £900 a year. Crucially, SMEs are more likely to pay only £300 a year, as they are likely to have a more limited range of products compared with larger companies. To add further context, the medical technology sector generated £48 billion of turnover in 2023-24 and the total post-market surveillance cost was £17 million, representing 0.035% of total revenue. That is a good example of how consultation feedback and stakeholder engagement can be used to improve a proposal, in this case by modifying the fee structure to be more equitable and proportionate.
I recognise that manufacturers will always prefer to avoid additional costs, but I am satisfied that moving to a fair and, crucially, more predictable cost recovery approach to fund ongoing PMS is the right thing to do and that the changes made help to address the key concerns raised.
Finally, the MHRA has been working to help the wider medical technology sector to prepare for this change. The phased roll-out has given the sector time to adjust and get ready. The MHRA has published guidance explaining the new fee—how it will be calculated, what account holders need to do to ensure that their registration data is accurate, and how and when the payment needs to be made. The MHRA is improving the functionality of its DORS system so that account holders can see their chargeable GMDN categories, helping them to understand and check what they will be charged for in advance, to give them additional certainty. This new functionality will be ready for 1 April 2026. In the meantime, the MHRA has emailed all manufacturers directly with an estimated fee based on their registrations of November 2025.
In summary, these regulations introduce a necessary and fair annual registration fee from 1 April 2026 to help to fund the MHRA’s strengthened PMS ambitions, as well as its regulatory ambitions to make this country the world leader in life sciences and the medical technology sector. The approach has been improved in response to consultation feedback and is being introduced in a phased way to give maximum time to the sector to adapt, while ensuring that the MHRA has the resources it needs to protect patients and maintain confidence in our growing market. For those reasons, I commend the regulations to the Committee.
Dr Ahmed
I turn first to the Opposition spokesperson, the hon. Member for Sleaford and North Hykeham. Like me, she is a scholar of medicine, and she practiced in the NHS throughout all 14 years of the last Government. She will know, possibly at first hand, that the MHRA as a regulatory body has not been fit for purpose for a long time. It has lagged behind the inventions and innovations now available to patients, particularly in medical technology. She will also know it is this Government who are placing the MHRA at the service of patients by being bold in our reforming agenda and our leadership in regulating medical technology.
The proof point of that reform is our consultation with trusted groups, including trade associations such as the Association of British HealthTech Industries, the British In Vitro Diagnostics Association and the British Dental Association, all of which were consulted extensively over the course of these regulatory proposals, and with which I engage on a regular basis to garner their support, so that at every step of the way our life sciences sector plan is facilitated by our regulatory institutions and authorities. Indeed, the MHRA was present last week in front of a number of innovative biotechnology companies, whose message was loud and clear: they view the UK’s regulatory framework as first in class, innovative and forward-thinking, and they therefore see investing in our country as an attractive proposition.
On the impact assessment, I assure the Opposition spokesperson and the hon. Member for Winchester that we are not avoiding an impact assessment. In fact, we are supporting industry with a phased approach to fees, and we are open to an ongoing consultation and dialogue as this fee structure comes into place next year and the year after.
My hon. Friend the Member for Worcester is a learned Member of this House, and I entirely take on board his comments regarding insulin pumps. Wherever possible, in the discussions that I have had with my officials and the MHRA, we have said that this fee structure should include the totality of a device, rather than its component parts. I am very happy to take his comments back to my officials, so that we can make sure that he and his constituents are satisfied that there are no unintended consequences in that regard. I thank all Members for their contributions, and thank you, Ms Jardine.
Dr Johnson
The Minister is making a great speech, but he is not answering lots of the questions—I appreciate that he may not have all the answers. Can he commit to answering them by letter? Will he also talk about the possibility of obsolescence? If an item ceases to be registered—he is encouraging people to deregister things that they are no longer selling—can it still be used in the NHS? How would a doctor know whether something had ever been registered in the past and was safe?
Dr Ahmed
I am happy to write to the hon. Lady to give her a fuller answer. She knows that procurement in different parts of the NHS rightly reflects local clinical practices, although there are overarching national frameworks for buying such products. Innovation lends itself to the fact that, over time, patients will want to choose and move on to newer forms of devices that treat their conditions in line with the latest clinical evidence. I am very happy to write to her more extensively on obsolescence and her other questions.
I would like to address some points made on the following topics: the impact on SMEs; the impact on market attractiveness more extensively; GMDN suitability and transparency; clarity on costs; and the evaluation of value for money. I also want to make some points regarding Northern Ireland. On SMEs, as the Opposition spokesperson highlighted, I recognise that new regulatory costs can be felt more sharply by smaller firms, and the MHRA has listened carefully. That is why the fee has been designed to spread costs more equitably across the sector, and the majority will pay only £300 per year.
Following consultation feedback, charging is based on the number of GMDN level 2 categories that a manufacturer’s registered device falls into, rather than the much more granular level 5. That matters for SMEs because they are more likely to have closely related product variants that may attract multiple level 5 terms, but sit more generally within a single level 2 category. Under this approach, multiple products in one level 2 category are therefore charged once per year, reducing the need for repeat charges on minor product variations.
The MHRA estimates that around 56% of manufacturers will pay a single unit fee of £300 a year, and SMEs are most likely to fall into that group, because they typically have a narrower product range than the larger companies. The MHRA is not offering waivers or special SME rates. The charge is designed to be proportionate, and any waiver would simply shift costs elsewhere. The intention is to keep the charge predictable and proportionate, and to phase it in.
Finally, SMEs stand to benefit from a stronger PMS framework, leading to earlier identification of issues, fewer surprises and a more risk-proportionate and predictable regulatory approach that supports responsible innovation. I must make it clear that we are not asking for more money: we are simply changing the MHRA’s regulatory framework to put it on a more sustainable footing so that in the future it is less reliant on the taxpayer and, therefore, more pro-innovation, more pro-market and better able to have a healthier commercial relationship with new and established companies.
On innovation and UK attractiveness, a robust PMS framework is not a brake on innovation—far from it. It helps to make the market more predictable and investable, as per my conversations over the last couple of weeks with major and smaller biotech industry firms. In developing this instrument, we have ensured that the Secretary of State must have regard to three considerations set out in the Medicines and Medical Devices Act 2021: safety, availability, and the attractiveness of the whole of the United Kingdom as a place to research, develop, manufacture and, crucially, supply medical devices. This fee supports safety by ensuring the MHRA has sustainable funding for strengthened PMS, so that risks can be identified and acted on sooner. It supports availability by underpinning a stable and predictable system of oversight that helps to maintain continued safe access to effective devices.
Dr Johnson
Will this post-market surveillance continue if a device ceases to be registered?
Dr Ahmed
The anticipation would be that post-market surveillance will continue if devices are still used in a clinical setting.
PMS supports UK attractiveness by strengthening confidence in the market for patients, clinicians and investors, and by resourcing a more risk-proportionate, innovation-friendly approach to regulation, including making better use of real-world evidence and enabling more flexible and efficient regulatory burdens over time. A stronger PMS framework will also reduce uncertainty for innovators by enabling earlier proportionate action and helping to avoid sudden escalations that can disrupt plans or supply. By improving real-world evidence and post-market detail, it will also strengthen confidence in the UK as a place to generate evidence, invest and bring new devices to patients.
Hon. Members, including the hon. Member for Sleaford and North Hykeham, asked questions about global medical device nomenclature as the basis for apportioning costs. GMDN is internationally recognised for naming and grouping medical devices and is already used for UK device registration through the DORS, since 2018. Using GMDN categories means that the fee can be calculated from information that manufacturers already provide, making it less onerous, rather than creating a new system for reporting requirements purely for charging purposes. That helps to minimise the administrative burden across the sector, including for SMEs.
Category-based charging is also a practical and broadly proportionate proxy for the breadth of devices and types a manufacturer places on the market and, therefore, the likely level of PMS activity. It avoids a per-device approach and the complexity and burden of trying to calculate an actual PMS cost for each manufacturer.
On transparency, the MHRA is improving DORS, so as of 1 April account holders can see the chargeable GMDN level 2 categories linked to their registrations. Ahead of the go-live, MHRA has written directly to all manufacturers with their estimated fees so that they can check in advance their registration data and plan their budgets accordingly.
On clarity of costs, the consultation proposed an annual fee of £210 per GMDN term at level 5. The feedback was clear that that would be disproportionate, because level 5 is more granular in some areas than in others, exposing SMEs and manufacturers of devices such as in vitro diagnostics and surgical instruments to higher costs. In response, the MHRA redesigned the fee, so its charging is based now on the GMDN level 2 category, which is much broader, and consistent across product ranges. The unit price is higher because there are fewer level 2 categories than level 5, so the amount to recover is spread across fewer units, and the cost base has been updated to reflect inflation since the consultation.
The fee is also being introduced with a phased approach to give manufacturers time to adapt. The PMS has been fully subsidised by the DHSC in the year 2025-26, and this instrument introduces a part-subsidised annual fee model by 2026-27. The intention is to move to a fully cost recovery annual fee from 2027-28, once the new arrangements are embedded and a full impact assessment can be prepared.
On value for money and evaluation, the main objective of strengthening post-market surveillance is to improve health outcomes by increasing the quality and quantity of safety and performance data, and reducing the time from identifying a risk to making a corrective action. That supports patient safety and continued access to safe, effective devices and enables a more risk-proportionate, pro-innovation approach to regulation by strengthening the evidence base and supporting earlier proportionate action where needed.
Dr Johnson
If a device ceases to be registered, can a doctor still use it in the NHS—legally?
Dr Ahmed
As the hon. Lady knows, doctors are able, in certain circumstances, to prescribe unlicensed treatments to their patients if they feel it is a proportionate act to take. It is not something that is in guidelines or routinely recommended, but is at times at the discretion of individual clinicians. Clearly, that would be a peripheral activity, and something that could be looked at by local governance processes; but I am confident that these regulations strengthen the current post-market surveillance, so we are moving to a place of greater safety for the totality of the system.
The fee funds around 102 staff working across key areas, including medical device safety and surveillance yellow cards, software and diagnostics, and compliance and safety data. Roughly three quarters of these posts are existing roles, previously funded through the DHSC subsidy, with around one quarter being new posts that the MHRA expects to fill by the end of March 2026. Performance will be monitored through indicators such as the volume and quality of vigilance reporting, field safety corrective action and trend reporting, signal detection, and timeliness from the initial signal through to alerts and the corrective action being applied. The MHRA is committed to strengthening its internal metrics and producing new KPIs to track performance. These will be reviewed through the biennial fees uplift process to ensure that costs remain efficient and proportionate, and to avoid over or under-recovery.
I turn briefly to Northern Ireland. As hon. Members know, the regulatory position is different from that of Great Britain: under the Windsor framework, the EU devices regulations apply in Northern Ireland. This means that devices placed on the NI market must meet relevant EU requirements. The European Commission has recently announced that EUDAMED registration will become mandatory by May 2026. EUDAMED is the European Commission’s database that collects and stores data about devices on the EU and NI market. It is free for users, as it is funded centrally by the European Commission. In practice, that means that manufacturers, or their representatives, of devices—other than those that are custom-made—that are placing them on the EU or NI markets must register their devices on EUDAMED from 28 May 2026.
Out of a desire to avoid duplicative obligations, we are taking forward a separate piece of regulation that will mean that on 28 May 2026, devices other than custom-made ones, placed on the NI market will need to be registered with EUDAMED and will no longer need to be registered with MHRA, so the fee will not apply. Under EU regulations, custom-made devices are excluded from EUDAMED. They will still need to be registered with the MHRA, and will incur the fee.
Taken together, these regulations put the funding of the strengthened PMS on a clearer, more sustainable footing, so that those who benefit from access to the UK market contribute fairly to the ongoing regulatory work that supports their access. The fee has been redesigned in response to consultation feedback, is being phased in to give the sector time to adapt, and uses existing registration data to keep the administrative burden on business low.
Ultimately, this is about maintaining confidence in the safety and performance of medical devices, supporting continued access, and ensuring that the MHRA has the capacity to act quickly and proportionately if issues arise. I am happy to write to hon. Members if there any detailed points that I have not addressed; I have taken on board the comments of the hon. Member for Sleaford and North Hykeham and I am happy to write to her and the Committee. For those reasons, I invite the Committee to support these regulations for the sake of patient safety and our commercial environment, and I commend them to the Committee.
Question put.
ADHD Diagnosis
Zubir Ahmed Excerpts(1 month, 1 week ago)
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The Parliamentary Under-Secretary of State for Health and Social Care (Dr Zubir Ahmed)
It is a pleasure to serve under your chairship, Ms Vaz. I thank my hon. Friend the Member for Sefton Central (Bill Esterson) for securing what is, by all acknowledgement, an important debate on ADHD. I thank other hon. Members for their valuable contributions today, particularly my hon. Friends the Members for Hertford and Stortford (Josh Dean), for Sheffield Hallam (Olivia Blake) and for Warrington South (Sarah Hall), and the hon. Member for Yeovil (Adam Dance) for sharing personal experience that has been invaluable to this House. In this debate, we have heard moving testimonies and I want to thank all hon. Members who have shared personal and family experiences. I personally express my welcome and my deepest sympathies to Christine and Richard, the parents of Matthew Lock. I thank them for being in the Public Gallery for this debate, and thank them for all the invaluable work that they have done with the Department and with NHS England to raise awareness of the issues surrounding ADHD and suicide through the charity that they set up in Matthew’s memory.
We have learned, through this debate, the intersection between ADHD, other mental health conditions and suicide risk. Every suicide is a profound tragedy that leaves families, friends and communities devastated. That is why, in addition to our approach to ADHD, mental health and autism, we are committed to delivering the suicide prevention strategy for England, which aims to address the risk factors contributing to suicide to ensure that fewer lives are lost. We will work across Government to improve support to those who are suffering, and those who have been bereaved by suicide.
We know that people with ADHD have co-occurring neurodevelopmental conditions. We must not only intervene early but assess people with suspected neurodevelopmental conditions—about which I will say more later—and ensure that, following diagnosis, people have the right support to meet their needs, including their mental health needs. The Government have already taken significant steps to stabilise and improve NHS mental health services but, of course, there is so much more to do. Transforming the system always takes time but we are committed to delivering a new approach to mental health.
The 10-year health plan sets out the ambitious reform that we wish to undertake to make the system fit for the future. In line with that, we will go further to ensure that NHS mental health services deliver the care that people deserve and rightly expect. The publication of the “Staying safe from suicide” guidance in 2025 means that all mental health practitioners must now follow the latest advice in understanding and managing suicide. Associated training is now available to all NHS and non-NHS mental health staff.
Following the tragic loss of their son Matthew, Richard and Christine have been keen to ensure that other families are made aware of the increased risks of addiction and suicide that are associated with ADHD. NHS England has worked closely with Richard and Christine to revise content on the nhs.uk website, and has included separate, tailored content on ADHD for adults, children and young people. The website also specifically highlights the increased risks of suicide and addiction in those with ADHD, it signposts anyone who might be struggling to find urgent help and support, and has updated wording to reflect lived and clinical experience. I extend my thanks again to Richard and Christine for all their input to that work. I invite them into the Department to meet me alongside my colleague, the mental health Minister, to see how we can go further faster.
We know that too many patients are facing long waits to access services including ADHD assessments and support. I know that such issues are affecting our constituents up and down the country, as has been reflected in this debate, and I understand the devastating impact that that has on individuals and families. Lord Darzi’s report laid bare the growth in demand for ADHD assessments nationally. That has been so significant in recent years that it risks completely overwhelming the resource available. I thank everyone who has taken part in sharing evidence for Lord Darzi’s report, and with the subsequent ADHD taskforce established by NHS England. We know, from the taskforce’s report, that there are quality concerns with assessments. There has been rapid growth in remote assessments and in use of the independent sector. We are urgently looking into those concerns. That is why work is currently underway to improve ADHD services in both the short and long term to meet the needs of those waiting for an assessment, or those needing treatment for a diagnosis.
Dr Ahmed
I have met the chair of the taskforce: we discussed the outcomes, and the need—as the hon. Member mentioned in his remarks—for work on those outcomes to dovetail with the prevalence review. I think that would be the most appropriate way to provide a holistic response. We, of course, respect the findings of the report, which is an excellent scientific piece of work looking at the data underpinning the diagnoses.
Dr Ahmed
At present, the hon. Gentleman will have to ask my colleague the mental health Minister about the specifics, but my understanding is that the prevalence review will be a wider piece of work that will be partly informed by the ADHD taskforce report. It would be better to respond to them as a combination rather than as individual reports.
The House will know that on 4 December 2025 the Secretary of State announced the launch of the independent review into prevalence and support for mental health conditions, ADHD and autism. It will bring together the most respected researchers, clinicians and voluntary organisations in the country, alongside, crucially, people with lived experience, who will be directly engaged to scrutinise the evidence and support the development of recommendations. Part of that will be about how we address and label reporting, and I would expect that we come up with a better definition and a better way of reporting than we have at the moment.
The Government’s 10-year plan sets out the core principle of early intervention and support, and will make the NHS fit for the future. Through the NHS medium-term planning framework, published in October 2025, NHS England has set an expectation that local ICBs and trusts improve access, experience and outcomes for ADHD services over the next three years.
I heard the call from hon. Members for much more integration between community mental health services, GPs and other healthcare bodies. It is our expectation that through the NHS reform Bill and the disbanding of NHS England, as well the production of independent health authorities and strategic commissioning, the health service will be better able to serve the needs of children requiring assessment for mental health conditions and ADHD. We will end up having a helicopter view, which is currently not possible.
Olivia Blake
The review highlighted the lack of cross-Government working, so I wonder whether, for example, Access to Work could be looked at. Self-employed people currently have to wait six months to access it, and it is obviously a form of early intervention that gets people the support they need to stay in work.
Dr Ahmed
I thank my hon. Friend for her very valid point. It is important to mention that we expect that the prevalence review will align with the review that the Department for Work and Pensions is carrying out on employability and other issues affecting disability.
NHS England is working with ICBs that are trialling innovative ways of delivering ADHD services and is using this information to support systems to tackle ADHD waiting lists and provide support to address people’s needs. I understand that it is increasingly clear to patients and staff that the current highly specialist ADHD assessment model needs to evolve quickly. Moving to a more generalist service model could improve care and reduce waiting lists. That was one of the taskforce’s key recommendations.
Iqbal Mohamed
Approximately a quarter of the prison population—22,000, give or take—have ADHD. Will the Government commit to an impact assessment of what savings the Government could make, and how many people’s lives could be improved, by assessing people either before they commit a crime or after?
Valerie Vaz (in the Chair)
Order. The Minister knows that he has two minutes.
Dr Ahmed
As the hon. Gentleman will know, I have a lot of things in my purview, but prisons are not one of them. However, his point is well made. We expect that such sub-groups would be investigated and interrogated during the prevalence review.
I do have only two minutes, Ms Vaz, so I will move on quickly and not test your patience. In the longer term, we recognise the need to understand the factors behind the rising demand for services. We recognise that ADHD and autism frequently co-occur, which is why it will be important for the prevalence review to look at the conditions holistically as well as individually.
I acknowledge the impact that delays in accessing assessments and diagnosis are having on people, and I thank my hon. Friend the Member for Sefton Central for tabling this important and timely debate. I hope that the actions I have set out today, including the prevalence review and how it will dovetail with other reviews and other Departments, will provide some reassurance to my hon. Friend and other colleagues that we are taking these matters extremely seriously, and with a parity of esteem with any physical health condition or issue. I hope that all hon. Members’ constituents start to feel that progress very soon.
Valerie Vaz (in the Chair)
Bill Esterson, you have a few seconds to wind up.
Fuller Inquiry Phase 2 Report: Government Interim Update on Progress
Zubir Ahmed Excerpts(2 months, 1 week ago)
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The Parliamentary Under-Secretary of State for Health and Social Care (Dr Zubir Ahmed)
I am today updating the House on the Government’s progress in responding to the recommendations of the independent inquiry into the serious issues raised by the appalling actions of David Fuller, including an accompanying interim update published alongside this statement.
The final report of the Fuller inquiry, published on 15 July 2025, set out 75 recommendations to strengthen the security and dignity of people after death across a wide range of settings. The inquiry’s findings were clear: current arrangements for the care of the deceased are partial, piecemeal, and not universally mandated. A dedicated cross-Government programme board was established in July and has met fortnightly since.
At this interim stage solid progress has been made on 54 of the inquiry recommendations.
Eleven are accepted in full and work is already in progress to implement these recommendations—22, 23, 26, 27, 28, 30,31, 32, 33, 34 and 75—covering standards, data and operating procedures in the wider health sector. Implementation highlights include: the publication by the Human Tissue Authority on 1 December of updated guidance to ensure adverse incidents in the anatomy sector are recorded—recommendation 26—with incidents already being reported; agreement by NHS England that data collection on the conveyancing of deceased patients will be rolled out in 2026-27 for the first time—recommendation 31. Further details are included in the interim update publication— https://www.gov.uk/government/publications/fuller-inquiry-government-interim-update-on-phase-2-recommendations.
Forty-three of the inquiry’s recommendations relating to both NHS and local authority mortuaries require further work before they can be implemented. Those include nine recommendations—1 to 9—for the NHS estate, and NHS England continues to assess the recommendations and is working with NHS trusts to develop actions at trust board level. A further 12 of the inquiry’s recommendations —10 to 21—relate to governance, accountability and safeguarding in NHS trusts. Analysis of the logistics and costings of these recommendations is currently being carried out by NHS England. Recommendations 35 to 56 relate to local authority mortuaries, which include 21 HTA licensed mortuaries. MHCLG sought views via the Local Government Association on the state of the estate, and there is an LGA-led roundtable meeting in January. The LGA and HTA are also working together to assess how LA mortuaries’ current practices compare with the inquiry’s recommendations, and existing HTA standards in the post-mortem sector. The HTA has reviewed these recommendations against their own standards and concludes that seven are fully covered by existing HTA standards, and has shared this analysis with the LGA.
There are a further 21 recommendations still under consideration. Seven of these are miscellaneous recommendations—24, 25, 67, 68, 69, 70 and 73—and three are for LAs who contract with third party providers —57, 58 and 59. A roundtable was held in November regarding the role of faith organisations—67 and 68—in the care for the deceased in these settings. Outputs of the roundtable will inform the response to these two recommendations. In addition, the chief coroner has notified all coroners of the inquiry’s conclusions, in response to recommendation 70.
No decisions have been made regarding the 11 recommendations—29, 60, 61, 62, 63, 64, 65, 66, 69, 71, 72—relating to wider regulation in all settings that care for people after death. We are working closely with the NHS, local authorities, the Human Tissue Authority, the Care Quality Commission, and other partners to explore how we can ensure that robust and consistent standards are in place across all settings. This includes reviewing mortuary access controls, oversight arrangements, contractor vetting, and requirements for training and reporting.
The Government are committed to transparency and accountability as this work progresses. This update demonstrates that work is actively under way to consider and respond to the inquiry’s recommendations, with action already being taken towards implementing 54 of 75 recommendations. Full details of the status of all recommendations are contained in the published update. A full response to the inquiry’s recommendations will be published in summer 2026.
[HCWS1173]
Tackling Sexual Misconduct in the NHS
Zubir Ahmed Excerpts(2 months, 2 weeks ago)
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The Parliamentary Under-Secretary of State for Health and Social Care (Dr Zubir Ahmed)
Any instance of sexual violence, harassment or abuse in the NHS is unacceptable and will not be tolerated. On 5 December 2025, NHS England set out further actions for all trusts and integrated care boards, so that they can redouble their efforts and take swift and robust action to tackle sexual misconduct in the health service. This builds on action already taken to address sexual violence, harassment or abuse in the NHS.
In September 2023, the sexual safety charter was published by NHS England, and every trust and integrated care board has signed up to the charter now. In October 2024, NHS England produced a sexual misconduct policy framework, which it urged trusts and ICBs to adopt or adapt. E-learning was also introduced to support awareness of sexual safety in the NHS. In August 2025, NHS England set out further actions for all trusts and ICBs to take to identify and act against potential perpetrators of sexual misconduct in the NHS:
Complete an audit on their sexual misconduct policies.
Review policies, such as information sharing and chaperoning policies, to ensure that they are up to date.
Staff to complete training modules on sexual misconduct.
Keep electronic staff records up to date, with ongoing and complete investigations into staff.
The most recent letter went further still, by setting out new actions for trusts and ICBs:
Take part in national training on sexual misconduct investigations.
Ensure a pool of doctors or dentists have received specialist training in sexual misconduct.
Ask all primary care providers to sign up to the sexual safety charter, self-assess themselves, and confirm with their ICB that they have done so.
Principles to be reflected in chaperoning policies to ensure that chaperones are being used correctly and in an auditable way by providers.
Review groups to be adopted for sexual misconduct cases.
Issued a further audit on sexual misconduct policies for all trusts and ICBs to complete.
The Department of Health and Social Care fully endorses the actions taken by NHS England, and expects them to be rigorously implemented. The Department will require ongoing updates from NHS England on implementation on a quarterly basis. You can find further detail of the actions in the NHS England letters.
The August 2025 letter: https://www.england.nhs.uk/long-read/actions-to-tackle-sexual-misconduct-in-the-nhs/
The December 2025 letter: https://www.england.nhs.uk/long-read/an-update-on-actions-to-prevent-sexual-misconduct-in-the-nhs/
The NHS operates a robust approach to sexual misconduct. The Department of Health and Social Care stands with NHS England to take all necessary action to identify sexual perpetrators, and prevent them having access to our NHS. Together, we will continue to monitor and take all necessary action to help ensure the sexual safety of everyone accessing the NHS.
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