Asked by: Ayoub Khan (Independent - Birmingham Perry Barr)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health and Social Care, whether his Department has made an assessment of the potential merits of mandating the installation of dosage counters in all NHS-provided emergency asthma inhalers.
Answered by Karin Smyth - Minister of State (Department of Health and Social Care)
The Medicines and Healthcare products Regulatory Agency (MHRA) understands the term “emergency asthma inhalers” in this context to refer to reliever inhalers containing short-acting beta agonist (SABA) licensed for the rapid relief of symptoms during acute asthma attacks or bronchospasm, as well as for the prevention of exercise-induced bronchospasm. The MHRA is aware of ongoing safety concerns associated with the absence of integrated dose counters on SABA pressurised metered dose inhalers (pMDIs), particularly the risk that patients may unknowingly use inhalers that are empty or near empty during an asthma attack.
The MHRA has assessed the potential merits of mandating the inclusion of dose counters on SABA pMDIs. As part of this review, the MHRA has actively engaged with external national healthcare stakeholders and pharmaceutical industry to explore the feasibility of the integration. While the safety case for improved dose visibility is recognised, it is equally important to consider the potential impact of the product design change on supply resilience. The United Kingdom market for SABA pMDIs is currently limited to a small number of market authorisation holders and introducing a regulatory requirement without fully considering implementation timelines, material and personnel resources, and manufacturing capabilities could risk destabilising the supply of these critical medicines.
Rather than mandating dose counters on SABA pMDIs, the MHRA is currently pursuing a more flexible, proportionate approach to strongly recommend the inclusion of dose counters. This strategy seeks to improve patient safety outcomes while avoiding the risk of unintended supply disruption. The MHRA remains committed to working closely with industry and other stakeholders to ensure that any changes are introduced within a robust and pragmatic framework and timeline that safeguards patient access to essential respiratory medicines.
Asked by: Alex Mayer (Labour - Dunstable and Leighton Buzzard)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health and Social Care, what steps his Department is taking to (a) update and (b) improve NHS IT systems.
Answered by Karin Smyth - Minister of State (Department of Health and Social Care)
We are investing more than £2 billion in National Health Service technology and digital to run essential services and drive NHS productivity improvements.
In June 2023, NHS England agreed a Health Memorandum of Understanding (MOU), which is a strategic agreement between the NHS and Microsoft and underpins the national Microsoft licensing framework for NHS organisations. It delivers significant discounts and standardised licensing across the NHS and enables access to services.
Security and compliance are significantly strengthened through national access to Microsoft Defender, Office 365 security tools, and integration with the NHS Cyber Security Operations Centre. These tools standardise threat detection, data protection, and governance across the system, ensuring a consistent and elevated security posture. The MOU also supports a national IT operating model with service desks operating 24 hours a day, seven days a week, centralised incident management, and streamlined onboarding.
Operationally, the MOU delivers cost savings by eliminating redundant local contracts and enabling licence reconfiguration. It also positions the NHS for future innovation, with early access to artificial intelligence tools like Microsoft Copilot already embedded in the agreement. This ensures NHS organisations can scale digital transformation efforts while maintaining alignment with national strategy and funding models.
Asked by: Charlie Dewhirst (Conservative - Bridlington and The Wolds)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health and Social Care, what estimate he has made of the projected total cost of redundancy packages arising from the proposed changes to NHS England and DHSC; and what estimate he has made of the net financial benefit after these costs are accounted for.
Answered by Karin Smyth - Minister of State (Department of Health and Social Care)
The future Department will be smaller, more agile, and more efficient, delivering value for money for the public and empowering our health system to improve health and care for patients.
We recognise that to achieve this, there will be some short-term upfront costs as we undertake the integration of NHS England and the Department, but these costs and more will be recouped in future years because of a smaller and leaner centre.
By the end of the process, we estimate that these changes will save hundreds of millions of pounds a year, which will be reinvested in frontline services. At this stage it is too early to say what the upfront costs of integration are, including any redundancy, while transition planning is ongoing.
Asked by: Helen Morgan (Liberal Democrat - North Shropshire)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health and Social Care, whether his Department has approved a national redundancy scheme for the 50% integrated care board cost reduction target; and whether he has allocated funds allocated to meet exit costs.
Answered by Karin Smyth - Minister of State (Department of Health and Social Care)
There are significant workforce implications following the Prime Minister’s announcement of the integration of the Department and NHS England, and the associated reduction in size, as well as the subsequent announcement of integrated care board and National Health Service trusts corporate cost reductions. These reforms will deliver a more efficient, leaner centre, and will also free up capacity and help deliver significant savings of hundreds of millions of pounds a year, which will be reinvested in frontline services to cut waiting times through the Government’s Plan for Change. Through the 2025 Spending Review, we are working with NHS England and HM Treasury on how the costs of restructuring will be met. Those discussions have not yet concluded. NHS England expects to launch a national scheme shortly.
Asked by: Alison Hume (Labour - Scarborough and Whitby)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health and Social Care, what steps he is taking to consult with people who have rare conditions on the integration of NHS England functions into his Department.
Answered by Ashley Dalton - Parliamentary Under-Secretary (Department of Health and Social Care)
Working under the UK Rare Diseases Framework, the Government is committed to improving the lives of those living with rare diseases.
Through our public consultation on the 10 Year Plan, the Government has shown that we are committed to engaging with the public, patients, and clinicians. We are currently in the initial phases of scoping and designing a new integrated Department that aims to enhance the efficiency and effectiveness of our healthcare system. Ministers and senior Department officials will work with the new executive team at the top of NHS England, led by Sir Jim Mackey, to lead the formation of a new joint centre. As we work to bring the two organisations together, we will ensure that we continue to evaluate impacts of all kinds.
Asked by: Ben Obese-Jecty (Conservative - Huntingdon)
Question to the Home Office:
To ask the Secretary of State for the Home Department, what assessment she has made of the merits of ensuring people coming to the UK have an appropriate level of English Language skills.
Answered by Seema Malhotra - Parliamentary Under-Secretary of State (Department for Education) (Equalities)
The White Paper sets out the Government’s proposals to increase the level of language ability required.
The ability for individuals to communicate is essential to perform civic duties, and for all social connections including, crucially, with the communities in which they live and with state and other agencies such as local authorities and non- government services. Without adequate language skills, there is a risk of isolation as well as poor integration.
Analysis of the Office for National Statistics’ Longitudinal Study, which looks across generations of migrants to the UK, shows that people with better English language skills were more likely to have worked at any time, be economically active or in full-time employment at present.
Being able to speak and understand English also ensures that those coming to work here are less vulnerable to abuse and exploitation in the workplace.
Asked by: Peter Dowd (Labour - Bootle)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health and Social Care, whether his Department has made an assessment of the potential impact of suspending the medicines repurposing programme on people affected by rare conditions.
Answered by Karin Smyth - Minister of State (Department of Health and Social Care)
In April 2025, a decision was made to suspend the national Medicines Repurposing Programme. The decision was made with consideration to the following factors:
There are alternative sources of advice and support for clinicians or charities wanting to repurpose a medicine, including for a rare condition, such as the Medical Research Council, National Institute for Health and Care Research, and scientific advice from the Medicines and Healthcare products Regulatory Agency (MHRA).
Medicines repurposing means using an existing medicine in a new way, outside of its current marketing authorisation. Clinicians are very familiar with the option of prescribing medicines outside their licence, known as off-label use, particularly within specialised care. Off-label access is often agreed at a local level, informed by the available evidence and clinical guidelines, and where the clinician feels this best meets the needs of the patient. When appropriate and supported by the available evidence, national guidance from organisations including the National Institute for Health and Care Excellence or the British National Formulary could potentially support equitable patient access to repurposed medicines.
A further potential route to support patient access to a repurposed medicine used in specialised care in England is to develop a national clinical commissioning policy. A policy will confirm whether a specific treatment should be routinely available to eligible patients in the National Health Service. A policy can only be developed if the medicine is used within prescribed specialised services, namely services for which NHS England is the accountable commissioner, and not services where the accountable commissioners are integrated care boards. National clinical policies are based on the available research evidence and may be subject to a process of funding prioritisation, depending on the cost of the treatment concerned. A NHS clinician can propose a new or revised national clinical commissioning policy where there is sufficient supporting evidence. More information on the process is available at the following link:
https://www.youtube.com/watch?v=Ya1A9WTzQXQ
NHS England develops clinical commissioning policies in line with published methods and eligibility criteria, which have been subject to consultation. A clinical commissioning policy can recommend medicines that are used on-label or off-label. More information on the policies is available at the following link:
https://www.england.nhs.uk/publication/methods-national-clinical-policies/
The national medicines repurposing programme included a small number of medicines to treat rare diseases. In some cases, the programme supported academics to obtain MHRA scientific advice and gather evidence to support a licensing application. To date, no licensing applications have been received via the programme for medicines to treat rare disease.
Asked by: Alison Hume (Labour - Scarborough and Whitby)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health and Social Care, what steps is he taking to help ensure that the National Institute for Health and Care Excellence guidelines for Myalgic Encephalomyelitis are followed by NHS staff.
Answered by Ashley Dalton - Parliamentary Under-Secretary (Department of Health and Social Care)
National Institute for Health and Care Excellence (NICE) guidelines are not mandatory, but the Government does expect healthcare commissioners to take the guidelines fully into account when designing services to meet the needs of their local population, and to work towards their implementation over time. NHS England remains committed to supporting integrated care boards to ensure equitable access and evidence-based care. This partnership will support the integration of best practices and insights to enhance service quality and consistency across the system.
There are steps that the Government is taking to improve care for patients with myalgic encephalomyelitis, also known as chronic fatigue syndrome (ME/CFS). It is a priority for the Department to publish the final ME/CFS delivery plan by the end of June 2025. The plan will focus on boosting research, improving attitudes and education, and bettering the lives of people with this debilitating disease. The responses to the interim delivery plan consultation, along with continued close engagement with other parts of the Government, the National Health Service, and external stakeholders including the NICE, will inform the development of the final ME/CFS delivery plan.
Asked by: James McMurdock (Reform UK - South Basildon and East Thurrock)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health and Social Care, what steps she is taking to ensure families with disabled children have timely access to medical equipment.
Answered by Stephen Kinnock - Minister of State (Department of Health and Social Care)
My Rt Hon. Friend, the Secretary of State for Health and Social Care, meets regularly with external sector partners on a variety of issues.
Integrated care boards (ICBs) in England are responsible for commissioning services to meet the health needs of their local population, including for disability equipment. Each ICB must have an executive lead for children and young people with special education needs and disabilities (SEND), who will support the board to perform its functions effectively in the interests of children and young people with SEND.
We expect ICBs to follow guidance from the National Institute for Health and Care Excellence (NICE). In 2022, the NICE published the guidance, Disabled children and young people up to 25 with severe complex needs: integrated service delivery and organisation across health, social care and education, which is available at the following link:
Local authorities are responsible for providing social care services for disabled children, which can include specialist equipment. The guidance on supporting disabled children and their carers can be found at the following link:
Since July 2015, NHS England has collected quarterly data from clinical commissioning groups, now ICBs, on wheelchair provision, including waiting times, to enable targeted action if improvement is required. NHS England is taking several steps to reduce regional variation in the quality and provision of National Health Service wheelchairs, and to support ICBs to reduce delays in people receiving wheelchair equipment. Data on the length of time taken to provide other equipment for disabled children is not collected centrally.
Asked by: James McMurdock (Reform UK - South Basildon and East Thurrock)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health and Social Care, what discussions he has had with representatives of healthcare professions on levels of unmet equipment needs for children with disabilities.
Answered by Stephen Kinnock - Minister of State (Department of Health and Social Care)
My Rt Hon. Friend, the Secretary of State for Health and Social Care, meets regularly with external sector partners on a variety of issues.
Integrated care boards (ICBs) in England are responsible for commissioning services to meet the health needs of their local population, including for disability equipment. Each ICB must have an executive lead for children and young people with special education needs and disabilities (SEND), who will support the board to perform its functions effectively in the interests of children and young people with SEND.
We expect ICBs to follow guidance from the National Institute for Health and Care Excellence (NICE). In 2022, the NICE published the guidance, Disabled children and young people up to 25 with severe complex needs: integrated service delivery and organisation across health, social care and education, which is available at the following link:
Local authorities are responsible for providing social care services for disabled children, which can include specialist equipment. The guidance on supporting disabled children and their carers can be found at the following link:
Since July 2015, NHS England has collected quarterly data from clinical commissioning groups, now ICBs, on wheelchair provision, including waiting times, to enable targeted action if improvement is required. NHS England is taking several steps to reduce regional variation in the quality and provision of National Health Service wheelchairs, and to support ICBs to reduce delays in people receiving wheelchair equipment. Data on the length of time taken to provide other equipment for disabled children is not collected centrally.