Asked by: Lord Harper (Conservative - Life peer)
Question to the Department of Health and Social Care:
To ask His Majesty's Government what assessment they have made of the impact of removing eligibility for the COVID-19 booster vaccine on people with learning disabilities.
Answered by Baroness Merron - Parliamentary Under-Secretary (Department of Health and Social Care)
The Government is committed to protecting those most vulnerable to COVID-19 through vaccination, as guided by the independent Joint Committee on Vaccination and Immunisation (JCVI). The primary aim of the national COVID-19 vaccination programme remains the prevention of serious illness, resulting in hospitalisations and deaths, arising from COVID-19.
The JCVI has advised that population immunity to COVID-19 has been increasing due to a combination of naturally acquired immunity following recovery from infection and vaccine-derived immunity. COVID-19 is now a relatively mild disease for most people, though it can still be unpleasant, with rates of hospitalisation and death from COVID-19 having reduced significantly since COVID-19 first emerged.
The focus of the JCVI advised programme has therefore moved towards targeted vaccination of the two groups who continue to be at higher risk of serious disease and mortality. These are the oldest adults and individuals who are immunosuppressed. The JCVI’s full advice for autumn 2025 is available on the GOV.UK website, in an online only format. The Government has accepted the JCVI’s advice for autumn 2025 and in line with the advice a COVID-19 vaccination is being offered to the following groups in autumn 2025:
As with other United Kingdom vaccination programmes, the JCVI’s advice on eligibility carefully considered the evidence on the risk of illness, serious disease, or death as a consequence of infection, in specific groups, as well as a cost-effectiveness analysis. The JCVI has engaged a number of organisations representing adults with learning disabilities to discuss the COVID-19 vaccine eligibility criteria.
The most recent Learning from Lives and Deaths: People with a Learning Disability and Autistic People Annual Report, based on 2023 data and published in September 2025, highlights how COVID-19 has fallen significantly as a cause of death in people with learning disabilities since the pandemic in 2021. Although it is important to caveat that the data in this report may not be complete for 2023 due to data collection issues, the trend observed provides reassurance that the risk of severe COVID-19 is much lower now than previously, including for people with a learning disability and autistic people.
As for all vaccines, the JCVI keeps the evidence under regular review.
Asked by: Lord Harper (Conservative - Life peer)
Question to the Department of Health and Social Care:
To ask His Majesty's Government what assessment they have made of the current level of risk from COVID-19 to people with learning disabilities.
Answered by Baroness Merron - Parliamentary Under-Secretary (Department of Health and Social Care)
The Government is committed to protecting those most vulnerable to COVID-19 through vaccination, as guided by the independent Joint Committee on Vaccination and Immunisation (JCVI). The primary aim of the national COVID-19 vaccination programme remains the prevention of serious illness, resulting in hospitalisations and deaths, arising from COVID-19.
The JCVI has advised that population immunity to COVID-19 has been increasing due to a combination of naturally acquired immunity following recovery from infection and vaccine-derived immunity. COVID-19 is now a relatively mild disease for most people, though it can still be unpleasant, with rates of hospitalisation and death from COVID-19 having reduced significantly since COVID-19 first emerged.
The focus of the JCVI advised programme has therefore moved towards targeted vaccination of the two groups who continue to be at higher risk of serious disease and mortality. These are the oldest adults and individuals who are immunosuppressed. The JCVI’s full advice for autumn 2025 is available on the GOV.UK website, in an online only format. The Government has accepted the JCVI’s advice for autumn 2025 and in line with the advice a COVID-19 vaccination is being offered to the following groups in autumn 2025:
As with other United Kingdom vaccination programmes, the JCVI’s advice on eligibility carefully considered the evidence on the risk of illness, serious disease, or death as a consequence of infection, in specific groups, as well as a cost-effectiveness analysis. The JCVI has engaged a number of organisations representing adults with learning disabilities to discuss the COVID-19 vaccine eligibility criteria.
The most recent Learning from Lives and Deaths: People with a Learning Disability and Autistic People Annual Report, based on 2023 data and published in September 2025, highlights how COVID-19 has fallen significantly as a cause of death in people with learning disabilities since the pandemic in 2021. Although it is important to caveat that the data in this report may not be complete for 2023 due to data collection issues, the trend observed provides reassurance that the risk of severe COVID-19 is much lower now than previously, including for people with a learning disability and autistic people.
As for all vaccines, the JCVI keeps the evidence under regular review.
Asked by: Lord Harper (Conservative - Life peer)
Question to the Department of Health and Social Care:
To ask His Majesty's Government what assessment they have made of (1) the extent, and (2) the quality, of specialist palliative care commissioning of (a) in-patient beds, (b) community support teams, (c) hospital support teams, and (d) 24/7 advice.
Answered by Baroness Merron - Parliamentary Under-Secretary (Department of Health and Social Care)
Palliative care services are included in the list of services an integrated care board (ICB) must commission. This promotes a more consistent national approach and supports commissioners in prioritising palliative care and end of life care. To support ICBs in this duty, NHS England has published statutory guidance and service specifications.
As set out in that guidance, this could be through universal services, for example general practitioners and community nursing services, or via specialist services where appropriate. However, not all patients will require specialist palliative or end of life care.
This guidance also makes specific reference to commissioners defining how their services will meet population needs 24/7 and includes a priority action for ensuring that staff, patients, and carers can access the care and advice they need, whatever time of day.
NHS England has developed a palliative care and end of life care dashboard, which brings together all relevant local data in one place. The dashboard helps commissioners understand the palliative care and end of life care needs of their local population.
Additionally, NHS England has a legal duty to annually assess the performance of each ICB in respect of each financial year and to publish a summary of its findings. This assessment must assess how well the ICB has discharged its functions.
Asked by: Lord Harper (Conservative - Life peer)
Question to the Department of Health and Social Care:
To ask His Majesty's Government, further to the remarks by Baroness Merron on 20 October (HL Deb col 480), in what way is the Mental Health Act "very significant" in supporting people with learning disabilities to access NHS services.
Answered by Baroness Merron - Parliamentary Under-Secretary (Department of Health and Social Care)
The Government’s 10-Year Health Plan sets out to tackle health inequalities and people with disabilities are a priority for care from a neighbourhood team with more holistic, on-going support. Ahead of this, action is underway to improve access and support through staff training, proactive health checks and plans, and the Mental Health Act reforms.
The Government knows that people with a learning disability and autistic people have poorer health outcomes than the general population, including, on average, dying younger. They continue to experience disparities in the quality of care they receive, which may include barriers to accessing the right support.
The Government is rolling out the Oliver McGowan Mandatory Training on Learning Disability and Autism to the health and adult social care workforce to ensure staff have the right knowledge and skills to provide safe, informed care. Oliver’s Training is the Government’s preferred package for providers registered with the Care Quality Commission to meet the statutory training requirement under the Health and Care Act 2022. Over three million people have completed the e-learning package, the first part of this training, and more than 2,700 people have been trained to deliver the interactive second part nationwide.
Annual health checks for people with a learning disability are a crucial way to identify undetected conditions early and ensure the appropriateness of ongoing treatments. NHS England is working with people with lived experience, clinical professionals, and commissioners to produce a quality framework to ensure that these vital checks are high-quality. NHS England is also taking forward a range of work to improve the quality of the services accessed by people with a learning disability, including rollout of the Reasonable Adjustment Digital Flag across health and care services which enables health and publicly funded care professionals to record, share, and view details of the reasonable adjustments which individuals need to support their care and treatment.
The number of people with a learning disability and autistic people in mental health hospitals is unacceptable, and there are still too many people being detained who could be supported to live well in their communities. The Mental Health Bill currently before Parliament limits the scope of the ability to detain people with a learning disability and autistic people so that they can only be detained under Part 2, section 3 if they have a co-occurring mental disorder that requires hospital treatment. It also introduces measures to improve community support, including putting Care (Education) and Treatment Reviews and Dynamic Support Registers on a statutory footing, and placing certain duties on integrated care boards and local authorities when exercising existing commissioning duties.
Asked by: Lord Harper (Conservative - Life peer)
Question to the Department of Health and Social Care:
To ask His Majesty's Government what assessment they have made of the issues faced by people with learning disabilities in accessing NHS services; and what plans they have to address those issues.
Answered by Baroness Merron - Parliamentary Under-Secretary (Department of Health and Social Care)
The Government’s 10-Year Health Plan sets out to tackle health inequalities and people with disabilities are a priority for care from a neighbourhood team with more holistic, on-going support. Ahead of this, action is underway to improve access and support through staff training, proactive health checks and plans, and the Mental Health Act reforms.
The Government knows that people with a learning disability and autistic people have poorer health outcomes than the general population, including, on average, dying younger. They continue to experience disparities in the quality of care they receive, which may include barriers to accessing the right support.
The Government is rolling out the Oliver McGowan Mandatory Training on Learning Disability and Autism to the health and adult social care workforce to ensure staff have the right knowledge and skills to provide safe, informed care. Oliver’s Training is the Government’s preferred package for providers registered with the Care Quality Commission to meet the statutory training requirement under the Health and Care Act 2022. Over three million people have completed the e-learning package, the first part of this training, and more than 2,700 people have been trained to deliver the interactive second part nationwide.
Annual health checks for people with a learning disability are a crucial way to identify undetected conditions early and ensure the appropriateness of ongoing treatments. NHS England is working with people with lived experience, clinical professionals, and commissioners to produce a quality framework to ensure that these vital checks are high-quality. NHS England is also taking forward a range of work to improve the quality of the services accessed by people with a learning disability, including rollout of the Reasonable Adjustment Digital Flag across health and care services which enables health and publicly funded care professionals to record, share, and view details of the reasonable adjustments which individuals need to support their care and treatment.
The number of people with a learning disability and autistic people in mental health hospitals is unacceptable, and there are still too many people being detained who could be supported to live well in their communities. The Mental Health Bill currently before Parliament limits the scope of the ability to detain people with a learning disability and autistic people so that they can only be detained under Part 2, section 3 if they have a co-occurring mental disorder that requires hospital treatment. It also introduces measures to improve community support, including putting Care (Education) and Treatment Reviews and Dynamic Support Registers on a statutory footing, and placing certain duties on integrated care boards and local authorities when exercising existing commissioning duties.
Asked by: Lord Harper (Conservative - Life peer)
Question to the Department of Health and Social Care:
To ask His Majesty's Government what plans they have, if any, to adopt a policy to achieve equality of access to NHS services for people with learning disabilities and those without such disabilities.
Answered by Baroness Merron - Parliamentary Under-Secretary (Department of Health and Social Care)
The Government’s 10-Year Health Plan sets out to tackle health inequalities and people with disabilities are a priority for care from a neighbourhood team with more holistic, on-going support. Ahead of this, action is underway to improve access and support through staff training, proactive health checks and plans, and the Mental Health Act reforms.
The Government knows that people with a learning disability and autistic people have poorer health outcomes than the general population, including, on average, dying younger. They continue to experience disparities in the quality of care they receive, which may include barriers to accessing the right support.
The Government is rolling out the Oliver McGowan Mandatory Training on Learning Disability and Autism to the health and adult social care workforce to ensure staff have the right knowledge and skills to provide safe, informed care. Oliver’s Training is the Government’s preferred package for providers registered with the Care Quality Commission to meet the statutory training requirement under the Health and Care Act 2022. Over three million people have completed the e-learning package, the first part of this training, and more than 2,700 people have been trained to deliver the interactive second part nationwide.
Annual health checks for people with a learning disability are a crucial way to identify undetected conditions early and ensure the appropriateness of ongoing treatments. NHS England is working with people with lived experience, clinical professionals, and commissioners to produce a quality framework to ensure that these vital checks are high-quality. NHS England is also taking forward a range of work to improve the quality of the services accessed by people with a learning disability, including rollout of the Reasonable Adjustment Digital Flag across health and care services which enables health and publicly funded care professionals to record, share, and view details of the reasonable adjustments which individuals need to support their care and treatment.
The number of people with a learning disability and autistic people in mental health hospitals is unacceptable, and there are still too many people being detained who could be supported to live well in their communities. The Mental Health Bill currently before Parliament limits the scope of the ability to detain people with a learning disability and autistic people so that they can only be detained under Part 2, section 3 if they have a co-occurring mental disorder that requires hospital treatment. It also introduces measures to improve community support, including putting Care (Education) and Treatment Reviews and Dynamic Support Registers on a statutory footing, and placing certain duties on integrated care boards and local authorities when exercising existing commissioning duties.
Asked by: Lord Harper (Conservative - Life peer)
Question to the Department of Health and Social Care:
To ask His Majesty's Government how many full-time equivalent officials have been working on the Terminally Ill Adults (End of Life) Bill (1) in total, and (2) in each Department.
Answered by Baroness Merron - Parliamentary Under-Secretary (Department of Health and Social Care)
The number of officials providing technical drafting support and workability advice to the Sponsors of the Terminally Ill Adults (End of Life) Bill has fluctuated since January 2025. As of 1 September 2025, there were 11.8 full-time equivalent (FTE) officials in the Department of Health and Social Care. Additionally, 3.1 FTE officials from the Ministry of Justice, 3.2 FTE officials from the Government Legal Department, and 1.8 FTE officials from Cabinet Office were supporting this team, also counted as of 1 September 2025. The total FTE for officials working on the Bill as of 1 September 2025 was 19.9.
Where needed contributions on specific, individual, technical issues have been sought from other teams, but the FTE cannot be accurately quantified for these issues.
Asked by: Lord Harper (Conservative - Life peer)
Question to the Department of Health and Social Care:
To ask His Majesty's Government whether the officials working on the Terminally Ill Adults (End of Life) Bill have been doing so only to the extent necessary to ensure that the Bill is technically and legally workable should it become law.
Answered by Baroness Merron - Parliamentary Under-Secretary (Department of Health and Social Care)
The Government is neutral on the principle of assisted dying and whether the Bill becomes law. Officials are working to fulfil the Government’s duty to the statute book, providing technical drafting support and workability advice.
Asked by: Lord Harper (Conservative - Life peer)
Question to the Department of Health and Social Care:
To ask His Majesty's Government what assessment they have made of the cost of ensuring that high-quality palliative care is available to everyone in England Wales who requires that care.
Answered by Baroness Merron - Parliamentary Under-Secretary (Department of Health and Social Care)
The funding and provision of palliative and end of life care in Wales is a matter for the Welsh Government.
Palliative care and end of life care are broad, holistic approaches provided through a range of professionals and providers, generalist and specialist across the National Health Service, social care and voluntary sector organisations. Therefore, the cost of provision is challenging to measure in its totality.
One of the three ‘shifts’ that the 10 Year Health Plan will deliver is around the Government’s determination to shift healthcare out of hospitals and into the community, to ensure patients and their families receive personalised care in the most appropriate setting. Palliative care and end of life care services will have a big role to play in that shift and were highlighted in the Plan as being an integral part of neighbourhood teams.
The Department and NHS England are currently looking at how to improve the access, quality and sustainability of all-age palliative and end of life care in line with the 10 Year Health Plan.
The Government and the NHS will closely monitor the shift towards strategic commissioning of palliative care and end of life care services to help ensure that services remove variation in access and quality, although some variation may be appropriate to reflect both innovation and the needs of local populations.
Asked by: Lord Harper (Conservative - Life peer)
Question to the Department of Health and Social Care:
To ask His Majesty's Government what plans they have to ensure that high quality palliative care is available to everyone in England and Wales who requires that care, and when they expect that care to be available.
Answered by Baroness Merron - Parliamentary Under-Secretary (Department of Health and Social Care)
The funding and provision of palliative and end of life care in Wales is a matter for the Welsh Government.
Palliative care and end of life care are broad, holistic approaches provided through a range of professionals and providers, generalist and specialist across the National Health Service, social care and voluntary sector organisations. Therefore, the cost of provision is challenging to measure in its totality.
One of the three ‘shifts’ that the 10 Year Health Plan will deliver is around the Government’s determination to shift healthcare out of hospitals and into the community, to ensure patients and their families receive personalised care in the most appropriate setting. Palliative care and end of life care services will have a big role to play in that shift and were highlighted in the Plan as being an integral part of neighbourhood teams.
The Department and NHS England are currently looking at how to improve the access, quality and sustainability of all-age palliative and end of life care in line with the 10 Year Health Plan.
The Government and the NHS will closely monitor the shift towards strategic commissioning of palliative care and end of life care services to help ensure that services remove variation in access and quality, although some variation may be appropriate to reflect both innovation and the needs of local populations.