Asked by: Rebecca Paul (Conservative - Reigate)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health and Social Care, what steps he is taking to ensure that NHS staff are not able to falsely certify documents later used in applications for a Mental Health Breathing Space.
Answered by Zubir Ahmed - Parliamentary Under-Secretary (Department of Health and Social Care)
Access to Mental Health Crisis Breathing Space can only be started if an Approved Mental Health Professional confirms that the individual is receiving mental health crisis treatment. The debt adviser must also seek confirmation from a nominated point of contact every 30 days that the individual is still receiving eligible mental health crisis treatment in order for the individual to continue to receive the moratorium’s protections.
With regard to National Health Service staff, regulators set standards of conduct that regulated health professionals must uphold. These already emphasise the importance of good record keeping. Falsifying patient records could be considered serious misconduct and may lead to a professional's registration being restricted or revoked.
We continue to keep the Breathing Space Scheme under review to ensure it is operating as intended.
Asked by: Rebecca Paul (Conservative - Reigate)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health and Social Care, how many NHS penalty charges for incorrectly claimed free prescriptions have been issued to individuals who qualified for but did not hold NHS medical exemption certificates in the last 12 months.
Answered by Zubir Ahmed - Parliamentary Under-Secretary (Department of Health and Social Care)
From November 2024 to October 2025, the NHS Business Service Authority issued 47,058 penalty charge notices (PCNs) to people who claimed a medical exemption but were found to have no exemption in place when checked. Of these, 21,328 were eased, for various reasons including the patient subsequently applying for an exemption successfully. The number of easements in this category cannot be confirmed. Of the 47,058 PCNs issued 3,583 people received multiple PCNs.
Although the Department has made no formal assessment of the effectiveness of issuing PCNs as a deterrent against improper claims, the fact that the vast majority who receive one PCN do not go on to receive another would, in my opinion, suggest a potential deterrent effect.
Asked by: Rebecca Paul (Conservative - Reigate)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health and Social Care, what assessment his Department has made of the effectiveness of issuing penalty charge notices as a deterrent against improper claims of free NHS prescriptions.
Answered by Zubir Ahmed - Parliamentary Under-Secretary (Department of Health and Social Care)
From November 2024 to October 2025, the NHS Business Service Authority issued 47,058 penalty charge notices (PCNs) to people who claimed a medical exemption but were found to have no exemption in place when checked. Of these, 21,328 were eased, for various reasons including the patient subsequently applying for an exemption successfully. The number of easements in this category cannot be confirmed. Of the 47,058 PCNs issued 3,583 people received multiple PCNs.
Although the Department has made no formal assessment of the effectiveness of issuing PCNs as a deterrent against improper claims, the fact that the vast majority who receive one PCN do not go on to receive another would, in my opinion, suggest a potential deterrent effect.
Asked by: Rebecca Paul (Conservative - Reigate)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health and Social Care, what assessment his Department has made of the potential impact of the requirement to obtain a medical exemption certificate before being eligible to claim free prescriptions on people with chronic illnesses.
Answered by Zubir Ahmed - Parliamentary Under-Secretary (Department of Health and Social Care)
The Department has made no assessment.
The exemption certificate provides the patient with evidence to demonstrate to dispensers that they are entitled to have the National Health Service cover the cost of their prescriptions. The exemption certificate requirement also allows for the verification of claims for exemption, and for fraud to be identified and pursued.
It is straightforward to apply for a medical exemption certificate; the patient should ask their doctor for form FP92A. The form includes guidance on how to complete it and who can authorise it. A healthcare professional (HCP), e.g. a hospital doctor or general practitioner (GP), or at the GP’s discretion a member of the GP’s practice who can access medical records, must authorise the application to confirm the patient has the qualifying condition. If a patient is unable to complete the form themselves then a relative or HCP can complete it on their behalf and insert their name in the signature box.
Asked by: Rebecca Paul (Conservative - Reigate)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health and Social Care, whether his Department has identified service gaps in the provision of primary care, mental health, dentistry and substance misuse services at HMP/YOI Downview.
Answered by Zubir Ahmed - Parliamentary Under-Secretary (Department of Health and Social Care)
Primary care, mental health, dentistry, and substance misuse services at HMP/YOI Downview are delivered under the national specification for integrated healthcare.
As part of the commissioning monitoring processes outlined in the NHS Strategic Commissioning Framework, which covers all National Health Service commissioned services, including health and justice, providers are measured against the mandatory performance indicators within the national specification and any potential inconsistencies in service delivery are identified.
Independent processes are also embedded within service delivery monitoring. These include annual healthcare needs assessments, equality impact assessments, Independent Monitoring Board reports, Care Quality Commission reports and inspections, and user experience consultations. An annual user experience has also been carried out across all prisons in the South East.
Asked by: Rebecca Paul (Conservative - Reigate)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health and Social Care, whether his Department plans to provide additional support for women who face additional prescription costs due to (a) menorrhagia and (b) other menstrual issues caused by (i) miscarriage and (ii) other significant traumas.
Answered by Zubir Ahmed - Parliamentary Under-Secretary (Department of Health and Social Care)
There are no plans to review the support available to women facing these issues.
A maternity exemption certificate can be applied for as soon as a healthcare professional has confirmed that the patient is pregnant or has given birth, including still-birth, in the previous twelve months, and this provides exemption from prescription costs until 12 months after the due date. The certificate remains valid if the patient has a miscarriage. The certificate is automatically backdated one month from the date the application is received by the NHS Business Services Authority.
If a patient is not entitled to the maternity exemption, they can purchase a prescription prepayment certificate (PPC), which allows them to claim as many prescriptions as they need for a set cost. A three-monthly PPC, costing £32.05, or an annual PPC, costing £114.50, will save people money if they need four or more items in three months or 12 or more items in 12 months. To help spread the cost, people can pay for an annual PPC by ten monthly direct debits. A holder of a 12-month certificate can get all the prescriptions they need for just over £2 per week.
Approximately 40% of the population are currently liable to pay the prescription charge though approximately 89% of the items dispensed in the community are dispensed free of charge.
Asked by: Rebecca Paul (Conservative - Reigate)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health and Social Care, what recent steps his Department has taken to ensure (a) equality of access to and (b) quality of healthcare provision across the (i) women’s and (ii) Children and Young People's estate.
Answered by Zubir Ahmed - Parliamentary Under-Secretary (Department of Health and Social Care)
To improve health and social care outcomes for all women in prison and upon their release, NHS England and His Majesty’s Prison and Probation Service commissioned the National Women’s Prisons Health and Social Care Review. The review’s report identified a number of recommendations to improve equity and quality of care to meet the specific needs of women in prison.
A wide range of actions to implement these recommendations are taking place at establishment, regional, and national levels, backed by £21 million across three years, and overseen by the Joint Women's Prison Health and Social Care Review Implementation Programme Board.
The health issues facing those detained in the children and young people secure estate are systematically kept under review through regular health and wellbeing needs assessments and the Healthcare Standards for Children and Young People in Secure Settings.
The Framework for Integrated Care operates in the children and young people secure estate as a coherent structure for a comprehensive, trauma-informed system of care that focuses on individualised care rather than on separate labels, diagnoses, or interventions.
NHS England has also commissioned the three-year Benchmarking Project, aimed at assessing and supporting the implementation of the Healthcare Standards for Children and Young People in Secure Settings.
Further work is underway to identify where the existing pathway in the children and young people secure estate requires enhancement to better support the placement, management, and care of all girls in secure settings. This work will be informed by evidence and best practice and will be developed with experts to test the most appropriate model of care.
Asked by: Rebecca Paul (Conservative - Reigate)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health and Social Care, what the average waiting time is for routine mental health appointments across the prison estate in England.
Answered by Zubir Ahmed - Parliamentary Under-Secretary (Department of Health and Social Care)
The information requested is not held centrally. As part of the formal prisoner induction process, all prisoners undergo health screening that incorporates a mental health assessment. The secondary care mental health assessment is carried out by a mental health professional. Routine assessments are carried out within five working days. Where an individual is in a state of mental health crisis, presents with rapidly escalating needs, or is at risk of immediate harm to themselves or others, an urgent assessment should be undertaken within 48 hours.
Asked by: Rebecca Paul (Conservative - Reigate)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health and Social Care, with reference to the Independent Monitoring Board's report entitled Annual report of the Independent Monitoring Board at HMP/YOI Downview, published on 3 September 2025, what steps he is taking to ensure acutely mentally unwell prisoners are swiftly (a) identified and (b) given care in an appropriate facility at (a) HMP/YOI Downview, (b) other prisons and (c) other young offenders institutions.
Answered by Zubir Ahmed - Parliamentary Under-Secretary (Department of Health and Social Care)
NHS England commissions prison health care services for HMP/YOI Downview and every other prison and young offenders institution in England. Every prison has onsite health care services including primary care, mental health, dentistry, and substance misuse teams.
The National Service Specification for integrated mental health sets out how patients within secure settings, who require support for their mental wellbeing, should receive the same level of healthcare as people in the community, both in terms of the range of interventions available to them, in order to meet their needs, and the quality and standards of those interventions.
This includes access to crisis intervention and crisis prevention for those at high risk of self-harm and suicide, where such behaviours relate to poor emotional wellbeing and/or minor psychiatric morbidity.
Access to mental health provision is available to every person in prison at any stage of their sentence, beginning at the point of entry. NHS England commissions first night reception screening to have a registered nurse/practitioner review patients’ medical history to address any immediate health needs and risks and to ensure medication is made available as soon as possible and that onward referrals to onsite healthcare teams, including mental health services, for both urgent face to face appointments, within 24 hours, and routine face to face appointments, within five working days, are made.
Outside of reception screening, people in prison can be referred or can self-refer to mental health services, within those timeframes.
When someone is acutely unwell, they can be transferred from prisons and other places of detention to hospital for treatment, under the Mental Health Act, within the target transfer period of 28 days. The Mental Health Bill, currently going through Parliament, introduces a statutory 28-day time limit within which agencies must seek to ensure individuals who meet the criteria for detention under the act are transferred to hospital for treatment. NHS England’s South East Health and Justice team is funding a transfer and remissions co-ordinator from January 2025, to improve, where possible, safe, effective, and efficient transfers to hospital level treatment and interventions.
NHS England is reviewing the National Integrated Prison Service Specification to ensure it continues to meet the needs of the prison population.
Asked by: Rebecca Paul (Conservative - Reigate)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health and Social Care, what assessment he has made of the potential implications for his policies of the recommendations on surrogacy in the report by the UN Special Rapporteur for Violence Against Women and Girls entitled Report of the Special Rapporteur on violence against women and girls, its causes and consequences: The different manifestations of violence against women and girls in the context of surrogacy, published on 14 July 2025.
Answered by Karin Smyth - Minister of State (Department of Health and Social Care)
The UN Special Rapporteur’s report is framed within the context of Violence Against Women and Girls and recommends banning surrogacy in all forms.
The United Kingdom Government supports surrogacy as an option for family formation, for people unable to carry their own children. For this option, we recommend the use of UK not-for-profit surrogacy organisations.
For those considering surrogacy overseas, we recommend taking specialist legal advice and consulting the advice published by the Foreign, Commonwealth and Development Office, which is available at the following link:
https://www.gov.uk/government/publications/surrogacy-overseas/surrogacy-overseas