Draft Medical Devices (Fees Amendment) Regulations 2026

Zubir Ahmed Excerpts

Wednesday 21st January 2026 General Committees

[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.

--- Later in debate ---

[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?

--- Later in debate ---

[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

Tuesday 20th January 2026 Westminster Hall

[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 Evans]

On that point, the Minister mentioned the taskforce. It did produce its report, with its recommendations, and the Government have not yet responded to those recommendations. Will the Minister give a timescale for when he is looking to do so?

[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 Evans]

To clarify, if it is going to dovetail, is he suggesting that the recommendations will come out in the report in the summer, all in one lump, or will we see the recommendations of the taskforce come out before we see the full report of the newly commissioned work?

[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

Tuesday 16th December 2025 Written Statements

[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

Tuesday 9th December 2025 Written Statements

[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.

[HCWS1147]

Terminal Illness: Mental Health Support

Zubir Ahmed Excerpts

Wednesday 3rd December 2025 Westminster Hall

[The Parliamentary Under-Secretary of State for Health and Social Care (Dr Zubir Ahmed)]

It is a pleasure to serve under your chairmanship, Sir Jeremy, and I start by sincerely thanking my hon. Friend the Member for Altrincham and Sale West (Mr Rand) for securing this debate. I also welcome Mike and his family to the Public Gallery, and pay tribute to Mike for all his efforts.

My hon. Friend raises an important issue that can affect so many people—all people perhaps, at some point—about ensuring that when someone is diagnosed with a terminal illness, they can receive the mental and emotional support that they need in the place that they need it. We want to be a society where every person receives high-quality, compassionate and personalised care from diagnosis through to the end of life. The Government are determined to shift more healthcare out of hospitals into the community to ensure that patients receive personalised care in the most appropriate setting.

Palliative care and end-of-life care services, including those provided by hospices, have a big role to play in that shift. Palliative care services are included in the list of services that an integrated care board must commission, promoting a more consistent national approach and supporting commissioners to prioritise palliative care and end-of-life care. To support that process, NHS England has published statutory guidance stating that ICBs must work to ensure that there is sufficient provision of care services to meet the needs of their local population. It also includes references to mental health, wellbeing and support for those with palliative care and end-of-life care needs.

Of course, there are many examples of voluntary initiatives, such as grief or bereavement cafés, or the Good Grief community, which aims to support people at the end of their life and their families through a programme of events and courses, and the provision of resources that often include pre-bereavement advice and support.

I know that my hon. Friend the Member for Altrincham and Sale West feels passionately about mental health support for those with palliative care and end-of-life care needs, and that he has been supporting Mike’s campaign for improved mental health services and support. I offer him my deep appreciation, as well as a meeting with the Minister for Care and end-of-life care officials, so that we can engage him around the palliative care and end-of-life care modern service framework that was recently announced, which we hope to publish in the spring.

The Government are also transforming the current mental health system, ensuring that people get access to the right care at the right time in the right place. That is why we are increasing our investment in mental health support by £688 million in cash terms.

The hon. Member for Hinckley and Bosworth (Dr Evans), who spoke for the official Opposition, talked about impact assessments. I gently say to him, in the context of this convivial and constructive debate, that when we came into office we had an impact assessment by virtue of the Darzi review, which highlighted in stark terms the difficulties that the NHS in its totality is under after 14 years—the difficulties that we inherited. I also point out that our real-terms investment of £26 billion is an increase to the NHS budget that will translate into, among many other things, a new national cancer plan. That will examine not only the process of getting the best treatments to patients, but improving communication, improving pathways, and instilling better and more bespoke mental wellbeing support into some of those pathways.

[Dr Evans]

The Minister is indeed right to say that there was an injection of cash, but the proportion of funding being spent on mental health was actually cut. The written ministerial statement is very clear that that proportion went from 8.78% to 8.71%, which the royal college said was about £300 million of investment. Can he confirm from the Dispatch Box—if he cannot, he can write to me later—whether the Government are still committed to the mental health investment standard, or is that commitment going to change? Currently, it is unclear whether they are still committed.

[Dr Ahmed]

The mental health investment standard is something that we expect ICBs to meet. I will gently push back on what the hon. Gentleman is saying because, as we have been so succinctly reminded in this debate, investing in mental wellbeing is about more than just headline figures. For instance, we need psychology in oncology, in children’s health, and in other forms of cancer care. The provision of such services is not always recorded in the way that the hon. Gentleman would wish it to be recorded, but there are still formats and sub-types of mental health support.

The Government are also keen to press ahead with our 10-year plan, and we are setting out ambitious plans to boost mental health support across the country while delivering the shift from hospital to community. As part of that process, we wish to open around 85 mental health emergency departments, reducing pressure on busy A&E services, which are the last places that people with mental health needs should be, and ensuring that people have the right support they need in a calm, compassionate environment.

We will also use new integrated health organisations to break down barriers between services, which I also think is really important in the context of this debate, and to ensure integrated and holistic care, addressing both physical and mental healthcare needs, with more freedom to determine how best to meet the needs of those local populations. That will build on the work that has already begun to bring down waiting lists. As I said, we are investing an extra £688 million this year to transform mental health services. On staffing, I am pleased to say that almost 7,000 extra mental health workers have been recruited since July 2024, against our target of 8,500 by the end of this Parliament.

We are also expanding talking therapies, and we have committed to continuing that expansion over the coming years. More adults already benefit from better access to those therapies, and the aim is for over 900,000 people to complete a course of treatment with improved effectiveness and quality of services by March 2029. Anyone who develops a common mental health condition, such as anxiety or depression, in any context, including terminal illness, can self-refer to talking therapies. [Interruption.]

[Sir Jeremy Wright (in the Chair)]

Order. I am sorry to interrupt the Minister, but a Division has been called. I am very much in the Minister’s hands at this point, and I am conscious that there may be more he wishes to say. If he has only a minute or two of his speech remaining, I gather there will be several Divisions, so I do not want to force everyone to come back for just that. If he has more to say, there is of course more time for him to take, and the same applies to the hon. Member for Altrincham and Sale West. I am in the Minister’s hands; does he wish to conclude now, or would he rather come back?

[Dr Ahmed]

I am grateful for your direction, Sir Jeremy. I need one minute to conclude my remarks, and I will then pass on to my hon. Friend the Member for Altrincham and Sale West.

[Sir Jeremy Wright (in the Chair)]

Order. I am afraid that we will now need to suspend as the Division is active. I will suspend the sitting for 15 minutes for the first Division and for 10 minutes for any subsequent Divisions. I gather that there may be several Divisions, so I apologise to the Minister and all other Members who will have to wait.

--- Later in debate ---

[Dr Ahmed]

Thank you, Sir Jeremy. Can I reassure all Members participating in this debate of the Government’s commitment to deliver on the issues that have been raised? We will work constructively with everyone, including patients and their families, as we develop the framework that Members have already outlined. We will also work with other mental health partners, local authorities and charities so that everyone can be assured that the Government are playing their part in delivering a better standard of access to care for not only palliative care but mental health care in that context.

[Sir Jeremy Wright (in the Chair)]

The hon. Member for Altrincham and Sale West may have a very brief word.

Pandemics: Support for People with Autism

Zubir Ahmed Excerpts

Tuesday 2nd December 2025 Westminster Hall

[The Parliamentary Under-Secretary of State for Health and Social Care (Dr Zubir Ahmed)]

It is a pleasure to serve under your chairmanship, Mr Vickers. I am grateful to my hon. Friend the Member for Ipswich (Jack Abbott) for raising this important topic. Having known him for the last 14 months, I know how passionately he feels about the national health service in his area, particularly the mental health service provision in his area. His constituents can be rightly proud of his doughty advocacy on their behalf. My hon. Friend spoke about his constituent’s campaign to improve support for autistic people following his very difficult experiences during the covid-19 pandemic. I also place on the record my commendation of Ivan for his tireless work to ensure that autistic people will receive the right form of support.

We have heard today of the challenges that autistic people faced during the pandemic. It is important that we learn from those experiences and ensure we do better in future. In 2020, the Department of Health and Social Care commissioned research into the impact of the pandemic on autistic people and their families. The report, published in May ’21, made several key recommendations that chime with the issues my hon. Friend so eloquently raised today. It included findings about access to education for autistic children during lockdown; lack of respite and support for family members and carers; the impact of the pandemic on the mental health of autistic people and the challenges they face accessing healthcare in the round; and, as highlighted in this debate, the need for clear communication and transparency of decision making to help autistic people to follow advice and guidance appropriately.

I want to provide reassurance that the Government remain committed to learning the lessons from the pandemic, to help us to prepare better in future. As my hon. Friend the Member for Ipswich alluded to, the Government have acknowledged the disproportionate impact that the pandemic had on vulnerable groups in the United Kingdom. Module 1 of the UK covid-19 inquiry was published in July last year and focused on the UK’s resilience and preparedness for the pandemic. The Government’s response, published in January this year, sets out the changes we have made to ensure that we reduce the potential unequal impacts of events on particular groups or individuals in any future pandemics. However, as my hon. Friend also highlighted, we recognise that there is a lot of further work to do to ensure that the impact of inequalities and vulnerabilities in pandemic decision making is fully anticipated and planned for.

The inquiry recently published module 2 of its report, focusing on UK decision making and political governance. The report highlights that considerable numbers of people suffered from the social, economic and cultural consequences of steps taken to combat the pandemic, such as lockdown, including the impacts of social isolation, loneliness and declining mental health, and of course the chopping and changing of advice—which was sometimes necessary, but perhaps, on reflection, sometimes unnecessary. Module 10 of the inquiry is focusing on the impact of the pandemic on society in more detail and will carefully consider the findings in due course.

It is clearly critical that the UK is prepared for a future pandemic, and that is rightly a top priority for the Government. The Department’s new strategic approach to pandemic preparedness continues to recognise the disproportionate and unintended impacts that pandemics can have on vulnerable people and groups. The Department is therefore committed to publishing a new pandemic preparedness strategy, which will be published next year and will show how the unequal impacts of pandemics on social health and healthcare are considered in all areas of preparedness and response.

As my hon. Friend also alluded to, we have recently concluded participation in Exercise Pegasus, the largest ever simulation of a pandemic in UK history. Exercise Pegasus gives us an opportunity to examine our preparedness, capabilities and response arrangements, and we will continue to learn as we plan for phase 4 of the exercise in 2026. The Government have committed to communicating the findings and lessons, and a post-exercise report will be delivered in due course.

I recognise the concerns raised about accessible communications during the pandemic, and hear loudly my hon. Friend’s reflections. The UK Health Security Agency was established in 2021 and is responsible for preventing, preparing and responding to infectious diseases and other environmental hazards. The UKHSA collaborates closely with the voluntary and community sector, including organisations working with and representing autistic people. That close collaboration has allowed it to gain rapid feedback from those organisations regarding the efficacy of communication and guidance materials so that they can be adapted as required, in real time, to communicate with all members of our society and not just some.

More broadly, the Government recognise the importance of accessible communications and have published guidance on that for all Government Departments. Within health and social care, all NHS organisations and publicly funded social care providers are expected to meet the accessible information standard, which details the approach to supporting the information and communication needs of people with disability, impairment or sensory loss. NHS England published a revised standard in June this year to ensure that the communication needs of people with a disability, impairment or sensory loss are met within health and care provision. We are also taking steps in the health and care system to improve the accessibility of services for autistic people more broadly. For example, there is work underway in NHS England to make sure that staff in health settings know that they need to make reasonable adjustments for people. That includes the introduction of a reasonable adjustment digital flag, which enables the recording of key information about a citizen or a patient, including that a person is autistic, and the reasonable adjustment needs to ensure support can be tailored appropriately.

[Chris Vince]

Would that digital flag also flag up something like someone being a young carer or having caring responsibilities?

[Dr Ahmed]

I will have to go back and check that particular sub-group of flagging and get back to my hon. Friend, but I think the point he makes is that, wherever possible, we should be identifying those groups that have specific communication needs, by virtue of either their own personal health or social needs, or the needs of those they are looking after. He makes a very valid point and I will be delighted to write to him with a more detailed response than I can give at the moment.

More broadly, I have heard concerns about support for autistic people. I reassure my hon. Friend the Member for Ipswich that we are committed to supporting autistic people, who should have the right support in place, tailored to their individual needs. Our 10-year health plan sets out an ambitious reform agenda to transform the NHS and rightly make it fit for the future. That future must at its core include early intervention and support for autistic people and those with specific needs.

We are working with the Department for Education on reforms to the special educational needs and disabilities system, ensuring that joined-up support is available across education and health, including for autistic children and young people. We are also taking steps to improve access to adult social care services for those who need them. To build consensus on plans for a national care service, Baroness Casey is chairing an independent commission to shape the medium and long-term landscape reforms needed, and we have been putting the core foundations in place to facilitate that. That includes strengthening joined-up care between health and social care, so that people experience more integrated, person-centred care, including through the development of neighbourhood health services.

I have also heard about the impact of the pandemic on autistic people’s mental health and wellbeing. We know that autistic people are, sadly, disproportionately impacted by mental ill health and face challenges in accessing services in relation to their mental health. We are taking steps to address that, including raising awareness and understanding of autism within health and social care systems. We have been rolling out the Oliver McGowan mandatory training on learning disability and autism to support Care Quality Commission-registered providers to meet their statutory requirements and ensure that their staff receive specific training on learning disability and autism. NHS England has been rolling out additional training services across its mental health services, and has published guidance for mental health services on meeting the needs of autistic adults and guidance on adaptations of NHS talking therapies specifically designed for autistic people.

I am sure that my hon. Friend is aware that the House of Lords special inquiry Committee on the Autism Act 2009 published its report and recommendations for Government on 23 November. I understand that his constituent Ivan contributed to the inquiry, and I personally thank him and others for sharing their valuable insights and experiences, despite all the trauma that they have been through. The Government are carefully considering the Committee’s recommendations on the next autism strategy and support for autistic people, and we will respond formally in due course.

I end by reiterating my thanks to my hon. Friend and his constituent Ivan. I also thank my hon. Friend the Member for Harlow (Chris Vince) and the hon. Members for Westmorland and Lonsdale (Tim Farron), for Strangford (Jim Shannon), for Upper Bann (Carla Lockhart) and for Birmingham Perry Barr (Ayoub Khan) for their contributions.

Whether through Exercise Pegasus, looking at how we can better co-create guidance with vulnerable groups, using better guidance tailored for specific communities, using digital flags on health records, or indeed better mandatory training, I give my hon. Friend the Member for Ipswich this assurance: no longer will disabled people or people with specific or additional needs be treated as an afterthought. They will be at the forefront of our minds when planning future pandemic training and preparedness—and when executing that preparedness, should we be so unfortunate as to suffer another pandemic. He has my assurance, and I am once again grateful to him for securing this debate.

Question put and agreed to.

Children of Alcoholics

Zubir Ahmed Excerpts

Wednesday 26th November 2025 Westminster Hall

[The Parliamentary Under-Secretary of State for Health and Social Care (Dr Zubir Ahmed)]

It is a pleasure to serve under your chairmanship, Mrs Harris. I congratulate the hon. Member for Mid Norfolk (George Freeman) on securing this important debate, in particular during what must be an unimaginably difficult week for him. I think I speak for all of us when I say that we send him our love and sympathy. I also thank my hon. Friend the Member for Stoke-on-Trent Central (Gareth Snell) for sharing his powerful personal story, and the hon. Member for Strangford (Jim Shannon) and my hon. Friend the Member for York Central (Rachael Maskell) for their thoughtful contributions. I will be very happy, once the APPG has been convened, to liaise with the hon. Member for Mid Norfolk and the Under-Secretary of State for Health and Social Care, my hon. Friend the Member for West Lancashire (Ashley Dalton), who has responsibility for public health, to see what form of meeting can be arranged.

Alcoholism is a tragedy that blights communities across the United Kingdom, including in my constituency of Glasgow South West and the west of Scotland. Having practised as a medical doctor for more than 20 years, I have seen it, including in some of the transplant patients who have arrived across my operating table. As much as I love my job as a surgeon, I would love nothing more than for those transplants to never be needed again.

I want to reassure colleagues that this brief sits not just with my hon. Friend the Member for West Lancashire, but with all Ministers across Government, who are rightly focused on raising the healthiest generation of children in history. We want to support children whose parents have alcohol problems, but we also want to support their parents to get better.

Although not all children of parents with an alcohol problem will experience harm, they are clearly at far greater risk and, as we have heard, far too many of them will have their childhood scarred by their parents’ drinking. In 2024-25, 14% of child social worker assessments cited parental alcohol use, and in 2023-24 alcohol or drug use was identified in 43% of child safeguarding practice reviews where a child was seriously harmed or, sadly, died.

Children growing up in these environments are more likely to face additional challenges, such as parental mental health problems and sometimes, unfortunately, domestic abuse. The trauma from such experiences can last well into adulthood, which means that the cycle can repeat, with the trauma passed on through multiple generations. We must do everything we can to break that cycle.

As we have heard, alcoholism can affect anyone, but at times it hits hardest in some of our deprived communities. That is why from April next year, the Government will be rolling out Best Start family hubs to every local authority. Those hubs will provide a high-quality service for parents, and will focus on early child development and the digital resources to facilitate that. They will be open to all and based in communities where alcoholism is most prevalent, ensuring that services reach the children and families who are likely to benefit most from them.

The Government have also confirmed that we are giving vulnerable families and children better access to local support services. Our strategy is based, first, on breaking the cycle of late intervention and, secondly, on helping more children and families to stay safely together as a unit. We are doing this through the national roll-out of the family help multi-agency child protection and family group decision-making reforms, which will be delivered through the Families First Partnership programme led by my right hon. Friend the Secretary of State for Education. The programme’s funding amounts to £2.4 billion over the next three years. To help identify vulnerable children and families affected by parental alcohol problems who need a helping hand, my Department will support local authorities with an additional range of resources, including local prevalence and treatment data, and child safeguarding guidance for alcohol and drug treatment services.

We are doing this for children and their families, but we must also target our support to make a sustainable difference to pregnant women with alcohol problems. Timely and effective treatment is key, because drinking in pregnancy leads to long-term harm for babies—for example, foetal alcohol spectrum disorder, which has already been highlighted in this debate. Unfortunately, the more that women drink, the greater the risk. That is why the UK chief medical officer’s guideline is that if a woman is pregnant or thinks she might become pregnant, the safest approach is not to drink at all.

It is a genuine tragedy that pregnant women and mothers with alcohol problems are sometimes the most stigmatised and harshly judged people in our society. That means it is incredibly difficult for those women to speak out about their issues and to let services know that they have children, which prevents women, children and families from getting the help they deserve. We cannot forget that many women who drink during pregnancy come from homes where their own parents were dependent on alcohol and are often at the sharpest end of not only inequality, but complex and multiple other needs. Many of them were victims of trauma and abuse in their own childhood.

That is why the Government are committed to reducing stigma, improving the quality of treatment and making support available to every woman who needs it. First, we are piloting local approaches to reduce stigma among doctors, nurses and other healthcare professionals. Secondly, we will soon publish the UK’s first clinical guidelines for alcohol treatment that include advice for supporting pregnant women and parents to stop or safely slow down their alcohol use. Thirdly, the Department of Health and Social Care and NHS England are finalising the co-occurring mental health and substance use delivery framework, which will outline the commitments that we are making to improve integration of alcohol and drug treatment with mental health services at a national level. Fourthly, we plan to publish guidance on how treatment providers can better support and improve service provision for women. We will work with local commissioners to ensure that they consider in their drug and alcohol treatment commissioning plans the specific needs of pregnant women and parents.

We are also continuing to invest in improvements to local alcohol treatment services, which faced significant cuts followed by a decade of disinvestment. Just last week, the Government announced an investment of £13.4 billion—a 5.6% cash increase—over the next three years in local authorities’ vital public health work through the consolidated public health grant. That includes the overall £1 billion of drug and alcohol treatment and recovery improvement grants over the next three years. But treatment alone is not enough to improve outcomes for children. The evidence suggests that alcohol treatment, combined with support to help parents raise their kids, can increase the likelihood of recovery from alcohol dependency, reduce the risk of child neglect or abuse and, crucially, keep families together.

I am grateful for the opportunity to respond to this debate. It has given me the chance to outline how the Government are laser-focused on improving outcomes for children from all kinds of backgrounds who find themselves in these situations—children who, through no fault of their own, were born to parents who suffer from alcohol problems. I hope I have demonstrated that our approach is based not on stigmatising, but on keeping families together. That is why our strategy is based on Best Start family hubs and the Families First Partnership programme, so that we can make sure that parents in alcohol treatment services also receive vital parenting and family support.

The Department for Education has released statutory guidance called “Working Together to Safeguard Children”, and I want to pick out one line from it:

“Nothing is more important than children’s welfare.”

That could not be more true. Everything we are doing across Government is aimed at improving children’s health and protecting child welfare, so that every child can thrive in a loving, safe and stable home.

Let me end by speaking directly about the hon. Member for Mid Norfolk. Today he has spoken not only in this place, but to the nation. In doing so, he has ensured that more Members and citizens of our nation will now look, acknowledge and see below the line, so that together we can ensure that more children do not continue to suffer in silence.

Question put and agreed to.

Oral Answers to Questions

Zubir Ahmed Excerpts

Tuesday 25th November 2025 Commons Chamber

[Liz Twist (Blaydon and Consett) (Lab)]

2. What steps he is taking to ensure parity of esteem between mental and physical health services.

[The Parliamentary Under-Secretary of State for Health and Social Care (Dr Zubir Ahmed)]

Too many people are waiting too long for mental health support. Since coming into office, the Government have put mental health support services on the road to recovery. We promised 8,500 more mental health staff by the end of the Parliament, and we have already recruited 6,500 of them. We are introducing the first 24/7 mental health crisis support services through NHS 111, and we have rolled out mental health support to schools and colleges across the country, providing help to 5 million children and young people.

[Liz Twist]

Our mental health system is still suffering from the strain of 14 years of Conservative government. Rethink Mental Illness has reported that 12 times as many people are now waiting for mental health treatment than for physical health treatment. Nearly one third of those surveyed attempted suicide while waiting, and one in five lost their jobs. What are the Government doing to tackle those long waits and offer support to people before they reach crisis point?

[Dr Ahmed]

I thank my hon. Friend for all her tireless work to improve the lives of people living with mental illness and to prevent suicide. The 10-year health plan will build on the work that has already been done to reduce waiting lists, including through an extra £688 million of real-terms investment this year, the hiring of more staff and the expansion of talking therapies for an extra 380,000 patients. In addition, as she will know, the Mental Health Bill, which is in its final parliamentary stages, will modernise legislation and make a significant impact on the lives of those who live with mental illness.

[Wera Hobhouse (Bath) (LD)]

My all-party parliamentary group on eating disorders recently published a report on preventing eating disorder-related death. The report highlighted that eating disorders are not accurately recorded on death certificates. I was promised an update from the Minister for Women’s Health and Mental Health over two months ago, but am yet to receive one. How much longer will I have to wait?

[Dr Ahmed]

I am genuinely sorry that the hon. Lady has not received the reply to which she is entitled. I will look into it myself, take it up with my ministerial colleague, and ensure that a reply is expedited in the fashion in which it should have been in the first place.

--- Later in debate ---

[Cat Smith (Lancaster and Wyre) (Lab)]

11. If he will set out a timeline for responding to the Hughes report, published on 7 February 2024.

[The Parliamentary Under-Secretary of State for Health and Social Care (Dr Zubir Ahmed)]

We are carefully considering the work undertaken by the Patient Safety Commissioner, which sets out various potential options for redress. I am both a clinician and a Minister who has recently taken on this area, and my hon. Friend will know that this is highly complex work, but it is a complexity that I am willing to step into. It requires input and planning across Government, which takes time. I am certainly committed to taking this issue seriously, and I will return to update my hon. Friend and the House in due course.

[Cat Smith]

I welcome the new Minister to his post. I have been campaigning on this issue for 10 years, and I have a stack of letters and answers to written parliamentary questions that say things like “in due course” and “the Government are considering”. On behalf of a group of people who have been gaslit by the medical profession, will the Minister step up and be the Minister who ensures that these families, who are victims of the sodium valproate scandal, actually see the redress that they absolutely deserve? Will he make sure that they get a meeting with him at the earliest opportunity?

[Dr Ahmed]

I thank my hon. Friend for all her tireless work, campaigning and advocacy on this issue for many years, particularly since the Hughes report was published in February 2024. Like me, she will be sensitive to the fact that we are coming up to the two-year anniversary of that report. It is a call to action for me and the Department to answer the questions that she has been asking for so long. I have a meeting with the Patient Safety Commissioner very shortly, and I am very happy to meet her separately when she wishes.

[Robin Swann (South Antrim) (UUP)]

The Minister will know that the Hughes report focused very much on England, but those affected by the redress scheme will be found across the entire United Kingdom. Will he ensure that he engages with Health Ministers from the devolved authorities?

[Dr Ahmed]

The hon. Gentleman can certainly be given that assurance from me, as the Minister also responsible for four-nation engagement. The Hughes report examined both the sodium valproate and pelvic mesh issues, and I know that these resonate across the four nations, particularly when it comes to licensing and regulation of medical technology. He has that assurance from me.

[Alison Griffiths (Bognor Regis and Littlehampton) (Con)]

12. What steps he is taking to help prevent industrial action in the NHS.

--- Later in debate ---

[Tristan Osborne (Chatham and Aylesford) (Lab)]

T5. The Public Accounts Committee has recently scrutinised the state of clinical negligence in the UK. At £60 billion, the Government liability for clinical negligence significantly increased under the last Government. The Government have commissioned David Lock to review the issue. Does the Secretary of State agree that reform is desperately needed in this space?

[The Parliamentary Under-Secretary of State for Health and Social Care (Dr Zubir Ahmed)]

My hon. Friend is absolutely right. As announced in the 10-year health plan, David Lock KC is providing expert policy advice on the rising legal costs of clinical negligence and how we can improve patients’ experience of claims. That review is ongoing, and following initial advice to Ministers and the recent report from the National Audit Office, the results of David Lock’s work will inform future policymaking in this area. I am happy to update my hon. Friend as soon as that happens.

[Dr Danny Chambers (Winchester) (LD)]

T3. Reports that one in three adults have been relying on chatbots and artificial intelligence tools for mental health advice and therapy are concerning, because those tools are currently unregulated and potentially dangerous. One reason why people are using them is that mental health waiting lists are so long. What is the Secretary of State doing to reduce mental health waiting lists, so that people can speak to a qualified mental health practitioner instead of relying on unregulated AI tools?

--- Later in debate ---

[Kenneth Stevenson (Airdrie and Shotts) (Lab)]

T6. As a faithful, I commend the Secretary of State for reaffirming his commitment to driving forward digital innovation in the NHS. Does he agree that Scotland should mirror the UK so that we do not fall behind the pace with developments that could be game changing in terms of outcomes for patients and staff alike?

[Dr Ahmed]

While the NHS in Scotland has no app and no plans for a national roll-out, the NHS in England has had an app since 2019, with 71 million logins in October 2025. Three in four people now have the app in their pockets and it has more subscribers in England than Netflix. You may ask, Mr Speaker, why NHS Scotland does not have an app? The answer comes in a freedom of information request by the champion journalist Simon Johnson: when asked about some of the drawbacks of applying the NHS England app in Scotland, they said:

“political optics of adopting an English solution”.

It is time for Analogue John to move over and let Anas Sarwar and Jackie Baillie finally drag the Scottish NHS into the 21st—

[Mr Speaker]

Order. We are on topical questions. The Prime Minister is in the Chamber. If you do not want Members to get in, please tell me; it would be easier.

--- Later in debate ---

[Peter Swallow (Bracknell) (Lab)]

Bracknell is a life sciences superpower, with Eli Lilly, Sandoz and Boehringer Ingelheim all having a footprint in our town. What can we do to speed up clinical trial set-up to help to deliver the next generation of treatments for our NHS?

[Dr Ahmed]

The Government are already committed to clinical trials being under 150 days by next March. I commend my hon. Friend on all the work he does with his local pharmaceutical companies in advancing medical science locally and nationally.

[David Mundell (Dumfriesshire, Clydesdale and Tweeddale) (Con)]

The Secretary of State will be aware that since the law change, the number of children who have received NHS prescriptions for medical cannabis for severe epilepsy has been pitifully low. Families and campaigners believe that part of the reason is that the Home Office still has large responsibility for those products. Will the Secretary of State meet me and other interested MPs to discuss whether his Department could take more responsibility?

[Dr Ahmed]

Although the Government have no plans to change the departmental responsibilities applicable to unlicensed cannabis-based products, we are cognisant of the need for research in this area. We have agreed to more than £8.5 million in funding for two world-first clinical trials to investigate the safety and efficacy of cannabinoid treatments for drug-resistant epilepsy in both adults and children, and I am happy to speak to the right hon. Gentleman about this matter further.

[Sonia Kumar (Dudley) (Lab)]

I have seen at first hand how severe musculoskeletal conditions such as lower back pain can devastate someone’s ability to work, have relationships and sleep, as well as their overall wellbeing. The education of more than 1 million children is disrupted by MSK conditions due to missed schooling and fragmented, hard-to-navigate services. Will the Minister therefore prioritise MSK conditions in phase 2 of the modern service framework and confirm when that will be published?

NHS Prescription Charges

Zubir Ahmed Excerpts

Monday 24th November 2025 Written Statements

[The Parliamentary Under-Secretary of State for Health and Social Care (Dr Zubir Ahmed)]

The Prime Minister has announced that NHS prescription charges in England will be frozen for a second successive year.

This builds on wider Government action as part of the plan for change to tackle the cost of living pressures and will save patients around £12 million in 2026-27.

The single charge for prescriptions in England will remain at £9.90. The cost of prescription prepayment certificates will also remain the same, with three-month PPCs staying at £32.05, 12-month PPCs at £114.50, and the hormone replacement therapy PPC staying at £19.80.

The charges freeze will also apply to NHS wigs and fabric supports. These prices will remain at current levels:

Surgical brassiere—£32.50

Abdominal or spinal support—£49.05

Stock modacrylic wig—£80.15

Partial human hair wig—£212.35

Full bespoke human hair wig—£310.55

Around 89% of prescription items in England are already dispensed free of charge to children, the over-60s, pregnant women, and those with certain medical conditions. This freeze will not impact current exemptions. All working-age adults who would normally pay for their prescriptions, which is estimated to be around 40% of the population, could benefit from the freeze.

In addition to the freeze on charges, the NHS low-income scheme continues to offer help to those on low incomes who otherwise need to pay for prescriptions, while prescriptions are free for eligible people in certain groups such as pensioners, students aged under 19 in qualifying full-time education, and those who receive certain qualifying state benefits or live in care homes.

[HCWS1091]

Draft Health and Care Act 2022 (Consequential Amendments) Regulations 2025

Zubir Ahmed Excerpts

Wednesday 19th November 2025 General Committees

[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 Health and Care Act 2022 (Consequential Amendments) Regulations 2025.

It is a pleasure to serve under your chairmanship, Mr Twigg. A copy of the draft regulations was laid before the House on 21 October.

There are estimated to be around 47,000 people in the UK with Down’s syndrome. Despite existing legal duties and frameworks, those people face real challenges in accessing the care and support they need to live the lives they want to in their own communities. This Government are determined to set that right. Through the implementation of the Down Syndrome Act 2022, aligned with the overarching aims of our 10-year health plan for England, we are striving to improve the life outcomes for people with Down’s syndrome by improving their access to services, raising awareness and understanding of their needs, and breaking down the barriers to opportunity that they and other disabled people face. The draft regulations will make a technical but necessary amendment to the Down Syndrome Act to support its effective implementation, and it is right that they should be given full scrutiny in Committee.

I will begin by setting out what the Down Syndrome Act requires. Under the Act, the Secretary of State for Health and Social Care is required to give guidance to relevant authorities in health, social care, education and housing services on what they should be doing to meet the needs of people with Down’s syndrome. Relevant authorities must have due regard to the final statutory guidance, once published. This Government want disabled people’s access to, and experience of, healthcare services to be equitable and effective. The guidance under the Down Syndrome Act supports that aim by raising awareness of, and bringing together in one place, the practical steps that organisations should take to meet the needs of people with Down’s syndrome. It also helps to clarify the support and services that people with Down’s syndrome can expect to receive.

On 5 November, we launched a public consultation on draft guidance under the Down Syndrome Act. Work to develop the draft guidance has involved significant engagement with people with lived experience and, importantly, with the organisations that support them. The consultation presents a further opportunity for people with lived experience and their families to share their views. We expect the guidance to improve support for people with Down’s syndrome and for those with other, similar conditions. In order for the guidance to deliver improvements for those people, it needs to be implemented effectively across the range of communities that it serves.

On 9 May 2023, NHS England published statutory guidance stating that every integrated care board should identify a member of its board to lead on supporting that ICB to perform its functions effectively in the interests of people with Down’s syndrome. The NHS England guidance also states that ICBs should have a lead for learning disability and autism, and a lead for children and young people with special educational needs and disabilities. It will be important for ICB leads to work collaboratively across the integrated care system, with local authority, public health, education and wider partners. The consultation on the draft guidance will help us to understand whether the guidance is clear, informative and useful to relevant authorities in carrying out their legislative requirements in support of people with Down’s syndrome. We will use the feedback received to ensure the guidance is fit for purpose.

I now turn to what the draft regulations will do. Under the Down Syndrome Act, relevant authorities must have due regard to the final statutory guidance when exercising their relevant functions. The Act does not create any functions beyond that duty. The schedule to the Act specifies the relevant authorities that must have due regard to the guidance and the specific functions of those bodies to which the guidance applies. As drafted, the schedule does not include NHS England or ICBs. Rather, it refers to the National Health Service Commissioning Board, which was the former name of NHS England, and to clinical commissioning groups, which were the commissioning bodies in place at the time the Down Syndrome Act was passed.

These draft regulations seek to bring the legislation up to date by replacing references to CCGs with ICBs, and references to the National Health Service Commissioning Board with NHS England. The changes are required because the Health and Social Care Act 2022 made provision for the abolition of CCGs and replaced them with ICBs, and renamed the National Health Service Commissioning Board as NHS England. The purpose of that change is to bring ICBs and NHS England within scope of the Down Syndrome Act duty to have due regard to the guidance.

Final guidance issued under the Down Syndrome Act will not be published until these changes come into force. We intend to publish the guidance before the planned abolition of NHS England comes into effect. We understand that the ongoing reforms across Government affect the timing and content of the final guidance, and its content after publication. We will keep the final guidance under review, and it will be updated to reflect the latest policy and legislative frameworks as and when necessary.

The Down’s syndrome guidance will not be statutory for those not specified in the schedule to the Down Syndrome Act, which means that persons who are not relevant authorities are under no obligation to have due regard to the guidance. It is therefore important that we change the wording in the Down Syndrome Act now to ensure that the guidance will apply to current relevant authorities. The change will also ensure that the legislation is in alignment with NHS England’s statutory guidance on the ICB leads on Down’s syndrome. ICB leads are responsible for the implementation of the guidance under the Down Syndrome Act. It is therefore critical that they are referenced in the legislation itself.

The regulations will come into force on the day after the date on which they are made. The rationale is to ensure that the duty under the Down Syndrome Act to give guidance to relevant authorities applies to the correct authorities. The regulations will have no material effect until the final guidance is published. We therefore do not believe it necessary to engage with or notify the public further on these changes.

By making important updates to the Down Syndrome Act, these regulations will provide vital assurance that the guidance will be implemented effectively, ensuring that it can achieve the aim of improving the life outcomes of those with Down’s syndrome. I commend this statutory instrument to the Committee.

--- Later in debate ---

[Dr Ahmed]

I am grateful to the right hon. Gentleman for showing the consensus on the Down Syndrome Act. It should be placed on record that the Act was a private Member’s Bill sponsored by Sir Liam Fox, then a Conservative Member. I am delighted to carry forward the draft regulations on the basis of that consensus.

The right hon. Gentleman asked what these statutory instruments will look like in relation to future iterations of NHS governance structures. As he said, NHS England will continue to undertake the statutory functions until parliamentary time allows for legislative changes. I am confident that the Down Syndrome Act and Acts like it will be components of the primary legislation that will be required to make those new arrangements, such that we will not require this type of Delegated Legislation Committee process again.

I will take back the question about digital access to the consultation process to my officials. The right hon. Gentleman raises a very important point on exclusion, of which I am also very cognisant. I am happy to write to him with a fuller answer.

Again, I am grateful for the consensus on both sides of the Committee. I commend the draft regulations to the Committee.

Question put and agreed to.