Written questions by Bennett.

What steps he is taking to ensure people who need joint replacement surgery are able to access treatment where they live.

The Government is committed to putting patients first, including those waiting for joint replacement surgery. Too many people have been left in limbo, with their personal and professional lives on hold waiting for National Health Service treatment. We understand the impact that long waits can have on patients’ mental health, which is why we have committed, in the Government’s Plan for Change, to return to the 18-week Referral to Treatment standard, which has not been met for almost a decade.We will ensure that patients are not only seen on time but also have the best possible experience of care. Our Elective Reform Plan, published on 6 January 2025, has committed us to working with patients and their carers to co-develop minimum standards for their experience of care.Dedicated and protected surgical hubs are helping to reduce elective surgery wait times by focusing on high volume low complexity surgeries, such as joint replacement surgery. As of March 2025, there are 114 elective surgical hubs that are operational across England.The Elective Reform Plan has committed to providing quicker access for patients to common surgical hub procedures by opening 17 new and expanded surgical hubs by June 2025, and by ramping up the number of hubs over the next three years, so even more operations can be carried out near where patients live.

How many of the new surgical hubs will be focused solely on orthopaedic procedures.

The Elective Reform Plan has committed to providing quicker access for patients to common surgical hub procedures by opening 17 new and expanded surgical hubs by June 2025 and ramping up the number of hubs over the next three years, so more operations can be carried out.In line with direction set by the Getting it Right First Time High Volume Low Complexity programme, surgical hubs focus on driving improvement in six high volume specialties: ophthalmology; general surgery; trauma and orthopaedics, which includes spinal surgery; gynaecology; ear, nose and throat; and urology. There are no plans for any of the new hubs to solely focus on orthopaedic procedures.

What steps his Department is taking to ensure that retailers (a) provide (i) clear, (ii) accurate and (iii) impartial information on the nutritional sufficiency of infant formula products in (A) retail outlets and (B) online shopping channels and (b) display brands of infant formula together on retail shelves.

Infant feeding is critical to a baby’s healthy growth and development. The Government is committed to giving every child the best start in life and that includes helping families to access support to feed their baby.Whilst breastfeeding has significant health benefits, we recognise that for those families that cannot or choose not to breastfeed, it is vital that they have access to infant formula that is affordable and high quality. Infant formula regulations ensure that all infant formula is suitable for meeting the nutritional needs of babies, regardless of the price or brand.The Government welcomes the Competition and Markets Authority’s market study report on infant formula and follow-on formula. The report included recommendations related to clear, accurate and impartial information on the nutritional sufficiency of all infant formula products on product labelling and in retail settings as well as a recommendation related to displaying all brands of infant formula together and separate from other formula milks. We will carefully consider its findings and recommendations and respond in due course.

What steps his Department is taking to ensure that healthcare settings provide (i) timely, (ii) clear, (iii) accurate and (iv) impartial information on the nutritional sufficiency of infant formula products and (b) implement standardised infant formula labelling on products.

Infant feeding is critical to a baby’s healthy growth and development. The Government is committed to giving every child the best start in life and that includes helping families to access support to feed their baby.Whilst breastfeeding has significant health benefits, we recognise that for those families that cannot or choose not to breastfeed, it is vital that they have access to infant formula that is affordable and high quality. Infant formula regulations ensure that all infant formula is suitable for meeting the nutritional needs of babies, regardless of the price or brand.The Government welcomes the Competition and Markets Authority’s market study report on infant formula and follow-on formula. The report included recommendations related to clear, accurate and impartial information on the nutritional sufficiency of all infant formula products on product labelling and in retail settings as well as a recommendation related to displaying all brands of infant formula together and separate from other formula milks. We will carefully consider its findings and recommendations and respond in due course.

If he will publish funding by the Better Care Fund to support unpaid carers for (a) 2023 and (b) 2024, by region.

I refer the hon. Member to the answer I gave on 3 March 2025 to Question 33291.

If he will take steps to ensure that Group B Streptococcus-specific enriched culture medium testing is available in hospital laboratories.

Enriched culture medium testing is used in National Health Service laboratories. Current clinical practice is that if a routine urine test in pregnancy indicates a bacterial infection, microbiology techniques, such as enriched culture medium plates, should be used to identify the bacteria.

If he will take steps to ensure that the results of the GBS3 trial are acted upon (a) quickly and (b) effectively.

The UK National Screening Committee (UK NSC) stands ready to receive the results of the GBS3 trial. The UK NSC Secretariat is in close and regular contact with the researchers. The committee will consider the evidence from the trial, once the report is available.

What recent discussions his Department has had with the Joint Committee on Vaccination and Immunisation on the (a) development and (b) future rollout of a Group B Streptococcus vaccine.

The Joint Committee on Vaccination and Immunisation (JCVI) has identified that maternal vaccine products to protect infants against group B streptococcus (GBS) are currently in development. A sub-committee of the JCVI will be stood up to evaluate the benefits of a GBS vaccination programme.Should a GBS vaccine be approved for use by the Medicines and Healthcare products Regulatory Agency, the JCVI would review evidence on the safety, efficacy, impact, and cost-effectiveness of a potential vaccination programme. Based on this evidence, the JCVI would provide advice to the Department in order to develop a vaccination policy and decide on any potential future roll out in England.

If he will publish funding by the Better Care Fund to support unpaid carers for (a) 2023 and (b) 2024, by region; and what information his Department holds on regional variation in Better Care Fund spending.

NHS England publishes planning data for the Better Care Fund, by region and local authority. This provides a breakdown of income, planned expenditure by different types of activity and planned performance against agreed metrics. The latest data is available at the following link:https://www.england.nhs.uk/publication/better-care-fund-2023-to-2025-planning-data/The publication includes data on planned expenditure on ‘carers services’, including by region. This expenditure will include spend on unpaid carers, but it is not possible to provide a figure for spend on unpaid carers specifically.

Whether he plans to require integrated care boards to remove requirements for (a) same sex couples and (b) single women to have privately-funded IVF cycles before they are accepted for NHS-funded IVF cycles.

The Government recognises that fertility treatment across the National Health Service in England is subject to variation in access. Work is continuing on joint advice from the Department and NHS England about the offer around NHS-funded fertility services, including the issues for female same sex couples.Funding decisions for health services in England are made by integrated care boards and are based on the clinical needs of their local population. We expect these organisations to commission fertility services in line with National Institute for Health and Care Excellence (NICE) guidelines, ensuring equal access to fertility treatment across England. NICE is currently reviewing these guidelines.

Whether he plans to require integrated care boards to remove requirements for (a) same sex couples and (b) single women to have privately-funded IVF cycles before they are accepted for NHS-funded IVF cycles.

The Government recognises that fertility treatment across the National Health Service in England is subject to variation in access. Work continues on joint advice from the Department and NHS England about the offer around NHS-funded fertility services, including the issues for female same sex couples. Funding decisions for health services in England are made by integrated care boards (ICBs) and are based on the clinical needs of their local population. We expect these organisations to commission fertility services in line with National Institute for Health and Care Excellence (NICE) guidelines, ensuring equal access to fertility treatment across England. NICE is currently reviewing these guidelines.

What information his Department holds on how much local authorities have spent on unpaid carers in each of the last five years.

The Department holds data on the number of unpaid carers over the age of 18 receiving direct support from local authorities (LAs) in England, and the cost of this support. Data is collected from LAs in the Short and Long Term data return and the Adult Social Care Finance Return, and published in the Adult Social Care Activity and Finance Report, which is available at the following link:https://digital.nhs.uk/data-and-information/publications/statistical/adult-social-care-activity-and-finance-report

Whether he has made an assessment of the adequacy of the provision of specialists in female urology across England to ensure that women suffering from recurrent episodes of UTIs receive the highest levels of care.

No such assessment has been made by the Department. Such services are locally managed and commissioned in accordance with the population’s needs.

How the recently published policy framework for the Better Care Fund will support unpaid carers; and whether the Better Care Fund includes any ringfenced funding for supporting unpaid carers.

The Better Care Fund (BCF) includes funding that can be used for unpaid carer support, including short breaks and respite services for carers. As set out in the BCF policy framework published on 30 January 2025, to meet the objectives of the BCF, local areas should provide support for unpaid carers.Funding for supporting unpaid carers is not ringfenced within the BCF. Local authorities and integrated care boards agree the amount of BCF funding in their locality that will be committed to support carers, in the context of other sources of funding and with reference to their statutory duties to support unpaid carers. As a result, actual spend by local authorities on services to support carers may differ.

Whether he plans to increase the proportion of carers who are provided practical support after they have undertaken a carer’s assessment.

Local authorities have a responsibility to support those caring for family and friends.Under the Care Act 2014, local authorities must provide a range of high-quality care services, including support for carers. They are required to conduct Carer’s Assessments for individuals who may need support and to meet their eligible needs upon request.We have already taken some steps to support carers. From April 2025, the Government will raise the Carer's Allowance earnings limit from £151 to £196 a week, the largest increase since the allowance was introduced in 1976.Additionally, the Accelerating Reform Fund has allocated £42.6 million over 2023/24 and 2024/25 to support innovation and improve services for unpaid carers. Lord Darzi’s independent review of the National Health Service calls for a fresh approach to supporting unpaid carers, to improve outcomes for carers, those receiving care, and the NHS. We will consider these findings in our 10-Year Health Plan and in shaping future adult social care reforms.The Government is launching an independent commission into adult social care as part of our critical first steps towards delivering a National Care Service.The Commission will start a national conversation about what working age adults, older people, and their families expect from adult social care, including exploring the needs of unpaid carers who provide vital care and support.

Whether he has made an assessment of the potential merits of placing a new statutory duty on local authorities to ensure all unpaid carers are able to take regular breaks.

This Government is committed to ensuring families have the support they need. We want to ensure that people who care for family and friends are better able to look after their own health and wellbeing. Local authorities have duties to support people caring for their family and friends. The Care Act 2014 requires local authorities to deliver a wide range of sustainable, high-quality care and support services, including support for carers such as respite and breaks.The Government recognises the challenges facing the adult social care system. That is why the Government is launching an independent commission into adult social care as part of our critical first steps towards delivering a National Care Service.The Commission will start a national conversation about what working age adults, older people, and their families expect from adult social care, including exploring the needs of unpaid carers who provide vital care and support. Lord Darzi’s independent review of the National Health Service is clear that a fresh approach to supporting and involving unpaid carers is required to improve outcomes for carers, people needing care and the NHS.We will carefully consider these findings as part of our 10-year plan for reforming and modernising the NHS and as we develop plans to reform adult social care, including through the National Care Service.Further, I recently met with employers and the Department for Business and Trade to discuss how employers are driving best practice in supporting working carers. The Government is committed to reviewing the implementation of Carer’s Leave and examining the benefits of introducing paid Carer’s Leave.

If he will make a comparative assessment of levels of access to Enhertu for cancer patients in (a) England, (b) Wales, (c) Northern Ireland and (d) Scotland.

No assessment has been made, as health is a devolved matter and decisions on the availability of medicines in Scotland, Wales, and Northern Ireland are a matter for their own administrations.Decisions on whether new medicines should be routinely funded by the National Health Service in England are made on the basis of recommendations from the National Institute for Health and Care Excellence (NICE), following an evaluation of a treatment’s costs and benefits. These are very difficult decisions to make, and it is important that they are made independently and on the basis of the available evidence.NICE published guidance in July 2024 on the use of Enhertu for the treatment of HER-2 low metastatic and unresectable breast cancer and was unfortunately unable to recommend it for routine NHS funding. I understand that NICE and NHS England have sought to apply as much flexibility as they can in their considerations of Enhertu for HER2-low breast cancer, and have made it clear to the companies that their pricing of the drug remains the only obstacle to access.Ministers met with the manufacturers of Enhertu, AstraZeneca, and Daiichi Sankyo in November 2024, to encourage them to re-engage in commercial discussions with NHS England. Despite NICE and NHS England offering unprecedented flexibilities, the companies were unable to offer Enhertu at a cost-effective price. NICE’s guidance, published in July 2024, will therefore remain unchanged. Although the deadline for a rapid review has now passed, NICE has reassured me that the door remains open for the companies to enter into a new NICE appraisal if they are willing to offer Enhertu at a cost-effective price.

With reference to Coroner Deborah Archer's report entitled Maeve Boothby O’Neill: Prevention of Future Deaths Report, reference 2024-0530, dated 7 October 2024, what steps he has taken to ensure that the (a) care for patients and (b) training available for (i) GPs, (ii) hospital doctors and (ii) other health workers on treating patients with myalgic encephalomyelitis and chronic fatigue syndrome is adequate.

We are committed to improving care and support for people with myalgic encephalomyelitis, also known as chronic fatigue syndrome (ME/CFS). We recognise how devastating the symptoms can be, and the significant impact they can have on patients and their families.The Department has reconvened the ME/CFS Task and Finish Group, including senior Department and cross-Government officials, ME/CFS specialists and representatives from NHS England, the National Institute for Health and Care Excellence, the devolved administrations, and ME/CFS charities and organisations. With stakeholder engagement via the ME/CFS Task and Finish Group, we are developing the final delivery plan for ME/CFS, which we aim to publish by the end of March. The plan will focus on boosting research, improving attitudes and education, and bettering the lives of people with this debilitating disease.The Department is also working with NHS England to develop an e-learning programme on ME/CFS for healthcare professionals, with the aim of supporting staff to be able to provide better care and improve patient outcomes. Sessions one and two of the e-learning programme are now available. The third session will become available later in 2025.The Medical Schools Council will promote the NHS England e-learning programme on ME/CFS to all United Kingdom medical schools, and encourage those medical schools to provide undergraduates with direct patient experience of ME/CFS. The General Medical Council (GMC) is the regulator of medical schools, and it is important that education is reenforced at different stages of medical training. Royal colleges play an important role in this. The GMC has included ME/CFS in the content map for the new national exam, so all medical schools will need to teach it as a subject.NHS England is currently undertaking a stocktake, commissioned in September 2024 and due at the end of January 2025, that will provide a more accurate, in-depth overview of the position of post-COVID-19 services across England. The scope of this commission has been extended to include ME/CFS services.

What steps he is taking to ensure the universal provision of Fracture Liaison Services by 2030.

The Government and NHS England support the clinical case for services which help to prevent fragility fractures and support the patients who sustain them. According to the Fracture Liaison Service Database 2022, at least 60 trusts in England had access to a Fracture Liaison Service. My Rt Hon. Friend, the Secretary of State for Health and Social Care is committed to rolling out fracture liaison services across every part of the country by 2030.

Whether he has had discussions with the National Institute for Health and Care Excellence on the licensing process for the drug sipavibart.

Department officials regularly discuss a range of topics with the National Institute for Health and Care Excellence (NICE), including progress with specific appraisals, such as for sipavibart.The NICE started its appraisal of the medicine sipavibart for p...