Written questions by McDonald.

What assessment he has made of the adequacy of and the capacity in the specialist spinal cord injury service.

Specialised spinal cord injury services are currently commissioned by NHS England Specialised Commissioning, in line with the service specification published by the Clinical Reference Group. This translates to 385 spinal cord injury beds commissioned from eight providers in England. NHS England provides annual funding of approximately £80 million to spinal cord injury centres to deliver inpatient care and outreach to secondary care prior to admission and to community services following discharges to support transition.NHS England recognises that services have experienced increasing referrals alongside complexity of presentations. NHS England plans to undertake work during 2026/27 to assess the adequacy of treatment pathways within specialised spinal injury services and will consider if any further updates are required to the national service specification based on the findings.All spinal cord injury providers are required to submit outcome data to the Specialised Services Quality Dashboard. These data enable the National Health Service to monitor of the quality of care, including clinical outcomes and equitability of access. The data is linked to the national spinal cord injury (SCI) registry, which provides audit data.The dashboard is a key tool in monitoring the quality of services, enabling comparison between service providers, and supporting improvements over time in the outcomes of services commissioned by NHS England.Additionally, in March 2025, NHS England published the Spinal Services Clinical Network Specification, which establishes expectations for spinal clinical networks to standardise pathways and reduce variation, with the aim of improving access to care for patients.Spinal Cord Injury services in England are commissioned against the published national service specification, which sets out the mandated standards that all providers are required to meet for all patients, including in relation to rehabilitation. The service specification mandates that spinal cord injury centres must provide restorative rehabilitation and re-enablement, and support patients’ reintegration into the community. When a patient is admitted to a spinal cord injury centre, there must be a focus on rehabilitation from the outset, with treatment by a co-ordinated multidisciplinary team. The specification is available at the following link:https://www.england.nhs.uk/wp-content/uploads/2019/04/service-spec-spinal-cord-injury-services-all-ages.pdf

If he will commit to making the 2022 SCI Rehabilitation Standards mandatory.

Specialised spinal cord injury services are currently commissioned by NHS England Specialised Commissioning, in line with the service specification published by the Clinical Reference Group. This translates to 385 spinal cord injury beds commissioned from eight providers in England. NHS England provides annual funding of approximately £80 million to spinal cord injury centres to deliver inpatient care and outreach to secondary care prior to admission and to community services following discharges to support transition.NHS England recognises that services have experienced increasing referrals alongside complexity of presentations. NHS England plans to undertake work during 2026/27 to assess the adequacy of treatment pathways within specialised spinal injury services and will consider if any further updates are required to the national service specification based on the findings.All spinal cord injury providers are required to submit outcome data to the Specialised Services Quality Dashboard. These data enable the National Health Service to monitor of the quality of care, including clinical outcomes and equitability of access. The data is linked to the national spinal cord injury (SCI) registry, which provides audit data.The dashboard is a key tool in monitoring the quality of services, enabling comparison between service providers, and supporting improvements over time in the outcomes of services commissioned by NHS England.Additionally, in March 2025, NHS England published the Spinal Services Clinical Network Specification, which establishes expectations for spinal clinical networks to standardise pathways and reduce variation, with the aim of improving access to care for patients.Spinal Cord Injury services in England are commissioned against the published national service specification, which sets out the mandated standards that all providers are required to meet for all patients, including in relation to rehabilitation. The service specification mandates that spinal cord injury centres must provide restorative rehabilitation and re-enablement, and support patients’ reintegration into the community. When a patient is admitted to a spinal cord injury centre, there must be a focus on rehabilitation from the outset, with treatment by a co-ordinated multidisciplinary team. The specification is available at the following link:https://www.england.nhs.uk/wp-content/uploads/2019/04/service-spec-spinal-cord-injury-services-all-ages.pdf

What steps he has taken to consult specialist healthcare professionals and people with lived experience of spinal cord injury in determining changes to commissioning structures for specialist spinal cord injury services to address geographic variations in (a) access and (b) quality of rehabilitation services for people with spinal cord injury.

Ahead of its planned abolition, NHS England has been considering whether any specialised services currently retained for national commissioning by NHS England should transfer to integrated care boards (ICBs) or become the commissioning responsibility of the Department. This process, which has included engagement with NHS England’s regional commissioning teams and relevant national clinical leads, has identified 11 services, including spinal cord injury services, which would benefit from a more integrated approach to commissioning achieved through the transfer of commissioning responsibility to ICBs. A final decision on which specialised services will transfer and become the commissioning responsibility of ICBs will need approval by Parliament for the necessary changes in primary legislation and, where required, secondary legislation.Changes to the commissioning architecture will not themselves result in any service change. Where commissioning plans would result in service change, commissioners have a statutory duty to involve and consult the public, which would provide an opportunity to hear from people with lived experience. We recognise that where responsibility for commissioning specialised services is transferred to ICBs, it will be important to maintain expert commissioning knowledge and capability. That is why we are taking steps to establish an office for Pan-ICB Commissioning within each of the seven National Health Service regions to support all ICBs across a region in commissioning specialised services, including the planning and commissioning of services ‘at scale’ where this is appropriate.The Government fully recognises the importance of maintaining a national framework of standards and clinical commissioning policies to ensure equitable access to specialised services for all patients. This will apply to all specialised services regardless of whether they become the commissioning responsibility of ICBs or the Department in the future.We are committing to addressing geographic variation in the access to and the quality of rehabilitation services for people with spinal cord injury. In October 2025, the National Institute for Health and Care Excellence (NICE) published new guidance on rehabilitation for chronic neurological disorders, which includes rehabilitation for spinal cord injury. NICE guidelines are evidence-based, informed by clinical expertise, and represent best practice. The Government expects commissioners and service providers to take NICE guidance fully into account when designing services that meet the needs of their local population and work towards implementation over time.

If he will make an assessment of the adequacy of service specifications and commissioning plans for spinal cord injury.

Specialised spinal cord injury services are currently commissioned by NHS England Specialised Commissioning, in line with the service specification published by the Clinical Reference Group. This translates to 385 spinal cord injury beds commissioned from eight providers in England. NHS England provides annual funding of approximately £80 million to spinal cord injury centres to deliver inpatient care and outreach to secondary care prior to admission and to community services following discharges to support transition.NHS England recognises that services have experienced increasing referrals alongside complexity of presentations. NHS England plans to undertake work during 2026/27 to assess the adequacy of treatment pathways within specialised spinal injury services and will consider if any further updates are required to the national service specification based on the findings.All spinal cord injury providers are required to submit outcome data to the Specialised Services Quality Dashboard. These data enable the National Health Service to monitor of the quality of care, including clinical outcomes and equitability of access. The data is linked to the national spinal cord injury (SCI) registry, which provides audit data.The dashboard is a key tool in monitoring the quality of services, enabling comparison between service providers, and supporting improvements over time in the outcomes of services commissioned by NHS England.Additionally, in March 2025, NHS England published the Spinal Services Clinical Network Specification, which establishes expectations for spinal clinical networks to standardise pathways and reduce variation, with the aim of improving access to care for patients.Spinal Cord Injury services in England are commissioned against the published national service specification, which sets out the mandated standards that all providers are required to meet for all patients, including in relation to rehabilitation. The service specification mandates that spinal cord injury centres must provide restorative rehabilitation and re-enablement, and support patients’ reintegration into the community. When a patient is admitted to a spinal cord injury centre, there must be a focus on rehabilitation from the outset, with treatment by a co-ordinated multidisciplinary team. The specification is available at the following link:https://www.england.nhs.uk/wp-content/uploads/2019/04/service-spec-spinal-cord-injury-services-all-ages.pdf

What steps he has taken to consult specialist healthcare professionals and people with lived experience of spinal cord injury in determining changes to commissioning structures for specialist spinal cord injury services.

Ahead of its planned abolition, NHS England has been considering whether any specialised services currently retained for national commissioning by NHS England should transfer to integrated care boards (ICBs) or become the commissioning responsibility of the Department. This process, which has included engagement with NHS England’s regional commissioning teams and relevant national clinical leads, has identified 11 services, including spinal cord injury services, which would benefit from a more integrated approach to commissioning achieved through the transfer of commissioning responsibility to ICBs. A final decision on which specialised services will transfer and become the commissioning responsibility of ICBs will need approval by Parliament for the necessary changes in primary legislation and, where required, secondary legislation.Changes to the commissioning architecture will not themselves result in any service change. Where commissioning plans would result in service change, commissioners have a statutory duty to involve and consult the public, which would provide an opportunity to hear from people with lived experience. We recognise that where responsibility for commissioning specialised services is transferred to ICBs, it will be important to maintain expert commissioning knowledge and capability. That is why we are taking steps to establish an office for Pan-ICB Commissioning within each of the seven National Health Service regions to support all ICBs across a region in commissioning specialised services, including the planning and commissioning of services ‘at scale’ where this is appropriate.The Government fully recognises the importance of maintaining a national framework of standards and clinical commissioning policies to ensure equitable access to specialised services for all patients. This will apply to all specialised services regardless of whether they become the commissioning responsibility of ICBs or the Department in the future.We are committing to addressing geographic variation in the access to and the quality of rehabilitation services for people with spinal cord injury. In October 2025, the National Institute for Health and Care Excellence (NICE) published new guidance on rehabilitation for chronic neurological disorders, which includes rehabilitation for spinal cord injury. NICE guidelines are evidence-based, informed by clinical expertise, and represent best practice. The Government expects commissioners and service providers to take NICE guidance fully into account when designing services that meet the needs of their local population and work towards implementation over time.

What data his Department holds on the number of GP appointments (a) offered, (b) attended and (c) cancelled by practices in Middlesbrough and Thornaby East constituency in the most recent year for which data is available; and if will make it his policy to monitor trends in practice-cancelled appointments.

General Practice Appointment Data is published monthly by NHS England and captures information on appointments that have occurred, rather than those that are offered. The data also only includes appointments that were attended or marked as 'Did Not Attend' (DNA), not those that are cancelled.Since cancelled slots can often be rebooked and used by other patients, the most reliable and meaningful data to collect are both attended appointments and DNAs.In September 2025, in the Middlesbrough and Thornaby East Constituency, 1.04 million appointments were delivered, and 54,000 appointments were not attended.

How many dental practices are currently accepting new NHS patients in Middlesbrough and Thornaby East constituency; and what data his Department holds on waiting times for NHS dental treatment in that constituency for the latest available period.

Patients in England are not registered with a National Health Service dental practice, although many NHS dental practices do tend to see patients regularly. There is no geographical restriction on which practice a patient may attend. Some dental practices may operate local waiting list arrangements. Therefore, data on waiting times for NHS dental treatment is not held centrally.As of 3 November 2025, there were six NHS dentist practices in the Middlesbrough and Thornaby East constituency, with one showing as ‘accepting new child patients when availability allows’ and zero showing as ‘accepting new adult patients when availability allows’. This data is sourced from the Find a Dentist website and is matched to constituencies based on the postcode data shown on the website, at the following link:https://www.nhs.uk/service-search/find-a-dentistIntegrated care board (ICBs) are responsible for commissioning primary care services, including NHS dentistry, to meet the needs of the local population. For the Middlesbrough and Thornaby East constituency, this is the North East and North Cumbria ICB.We have asked ICBs to commission extra urgent dental appointments across the country, with appointments more heavily weighted towards those areas where they are needed the most. The Government is also considering the outcomes of the consultation on immediate improvements to dental care and will publish a response shortly.We are committed to reforming the dental sector and we will deliver fundamental contract reform before the end of this Parliament.

With reference to his Department's press release entitled Dental patients to benefit from 700,000 extra urgent appointments, published on 21 February 2025, how many additional urgent dental appointments will be delivered in Middlesbrough and Thornaby East constituency in (a) 2025–26 and (b) 2026-27.

We have asked integrated care boards (ICBs) to commission extra urgent dental appointments to make sure that patients with urgent needs can get the treatment they require. ICBs have been making extra appointments available from April 2025.Appointments are available across the country, with specific expectations for each region. These appointments are more heavily weighted towards those areas where they are needed the most. The NHS North East and North Cumbria ICB, which includes the Middlesbrough and Thornaby East constituency, is expected to deliver 57,559 additional urgent dental appointments as part of the scheme.Data on delivery of urgent dental care, including additional delivery, will be published annually as part of the NHS Dental Statistics England Official Statistics series. These statistics are released each August and are the primary source of data on the delivery of NHS dental care. On 16 December, we published the Government’s response to the public consultation on quality and payment reforms to the NHS dental contract. The changes will be introduced from April 2026. These reforms will put patients with greatest need first, incentivising urgent care and complex treatments. More information is available at the following link: https://www.gov.uk/government/consultations/nhs-dentistry-contract-quality-and-payment-reforms/outcome/government-response-to-consultation-on-nhs-dentistry-contract-quality-and-payment-reforms

With reference to the oral contribution of the Minister for Care of 15 October 2025 on Jhoots Pharmacy, Official Report, column 377, what progress his officials have made in exploring options to strengthen the regulatory framework for pharmacies that breach their NHS terms of service.

On 11 November, I wrote to all Members of this House with an update on actions taken to date.The Department is currently conducting an analysis of how pharmacies are regulated to ensure that all those with contract management and registration responsibilities can swiftly take action proportionate to the scale of the failures. If this analysis identifies gaps that can be filled by legislative changes, the House will be able scrutinise any proposed legislative changes in the usual way.Where pharmacies close, integrated care boards (ICBs) will work with other local pharmacies and general practices to ensure patients can continue to access their medicines. Patients may also use distance-selling pharmacies, which are required to deliver prescription medicines directly to patients’ homes free of charge.The Department continues to monitor changes to the provision of pharmaceutical services to patients. Local authorities’ Health and Wellbeing Boards are also required to undertake and update pharmaceutical needs assessments to ensure that provision in their area is adequate. These assessments and any supplementary statements are published.Pharmacy premises and pharmacy professionals are monitored and regulated by the General Pharmaceutical Council (GPhC), and ICBs monitor and enforce adherence to the NHS Terms of Service for pharmacies. The details about actions taken by the GPhC are published on their website.Pharmacy staff and locum pharmacists are not employed by the National Health Service but by pharmacy businesses who both provide private pharmaceutical services and hold contracts for NHS services. Any dispute between staff or employed locum pharmacists and a pharmacy business should be raised with the Advisory, Conciliation, and Arbitration Service which has powers to provide arbitration and binding decisions in such matters.

With reference to his statement of 15 October 2025 on Jhoots Pharmacy, Official Report, col 377, when he plans to update the House on the outcome of his officials’ engagement with Integrated Care Boards and the General Pharmaceutical Council on regulatory action against Jhoots Pharmacy.

On 11 November, I wrote to all Members of this House with an update on actions taken to date.The Department is currently conducting an analysis of how pharmacies are regulated to ensure that all those with contract management and registration responsibilities can swiftly take action proportionate to the scale of the failures. If this analysis identifies gaps that can be filled by legislative changes, the House will be able scrutinise any proposed legislative changes in the usual way.Where pharmacies close, integrated care boards (ICBs) will work with other local pharmacies and general practices to ensure patients can continue to access their medicines. Patients may also use distance-selling pharmacies, which are required to deliver prescription medicines directly to patients’ homes free of charge.The Department continues to monitor changes to the provision of pharmaceutical services to patients. Local authorities’ Health and Wellbeing Boards are also required to undertake and update pharmaceutical needs assessments to ensure that provision in their area is adequate. These assessments and any supplementary statements are published.Pharmacy premises and pharmacy professionals are monitored and regulated by the General Pharmaceutical Council (GPhC), and ICBs monitor and enforce adherence to the NHS Terms of Service for pharmacies. The details about actions taken by the GPhC are published on their website.Pharmacy staff and locum pharmacists are not employed by the National Health Service but by pharmacy businesses who both provide private pharmaceutical services and hold contracts for NHS services. Any dispute between staff or employed locum pharmacists and a pharmacy business should be raised with the Advisory, Conciliation, and Arbitration Service which has powers to provide arbitration and binding decisions in such matters.

With reference to the oral contribution of the Minister for Care of 15 October 2025 on Jhoots Pharmacy, Official Report, column 377, what estimate his Department has made of how many people have been left without local pharmacy access as a result of Jhoots’s actions; and what steps he is taking to tackle that lack of access.

On 11 November, I wrote to all Members of this House with an update on actions taken to date.The Department is currently conducting an analysis of how pharmacies are regulated to ensure that all those with contract management and registration responsibilities can swiftly take action proportionate to the scale of the failures. If this analysis identifies gaps that can be filled by legislative changes, the House will be able scrutinise any proposed legislative changes in the usual way.Where pharmacies close, integrated care boards (ICBs) will work with other local pharmacies and general practices to ensure patients can continue to access their medicines. Patients may also use distance-selling pharmacies, which are required to deliver prescription medicines directly to patients’ homes free of charge.The Department continues to monitor changes to the provision of pharmaceutical services to patients. Local authorities’ Health and Wellbeing Boards are also required to undertake and update pharmaceutical needs assessments to ensure that provision in their area is adequate. These assessments and any supplementary statements are published.Pharmacy premises and pharmacy professionals are monitored and regulated by the General Pharmaceutical Council (GPhC), and ICBs monitor and enforce adherence to the NHS Terms of Service for pharmacies. The details about actions taken by the GPhC are published on their website.Pharmacy staff and locum pharmacists are not employed by the National Health Service but by pharmacy businesses who both provide private pharmaceutical services and hold contracts for NHS services. Any dispute between staff or employed locum pharmacists and a pharmacy business should be raised with the Advisory, Conciliation, and Arbitration Service which has powers to provide arbitration and binding decisions in such matters.

With reference to the oral contribution of the Minister for Care of 15 October 2025 on Jhoots Pharmacy, Official Report, column 377, what mechanisms his Department has put in place to monitor the performance of (a) Jhoots Pharmacy and (b) other large pharmacy chains; and how he plans to report to Parliament on progress on that monitoring.

On 11 November, I wrote to all Members of this House with an update on actions taken to date.The Department is currently conducting an analysis of how pharmacies are regulated to ensure that all those with contract management and registration responsibilities can swiftly take action proportionate to the scale of the failures. If this analysis identifies gaps that can be filled by legislative changes, the House will be able scrutinise any proposed legislative changes in the usual way.Where pharmacies close, integrated care boards (ICBs) will work with other local pharmacies and general practices to ensure patients can continue to access their medicines. Patients may also use distance-selling pharmacies, which are required to deliver prescription medicines directly to patients’ homes free of charge.The Department continues to monitor changes to the provision of pharmaceutical services to patients. Local authorities’ Health and Wellbeing Boards are also required to undertake and update pharmaceutical needs assessments to ensure that provision in their area is adequate. These assessments and any supplementary statements are published.Pharmacy premises and pharmacy professionals are monitored and regulated by the General Pharmaceutical Council (GPhC), and ICBs monitor and enforce adherence to the NHS Terms of Service for pharmacies. The details about actions taken by the GPhC are published on their website.Pharmacy staff and locum pharmacists are not employed by the National Health Service but by pharmacy businesses who both provide private pharmaceutical services and hold contracts for NHS services. Any dispute between staff or employed locum pharmacists and a pharmacy business should be raised with the Advisory, Conciliation, and Arbitration Service which has powers to provide arbitration and binding decisions in such matters.

With reference to the oral contribution of the Minister for Care of 15 October 2025 on Jhoots Pharmacy, Official Report, column 377, what steps he is taking to ensure continued patient access to medicines in areas where Jhoots Pharmacy branches have reduced opening hours or closed; and when he expects Integrated Care Boards to have implemented full contingency arrangements.

On 11 November, I wrote to all Members of this House with an update on actions taken to date.The Department is currently conducting an analysis of how pharmacies are regulated to ensure that all those with contract management and registration responsibilities can swiftly take action proportionate to the scale of the failures. If this analysis identifies gaps that can be filled by legislative changes, the House will be able scrutinise any proposed legislative changes in the usual way.Where pharmacies close, integrated care boards (ICBs) will work with other local pharmacies and general practices to ensure patients can continue to access their medicines. Patients may also use distance-selling pharmacies, which are required to deliver prescription medicines directly to patients’ homes free of charge.The Department continues to monitor changes to the provision of pharmaceutical services to patients. Local authorities’ Health and Wellbeing Boards are also required to undertake and update pharmaceutical needs assessments to ensure that provision in their area is adequate. These assessments and any supplementary statements are published.Pharmacy premises and pharmacy professionals are monitored and regulated by the General Pharmaceutical Council (GPhC), and ICBs monitor and enforce adherence to the NHS Terms of Service for pharmacies. The details about actions taken by the GPhC are published on their website.Pharmacy staff and locum pharmacists are not employed by the National Health Service but by pharmacy businesses who both provide private pharmaceutical services and hold contracts for NHS services. Any dispute between staff or employed locum pharmacists and a pharmacy business should be raised with the Advisory, Conciliation, and Arbitration Service which has powers to provide arbitration and binding decisions in such matters.

With reference to the oral contribution of the Minister for Care of 15 October 2025 on Jhoots Pharmacy, Official Report, column 377, what estimate he has made of the number of locum pharmacists who have lost earned income as a result of the closure of Jhoots Pharmacies; and what guidance his Department has issued to ensure those pharmacists receive such payments.

On 11 November, I wrote to all Members of this House with an update on actions taken to date.The Department is currently conducting an analysis of how pharmacies are regulated to ensure that all those with contract management and registration responsibilities can swiftly take action proportionate to the scale of the failures. If this analysis identifies gaps that can be filled by legislative changes, the House will be able scrutinise any proposed legislative changes in the usual way.Where pharmacies close, integrated care boards (ICBs) will work with other local pharmacies and general practices to ensure patients can continue to access their medicines. Patients may also use distance-selling pharmacies, which are required to deliver prescription medicines directly to patients’ homes free of charge.The Department continues to monitor changes to the provision of pharmaceutical services to patients. Local authorities’ Health and Wellbeing Boards are also required to undertake and update pharmaceutical needs assessments to ensure that provision in their area is adequate. These assessments and any supplementary statements are published.Pharmacy premises and pharmacy professionals are monitored and regulated by the General Pharmaceutical Council (GPhC), and ICBs monitor and enforce adherence to the NHS Terms of Service for pharmacies. The details about actions taken by the GPhC are published on their website.Pharmacy staff and locum pharmacists are not employed by the National Health Service but by pharmacy businesses who both provide private pharmaceutical services and hold contracts for NHS services. Any dispute between staff or employed locum pharmacists and a pharmacy business should be raised with the Advisory, Conciliation, and Arbitration Service which has powers to provide arbitration and binding decisions in such matters.

What assessment his Department has made of the potential impact of the real terms value of wages set by Government pay awards in the (a) Dentists and Doctors Pay Review Body and (b) NHS Pay Review Body for 2025-26 on trends in the levels of (i) recruitment and (ii) retention of public sector workforce staff.

This specific assessment has not been made. Pay is an important factor in the National Health Service being able to continue to attract and reward talented staff. Pay review bodies are required to take careful account of the economic and financial evidence submitted by the Government, trades unions, representatives of NHS employers, and others to reach their recommendations on pay.When considering evidence in order to make pay recommendations, the Dentists and Doctors Pay Review Body and the NHS Pay Review Body pay due regard to many factors, including the potential impact of pay on staff recruitment and retention, as a core component of the terms of reference for pay review bodies.

If he will make an assessment of the potential merits of agreeing a long-term strategy with the (a) Review Body on Doctors' and Dentists' Remuneration and (b) NHS Pay Review Body to help improve pay in the NHS.

There are no current plans to make these specific assessments. The Government is committed to a credible, independent Pay Review Body (PRB) process as the right mechanism to recommend annual pay increases for most public sector staff. In her statement on the public finances on 29 July 2024, my Rt. Hon. Friend, the Chancellor of the Exchequer confirmed that the Government wished to continue to use the PRB process.The role of the NHS Pay Review Body and the Dentists and Doctors Pay Review Body is to make recommendations to the Prime Minister and ministers on the annual pay award for National Health Service staff and other related matters within their remit. They act independently of the Government.The PRBs lay out in their reports the reasoning for their recommended awards based on their terms of reference. In reaching their recommendations, the review bodies have regard to recruitment and retention and are required to take careful account of the economic and other evidence submitted by the Government, trades unions, representatives of NHS employers, and others.The Government is not bound by PRB recommendations, and it's for my Rt Hon. Friend, the Secretary of State for Health and Social Care to decide how to respond to the recommendations of PRBs for the NHS in England.

What assessment he has made of the potential implications for his Department's policies of trends in levels of confidence of workforce unions in public health sector pay review body processes.

This specific assessment has not been made. My Rt Hon. Friend, the Secretary of State for Health and Social Care has met regularly with unions to help rebuild the relationship between the Government and National Health Service staff.Whilst we will continue to use the Pay Review Bodies to set pay, we have listened to union concerns about the process, which is why we have committed to remitting in July this year, with an ambition to announce and implement uplifts as early as possible in 2026/27.

What assessment his Department has made of the potential implications for his Department's polices of the request of workforce unions for the establishment of direct pay negotiations in the health sector.

The Pay Review Body (PRB) process is the established mechanism for determining pay uplifts in the public sector. PRBs carefully consider evidence submitted to them from a range of stakeholders, including the Government and trade unions.The Government is committed to a credible, independent PRB process as the way to set pay for National Health Service staff in England, and there are no plans to replace the process with direct negotiations.However, we have listened to union concerns about the process, which is why we committed to improving the timeline this year and will look to build on that by remitting the PRBs to begin the next pay round in July, putting us on track to announce pay awards as early as possible in 2026/27.

What assessment his Department has made of the potential merits for recruitment and retention of agreeing a long-term strategy to improve pay in real terms for the workforces covered by (a) the Dentists and Doctors Pay Review Body and (b) the NHS Pay Review Body.

There are no current plans to make these specific assessments. The Government is committed to a credible, independent Pay Review Body (PRB) process as the right mechanism to recommend annual pay increases for most public sector staff. In her statement on the public finances on 29 July 2024, my Rt. Hon. Friend, the Chancellor of the Exchequer confirmed that the Government wished to continue to use the PRB process.The role of the NHS Pay Review Body and the Dentists and Doctors Pay Review Body is to make recommendations to the Prime Minister and ministers on the annual pay award for National Health Service staff and other related matters within their remit. They act independently of the Government.The PRBs lay out in their reports the reasoning for their recommended awards based on their terms of reference. In reaching their recommendations, the review bodies have regard to recruitment and retention and are required to take careful account of the economic and other evidence submitted by the Government, trades unions, representatives of NHS employers, and others.The Government is not bound by PRB recommendations, and it's for my Rt Hon. Friend, the Secretary of State for Health and Social Care to decide how to respond to the recommendations of PRBs for the NHS in England.

What estimate his Department has made of the potential impact of the pay awards made through the (a) Dentists and Doctors Pay Review Body and (b) NHS Pay Review Body processes on the real terms value of wages in each year since 2010.

The table attached shows the estimated average increases to basic pay, where these were based on pay review body recommendations for members of the Hospital and Community Health Sector workforce in England, as well as the average consumer price index inflation for each year since 2010/11.In 2011/12 and 2012/13, the pay review bodies were stood down. Between 2013/14 and 2017/18, the pay review bodies reported, but headline recommendations were determined by public sector pay policy.As independent contractors, it is for general practice partners to determine uplifts in pay for themselves and their employees. As dental practices are similarly private businesses, it falls to them to set employee pay and conditions.Each year, the Government sets out the funds available to the Department, and in reaching their conclusions, pay review bodies take careful account of economic and other evidence submitted by employers, the Government, unions, and others.