Written questions by Gelderd.

What steps he is taking to tackle health inequalities in coastal communities, in the context of the Chief Medical Officer’s annual report 2021: health in coastal communities, published on 21 July 2021.

The Chief Medical Officer in his 2023 Annual Report made clear that future health and care needs will vary significantly, with the populations of rural, semi-rural and coastal areas more likely to experience worse health outcomes. In the 10-Year Health Plan, the Government commits to reducing the gap in healthy life expectancy between the richest and poorest areas by tackling health inequalities and the social determinants of health.The Department will address under performance in areas with the worst health outcomes, including coastal communities, where access is often poor. National Health Service regions are compiling action plans for each provider in these areas to begin improvements.

What steps his Department plans to take account of the age profile of communities in Cornwall when allocating resources for health and social care in that area.

Integrated care boards (ICBs), including the Cornwall Isles of Scilly ICB, receive funding allocations from NHS England to pay for the services they commission. Most funding is allocated as a non-ringfenced budget, informed by a calculation of what would constitute a ‘fair share’ of funding based on a formula that takes account of population, age, need, deprivation and health inequalities considerations.NHS England published a ‘Technical Guide to Allocation Formulae and Convergence’ that sets out the methodology; the formula takes into account age profiles in the modelling of the need for health care services by recognising that older populations typically have a higher need per capita. The guide is available at the following link:https://www.england.nhs.uk/wp-content/uploads/2025/02/PRN01601-technical-guide-to-allocation-formulae-and-convergence-for-2025-to-2026-revenue-allocations.pdf

What assessment his Department has made of the adequacy of access to defibrillators in (a) South East Cornwall constituency and (b) other (i) rural and (ii) coastal areas.

To improve patients' survival rates following out-of-hospital cardiac arrests, the Government committed to improving access to automated external defibrillators (AEDs) in public spaces and reducing inequalities in access to these life saving devices. Following the depletion of the existing AED fund, launched in in September 2023, the Government approved a further £500,000 in August 2024 to fulfil existing applications to the Fund.Funding was allocated where there was the greatest need, for example, remote communities with extended ambulance response times, places with high footfall and high population densities, hotspots for cardiac arrest including sporting venues and venues with vulnerable people, and deprived areas. There are no plans to undertake further work on improving access or provide additional support for AEDs, in light of the rapid expansion of AEDs across the UK.We recognise the important work the British Heart Foundation (BHF) has undertaken in identifying communities with limited access to a defibrillator. The BHF undertook this work as part of its 2025 community defibrillator fund programme. The BHF is urgently encouraging areas eligible to apply to its 2025 scheme to do so. Further information is available at the following link:https://www.bhf.org.uk/how-you-can-help/how-to-save-a-life/defibrillators/apply-for-a-free-defibrillator-for-your-communityAcross the South West, there are currently over 12,000 public access defibrillators registered on The Circuit, with most being privately owned. Approximately 1,000 of these defibrillators are owned and managed by the South Western Ambulance Service (SWAST).SWAST is working to improve the availability, accessibility and emergency readiness of all public accessible defibrillators across the South West. SWAST is currently contacting guardians of defibrillators which have not had a status check registered on The Circuit for more than three months. This proportion has, as a result, reduced from one third of all defibrillators to 17% over the past year. SWAST is also working with all schools across the South West to encourage them to register their defibrillator on The Circuit, with 90% of schools across the South West now having a defibrillator registered, the highest percentage in the country. SWAST is also promoting the labelling of public access defibrillators using stickers produced by The Circuit to reduce the time taken for a defibrillator to return to its cabinet after allocation, reducing the time that it is unavailable.

What steps his Department is taking to support communities with the (a) maintenance and (b) running costs of public defibrillators.

To improve patients' survival rates following out-of-hospital cardiac arrests, the Government committed to improving access to Automated External Defibrillators (AEDs) in public spaces and reducing inequalities in access to these life-saving devices. Following the depletion of the existing AED fund, launched in September 2023, the Government approved a further £500,000 in August 2024 to fulfil existing applications to the Fund.Funding was allocated where there was the greatest need, for example: remote communities with extended ambulance response times; places with high footfall and high population densities; hotspots for cardiac arrest including sporting venues and venues with vulnerable people; and deprived areas.There are no plans to undertake further work on improving access or provide additional support for AEDs, in light of the rapid expansion of AEDs across the UK. According to the British Heart Foundation (BHF), there are now over 110,000 defibrillators in the United Kingdom registered on The Circuit, the independently operated national AED database.We recognise the important work the BHF has undertaken in identifying communities with limited access to a defibrillator. The BHF undertook this work as part of their 2025 community defibrillator fund programme.The BHF are urgently encouraging areas eligible to apply to their 2025 scheme to do so. Further information is available at the following link:https://www.bhf.org.uk/how-you-can-help/how-to-save-a-life/defibrillators/apply-for-a-free-defibrillator-for-your-communityAs well as the BHF, several other UK charities provide and support access to AEDs, and in some cases provide support for their maintenance and running costs. London Hearts, AED Donate, and Community Heartbeat Trust are prominent examples working to increase the availability of AEDs.

Whether his Department plans to increase the availability of defibrillators in (a) South East Cornwall constituency and (b) other (i) rural and (ii) coastal areas.

To improve patients' survival rates following out-of-hospital cardiac arrests, the Government committed to improving access to automated external defibrillators (AEDs) in public spaces and reducing inequalities in access to these life saving devices. Following the depletion of the existing AED fund, launched in in September 2023, the Government approved a further £500,000 in August 2024 to fulfil existing applications to the Fund.Funding was allocated where there was the greatest need, for example, remote communities with extended ambulance response times, places with high footfall and high population densities, hotspots for cardiac arrest including sporting venues and venues with vulnerable people, and deprived areas. There are no plans to undertake further work on improving access or provide additional support for AEDs, in light of the rapid expansion of AEDs across the UK.We recognise the important work the British Heart Foundation (BHF) has undertaken in identifying communities with limited access to a defibrillator. The BHF undertook this work as part of its 2025 community defibrillator fund programme. The BHF is urgently encouraging areas eligible to apply to its 2025 scheme to do so. Further information is available at the following link:https://www.bhf.org.uk/how-you-can-help/how-to-save-a-life/defibrillators/apply-for-a-free-defibrillator-for-your-communityAcross the South West, there are currently over 12,000 public access defibrillators registered on The Circuit, with most being privately owned. Approximately 1,000 of these defibrillators are owned and managed by the South Western Ambulance Service (SWAST).SWAST is working to improve the availability, accessibility and emergency readiness of all public accessible defibrillators across the South West. SWAST is currently contacting guardians of defibrillators which have not had a status check registered on The Circuit for more than three months. This proportion has, as a result, reduced from one third of all defibrillators to 17% over the past year. SWAST is also working with all schools across the South West to encourage them to register their defibrillator on The Circuit, with 90% of schools across the South West now having a defibrillator registered, the highest percentage in the country. SWAST is also promoting the labelling of public access defibrillators using stickers produced by The Circuit to reduce the time taken for a defibrillator to return to its cabinet after allocation, reducing the time that it is unavailable.

Whether his Department plans to allocate (a) new and (b) ring-fenced funding to support the implementation of the Final Delivery Plan for Myalgic Encephalomyelitis/Chronic Fatigue Syndrome, published in July 2025.

We recognise the negative impact that myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS) has on patients and their loved ones, and also the cost to health and care services and the wider economy through, for example, loss of work and an increased benefits bill. We, therefore, recently published the ME/CFS final delivery plan, which focuses on boosting research, improving attitudes and education, and bettering the lives of people with this debilitating disease.There are currently no plans to allocate new or ring-fenced funding specifically to support the implementation of the ME/CFS final delivery plan. However, we continue to commission research on ME/CFS services across the United Kingdom, focussing on the most severely affected. The plan includes increased funding for research, awarded through the National Institute for Health and Care Research, into how existing medicines can be used for post-viral conditions, including ME/CFS. Additionally, there are always opportunities for researchers to bid for and secure research funding for ME/CFS through our open research funding calls.

Whether he plans to introduce (a) additional funding and (b) policy changes to expand (i) therapeutic and (ii) foster care options for young people over 16.

The Government is committed to raising the healthiest generation of children ever and giving mental health the same importance as physical health.The Department of Health and Social Care set out in the 10-Year Health Plan how we will work to better identify and meet children's and young people’s mental health needs. We will continue to roll out Mental Health Support Teams to schools and colleges in England, to reach full national coverage by 2029/30.The Department for Education has announced £25 million in transformation funding to recruit hundreds more new foster families and strengthen support to retain existing carers to improve the life chances of thousands of children. This will ensure that children in foster care experience greater stability. This is additional to the £15 million announced at the Autumn Budget 2024, which aims to recruit more foster carers. This will include foster care recruitment for older children and those with more complex needs.The 2025 Spending Review also included capital funding to provide more foster care placements, by renovating and extending foster care homes.

What assessment he has made of the (a) travel distances and (b) levels of public transport in (i) site planning and (ii) service design for neighbourhood health centres in rural areas; and what his timeline is for the rollout of those centres.

The Government aims to establish a Neighbourhood Health Centre in every community by 2035. Neighbourhood Health Centres will provide easier, more convenient access to a full range of healthcare services.Nationwide coverage will take time, but we will start in the areas of greatest need where healthy life expectancy is lowest, including rural towns and communities with higher deprivation levels, using public capital to update and refurbish existing, under-used buildings.We expect neighbourhood teams and services to be designed in a way that reflects the specific needs of local populations. While the focus on personalised, coordinated care will be consistent, services will look different in rural communities, coastal towns, and deprived inner cities, to reflect local needs.On 21 July 2025, I wrote to Members of Parliament highlighting that the Department and NHS England have written to integrated care boards and local authorities to invite applications to participate in the National Neighbourhood Health Implementation Programme, to establish a Neighbourhood Health Centre delivery pipeline.

If he will take steps to introduce a nationwide system to ensure that people experiencing mental health crises have access to support services when they need them; and what assessment he has made of the adequacy of the mental health support provision for patients in South East Cornwall constituency.

We recognise the importance of ensuring that individuals experiencing mental health crisis can access timely, effective and appropriate support, including those in South East Cornwall. Substantial progress has been achieved in building more robust crisis care pathways across all ages and in all regions, towards ensuring that people in mental health crisis can receive the right care.For example, the Government has committed £26 million in capital investment to support people in mental health crisis, including opening new mental health crisis centres across England, which aim to provide accessible and responsive care for individuals in mental health crisis. In addition, we are piloting several neighbourhood mental health centres which provide support to individuals in crisis without needing to book an appointment; these operate 24 hours a day, seven days a week.People of all ages in England experiencing a mental health crisis can speak to a trained National Health Service professional at any time of the day via the NHS 111 service. This service gives people the chance to be listened to by a trained member of staff who can help direct them to the right place.We will fulfil the Government’s commitment to recruit an additional 8,500 mental health staff by the end of the Parliament.NHS commissioners in England are responsible for ensuring that mental health services are safe, effective, sustainable and meet the needs of the population.

What plans his Department has to harmonise referral (a) rules and (b) procedures for mental health crisis support across regional NHS trusts; and if he will make an assessment of the potential impact of differences between those rules and procedures on the time taken for people living in South East Cornwall constituency to access mental health support.

We recognise the importance of ensuring equitable access to mental health crisis support across all regions, including in South East Cornwall. Substantial progress has been achieved in building more robust crisis care pathways across all ages and in all regions, towards ensuring that people in mental health crisis have access to timely and appropriate support.For example, the Government has committed £26 million in capital investment to open new mental health crisis centres across England, which aim to provide accessible and responsive care for individuals in mental health crisis. In addition, we are piloting several neighbourhood mental health centres which provide support to individuals in crisis without needing to book an appointment. These centres operate 24 hours a day, seven days a week.People of all ages in England experiencing a mental health crisis can speak to a trained National Health Service professional at any time of the day via the NHS 111 service. This service gives people the chance to be listened to by a trained member of staff who can help direct them to the right place.

What steps his Department is taking to involve (a) patients, (b) families and (c) communities in changes to the mental health referral system in (i) England and (ii) South East Cornwall constituency.

Any changes to mental health referral systems should be developed with the input of patients, families, and communities, to ensure services meet their needs.At local level, we would expect National Health Service trusts, including those in the South East Cornwall constituency, to take the same approach in actively engaging with service users and local communities when making changes to local referral pathways.We are also taking steps in legislation to improve how people subject to the Mental Health Act and their families or people close to them are involved in decisions about their care. The Mental Health Bill includes a new clinical checklist that requires clinicians to take certain steps when deciding a patient’s care and treatment, where they are detained under the Mental Health Act. This enables clinicians to support the patient to take part in decision making about their care, to consider their wishes and feelings, including those in an Advance Choice Document, to consult with those close to them, and to avoid making unjustified assumptions about the patient. This ensures care and treatment decisions are more patient centric.

What steps his Department is taking to improve access to defibrillators in rural communities; and whether he has considered providing additional support for the (a) installation and (b) maintenance of publicly accessible defibrillators in these areas.

To improve patients' survival rates following out-of-hospital cardiac arrests, the Government committed to improving access to Automated External Defibrillators (AEDs) in public spaces and reducing inequalities in access to these life saving devices. Following the depletion of the existing AED fund, launched in in September 2023, the Government approved a further £500,000 in August 2024 to fulfil existing applications to the fund.Applications to the fund were allocated where there is the greatest need, for instance remote communities with extended ambulance response times, places with high footfall and high population densities, hotspots for cardiac arrest including sporting venues and venues with vulnerable people, and deprived areas.There are no plans to undertake further work on improving access or providing additional support for AEDs, in light of the rapid expansion of AEDs across the United Kingdom.There are now over 100,000 defibrillators in the UK registered on The Circuit, which represents an increase of 30,000 since September 2023. 58.6% of the over 100,000 defibrillators are accessible on a 24/7 basis.The Circuit is operated independently by the British Heart Foundation, in partnership with the Resuscitation Council UK, the Association of Ambulance Chief Executives, and the National Health Service.

Whether he has made an assessment of the potential impact of welfare reforms on (a) unpaid carers and (b) their access to (i) respite and (ii) support services.

The Government is committed to supporting unpaid carers, who provide invaluable support to elderly or disabled people.In the recent Pathways to Work Green Paper, published on 18 March 2025, we announced a broad package of reforms to the health and disability benefit and support system, including changes to the Personal Independence Payment (PIP). For those who are affected by the new eligibility changes, including for linked entitlements such as Carer’s Allowance, we are consulting on how best to support this group, including how to make sure health and eligible care needs are met.The Government will consider the impacts on benefits for unpaid carers as part of its wider consideration of responses to the consultation as it develops its detailed proposals for change. Through the Green Paper we are consulting on the support needed for those who may lose any entitlements as a result of receiving PIP daily living and what this support could look like. The Department for Work and Pensions will also work closely with the Department of Health and Social Care and others on how the health and eligible care needs of those who would lose entitlement to PIP could be met outside the benefits system.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.The Better Care Fund includes funding that can be used for unpaid carer support, including short breaks and respite services for carers.

What steps his Department is taking to help people in South East Cornwall constituency to access healthcare services in Devon using the Tamar Crossings.

The Government acknowledges that the Tamar Crossings are an important local issue. We are determined to work with the National Health Service to ensure that everyone can access a general practice and other healthcare services, and we will move towards a Neighbourhood Health Service, with more care delivered in local communities.

Whether his Department plans to allocate funding for community-based programmes for gambling harm (a) prevention and (b) early intervention in (i) rural, (ii) hard-to-reach and (iii) other areas.

On 12 February 2025, the Office for Health Improvement and Disparities (OHID) was appointed as the lead commissioning body for the prevention of gambling-related harms in England, alongside the appropriate bodies in Scotland and Wales.OHID is progressing work on the design of the new commissioning programme, working closely with NHS England as a future treatment commissioner, and with the responsible bodies in Scotland and Wales, to ensure alignment across prevention, early intervention, and treatment, so that those in need can access the right help at the right time. Decisions on how the levy funding will be allocated will be confirmed at the earliest opportunity.

What progress his Department has made in determining which body will be responsible for (a) commissioning and (b) providing strategic direction for (i) community engagement, (ii) prevention and (iii) early intervention for gambling harms.

On 12 February 2025, the Office for Health Improvement and Disparities (OHID) was appointed as the lead commissioning body for the prevention of gambling-related harms in England, alongside the appropriate bodies in Scotland and Wales.OHID is progressing work on the design of the new commissioning programme, working closely with NHS England as a future treatment commissioner, and with the responsible bodies in Scotland and Wales, to ensure alignment across prevention, early intervention, and treatment, so that those in need can access the right help at the right time. Decisions on how the levy funding will be allocated will be confirmed at the earliest opportunity.

What steps his Department is taking to ensure that gambling harm (a) prevention and (b) early intervention services will receive support following the transition of gambling harm treatment commissioning to the NHS (i) in isolated communities and (ii) for vulnerable and higher-risk groups in Cornwall.

On 12 February 2025, the Office for Health Improvement and Disparities (OHID) was appointed as the lead commissioning body for the prevention of gambling-related harms in England, alongside the appropriate bodies in Scotland and Wales.OHID is progressing work on the design of the new commissioning programme, working closely with NHS England as a future treatment commissioner, and with the responsible bodies in Scotland and Wales, to ensure alignment across prevention, early intervention, and treatment, so that those in need can access the right help at the right time. Decisions on how the levy funding will be allocated will be confirmed at the earliest opportunity.

What steps he is taking to increase access to targeted treatments for patients with rare cancers, such as Langerhans Cell Histiocytosis and Erdheim Chester Disease.

The Department is committed to working with the pharmaceutical industry to develop a more efficient, more competitive, and more accessible clinical research system in the United Kingdom, ensuring that all patients, including those with rarer cancers like Langerhans Cell Histiocytosis and Erdheim Chester disease, have access to cutting-edge clinical research and innovative, lifesaving treatments.We are also committed to improving waiting times for cancer treatment, so that people with cancer, including rarer cancers, can get access to the care they need more quickly. We will start by delivering an extra 40,000 operations, scans, and appointments each week, as the first step to ensuring early diagnosis and faster treatment.Finally, the National Cancer Plan will include further details on how we will improve outcomes for cancer patients, as well as speeding up diagnosis and treatment, ensuring patients have access to the latest treatments and technology. The plan will seek to improve every aspect of cancer care, to improve the experience and outcomes for people with cancer, including rare and less common cancers.

What steps his Department is taking to help improve health outcomes for patients with rare diseases, in the context of the recent announcement by NHS Specialised Commissioning on (a) dabrafenib and (b) trametinib.

In January 2021, the Government published the UK Rare Diseases Framework providing a national vision for how to improve the lives of those living with rare diseases. The 2025 England Rare Diseases Action Plan was published on 28 February 2025.Dabrafenib and trametinib are medicines mostly used for children with cancer. We are committed to getting the National Health Service diagnosing cancer earlier and treating it faster so that more children and young people survive, and we will improve young cancer patients’ experience across the system.That is why on 4 February 2025 we relaunched the Children and Young People Cancer Taskforce to identify tangible ways to improve outcomes and experience for children and young people with cancer. The taskforce will explore opportunities for improvement across detection and diagnosis, genomic testing and treatment, research and innovation, and patient experience.

What steps his Department is taking to meet priority four of the policy paper entitled The UK Rare Diseases Framework, published on 9 January 2021.

The Government is committed to improving the lives of those living with rare diseases. The UK Rare Diseases Framework sets out four priorities collaboratively developed with the rare disease community, which includes priority four on improving access to specialist care, treatments, and drugs. We remain committed to delivering under the framework, and published the fourth England action plan on 28 February 2025.Under priority four:- we have worked with industry, clinicians, and patients to understand the challenges and opportunities of early access pathways for rare disease therapies;- we have committed to continuing to keep the effectiveness of the schemes for rare treatments under review;- the National Institute for Health and Care Excellence has launched a review of its highly specialised technology programme for evaluating rare disease treatments;- introduced action 38 on reforming clinical trial regulations; and- introduced action 39 on developing an operational framework for individualised therapies in the National Health Service.For further details, the 2025 England Rare Diseases Action Plan is available at the following link:https://www.gov.uk/government/publications/england-rare-diseases-action-plan-2025