Written questions by Ribeiro-Addy.

Pursuant to the Answer of 11 March 2025 to Question 33570 on General Practitioners: Unemployment, which bodies hold data on the number of unemployed GPs; and for what reason that data is not held centrally.

While the General Medical Council register contains data on the number of qualified general practitioners (GPs), the National Health Service is not the is not the sole employer of GPs. They may choose to undertake private work, to work in other settings outside of general practice, for example, prisons or army bases, or to work abroad. Since the NHS only collects data on GPs employed through the NHS, unemployment figures are not available.

What assessment he has made of the potential impact of the proposed increase in the certificate of sponsorship fee on the adult social care sector; and if he will hold discussions with the Chancellor of the Exchequer on making more funding available to support the adult social care sector.

The Immigration and Nationality (Fees) (Amendment) Order 2025, laid on 21 January 2025, sets out increases to the fee maxima that applies to the Certificate of Sponsorship from £300 to £525. These changes were agreed via collective agreement. If fees increase as set out in the Explanatory Memorandum to this Order, an Impact Assessment will be produced by the Home Office.International recruitment has played a valuable role in helping grow the adult social care workforce. The Government recognises the scale of reforms needed to make the adult social care sector attractive, to support sustainable workforce growth and improve the retention of the domestic workforce. The Government is making available up to £3.7 billion of additional funding for social care authorities in 2025/26, which includes an £880 million increase in the Social Care Grant.Adult social care is a central part of local government’s responsibilities. Decisions about the funding of all local government priorities will be taken in the round at the Spending Review.

If he will make an estimate of the annual cost of cannabis-related health conditions to the NHS.

The Department is committed to reducing the harm from all illicit drugs. Any illegal drug use, including cannabis, can be harmful, both from immediate side-effects and long-term physical and mental health problems. It can, for some, have a negative impact on their fertility. Cannabis use can contribute to and exacerbate existing mental health problems or can accelerate their development in people predisposed to mental health problems.No estimate has been made of the annual cost to the National Health Service specifically of cannabis-related health conditions or the impact of cannabis-related mental health conditions on NHS finances. An assessment cannot be accurately made because the data relating to cannabis and mental health related health conditions and admissions is presented across various settings. The diagnosis code for ‘mental and behavioural disorders due to use of cannabinoids’ does not include admissions to mental health hospitals or cannabis-related treatment occurring outside of a hospital setting.Dame Carol Black’s review of evidence related to drugs, published in February 2020, estimated the cost to the NHS of illegal drug use, not substance specific, at £431 million per annum. This includes admissions in secondary care, prison treatment and infectious disease. However, this figure does not include other NHS costs such as primary care or accident & emergency usage so will be an underestimate.

What recent assessment his Department has made of the potential impact of cannabis-related mental health admissions on NHS finances.

The Department is committed to reducing the harm from all illicit drugs. Any illegal drug use, including cannabis, can be harmful, both from immediate side-effects and long-term physical and mental health problems. It can, for some, have a negative impact on their fertility. Cannabis use can contribute to and exacerbate existing mental health problems or can accelerate their development in people predisposed to mental health problems.No estimate has been made of the annual cost to the National Health Service specifically of cannabis-related health conditions or the impact of cannabis-related mental health conditions on NHS finances. An assessment cannot be accurately made because the data relating to cannabis and mental health related health conditions and admissions is presented across various settings. The diagnosis code for ‘mental and behavioural disorders due to use of cannabinoids’ does not include admissions to mental health hospitals or cannabis-related treatment occurring outside of a hospital setting.Dame Carol Black’s review of evidence related to drugs, published in February 2020, estimated the cost to the NHS of illegal drug use, not substance specific, at £431 million per annum. This includes admissions in secondary care, prison treatment and infectious disease. However, this figure does not include other NHS costs such as primary care or accident & emergency usage so will be an underestimate.

What assessment he has made of the potential impact of the proposed increase in the certificate of sponsorship fee on recruitment in the social care sector.

The Immigration and Nationality (Fees) (Amendment) Order 2025, laid on 21 January 2025, sets out increases to the fee maxima that applies to the Certificate of Sponsorship from £300 to £525. These changes were agreed via collective agreement. If fees increase as set out in the Explanatory Memorandum to this Order, an Impact Assessment will be produced by the Home Office.International recruitment has played a valuable role in helping to grow the adult social care workforce. The Government recognises the scale of reforms needed to make the adult social care sector attractive, to support sustainable workforce growth and improve the retention of the domestic workforce. The Government is making available up to £3.7 billion of additional funding for social care authorities in 2025/26, which includes an £880 million increase in the Social Care Grant.

Whether his Department has considered funding public health campaigns to educate young people on the risks of cannabis use within a regulated market.

Cannabis is controlled as a Class B drug under the Misuse of Drugs Act 1971.The Government recognises the clear medical and scientific evidence of the harms of this drug.The Government will continue to work with our partners to discourage drug use and to alert people, particularly young people, to the potential dangers of cannabis.The Government has a drug information and advice service called Talk to FRANK, which aims to reduce drug misuse and its harms by increasing awareness, particularly for young people and parents. FRANK offers easy to read information on the risks of using cannabis and basic harm reduction advice. Information on cannabis is available at the following link:https://www.talktofrank.com/drug/cannabisThe website also has details of drug treatment services and support organisations.

What assessment he has made with Cabinet colleagues of the potential impact of proposed changes to the level of the certificate of sponsorship fee per worker on the adequacy of the funding settlement for adult social care announced in the Autumn Budget 2024.

The Immigration and Nationality (Fees) (Amendment) Order 2025, laid on 21 January 2025, sets out increases to the fee maxima that applies to the Certificate of Sponsorship from £300 to £525. These changes were agreed via collective agreement. If fees increase as set out in the Explanatory Memorandum to this Order, an Impact Assessment will be produced by the Home Office.International recruitment has played a valuable role in helping to grow the adult social care workforce. The Government recognises the scale of reforms needed to make the adult social care sector attractive, to support sustainable workforce growth and improve the retention of the domestic workforce. The Government is making available up to £3.7 billion of additional funding for social care authorities in 2025/26, which includes an £880 million increase in the Social Care Grant.

What assessment he has made of the potential impact of the planned increase in employer National Insurance contributions on GPs.

We have made necessary decisions to fix the foundations of the public finances in the Autumn Budget. Resource spending for the Department will be £22.6 billion more in 2025/26 than in 2023/24, as part of the Spending Review settlement. The employers’ National Insurance rise will be implemented in April 2025.We are investing an additional £889 million in general practice to reinforce the front door of the National Health Service, bringing total spend on the GP Contract to £13.2 billion in 2025/26. This is the biggest increase in over a decade.

What assessment he has made of the adequacy of the Carr-Hill formula in allocating funding for GP practices in areas with high levels of deprivation.

The Carr-Hill formula aims to ensure that resources are directed to general practices (GPs) based on an estimate of their patient workload. It takes into account many factors under two groups, namely 'drivers of workload' and 'unavoidable costs', including additional needs related to morbidity and mortality, but it does not specifically address deprivation. Plans to review this funding formula may be revisited in future. However, any changes would need careful planning to ensure they do not threaten stability or cause financial uncertainty for GPs.We are committed to ensuring that primary care medical services receive appropriate support and resources. We recently announced a proposed funding uplift for GPs for 2025/26 of £889 million. This is the largest uplift to GP funding since the beginning of the five-year framework and means a rising share of total National Health Service resources being directed towards GPs.

What assessment he has made of the adequacy of the Additional Roles Reimbursement Scheme.

The Additional Roles Reimbursement Scheme (ARRS) is subject to annual review as part of the consultation on the GP contract with professional representatives.The consultation on the 2025/26 GP contract has now concluded and the General Practitioners Committee England has voted in support of the proposed changes for 25/26. Several changes have been confirmed to increase the flexibility of the ARRS. This includes general practitioners (GPs) and practice nurses included in the main ARRS funding pot, an uplift of the maximum reimbursable rate for GPs in the scheme, and no caps on the number of GPs that can be employed through the scheme.

How many GPs have been employed under the Additional Roles Reimbursement Scheme.

Primary care networks have been able to recruit newly qualified general practitioners (GPs) through the scheme since October 2024, with £82 million in funding provided in 2024/25. Information on the number of recently qualified GPs for which primary care networks are claiming reimbursement via the Additional Roles Reimbursement Scheme is currently being collated, but is not yet published. We are working to verify the data and establish its reliability, which is necessary before any dataset can be published.

What assessment has he made of the number of registered GPs not in employment; and whether he is taking steps to reduce the number of unemployed GPs.

We hugely value the critical role that general practitioners (GPs) play and are determined to address the issues they face by shifting the focus of the National Health Service beyond hospitals and into the community. The Government committed to recruiting over 1,000 recently qualified GPs through an £82 million boost to the Additional Roles Reimbursement Scheme (ARRS) over 2024/25, as part of an initiative to address GP unemployment and secure the future pipeline of GPs.We are investing an additional £889 million through the GP contract to reinforce the front door of the NHS, bringing total spend on the GP Contract to £13.2 billion in 2025/26. This is the biggest increase in over a decade.Under recently announced changes to the GP contract in 2025/26, the ARRS will become more flexible to allow primary care networks (PCNs) to respond better to local workforce needs. The two ARRS pots will be combined to create a single pot for reimbursement of patient facing staff costs. There will be no restrictions on the number or type of staff covered, including GPs and practice nurses.In a drive to recruit GPs via the ARRS and to bring back the family doctor, the salary element of the maximum reimbursement amount that PCNs can claim for GPs will be increased from £73,113 in 2024/25, the bottom of the salaried GP pay range, to £82,418, an uplift of £9,305 representing the lower quartile of the salaried GP pay range, as some GPs will be entering their second year in the scheme. Proportionate employer on-costs will also be included within the overall maximum reimbursement amount which PCNs will be able to claim.Data on the number of unemployed GPs is not held centrally.

What assessment has he made of the adequacy of the mechanisms in place for ICBs to hold Swift Queue to account for faulty services.

NHS England has not undertaken a specific assessment of the mechanisms in place for integrated care boards (ICBs) to hold Swift Queue accountable for service performance. However, ICBs, as commissioners of local health services, are responsible for ensuring that contracted service providers, including those providing digital booking systems, meet agreed performance and quality standards.Where issues arise with faulty services, ICBs have contractual levers available to address concerns, which may include service improvement plans, financial penalties, or contract reviews. If a specific issue has been identified with Swift Queue’s service provision, affected ICBs are expected to take appropriate action to resolve the matter in the interests of patient care. Where an ICB identifies systemic failures with Swift Queue or any similar provider, they can escalate concerns through NHS England and the relevant regulatory bodies.To note, ICBs are not always responsible for commissioning services like Swift Queue. National Health Service trusts may also directly procure and manage such contracts for their own operations. If an NHS trust has commissioned Swift Queue, then it holds responsibility for ensuring the system functions properly, using its contractual levers to address service issues. Regardless of the commissioner, ICB or trust, NHS England can provide oversight and guidance if widespread or systemic issues arise with the platform.

For what reason rheumatoid arthritis patients are not entitled to free NHS prescriptions; and if he will take steps to review the eligibility for free prescriptions for those patients.

There are no current plans to review the list of prescription charge exemptions or the list of medical conditions that entitle someone to apply for a medical exemption certificate.There are extensive arrangements in place in England to ensure that prescriptions are affordable for everyone. Approximately 89% of prescription items are dispensed free of charge in the community in England, and there is a wide range of exemptions from prescription charges already in place for which those with rheumatoid arthritis may be eligible. Eligibility depends on the patient’s age, whether they are in qualifying full-time education, whether they are pregnant or have recently given birth, whether they have a qualifying medical condition or whether they are in receipt of certain benefits or a war pension.People on low incomes can apply for help with their health costs through the NHS Low Income Scheme. Prescription prepayment certificates (PPCs) are also available. PPCs allow people to claim as many prescriptions as they need for a set cost, with 3-month and 12-month certificates available. The 12-month PPC can be paid for in instalments.

What the cost to the NHS is of sourcing a haematopoietic stem cell donation from the UK Aligned Stem Cell Registry compared to stem cell donation imports from United States, Germany and Poland; and what the oversight mechanism is for agreeing these costs.

Details on the costs of haematopoietic stem cell transplants are not held centrally by the Department.The UK Aligned Stem Cell Registry supplies stem cells from United Kingdom donors to the National Health Service. It is made up of four partners: Anthony Nolan and DKMS UK, which are both independent charities; NHS Blood and Transplant; and the Welsh Bone Marrow Donor Registry. The cost to the NHS for provisions of donated peripheral blood stem cells (PBSCs), cord blood units and donor lymphocytes from UK sources is reviewed annually by the UK Aligned Registry partners and reflects the costs involved in the provision of cell products. Costs are communicated to transplant centres by Anthony Nolan on behalf of the Aligned Registry, with due notice of implementation. Cost increases are maintained at or below inflation with adjustments to avoid any corresponding large increase in a given year.For products from international sources, Anthony Nolan is the importing organisation. Products are charged at the international registry fee plus a flat service fee. The international registry fee can vary significantly, depending on the organisation or country from which the product is being imported, the graft source, whether it be PBSCs, bone marrow or cord blood units, and the current foreign exchange rate. The service fee includes: management and maintenance of the search system and international search connections; facilitating the import of the stem cell product; quality assurance and management; and legal and insurance costs for the import of stem cell products.Fees for both UK and international cell products are charged directly to NHS transplant centres. NHS England has oversight of the tariff paid to NHS hospitals to cover the cost of unrelated donor transplantation and individual NHS hospitals or Trusts oversee how funds for unrelated transplants are allocated.The choice of donor is made by the medical team, who choose the donor they feel will be best for their patient, whether that is a donor available in the UK or one available overseas.

What steps his Department is taking to improve the number of haemopoietic stem cell transplants sourced from the UK.

The Department’s Stem Cell Programme has provided £2.4 million of funding for the period 2022-25. The programme is being delivered by NHS Blood and Transplant (NHSBT) and Anthony Nolan. It aims to enhance the resilience of the United Kingdom's stem cell supply by strategically recruiting donors, particularly those most likely to donate, and to address health disparities through targeted campaigns, with a focus on ethnic minority communities. By increasing the pool of potential donors, the programme seeks to improve the availability of matches in the UK, ultimately reducing waiting times for patients in need of stem cell treatment.The UK aligned registry has over 2.3 million potential stem cell donors registered. NHSBT and Anthony Nolan are raising awareness of the importance of stem cell donation and increasing the number of donors on the register through a range of methods including partnering with community organisations, working with volunteer student groups, and engaging with active blood, plasma and platelet donors.

What percentage of haemopoietic stem cell transplant performed by the NHS were from UK registered donors between 1 October 2024 to 31 December 24 or the last three months for which data is available.

For the third quarter of 2024/25, registered donors in the United Kingdom provided by the Aligned Registry accounted for 23% (n=73) of the total unrelated, allogeneic haematopoietic stem cell transplants (n=311) for UK patients.

Whether it is his Department's policy that babies in the third trimester that have been removed from their mother after her death should not be (a) recognised and (b) recorded as stillborn.

The definition of a stillborn child in England and Wales is contained in the Births and Deaths Registration Act 1953 section 41, and was amended by the Stillbirth (Definition) Act 1992 section 1(1). This act defines a stillbirth as ‘a child which has issued forth from its mother after the 24th week of pregnancy and which did not at any time breathe or show any other signs of life’.It is expected that babies are recognised and recorded as stillborn in accordance with this definition.

What assessment he has made of the potential merits of making women with endometriosis eligible for flu vaccinations.

Eligibility for the seasonal influenza vaccination programme is based, each year, on the expert advice and recommendations of the independent Joint Committee on Vaccination and Immunisation (JCVI) with the aim to protect those most at risk of serious illness and hospitalisation. This advice is kept under regular review.The latest JCVI advice for the 2025/26 flu season is available at the following link:https://www.gov.uk/government/publications/flu-vaccines-2025-to-2026-jcvi-advice/jcvi-statement-on-influenza-vaccines-for-2025-to-2026

What steps his Department is taking to make Sleepio accessible to NHS patients in Lambeth.

Sleepio is available for local commissioning by integrated care systems should they choose to commission this product, as part of local insomnia care and treatment pathways.No central assessments relating to funding or availability of this product are currently planned.