Written questions by Maguire.

What assessment his Department has made of patient outcomes for those undergoing heroin detoxification using Buvidal compared to Methadone.

No assessment has been made on patient outcomes for those undergoing heroin detoxification using buprenorphine long-acting injection, branded Buvidal, compared to methadone specifically. The Office for Health Improvement and Disparities is currently undertaking analysis of National Drug Treatment Monitoring System data to look at the comparative outcomes between Buvidal and other opioid substitution treatment medicines generally, not just methadone. This work is currently incomplete.Treatment decisions are taken between a person and their clinician to ensure the right option for them, and long-acting injectable buprenorphine, branded as Buvidal, oral buprenorphine, and methadone should be offered as part of a package of care, alongside the usual talking therapies and recovery support that can help people stay off drugs. Local authorities are responsible for commissioning drug and alcohol services according to local need, and this includes the provision of buprenorphine long-acting injections.

What steps his Department is taking to (a) train, (b) recruit and (c) retain GPs in (i) North Cornwall constituency and (ii) other rural areas.

We acknowledge the urgent challenge of ensuring that rural areas, including North Cornwall, have the resources to continue serving their patients. To address this, we will increase capacity in general practice (GP) and ensure that rural areas have the necessary workforce to provide integrated, patient-centred services.We are committed to training thousands more GPs across the country, including in rural areas, and have 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. My Rt Hon. Friend, the Secretary of State for Health and Social Care has confirmed that recently qualified GPs who are employed via the ARRS will continue to be supported through the scheme in 2025/26.Cornwall and the Isles of Scilly have a full-time equivalent rate of 4.8 GPs, almost double the national rate of 2.5, per weighted 10,000 population. The NHS Cornwall and Isles of Scilly Integrated Care Board commissions the Cornwall Primary Care Training Hub to support and provide training, recruitment, and retention of GPs and other staff for all practices across Cornwall and the Isles of Scilly, including the North Cornwall constituency, as part of the north and east integrated care area. This includes relocation support, coaching and mentoring, professional development opportunities, sponsorship for international graduates, and bespoke support for GP partner retention. Thirty-six doctors are recruited into the Cornwall training programme annually, and this has increased by two for 2025/26 recruitment.

Whether he has made an assessment of the potential impact of the changes made to the death certification process implemented in September 2024 on the time taken to process death certificates.

The Government is monitoring the impact of the death certification reforms which came into legal effect on 9 September 2024. Early data indicates the median time taken to register a death appears to have risen by one day, from seven days to eight. This figure is for all deaths, as it includes those certified by a doctor and those investigated by a coroner. The average time taken to register has increased further over the Christmas weeks, but this was expected given increases are observed during this period every year. Latest data from the Office for National Statistics indicates that the average time has subsequently decreased.The median time taken to register a death varies depending on the type of certification. Deaths certified by a doctor, that comprise approximately 80% of deaths registered each week, have typically had a median time to registration of seven days, though there can be variation at a local level. It is important to note that the medical examiner system was active on a non-statutory basis before the introduction of the statutory system on 9 September 2024, and this makes direct ‘before’ and ‘after’ comparisons challenging to draw conclusions from.The core purposes of the death certification reforms are to introduce scrutiny of the cause of death to detect and deter malpractice, to improve reporting, and crucially to put the bereaved at the centre of the process by offering a conversation with the medical examiner about the cause of death. The expectation on doctors and medical examiners is clear, that they should complete certification as quickly and efficiently as possible, and the Government is working with all stakeholders to make sure this is the case.

Whether he has made an assessment of the potential impact of the changes made to the death certification process implemented in September 2024 on the time taken to process death certificates.

The Government is monitoring the impact of the death certification reforms which came into legal effect on 9 September 2024. Early data indicates the median time taken to register a death appears to have risen by one day, from seven days to eight. This figure is for all deaths, as it includes those certified by a doctor and those investigated by a coroner. The average time taken to register has increased further over the Christmas weeks, but this was expected given increases are observed during this period every year. Latest data from the Office for National Statistics indicates that the average time has subsequently decreased.The median time taken to register a death varies depending on the type of certification. Deaths certified by a doctor, that comprise approximately 80% of deaths registered each week, have typically had a median time to registration of seven days, though there can be variation at a local level. It is important to note that the medical examiner system was active on a non-statutory basis before the introduction of the statutory system on 9 September 2024, and this makes direct ‘before’ and ‘after’ comparisons challenging to draw conclusions from.The core purposes of the death certification reforms are to introduce scrutiny of the cause of death to detect and deter malpractice, to improve reporting, and crucially to put the bereaved at the centre of the process by offering a conversation with the medical examiner about the cause of death. The expectation on doctors and medical examiners is clear, that they should complete certification as quickly and efficiently as possible, and the Government is working with all stakeholders to make sure this is the case.

What recent assessment his Department has made of the adequacy of NHS dental capacity in Bude.

Data on dental activity is available at integrated care board (ICB) level, with statistics available from the NHS Business Services Authority. These are available at the following link, with the most recent statistics for 2023/24 having been published on 22 August 2024: https://www.nhsbsa.nhs.uk/statistical-collections/dental-england/dental-statistics-england-202324 The data for NHS Cornwall and Isles of Scilly ICB, which includes Bodmin, Bude, Camelford, Launceston, Padstow, Wadebridge, Tintagel, Delabole, Port Isaac and Saint Columb Major, shows that 34% of adults were seen by a National Health Service dentist in the previous 24 months up to June 2024, compared to 40% in England; and 48% of children were seen by an NHS dentist in the previous 12 months up to June 2024, compared to 56% in England. The Government plans to tackle the challenges for patients trying to access NHS dental care with a rescue plan to provide 700,000 more urgent dental appointments and recruit new dentists to areas that need them most. To rebuild dentistry in the long term, we will reform the dental contract with the sector, with a shift to focus on prevention and the retention of NHS dentists.

What recent assessment his Department has made of the adequacy of NHS dental capacity in Camelford.

Data on dental activity is available at integrated care board (ICB) level, with statistics available from the NHS Business Services Authority. These are available at the following link, with the most recent statistics for 2023/24 having been published on 22 August 2024: https://www.nhsbsa.nhs.uk/statistical-collections/dental-england/dental-statistics-england-202324 The data for NHS Cornwall and Isles of Scilly ICB, which includes Bodmin, Bude, Camelford, Launceston, Padstow, Wadebridge, Tintagel, Delabole, Port Isaac and Saint Columb Major, shows that 34% of adults were seen by a National Health Service dentist in the previous 24 months up to June 2024, compared to 40% in England; and 48% of children were seen by an NHS dentist in the previous 12 months up to June 2024, compared to 56% in England. The Government plans to tackle the challenges for patients trying to access NHS dental care with a rescue plan to provide 700,000 more urgent dental appointments and recruit new dentists to areas that need them most. To rebuild dentistry in the long term, we will reform the dental contract with the sector, with a shift to focus on prevention and the retention of NHS dentists.

What recent assessment his Department has made of the adequacy of NHS dental capacity in Wadebridge.

Data on dental activity is available at integrated care board (ICB) level, with statistics available from the NHS Business Services Authority. These are available at the following link, with the most recent statistics for 2023/24 having been published on 22 August 2024: https://www.nhsbsa.nhs.uk/statistical-collections/dental-england/dental-statistics-england-202324 The data for NHS Cornwall and Isles of Scilly ICB, which includes Bodmin, Bude, Camelford, Launceston, Padstow, Wadebridge, Tintagel, Delabole, Port Isaac and Saint Columb Major, shows that 34% of adults were seen by a National Health Service dentist in the previous 24 months up to June 2024, compared to 40% in England; and 48% of children were seen by an NHS dentist in the previous 12 months up to June 2024, compared to 56% in England. The Government plans to tackle the challenges for patients trying to access NHS dental care with a rescue plan to provide 700,000 more urgent dental appointments and recruit new dentists to areas that need them most. To rebuild dentistry in the long term, we will reform the dental contract with the sector, with a shift to focus on prevention and the retention of NHS dentists.

What recent assessment his Department has made of the adequacy of NHS dental capacity in Padstow.

Data on dental activity is available at integrated care board (ICB) level, with statistics available from the NHS Business Services Authority. These are available at the following link, with the most recent statistics for 2023/24 having been published on 22 August 2024: https://www.nhsbsa.nhs.uk/statistical-collections/dental-england/dental-statistics-england-202324 The data for NHS Cornwall and Isles of Scilly ICB, which includes Bodmin, Bude, Camelford, Launceston, Padstow, Wadebridge, Tintagel, Delabole, Port Isaac and Saint Columb Major, shows that 34% of adults were seen by a National Health Service dentist in the previous 24 months up to June 2024, compared to 40% in England; and 48% of children were seen by an NHS dentist in the previous 12 months up to June 2024, compared to 56% in England. The Government plans to tackle the challenges for patients trying to access NHS dental care with a rescue plan to provide 700,000 more urgent dental appointments and recruit new dentists to areas that need them most. To rebuild dentistry in the long term, we will reform the dental contract with the sector, with a shift to focus on prevention and the retention of NHS dentists.

What recent assessment his Department has made of the adequacy of NHS dental capacity in Port Isaac.

Data on dental activity is available at integrated care board (ICB) level, with statistics available from the NHS Business Services Authority. These are available at the following link, with the most recent statistics for 2023/24 having been published on 22 August 2024: https://www.nhsbsa.nhs.uk/statistical-collections/dental-england/dental-statistics-england-202324 The data for NHS Cornwall and Isles of Scilly ICB, which includes Bodmin, Bude, Camelford, Launceston, Padstow, Wadebridge, Tintagel, Delabole, Port Isaac and Saint Columb Major, shows that 34% of adults were seen by a National Health Service dentist in the previous 24 months up to June 2024, compared to 40% in England; and 48% of children were seen by an NHS dentist in the previous 12 months up to June 2024, compared to 56% in England. The Government plans to tackle the challenges for patients trying to access NHS dental care with a rescue plan to provide 700,000 more urgent dental appointments and recruit new dentists to areas that need them most. To rebuild dentistry in the long term, we will reform the dental contract with the sector, with a shift to focus on prevention and the retention of NHS dentists.

What recent assessment his Department has made of the adequacy of NHS dental capacity in Launceston.

Data on dental activity is available at integrated care board (ICB) level, with statistics available from the NHS Business Services Authority. These are available at the following link, with the most recent statistics for 2023/24 having been published on 22 August 2024: https://www.nhsbsa.nhs.uk/statistical-collections/dental-england/dental-statistics-england-202324 The data for NHS Cornwall and Isles of Scilly ICB, which includes Bodmin, Bude, Camelford, Launceston, Padstow, Wadebridge, Tintagel, Delabole, Port Isaac and Saint Columb Major, shows that 34% of adults were seen by a National Health Service dentist in the previous 24 months up to June 2024, compared to 40% in England; and 48% of children were seen by an NHS dentist in the previous 12 months up to June 2024, compared to 56% in England. The Government plans to tackle the challenges for patients trying to access NHS dental care with a rescue plan to provide 700,000 more urgent dental appointments and recruit new dentists to areas that need them most. To rebuild dentistry in the long term, we will reform the dental contract with the sector, with a shift to focus on prevention and the retention of NHS dentists.

What recent assessment his Department has made of the adequacy of NHS dental capacity in Tintagel.

Data on dental activity is available at integrated care board (ICB) level, with statistics available from the NHS Business Services Authority. These are available at the following link, with the most recent statistics for 2023/24 having been published on 22 August 2024: https://www.nhsbsa.nhs.uk/statistical-collections/dental-england/dental-statistics-england-202324 The data for NHS Cornwall and Isles of Scilly ICB, which includes Bodmin, Bude, Camelford, Launceston, Padstow, Wadebridge, Tintagel, Delabole, Port Isaac and Saint Columb Major, shows that 34% of adults were seen by a National Health Service dentist in the previous 24 months up to June 2024, compared to 40% in England; and 48% of children were seen by an NHS dentist in the previous 12 months up to June 2024, compared to 56% in England. The Government plans to tackle the challenges for patients trying to access NHS dental care with a rescue plan to provide 700,000 more urgent dental appointments and recruit new dentists to areas that need them most. To rebuild dentistry in the long term, we will reform the dental contract with the sector, with a shift to focus on prevention and the retention of NHS dentists.

What recent assessment his Department has made of the adequacy of NHS dental capacity in Bodmin.

Data on dental activity is available at integrated care board (ICB) level, with statistics available from the NHS Business Services Authority. These are available at the following link, with the most recent statistics for 2023/24 having been published on 22 August 2024: https://www.nhsbsa.nhs.uk/statistical-collections/dental-england/dental-statistics-england-202324 The data for NHS Cornwall and Isles of Scilly ICB, which includes Bodmin, Bude, Camelford, Launceston, Padstow, Wadebridge, Tintagel, Delabole, Port Isaac and Saint Columb Major, shows that 34% of adults were seen by a National Health Service dentist in the previous 24 months up to June 2024, compared to 40% in England; and 48% of children were seen by an NHS dentist in the previous 12 months up to June 2024, compared to 56% in England. The Government plans to tackle the challenges for patients trying to access NHS dental care with a rescue plan to provide 700,000 more urgent dental appointments and recruit new dentists to areas that need them most. To rebuild dentistry in the long term, we will reform the dental contract with the sector, with a shift to focus on prevention and the retention of NHS dentists.

What recent assessment his Department has made of NHS dentist capacity in Saint Columb Major.

Data on dental activity is available at integrated care board (ICB) level, with statistics available from the NHS Business Services Authority. These are available at the following link, with the most recent statistics for 2023/24 having been published on 22 August 2024: https://www.nhsbsa.nhs.uk/statistical-collections/dental-england/dental-statistics-england-202324 The data for NHS Cornwall and Isles of Scilly ICB, which includes Bodmin, Bude, Camelford, Launceston, Padstow, Wadebridge, Tintagel, Delabole, Port Isaac and Saint Columb Major, shows that 34% of adults were seen by a National Health Service dentist in the previous 24 months up to June 2024, compared to 40% in England; and 48% of children were seen by an NHS dentist in the previous 12 months up to June 2024, compared to 56% in England. The Government plans to tackle the challenges for patients trying to access NHS dental care with a rescue plan to provide 700,000 more urgent dental appointments and recruit new dentists to areas that need them most. To rebuild dentistry in the long term, we will reform the dental contract with the sector, with a shift to focus on prevention and the retention of NHS dentists.

What recent assessment his Department has made of the adequacy of NHS dental capacity in Delabole.

Data on dental activity is available at integrated care board (ICB) level, with statistics available from the NHS Business Services Authority. These are available at the following link, with the most recent statistics for 2023/24 having been published on 22 August 2024: https://www.nhsbsa.nhs.uk/statistical-collections/dental-england/dental-statistics-england-202324 The data for NHS Cornwall and Isles of Scilly ICB, which includes Bodmin, Bude, Camelford, Launceston, Padstow, Wadebridge, Tintagel, Delabole, Port Isaac and Saint Columb Major, shows that 34% of adults were seen by a National Health Service dentist in the previous 24 months up to June 2024, compared to 40% in England; and 48% of children were seen by an NHS dentist in the previous 12 months up to June 2024, compared to 56% in England. The Government plans to tackle the challenges for patients trying to access NHS dental care with a rescue plan to provide 700,000 more urgent dental appointments and recruit new dentists to areas that need them most. To rebuild dentistry in the long term, we will reform the dental contract with the sector, with a shift to focus on prevention and the retention of NHS dentists.

If he will have discussions with the Integrated Care Board on the need for GP surgeries in Camelford and Bodmin.

Integrated care boards (ICB) are responsible for planning and commissioning healthcare services to meet the reasonable needs of the people for whom they are responsible, including primary medical services. ICBs are best placed to understand the needs of their local population and to make decisions on new general practice (GP) surgeries based on those needs. ICBs’ annual commissioning plans must consider requirements for new practices, including those driven by population growth, contract expiries, or unplanned closures. We expect ICBs to act if services are not meeting the reasonable needs of their patients.The Government is committed to delivering a National Health Service that is fit for the future. That is why we have set out our commitment to fix the front door to the NHS, for example through the £102 million of capital funding announced at the Autumn Budget for upgrades to GP estates over the next financial year.We know that some patients are struggling to see a GP and we are committed to improving GP provision across the country, including in the Cornwall and Isles of Scilly ICB area.We recognise the pressure that housing developments can place upon local health infrastructure. At a national level, we continue to work closely with the Ministry of Housing, Communities and Local Government to address this issue in national planning guidance and ensure all new and existing developments have an adequate level of healthcare infrastructure for the community.

If his Department will undertake a review of the prescription charge exemption list to include more (a) chronic and (b) lifelong conditions.

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 long term or chronic conditions 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 three-month and 12-month certificates available. The 12-month PPC can be paid for in instalments.

What steps he is taking to make NHS dental care more accessible for people in North Cornwall constituency.

This Government plans to tackle the challenges for patients trying to access National Health Service dental care with a rescue plan to provide 700,000 more urgent dental appointments and recruit new dentists to areas that need them most. To rebuild dentistry in the long term, we will reform the dental contract, with a shift to focus on prevention and the retention of NHS dentists.The responsibility for commissioning primary care services, including NHS dentistry, to meet the needs of the local population is delegated to integrated care boards (ICBs) across England. For North Cornwall constituency, this is the Cornwall and Isles of Scilly ICB. The Cornwall and Isles of Scilly ICB is taking actions to make NHS dental care more accessible, including the commissioning of additional urgent dental care appointments across the South-West, a dental helpline for urgent advice; and an access pilot project in Cornwall to support the most vulnerable people to access an NHS dentist.

Whether his Department has made an assessment of the potential merits of reforming the NHS dental contract to (a) make appointments more accessible and (b) to tackle the backlog of people waiting for NHS dental appointments.

To rebuild dentistry in the long term, we will reform the dental contract, with a shift to focus on prevention and the retention of National Health Service dentists. There are no perfect payment systems and careful consideration needs to be given to any potential changes to the complex dental system so that we deliver a system better for patients and the profession.

What steps his Department is taking to reduce the backlog of people waiting for NHS dental appointments in North Cornwall constituency.

This Government plans to tackle the challenges for patients trying to access National Health Service dental care with a rescue plan to provide 700,000 more urgent dental appointments and recruit new dentists to areas that need them most. To rebuild dentistry in the long term, we will reform the dental contract, with a shift to focus on prevention and the retention of NHS dentists.The responsibility for commissioning primary care services, including NHS dentistry, to meet the needs of the local population is delegated to integrated care boards (ICBs) across England. For North Cornwall constituency, this is the Cornwall and Isles of Scilly ICB. The Cornwall and Isles of Scilly ICB is taking actions to make NHS dental care more accessible, including the commissioning of additional urgent dental care appointments across the South-West, a dental helpline for urgent advice; and an access pilot project in Cornwall to support the most vulnerable people to access an NHS dentist.

What steps his Department is taking to improve ambulance waiting times in Bude.

The Government has committed to supporting the National Health Service to improve performance and achieve the standards set out in the NHS Constitution, including for ambulance response times.As a first step, my Rt. Hon. Friend, the Secretary of State for Health and Social Care, appointed Professor Lord Darzi to lead an independent investigation of the NHS’ performance. The investigation’s findings were published on 12 September 2024 and will feed into the Government’s work on a 10-Year Health Plan to radically reform the NHS and build a health service that is fit for the future.Ahead of this winter, NHS England has set out the priorities for the NHS to maintain and improve patient safety and experience, including actions to support patient flow and ensure ambulances are released in a timely way. NHS England’s winter letter, sent to all integrated care boards including NHS Cornwall and Isles of Scilly Integrated Care Board which serves Bude, is available at the following link:https://www.england.nhs.uk/long-read/winter-and-h2-priorities