Written questions by Dewhirst.

Whether his Department has made an assessment of the potential impact of proposed changes to NHS staffing levels on the economy of local communities.

NHS England has asked integrated care boards (ICBs) to act primarily as strategic commissioners of health and care services and reduce duplication of responsibilities within the health and care structure. To deliver on this commitment, ICBs have drafted and shared their delivery and resource plan including staffing management in accordance with the guidance set out in Sir Jim Mackey's letter of 1 April 2025 and the Model ICB framework. NHS England is working with ICBs to review and implement these plans.NHS England is also working closely with ICBs to ensure these changes do not compromise quality of care or the statutory responsibilities of ICBs. We expect ICBs to consider how these changes impact on staff and take the necessary steps to protect frontline staff. No specific assessment has been made in regard to the impact on the economy of the local communities.

What assessment his Department has made of the capacity of Integrated Care Boards to deliver services effectively (a) during and (b) after proposed structural reforms.

NHS England has asked integrated care boards (ICBs) to act primarily as strategic commissioners of health and care services and reduce duplication of responsibilities within the health and care structure. To deliver on this commitment, ICBs have drafted and shared their delivery and resource plan including staffing management in accordance with the guidance set out in Sir Jim Mackey's letter of 1 April 2025 and the Model ICB framework. NHS England is working with ICBs to review and implement these plans.NHS England is working closely with ICBs to ensure these changes do not compromise quality of care or the statutory responsibilities of ICBs.

What assessment his Department has made of the potential impact of proposed NHS workforce reductions on (a) East Yorkshire and (b) other (i) rural and (ii) coastal communities.

NHS England has asked integrated care boards (ICBs) to act primarily as strategic commissioners of health and care services and reduce duplication of responsibilities within the health and care structure. All ICBs, including Humber and North Yorkshire ICB and other ICBs covering rural and coastal areas, have drafted and shared their delivery and resource plan in accordance with the guidance set out in Sir Jim Mackey's letter of 1 April 2025 and the Model ICB framework. NHS England is working with ICBs to review and implement these plans.NHS England is working closely with ICBs to ensure these changes do not compromise quality of care or the statutory responsibilities of ICBs. We expect ICBs to consider how these changes impact on staff and take the necessary steps to protect frontline staff. No specific assessment of impact has been made for rural and coastal communities.

What (a) analysis and (b) modelling he used for the target of 50% reduction in staff across (i) NHS England and (ii) his Department; and whether that target was based on (A) internal performance reviews, (B) external advice and (C) financial modelling.

The future Department will be smaller, more agile, and more efficient, delivering value for money for the public and empowering our health system to improve health and care for patients. To realise this vision, the new Department will be stripped of duplication and bureaucracy. It will also need to operate very differently from the current arrangement, making important decisions about what it does and does not do and transforming ways of working.As part of these changes, we are intending to reduce the headcount across the Department and NHS England which will deliver hundreds of millions of pounds of savings each year which can be recycled into front line service delivery. Work is progressing to now take forward the detailed design and operating model for the new integrated organisation, and plan for the smooth transfer of people, functions and responsibilities. The precise reduction agreed will be done through careful design, deliberation and consultation in the spirit of making sure that the set-up is right for the longer term.

What estimate he has made of the projected total cost of redundancy packages arising from the proposed changes to NHS England and DHSC; and what estimate he has made of the net financial benefit after these costs are accounted for.

The future Department will be smaller, more agile, and more efficient, delivering value for money for the public and empowering our health system to improve health and care for patients. We recognise that to achieve this, there will be some short-term upfront costs as we undertake the integration of NHS England and the Department, but these costs and more will be recouped in future years because of a smaller and leaner centre. By the end of the process, we estimate that these changes will save hundreds of millions of pounds a year, which will be reinvested in frontline services. At this stage it is too early to say what the upfront costs of integration are, including any redundancy, while transition planning is ongoing.

If she will publish an impact assessment on the (a) proposed abolition of NHS England and (b) planned 50% reduction in the combined workforce of (i) NHS England and (ii) the Department for Health and Social Care.

It is only right that with such significant reform, we commit to carefully assessing and understanding the potential impacts, as is due process. Evidence from these ongoing assessments will inform our programme as appropriate. Furthermore, the Government is committed to transparency, and will consider how best to ensure the public and parliamentarians are informed of the outcomes and impact of both the abolition of NHS England and the reduction in workforce.

What cross-Departmental research his Department has commissioned into the link between (a) debt, (b) benefit sanctions, (c) child maintenance arrears and (d) suicide risk; and what mental health interventions are in place for people in financial hardship.

We recognise the effect that financial pressures, such as debt collection practices, benefit sanctions, and child maintenance arrears, can have on some people’s mental health and their risk of developing suicidal thoughts.The cross-Government, cross-sector suicide prevention strategy for England includes financial difficulty as a priority area for action and sets out work Government departments are doing to address this. For example, the Department for Work and Pensions has committed both to strengthening its guidance for staff to better support customers who disclose that they are experiencing suicidal thoughts, and mandating mental health awareness training for all frontline staff.We have also worked with colleagues at HM Treasury and the Money and Pensions Service to promote the mental health Breathing Space scheme, which gives those with mental ill health facing financial difficulties space to receive debt advice, without pressure from creditors or mounting debts.This is in addition to the mental health support available through general practitioners, NHS Talking Therapies, and NHS 111.

What assessment he has made of trends in the level of health inequalities in coastal communities.

The Honourable Member for Bridlington and the Wolds is right that coastal communities face unique challenges when it comes to health inequalities. Through our health mission, we are looking to halve the gap in healthy life expectancy between the richest and poorest regions.The NHS also has a programme to reduce health inequalities in the most deprived 20% of the population and improve outcomes for groups that experience the worst access, experience, and outcomes within the NHS. 6 Coastal Integrated Care Boards have been launched in coastal communities and are working to reduce economic inactivity as a mechanism for reducing health inequalities.

What steps he is taking to support ex-blue light service personnel with complex post-traumatic stress disorder.

National Health Service mental health services are available to support the mental health of ex blue light staff who have experienced trauma in their past or who might have post-traumatic stress disorder (PTSD). They can access evidence-based mental health treatment via their general practitioner or by self-referring to their local NHS Talking Therapies service, with details on how to do so available at the following link:https://www.nhs.uk/mental-health/talking-therapies-medicine-treatments/talking-therapies-and-counselling/nhs-talking-therapies/People with complex PTSD may be offered therapies used to treat it, such as trauma-focused cognitive behavioural therapy or eye movement desensitisation and reprocessing. They may also be offered treatment for other problems they may have, such as depression or alcohol addiction.

What steps he is taking to expand the availability of veteran-specific mental health services in (a) rural and (b) deprived areas.

NHS England commissions Op COURAGE, the integrated mental health and wellbeing service, which allows veterans to make self-referrals.The service has been designed to support veterans from all areas, including rural and deprived areas, and is delivered from a range of locations, including National Health Service trusts, general practices, Poppy Shops, veteran hubs, and drop-in centres. Elements of the service may also be provided online, if this is clinically appropriate. The Government recognises that not all veterans want to use veteran-specific mental health services and can instead choose to use mainstream NHS services, such as Talking Therapies, which are available to both veterans and civilians.Integrated care boards are responsible for providing health and care services to meet the needs of their local populations, taking into account local considerations such as access to services in rural areas.The Government recognises that too many people are not receiving the mental health care they need, and that waits for mental health services are too long. We are determined to change this and ensure that mental health has the same focus as physical health, to help people in rural areas access high quality mental health support when they need it.

With reference to the Register Of Interests Of Members' Secretaries And Research Assistants, published on 22 November 2024, whether Matthew Goodin (a) attends meetings in his Department and (b) sits in the special adviser's office.

Matthew Goddin does not attend Departmental meetings. As a member of Parliamentary staff, he meets with my Rt. Hon. Friend, the Secretary of State for Health and Social Care, to discuss Parliamentary business.

What estimate he has made of the potential increase in illegal tobacco sales as a consequence of the implementation of a generational ban on tobacco sales.

Evidence shows that when we have previously introduced targeted tobacco control measures, they have had a positive impact on tackling the problems of illicit tobacco. Consumption of illicit cigarettes has gone from 15 billion cigarettes in 2000/2001 to 1.5 billion cigarettes in 2022/2023. When the age of sale was increased from 16 to 18 years old in 2007, this created 1.3 million more people who were no longer able to be sold cigarettes, and who in theory would be in the market for illicit cigarettes. However, in practice, the number of illicit cigarettes consumed fell by 25%, from 10 billion in 2005/06 to 7.5 billion in 2007/08.The Government is investing over £100 million over five years to boost HM Revenue and Customs and Border Force’s enforcement capabilities to tackle illicit tobacco, supporting their Illicit Tobacco Strategy. In 2025/26 we will invest £30 million of new funding in total for enforcement agencies, including Trading Standards.

If he will make an estimate of the potential increase in incidents of (a) violent crime, (b) physical abuse and (c) verbal intimidation against shopkeepers as a result of a generational ban on tobacco sales.

Smoking is the number one preventable cause of death, disability, and ill health. The Tobacco and Vapes Bill will put us on track to a smoke-free United Kingdom, helping to reduce 80,000 preventable deaths, reduce the burden on the National Health Service, and reduce the burden on the taxpayer.The impact assessment for the bill was published on 5 November and is considered ‘fit for purpose’ by the Regulatory Policy Committee. Whilst the impact assessment was unable to provide an estimate for the number of incidents of abuse towards retail workers due to a lack of evidence, we will consider approaches to assess this specific impact, including using publicly available data, when evaluating the policy.To mitigate the risk that the smoke-free generation policy will increase the incidence of abuse towards retail workers, we are working closely with retailers and will continue to utilise the long lead-in time to best support retailers and the public in preparing for and implementing the changes to the legislation, which includes rolling out information campaigns for the public and retail workers.We will not stand for violence and abuse against shopworkers. Everyone has a right to feel safe on the job. The Government will introduce a new offence of assaulting a retail worker to protect the hardworking and dedicated staff that work in stores.

Whether the Government will take steps to support the mental health of shopkeepers responsible with enforcing the implementation of a generational ban on tobacco sales.

Smoking is the number one preventable cause of death, disability, and ill health. The Tobacco and Vapes Bill will put us on track to a smoke-free United Kingdom, helping to reduce 80,000 preventable deaths, reduce the burden on the National Health Service, and reduce the burden on the taxpayer.The impact assessment for the bill was published on 5 November and is considered ‘fit for purpose’ by the Regulatory Policy Committee. Whilst the impact assessment was unable to provide an estimate for the number of incidents of abuse towards retail workers due to a lack of evidence, we will consider approaches to assess this specific impact, including using publicly available data, when evaluating the policy.To mitigate the risk that the smoke-free generation policy will increase the incidence of abuse towards retail workers, we are working closely with retailers and will continue to utilise the long lead-in time to best support retailers and the public in preparing for and implementing the changes to the legislation, which includes rolling out information campaigns for the public and retail workers.We will not stand for violence and abuse against shopworkers. Everyone has a right to feel safe on the job. The Government will introduce a new offence of assaulting a retail worker to protect the hardworking and dedicated staff that work in stores.

What steps his Department is taking to help increase the screening rates for prostate cancer in men aged over 50; and if he will take steps to increase the level of funding available to help screen more men over 50 for prostate cancer.

Screening for prostate cancer is currently not recommended by the UK National Screening Committees (UK NSC) due to the inaccuracy of the current best test called the Prostate Specific Antigen (PSA). A PSA-based screening programme could harm some men as many would be diagnosed with a cancer that would not have caused them problems during their life. This would lead to additional tests and treatments which can also have harmful side effects, for example, sexual dysfunction and incontinence.That is why no steps have been taken to increase the screening rates and funding for prostate cancer screening for men over 50. However, the Government have invested £16 million into a trial seeking to find better methods of detecting prostate cancer.

Pursuant to the Answer of 17 October 2024 to Question 7005 on Department of Health and Social Care: Official Cars, if he will name which specific senior officials have access to a Government car; and whether those senior officials had access to a Government car before the 2024 general election.

For security reasons specific details of allocations including make and model of vehicles are not issued. The arrangements relating to the usage of vehicles in the Government Car Service are set out in the Civil Service Management Code.

Pursuant to the Answer of 18 October 2024 to Question 7004 on Department of Health and Social Care: Official Cars, whether any of the three vehicles are electric cars.

For security reasons specific details of allocations including make and model of vehicles are not issued. The arrangements relating to the usage of vehicles in the Government Car Service are set out in the Civil Service Management Code.

What his Department's policy is on the allocation of Government Car Service cars to senior officials; what the policy was on 24 May 2024; and which senior officials have been granted access to the service since 4 July 2024.

The Government Car Service (GCS) offers vehicles to Government departments as a shared resource. Each department independently determines the allocation of these vehicles.The arrangements relating to the using of vehicles in the GCS are set out in the Civil Service Management Code. There has been no change in this policy since the 2024 General Election.

Pursuant to the Answers of 6 September 2024 to Questions 2306 and 2308 on Ministers: Official Cars, which (a) Ministers and (b) officials in (i) his Department and (ii) NHS England have (A) been allocated a dedicated vehicle and (B) access to use of a shared vehicle from the Government Car Service; what the (1) make, (2) model and (3) fuel type is for each car; and what the budget was for those cars in the 2024-25 financial year.

The Government Car Service offers vehicles to Government departments as a shared resource. Each Department independently determines the allocation of these vehicles to its ministerial cadre/officials, as under previous administrations. The Department is currently allocated three vehicles including allocated and shared vehicles.For security reasons specific details of allocations including make and model of vehicles are not issued. The average cost to a Department for a single Department Pool Car in 2024/25 financial year is £108,000 per annum.

Pursuant to the answer of 2 September 2024 to Question 2636 on NHS England: Communication and Management Consultants, what is the monetary value of the communications and engagement lot for consultancy and advisory services framework run by NHS Shared Business Services, announced on 20 August 2024.

Lot four of the Consultancy and Advisory Services framework agreement for communications, engagement, and research services, managed by NHS Shared Business Services and announced on 20 August 2024, has an estimated value of £45 million, which is the maximum amount expected to be spent against this lot. The framework is available for use by the National Health Service and all United Kingdom public sector bodies outside of the NHS.