Written questions by Beales.

What assessment he has made of the potential merits of expanding access to HIV PrEP through community pharmacies.

The HIV Action Plan, published on World AIDS Day, 1 December 2025, sets out how the Government will enable every level of the healthcare system to work together to engage everyone in prevention, testing and treatment, tackle stigma, and reach our ambition to end new HIV transmissions by 2030. This includes a dedicated action to deliver tailored and targeted HIV prevention, treatment, and care services to meet the needs of local populations and address inequalities, including access to HIV pre-exposure prophylaxis (PrEP). Access to HIV PrEP in England is via commissioned level 3 sexual health services. These are commissioned by local authorities for people in the community. Decisions on the configuration of these services ultimately rest with local authorities, who may choose to involve pharmacies in PrEP pathways. To reduce inequalities in education, access, and uptake of HIV prevention interventions, the Government will work with local government on wider implementation of new PrEP approaches and technologies. This includes building and promoting the evidence around alternative delivery settings, digital platforms for remote PrEP prescribing, and new injectable PrEP medications, following regulatory due process.

What plans he has to develop a new national alcohol strategy for England.

I refer the Hon. Member to the answer I gave to the Hon. Member for York Central on 23 January 2026 to Question 105860.The Government is committed to shortening the amount of time spent in ill health and preventing premature deaths caused by alcohol. Action to prevent harms from alcohol feature in several current strategies and plans.

What steps he is taking to manage conflicts of interest associated with alcohol industry involvement in public health policy.

The Department already has established arrangements in place to manage conflicts of interest for both ministers and civil servants, including where these relate to the alcohol industry.Ministerial conduct is governed by the Ministerial Code, which sets out requirements on the declaration and handling of ministers’ interests. Civil servants are bound by the Civil Service Code, and by departmental policies that set out how actual, potential, or perceived conflicts of interest must be identified, declared, and managed.The Department keeps its internal guidance under regular review to ensure it remains aligned with cross-Government standards and supports transparent and accountable decision-making.

If he will make an assessment of the potential merits of introducing restrictions on alcohol in line with existing restrictions on the marketing of less healthy food and drink.

Currently alcohol advertising and promotion in the United Kingdom is regulated primarily through the Advertising Standards Authority (ASA), which administers the mandatory Advertising Codes, written by the Committee of Advertising Practice and the Broadcast Committee of Advertising Practice, across media through self-regulation for non-broadcast advertising and co-regulation, with Ofcom as a statutory backstop, for broadcast advertising. The ASA’s Advertising Codes contain specific rules about how alcohol can be advertised, as they recognise the social imperative of ensuring that alcohol advertising is responsible.The Department of Health and Social Care will continue to work with the Department for Digital, Culture, Media and Sport, as the lead Government department responsible for advertising, to consider if additional statutory restrictions on marketing and advertising are needed to reduce alcohol related harms.

What assessment his Department has made of the adequacy of eye care services.

Integrated care boards (ICBs) are responsible for commissioning primary and secondary eye care services to meet local need. We are not aware of any issues with the availability of sight testing services. The decision to commission enhanced eye care services will be determined by local ICBs following a local needs assessment.

What assessment his Department has made of the adequacy of steps taken by Integrated Care Boards to address regional inequalities in access to eye care services.

No assessment has been made. Integrated care boards, as commissioners of primary and secondary eye care services, are required to work with local authorities to assess the current and future health, care, and wellbeing needs of their local populations. They will then set out, in joint local health and wellbeing strategies, how they will meet those needs, and this could include addressing any identified inequalities in accessing services. Understanding patient demographics is an essential step in identifying and tackling health inequalities. The Elective Reform Plan included a commitment to publish waiting list information broken down by demographics to allow greater visibility of potential health inequalities. The Elective Reform Plan is available at the following link: https://www.england.nhs.uk/publication/reforming-elective-care-for-patients/ This enables local health services to understand the demographics of patients on their waiting list to better tailor services to their needs. Data on demographics of the elective waiting list can be found at the following link for the week ending 26 October 2025: https://www.england.nhs.uk/statistics/statistical-work-areas/rtt-waiting-times/wlmds/ It shows referral to treatment waiting times from the Waiting List Minimum Data Set for Ophthalmology split by age, sex, deprivation, and ethnicity. The Public Health Outcomes Framework Eye Health Indicator also continues to track the rate of sight loss for age-related macular degeneration, glaucoma, and diabetic retinopathy. This information is available to commissioners and can be used to drive improved local outcomes and interventions.

What assessment his Department has made of the potential impact of the (a) Minor Eye Conditions Service and (b) Community Urgent Eyecare Service on (i) patient outcomes and (ii) unnecessary referrals to secondary care.

Integrated care boards (ICBs) are responsible for assessing the health needs of their local population and for commissioning primary and secondary eye care services to meet them. This can include the commissioning of enhanced eye care services from high street optical practices.NHS England accelerator pilots have demonstrated that improved IT connectivity and a single point of access can significantly speed up eye care referrals and support more patients to be managed in the community, in line with the ambitions in the 10-Year Health Plan.

What assessment his Department has made of the potential impact of Housing First interventions for people experiencing homelessness on (a) health outcomes and (b) costs to the NHS.

The Department is committed to improving health outcomes for people experiencing homelessness. We are working closely with the Ministry of Housing, Communities and Local Government to support those experiencing homelessness with multiple and complex needs.The Government published an evaluation of the Housing First pilots, including their impact on health outcomes, a copy of which is attached. However, Housing First is not a Department of Health and Social Care policy, therefore the National Health Service has not undertaken analysis of its effectiveness and costs.

What assessment his Department has made of the potential impact of implementing the recommendations of the report by the Association of Optometrists entitled Key Interventions to Transform Eye Care and Eye Health, published in October 2024, relating to a national-roll out of (a) Community Urgent Eye Service and Minor Eye Conditions Service, (b) the Integrated Glaucoma Pathway, and (c) the Integrated Cataract Pathway for pre and post assessments on costs to the NHS.

Integrated care boards (ICBs) are responsible for assessing the health needs of their local population and for commissioning primary and secondary eye care services to meet them. This can include the commissioning of enhanced eye care services from high street optical practices.NHS England accelerator pilots have demonstrated that improved IT connectivity and a single point of access can significantly speed up eye care referrals and support more patients to be managed in the community, in line with the ambitions in the 10-Year Health Plan.

What assessment his Department has made of the effectiveness of the (a) Minor Eye Conditions Service and (b) Community Urgent Eyecare Service.

Integrated care boards (ICBs) are responsible for assessing the health needs of their local population and for commissioning primary and secondary eye care services to meet them. This can include the commissioning of enhanced eye care services from high street optical practices.NHS England accelerator pilots have demonstrated that improved IT connectivity and a single point of access can significantly speed up eye care referrals and support more patients to be managed in the community, in line with the ambitions in the 10-Year Health Plan.

What assessment his Department has made of the adequacy of the provision of a Minor Eye Conditions Service in every part of the country.

Integrated care boards (ICBs) are responsible for assessing the health needs of their local population and for commissioning primary and secondary eye care services to meet them. This can include the commissioning of enhanced eye care services from high street optical practices.NHS England accelerator pilots have demonstrated that improved IT connectivity and a single point of access can significantly speed up eye care referrals and support more patients to be managed in the community, in line with the ambitions in the 10-Year Health Plan.

What measures his Department is taking to improve the access people experiencing homelessness have to health and social care services.

The Department recognises the importance of ensuring that people experiencing homelessness have access to appropriate health and social care services. National Institute for Health and Care Excellence guideline 214, titled Integrated health and social care for people experiencing homelessness, sets out clear expectations for services to be accessible and tailored to individual needs, and is available at the following link:https://www.nice.org.uk/guidance/ng214/chapter/Recommendations#intermediate-careWe are exploring how best to encourage integrated care boards to adopt and embed this guidance within their commissioning processes.People experiencing homelessness are considered as an inclusion health group. Inclusion health groups are a key cohort within the locally identified priority ‘PLUS’ populations in NHS England’s Core20PLUS5 framework to reduce healthcare inequalities. Further information on NHS England’s Core20PLUS5 framework is available at the following link:https://www.england.nhs.uk/about/equality/equality-hub/national-healthcare-inequalities-improvement-programme/core20plus5/Integrated care boards are responsible for implementing this approach, aiming to reduce inequalities in health outcomes and improve equitable access to healthcare treatments and services.

What steps his Department is taking to expand the use of community optometry services.

Integrated care boards are responsible for assessing the health needs of their local population and commissioning primary and secondary eye care services to meet them.This can already include the commissioning of enhanced eye care services from high street optical practices, including minor and urgent eye care services and glaucoma referral refinement services.NHS England accelerator pilots have demonstrated that improved IT connectivity and a single point of access can significantly speed up eye care referrals and support more patients to be managed in the community, in line with the ambitions in the 10-Year Health Plan.

What steps his Department is taking to expand the use of optometry-led diagnostic and treatment pathways.

Integrated care boards are responsible for assessing the health needs of their local population and commissioning primary and secondary eye care services to meet them.This can already include the commissioning of enhanced eye care services from high street optical practices, including minor and urgent eye care services and glaucoma referral refinement services.NHS England accelerator pilots have demonstrated that improved IT connectivity and a single point of access can significantly speed up eye care referrals and support more patients to be managed in the community, in line with the ambitions in the 10-Year Health Plan.

Whether his Department has assessed the importance of including accessible behaviour-change and drinking moderation tools, including links to digital health support, as part of the new mandatory alcohol labelling standards.

In Fit for the Future: 10-Year Health Plan for England, the Government committed to strengthening and expanding existing voluntary guidelines for alcohol labelling by introducing a mandatory requirement for alcoholic drinks to display consistent nutritional information and health warning messages.Department officials are currently working at pace to develop the policy. We are reviewing all available evidence and engaging with stakeholders to assess the potential content of the mandatory labels.The Government currently provides drinking moderation tools like the new NHS Healthy Choices Quiz which is designed to help people to improve their health and wellbeing. It asks a range of lifestyle questions, including those about alcohol consumption, provides an overall score out of ten, and directs people to relevant National Health Service support services such as the Drink Free Days app.

What assessment he made of the difference in uptake rates between maternal and infant RSV immunisations when developing the national immunisation programme.

The policy for the respiratory syncytial virus (RSV) programme is based on the advice of the Joint Committee on Vaccination and Immunisation (JCVI), an independent expert advisory committee. The JCVI considered RSV modelling that included different levels of uptake for maternal or infant immunisation. The JCVI advised that either antenatal maternal vaccination or infant monoclonal antibody immunisation strategies could be suitable for a universal United Kingdom programme and did not have a preference. Maternal vaccination became the UK programme from September 2024 following a competitive tender.The JCVI had noted that protection of preterm infants would need to be looked at if the UK adopted a maternal vaccination programme. At the October 2024 meeting the JCVI advised that a programme to extend a potential offer of nirsevimab, a monoclonal antibody, to very and extremely premature infants could be cost effective.Based on JCVI’s advice, the RSV selective immunisation programme for high-risk infants switched in September 2025 from using palivizumab to using nirsevimab, and was extended to include premature babies born at less than 32 weeks gestation.

Whether his Department has assessed how alcohol labelling reforms could support local public-health and community-based initiatives aimed at reducing alcohol-related harm, particularly in areas with significant health inequalities.

In Fit for the Future: 10-Year Health Plan for England, the Government committed to strengthening and expanding existing voluntary guidelines for alcohol labelling by introducing a mandatory requirement for alcoholic drinks to display consistent nutritional information and health warning messages.Clear and consistent labelling is expected to increase awareness of the health risks and to empower consumers to make more informed choices, complementing local public health strategies and community-level interventions.The Government also committed to supporting community level innovations where they have shown promise in reducing alcohol harm. Officials are working at pace to take forward these commitments.

What assessment he has made of the potential merits of developing a Modern Service Framework for respiratory health.

Modern service frameworks will define an aspirational, long-term outcome goal for a major condition and then identify the best evidenced interventions and the support for delivery. Early priorities will include cardiovascular disease, severe mental illness, and the first ever service framework for frailty and dementia.The Government will consider other long-term conditions for future waves of modern service frameworks, including respiratory conditions. The criteria for determining other conditions for future modern service frameworks will be based on where there is potential for rapid and significant improvements in quality of care and productivity.

What proportion of NHS England’s total budget has been allocated to vaccination and immunisation programmes in each of the last five years.

NHS England is responsible for the operational delivery of vaccination and immunisation programmes, although this does not include the procurement of vaccines. The following table shows the proportion of NHS England’s total budget allocated to the operational delivery of vaccination and immunisation programmes for the last five years, where accounts have already been published:Financial yearVaccination and immunisation costs (£m)NHS England total budget (£m)Proportion of NHE England total budget spend on vaccination and immunisation2019/20309121,3340.25%2020/21955147,1320.65%2021/221,499147,9731.01%2022/23989155,2280.64%2023/24852165,9260.51%

Pursuant to the Answer of 28 October 2025 to Question 83204, what step he is taking to secure a recurrent budget for abiraterone in high risk, non-metastatic prostate cancer, in the context of it being ranked top priority for routine commissioning at the Clinical Priorities Advisory Group Prioritisation Meeting in 2024-25.

We are pleased to confirm that NHS England announced on 16 January that patients with non‑metastatic prostate cancer will now have access to abiraterone in combination with prednisolone, where it is deemed to be clinically beneficial. This development has been made possible by the health service buying and delivering treatments at better value.This decision marks a major step forward in the Government’s ongoing work to improve cancer outcomes, ensure earlier access to effective treatments, and support men and their families across England.