Written questions by Morgan.

What steps he is taking to improve (a) diagnosis and (b) care of Placenta Accreta Spectrum.

The diagnosis of placenta accreta spectrum is primarily done in the antenatal period using ultrasound imaging. To ensure effective diagnosis and management of placenta accreta spectrum, national guidance is provided within the National Institute for Health and Care Excellence (NICE) guidance and the Royal College of Obstetricians and Gynaecologists’ Placenta Praevia and Placenta Accreta: Diagnosis and Management Guideline. The NICE guidance and the Royal College of Obstetricians and Gynaecologists’ guidelines are available, respectively, at the following two links:https://www.nice.org.uk/guidance/ng192/documents/draft-guideline-2https://www.rcog.org.uk/guidance/browse-all-guidance/green-top-guidelines/placenta-praevia-and-placenta-accreta-diagnosis-and-management-green-top-guideline-no-27a/In 2020, NHS England commissioned placenta accreta networks in the United Kingdom to support local and regional screening, shared protocols, and co-ordinated referral pathways to specialist pregnancy accreta centres. These centres consist of highly experienced multidisciplinary teams with the expertise to manage this condition and improve the safety outcomes for women and babies.

Food and Rural Affairs, with reference to question 103472 of 6 January 2026 regarding border control, what her plans are for the 2026 breeding season.

Equine germinal products are a high-risk commodity and require 100% documentary and identity checks upon import from the EU under the Border Target Operating Model. For the 2026 breeding season, the Government will continue to maintain the existing system of official import controls. Specifically, all consignments of equine germinal products imported from the EU and EFTA will be subject to import controls at a designated Border Control Post; with the facilitation scheme available for chilled equine germinal products, where conditions apply.

Food and Rural Affairs, what assessment her Department has made of the potential impact of the change in the level of the Canal and River Trust’s grant settlement since 2017 on the safety and integrity of inland waterways.

The current 15-year Government grant provided to the Canal and River Trust was adjusted for inflation for the first 10 years between 2012 and 2022, with the agreement clearly stating that the final five years of the grant from 2022 to 2027 would be capped at the 2022 level, which is £52.6 million a year. This represented 22% of the Trust’s total 2024/25 income of £232 million. The majority of its funding is from commercial and charitable sources, including its £1billion investment endowment. The Trust continues to have the agreed objective of reducing reliance on Government funding and progressively moving towards greater financial self-sufficiency by developing alternative income streams. A comprehensive review of the grant funding in 2022 concluded that there was a case for continued Government funding, and the new 10-year grant of £401 million between 2027 and 2037 will continue to support the Trust.

Food and Rural Affairs, what steps she is taking to protect watercraft operating on the canal network.

Responsibility for the safety of watercraft operating on the canal network rests with the navigation authorities concerned. Requirements for insurance and compliance with the Boat Safety Scheme standards form part of the conditions set by the navigation authorities for licences to operate on their waterways.

Food and Rural Affairs, if she will make an assessment of the potential merits of establishing an emergency contingency fund to support (a) waterways-dependent businesses and (b) tourism in the context of the December 2025 canal breach in Whitchurch.

Defra’s relationship with the inland waterways sector focuses on providing grant support for the two largest navigation authorities, the Canal and River Trust and the EA Navigations, which between them cover around 2,630 miles of waterways. This support contributes to the infrastructure maintenance of their networks, while respecting their operational independence to manage their waterways for the benefit of businesses and tourism.

Food and Rural Affairs, what steps she is taking to improve the structural integrity of the canal network.

Responsibility for ensuring the structural integrity of the canal network rests with the navigation authorities concerned. The largest navigation authority is the Canal and River Trust, with some 2,000 miles of waterways. The Government is currently providing the Trust with an annual grant of £52.6 million to support maintenance of the network infrastructure and has agreed a further £401 million grant for the ten years 2027-2037.

Food and Rural Affairs, whether her Department has produced a recent risk assessment for the impact of canal embankment breaches on narrowboats.

Responsibility for the safe operation of canals rests with the navigation authorities. In the case of the Canal and River Trust, Defra officials meet the Trust’s senior management team to discuss the Trust’s work and use of the Government grant funding, as well as engaging regularly with the Trust throughout the year on any matters as they arise.

Whether he has made an assessment of the potential impact of NHS spending on pharmaceutical products on NHS service provision in the context of the UK-US trade deal.

By increasing the standard National Institute for Health and Care Excellence (NICE) cost-effectiveness threshold, we are increasing the value that we place on innovations that deliver improvements to patient health. Alongside the changes that we announced in the Life Sciences Sector Plan, this will increase both the speed and breadth of patient access to innovative medicines and encourage growth in United Kingdom-based clinical trials.Costs will start smaller but will increase over time as the NICE approves more life improving and lifesaving medicines. Total costs over the Spending Review period are expected to be approximately £1 billion. But the final costs will depend on which medicines NICE decides to approve and the actual uptake of these.This deal is a vital investment that builds on the strength of our National Health Service and world leading life sciences sector to increase access to life-changing medicines without taking essential funding from our frontline NHS services. We will always prioritise the needs of NHS patients and at the Spending Review we delivered a record real terms increase for day-to-day spending for the NHS in England up to April 2029.This deal will be funded by allocations made at the Spending Review, where front line services will remain protected through the record funding secured. Future year funding will be settled at the next Spending Review.

When he expects fax machines to be phased out of use in Shrewsbury and Telford Hospital NHS Trust.

My Rt Hon. Friend, the Secretary of State for Health and Social Care, has instructed National Health Service trusts to stop using fax machines for anything other than business continuity. The trust has informed NHS England that they currently only use fax machines for administrative tasks.NHS England will be meeting with the Shrewsbury and Telford Hospital NHS Trust to work with them on their decommissioning plans. As such, there is currently no date set for when fax machines will be phased out.

What recent assessment he has made of the use of fax machines by Shrewsbury and Telford Hospital NHS Trust.

My Rt Hon. Friend, the Secretary of State for Health and Social Care, has instructed National Health Service trusts to stop using fax machines for anything other than business continuity. The trust has informed NHS England that they currently only use fax machines for administrative tasks.NHS England will be meeting with the Shrewsbury and Telford Hospital NHS Trust to work with them on their decommissioning plans. As such, there is currently no date set for when fax machines will be phased out.

What steps he is taking to incorporate the National Audit Office recommendations regarding the 2023 Long Term Workforce Plan into the development of the 10 Year Workforce Plan.

The 10 Year Workforce Plan will ensure the National Health Service has the right people in the right places, with the right skills to care for patients, when they need it.To address the National Audit Office’s recommendations regarding the 2023 Long Term Workforce Plan, updated workforce modelling and its underlying assumptions will be set out in and alongside the new plan when published in spring 2026. It will be supported by external independent scrutiny.We are committed to engagement with external stakeholders. On the 26 September 2025 we launched a formal call for evidence, which provided stakeholders the opportunity to contribute directly to the plan’s development. This closed on 7 November 2025. The submissions to our call for evidence are being analysed to inform the development of the plan.

What assessment his Department has made of the National Audit Office recommendations in its analysis of the 2023 Long Term Workforce Plan (a) in general and (b) specifically the recommendation that assumptions should be generated in transparent and systematic consultation with external stakeholders.

The 10 Year Workforce Plan will ensure the National Health Service has the right people in the right places, with the right skills to care for patients, when they need it.To address the National Audit Office’s recommendations regarding the 2023 Long Term Workforce Plan, updated workforce modelling and its underlying assumptions will be set out in and alongside the new plan when published in spring 2026. It will be supported by external independent scrutiny.We are committed to engagement with external stakeholders. On the 26 September 2025 we launched a formal call for evidence, which provided stakeholders the opportunity to contribute directly to the plan’s development. This closed on 7 November 2025. The submissions to our call for evidence are being analysed to inform the development of the plan.

What steps he is taking to help reduce the potential impact of chronic respiratory conditions on the NHS this winter.

NHS England, working with the Department, the UK Health Security Agency, and other partners, is taking action to reduce the impact of respiratory conditions on the National Health Service this winter. This includes robust, consistent Infection Prevention and Control measures, and a campaign to encourage eligible people to get their winter vaccinations. Further details of the actions being taken to reduce demand on acute services during winter are available at the following link:https://www.england.nhs.uk/long-read/urgent-and-emergency-care-plan-2025-26/

If his Department will take steps to help ensure that health boards and trusts collect and publish data on the provision of respiratory diagnostics.

I refer the Hon. Member to the answer I gave to the Hon. Member for Chelmsford on 27 October 2025 to Question 83430.

What steps he is taking to help (a) increase capacity for and (b) reduce inequalities in access to respiratory diagnosis.

Community diagnostic centres (CDCs) are increasing capacity and access to respiratory diagnostic tests such as spirometry and fractional exhaled nitric oxide, and will continue to do so as more sites come online. For example, the first five months of 2025/26 saw an increase in CDC spirometry testing of approximately 2,000 tests per month more than in the previous year.In addition, 101 CDCs across the country now offer out-of-hours services 12 hours a day, seven days a week, meaning patients across the country can access vital diagnostic tests around busy working lives.

If he will outline the criteria used to decide which conditions should receive a modern service framework; and whether respiratory health meets these criteria.

I refer the hon. Member to the answer I gave to the hon. Member for Lewes on 27 October 2025 to Question 82544.

If his Department will make an assessment of the potential merits of commissioning neighbourhood level respiratory diagnostic hubs.

Respiratory diagnostic hubs have been piloted and developed in many parts of England and this learning will inform the development of more neighbourhood health services.Community diagnostic centres (CDCs) are also supporting the shift to neighbourhood health, with 170 CDCs now being operational across England. All standard model CDCs are required to offer a range of diagnostic tests that support diagnosis of respiratory conditions, including spirometry and lung function tests.CDCs offer local populations a wide range of diagnostic tests closer to home and greater choice on where and how they are undertaken, reducing the need for hospital visits and speeding up diagnosis, whilst also reducing pressure on hospitals.We are continuing to invest in expanding diagnostic capacity in the National Health Service, including through increasing CDC capacity. As set out in the Elective reform Plan, we plan to build up to five more CDCs, as part of £600 million capital funding for diagnostics in 2025/26. We are also increasing the operating hours of existing sites so that more offer services 12 hours a day, seven days a week.

If the 10 Year Workforce Plan will expand the number of medical specialty training places to meet population demand, beyond the 1,000 proposed in the 10 Year Health Plan.

On 8 December, the Government put an offer in writing to the British Medical Association Resident Doctors Committee (BMA RDC) which was rejected. The offer would have increased the number of specialty training posts over the next three years from the 1,000 announced in the 10-Year Health Plan to 4,000, bringing forward 1,000 of these specialty training posts to start in 2026. The BMA have rejected the Government's offer, so that is not going ahead. Our door remains open, and this Government is determined to put an end to these damaging cycles of disruption. On 8 January 2026, my Rt. Hon. Friend, the Secretary of State for Health and Social Care, met with the BMA RDC to kick off a series of talks to resolve the dispute.The 10 Year Workforce Plan will ensure that the National Health Service has the right people in the right places, with the right skills to care for patients, when they need it. It will include modelling of the potential size and shape of the future workforce and implications for major professions.We are engaging with partners throughout this process, including universities and higher education institutes. A number of organisations with expertise in higher education were invited to and attended a ministerially led partner event on 5 November. As we continue the open and wide-ranging conversations we’ve been having with staff, patients and organisations across the country, we will ensure that the engagement is robust and representative of different stakeholder groups.

If he will take steps to support educators, supervisors, mentors and trainers in the 10 Year Workforce Plan and work with employers to increase capacity for medical education and training.

On 8 December, the Government put an offer in writing to the British Medical Association Resident Doctors Committee (BMA RDC) which was rejected. The offer would have increased the number of specialty training posts over the next three years from the 1,000 announced in the 10-Year Health Plan to 4,000, bringing forward 1,000 of these specialty training posts to start in 2026. The BMA have rejected the Government's offer, so that is not going ahead. Our door remains open, and this Government is determined to put an end to these damaging cycles of disruption. On 8 January 2026, my Rt. Hon. Friend, the Secretary of State for Health and Social Care, met with the BMA RDC to kick off a series of talks to resolve the dispute.The 10 Year Workforce Plan will ensure that the National Health Service has the right people in the right places, with the right skills to care for patients, when they need it. It will include modelling of the potential size and shape of the future workforce and implications for major professions.We are engaging with partners throughout this process, including universities and higher education institutes. A number of organisations with expertise in higher education were invited to and attended a ministerially led partner event on 5 November. As we continue the open and wide-ranging conversations we’ve been having with staff, patients and organisations across the country, we will ensure that the engagement is robust and representative of different stakeholder groups.

What steps she is taking to support charities providing community transport.

The Government recognises the vital role community transport operators play in connecting people with their communities, enabling access to employment, education and other essential services such as healthcare. The Department makes available up to £3.8 million each year through the Bus Service Operators Grant (BSOG) to community transport operators. An uplift of 60% has been added to BSOG claims for community transport operators until 31 March 2026. This means community transport operators will receive £1.60 for every £1 claimed, reflecting the increased costs faced by the sector.