Written questions by Cartlidge.

What steps his Department is taking to support access to Enhertu for patients with secondary breast cancer.

The National Institute for Health and Care Excellence (NICE) makes independent, evidence-based recommendations for the National Health Service in England on whether new licensed medicines should be routinely funded for eligible patients based on an evaluation of clinical and cost effectiveness.NICE has recommended Enhertu, also known as trastuzumab deruxtecan, for use in the Cancer Drugs Fund for the treatment of women with HER2-positive secondary breast cancer and it is now available for the treatment of eligible patients while further data on its effectiveness is being collected that will inform a NICE decision on routine funding.NICE published guidance in July 2024 on the use of Enhertu for the treatment of HER-2 low metastatic and unresectable breast cancer and was unfortunately unable to recommend it for routine NHS funding. I understand that NICE and NHS England have sought to apply as much flexibility as they can in their considerations of Enhertu for HER2-low breast cancer and have made it clear to the companies that their pricing of the drug remains the only obstacle to access.Ministers met with the manufacturers of Enhertu, AstraZeneca and Daiichi Sankyo in November 2024, to encourage them to re-engage in commercial discussions with NHS England. Despite NICE and NHS England offering unprecedented flexibilities, the companies were unable to offer Enhertu at a cost-effective price. NICE’s guidance published in July 2024 will therefore remain unchanged. NICE has reassured me that the door remains open for the companies to enter into a new NICE appraisal if they are willing to offer Enhertu at a cost-effective price.Since January 2022, NICE has recommended all but one of the treatments for breast cancer that it has assessed. These treatments are now available to eligible National Health Service patients.

What progress his Department has made on providing new breast cancer screening units.

Since 2023, ten new mobile breast screening units and nine new static breast screening units have been provided, alongside 37 wider upgrades covering hardware, software and live remote access for existing units.Breast screening services are commissioned regionally, against a national service specification. Local breast screening providers are responsible for managing their equipment replacement plans and planning for service delivery to ensure they have sufficient capacity to delivery timely breast screening to their eligible population. Alongside the estate and equipment investment, comprehensive data is being collected via a workforce survey for breast screening services to support workforce planning at a local, regional and national level.Early diagnosis is a key focus of the National Cancer Plan, which will build on the shifts in care set out in the 10-Year Health Plan to diagnose cancers earlier. Through the 10-Year Health Plan, we will make it easier for people to access cancer screening, diagnostic and treatment in patients’ local areas, backed by the latest technology to drive up this country’s cancer survival rates.

What steps his Department is taking to ensure that planned service upgrades to breast cancer screening capacity are delivered on time.

Since 2023, ten new mobile breast screening units and nine new static breast screening units have been provided, alongside 37 wider upgrades covering hardware, software and live remote access for existing units.Breast screening services are commissioned regionally, against a national service specification. Local breast screening providers are responsible for managing their equipment replacement plans and planning for service delivery to ensure they have sufficient capacity to delivery timely breast screening to their eligible population. Alongside the estate and equipment investment, comprehensive data is being collected via a workforce survey for breast screening services to support workforce planning at a local, regional and national level.Early diagnosis is a key focus of the National Cancer Plan, which will build on the shifts in care set out in the 10-Year Health Plan to diagnose cancers earlier. Through the 10-Year Health Plan, we will make it easier for people to access cancer screening, diagnostic and treatment in patients’ local areas, backed by the latest technology to drive up this country’s cancer survival rates.

Whether his Department plans to increase the use of radiotherapy to help reduce local cancer treatment delays.

We will improve National Health Service waiting time performance, so patients are diagnosed faster and have quicker access to the treatments they require, including radiotherapy. However, we do recognise that there is much more to be done to ensure that this is the reality for all patients across the country.Radiotherapy is vital in cancer care, and it remains a key priority for the Government to reduce radiotherapy waiting times and provide the highest quality of treatment available. This is why the Government has invested £70 million of central funding on 28 new radiotherapy machines across the country to replace older, less efficient radiotherapy machines.

What assessment he has made of the adequacy of NHS radiotherapy waiting times.

We will improve National Health Service waiting time performance, so patients are diagnosed faster and have quicker access to the treatments they require, including radiotherapy. However, we do recognise that there is much more to be done to ensure that this is the reality for all patients across the country.Radiotherapy is vital in cancer care, and it remains a key priority for the Government to reduce radiotherapy waiting times and provide the highest quality of treatment available. This is why the Government has invested £70 million of central funding on 28 new radiotherapy machines across the country to replace older, less efficient radiotherapy machines.

What steps he plans to take to increase support available for people with neurological conditions.

Our 10-Year Health Plan, Fit for the Future, will ensure that people with neurological conditions receive better support through its three shifts: from hospital to community; from analogue to digital; and from sickness to prevention.Neighbourhood health centres will provide integrated, accessible, and localised services that will focus on early detection and diagnosis and comprehensive multidisciplinary care. By being community-based, the centres will reduce barriers to care and ongoing support and will empower patients to manage their condition more effectively.People with complex conditions will be offered a personalised care plan, developed with healthcare professionals. These will improve care coordination and ensure care is tailored to the individual's needs.We have committed to at least doubling the number of people offered a personal health budget by the 2028/29 financial year, and we will make personal health budgets a universal offer for all who would benefit from them by 2035. This will give people greater autonomy, flexibility, and involvement in their own healthcare, allowing them to organise the care that best meets their needs.Digital tools like the NHS App will empower patients to manage their conditions, access information, and communicate with healthcare professionals more easily. Digital technologies will also enable remote monitoring of patients, allowing for early intervention and personalised care.The 10-Year Health Plan envisions a healthcare system that is more proactive, personalised, and digitally enabled, leading to earlier diagnosis, more effective management, and ultimately, better outcomes for individuals with long-term conditions, including those with neurological conditions.

What steps he is taking to support research into motor neurone disease.

Government responsibility for delivering motor neurone disease research (MND) is shared between the Department of Health and Social Care, with research delivered via the National Institute for Health and Care Research (NIHR), and the Department for Science, Innovation and Technology, with research delivered via UK Research and Innovation (UKRI), and in particular via the Medical Research Council.The commitment to allocate £50 million to MND research was introduced by the previous administration. As of 4 June 2025, when the data was last analysed, a total of £50.2 million has been committed to MND research since the start of the 2022/23 financial year. We will continue to invest in MND research via open competition, with no maximum funding limit.The Government is investing into MND research across a range of areas, including an £8 million investment via the NIHR’s EXPERTS-ALS trial, an early phase clinical research trial which screens for drugs that have the potential to be successful in clinical trials for people with MND.The MND Translational Accelerator, supported by £6 million of Government funding, is connecting the UK Dementia Research Institute, the UK MND Research Institute, and Dementias Platform UK. Twelve projects have been funded through the accelerator, and all are aimed at speeding up the development of treatments for MND.The NIHR and UKRI will continue to welcome funding applications for research into any aspect of human health and care, including MND. These applications are subject to peer review and judged in open competition, with awards being made on the basis of the importance of the topic to patients and health and care services, value for money, and scientific quality.Welcoming applications on MND to all NIHR and UKRI programmes enables maximum flexibility both in terms of the amount of research funding a particular area can be awarded, and the type of research which can be funded.

How much of the £50 million allocated for targeted motor neurone disease research has been allocated as of September 2025.

Government responsibility for delivering motor neurone disease research (MND) is shared between the Department of Health and Social Care, with research delivered via the National Institute for Health and Care Research (NIHR), and the Department for Science, Innovation and Technology, with research delivered via UK Research and Innovation (UKRI), and in particular via the Medical Research Council.The commitment to allocate £50 million to MND research was introduced by the previous administration. As of 4 June 2025, when the data was last analysed, a total of £50.2 million has been committed to MND research since the start of the 2022/23 financial year. We will continue to invest in MND research via open competition, with no maximum funding limit.The Government is investing into MND research across a range of areas, including an £8 million investment via the NIHR’s EXPERTS-ALS trial, an early phase clinical research trial which screens for drugs that have the potential to be successful in clinical trials for people with MND.The MND Translational Accelerator, supported by £6 million of Government funding, is connecting the UK Dementia Research Institute, the UK MND Research Institute, and Dementias Platform UK. Twelve projects have been funded through the accelerator, and all are aimed at speeding up the development of treatments for MND.The NIHR and UKRI will continue to welcome funding applications for research into any aspect of human health and care, including MND. These applications are subject to peer review and judged in open competition, with awards being made on the basis of the importance of the topic to patients and health and care services, value for money, and scientific quality.Welcoming applications on MND to all NIHR and UKRI programmes enables maximum flexibility both in terms of the amount of research funding a particular area can be awarded, and the type of research which can be funded.

What assessment he has made of the adequacy of the £26 million NHS England Children’s Hospice Grant for meeting the costs faced by children’s hospices in South Suffolk.

Palliative care services are included in the list of services that integrated care boards (ICBs), including the Suffolk and North East Essex ICB, must commission. This promotes a more consistent national approach and supports commissioners in prioritising palliative and end of life care. ICBs are responsible for the commissioning of palliative and end of life care services, to meet the needs of their local populations. To support ICBs in this duty, NHS England has published statutory guidance and service specifications.We are supporting the hospice sector with a £100 million capital funding boost for eligible adult and children’s hospices in England to ensure they have the best physical environment for care.We are also providing £26 million of revenue funding to support children and young people’s hospices for 2025/26. This is a continuation of the funding which until recently was known as the children and young people’s hospice grant.  We cannot yet confirm what the funding for 2026/27 will be, or how it will be administered.The Department and NHS England are looking at how to improve the access, quality, and sustainability of all-age palliative care and end of life care in line with the 10 Year Health Plan.The Government and the National Health Service will closely monitor the shift towards the strategic commissioning of palliative care and end of life care services to ensure that the future state of services reduces variation in access and quality, although some variation may be appropriate to reflect both innovation and the needs of local populations.Officials will present further proposals to ministers over the coming months, outlining how to operationalise the required changes to palliative care and end of life care to enable the shift from hospital to community, including as part of neighbourhood health teams.

What proportion of the planned £29 billion annual increase in the NHS budget over the next three years will be allocated to children’s palliative care services.

Palliative care services, including for children, are included in the list of services that integrated care boards (ICBs), including the Suffolk and North East Essex ICB, must commission.To support ICBs in this duty, NHS England has published statutory guidance and service specifications. The statutory guidance states that ICBs must work to ensure that there is sufficient provision of care services to meet the needs of their local populations, which can include hospice services available within the ICB catchment.The Department and NHS England are looking at how to improve the access, quality, and sustainability of all-age palliative care and end of life care in line with the 10 Year Health Plan.The Government and the National Health Service will closely monitor the shift towards the strategic commissioning of palliative care and end of life care services to ensure that the future state of services reduces variation in access and quality, although some variation may be appropriate to reflect both innovation and the needs of local populations.Officials will present further proposals to ministers over the coming months, outlining how to operationalise the required changes to palliative care and end of life care to enable the shift from hospital to community, including as part of neighbourhood health teams.

Whether he plans to extend the NHS England Children’s Hospice Grant beyond the 2025-26 financial year.

Palliative care services are included in the list of services that integrated care boards (ICBs), including the Suffolk and North East Essex ICB, must commission. This promotes a more consistent national approach and supports commissioners in prioritising palliative and end of life care. ICBs are responsible for the commissioning of palliative and end of life care services, to meet the needs of their local populations. To support ICBs in this duty, NHS England has published statutory guidance and service specifications.We are supporting the hospice sector with a £100 million capital funding boost for eligible adult and children’s hospices in England to ensure they have the best physical environment for care.We are also providing £26 million of revenue funding to support children and young people’s hospices for 2025/26. This is a continuation of the funding which until recently was known as the children and young people’s hospice grant.  We cannot yet confirm what the funding for 2026/27 will be, or how it will be administered.The Department and NHS England are looking at how to improve the access, quality, and sustainability of all-age palliative care and end of life care in line with the 10 Year Health Plan.The Government and the National Health Service will closely monitor the shift towards the strategic commissioning of palliative care and end of life care services to ensure that the future state of services reduces variation in access and quality, although some variation may be appropriate to reflect both innovation and the needs of local populations.Officials will present further proposals to ministers over the coming months, outlining how to operationalise the required changes to palliative care and end of life care to enable the shift from hospital to community, including as part of neighbourhood health teams.

Whether he plans to undertake a comprehensive review of the (a) planning, (b) commissioning and (c) funding of children’s palliative care in South Suffolk.

Palliative care services, including for children, are included in the list of services that integrated care boards (ICBs), including the Suffolk and North East Essex ICB, must commission.To support ICBs in this duty, NHS England has published statutory guidance and service specifications. The statutory guidance states that ICBs must work to ensure that there is sufficient provision of care services to meet the needs of their local populations, which can include hospice services available within the ICB catchment.The Department and NHS England are looking at how to improve the access, quality, and sustainability of all-age palliative care and end of life care in line with the 10 Year Health Plan.The Government and the National Health Service will closely monitor the shift towards the strategic commissioning of palliative care and end of life care services to ensure that the future state of services reduces variation in access and quality, although some variation may be appropriate to reflect both innovation and the needs of local populations.Officials will present further proposals to ministers over the coming months, outlining how to operationalise the required changes to palliative care and end of life care to enable the shift from hospital to community, including as part of neighbourhood health teams.

What support he is providing to (a) NHS trusts and (b) pharmacies to manage supply disruptions of pancreatic enzyme replacement therapy.

The Department is continuing to work with all suppliers of pancreatic enzyme replacement therapy (PERT) to help resolve the supply issues in the short and longer term. This includes asking that they expedite deliveries, source stock from other markets, and increase production. Through these discussions we have managed to secure additional volumes for 2025 for the United Kingdom. The Department has also reached out to specialist importers who have sourced unlicensed stock to assist in covering the remaining gap in the market.We have widely disseminated comprehensive guidance to healthcare professionals, including National Health Service trusts, general practices, and pharmacies, about these supply issues, which provide advice on how to manage patients whilst there is disruption to supply. The Department has issued additional management advice to healthcare professionals which directs clinicians to consider unlicensed imports when licensed stock is unavailable, and which includes actions for integrated care boards to have local mitigation plans in place and implemented to ensure that no patient is left without PERT.The Department will continue to work closely with the manufacturers to resolve the issues as soon as possible, to ensure patients have continuous access to medicines. The Department also meets regularly with the affected patient advocacy groups and charities, clinicians, and other relevant stakeholders, to ensure they are kept informed on the latest supply picture and any communications issued. If any patient is concerned about their treatment, they should discuss this with their clinician at the earliest opportunity.

What steps he is taking to help tackle regional differences in access to specialist care.

We are committed to returning to the NHS constitutional standard that 92% of patients wait no longer than 18 weeks from referral to consultant-led treatment by March 2029. Our ‘Reforming elective care for patients’ plan, published in January, sets out how the NHS will reform elective care services equitably and inclusively for all patients.As an interim goal, NHS England’s Operational Planning Guidance 2025/26 has set the national ambition for 65% of patients waiting no longer than 18 weeks for treatment, with every trust expected to deliver a minimum 5 percentage point improvement in performance.To support this improvement across all trusts, there is a robust performance management process in place. The new NHS Oversight Framework 2025/26 ensures that there is public accountability for performance and NHS England works with systems and providers to support improvement.There is a specific process in place to identify, intervene and support the providers whose performance on elective waiting lists is most challenged, led by NHS England national and regional teams.NHS England is also providing further targeted support through the Further Faster 20 programme, working with 20 trusts in areas of high economic inactivity to help rapidly reduce waiting times and support people returning to the workforce.

What assessment he has made of the potential impact of long ambulance transfer times for cardiac emergencies on (a) Suffolk and (b) nationally.

Cardiac emergencies include a range of potentially life-threatening conditions, such as cardiac arrest, which requires a Category 1 ambulance response, and heart attacks, which require a Category 2 ambulance response. These classifications come from the Ambulance Response Programme, designed to ensure the sickest patients receive the fastest response and that all patients get the right response the first time. Delays in response times are known to have impacts on patient outcomes.The Government is determined to improve response times, and we have already seen improvements in both Suffolk and nationally. In the East of England, the latest figures show that Category 1 incidents were responded to in, on average, 8 minutes 37 seconds and Category 2 incidents in 32 minutes 35 seconds. This is faster than 9 minutes 1 second and 38 minutes 42 seconds, in July 2024. Nationally, the latest figures show that Category 1 incidents were responded to in, on average, 7 minutes 56 seconds and Category 2 in 28 minutes 40 seconds. This is faster than 8 minutes 15 seconds and 33 minutes 24 seconds, in July 2024.

What steps he is taking to increase the availability of pancreatic enzyme replacement therapy.

The Department is continuing to work with all suppliers of pancreatic enzyme replacement therapy (PERT) to help resolve the supply issues in the short and longer term. This includes asking that they expedite deliveries, source stock from other markets, and increase production. Through these discussions we have managed to secure additional volumes for 2025 for the United Kingdom. The Department has also reached out to specialist importers who have sourced unlicensed stock to assist in covering the remaining gap in the market.We have widely disseminated comprehensive guidance to healthcare professionals, including National Health Service trusts, general practices, and pharmacies, about these supply issues, which provide advice on how to manage patients whilst there is disruption to supply. The Department has issued additional management advice to healthcare professionals which directs clinicians to consider unlicensed imports when licensed stock is unavailable, and which includes actions for integrated care boards to have local mitigation plans in place and implemented to ensure that no patient is left without PERT.The Department will continue to work closely with the manufacturers to resolve the issues as soon as possible, to ensure patients have continuous access to medicines. The Department also meets regularly with the affected patient advocacy groups and charities, clinicians, and other relevant stakeholders, to ensure they are kept informed on the latest supply picture and any communications issued. If any patient is concerned about their treatment, they should discuss this with their clinician at the earliest opportunity.

What assessment he has made of the adequacy NHS investment to combat waiting lists in (a) Suffolk and (b) nationally.

The Elective Reform Plan, published in January 2025, set an overall ambition to deliver on the commitment that 92% of patients will wait no longer than 18 weeks from referral to consultant-led treatment – in line with the NHS constitutional standard – by March 2029.We are funding the activity needed to meet this ambition, which included an additional £1.8 billion funding for additional activity delivered in 2024/25, all within a record £25.6 billion increase in funding for the NHS.As a result of this, good progress has already been seen on the waiting list. As of June 2025, the waiting list had reduced nationally by over 250,000 compared to July 2024.NHS England’s Planning Guidance for 2025/26 sets a target that 65% of patients wait for 18 weeks or less by March 2026, with every trust, including those in Suffolk, expected to deliver a minimum five percentage point improvement over that period.As set out in our Elective Reform Plan, we are providing the NHS with the resources it needs to continue to deliver this activity, but with the clear expectation that reforms are implemented in an affordable way.

What assessment he has made of trends in the level of regional differences of NHS waiting lists.

The Department of Health and Social Care and NHS England regularly monitor regional variation in NHS waiting lists to address variation in performance, so patients can expect to receive high quality care in a timely way, wherever they live.NHS England offers a range of support to providers across England to address the longest waits and implement reforms, including tailored regional and national support, sharing of best practice, and additional support via their Getting It Right First Time (GIRFT) programme.Data on current regional waiting lists, as of June 2025, is given in the table below.RegionTotal number of incomplete pathways (size of waiting list)% within 18 weeks London Commissioning Region1,193,638 62.3%South West Commissioning Region633,647 65.4%South East Commissioning Region1,096,222 61.5% Midlands Commissioning Region1,353,783 60.0% East of England Commissioning Region928,937 57.0% North West Commissioning Region1,029,327 58.6% North East and Yorkshire Commissioning Region995,89767.5% Total (National)7,369,169 61.5%Source: NHS England, Monthly RTT Waiting Times Data Collection

What steps he is taking to ensure equal access to advanced cancer diagnostic tools for patients across all regions of the UK.

Health is a devolved matter. The Government is supporting NHS England in ensuring patients have equal access to cancer diagnostic tools across England.The Department of Health and Social Care is carrying out work to assess the barriers of effective adoption and improve the way artificial intelligence (AI) and diagnostic tools are deployed across the NHS in England. This is alongside the AI Diagnostic Fund, a £21 million fund allocated to 11 imaging networks, covering 64 trusts (49% of total) across all regions in England, to support the deployment of AI diagnostic tools to assist NHS staff to diagnose conditions such as cancer faster.The NHS Cancer Programme’s Innovation Open Call is held to identify and support the most promising innovations and has funded cancer diagnostic innovations in areas including medical devices, in vitro diagnostics, digital health solutions, behaviour interventions, artificial intelligence, robotics, and new models of care.The National Cancer Plan will include further details on how we will improve outcomes for cancer patients, as well as speeding up diagnosis and treatment, ensuring patients have access to latest tools and technology.

Whether funding for NHS waiting lists is proportionate to the average waiting list time in each region.

National Health Service funding provided to integrated care boards is decided via NHS England's Fair Share model and through the NHS resource allocation formula.The NHS resource allocation formula is intended to support equal opportunity of access for equal need, taking account of NHS England’s duty to have regard to the need to reduce health inequalities. The formula takes account of factors such as demography, morbidity, deprivation, and the unavoidable cost of providing services in different areas. In addition, a further adjustment to address health inequalities and unmet needs increases the resources directed to deprived areas. The formula is based on independent academic research and is overseen by the independent Advisory Committee on Resource Allocation, which provides advice to my Rt Hon. Friend, the Secretary of State for Health and Social Care and the Chief Executive of NHS England. Further detail on fair shares is available at the following link:https://www.england.nhs.uk/allocations/