Written questions by Brown-Fuller.

Whether targets to improve early diagnosis of myeloma will form part of the national cancer plan.

It is a priority for the Government to support the National Health Service to diagnose cancer, including blood cancers such as myeloma, as well as other unstageable cancers, as early and quickly as possible, and to treat it faster, in order to improve outcomes.To tackle late diagnoses of blood cancers, the NHS is implementing non-specific symptom pathways for patients who present with symptoms such as weight loss and fatigue, which do not clearly align to a tumour type. Blood cancers are one of the most common cancer types diagnosed through these pathways.We will get the NHS diagnosing blood cancer earlier and treating it faster, and we will support the NHS to increase capacity to meet the demand for diagnostic services through investment, including for magnetic resonance imaging and computed tomography scanners.The National Cancer Plan will include further details on how we will improve outcomes for cancer patients, including speeding up diagnosis and treatment, ensuring patients have access to the latest treatments and technology, and ultimately drive up this country’s cancer survival rates.

What steps his Department is taking to reduce the number of people on NHS waiting lists in Chichester constituency.

The Government is committed to putting patients first. Tackling waiting lists is a key part of our Health Mission. We have now exceeded our pledge to deliver an extra two million operations, scans, and appointments, having now delivered 4.9 million more appointments. This marks a vital first step to delivering on the commitment that 92% of patients will wait no longer than 18 weeks from referral to consultant-led treatment, in line with the National Health Service constitutional standard, by March 2029. Our Reforming elective care for patients plan, published in January, sets out how the NHS will reform elective care services and deliver on our ambitions.We are transforming diagnostics to cut long waits through community diagnostic centres (CDCs). Patients in the Chichester constituency are likely to be referred to either Bognor Regis War Memorial Hospital CDC, which has been delivering diagnostic activity since November 2021, or the University of Chichester Bognor Regis CDC, which has been delivering diagnostic activity since March.Dedicated and protected surgical hubs are transforming the way that NHS provides elective care by focusing on high-volume low-complexity surgeries. As of September, there are currently 120 operational surgical hubs across England. In Sussex, there is currently one operational surgical hub, at the Sussex Orthopaedic Treatment Centre, which opened in 2012. These surgical hubs help separate elective care facilities from urgent and emergency care, improving outcomes for patients and reducing pressures on hospitals. The Department is committed to ramping up the number of hubs over the next three years so that more operations can be carried out.

What comparative assessment he has made of the adequacy of the availability of ultrasound in primary care in (a) the UK, (b) Germany and (c) the Nordic nations; and what steps his Department is taking to expand access to diagnostic ultrasound in UK primary care (i) for gynaecological conditions and (ii) in general.

We are committed to transforming diagnostic services and will support the NHS to increase diagnostic capacity to meet the demand for diagnostic services.Our 10-Year Health Plan commits to shifting care from hospital to community, including diagnostic tests, and to ensuring care is more integrated across primary and secondary care.Diagnostic tests, such as ultrasounds, should be more easily accessible and located in the community and directly referred from primary care where possible, which is more convenient for patients than going to hospital. We have committed to build upon the current 169 Community Diagnostic Centres (CDCs) that are open across the country by expanding a number of these and by building up to five new CDCs, as well as expanding the number of CDCs that are open 12 hours a day, 7 days a week.We are also working to improve access for GP services to diagnostic tests, for example in CDCs. The GP Direct Access Programme has published guidance on the use of urgent direct access referrals to specific diagnostic tests. This includes, for example, ultrasounds for abdomen and pelvis for suspected different intra-abdominal cancers including those of the pancreas, colon, urological tract or lymphoma. Guidance is available at the following link: https://www.england.nhs.uk/long-read/urgent-gp-direct-access-to-diagnostic-services-for-people-with-symptoms-not-meeting-the-threshold-for-an-urgent-suspected-cancer-referral/.The Department of Health and Social Care has not currently made a comparative assessment of the adequacy of the availability of ultrasound in primary care in, the UK, Germany and the Nordic nations. NHS England monitors the age and distribution of imaging assets including ultrasound scanners (for non-obstetric use) across the country via its annual National Imaging Data Collection, which is available at the following link: https://www.england.nhs.uk/statistics/statistical-work-areas/diagnostics-waiting-times-and-activity/national-imaging-data-collection/.In March 2024, there were 3,468 ultrasound scanners assets in England, an increase of 467 compared to 3,001 in March 2023.

Whether he plans to (a) implement the Care Act 2014 provisions on protecting individuals from unaffordable care costs and (b) introduce a more generous means test for social care funding.

In July 2024, the Chancellor of the Exchequer announced that the planned adult social care charging reforms, which were inherited from the previous government, would not be taken forward in October 2025.The means test thresholds for support with adult social care costs are reviewed annually. The rates for the next financial year will be published via a Local Authority Circular in due course.The Government is committed to reforming the adult social care sector. We have launched an independent commission into adult social care as part of our critical first steps towards delivering a National Care Service. The Terms of Reference are sufficiently broad to enable Baroness Casey to independently consider how to build a social care system fit for the future, including considering the affordability of care costs if she sees fit.

What steps he is taking to increase the number of full-time psychiatrists in the NHS (a) nationally and (b) in Chichester constituency.

Decisions about recruitment are matters for individual National Health Service trusts. NHS trusts manage their recruitment at a local level, ensuring they have the right number of staff in place, with the right skill mix, to deliver safe and effective care.However, we know that the NHS has been facing workforce shortages for a number of years. While there has been growth in the mental health workforce over recent years, more is needed. That is why, as part of our mission to build an NHS that is fit for the future and that is there when people need it, the Government is recruiting an additional 8,500 mental health workers, including psychiatrists, by the end of this Parliament. We are more than halfway towards this target, which will help to ease pressure on busy mental health services.

What steps he is taking to widen access to appropriate therapy treatments for people with post-traumatic stress disorder (a) nationally and (b) in Chichester constituency.

The NHS Sussex Integrated Care Board is responsible for commissioning services to meet the mental health needs of the people in Chichester.People with post-traumatic stress disorder can self-refer to NHS Talking Therapies or their general practitioner can refer them.Nationally, the Government is investing an extra £688 million this year to transform mental health services. We have chosen to prioritise funding to expand NHS Talking Therapies, so that the number of people completing a course of treatment is expected to increase by 384,000 by 2028/29.We are also delivering on our commitment to recruit an additional 8,500 mental health workers for children and adults by the end of this Parliament. We are more than halfway towards this target, which will help to ease pressure on busy mental health services.

What assessment he has made of the potential implications for his policies of the report entitled World Breastfeeding Trends Initiative UK Report 2024, published in March 2025.

The Government is committed to giving children the best start in life, and infant feeding plays a crucial role in achieving this. We recognise the concerns raised in the World Breastfeeding Trends Initiative’s United Kingdom report and are considering the recommendations.We are already taking action to improve infant feeding support. We are strengthening the midwifery and health visiting workforce and building on these services by investing £18.5 million this year for infant feeding services through the Family Hubs and Start for Life programme in 75 local authorities in England. We are also investing in the National Breastfeeding Helpline which provides UK-wide support 24 hours a day, every day of the year, and are expanding Start for Life communications.

Whether his Department has made an assessment of the potential merits of widening the scope of the infant formula legislation to include the (a) digital and (b) other marketing of all (i) formula milks up to age 36 months and (ii) (A) bottles, (B) teats and (C) other equipment.

Infant feeding is critical to a baby’s healthy growth and development. The Government is committed to giving every child the best start in life, and that includes helping families to access support to feed their baby.Whilst breastfeeding has significant health benefits, we recognise that for those families that cannot or choose not to breastfeed, it is vital that they have access to infant formula that is affordable and high quality. Infant formula regulations ensure that all infant formula and follow on formula are safe and meet the nutritional requirements of babies and infants.The regulations cover the composition, marketing, and labelling of infant formula and follow-on formula but they do not cover bottle, teats, or other equipment, and there are no plans to extend the regulations to these areas nor to extend the regulations to other formula milks.

What plans his Department has to improve the (a) protection, (b) promotion and (c) support of optimal infant feeding.

It is important that all families are supported to make the right choices for them and to achieve their infant feeding goals. This includes families who cannot breastfeed or choose not to. We know that breastfeeding has significant benefits and are committed to encouraging and supporting breastfeeding.Most families will receive infant feeding information and support from midwives and health visitors. We are taking action to strengthen these services. We are taking further steps, including investing £18.5 million through the Family Hubs and Start for Life programme in 2025/26 to encourage breastfeeding and to provide infant feeding support across 75 local authorities in England. We have increased the capacity of the National Breastfeeding Helpline. The Start for Life communication programme also includes advice on breast and bottle-feeding and introducing solid foods.

What steps his Department is taking to increase the availability of autism assessments in (a) England and (b) Chichester constituency.

The Government has recognised that, nationally, the demand for assessments for autism has grown significantly in recent years and that people are experiencing severe delays for accessing such assessments. The Government’s 10-Year Health Plan will make the National Health Service fit for the future, and it recognises the need for early intervention and support, without the need for diagnosis.It is the responsibility of integrated care boards (ICBs) to make available appropriate provision to meet the health and care needs of their local population, including provision of autism services, in line with relevant National Institute for Health and Care Excellence guidelines.On 5 April 2023, NHS England published a national framework and operational guidance to help ICBs and the NHS to deliver improved outcomes for children, young people, and adults referred to an autism assessment service. The guidance also sets out what support should be available before an assessment and what support should follow a recent diagnosis of autism, based on the available evidence. Since publication, NHS England has been supporting systems and services to identify where there are challenges for implementation and how they might overcome these.

What steps his Department is taking to improve NHS 111 response times.

The Government is committed to continuing to improve NHS 111 to ensure patients can access the right care the first time, only visiting accident and emergency when necessary.The latest published data shows that May 2025 saw the lowest average NHS 111 call answer time since records began in April 2021, 4 seconds faster than in April 2025, and 58 seconds faster than in May 2024. The average NHS 111 call answer time in the year to date is 46 seconds, compared to 157 seconds in the same period in 2024.Whilst NHS 111 response times have improved, we recognise there is more to do. On 6 June 2025, we published our Urgent and Emergency Care Plan for 2025/26, which includes the commitment to publish and implement the recommendations from the NHS 111 review to make the service quicker and simpler to navigate.

What assessment he has made of the adequacy of the availability of job opportunities for newly qualified nurses.

Decisions on the employment of newly qualified nurses are a matter for individual National Health Service trusts, which manage their recruitment at a local level, ensuring they have the right number of staff in place, with the right skill mix, to deliver safe and effective care.We are working closely with NHS England, employers, universities, and regional nursing leads to ensure support is in place to help graduating nurses find a role as soon as possible after qualification and transition into the workplace.

What steps his Department is taking to reduce waste in the NHS.

There are a range of initiatives in the National Health Service to tackle waste, ranging from locally managed walking aid refurbishment schemes to innovative projects on the reuse of surgical textiles. NHS England has also been working to reduce the wastage of medicines, as recommended in the National Overprescribing Review in 2020.In addition, in October 2024, the Department published the Design for Life roadmap, a new strategy to transition away from all avoidable single-use medical technology products towards a functioning circular system by 2045. The Design for life Roadmap is available at the following link:https://assets.publishing.service.gov.uk/media/679ca015a9ee53687470a2ed/design-for-life-roadmap.pdfSingle-use medical devices such as tourniquets and scissors, as well as high-tech electronic devices like harmonic shears, are often expensive and are thrown away after a single use. The programme is building on examples of where NHS organisations are already achieving cost, waste, and carbon savings.

What his planned timeline is for responding to the Competition and Markets Authorities recommendations in their report into the infant formula and follow-on formula market, published on 20 February 2024.

Infant feeding is critical to a baby’s healthy growth and development. The Government is committed to giving every child the best start in life, and that includes helping families to access support to feed their baby.Whilst breastfeeding has significant health benefits, we recognise that for those families that cannot or choose not to breastfeed, it is vital that they have access to infant formula that is affordable and high quality. Infant formula regulations ensure that all infant formula is suitable for meeting the nutritional needs of babies, regardless of the price or brand.The Government welcomes the Competition and Markets Authority’s market study into the United Kingdom’s infant formula and follow-on formula market. We are working closely with other Government departments and the devolved administrations to carefully consider its findings and recommendations, and will respond fully in due course.

If he will review the decision by NHS Hampshire and Isle of Wight Integrated Care Board to close Westbourne Surgery.

The Department understands that the general practice (GP) partners at Emsworth Medical Practice have arrived at the decision to propose the closure of the Westbourne Branch Surgery and that the proposed date of closure is 27 June 2025.There are no plans to review the decision by NHS Hampshire and Isle of Wight Integrated Care Board to close Westbourne Surgery. There is a high bar set out in guidance for intervention by my Rt. Hon. friend, the Secretary of State for Health and Social Care, in contested reconfiguration cases, who would expect all avenues of local resolution to be exhausted before a call-in request is made.Responsibility for the delivery, implementation, and funding decisions for services ultimately rests with the appropriate National Health Service commissioner, in this case, NHS Hampshire and Isle of Wight Integrated Care Board (ICB), rather than the Department. The closure of a GP surgery is an issue that is considered and decided upon by local commissioners following an application from a GP provider.Local health and care organisations are best placed to make decisions on commissioning services for their communities, working with local authorities, stakeholders, and local populations to meet people’s needs.When a practice does close, patients will be informed of the closure and advised to register at another local practice of their choice within their area. Commissioners must put in place appropriate measures to ensure that the affected patients have access to GP services.

What progress his Department has made on implementing the Immediate and Essential Actions of the Ockenden review, published on 30 March 2022.

All the recommendations made by Donna Ockenden in her review into maternity services at the Shrewsbury and Telford Hospital Trust in 2022 were accepted, including the requests made to the Government, the health system more widely, and the trust. Following publication of the Ockenden review, NHS England wrote to all trusts and systems asking them to deliver the recommendations and report to their public boards.To support this delivery, NHS England’s three-year delivery plan for maternity and neonatal services brought together the immediate and essential actions from the Ockenden review with those from other reports and guidance. The National Health Service’s operational planning guidance sets out the expectation that trusts should implement the key actions from the plan. In accordance with the NHS operating framework, it is for integrated care boards to oversee local progress with this. The technical guidance which accompanies the plan sets out how we are monitoring progress at a national level.The plan is in its final year of delivery, and progress has been made across the four themes to improve outcomes and experiences for women and their babies.The Shrewsbury and Telford Hospital Trust has seen a significant improvement in overall midwifery staffing levels. The trust has enhanced its senior and specialist midwifery teams to provide additional leadership, expert advice, and support for women and families, as well as the clinical teams. The Shrewsbury and Telford Hospital Trust now has in place robust training programmes that equip the maternity workforce with up-to-date skills, training, and development, including in the management of emergency scenarios.On 23 June 2025, my rt. Hon. Friend, the Secretary of State for Health and Social Care, announced the launch of an independent, national Investigation into NHS maternity and neonatal services to look at the systemic issues behind why so many women, babies and families experience unacceptable care. It will look at up to 10 maternity and neonatal units where there are specific issues, international evidence, adoption of best practice and a system-wide investigation of maternity and neonatal care. There have been several reviews, inquiries and national research into maternity and neonatal care in recent years, including Ockenden. The investigation will bring together lessons from past these reviews and will produce, by December 2025, one clear set of national recommendations to achieve high quality, safe care across maternity and neonatal services, and that women and families are listened to. The investigation will take previous recommendations, including the Immediate and Essentials actions from Ockenden, into consideration to ensure we are providing clarity to the system and effectively delivering the change needed.Alongside this, my rt. Hon. Friend, the Secretary of State for Health and Social Care, also announced we would be establishing a National Maternity and Neonatal Taskforce, which he would chair. It will use the recommendations from the investigation to develop a national plan to drive improvements across maternity and neonatal care, holding the system to account for delivering the actions and working closely with families to ensure their voices are central to this work.

Whether GP training includes a mandatory rotation on (a) obstetrics and (b) gynaecology.

The curricula for postgraduate medical specialty training are set by individual royal colleges and faculties. The General Medical Council approves curricula and assessment systems for each training programme. Curricula emphasise the skills and approaches that a doctor must develop in order to ensure accurate and timely diagnoses and treatment plans for their patients. The Royal College of General Practitioners (RCGP) sets the curriculum that all general practitioners (GPs) must cover before they are able to pass the examination to become a member of the RCGP and to work independently as a GP.Obstetrics and gynaecology are not mandatory specialties in a GP programme, and there are no mandatory jobs in GP specialty training. GP training is a balanced programme which allows the trainee to meet the outcomes of the curriculum. Women's health, including sexual and reproductive health, is a significant element of the General Practice and Community Placement elements of GP specialty training and of the curriculum.

What assessment he has made of the potential impact of US tariffs on the domestic supply of (a) methylphenidate and (b) pancreatic enzyme replacement therapy.

The Department is working closely with life sciences stakeholders and other Government departments to assess the potential impact of United States tariffs on global medicine supply chains. We have a range of well-established processes to mitigate risks to patients where there are shortages. We will continue to review the need to utilise these procedures as more information becomes available on the impact of tariffs on any specific products or companies.

What assessment he has made of the potential impact of US tariffs on the UK pharmaceutical industry.

The Department is working closely with United Kingdom pharmaceutical firms and trade associations to understand how United States tariffs may impact the sector and the trade of individual products. As this is an evolving situation, these assessments are ongoing, but we will continue to closely review the potential impact as more information becomes available.

What progress he has made on increasing the availability of (a) methylphenidate and (b) pancreatic enzyme replacement therapy.

As a result of intensive work, some issues with attention deficit hyperactivity disorder medicines have resolved. All strengths of lisdexamfetamine, atomoxetine capsules, atomoxetine oral solution, and guanfacine prolonged-release tablets are now available.However, whilst supply of methylphenidate prolonged-release tablets has greatly improved, some issues persist. We are continuing to work to resolve these remaining issues by engaging with all suppliers of methylphenidate prolonged-release tablets and capsules to assess the challenges faced and their actions to address them. We are also directing suppliers to secure additional stocks, expedite deliveries where possible, and review plans to build further capacity to support the continued growth in demand for the short and long-term. The Department is also working with new suppliers of methylphenidate prolonged-release tablets to improve supply and resiliency for the United Kingdom’s market.The Department is continuing to engage with all suppliers of pancreatic enzyme replacement therapy (PERT) to mitigate the supply issue that is affecting the whole of the UK. Through this, we have managed to secure additional volumes of PERT for 2025 for the UK. We are continuing to work with all suppliers to understand what more can be done to add further resilience to the market. The Department has also reached out to specialist importers who have sourced unlicensed stock to assist in covering the remaining gap in the market.In the longer term, the Department has had interest from non-UK suppliers wishing to bring their products to the UK and, along with colleagues in the Medicine and Healthcare products Regulatory Agency, we are working with these potential suppliers, and if authorised, these products could further diversify and strengthen the market.