Written questions by Shannon.

What steps he is taking with Cabinet colleagues to help encourage people to have healthy diets.

Supporting people to stay healthier for longer is at the heart of this government’s Health Mission. Government advice on a healthy, balanced diet is encapsulated in the United Kingdom’s national food model, the Eatwell Guide. The Eatwell Guide depicts a healthy, balanced diet that is based on fruit, vegetables and higher fibre starchy carbohydrates. The Eatwell Guide principles are promoted through the NHS.uk website and the Government’s social marketing campaign, Better Health, including Healthier Families and Start for Life. The guide is available at the following link:https://www.gov.uk/government/publications/the-eatwell-guideThe Healthy Start scheme was introduced in 2006 to encourage a healthy diet for pregnant women, babies, and young children under four from very low-income households. It can be used to buy, or put towards the cost of, fruit, vegetables, pulses, milk, and infant formula. Healthy Start beneficiaries have access to free Healthy Start Vitamins for pregnant women and children aged under four. In October 2024, Healthy Start supported over 353,000 beneficiaries; this figure is higher than the previous paper voucher scheme.The School Fruit and Vegetable scheme provides children in Key Stage 1 at state-funded primary schools with a free portion of fruit or vegetable every school day, to help to encourage healthier eating.The Government is also committed to implementing the advertising restrictions for less healthy food and drink on TV and online, bringing forward the necessary secondary legislation to deliver our commitment to ban the sale of high-caffeine energy drinks to children under 16 years old, and limiting school children’s access to fast food. Further action under the Government’s Health Mission will be set out in due course.

Whether his Department plans to develop a respiratory action plan to support patients with chronic obstructive pulmonary disease.

The 10-Year Health Plan will consider the change needed to meet the three Health Mission goals, those being: a fairer system where everyone lives well for longer; a National Health Service that is there when people need it; and fewer lives lost to the biggest killers.We will carefully be considering policies with input from the public, patients, health staff, and our stakeholders as we develop the plan.NHS England is leading on the development of an approach for chronic obstructive pulmonary disease management, to proactively manage rising risk patients in winter, to reduce demand on primary and secondary care. This includes the identification of rising risk patients, optimisation of care, support and management through remote monitoring and a greater focus on self-management and education, and access to strengthened support in the community.

If he will make an assessment of the potential impact of the proposed reform of Medicines and Healthcare products Regulatory Agency statutory fees on investment in the UK market by medical technology companies in the (a) short and (b) long term.

The Medicines and Healthcare products Regulatory Agency (MHRA) regulates medicines, medical devices, and blood components for transfusion in the United Kingdom.Most of the MHRA’s income comes from charging fees for its services. Its fees are set to recover the full cost of delivering the respective services. This is in compliance with the HM Treasury guidance, Managing Public Money.The MHRA aims to update its fees every two years, so that it can continue to recover its costs. This ensures the agency’s continued financial sustainability, and the ongoing delivery of its services.The MHRA has recently consulted on its current fee uplift. The consultation has now closed, and they are analysing the responses. The Government response to the consultation should be published in the new year.By ensuring that the MHRA is fully recovering costs, it is in a better position to deliver the level of service that industry, patients, and the public want and expect. The fees uplift is not expected to adversely impact the UK favourability in the short- or the long-term. Regular fee increases are standard practice across all regulators.

If he will take steps to ensure Integrated Care Systems are resourced to provide medicines for (a) chronic obstructive pulmonary disease and (b) other life-threatening respiratory diseases.

As part of the 2024 Autumn Budget, the Government has allocated the National Health Service an extra £25.7 billion over this year and the next.Medicines for chronic obstructive pulmonary disease and other respiratory diseases are commissioned by local NHS integrated care boards, who are responsible for developing commissioning policies in line with national guidance.NHS England has established 13 Respiratory Clinical Networks across the country. These have been vital in providing clinical leadership for respiratory services and supporting services in primary care.

If he will make an assessment of the potential impact of proposed reforms to the Medicines and Healthcare products Regulatory Agency's statutory fees structures on (a) the Agency, (b) industry, (c) the NHS and (d) patients.

The Medicines and Healthcare products Regulatory Agency (MHRA) regulates medicines, medical devices, and blood components for transfusion in the United Kingdom.Most of the MHRA’s income comes from charging fees for its services. Its fees are set to recover the full cost of delivering the respective services. This is in compliance with the HM Treasury guidance, Managing Public Money.The MHRA aims to update its fees every two years, so that it can continue to recover its costs. This ensures the agency’s continued financial sustainability, and the ongoing delivery of its services.The MHRA has recently consulted on its current fee uplift. The consultation has now closed, and they are analysing the responses. The Government response to the consultation should be published in the new year. With regards to the expected impacts:the fees uplift will ensure the MHRA’s continued financial sustainability and the ongoing delivery of its services;the MHRA’s fees will increase for industry, as by ensuring that the MHRA is fully recovering costs, it will be in a better position to deliver the level of service that the industry wants and expects;the MHRA’s fees will increase for everyone, including the National Health Service, however, the impact on the NHS is expected to be small as it represents a small proportion of the MHRA’s total income, and the increase in its costs is also expected to be small; andthe fees uplift it will ensure the MHRA is sufficiently resourced to deliver its public health duties for patients, and additionally, the charging fees mean that the regulated bear the cost of regulation, rather than the taxpayer and patients themselves.

What assessment he has made of the potential implications for his policies of proposals to end funding of IsaPD.

We have made no such assessment. The National Institute for Health and Care Excellence (NICE) makes recommendations on whether new medicines should be routinely funded by the National Health Service based on an assessment of their costs and benefits.The NICE is currently updating its existing guidance on the use of isatuximab with pomalidomide and dexamethasone for treating relapsed and refractory multiple myeloma, following a period of managed access via the Cancer Drugs Fund.The NICE was unable to recommend isatuximab with pomalidomide and dexamethasone as a clinically and cost-effective use of NHS resources in its final draft guidance published on 20 June. The NICE received two appeals against its draft recommendation which were heard by an independent panel. The panel has upheld the appeal on some grounds and the NICE’s appraisal committee will meet to consider the appeal panel’s findings.Any changes to the NICE’s recommendations for isatuximab with pomalidomide and dexamethasone are not intended to affect people who started treatment during the period of managed access, who will continue to have access to isatuximab with pomalidomide and dexamethasone until they and their clinician consider it appropriate to stop.It is right that the NICE makes its decisions at arm’s length of the Government and in line with its carefully developed methods and processes. As such, it would not be appropriate for the Department to intervene in the NICE’s decision-making.

How many women have been newly prescribed hormone replacement therapy in the last 12 months.

The NHS Business Services Authority does not hold data relating to the number of women who have been newly prescribed hormone replacement therapy (HRT) products in the last 12 months. However, the available data does indicate that the estimated number of identified patients who were prescribed at least one HRT drug item in England increased by 12%, from 2.3 million in 2022/23 to 2.6 million in 2023/24. Further information is available at the following link:https://nhsbsa-opendata.s3.eu-west-2.amazonaws.com/hrt/hrt_June_2024_v001.html

What his Department's policy is on legalising medicinal cannabis.

Since 1 November 2018, there has been a legal route for cannabis-based products for medicinal use to be prescribed by doctors on the General Medical Council specialist register, in accordance with the Misuse of Drugs Regulations 2001. The Government has no current plans to change this.

Whether he has had discussions with the Department of Health in Northern Ireland on improving health outcomes for people on waiting lists for the treatment of endometriosis.

It is unacceptable that patients across the United Kingdom continue to wait lengthy periods for treatment, including for endometriosis. Cutting waiting lists is a key priority for the Government. We recognise the challenges faced by women with endometriosis and the significant impact it has on their lives, their relationships and their participation in education and the workforce.Departmental officials have met and continue to meet with counterparts across the four nations to share learning across a range of women’s health policy issues, including menstrual health. Together we aim to deliver faster, improved, and more equitable health outcomes for all patients across the UK, and to strengthen our collaboration in achieving these common goals.The Department of Health in Northern Ireland has identified challenges within gynaecology care, including for endometriosis and commissioned NHS England's Getting It Right First Time (GIRFT) programme to conduct an independent review of gynaecology waiting lists in Northern Ireland, published in January 2024. The report set out a number of recommendations and is available at the following link:https://www.health-ni.gov.uk/publications/gynaecology-girft-report-january-2024

Whether he plans to review the funding model for hospices for children and young people as part of the 10-Year Health Plan for the NHS.

Most hospices are charitable, independent organisations which receive some statutory funding for providing services within the National Health Service. The amount of funding charitable hospices receive varies by integrated care board (ICB) area, and will, in part, be dependent on the breadth of palliative and end of life care provision within each ICB catchment area.We have committed to develop a 10-year plan to deliver an NHS fit for the future. We will carefully be considering policies, including those that impact people with palliative and end of life care needs, with input from the public, patients, health staff, and our stakeholders, including those in the hospice sector, as we develop the plan.The engagement process has been launched, and I would encourage the palliative and end of life care sector, including hospice providers, service users and their families, to engage with that process to allow us to fully understand what is not working as well as it should and what the potential solutions are. More information is available at the following link:https://change.nhs.uk/en-GB/

What data his Department holds on the number of people diagnosed with sleep apnea in the last 12 months.

The Department can provide the number of hospital admissions where there was a diagnosis of sleep apnoea, although it should be noted that there are likely to be other cases where the condition was diagnosed in a primary care setting. The number of hospital admissions for 2023/24 where there was a diagnosis of sleep apnoea was 21,042. Please also note that this data is a count of episodes, not patients, as a patient may have had more than one admission within the requested timeframe.

How many people were being treated for lung cancer in August 2024.

The number of people who received either a first or subsequent treatment for lung cancer in August 2024 was 4,672.

What assessment he has made of the potential implications for his policies of the prolonged use of steroid creams.

The decision to prescribe a particular drug is a clinical one, and should be based on the patient’s medical needs. Decisions about what medicines to prescribe are made by the doctor or healthcare professional responsible for that part of the patient’s care, and prescribers are accountable for their prescribing decisions, both professionally and to their service commissioners. It is for the general practitioner or other responsible clinician to work with their patient and decide on the course of treatment, with the provision of the most clinically appropriate care for the individual always being the primary consideration.The Medicines and Healthcare products Regulatory Agency (MHRA) is responsible for continually monitoring the safety of medicines and taking action to minimise risks to patients where necessary. The MHRA has reviewed topical steroid withdrawal reactions, and first communicated about these reactions in September 2021. This communication is available at the following link:www.gov.uk/drug-safety-update/topical-corticosteroids-information-on-the-risk-of-topical-steroid-withdrawal-reactions.Since then, the MHRA has continued to monitor reports of topical steroid withdrawal reactions and has undertaken a further review, which was published in May 2024. This review is available at the following link:www.gov.uk/drug-safety-update/topical-steroids-introduction-of-new-labelling-and-a-reminder-of-the-possibility-of-severe-side-effects-including-topical-steroid-withdrawal-reactions.Further advice has been sought from dermatologists, the National Eczema Society, and the Commission on Human Medicines, and the MHRA is taking forward a number of actions, including updated warnings in the product information and the inclusion of information regarding the potency of topical steroids on the packaging. The MHRA is engaging with the British Association of Dermatologists who have released an updated statement. The statement is available at the following link:https://cdn.bad.org.uk/uploads/2024/02/22095550/Topical-Steroid-Withdrawal-Joint-Statement.pdf.Topical corticosteroid product information contains the following warnings about the dangers of long-term use: ‘Long-term use of topical steroids can result in the development of rebound flares after stopping treatment (topical steroid withdrawal syndrome). A severe form of rebound flare can develop which takes the form of a dermatitis with intense redness, stinging and burning that can spread beyond the initial treatment area. It is more likely to occur when delicate skin sites such as the face and flexures are treated. Should there be a reoccurrence of the condition within days to weeks after successful treatment a withdrawal reaction should be suspected. Reapplication should be with caution and specialist advise is recommended in these cases or other treatment options should be considered’.

What estimate he has made of the number of people being treated for diet related illnesses.

Diet is an important part of maintaining good health and reducing the risk of chronic diseases such as cardiovascular disease, type 2 diabetes, and some cancers, such as bowel, breast, and pancreatic cancer. Illnesses related to diet are very broad, ranging from malnutrition, dental decay, mental health conditions, and other diseases attributable to overweight and obesity.Comparable data is not directly available on the number of people being treated for all diet related illnesses. There is data on the number of people being treated for some illnesses which can be attributed to dietary risk factors. However, it is not known if all these cases were caused by diet related risk factors. From a malnutrition perspective, in 2022/23, there were 10,795 admissions for malnutrition reported by National Health Service trusts. Further information on malnutrition is available at the following link:https://digital.nhs.uk/supplementary-information/2024/malnutrition-admissions-by-provider-2009-10-to-2022-23It is estimated 8.5% of adults in the United Kingdom have diabetes. For people with type 2 diabetes, we estimate that 810,000 people achieved all three treatments targets, those being National Institute for Health and Care Excellence recommended treatment targets for Hba1c (glucose control), blood pressure, and serum cholesterol, in 2020/21, which is the equivalent to 35.5% of people with type 2 Diabetes. Further information is available at the following link:https://fingertips.phe.org.uk/profile/cardiovascular/data#page/In 2022/23, NHS England data shows that 214,000 hospital admissions were due to coronary heart disease. It is possible to estimate the number of people with some illnesses which can be partly attributed to diet related risk factors, including cardiovascular disease and type 2 diabetes. NHS England estimates that approximately 1.9 million individuals in England have coronary heart disease, which is a component of cardiovascular disease. Further information is available at the following link:https://fingertips.phe.org.uk/profile/cardiovascular/data#page/The Office for Health Improvement and Disparities estimates that approximately 4 million individuals in England have both type 1 and 2 diabetes, with further information available at the following link:https://fingertips.phe.org.uk/profile/diabetes-ft/data#page/Estimates are also available on the proportion of cases or deaths from some illnesses which can be attributed to diet related risk factors. The Global burden of disease estimated that in England there were approximately 50,000 deaths attributable to diet related risk factors in 2021. Further information is available at the following link:https://vizhub.healthdata.org/gbd-results/Finally, Cancer Research UK estimates that 6%, or 23,000 out of 385,000, of cancer cases in the UK are attributable to obesity and overweight.

How many people are being treated for chronic obstructive pulmonary disease.

The Department does not hold this data. Most chronic obstructive pulmonary disease treatment will take place in the community, so this information will be held at a regional level.

What assessment he has made of the adequacy of dementia diagnosis times; and what steps his Department is taking to improve diagnosis rates.

We are committed to improving dementia diagnosis rates and recovering them to the national ambition for two thirds of people with dementia to have a formal diagnosis.NHS England has funded an evidence-based improvement project to fund two trusts in each region, 14 sites in total, to pilot the Diagnosing Advanced Dementia Mandate tool to improve the diagnosis of dementia and the provision of support in care homes. All pilots completed at the end of May 2024, and it is anticipated that learning will be shared by end of the third quarter of 2024/25.The Government’s Dame Barbara Windsor Dementia Goals programme is investing in innovations in biomarkers, clinical trials, and implementation. Some of these innovations could support improved diagnosis in the future, if validated for clinical use.

What funding his Department provides for research on rare genetic disorders.

The Department remains committed to supporting research into rare diseases, and pioneering research is an underpinning theme of the UK Rare Diseases Framework. Since April 2022, the Department has invested over £2.2 million for the National Institute of Health and Care Research to carry out research programmes related to rare genetic diseases, and £341 million for Genomics England. This covers all funding allocated to Genomics England for the 2022/23 to 2024/25 financial years, including to deliver the National Genomic Research Library to enable research into rare genetic diseases, and for the Generation Study to evaluate the use of whole genome sequencing to diagnose rare genetic conditions in newborns.

What steps he is taking to prevent the spread of Mpox.

There are two distinct types, known as clades, of the Mpox virus, specifically clade I and clade II. The previous significant outbreak in the United Kingdom in 2022 was from clade II. Details of the current National Health Service Mpox vaccination programme are available at the following link:https://www.nhs.uk/conditions/mpox/#:~:text=people%20who%27ve%20been%20in,up%20to%2014%20days%20afterClade I is currently classified as a high consequence infectious disease. The UK Health Security Agency (UKHSA) has led extensive planning across the Government and the NHS to deal with Mpox cases in the UK, and will coordinate contact tracing and offer testing and vaccination to contacts as needed.Four cases of clade I Mpox have been detected in the UK, three of which are household contacts of the first case. All four patients are currently under specialist medical care.In line with the advice of the Advisory Committee for Dangerous Pathogens, the border response for direct flights from affected countries includes pre-arrival health declarations. Digital messaging is displayed on information screens at 10 international airports in England and the Eurostar terminal, and the UKHSA is meeting flights from affected countries and giving health advice leaflets to passengers and crew.We are placing a strong emphasis on ensuring that there are high levels of awareness among clinicians about the risks and the actions they need to take. The UKHSA Returning Workers Scheme for organisations sending workers to outbreak areas also provides pre-travel advice, active monitoring on return, and medical support for symptomatic returnees when necessary. Pre-travel advice for Mpox is publicly available on TravelHealthPro website, which is available at the following link:https://travelhealthpro.org.uk/The risk to the general population of the UK of being exposed to Mpox clade I is currently considered low.

If he will provide additional funding for prostate cancer (a) care and (b) research.

The Government is committed to getting the National Health Service diagnosing cancer earlier and treating it faster, so that more patients survive with better outcomes, including for those with prostate cancer. The NHS is working towards the Faster Diagnosis Standard (FDS), which ensures a patient receives their cancer diagnosis or has cancer ruled out within 28 days of an urgent referral. NHS England has streamlined cancer pathways, including implementing a best-timed prostate cancer diagnostic pathway, so that those suspected of prostate cancer receive a multi-parametric magnetic resonance imaging scan first, which ensures that only those men most at-risk undergo an invasive biopsy. Best practice timed pathways support the on-going improvement effort to shorten diagnosis pathways, reduce variation, improve experience of care, and meet the FDS.Furthermore, the NHS England’s Getting It Right First Time programme published guidance in April 2024 to support the implementation of good practice in the management of prostate cancer, which includes ensuring the diagnostic pathways for prostate cancer were implemented from a primary care setting to a secondary care presentation.The Government is strongly committed to supporting research into cancer. Through partnerships with patients, researchers, funders, and charities we continue to play a significant role in global efforts against the disease. Research is crucial in tackling cancer, which is why the Department invests £1.5 billion per year in health research through the National Institute for Health and Care Research (NIHR). NIHR research expenditure for all cancers was £121.8 million in 2022/23. The NIHR spends more on cancer than any other disease group.The TRANSFORM trial is an important example of prostate cancer research, as a £42 million screening trial which aims to find ways of detecting prostate cancer earlier. Prostate Cancer UK is leading the development of the trial, with the Government contributing £16 million through the NIHR. The TRANSFORM trial will also aim to address some of the inequalities that exist in prostate cancer diagnosis today, ensuring that at least 10% of the men who are invited to participate in the trial are black, to inform a targeted approach for earlier diagnosis.The NIHR welcomes funding applications for research into any aspect of human health, including prostate cancer. 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.

How many medical technologies were (a) piloted in the NHS in (i) 2023 and (ii) 2024, (b) supported after successful pilots in those years and (c) adopted at scale in the last year.

In February 2023, the Department published its first ever strategy for MedTech, as well as a one year on update in April 2024, outlining our priorities for improving the adoption and spread of safe, effective, and innovative medical technologies across the National Health Service.NHS England holds data on innovation adoption and scale for specific NHS England programmes and policies, such as the MedTech Funding Mandate programme. Providing data on individual programmes in response to this question does not provide a complete picture of activity.For example, the Health Tech Adoption and Acceleration Fund will have funded a mixture of pilots and scaling of existing programmes, however this was largely managed at local level, and NHS England do not centrally hold data on what is a pilot and what is a scaled programme.Pilot and evaluation data is held at provider level, which includes acute, primary, community, and secondary care providers. These organisations are not required to report pilot outcomes to NHS England. They work autonomously but in partnership with technology evaluators, academics, researchers, or other expert partners such as the Health Innovation Networks. NHS England produces an annual Health Innovation Network report, which is due to come out this Autumn. The 2022/23 is available at the following link:https://thehealthinnovationnetwork.co.uk/wp-content/uploads/2023/08/AHSN-Network-Workforce-Impact-Report-2023.pdfThe data is aggregated, so it is not possible to extrapolate from the report how many of the projects are technology pilots.