Written questions by Milne.

What assessment his Department has made of the potential merits of providing breast cancer screening for women under 40 with Neurofibromatosis type 1.

The Government is committed to improving cancer screening services in line with the National Cancer Plan and as part of the 10-Year Health Plan’s shift from treatment to prevention.Neurofibromatosis type 1 (NF1) affects individuals differently. An individual’s risk of breast cancer is based on a number of factors. These factors may vary throughout a lifetime which is why individuals are advised to seek advice from their health professionals.Most individuals with NF1 would be considered at moderate risk of breast cancer, which would mean they could be referred to local cancer surveillance programme commissioned via the integrated care boards.The National Institute of Health and Care Excellence’s guidance does not address NF1 specifically but does state that people with certain genetic conditions should be referred through to a geneticist to consider their risk and may qualify for annual breast screening between the ages of 40 and 50 years old.The UK National Screening Committee (UK NSC), which advises the Government on all screening matters, has never been asked to look at creating a separate programme for women with NF1. Any individual or organisation can submit a proposal during the committee’s three-month open call for topics.The UK NSC will consider whether the proposal is within the UK NSC remit and, if so, how the topic should be explored further.

What assessment his Department has made of the potential impact of the Food Standard Agency’s official control charges on the viability of small and medium sized abattoirs.

Information on the 2025/26 charge rates for official controls, or inspections, conducted in meat premises is available on the Food Standards Agency’s (FSA’s) website at the following link:https://www.food.gov.uk/business-guidance/charges-for-controls-in-meat-premisesAs in previous years, the impact of charges will be offset by a discount which provides the greatest proportional support to smaller businesses. The impact of the discount on different sized food businesses in England and Wales for 2025/26 is set out in the Cost Data Slides the FSA has published.The FSA has conducted an evaluation of the current discount scheme which began with a Call for Evidence in autumn 2024. Extensive stakeholder engagement and consideration by the FSA Board in its public meetings has followed which has informed proposals for a revised scheme. At its public meeting on 10 December, the FSA Board agreed to a full public consultation on proposals for a scheme that would direct more targeted support towards smaller abattoirs. The consultation is planned for spring 2026 and will be accompanied by an assessment of impact.

Whether he plans to grant local authorities powers to apply local means-testing policies to the Disabled Facilities Grant budget.

In England, we continue to fund the Disabled Facilities Grant (DFG) which is administered by local authorities. This grant helps eligible older and disabled people on low incomes to adapt their homes to make them safe and suitable for their needs. Practical changes include installing stairlifts, level-access showers, and ramps.Local authorities already have a significant amount of flexibility in how they deliver the DFG, including removing means testing for grants costing under a certain amount. Local authorities have flexibility on determining the level below which they wish to remove the means test.We have provided an additional £172 million over two years to uplift the DFG, which could fund approximately 15,000 extra home adaptations. This brings total funding for the DFG to £711 million in each of 2024/25 and 2025/26.

What information his Department holds on the number of claims for clinical negligence in each NHS Trust in the most recent period for which data is available.

NHS Resolution (NHSR) manages clinical negligence and other claims against the National Health Service in England. The table attached shows the number of clinical claims and incidents received in the 2024/25 financial year, broken down by NHS trust.The table provided sets out the number of clinical negligence claims and incidents notified to NHSR by NHS trusts in the most recent period for which data is available. It should be noted that these figures are based on the financial year in which a claim or incident was notified to NHSR, however, the incident may have occurred in previous financial years.

Whether David Lock KC’s review of the legal costs of clinical negligence will be published.

The rising costs of clinical negligence claims against the National Health Service in England are of great concern to the Government. Costs have more than doubled in the last 10 years and are forecast to continue rising, putting further pressure on NHS finances.As announced in the recently published 10-Year Health Plan for England, David Lock KC will be providing expert policy advice on the rising legal costs and how we can improve patients’ experience of clinical negligence claims, ahead of a review by the Department in the autumn. The results of David Lock’s work will inform future policy making in this area. No decisions on policy have been taken at this point. The Government will provide an update on the work done and next steps, in due course.

What (a) organisations and (b) individuals has David Lock KC had discussions with as part of his review into the legal costs of clinical negligence.

The rising costs of clinical negligence claims against the National Health Service in England are of great concern to the Government. Costs have more than doubled in the last 10 years and are forecast to continue rising, putting further pressure on NHS finances.As announced in the recently published 10-Year Health Plan for England, David Lock KC will be providing expert policy advice on the rising legal costs and how we can improve patients’ experience of clinical negligence claims, ahead of a review by the Department in the autumn. The results of David Lock’s work will inform future policy making in this area. No decisions on policy have been taken at this point. The Government will provide an update on the work done and next steps, in due course.

What estimate his Department have made of potential savings of the implementation of Fixed Recoverable Costs for clinical negligence claims valued up to (a) £25,000, (b) £100,000 and (c) £250,000.

The rising costs of clinical negligence claims against the National Health Service in England are of great concern to the Government. Costs have more than doubled in the last 10 years and are forecast to continue rising, putting further pressure on NHS finances.As announced in the recently published 10-Year Health Plan for England, David Lock KC will be providing expert policy advice on the rising legal costs and how we can improve patients’ experience of clinical negligence claims, ahead of a review by the Department in the autumn. The results of David Lock’s work will inform future policy making in this area. No decisions on policy have been taken at this point. The Government will provide an update on the work done and next steps, in due course.

Whether his Department has made an assessment of the potential impact of repealing S2(4) of the Law Reform (Personal Injuries) Act 1948 on NHS costs.

The rising costs of clinical negligence claims against the National Health Service in England are of great concern to the Government. Costs have more than doubled in the last 10 years and are forecast to continue rising, putting further pressure on NHS finances.As announced in the recently published 10-Year Health Plan for England, David Lock KC will be providing expert policy advice on the rising legal costs and how we can improve patients’ experience of clinical negligence claims, ahead of a review by the Department in the autumn. The results of David Lock’s work will inform future policy making in this area. No decisions on policy have been taken at this point. The Government will provide an update on the work done and next steps, in due course.

Whether his Department has made an assessment of the effectiveness of utilising shareable health data to help (a) fire and rescues services and (b) local authorities identify vulnerable residents.

The Department has not made a formal assessment of using health data in this way but is aware of exploratory work underway in the National Health Service, including in Greater Manchester. This year the Department is working to tackle the underlying barriers to linking health and non-health data to improve outcomes and is supporting a small number of priority projects.

When he plans to publish the men’s health strategy; and whether it will include funding to help prevent (a) suicide and (b) premature death for men.

We are developing a Men's Health Strategy which will seek to improve the health and wellbeing of all men in England. This includes finding the right ways to promote healthier behaviours, improving outcomes for health conditions that hit men harder, and improving engagement with healthcare. The strategy will be informed by the Call for Evidence which closed on 17 July 2025. We aim to launch the Men’s Health Strategy later this year.

How many of the commercial arrangements made by NHS England with marketing authorisation holders between January 2020 and September 2025 involving indication-specific pricing were for indications for (a) rare non-oncology and (b) ultra-rare non-oncology conditions.

Between January 2020 and September 2025, NHS England entered into 75 commercial arrangements involving indication-specific pricing. Of these, eight of the commercial agreements have involved indication-specific pricing for rare non-oncology conditions, and of those eight, two were for indications classed as ultra-rare non-oncology conditions. Please note that the following definitions of rare and ultra rare non-oncology conditions have been applied: rare, meaning a condition which affects less than 1 in 2,000 people, as per the National Health Service rare diseases framework; and ultra-rare, meaning a condition affecting 1 in 50,000 people or fewer in England.

If his Department will include a target in a future Rare Disease Action Plan on proportionate access to multi-indication medicines for (a) rare and (b) ultra-rare disease patients.

Improving access to specialist care, treatments, and drugs is a priority under the UK Rare Diseases Framework. The 2025 England Rare Diseases Action Plan was published in February 2025 and reports on progress against existing actions under this priority. This included reviewing the effectiveness of the Early Access to Medicines Scheme, the Innovative Licensing and Access Pathway, and the Innovative Medicines Fund, which are key access initiatives aimed at facilitating earlier availability of innovative treatments. Our review specifically assessed how effective these pathways are in supporting timely access to therapies for individuals living with rare diseases.As set out in the Life Sciences Sector plan, we will be introducing a new and proportionate approach to National Institute for Health and Care Excellence (NICE) appraisals and NHS indication-specific based pricing agreements for medicines with large numbers of indications, strong long-term outcome data, and low affordability risk. This will support treatments for rare diseases. There are currently no plans to introduce an access target, as it is essential to review the available evidence on a case-by-case basis. However, the Government remains committed to improving access to medicines for rare and ultra-rare diseases.

How many integrated care boards have a designated senior leader responsible for (a) neurology and (b) rehabilitation services.

This information is not held centrally. Integrated care boards (ICBs) are responsible for designating senior leaders as appropriate, as well as for commissioning most services for people with long term conditions including for neurology and rehabilitation services. ICBs are allocated funding by NHS England to meet local need and priorities and improve outcomes.

When he plans to publish the Delivery Plan for ME/CFS.

The myalgic encephalomyelitis, also known as chronic fatigue syndrome, final delivery plan will be published shortly. The plan will focus on boosting research, improving attitudes and education, and bettering the lives of people with this debilitating disease.

What steps he is taking is taking to ensure that people diagnosed with invasive lobular breast cancer are routinely offered MRI scans for follow-up monitoring.

The National Health Service is committed to ensuring that all cancer patients in England, including those with lobular breast cancer, have access to personalised care, including a needs assessment, a care plan, and health and wellbeing information and support.Treatment for cancer is highly individualised and decisions about cancer treatment, including ongoing monitoring and follow up care, are typically made by clinicians and multidisciplinary teams of healthcare professionals. These decisions are based on medical assessments and what's best for the individual's overall health and well-being.

Whether the scope of the Government’s independent commission into adult social care include the means testing which underpins the Disabled Facilities Grant.

We have launched an independent commission into adult social care as part of our first steps towards delivering a National Care Service.Baroness Casey and her team will look at what fundamental reforms will be needed, what social care should look like, who should it serve, and who should be responsible and accountable for its services.The Terms of Reference for the commission are sufficiently broad to enable Baroness Casey to independently consider how to build a social care system fit for the future, including aspects of the Disabled Facilities Grant (DFG) if she sees fit.To ensure the DFG is as effective as possible, we continue to keep different aspects of the grant, including the means test, under consideration.

What steps his Department is taking to ensure that the 2013 mandate to accurately collect and collate data on cancer recurrence is being fully implemented.

The Department is committed to ensuring that data on cancer is complete and of sufficiently high quality. The National Disease Registration Service (NDRS) collects recurrence data for non-primary cancers via data submissions as part of the Cancer Outcomes and Services Dataset (COSD). The COSD has been the national standard for reporting cancer in the National Health Service in England since January 2013, and provides a helpdesk and data liaison service to support data completeness.

Whether the National Audit of Metastatic Breast Cancer will provide a specific breakdown by (a) breast cancer subtype and (b) hormone receptor status.

We are committed to improving the lives of those diagnosed with both primary and secondary breast cancer. The Department does not hold the information to make a comparative assessment of the average spend per patient with primary or secondary breast cancer.Reducing unwarranted variation in cancer treatment is a strategic priority for the National Health Service. NHS England commissioned new clinical audits on primary and metastatic breast cancer to increase the consistency of access to treatments. On 12 September 2024, the National Cancer Audit Collaborating Centre published their State of the Nation Report on breast cancer. Officials at the Department and NHS England are in the process of considering the audit’s findings and what any next steps could be. To drive up the completeness of data for breast cancer, progesterone receptor status is already collected as part of the NHS Cancer Outcomes and Services Data set. No specific breakdown is available at this time.

How much the NHS spends on average per patient with secondary (metastatic) breast cancer; and if he will make a comparative assessment of the average spend per patient with primary breast cancer.

We are committed to improving the lives of those diagnosed with both primary and secondary breast cancer. The Department does not hold the information to make a comparative assessment of the average spend per patient with primary or secondary breast cancer.Reducing unwarranted variation in cancer treatment is a strategic priority for the National Health Service. NHS England commissioned new clinical audits on primary and metastatic breast cancer to increase the consistency of access to treatments. On 12 September 2024, the National Cancer Audit Collaborating Centre published their State of the Nation Report on breast cancer. Officials at the Department and NHS England are in the process of considering the audit’s findings and what any next steps could be. To drive up the completeness of data for breast cancer, progesterone receptor status is already collected as part of the NHS Cancer Outcomes and Services Data set. No specific breakdown is available at this time.

What steps his Department is taking to provide routine access to circulating tumour DNA blood tests to support the (a) detection and (b) treatment of breast cancer.

The Department remains committed to improving faster and earlier detection of breast cancer and will work to ensure that patients have timely access to lifesaving, innovative treatments. We have now exceeded our pledge to deliver an extra two million operations, scans, and appointments, having now delivered over four million more appointments as the first step to ensuring earlier and faster access to treatment. There are no current plans to provide routine access to circulating tumour DNA blood tests.The Government’s wider investments into breast cancer research include a £1.3 million project to determine whether an abbreviated form of breast magnetic resonance imaging can detect breast cancers missed by screening through mammography, including lobular breast cancer. We are also proud to have invested £29 million into the Institute of Cancer Research and the Royal Marsden National Institute for Health and Care Research Biological Research Centre in 2022, supporting their efforts to strengthen research into cancer, including breast cancer.