Written questions by Smith.

What assessment he has made of the adequacy of research funding models, in the context of the forthcoming national cancer plan; and whether he has made an assessment of the potential impact of research funding models on supporting (a) equitable, (b) clinical and (c) economic opportunities.

The Department is committed to ensuring that all patients, including those with cancer, have access to cutting-edge clinical trials and innovative, lifesaving treatments.The Department is committed to turbocharging clinical research and delivering better patient care, to make the United Kingdom a world-leading destination for clinical research. We are working to fast-track clinical trials to drive global investment into life sciences, improve health outcomes, and accelerate the development of the medicines and therapies of the future, including treatments for cancer.The Department funded National Institute for Health and Care Research (NIHR) funds research and research infrastructure which supports patients and the public to participate in high-quality research, including research on cancer. The NIHR also provides an online service called Be Part of Research, which promotes participation in health and social care research by allowing users to search for relevant studies and register their interest. This makes it easier for people to find and take part in health and care research that is relevant to them, including cancer studies.Research is crucial in tackling cancer, which is why the Department invests over £1.6 billion per year in health research through the NIHR. The NIHR spent £133 million on cancer research in 2023/24, reflecting its high priority. The National Cancer Plan, due to be published in the second half of this year, will have a focus on research and innovation. It will include details on how we will improve outcomes for cancer patients, as well as speeding up diagnosis and treatment, ensuring patients have access to the latest treatments and technology, and ultimately driving up this country’s cancer survival rates.

What plans he has to increase screening programmes to improve early diagnosis of cancers, in the context of the forthcoming National Cancer Plan.

Early diagnosis is a key focus of the National Cancer Plan, which will build on the three 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 services in patients’ local areas. We will increase participation in screening programmes through digital booking and by taking innovative approaches like self-sampling for cervical screening.The National Cancer Plan, to be published later this year, will include further details on how we will speed up diagnosis, including how we will prioritise screening programmes and improve participation.

What assessment he has made of the potential merits of integrating smoking cessation services into (a) A&E, (b) mental health services and (c) lung screening.

We are fully committed to our ambition for a smoke-free United Kingdom. Quitting smoking is one of the best things a person can do for their health, and our assessment of the evidence is that targeting people with smoking cessation support in in-patient, accident and emergency, and lung screening services can be successful.As set out in the 10-Year Health Plan, we remain committed to ensuring all hospitals integrate smoking cessation interventions into routine care. We will also fully roll out lung cancer screening for those with a history of smoking, which we expect will detect 9,000 cancers earlier each year.As of the end of 2024/25, 93% of National Health Service in-patient services and 97% of maternity services had a tobacco dependence treatment offer. Specifically in mental health services, there was a 41% quit rate amongst those setting a quit date in these settings.Further to this, awards under our National Swap to Stop programme have been made to many NHS services, including mental health and accident and emergency. The programme offers smokers across England a free vape starter kit alongside behavioural support to help them quit smoking.

Whether he has made an assessment of the potential merits of increasing the use of the current mediation scheme for medical negligence disputes.

NHS Resolution manages clinical negligence and other claims against the National Health Service in England. NHS Resolution is committed to the use of dispute resolution, including the use of mediation and is working with claimant lawyers and its own lawyers on innovative approaches. This includes running pilots exploring which dispute resolution techniques work best in particular types of cases and introducing several into routine claim- handling. This approach is being developed further under NHS Resolution’s published 2025-28 strategy. Increasingly higher numbers of NHS Resolution’s cases are now resolved pre-action using a wide range of dispute resolution techniques. These approaches can improve the experience for patients and healthcare staff through a less adversarial approach and can also reduce legal costs for both sides. In 2023/24, 81% of all clinical claims handled by NHS Resolution were resolved without court proceedings.

What steps he is taking to provide mobile health services to support rural agricultural communities where (a) committing and (b) travelling to appointments at set times can be a challenge.

Integrated care boards (ICBs) are responsible for commissioning healthcare services that meet the needs of their local populations. When ICBs exercise their functions, they have a duty to reduce inequalities between persons with respect to their ability to access health services, and to reduce inequalities between patients with respect to the outcomes achieved for them by the provision of health services.The Department recognises that providing services in rural areas comes with significant additional costs, for example, in travel and staff time. That is why the funding formula used by NHS England to allocate funds to ICBs includes an element to better reflect the needs in some rural, coastal, and remote areas.The Department also wants ICBs to ensure that travel is not a prohibitive factor. There is a longstanding policy in the National Health Service that if you are eligible, you may be able to claim a refund for reasonable travel costs to receive services that are not primary medical, dental, or ophthalmic, following a referral by a healthcare professional. That scheme, the Healthcare Travel Costs Scheme, continues to apply.Furthermore, NHS England strives for digital services to improve healthcare access. NHS England published the Inclusive digital healthcare: a framework for NHS action on digital inclusion in September 2023, which is available at the following link:https://www.england.nhs.uk/long-read/inclusive-digital-healthcare-a-framework-for-nhs-action-on-digital-inclusion/This framework highlights that certain groups, including people living in areas with inadequate broadband and mobile data coverage, especially rural and coastal areas, face higher risks of both digital exclusion and health inequalities. The framework is designed to ensure NHS services are accessible to people who are digitally excluded.

What steps he is taking to encourage GP practices to provide walk-in appointments for (a) farmers and (b) other occupations where attending at a set time can be a challenge.

General practices are independent businesses contracted to provide National Health Services, and have autonomy to manage appointments in the way that best suits their patient population, including determining what services are available on a walk-in basis. To accommodate patients who may not be able to access general practices during core opening hours, integrated care boards in England are required to provide general practice out of hours services from 18:30 to 08:00 on weekdays, all weekends, and on bank holidays.Walk-in patients can also access care in other settings. Under Pharmacy First, community pharmacists can provide advice for minor illnesses and supply some prescription-only medicines without a prescription from a general practitioner, either following a referral or a walk-in. Patients with urgent but not life-threatening medical needs can also visit urgent treatment centres without an appointment.

What steps he is taking to provide sustainable funding for rural pharmacies.

We have increased the core funding for community pharmacy to £3.1billon pounds in 2025/26 and increased the commissioning of additional services like Pharmacy First. We have maintained the Pharmacy Access scheme that provides £19m to support pharmacies in areas where there are fewer pharmacies, including in rural areas.

If he will meet with the Lobular Moon Shot Project to discuss funding for lobular breast cancer research.

The Department invests £1.6 billion each year on research through its research delivery arm, the National Institute for Health and Care Research (NIHR). NIHR research expenditure for all cancers was £133 million in 2023/24 reflecting its high priority.We are proud to have invested £29 million into the Institute of Cancer Research (ICR) and the Royal Marsden NIHR Biological Research Centre in 2022, supporting their efforts to strengthen research into cancer, including lobular breast cancer. 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. On 4 February 2025 the Department announced that almost 700,000 women across the country will take part in a world-leading trial to test how cutting-edge artificial intelligence (AI) tools can be used to catch breast cancer cases earlier. The Early Detection using Information Technology in Health (EDITH) trial is backed by £11 million of Government support via the NIHR. The NIHR continues to encourage and welcome funding applications for research into any aspect of human health, including lobular breast cancer. Improving outcomes for people with cancer is a priority for the Government.

Whether he has had discussions with internet service providers and with national and international partners on steps taken to prevent unlicensed medicines from entering the UK.

The Medicines and Healthcare products Regulatory Agency (MHRA), acting on behalf of my Rt Hon. Friend, the Secretary of State for Health and Social Care, is responsible for the regulation of all medicines and medical devices in the United Kingdom, by ensuring they work and are acceptably safe. This includes applying the legal controls on the retail sale, supply, and advertising of medicines, which are set out in the Human Medicines Regulations 2012. These regulations apply equally to medicines advertised, sold, or supplied through the internet.Public safety is the number one priority for the MHRA, and its Criminal Enforcement Unit works hard to prevent, detect, and investigate illegal activity involving medicines and medical devices.The MHRA works closely with e-commerce and the internet industry to identify, remove, and block online content promoting the illegal sale of medicines and medical devices. It also seeks to identify and, where appropriate, prosecute online sellers responsible for putting public health at risk. Working with national and international partners, the MHRA successfully seizes millions of doses of illegally traded medicines each year.The MHRA’s #FakeMeds campaign provides advice to people in the UK who are considering buying medication online, outlining how products can be accessed from safe and legitimate sources. It also encourages people to report suspicious medicinal products and adverse side effects via its Yellow Card scheme, which is available at the following link:https://yellowcard.mhra.gov.uk/

Pursuant to the Answer of 14 November 2024 to Question 13215 on Lead: Contamination, when the review of lead in food (a) commenced and (b) plans to report.

The Food Standards Agency (FSA) is reviewing dietary lead as part of its ongoing risk analysis of environmental contaminants in food, including in areas with higher exposure. Scoping work has begun to identify the additional evidence needed, including plans to gather data on lead levels in food from high geochemical lead areas. The detailed schedule and plan for this work is not yet finalised. Updates on its progress will be made available on the FSA’s website.

Whether he is taking steps to prevent health companies based overseas from selling hormone treatments online to people living in the UK.

In response to recommendations by the Commission on Human Medicines, my Rt Hon. Friend, the Secretary of State for Health and Social Care announced an indefinite ban on gonadotropin-releasing hormone (GnRH) analogues for new patients with gender dysphoria and/or incongruence. This legislation came into effect on 1 January 2025 as the previous section 62 emergency order expired, and is available at the following link:https://www.legislation.gov.uk/uksi/2024/1319/madeThis indefinite order continues to prohibit the sale or supply of GnRH analogues prescribed by private United Kingdom-registered prescribers, for gender dysphoria or gender incongruence, to under 18 year olds not already taking them, and the sale and supply of the drugs against prescriptions from prescribers registered in the European Economic Area or Switzerland, for any purposes, to anyone under 18 years old.Regarding other hormone treatments, we would always recommend patients use services and clinical practitioners registered in the UK so they can be assured of the safety and quality of the services they receive. Medicines bought outside the legal supply chain do not have a UK marketing authorisation and may be harmful. The Medicines and Healthcare products Regulatory Agency works with national and international partners to prevent unlicensed medicines from entering the UK.

What plans he has to allow children who are (a) out of school and (b) in alternative provision to receive seasonal vaccinations that are otherwise provided on school premises.

The Government is committed to protecting those most at risk from vaccine preventable diseases through vaccination, as guided by the independent Joint Committee on Vaccination and Immunisation. This includes the offer of a seasonal flu vaccine to children aged two or three years old, primary school aged children, from Reception to Year 6, secondary school aged children, from Year 7 to Year 11, and children in clinical risk groups aged from six months old to less than 18 years old.NHS England is responsible for the commissioning of school age immunisation programmes that are delivered as part of the routine vaccination schedule. NHS England has confirmed that dedicated Immunisation Team providers are commissioned to deliver a 100% offer to all eligible school aged children, from Reception to Year 11, to get their flu vaccine at school. This is a mainly school-based model, with additional opportunities offered in community clinics for those who miss the school opportunity or who are not in mainstream education, for instance if they are home schooled. General practices are also commissioned by NHS England to deliver catchups for school aged children and young people on an opportunistic basis to maximise uptake. This information can be found at the National Health Service website, and is available at the following link: https://www.nhs.uk/vaccinations/child-flu-vaccine/

What steps the Food Standards Agency is taking to (a) assess and (b) mitigate the risk of lead contamination in (i) allotments and (ii) other food growing areas located on floodplains downstream of historical lead mines.

The Food Standards Agency (FSA) is planning to review dietary lead as part of its rolling programme of risk analysis of environmental contaminants in food. This will include consideration of areas where exposure is likely to be higher. Scoping work has started, including considering what, if any, additional evidence and data may be required.The FSA has not undertaken a specific estimation of the risk of lead contamination in silage or animal feed. However, in conjunction with the National Farmers Union, the FSA has provided advice to farmers to mitigate against lead entering the food chain, and how to avoid lead contamination. In addition, maximum levels for undesirable substances in products intended for animal feed have been established in Schedule 4 of the Animal Feed (Composition, Marketing and Use) (England) Regulations 2015, with further information on the regulations available at the following link:https://www.legislation.gov.uk/uksi/2015/255/schedule/4This includes levels for lead in feed materials and forage, which includes hay and silage. Any product which exceeds these limits is not permitted to be placed on the market. These regulations are enforced by local authorities. Under animal feed legislation, feed businesses, which include farmers, are responsible for making sure the feed they produce is safe for the animals it is intended for.The impact of flooding on areas of land with historical levels of lead contamination is a matter for local councils to consider under Part 2A of the Environmental Protection Act 1990. They have the duty to inspect their areas to identify contaminated land. This would cover situations where lead is washed from rivers or sediments onto floodplains or where existing lead contamination on land is impacted by flooding. Lead may be discharged into rivers from abandoned metal mines and the Environment Agency is working with the Coal Authority under the Department for Environment Food and Rural Affairs’ Water and Abandoned Metal Mines Programme to identify and tackle the priority discharges.

What estimate the Food Standards Agency has made of the risk of lead contamination in (a) silage and (b) animal feed produced on floodplains downstream of historical lead mining sites.

The Food Standards Agency (FSA) is planning to review dietary lead as part of its rolling programme of risk analysis of environmental contaminants in food. This will include consideration of areas where exposure is likely to be higher. Scoping work has started, including considering what, if any, additional evidence and data may be required.The FSA has not undertaken a specific estimation of the risk of lead contamination in silage or animal feed. However, in conjunction with the National Farmers Union, the FSA has provided advice to farmers to mitigate against lead entering the food chain, and how to avoid lead contamination. In addition, maximum levels for undesirable substances in products intended for animal feed have been established in Schedule 4 of the Animal Feed (Composition, Marketing and Use) (England) Regulations 2015, with further information on the regulations available at the following link:https://www.legislation.gov.uk/uksi/2015/255/schedule/4This includes levels for lead in feed materials and forage, which includes hay and silage. Any product which exceeds these limits is not permitted to be placed on the market. These regulations are enforced by local authorities. Under animal feed legislation, feed businesses, which include farmers, are responsible for making sure the feed they produce is safe for the animals it is intended for.The impact of flooding on areas of land with historical levels of lead contamination is a matter for local councils to consider under Part 2A of the Environmental Protection Act 1990. They have the duty to inspect their areas to identify contaminated land. This would cover situations where lead is washed from rivers or sediments onto floodplains or where existing lead contamination on land is impacted by flooding. Lead may be discharged into rivers from abandoned metal mines and the Environment Agency is working with the Coal Authority under the Department for Environment Food and Rural Affairs’ Water and Abandoned Metal Mines Programme to identify and tackle the priority discharges.

Whether the Food Standards Agency's planned review of dietary lead will consider the extent of contamination up to 100 kilometres downstream of historical lead mining sites.

The Food Standards Agency (FSA) is planning to review dietary lead as part of its rolling programme of risk analysis of environmental contaminants in food. This will include consideration of areas where exposure is likely to be higher. Scoping work has started, including considering what, if any, additional evidence and data may be required.The FSA has not undertaken a specific estimation of the risk of lead contamination in silage or animal feed. However, in conjunction with the National Farmers Union, the FSA has provided advice to farmers to mitigate against lead entering the food chain, and how to avoid lead contamination. In addition, maximum levels for undesirable substances in products intended for animal feed have been established in Schedule 4 of the Animal Feed (Composition, Marketing and Use) (England) Regulations 2015, with further information on the regulations available at the following link:https://www.legislation.gov.uk/uksi/2015/255/schedule/4This includes levels for lead in feed materials and forage, which includes hay and silage. Any product which exceeds these limits is not permitted to be placed on the market. These regulations are enforced by local authorities. Under animal feed legislation, feed businesses, which include farmers, are responsible for making sure the feed they produce is safe for the animals it is intended for.The impact of flooding on areas of land with historical levels of lead contamination is a matter for local councils to consider under Part 2A of the Environmental Protection Act 1990. They have the duty to inspect their areas to identify contaminated land. This would cover situations where lead is washed from rivers or sediments onto floodplains or where existing lead contamination on land is impacted by flooding. Lead may be discharged into rivers from abandoned metal mines and the Environment Agency is working with the Coal Authority under the Department for Environment Food and Rural Affairs’ Water and Abandoned Metal Mines Programme to identify and tackle the priority discharges.

If he will take steps to (a) ensure regular public data releases and (b) improve the timeliness of data available.

The Department is strongly committed to upholding the Code of Practice for Official Statistics, and its three constituent pillars of trustworthiness, quality, and value. As such, the Department is committed to releasing timely data at a frequency that meets the needs of users, as far as practicable.For example, over the winter, NHS England increased the frequency of its publications of data on urgent and emergency care, in response to the increased need for this data at this time.The Heads of Profession for Statistics in the Department and its arm’s-length bodies ensure that statistical producers continually review their products and improve the quality and frequency of publication, in line with the needs of the users of data and statistics.

With reference to his Department's consultation entitled Health and social care statistical outputs which closed on 5 March 2024, when he plans to respond to that consultation; and if he will publish a timeline for implementing the recommendations of that consultation.

The Department expects to publish a response to the consultation this year. Work is ongoing across the Department, the UK Health Security Agency, NHS England, and the Office for National Statistics to agree and align proposals following the feedback from users.Any resulting changes to statistical publications will be made in line with the Code of Practice for Official Statistics. The timings of each of these will vary by publication.

Whether the Food Standards Agency plans to develop guidance for residents in areas with high environmental lead contamination on the safe consumption of locally produced food.

The Food Standards Agency (FSA) is planning to review dietary lead as part of its rolling programme of risk analysis of environmental contaminants in food. This will include consideration of areas where exposure is likely to be higher.Previous reviews of lead have shown that while exposures are not a health concern for the majority of the population, a small risk to some individuals arising from exposure to high levels of lead in soil, dust, or in drinking water cannot be excluded. The FSA has started scoping this work, including considering what, if any, additional sampling may be required as well as identifying what information is already available to inform the assessment.Local authorities are responsible for inspecting contaminated land and addressing any issues arising from it under Part 2A of the Environmental Protection Act 1990.Public Health England, now the UK Health Security Agency (UKHSA), has issued advice about the use of potentially contaminated residential land for food. The UKHSA says that, to date, there is very limited data linking any health effects with land contamination in England. People should follow normal hygiene precautions and wash their hands thoroughly after working in the garden or an allotment, especially when in contact with soil and before handling food or drink. It is further advised that produce grown in the soil is washed and peeled, in order to remove any soil or dust.The outcome of our review will inform the need for additional guidance or other risk management measures, such as changes to permitted levels in different food categories.

Whether the Food Standards Agency plans to conduct targeted testing of food products in areas with high concentrations of abandoned lead mines.

The Food Standards Agency (FSA) is planning to review dietary lead as part of its rolling programme of risk analysis of environmental contaminants in food. This will include consideration of areas where exposure is likely to be higher.Previous reviews of lead have shown that while exposures are not a health concern for the majority of the population, a small risk to some individuals arising from exposure to high levels of lead in soil, dust, or in drinking water cannot be excluded. The FSA has started scoping this work, including considering what, if any, additional sampling may be required as well as identifying what information is already available to inform the assessment.Local authorities are responsible for inspecting contaminated land and addressing any issues arising from it under Part 2A of the Environmental Protection Act 1990.Public Health England, now the UK Health Security Agency (UKHSA), has issued advice about the use of potentially contaminated residential land for food. The UKHSA says that, to date, there is very limited data linking any health effects with land contamination in England. People should follow normal hygiene precautions and wash their hands thoroughly after working in the garden or an allotment, especially when in contact with soil and before handling food or drink. It is further advised that produce grown in the soil is washed and peeled, in order to remove any soil or dust.The outcome of our review will inform the need for additional guidance or other risk management measures, such as changes to permitted levels in different food categories.

What steps his Department has taken to ensure that the scope of the Food Standards Agency’s review of dietary lead as part of its risk analysis programme covers areas with high concentrations of abandoned lead mines.

The Food Standards Agency (FSA) is planning to review dietary lead as part of its rolling programme of risk analysis of environmental contaminants in food. This will include consideration of areas where exposure is likely to be higher.Previous reviews of lead have shown that while exposures are not a health concern for the majority of the population, a small risk to some individuals arising from exposure to high levels of lead in soil, dust, or in drinking water cannot be excluded. The FSA has started scoping this work, including considering what, if any, additional sampling may be required as well as identifying what information is already available to inform the assessment.Local authorities are responsible for inspecting contaminated land and addressing any issues arising from it under Part 2A of the Environmental Protection Act 1990.Public Health England, now the UK Health Security Agency (UKHSA), has issued advice about the use of potentially contaminated residential land for food. The UKHSA says that, to date, there is very limited data linking any health effects with land contamination in England. People should follow normal hygiene precautions and wash their hands thoroughly after working in the garden or an allotment, especially when in contact with soil and before handling food or drink. It is further advised that produce grown in the soil is washed and peeled, in order to remove any soil or dust.The outcome of our review will inform the need for additional guidance or other risk management measures, such as changes to permitted levels in different food categories.