Written questions by McCarthy.

Pursuant to the answer of 9 October 2025 to Question 76643 on Primodos, whether his Department plans to consider scientific evidence from Aaron. P. Adam et al (2026) titled Recurrent Constellations of Embryonic Malformations: Teratogenicity Linked to Transient Hypoxia and Hormone Pregnancy Tests Agrees With RCEM and Suggest a Reactive Oxygen Species Pathogenesis, as part of its review of the evidence on hormone pregnancy tests.

The Medicines and Healthcare products Regulatory Agency (MHRA), together with the wider Government, have committed to review any new scientific evidence which comes to light regarding the use of hormone pregnancy tests during early pregnancy and adverse pregnancy outcomes. In line with this commitment, the MHRA will consider whether the recent publication, Recurrent Constellations of Embryonic Malformations (RCEM): Teratogenicity Linked to Transient Hypoxia and Hormone Pregnancy Tests Agrees With RCEM and Suggest a Reactive Oxygen Species Pathogenesis, by Aaron. P. Adam et al, presents any new scientific evidence and will act as appropriate.

Whether he has had discussions with colleagues in NHS England on the development of a regenerative medicine strategy.

No such discussions have taken place. The Government is committed to ensuring the United Kingdom remains a global leader in the development of advanced therapies, including regenerative medicines, to drive innovation in the National Health Service and deliver life-changing outcomes for patients. The Department continues to work with public sector partners to promote a joined-up ecosystem that will support the development, regulation, and delivery of advanced therapies.The Government invests in research into regenerative medicine and advanced therapies through UK Research and Innovation. The £42 million UK Regenerative Medicine Platform (UKRMP) aimed at addressing the key translational challenges in regenerative medicine and at bringing innovative regenerative medicine therapies to the clinic. In its second phase, from 2018 to 2024, the UKRMP established three hubs: the Engineered Cell Environment Hub; the Smart Materials Hub; and the Pluripotent Stem Cells and Engineered Cells Hub.

What assessment he has made of the potential impact of regenerative medicine techniques on surgical recovery.

Regenerative techniques, such as cell therapies, growth factors, and bioengineered scaffolds, can accelerate wound healing, which is particularly valuable in complex or high‑risk surgeries. NHS England maintains an overview of the advanced therapy medicinal products in development and assesses the potential National Health Service impact and the requirements for individual treatments as part of its due diligence, ensuring the NHS is ready to deliver innovative new treatments that secure a positive Medicines and Healthcare products Regulatory Agency licensing decision and National Institute for Health and Care Excellence recommendation.

What comparative assessment his Department has made of the benefits and complications of ablation surgery for endometriosis patients.

The National Institute for Health and Care Excellence (NICE) is the independent body that develops authoritative, evidence-based guidance for the National Health Service on best practice in the care and management of patients with specific conditions based on an assessment of clinical and cost effectiveness.NICE has published a guideline on the diagnosis and management of endometriosis that includes recommendations on the use of ablation. The analysis underpinning NICE’s recommendations can be found in the full guideline that is available at the following link:https://www.nice.org.uk/guidance/ng73/evidence/full-guideline-pdf-4550371315NICE is working with NHS systems to ensure adoption of this best practice endometriosis care, including access to approved medicines.

What action his Department is taking to ensure (a) GPs and (b) GP nursing staff receive training on endometriosis.

General practitioners (GPs) and nurses are responsible for ensuring their own clinical knowledge, including on endometriosis and women’s health issues in general, remains up to date and for identifying learning needs as part of their continuing professional development, within their scope of practice.All United Kingdom registered doctors are expected to meet the professional standards set out in the General Medical Council’s (GMC’s) Good Medical Practice. The training curriculum for postgraduate trainee doctors is set by the Royal College of General Practitioners (RCGP) and has to meet the standards set by the GMC.The GMC has introduced the Medical Licensing Assessment to encourage a better understanding of common women’s health problems among all doctors as they start their careers in the UK. The content map for this assessment includes several topics relating to women’s health including menstrual problems, endometriosis, menopause, and urinary incontinence. This will encourage a better understanding of common women’s health problems among all doctors as they start their careers in the UK. Endometriosis is also included in the core curriculum for trainee GPs, and for obstetricians and gynaecologists. The British Medical Journal and RCGP offer online courses on endometriosis designed for healthcare professionals, including practice nurses.In November 2024, the National Institute for Health and Care Excellence (NICE) updated their guideline on endometriosis which makes firmer recommendations for healthcare professionals on referral and investigations for women with suspected diagnosis, which is available at the following link:https://www.nice.org.uk/guidance/NG73GPs and primary care networks have access to a regional Primary Care Training Hub, which brings together education and training resources from National Health Service organisations, community providers, as well as local authorities. Training hubs are usually run by a clinical leader and a manager supported by a network of primary care staff with education and training professionals based in the community. They work closely with primary care networks and integrated care systems to support workforce priorities and tackle health inequalities to help meet patient and population demand. Training hubs support all clinical staff, including nurses, to maintain their continuing professional development when new guidance, such as that from NICE, becomes available.

What assessment he has made of the potential impact of a respiratory Modern Service Framework on NHS provision in Bristol East constituency.

The Government will consider long-term conditions for future waves of modern service frameworks (MSFs), including respiratory conditions. The criteria for determining other conditions for future MSFs will be based on where there is potential for rapid and significant improvements in quality of care and productivity. After the initial wave of MSFs is complete, the National Quality Board will determine the conditions to prioritise for new MSFs as part of its work programme. There has not, therefore, been a specific assessment made in relation to National Health Service provision in the Bristol East constituency.

What support is available to meet the travel costs of pensioners with cancer diagnoses.

The Department recognises that the cost of travel should not be a barrier to cancer treatment. NHS England and the integrated care boards are responsible for commissioning and ensuring the healthcare needs of local communities are met, including providing support for travel. The National Health Service in England runs the Healthcare Travel Costs Scheme (HTCS) to provide financial assistance for travel to a hospital or other NHS premises for specialist NHS treatment or diagnostics tests when referred by a doctor or other primary healthcare professional. Patients who do not qualify for the HTCS and who are on a low income may be able to claim the costs from the Department for Work and Pensions through Universal Credit or Personal Independence Payment.

How many women in the Bristol East constituency have been affected by faulty PIP breast implants.

The role of the Medicines and Healthcare products Regulatory Agency (MHRA) is to monitor all incidents that are reported to us, making sure that these incidents are investigated fully and that any necessary action is taken. The poly implant prothèse (PIP) issue was a result of the use of a non-approved silicone in the production of the breast implants and fragile shells. Not all PIP implants manufactured during the affected period used industrial-grade silicone or had more fragile shells. As a result, rupture rates vary depending on the batch received and early rupture typically occurs within the first five to 10 years. Due to the overall fraudulent activity, we do not know how many fall into this category.We worked with the National Health Service and other health partners to ensure the issue was properly investigated. It is important to note that while PIP implants are associated with a higher risk of rupture, leading to symptoms such as tenderness or swollen lymph glands, there is no evidence linking ruptured PIP implants to serious long-term health issues. The PIP breast implants were withdrawn from the United Kingdom in 2010, and two independent reviews have identified lessons learned, the Howe Review (2012) and the Keogh Review (2013), with further information available on both, respectively, at the following two links:https://assets.publishing.service.gov.uk/government/uploads/system/uploads/attachment_data/file/216537/dh_134043.pdfhttps://www.gov.uk/government/publications/review-of-the-regulation-of-cosmetic-interventionsOne of the concerning issues for women with breast implants at the time of PIP was that women didn’t know they had PIP breast implants. It is estimated that approximately 47,000 British women had PIP implants fitted. We are unable to provide the granularity for individual constituencies, although further information is available at the following link:https://www.nhs.uk/conditions/pip-implants/However, please note that any PIP implants still in place have now exceeded 15 years in situ, which is the upper end of the 10 to 15 year typical life expectancy of a breast implant. As with any medical device reaching the end of its expected lifespan, clinical decisions regarding removal or replacement should be made on an individual basis in discussion between the doctor and the individual involved.The health system has enacted important changes since the publication of reviews focused on PIP implants. As a result of the Keogh Review, since 2016 the Breast and Cosmetic Implant Registry collects data on all types of breast implant and removal surgery in England and Scotland, which aims to help detect emerging safety issues and trace patients if necessary.As part of MHRA’s regulatory reform program, we are intending to also improve the traceability of medical devices through the introduction of Unique Device Identifiers (UDI) which will help identify individual medical devices and who manufactured the device or placed it on the market.

If he will expand access to drug detoxification services for people with substance abuse problems.

Local authorities are responsible for commissioning drug and alcohol treatment services according to local need as part of their public health responsibilities, and this includes the provision of drug detoxification services.In line with recommendations in Dame Carol Black’s independent review of drug treatment and recovery, the Department created a distinct grant to support and expand inpatient detoxification for people who use drugs and alcohol. The £10 million a year grant ran between 2022/23 and 2024/25, before being consolidated into the Drug and Alcohol Treatment and Recovery Improvement Grant in 2025/26.The additional funding has enabled four units to open and has seen a substantial increase in the number of people who have been able to benefit from medically supported detoxification in an inpatient setting.

If he will expand substitution therapy interventions for those with opioid dependency.

Local authorities are responsible for commissioning drug and alcohol treatment services according to local need, and this includes the provision of opioid substitution treatment such as methadone and both oral and long-acting injectable buprenorphine.On 20 November, the Government announced an investment of over £13.4 billion, a 5.6% cash increase, over the next three years in local authorities’ vital public health work through a consolidated Public Health Grant. This includes the overall £1 billion Drug and Alcohol Treatment and Recovery Improvement Grant. The Department advises local areas to prioritise resourcing opioid substitution therapy prescribing from this funding if the current provision is not adequate. Opioid substitution therapy is currently available in all local authorities in England, but access to long-acting injectable buprenorphine is too limited in some.The Department supports interventions to expand the provision of long-acting injectable buprenorphine. We are currently doing more analysis to understand cost-effectiveness, developing clinical guidance, and scoping how best to expand access to long-acting injectable buprenorphine further.

What comparative assessment he has made of trends in NHS dental costs and average wages in England.

No direct assessment has been made, however any decision to uplift dental patient charges is accompanied by an equalities impact assessment and informed by patient demographic data from the NHS Annual Dental Statistics and the GP Patient Survey NHS dentistry questions, with further information on both available, respectively, at the following two links:https://www.nhsbsa.nhs.uk/statistical-collections/dental-england/dental-statistics-england-202425https://gp-patient.co.uk/surveysandreportsThe National Health Service dental patient charge is a contribution to the cost of the NHS dental treatment the patient receives. Free NHS dental care is available to people who meet the following criteria:under 18 years old, or under 19 years old and in full-time education;pregnant or have had a baby in the previous 12 months;being treated in an NHS hospital and the treatment is carried out by the hospital dentist, although patients may have to pay for any dentures or bridges; orreceiving low-income benefits, or under 20 years old and a dependant of someone receiving low-income benefits.Support is also available through the NHS Low Income Scheme for those patients who are not eligible for exemption or full remission of dental patient charges. Further information is available at the following link:https://www.nhs.uk/nhs-services/dentists/who-is-entitled-to-free-nhs-dental-treatment-in-england/

What steps he is taking to encourage (a) breast cancer screening and (b) cervical screening programmes to raise awareness of other gynaecological cancers.

NHS England works to ensure that core public information on screening is easily accessible and understandable to the public, and it regularly and systematically reviews this information.For example, earlier this year, NHS England updated its cervical screening guidance to include that cervical screening is not a check for other cancers of the reproductive system, such as ovary, womb, vulval, or vaginal cancer. This guidance is available at the following link:https://www.gov.uk/government/publications/cervical-screening-description-in-brief/cervical-screening-helping-you-decide--2

If he will ensure early diagnosis of primary bone cancer is included in the National Cancer Plan.

Early diagnosis is a key focus of the National Cancer Plan. It is a priority for the Government to support the National Health Service to diagnose cancer, including primary bone cancer and other rare cancers, as early and quickly as possible, and to treat it faster, to improve outcomes.We are committed to transforming diagnostic services and will support the NHS to increase capacity to meet the demand for diagnostic services through investment in new capacity, including magnetic resonance imaging and computed tomography scanners.Furthermore, we have implemented non-specific symptom (NSS) pathways, designed to speed up the diagnosis of cancer by introducing a route to possible diagnosis for patients who display symptoms that could indicate cancer but do not align to specific cancers. The new NSS pathway complements current cancer diagnostic pathways, as well as providing elements that can be applied to existing pathways.The Government welcomes the recent publication of Sarcoma UK’s sarcoma state of the nation report as it highlights the importance of early diagnosis, care co-ordination across complex pathways, research into new treatments, and survivorship. Our forthcoming National Cancer Plan, which will be published in the new year, will set out how we will improve outcomes for all cancers, including sarcoma.

Pursuant to the Answer of 22 October 2025 to Question 78048 on General Practitioners: Recruitment, whether he plans to recruit more experienced GPs whose Certificate of Completion of Training Date was more than two years ago.

As self-employed contractors to the National Health Service, it is for general practices (GPs) to determine how they run their operations, including recruitment decisions.We are investing an additional £1.1 billion into GPs to reinforce the front door of the NHS, bringing total spend on the GP Contract to £13.4 billion in 2025/26. This is the biggest cash increase in over a decade and will facilitate the recruitment of GPs. The 8.9% boost to the GP Contract in 2025/26 is greater than the 5.8% growth to the NHS budget as a whole.In my previous response to Question 78048, I discussed the Additional Roles Reimbursement Scheme (ARRS), which has now recruited over 2,500 GPs since being introduced in October 2024, and which was brought in as a targeted response to the risk of new GP unemployment. Every year we consult with the profession about what services GPs provide, and the money providers are entitled to in return under their contract, taking account of the cost of delivering services. This includes reviewing the terms of various schemes such as the ARRS.

What discussions he has had with NHS England on the adequacy of the information available on the NHS website on cerebral autosomal dominant arteriopathy with subcortical infarcts and leukoencephalopathy.

There are over 7,000 rare diseases often needing highly specialised input, and so the National Health Service’s website is not always the most appropriate platform to disseminate such information. Working under the UK Rare Diseases Framework, the Government is committed to improving the lives of those living with conditions such as cerebral autosomal dominant arteriopathy with subcortical infarcts and leukoencephalopathy. Information to support healthcare professions with the diagnosis and care of this condition is provided in the NHS England Genomics Education Programme’s Knowledge Hub.

What steps he is taking to recruit more experienced GPs whose Certificate of Completion of Training date was more than two years ago.

We hugely value and appreciate the work that all general practitioners (GPs) do and recognise that it is vital for their roles to be satisfying, rewarding, and sustainable so that our GPs continue to contribute throughout their career.The Government committed to recruiting over 1,000 recently qualified GPs, with a Certificate of Completion of Training dated under two years ago, in primary care networks (PCNs) through an £82 million boost to the Additional Roles Reimbursement Scheme (ARRS) over 2024/25, as part of an initiative to secure the future pipeline of GPs, with over 1,000 doctors otherwise likely to have graduated into unemployment in 2024/25. Funding has been continued into 2025/26 with greater flexibilities also introduced to the scheme to allow PCNs to respond better to local workforce needs. Data on the number of recently qualified general practitioners for which PCNs are claiming reimbursement via the ARRS show that since 1 October 2024, over 2000 recently qualified GPs were recruited through the scheme.The ARRS is subject to annual review as part of the consultation on the GP contract with professional and patient representatives. NHS England works closely with the Department to implement any changes identified as part of this process. To build capacity in the GP workforce and reinforce the front door of the National Health Service, we have invested an additional £1.1 billion in GPs, bringing total spend on the GP Contract to £13.4 billion in 2025/26, the biggest increase in over a decade. The 8.9% boost to the GP Contract in 2025/26 is greater than the 5.8% growth to the NHS budget as a whole.