Written questions by French.

Whether he has had recent discussions with (a) NHS England, (b) the Royal Colleges and (c) the Joint Committee on Surgical Training on the future of Training Interface Group fellowships.

The Department and NHS England regularly engage with a wide range of stakeholders on issues relating to medical education and training.NHS England made the decision in 2025 to discontinue central funding of the salary support component of the Training Interface Group (TIG) programme, and to target financial resources more effectively to address regional workforce priorities.Regions or provider organisations that wish to continue developing these skills are still able to recruit, fund, and train staff using the curriculum set by the Joint Committee on Surgical Training.NHS England is also working to understand where they can enhance and support smaller, highly specialised areas of practice. NHS England specialised commissioning teams will feed into this work, which will consider how TIG programmes could be best supported in the future.

What steps he is taking to help support people with (a) Musculoskeletal conditions and (b) back pain conditions in Old Bexley and Sidcup constituency; and if he will make it his policy to utilise chiropractic capacity to support treatment within the NHS.

To support people with musculoskeletal (MSK) and back pain conditions, we are working to deliver the Getting It Right First Time (GIRFT) MSK Community Delivery Programme. GIRFT teams are working with health system leaders to further reduce MSK community waiting times, which are the highest of all community waits, and to improve data, metrics, and referral pathways to wider support services.In the Old Bexley and Sidcup constituency, those seeking support for MSK conditions and back pain conditions can access services such as the Bexley MSK Service, which provides specialist care for adults in the Bexley area experiencing a wide range of MSK conditions and which offers personalised treatment plans tailored to individual needs. Launched in Summer 2025, the getUBetter app, commissioned by the NHS South East London Integrated Care Board, is also accessible to Bexley residents aged 16 years old or over and those registered with a Bexley general practice. It offers information on local services, including self-referral options for leisure activities supporting health and wellbeing.NHS England does not nationally commission chiropractic care as it is a complementary and alternative medicine. Integrated care boards can make independent decisions on which health professionals they employ and may commission a limited amount of such treatment.

What assessment he has made of the potential merits of Local Authorities commissioning gambling harms prevention; and of their capacity to do so.

In April 2025, the statutory gambling levy came into effect to fund the research, prevention, and treatment of gambling-related harm across Great Britain. In its first year, the levy has raised nearly £120 million, with 30% allocated to gambling harms prevention activity. The Department for Culture, Media and Sport, which is responsible for the implementation and oversight of the gambling levy, remains confident that levy commissioners are best placed to make decisions on the future of their work programmes regarding the research, prevention, and treatment of gambling-related harms. As prevention commissioners, the Office for Health Improvement and Disparities (OHID) in England and the Scottish and Welsh administrations continue to work collaboratively on the development of their respective work programmes, drawing on expertise from across the system. OHID will employ a ‘test and learn’ approach as they transition to the new levy system, to better-understand what interventions are most effective in preventing gambling harms at a local, regional, and national level. Local authorities are well placed to play a central role in preventing gambling‑related harms across local communities. An OHID-led stocktake of local authority activity in this space indicated that whilst some activity is already underway, there is appetite within local authorities to do more. OHID are developing a fund for all upper-tier local authorities across England, which will aim to strengthen local capacity to tackle gambling‑related harm by facilitating improved understanding of local need and supporting the development of effective local and regional networks. This will be delivered alongside the Gambling Harms Prevention: Voluntary, Community and Social Enterprise grant fund which launched in January to fund voluntary, community, and social enterprise organisations to deliver prevention activity across England until March 2028. Further information on the Gambling Harms Prevention: Voluntary, Community and Social Enterprise grant fund is avaiable at the following link: https://find-government-grants.service.gov.uk/grants/gambling-harms-prevention-voluntary-community-and-social-enterprise-vcse-grant-fund-1

Pursuant to the answer of 21 November to question 91059 on Doctors: Training, if he will publish a timeline of HM Government's next steps.

The Medical Training (Prioritisation) Act 2026 received Royal Assent on 5 March 2026. The Medical Training (Prioritisation) Act 2026 (Commencement) Regulations 2026 were made on 5 March 2026, which brought into force all provisions of the Act on 6 March 2026.The timeline for the creation of 1,000 specialty training posts as set out in the 10-Year Health Plan will be confirmed in due course.

How much has been spent on training UK medical students in each of the last five years, and how many of those publicly-funded graduates did not secure Foundation or speciality training places in the NHS.

The following table sets out the total costs incurred by NHS England in providing medical education in England between 2021/22 and 2025/26, split by placement costs and bursaries:Financial yearPlacement costs (£)Bursaries (£)Total Education and Training costs (£)2025/26*897,330,129146,069,5621,043,399,6912024/25853,829,035140,565,328994,394,3632023/24789,778,565134,498,120924,276,6852022/23733,337,634126,186,114859,523,7482021/22708,292,911113,419,097821,712,008Source: NHS EnglandNotes:The Department of Health and Social Care does not have the information requested for the last five full financial years, so the accompanying table incorporates the forecast spend for 2025/26.The Department of Health and Social Care does not hold information on the costs incurred by the Department for Education or by bodies that the Department for Education sponsors, such as the Student Loans Company or the Office for Students. These areas of DfE provision will include tuition and maintenance loans as well as the Strategic Priorities grant which supports high cost STEM subjects. The United Kingdom Foundation Programme Office has sought to allocate Foundation Programme places to all eligible applicants in each of the past five years.The General Medical Council (GMC) publishes data on the proportion of doctors completing foundation year two who have subsequently entered the specialty training pipeline in each subsequent year. The data does not differentiate between the place of undergraduate study of doctors but given over 90% of doctors completing foundation year two are United Kingdom graduates, the data provides a good proxy for progression on to specialty training. This data is available as part of the GMC’s National Training Survey at the following link:https://edt.gmc-uk.org/progression-reports/recruitment-from-f2

What steps his Department is taking to prevent the loss of UK-trained medical graduates to (a) alternative careers and (b) emigration.

On 8 December 2025, the Government put an offer in writing to the British Medical Association Resident Doctors Committee which would put in place emergency legislation in the new year which would prioritise United Kingdom and Republic of Ireland medical graduates for foundation training, and prioritise UK and Republic of Ireland medical graduates and doctors who have worked in the National Health Service for a significant period of time for specialty training. This would apply to current applicants for training posts starting in 2026, and every year after that.Other measures in the offer include creating 4,000 more specialty training places, with 1,000 of these brought forward to this year, cost related measures, such as reimbursement for exam fees, to address the unique costs that resident doctors face, and increasing the less than full time allowance by 50% to £1,500.This is in addition to steps already taken by NHS England in September to tackle competition for speciality training places this year by changing General Medical Council registration requirements and limiting the number of applications that can be submitted by individuals.We have also made significant progress over the past year to improve the working lives of resident doctors. This includes agreeing an improved exception reporting system which will ensure doctors are compensated fairly for additional work, reviewing how resident doctors rotate through their training, and reforming and rationalising statutory and mandatory training to reduce unnecessary burden and repetition. In August 2025, NHS England published The NHS’s 10 Point Plan which set out actions for NHS England and trusts to improve resident doctors working conditions by fixing unacceptable working practices and getting the basics right for resident doctors. It aims to tackle basic issues like payroll errors, poor rota management, lack of access to rest facilities and hot food, and unnecessarily repeating training.

Whether his Department is taking steps to prioritise UK-trained medical graduates over overseas-trained applicants when allocating (a) Foundation Years and (b) speciality training posts; and if he will make it his policy to reintroduce a residency-based labour-market test for NHS training posts.

On 8 December 2025, the Government put an offer in writing to the British Medical Association Resident Doctors Committee which would put in place emergency legislation in the new year which would prioritise United Kingdom and Republic of Ireland medical graduates for foundation training, and prioritise UK and Republic of Ireland medical graduates and doctors who have worked in the National Health Service for a significant period of time for specialty training. This would apply to current applicants for training posts starting in 2026, and every year after that.Other measures in the offer include creating 4,000 more specialty training places, with 1,000 of these brought forward to this year, cost related measures, such as reimbursement for exam fees, to address the unique costs that resident doctors face, and increasing the less than full time allowance by 50% to £1,500.This is in addition to steps already taken by NHS England in September to tackle competition for speciality training places this year by changing General Medical Council registration requirements and limiting the number of applications that can be submitted by individuals.We have also made significant progress over the past year to improve the working lives of resident doctors. This includes agreeing an improved exception reporting system which will ensure doctors are compensated fairly for additional work, reviewing how resident doctors rotate through their training, and reforming and rationalising statutory and mandatory training to reduce unnecessary burden and repetition. In August 2025, NHS England published The NHS’s 10 Point Plan which set out actions for NHS England and trusts to improve resident doctors working conditions by fixing unacceptable working practices and getting the basics right for resident doctors. It aims to tackle basic issues like payroll errors, poor rota management, lack of access to rest facilities and hot food, and unnecessarily repeating training.

Whether he will issue guidance to the NHS on recruitment the recruitment of domestic graduates and non-UK applicants.

On 8 December 2025, the Government put an offer in writing to the British Medical Association Resident Doctors Committee which would put in place emergency legislation in the new year which would prioritise United Kingdom and Republic of Ireland medical graduates for foundation training, and prioritise UK and Republic of Ireland medical graduates and doctors who have worked in the National Health Service for a significant period of time for specialty training. This would apply to current applicants for training posts starting in 2026, and every year after that.Other measures in the offer include creating 4,000 more specialty training places, with 1,000 of these brought forward to this year, cost related measures, such as reimbursement for exam fees, to address the unique costs that resident doctors face, and increasing the less than full time allowance by 50% to £1,500.This is in addition to steps already taken by NHS England in September to tackle competition for speciality training places this year by changing General Medical Council registration requirements and limiting the number of applications that can be submitted by individuals.We have also made significant progress over the past year to improve the working lives of resident doctors. This includes agreeing an improved exception reporting system which will ensure doctors are compensated fairly for additional work, reviewing how resident doctors rotate through their training, and reforming and rationalising statutory and mandatory training to reduce unnecessary burden and repetition. In August 2025, NHS England published The NHS’s 10 Point Plan which set out actions for NHS England and trusts to improve resident doctors working conditions by fixing unacceptable working practices and getting the basics right for resident doctors. It aims to tackle basic issues like payroll errors, poor rota management, lack of access to rest facilities and hot food, and unnecessarily repeating training.

What assessment his Department has made of the potential merits of expanding domestic training places compared instead of continuing current levels of international recruitment.

On 8 December 2025, the Government put an offer in writing to the British Medical Association Resident Doctors Committee which would put in place emergency legislation in the new year which would prioritise United Kingdom and Republic of Ireland medical graduates for foundation training, and prioritise UK and Republic of Ireland medical graduates and doctors who have worked in the National Health Service for a significant period of time for specialty training. This would apply to current applicants for training posts starting in 2026, and every year after that.Other measures in the offer include creating 4,000 more specialty training places, with 1,000 of these brought forward to this year, cost related measures, such as reimbursement for exam fees, to address the unique costs that resident doctors face, and increasing the less than full time allowance by 50% to £1,500.This is in addition to steps already taken by NHS England in September to tackle competition for speciality training places this year by changing General Medical Council registration requirements and limiting the number of applications that can be submitted by individuals.We have also made significant progress over the past year to improve the working lives of resident doctors. This includes agreeing an improved exception reporting system which will ensure doctors are compensated fairly for additional work, reviewing how resident doctors rotate through their training, and reforming and rationalising statutory and mandatory training to reduce unnecessary burden and repetition. In August 2025, NHS England published The NHS’s 10 Point Plan which set out actions for NHS England and trusts to improve resident doctors working conditions by fixing unacceptable working practices and getting the basics right for resident doctors. It aims to tackle basic issues like payroll errors, poor rota management, lack of access to rest facilities and hot food, and unnecessarily repeating training.

Pursuant to the Answer of 30 October 2025 to Question 83371 on Abiraterone: Finance, what steps he is taking to secure recurrent budget allocation for abiraterone for use in cases of high-risk non-metastatic prostate cancer.

Abiraterone is not licensed for use in the treatment of high-risk, non-metastatic hormone-sensitive prostate cancer, and as such, cannot be evaluated by the National Institute for Health and Care Excellence (NICE) for routine use on the National Health Service. NICE makes recommendations for the NHS in England on the vast majority of new and significant licence indications but does not evaluate medicines that are used outside their marketing authorisations or “off-label”.These funding decisions are the responsibility of NHS commissioners who are required to make decisions on the basis of the available evidence. For cancer medicines, NHS England is the responsible commissioner and has an established mechanism to do so through its clinical prioritisation process. NHS England considered abiraterone as an off-label treatment for the treatment of hormone sensitive, non-metastatic prostate cancer through its clinical policy development process in 2024/25. Through this process, NHS England confirmed that there was sufficient supporting evidence to support the routine commissioning of abiraterone in this indication and it was ranked as the top priority for routine commissioning. However, it has not been possible to identify the necessary recurrent funding to support the commissioning of abiraterone, or any other treatments within the prioritisation round.This position takes into account the need to ensure the affordability of introducing any new routine commissioning policies, alongside maintaining existing services for patients, and meeting the NHS’ legal requirement to fund all NICE approved drugs. Abiraterone for the treatment of high-risk, hormone sensitive, non-metastatic prostate cancer remains the top priority for routine commissioning, and its position is being kept under active review.

If he will take steps to help ensure the continuity of the (a) National Gambling Helpline and (b) other national gambling harms charities.

The introduction of the new statutory levy on gambling operators, which came into effect in April 2025, guarantees independent, sustainable funding for the research, prevention, and treatment of gambling-related harms.The Government recognises the important role national gambling harm charities play in providing help and support for those experiencing gambling-related harms. To ensure the continuity of these services during the transition to the levy system, GambleAware will continue to commission existing treatment and support services until 31 March 2026.From 1 April 2026, NHS England will assume responsibility for commissioning the full gambling harms treatment pathway in England. Organisations, including those who operate the National Gambling Helpline, will be permitted to apply for ringfenced levy funding, provided they comply with the stated eligibility requirements. NHS England is actively working to confirm future commissioning arrangements and is committed to keeping stakeholders informed, with a further update expected in November.The Office for Improvement and Disparities, as the prevention commissioner for England under the levy, intends to launch a competitive grant process for 2026/27 to provide funding for the voluntary sector to deliver effective prevention activity. Further details will be confirmed in November 2025.

When the Clinical Priorities Advisory Group next plans to consider funding for Abiraterone in a prioritsation round.

NHS England considered abiraterone as an off-label treatment for hormone sensitive, non-metastatic prostate cancer through its clinical policy development process in 2024/25. Through this process, NHS England confirmed that there was sufficient supporting evidence to support the routine commissioning of abiraterone in this indication and it was ranked as the top priority for routine commissioning. This position is being kept under review, although currently there is no requirement for another meeting of the Clinical Priorities Advisory Group to reprioritise this policy, and the policy will be progressed as soon as recurrent funding is identified.

With reference to the 10 Year Health Plan for England, what assessment he has made of the potential merits of using (a) chiropractors and (b) other wider healthcare professionals to support the NHS in delivering neighbourhood health centres.

Neighbourhood health centres will provide easier, more convenient access to a full range of healthcare services on people’s doorsteps, and patients will be treated and cared for closer to their home by new teams of healthcare professionals.We have launched the National Neighbourhood Health Implementation Programme (NNHIP). The NNHIP will support systems across the country to test new ways of working, share learning, and scale what works. This programme will inform future strategy and policy development, and outcome metrics will be rigorously monitored.

What the tariff rate per patient was for (a) CT, (b) MRI and (c) ultrasound scans delivered in community diagnostic centres on (ii) 1 March and (ii) 1 June 2025.

The community diagnostic centre (CDC) tariff price list has evolved to align with the national payment scheme from April 2025. Tariff prices in CDCs are now consistent with acute and primary care provision so that the cost of the delivery of diagnostics is equitable with the rest of the National Health Service. The payment scheme can be found at the following link:https://www.england.nhs.uk/publication/2025-26-nhs-payment-scheme/The cost differential over the Spending Review 2021 period allowed CDCs under construction to be supported financially with the additional costs of setting up a new service. The following table shows the CDC price tariffs for 2024/25:Test typeTest name and descriptionPriceUltrasound (US) non-obstetric ultrasound (NOUS)US (NOUS) without contrast£52US (NOUS) with contrast£117Computed tomography (CT)CT with contrast£146CT without contrast£133Magnetic resonance imaging (MRI)MRI without contrast£177MRI with contrast£264 In addition, the following table shows the 2025/26 national payment scheme prices:Test typeTest name and descriptionPriceUltrasound (US) non-obstetric ultrasound (NOUS)US (NOUS) without contrast (under 20 mins)£48US (NOUS) without contrast (over 20 mins)£61US (NOUS) with contrast (under 20 mins)£99US (NOUS) with contrast (over 20 mins)£111Computed tomography (CT)CT with contrast 1 area (Adult)£98CT with contrast 1 area (Paediatrics age 6 to 18 years old)£161CT with contrast 2 area£105CT with contrast 3 area£115CT non contrast 1 area (Adult)£78CT non contrast 1 area (Paediatrics age 6 to 18 years old)£132CT non contrast 2 area£85CT non contrast 3 area£94Magnetic resonance imaging (MRI)MRI non contrast 1 area (Adult)£129MRI non contrast 1 area (Paediatric age 6 to 18 years old)£217MRI non contrast 2 area£155MRI non contrast more than 3 area£222MRI with contrast 1 area (Adult)£188MRI with contrast 1 area (Paediatric age 6 to 18 years old)£329

Pursuant to the Answer of 10 March to Question 34943 on Gambling: Health Services, what steps he is taking to ensure the new commissioning programme is in place before the end of the voluntary levy period.

It is a priority for the Government that in this crucial transition period, valuable support and treatment services for those experiencing gambling-related harm are protected. To minimise any disruption, operators must continue to provide financial contributions at their current levels until the levy is in force. The Government has received assurances from industry that this will be delivered.Following the appointment of lead commissioning bodies for research, prevention, and treatment under the statutory levy, all continue to work at pace to design the future commissioning programmes, and to ensure that there is no break in the provision of services. Spending decisions will be confirmed in due course.

What assessment he has made of the potential impact of changes to treatment tariffs on the ability of Community Diagnostic Centres to provide care.

As set out in the Plan for Change, we will ensure that 92% of patients return to waiting no longer than 18 weeks from Referral to Treatment by March 2029, a standard which has not been met consistently since September 2015.We have delivered an additional two million appointments between July and November 2024 compared to the same period in 2023, seven months ahead of schedule. This includes operations, consultations, diagnostic tests, and treatments such as chemotherapy, radiotherapy and endoscopy.The consultation on proposals for the 2025/26 NHS Payment Scheme closed on 28 February 2025. NHS England is currently reviewing the feedback received, including the aligned payment and incentive mechanism for community diagnostic centres (CDCs). NHS England will confirm decisions about the final scheme as soon as possible.Diagnostic activity continues to be undertaken in non-CDC settings, as well as in CDCs. As set out in the consultation, NHS England has proposed that the same payment approach is used for all diagnostic activity to ensure that the payment system is not a barrier to delivery.

When the Office for Health Improvement and Disparities will begin to distribute funding generated from the statutory Gambling Levy.

The Office for Health Improvement and Disparities is progressing work on the design of the new commissioning programme to prevent gambling related harms, alongside counterparts in Scotland and Wales, and is working closely with the Department for Culture, Media and Sport and HM Treasury. Decisions on how the levy will be governed will be confirmed in due course.

What steps his Department is taking to provide a redress scheme for those harmed by Sodium Valproate and surgical mesh implants.

The Government is carefully considering the valuable work done by the Patient Safety Commissioner and the resulting Hughes Report. The report sets out options for redress for those harmed by valproate and pelvic mesh. This is a complex matter involving work with other Government Departments. The Government will be providing an update to the Patient Safety Commissioner’s Report at the earliest opportunity.The Parliamentary Under-Secretary of State for Patient Safety, Women’s Health and Mental Health had an introductory meeting with individuals and stakeholders representing those harmed by sodium valproate on 12 December 2024 and patient groups representing those harmed by Pelvic mesh on 17 December 2024.The meetings were arranged so the Minister could hear individuals’ experiences of the issues raised in the Hughes Report and understand their key concerns around both financial and non-financial redress options.

What support his Department provides to the Cleft Registry and Audit Network.

The Government is committed to giving every child the best start in life and raising the healthiest generation of children ever.  NHS England commissions services for children, young people and adults with a cleft lip and/or palate.The patient pathway can start from pre-birth and continues into adulthood. Cleft services provide care through multi-disciplinary teams including orthodontists, speech and language therapists and clinical psychologists. These services are available to children and young people with a cleft lip and/or palate until they are at least 20 years old and to adults at any age. The service specifications outline the stages at which psychological support is provided and includes the requirement that all patients with a cleft lip and/or palate are regularly assessed and offered psychological support if needed. More information is available at the following link:https://www.england.nhs.uk/wp-content/uploads/2013/06/d07-cleft-lip.pdfAll cleft lip and/or palate services are required to submit data to the Cleft Registry and Audit Network, which is hosted and run by the Royal College of Surgeons and funded by NHS England.

Pursuant to the Answer of 12 November 2024 to Question 13158 on Sodium Valproate and Surgical Mesh Implants: Compensation, what further progress his Department has made in responding to the Hughes Report.

The Government is carefully considering the valuable work done by the Patient Safety Commissioner and the resulting Hughes Report. The report sets out options for redress for those harmed by valproate and pelvic mesh. This is a complex matter involving work with other Government Departments. The Government will be providing an update to the Patient Safety Commissioner’s Report at the earliest opportunity.The Parliamentary Under-Secretary of State for Patient Safety, Women’s Health and Mental Health had an introductory meeting with individuals and stakeholders representing those harmed by sodium valproate on 12 December 2024 and patient groups representing those harmed by Pelvic mesh on 17 December 2024.The meetings were arranged so the Minister could hear individuals’ experiences of the issues raised in the Hughes Report and understand their key concerns around both financial and non-financial redress options.