Written questions by Wrigley.

If his Department will make an assessment of the potential impact of the proposed increase in secondary Class 1 National Insurance contributions to 15% on (a) care provider employees, (b) the contribution of the care sector to the economy and (c) the future long-term funding settlement for adult social care.

The Government considered the cost pressures facing adult social care as part of the wider consideration of local government spending within the Spending Review process in 2024. To enable local authorities to deliver key services such as adult social care, the Government is making available up to £3.7 billion of additional funding for social care authorities in 2025/26 which includes an £880 million increase in the Social Care Grant.The Casey Commission will make longer-term recommendations for the transformation of adult social care, and how to best create a fair and affordable adult social care system.

If he will make an assessment of the potential merits of requiring large pharmacies to hold several months of reserve stock of medication.

Pharmacies are independent businesses and are expected to maintain a reasonable stock holding to meet their legal obligations to dispense all prescriptions with reasonable promptness, recognising that it is not feasible for a pharmacy to maintain stock of every medicine.Most pharmacies do not have space to hold several months of stock and such stock holding would come with a financial risk to the pharmacy as stock may expire. There are therefore no plans to require pharmacies to hold reserve stock of medication.

What assessment he has made of the potential impact of the shortage of quetiapine modified-release tablets on Bipolar patients.

The Department has made no such assessment. We are aware of supply issues affecting several brands and tablet strengths of quetiapine modified release tablets. Following the Department working with suppliers, there have been improvements in supply through February and early March 2025, with improvements in supply expected to continue through to May 2025, and full resolution expected in October 2025. The Department continues to work with the suppliers of quetiapine modified -release tablets to bring forward these future deliveries. Working with National Health Service specialists we have provided comprehensive management advice for this supply issue, advising healthcare professionals on how to manage patients during this time. Any patient who is worried about their condition, or access to these medications, should speak to their clinician in the first instance.

If he will make an assessment of the potential merits of requiring the NHS to offer pocket-sized trauma cards for patients to show during appointments.

There are currently no plans to assess the potential merits of introducing trauma cards in the National Health Service.

If he will make an assessment of the adequacy of assessment times for (a) ADHD, (b) autism and (c) Tourette's syndrome in Devon.

It is the responsibility of integrated care boards (ICBs) to make available appropriate provision to meet the health and care needs of their local population, including access to assessments for attention deficit hyperactivity disorder (ADHD), autism, and Tourette’s syndrome, in line with relevant National Institute for Health and Care Excellence guidance where available.Devon ICB advises it is working with local partners as part of One Devon to implement an integrated neurodiversity assessment pathway to reduce the complexity for families and schools seeking assessment. One Devon is also conducting work focused on autism waiting times recovery.Nationally, NHS England has published a national framework and operational guidance to help ICBs and the National Health Service to deliver improved outcomes for children, young people, and adults referred to an autism assessment service. NHS England has established an ADHD taskforce which will make recommendations about how to address the challenges faced by those affected by ADHD.

Whether he plans to ensure patients can (a) get better access to and (b) find out about (i) research and (ii) clinical trials for rare cancers.

The Department is committed to maximising our potential to lead the world in clinical trials and ensuring that clinical trials are more accessible.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 clinical research on rare cancers. NIHR research expenditure for all cancers was £133 million in 2023/24, reflecting its high priority. These investments are pivotal to informing efforts to improve cancer prevention, treatment, and outcomes, including for rare cancers.The NIHR provides an online service called Be Part of Research, which promotes participation in health and social care research, including research into rare cancers, 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.

If he will take steps to strengthen the Orphan drug regulations to encourage research into rare diseases.

The Human Medicines Regulations include specific incentives to support orphan medicines, designed to encourage the development of medicines for rare diseases. The regulations enable the Medicines and Healthcare products Regulatory Agency (MHRA) to grant orphan designation to a medicine intended for the prevention, diagnosis, or treatment of a rare condition. This orphan designation provides the product with a period of market exclusivity for the specified condition, preventing similar competitor medicines from entering the market during this time. The MHRA further supports developers of orphan medicines by offering a full or partial refund of the marketing authorisation fee following a positive orphan designation. There is evidence that the regulations for orphan medicines do support development, with approximately 150 medicines having been successfully developed and authorised for the diagnosis, prevention, and treatment of rare diseases and given orphan designation in the United Kingdom. The MHRA will continue to review its approach to orphan medicines and, where necessary, will propose updates to the criteria to further encourage research into rare diseases, to improve patient outcomes.

What assessment he has made of the potential impact of prescription charges on patients with long-term health conditions; and whether he has made an estimate of the number individuals not taking prescribed medications due to cost.

The Department has made no assessment of the impact of prescription charges on patients’ health outcomes, or the number of hospital admissions or general practice visits. The Department does not hold data on the number of individuals not taking prescribed medications due to cost.Approximately 89% of prescription items are dispensed free of charge in the community in England, and there are a wide range of exemptions from prescription charges already in place to help those with the greatest need. Eligibility depends on the patient’s age, whether they are in qualifying full-time education, whether they are pregnant or have recently given birth, whether they have a qualifying medical condition, or whether they are in receipt of certain benefits or a war pension.People with certain long-term medical conditions may qualify for a medical exemption, which entitles them to claim free prescriptions. Medical exemption is a long-standing exemption from prescription charges, which covers all the patient’s prescriptions, not just those for the qualifying condition. A list of the qualifying medical conditions and information on how to apply for a medical exemption certificate is available at the following link:www.nhsbsa.nhs.uk/medexPeople on low incomes can apply for help with their health costs through the NHS Low Income Scheme. People who need multiple prescription items and who do not qualify for an exemption, or the NHS Low Income Scheme, could save money with a prescription prepayment certificate (PPC). PPCs allow people to claim as many prescriptions as they need for a set cost, with three-month and 12-month certificates available, and the 12-month PPC can be paid for in direct debit instalments.

If he will appoint a named lead in the Department with a responsibility to support research and innovation for rare cancers.

There are no plans to appoint a named lead within the Department for this purpose as the Department supports research and innovation for rare cancers, and other conditions, through its research delivery arm, the National Institute for Health and Care Research (NIHR).Research is crucial in tackling cancer, which is why the Department spends £1.6 billion each year on research through the NIHR, with cancer as one of the largest areas of investment, at over £133 million in 2023/24, reflecting its high priority.The development and delivery of research for rare cancers is supported and enabled nationwide through the NIHR’s infrastructure, including the NIHR Research Delivery Network, the NIHR Clinical Research Facilities, the NIHR Biomedical Research Centres, the NIHR HealthTech Research Centres, the Experimental Cancer Medicine Centre, and the newly designated NIHR Commercial Research Delivery Centres. These all support the delivery of clinical research through facilities, staff resource, collaborations, and funding.

Whether his Department has make an assessment of the potential merits of reviewing the prescription charge exemption list to increase the support for patients with chronic illness.

There are no current plans to review the list of prescription charge exemptions or the list of medical conditions that entitle someone to apply for a medical exemption certificate.There are extensive arrangements in place in England to ensure that prescriptions are affordable for everyone. Approximately 89% of prescription items are dispensed free of charge in the community in England, and there is a wide range of exemptions from prescription charges already in place, for which those with rheumatoid arthritis may be eligible. Eligibility depends on the patient’s age, whether they are in qualifying full-time education, whether they are pregnant or have recently given birth, whether they have a qualifying medical condition, or whether they are in receipt of certain benefits or a war pension.People on low incomes can apply for help with their health costs through the NHS Low Income Scheme. Prescription prepayment certificates (PPCs) are also available. PPCs allow people to claim as many prescriptions as they need for a set cost, with three-month and 12-month certificates available. The 12-month PPC can be paid for in instalments.

What estimate his Department has made of the potential impact of the level of NHS prescription charges on (a) patients' health outcomes and (b) numbers of (i) hospital admissions and (ii) GP visits.

The Department has made no assessment of the impact of prescription charges on patients’ health outcomes, or the number of hospital admissions or general practice visits. The Department does not hold data on the number of individuals not taking prescribed medications due to cost.Approximately 89% of prescription items are dispensed free of charge in the community in England, and there are a wide range of exemptions from prescription charges already in place to help those with the greatest need. Eligibility depends on the patient’s age, whether they are in qualifying full-time education, whether they are pregnant or have recently given birth, whether they have a qualifying medical condition, or whether they are in receipt of certain benefits or a war pension.People with certain long-term medical conditions may qualify for a medical exemption, which entitles them to claim free prescriptions. Medical exemption is a long-standing exemption from prescription charges, which covers all the patient’s prescriptions, not just those for the qualifying condition. A list of the qualifying medical conditions and information on how to apply for a medical exemption certificate is available at the following link:www.nhsbsa.nhs.uk/medexPeople on low incomes can apply for help with their health costs through the NHS Low Income Scheme. People who need multiple prescription items and who do not qualify for an exemption, or the NHS Low Income Scheme, could save money with a prescription prepayment certificate (PPC). PPCs allow people to claim as many prescriptions as they need for a set cost, with three-month and 12-month certificates available, and the 12-month PPC can be paid for in direct debit instalments.

What steps his Department is taking to ensure that prescription charges do not act as a barrier to treatment for people with long-term medical conditions.

Approximately 89% of prescription items are dispensed free of charge in the community in England, and there is a wide range of exemptions from prescription charges already in place to help those with the greatest need. Eligibility depends on the patient’s age, whether they are in qualifying full-time education, whether they are pregnant or have recently given birth, whether they have a qualifying medical condition, or whether they are in receipt of certain benefits or a war pension.People with certain long-term medical conditions may qualify for a medical exemption, which entitles them to claim free prescriptions. The medical exemption is a long-standing exemption from prescription charges, which covers all the patient’s prescriptions, not just those for the qualifying condition. A list of the qualifying medical conditions and information on how to apply for a medical exemption certificate is available at the following link:www.nhsbsa.nhs.uk/medexPeople who do not qualify for an exemption and who need many prescription items could save money with a prescription prepayment certificate (PPC). PPCs allow people to claim as many prescriptions as they need for a set cost, with three-month and 12-month certificates available, and the 12-month PPC can be paid for in instalments.

Pursuant to the Answer of 8 January 2025 to Question 21470 on Hospices: Charitable Donations, what proportion of the recently announced investment for hospices has been allocated; and how much has been distributed to hospices in Newton Abbot constituency.

Integrated care boards are responsible for the commissioning of palliative and end of life care services, to meet the needs of their local populations. Most hospices are charitable, independent organisations which receive some statutory funding for providing National Health Services. Charitable hospices, as autonomous organisations, provide a range of services which go beyond that which statutory services are legally required to provide. Consequently, the funding arrangements reflect this. We are pleased to confirm that the Government has released the first £25 million tranche of the £100 million of capital funding, as referenced in the answer of 8 January 2025 to Question 21470, with Hospice UK kindly allocating and distributing the money to hospices throughout England. An additional £75 million will be available from April.There are a number of hospices in South Devon, serving people in the Newton Abbot constituency and the surrounding area, which are recipients of the £100 million of capital funding. Their allocations from the first £25 million tranche of funding are as follows:- £158,301 for Rowcroft, a Torbay and South Devon hospice;- £180,911 for Hospiscare in Exeter;- £16,934 for Sidmouth Hospice in Home; and- £176,616 for St Luke's Hospice in Plymouth.In addition to this record hospice funding package, I recently met the major palliative and end of life care and hospice stakeholders, and long-term sector sustainability, within the context of our 10-Year Health Plan, was discussed at length.

Pursuant to the Answer of 8 January 2025 to Question 21470 on Hospices: Charitable Donations, what steps his Department is taking to monitor the potential impact of declining charitable income on hospice services; and if he will introduce targeted financial support for hospices.

Integrated care boards are responsible for the commissioning of palliative and end of life care services, to meet the needs of their local populations. Most hospices are charitable, independent organisations which receive some statutory funding for providing National Health Services. Charitable hospices, as autonomous organisations, provide a range of services which go beyond that which statutory services are legally required to provide. Consequently, the funding arrangements reflect this. We are pleased to confirm that the Government has released the first £25 million tranche of the £100 million of capital funding, as referenced in the answer of 8 January 2025 to Question 21470, with Hospice UK kindly allocating and distributing the money to hospices throughout England. An additional £75 million will be available from April.There are a number of hospices in South Devon, serving people in the Newton Abbot constituency and the surrounding area, which are recipients of the £100 million of capital funding. Their allocations from the first £25 million tranche of funding are as follows:- £158,301 for Rowcroft, a Torbay and South Devon hospice;- £180,911 for Hospiscare in Exeter;- £16,934 for Sidmouth Hospice in Home; and- £176,616 for St Luke's Hospice in Plymouth.In addition to this record hospice funding package, I recently met the major palliative and end of life care and hospice stakeholders, and long-term sector sustainability, within the context of our 10-Year Health Plan, was discussed at length.

Pursuant to the Answer of 8 January 2025 to Question 21470 on Hospices: Charitable Donations, whether his Department has made an assessment of the potential implications for its policies of recent reports of reduced service in hospices.

Integrated care boards are responsible for the commissioning of palliative and end of life care services, to meet the needs of their local populations. Most hospices are charitable, independent organisations which receive some statutory funding for providing National Health Services. Charitable hospices, as autonomous organisations, provide a range of services which go beyond that which statutory services are legally required to provide. Consequently, the funding arrangements reflect this. We are pleased to confirm that the Government has released the first £25 million tranche of the £100 million of capital funding, as referenced in the answer of 8 January 2025 to Question 21470, with Hospice UK kindly allocating and distributing the money to hospices throughout England. An additional £75 million will be available from April.There are a number of hospices in South Devon, serving people in the Newton Abbot constituency and the surrounding area, which are recipients of the £100 million of capital funding. Their allocations from the first £25 million tranche of funding are as follows:- £158,301 for Rowcroft, a Torbay and South Devon hospice;- £180,911 for Hospiscare in Exeter;- £16,934 for Sidmouth Hospice in Home; and- £176,616 for St Luke's Hospice in Plymouth.In addition to this record hospice funding package, I recently met the major palliative and end of life care and hospice stakeholders, and long-term sector sustainability, within the context of our 10-Year Health Plan, was discussed at length.

Pursuant to the Answer of 8 January 2025 to Question 21470 on Hospices: Charitable Donations, if he will provide financial support to hospices to directly cover declining charitable incomes.

Integrated care boards are responsible for the commissioning of palliative and end of life care services, to meet the needs of their local populations. Most hospices are charitable, independent organisations which receive some statutory funding for providing National Health Services.Charitable hospices, as autonomous organisations, provide a range of services which go beyond that which statutory services are legally required to provide. Consequently, the funding arrangements reflect this.In addition to the record hospice funding package I mentioned in my previous answer, I recently met the major palliative and end of life care and hospice stakeholders, and long-term sector sustainability, within the context of our 10-Year Health Plan, was discussed at length.

If he will make an assessment of the adequacy of the availability of Pancreatic Enzyme Replacement Therapy (PERT) drugs; and if he will take steps to tackle shortages.

The Department monitors and manages medicine supply at a national level so that stocks remain available to meet regional and local demand. Information on stock levels within local areas is not held centrally.The Department is continuing to engage with all suppliers of pancreatic enzyme replacement therapy (PERT) to boost production and mitigate the supply issue. Suppliers have managed to secure additional pharmaceutical ingredients resulting in expected increased volumes of PERT for 2025. The Department has also reached out to specialist importers who have sourced unlicensed stock to assist in covering the gap in the market. In December 2024, the Department issued further management advice to healthcare professionals. This directs clinicians to prescribe unlicensed imports when licensed stock is unavailable, and includes actions for integrated care boards to ensure that local mitigation plans are put in place and implemented. The Department, in collaboration with NHS England, has created a webpage to include the latest updates on PERT availability and easily accessible advice on the prescribing and ordering of alternative PERT products.

If his Department will make an assessment of the potential impact of (a) inflation, (b) changes to National Insurance contributions and (c) local authority fee uplifts on healthcare providers.

Each year, the cost of providing healthcare changes because of changes in wages, inflation other inputs over which providers have little control. NHS England publishes a cost uplift factor to reflect these expected cost changes that forms part of the NHS Payment Scheme, and all payment arrangements must have regard to the figure.The 2025/26 NHS Payment Scheme is out for consultation until midnight on 28 February 2025. The proposed cost uplift factor for 2025/26 is 4.15%, and is broken down into costs affecting pay, drugs, capital, clinical negligence and other factors.

What steps he plans to take to tackle the causes of the shortage of Pancreatic enzyme replacement therapy medication.

The Department monitors and manages medicine supply at a national level so that stocks remain available to meet regional and local demand. Information on stock levels within local areas is not held centrally.The Department is continuing to engage with all suppliers of pancreatic enzyme replacement therapy (PERT) to boost production and mitigate the supply issue. Suppliers have managed to secure additional pharmaceutical ingredients resulting in expected increased volumes of PERT for 2025. The Department has also reached out to specialist importers who have sourced unlicensed stock to assist in covering the gap in the market. In December 2024, the Department issued further management advice to healthcare professionals. This directs clinicians to prescribe unlicensed imports when licensed stock is unavailable, and includes actions for integrated care boards to ensure that local mitigation plans are put in place and implemented. The Department, in collaboration with NHS England, has created a webpage to include the latest updates on PERT availability and easily accessible advice on the prescribing and ordering of alternative PERT products.

If he will take steps to intervene on the planned closure of the cardiac catherisation laboratory at Torbay Hospital.

Responsibility for the delivery, implementation, and funding decisions for services ultimately rests with the appropriate National Health Service commissioning body. All service changes should be based on clear evidence that they will deliver better outcomes for patients. Any substantial, planned service change is subject to a full public consultation and must meet the Government and NHS England’s ‘tests’ to ensure good decision making.The Health and Care Act 2022 provided new powers that allow for increased oversight and ministerial involvement in the reconfiguration of NHS services. These powers were commenced on 31 January 2024. My Rt Hon. Friend, the Secretary of State for Health and Social Care will decide whether to intervene if a call-in request has been submitted to the Department. There is an expectation that all avenues of local resolution are exhausted before a call-in request is accepted.The Department has not received a call-in request to intervene in the closure of the cardiac catherisation laboratory at Torbay.