Written questions by Foy.

What steps his Department is taking to increase the availability of autism assessments.

It is the responsibility of the integrated care boards (ICBs) to make available appropriate provision to meet the health and care needs of their local population, including autism assessments and diagnosis, in line with relevant National Institute for Health and Care Excellence (NICE) guidelines. In doing so, ICBs should take account of waiting lists, considering how local funding can be deployed to best meet the needs of their local population.On 5 April 2023, NHS England 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. Since publication, NHS England has been supporting systems and services to identify where there are challenges for implementation and how they might overcome these.NHS England is also working with research organisations to explore evidence-based models that support improved outcomes for those people waiting for an autism assessment.

Whether he plans to distribute the second tranche of hospice funding based on (a) levels of need and (b) areas of deprivation.

We are pleased to confirm that the Government has released the first £25 million tranche of the £100 million of capital funding, with Hospice UK kindly allocating and distributing the money to hospices throughout England. For this first tranche, individual hospice allocations were calculated based on the care expenditure of each hospice.The second tranche of £75 million of funding will be available from April. We will carefully consider whether the allocation model needs to be amended for this second tranche of funding, and will set out further details as soon as possible.

What steps his Department is taking to support hospices in City of Durham constituency.

We are supporting the hospice sector with a £100 million capital funding boost for adult and children’s hospices in England to ensure they have the best physical environment for care. We are working at great pace to get this year’s funding to hospices as soon as possible. We are currently finalising the delivery mechanisms, and are pleased that Hospice UK is standing ready to distribute the money to hospices throughout England, including to hospices in the City of Durham constituency. We are also providing £26 million of revenue funding to support children and young people’s hospices in 2025/26. NHS England is currently making decisions on the allocation and administration mechanisms for that funding and hopes to communicate plans to the sector later this month. Earlier this month, I met with key palliative and end of life care, including hospice, stakeholders on 3 February to discuss the long-term sustainability of palliative and end of life care, within the context of our 10-Year Health Plan.

What assessment his Department has made of the adequacy of access to NHS dental services in City of Durham constituency.

The Dental Statistics - England 2023/24, published by the NHS Business Services Authority on 22 August 2024, is available at the following link:https://www.nhsbsa.nhs.uk/statistical-collections/dental-england/dental-statistics-england-202324In the NHS Northeast and North Cumbria Integrated Care Board, which includes the City of Durham constituency, 45% of adults were seen by a National Health Service dentist in the previous 24 months to June 2024, compared to 40% in England. In addition, 58% of children were seen by an NHS dentist in the previous 12 months to June 2024, compared to 56% in England.The Government plans to tackle the challenges for patients trying to access NHS dental care with a rescue plan to provide 700,000 more urgent dental appointments and recruit new dentists to the areas that need them most.

What steps his Department is taking to improve access to mental health services in City of Durham constituency.

Waiting times for those referred to mental health services are too high all across England, including in the City of Durham constituency.Too many people with mental health issues are not getting the support or care they need, which is why we will fix the broken system to ensure we give mental health the same attention and focus as physical health, so that people can be confident in accessing high quality mental health support when they need it.Nationally, we plan to recruit an additional 8,500 mental health workers across child and adult mental health services in England to reduce delays and provide faster treatment. We will also introduce access to a specialist mental health professional in every school and roll out Young Futures hubs in every community.

What steps his Department is taking to support people with leukaemia in (a) City of Durham constituency and (b) the North East.

The National Health Service is taking crucial steps to improve cancer outcomes for patients across England, including for leukaemia. We will improve cancer survival rates and hit all NHS cancer waiting time targets, so no patient waits longer than they should.The Department is committed to implementing the recommendations of the Lord O'Shaughnessy review into commercial clinical trials, making sure that the United Kingdom leads the world in clinical trials, and to ensure that innovative, lifesaving treatments are accessible to NHS patients, including those with leukaemia.NHS England is also committed to ensuring that cancer patients in all parts of England are offered Holistic Needs Assessment and Personalised Care and Support Planning, ensuring care is focused on what matters most to each person. This commitment is being delivered in line with the NHS Comprehensive Model for Personalised Care, empowering people to manage their care and the impact of their cancer and maximise the potential of digital and community-based support.Health and wellbeing information and support is provided by healthcare professionals from diagnosis onwards and includes access to NHS Talking Therapy services for anxiety and depression, where considered clinically appropriate. These services are provided alongside wider work to improve psychosocial support for people affected by cancer where possible, such as through local partnerships with cancer support charities.The National Cancer Plan will include further details on how we support cancer patients, including those with blood cancer. We are now in discussions about what form that plan should take, and what its relationship to the 10-Year Health Plan and the Government’s wider Health Mission should be and will provide updates in due course.

Whether (a) he and (b) his Department has had discussions with County Durham and Darlington Foundation NHS Trust on delays to death certification.

The Government is monitoring the impact of the death certification reforms, which came into legal effect on 9 September 2024, but has not engaged with the County Durham and Darlington Foundation NHS Trust directly.The median time taken to register a death since the introduction of the reforms in England and Wales has typically been eight days. This figure is for all deaths, as it includes those certified by a doctor and those investigated by a coroner. The median time taken to register a death varies depending on the type of certification. Deaths certified by a doctor, that comprise approximately 80% of deaths registered each week, have typically had a median time to registration of seven days. It is important to note that the medical examiner system was active on a non-statutory basis before the introduction of the statutory system on 9 September, and this makes direct before and after comparisons challenging to draw conclusions from.The core purposes of the death certification reforms are to introduce scrutiny of the cause of death to detect and deter malpractice, to improve reporting, and crucially to put the bereaved at the centre of the process by offering a conversation with the medical examiner about the cause of death. The expectation on doctors and medical examiners is clear, that they should complete certification as quickly and efficiently as possible, and the Government is working with all stakeholders to make sure this is the case.

If he will make an assessment of the adequacy of the Medical Certificate of Cause of Death Regulations 2024 in the context of reports of delays to funeral services.

The Government is monitoring the impact of the death certification reforms, including the Medical Certificate of Cause of Death Regulations 2024, which came into legal effect on 9 September 2024. The median time taken to register a death since the introduction of the reforms in England and Wales has typically been eight days. This figure is for all deaths, as it includes those certified by a doctor and those investigated by a coroner. The median time taken to register a death varies depending on the type of certification. Deaths certified by a doctor, that comprise approximately 80% of deaths registered each week, have typically had a median time to registration of seven days. These figures are not broken down by hospital or community setting. It is important to note that the medical examiner system was active on a non-statutory basis before the introduction of the statutory system on 9 September, and this makes direct before and after comparisons challenging to draw conclusions from.The core purposes of the death certification reforms are to introduce scrutiny of the cause of death to detect and deter malpractice, to improve reporting, and crucially to put the bereaved at the centre of the process by offering a conversation with the medical examiner about the cause of death. The expectation on doctors and medical examiners is clear, that they should complete certification as quickly and efficiently as possible, and the Government is working with all stakeholders to make sure this is the case.

What the average time taken was to certify a death in (a) hospital and (b) the community in the period since changes were made to the death certification process in September 2024.

The Government is monitoring the impact of the death certification reforms, including the Medical Certificate of Cause of Death Regulations 2024, which came into legal effect on 9 September 2024. The median time taken to register a death since the introduction of the reforms in England and Wales has typically been eight days. This figure is for all deaths, as it includes those certified by a doctor and those investigated by a coroner. The median time taken to register a death varies depending on the type of certification. Deaths certified by a doctor, that comprise approximately 80% of deaths registered each week, have typically had a median time to registration of seven days. These figures are not broken down by hospital or community setting. It is important to note that the medical examiner system was active on a non-statutory basis before the introduction of the statutory system on 9 September, and this makes direct before and after comparisons challenging to draw conclusions from.The core purposes of the death certification reforms are to introduce scrutiny of the cause of death to detect and deter malpractice, to improve reporting, and crucially to put the bereaved at the centre of the process by offering a conversation with the medical examiner about the cause of death. The expectation on doctors and medical examiners is clear, that they should complete certification as quickly and efficiently as possible, and the Government is working with all stakeholders to make sure this is the case.

If he will make it his policy to prepare a cross-government strategy to reduce health inequalities in the North East.

The United Kingdom faces significant health inequalities, with life expectancy varying widely across and within communities. The Government is committed to building a fairer Britain by tackling the structural inequalities that contribute to poor health, particularly for disadvantaged groups.The Office for Health Improvement and Disparities’ North East and Yorkshire Regional Team collaborates with partners to provide system leadership for public health, reducing health inequalities. The team facilitates the delivery of national and local public health priorities, providing expert advice. It works with Directors of Public Health in local authorities, integrated care systems, Mayoral Combined Authorities, NHS England, and the wider National Health Service. The team also leads for public health workforce development and with Local Knowledge and Intelligence colleagues, and provides enhanced data, intelligence, and insights for population health.North East local authorities received a total of £238 million in Public Health Grant funding for 2024/25, with Durham County Council receiving £53.9 million for 2024/25. This provides services such as stop smoking, drug and alcohol treatment, health visiting and school nursing, and sexual health, among others, all of which contribute to addressing health inequalities. Additionally, Directors of Public Health from each local authority are working in partnership with the North East and North Cumbria Integrated Care Board to support action to address inequalities in access, experience, and outcomes associated with health care.Existing initiatives to reduce inequalities in relation to health services, in England, include NHS England’s Core20Plus5, which focuses on improving the five clinical areas in most need of accelerated improvement in the poorest 20% of the population, along with other underserved population groups identified at a local level, including groups that share protected characteristics, and socially excluded groups such as people experiencing homelessness.Durham County Council is one of 75 local authorities with high levels of deprivation receiving Family Hubs and Start for Life programme funding. The Government has committed a £126 million boost for families in 2025/26 to give every child the best start in life. Of this, Durham County Council will receive £1.68 million.

What steps his Department is taking to reduce health inequalities in City of Durham constituency.

The United Kingdom faces significant health inequalities, with life expectancy varying widely across and within communities. The Government is committed to building a fairer Britain by tackling the structural inequalities that contribute to poor health, particularly for disadvantaged groups.The Office for Health Improvement and Disparities’ North East and Yorkshire Regional Team collaborates with partners to provide system leadership for public health, reducing health inequalities. The team facilitates the delivery of national and local public health priorities, providing expert advice. It works with Directors of Public Health in local authorities, integrated care systems, Mayoral Combined Authorities, NHS England, and the wider National Health Service. The team also leads for public health workforce development and with Local Knowledge and Intelligence colleagues, and provides enhanced data, intelligence, and insights for population health.North East local authorities received a total of £238 million in Public Health Grant funding for 2024/25, with Durham County Council receiving £53.9 million for 2024/25. This provides services such as stop smoking, drug and alcohol treatment, health visiting and school nursing, and sexual health, among others, all of which contribute to addressing health inequalities. Additionally, Directors of Public Health from each local authority are working in partnership with the North East and North Cumbria Integrated Care Board to support action to address inequalities in access, experience, and outcomes associated with health care.Existing initiatives to reduce inequalities in relation to health services, in England, include NHS England’s Core20Plus5, which focuses on improving the five clinical areas in most need of accelerated improvement in the poorest 20% of the population, along with other underserved population groups identified at a local level, including groups that share protected characteristics, and socially excluded groups such as people experiencing homelessness.Durham County Council is one of 75 local authorities with high levels of deprivation receiving Family Hubs and Start for Life programme funding. The Government has committed a £126 million boost for families in 2025/26 to give every child the best start in life. Of this, Durham County Council will receive £1.68 million.

What steps his Department is taking to tackle shortages of ADHD medication in the North East.

The Department monitors and manages medicine supply at a national level so that stocks remain available to meet regional and local demand. Information is not collected on a local level. The Department has been working hard with industry and NHS England to help resolve supply issues with some attention deficit hyperactivity disorder (ADHD) medicines, which are affecting the United Kingdom and other countries around the world. As a result of intensive work, some issues have been resolved, and all strengths of lisdexamfetamine, atomoxetine capsules, and guanfacine prolonged-release tablets are now available.We are continuing to work to resolve supply issues where they remain, for methylphenidate prolonged-release tablets. We are engaging with all suppliers of methylphenidate prolonged-release tablets to assess the challenges faced and their actions to address them. We are also directing suppliers to secure additional stocks, expedite deliveries where possible, and review plans to further build capacity to support continued growth in demand for the short and long-term. We expect supply to improve in the UK throughout December 2024 and January 2025. However, we anticipate supply to be limited for some strengths, and we continue to work with all suppliers to ensure that the remaining issues are resolved as soon as possible. To improve supply chain resiliency, we are also working with prospective new suppliers of methylphenidate prolonged-release tablets to expand the UK supplier base.We are supporting an ADHD taskforce that NHS England is establishing to examine ADHD service provision. The taskforce will bring together expertise from across a broad range of sectors, including the National Health Service, education, and justice, to help provide a joined-up approach in response to concerns around rising demand. In collaboration with NHS England’s national ADHD data improvement plan, we plan to combine modelling for future growth forecasts, which will be shared with industry to improve demand forecasting for ADHD medicines.To minimise the impact of the shortages on patients, the Department has worked with specialist clinicians, including those within the NHS, to develop management advice for NHS clinicians to consider prescribing available alternative brands of methylphenidate prolonged release tablets generically, or available alternative ADHD medicines. To support ADHD patients throughout the NHS, we would expect all ADHD service providers and specialists to follow our guidance, which includes offering rapid response to primary care teams seeking urgent advice or opinions for the management of patients, including those known to be at a higher risk of adverse impact because of these shortages.To aid ADHD service providers and prescribers further we have widely disseminated our communications and continually update a list of currently available and unavailable ADHD products on the Specialist Pharmacy Service (SPS) website, helping ensure that those involved in the prescribing and dispensing of ADHD medications can make informed decisions with patients. The SPS website also offers additional guidance from NHS England specialists to help systems and healthcare professionals manage ADHD supply disruptions.

Whether (a) he and (b) his Department has had discussions with representatives of the vaping industry since the general election.

Since July 2024, no members of the Department have met with the vaping industry. This includes my Rt Hon. Friend, the Secretary of State for Health and Social Care. Details of ministerial meetings are updated quarterly in arrears, on the GOV.UK website.

Whether the policy paper entitled Stopping the start: our new plan to create a smokefree generation, last updated on 8 November 2023, reflects his Department's current policy.

The landmark Tobacco and Vapes Bill was introduced into Parliament on 5 November, and will be the single biggest public health intervention since the banning of smoking in indoor public spaces.This bill goes further than ever before. It will create the first smoke-free generation, gradually phasing out the sale of tobacco products across the country, enable the Government to strengthen the existing ban on smoking in public places to reduce the harms of passive smoking in certain outdoor settings, ban vapes and nicotine products from being promoted and advertised to children, and introduce tougher enforcement measures, including through providing powers to introduce a retail licensing scheme for tobacco and vapes.This bill will help deliver our ambition for a smoke-free United Kingdom, and forms part of our Health Mission to shift the health system from treatment to prevention.

What steps he is taking to improve the (a) recruitment and (b) retention of nurses.

Working with universities we are committed to training the staff we need to get patients seen on time, including more nurses, and will work closely with National Health Service trusts and their local education providers to do so and ensure nursing remains an attractive career choice.Targeted retention work for nurses and midwives is being undertaken by NHS England and led by the Chief Nursing Officer. This includes the introduction of a nursing and midwifery retention self-assessment tool which shares evidence on retention interventions and allows employers to assess their local plans and actions; a national preceptorship framework which provides early career support for nurses and midwives as they transition from education to employment; mentoring schemes; strengthened advice and support on pensions and flexible retirement options; and the publication of menopause policies and guidance.

What steps he is taking to increase the number of nurses.

Working with universities we are committed to training the staff we need to get patients seen on time, including more nurses, and will work closely with National Health Service trusts and their local education providers to do so and ensure nursing remains an attractive career choice.

Whether he plans to introduce auto-enrolment for the Healthy Start scheme.

The Healthy Start scheme is kept under review. There have been no discussions with my Rt Hon. Friend, Secretary of State for Work and Pensions on introducing auto-enrolment for Healthy Start.The Healthy Start scheme was introduced in 2006 to encourage a healthy diet for pregnant women, babies, and young children under four years old, from very low-income households. It can be used to buy, or put towards the cost of, fruit, vegetables, pulses, milk, and infant formula. Healthy Start beneficiaries have access to free Healthy Start Vitamins for pregnant women and children aged under four years old. Healthy Start now supports over 355,000 beneficiaries. This figure is higher than the previous paper voucher scheme.The NHS Business Services Authority operates the Healthy Start scheme on behalf of the Department. All applicants to the Healthy Start scheme, where they meet the eligibility criteria, must accept the terms and conditions of the prepaid card at the point of application. As the prepaid card is a financial product and cannot be issued without the applicant accepting these terms, the NHS Business Services Authority is not able to automatically provide eligible families with a prepaid card. However, we remain open to all viable routes to improve uptake.

What steps he is taking to reduce inequalities in dietary health.

Under our Health Mission we will move from a model of sickness to one of prevention, reducing health inequalities and closing the gap in healthy life expectancy, as well as delivering on our commitment to raise the healthiest generation ever. As part of this we are working with civil society, industry, and the public to address some of the biggest drivers of ill-health and health inequalities, including tackling obesity and poor diet, as obesity prevalence for children in deprived areas is double that of non-deprived areas.To this end, we are rolling out free breakfast clubs in every primary school, with an early adopter scheme launching in April 2025, so children start the day ready to learn, helping to break down barriers to opportunity and confront child poverty. All children in Reception, Year 1, and Year 2 in England’s state-funded schools are already entitled to universal infant free school meals, and disadvantaged pupils in state-funded schools, as well as 16 to 18-year-old students in further education, receive free meals on the basis of low income.In addition, our Healthy Food Schemes already provide support for those who need it the most. The Healthy Start scheme aims to encourage a healthy diet for pregnant women, babies, and young children under four years old from very low-income households. It can be used to buy, or put towards the cost of, fruit, vegetables, pulses, milk, and infant formula, with beneficiaries also having access to free Healthy Start Vitamins.We have also committed to banning the sale of high-caffeine energy drinks to children under the age of 16 years old, where we know average intakes of these drinks is highest among children from more deprived areas. Additionally, we are on track to ban junk food advertising to children from next year.

If he will make an assessment of the potential merits of introducing of a polluter pays levy on tobacco company to fund smoking cessation services; and if he will make it his policy to increase funding for (a) the swap-to-stop scheme, (b) tobacco control enforcement and (c) the national smoke-free pregnancy incentive scheme.

The Government is funding a broad package of measures to tackle the harm caused by smoking, including additional funding for local authority Stop Smoking Services, more enforcement activity around illegal tobacco and vape products, as well as recently launching a national smoke-free pregnancy incentive programme.On the issue of a polluter pays levy on the tobacco industry, the Chancellor makes decisions on tax policy at fiscal events in the context of public finances. The Government keeps all taxes under review during its yearly Budget process.

What steps his Department is taking to include policies on prevention in the proposed ten-year plan for health and social care.

As part of the Government’s five long-term missions, we will launch a 10-Year Health Plan to reform the National Health Service and make it fit for the future. The plan will set out a bold agenda to deliver on the three big shifts needed: moving healthcare from hospital to the community, from analogue to digital, and from sickness to prevention.A core part of the development of the 10-Year Health Plan, including its approach to prevention, will be an extensive engagement exercise with the public, staff, and stakeholders, including the third sector. Further details on how to get involved will be set out in the coming weeks.