Written questions by Gilmour.

What assessment his Department has made of the potential impact of stock levels of propanolol 80mg and 160mg modified release capsules until July 2026 on (i) patient outcomes and (ii) availability of medication which is a suitable substitute.

The Department is aware of supply issues affecting propranolol 80 milligram and 160 milligram modified release (MR) capsules due to ongoing manufacturing issues. The issues affecting propranolol 80 milligram MR capsules are expected to resolve by July 2026, while issues with propranolol 160 milligram MR capsules remain ongoing until further notice.The Department is working with all suppliers to help resolve the issues and improve supplies, including asking that they source stock from other markets. We have also reached out to specialist importers who have sourced unlicensed imports of propranolol 80 milligram and 160 milligram MR capsules. We have engaged with National Health Service specialist clinicians and issued comprehensive guidance on how to manage patients during this time and to advise on available alternative preparations.The Department continues to work with the supply chain teams and the Medicines and Healthcare products Regulatory Agency to mitigate the situation and ensure supplies are available for patients as soon as possible.

If he will set out how the National Cancer Plan for England will reduce barriers to innovative and life extending treatments for people with secondary breast cancer when those treatments are not approved by National Institute for Health and Clinical Excellence.

The National Cancer Plan commits to increasing access to the best innovative cancer treatments for all patients, including those with secondary breast cancer. The Cancer Drugs Fund has helped to ensure that, according to industry data, patients in England receive new cancer treatments 50% faster than the European Union average, and it will continue to provide earlier access to promising new treatments. By April 2026, a joint process between National Institute for Health and Care Excellence (NICE) and the Medicines and Healthcare products Regulatory Agency will boost the speed of decisions on licensing and appraisal of medicines, so that recommendations for the National Health Service to fund new drugs can be made faster.NICE has a strong track record in recommending treatments for breast cancer and will continue to evaluate all new medicines for breast cancer. There are no plans to routinely fund medicines where NICE has been unable to recommend them as clinically and cost effective.Since January 2022, NICE has recommended all but one of the treatments for breast cancer that it has assessed through the Cancer Drugs Fund, including treatments for secondary breast cancer such as Truqap and Korserdu, which are now available to eligible NHS patients.To ensure that people diagnosed with secondary breast cancer have timely access to new and innovative treatments, NHS England commissioned a National Audit of Metastatic Breast Cancer, which provides timely evidence for cancer service providers of where patterns of care in England may vary. The purpose of the audit is to identify information to increase the consistency of access to treatments and help stimulate improvements in cancer treatment and outcomes for patients. The NHS is now acting on those findings.

What assessment he has made of the adequacy of the administration of the Tier 2 NHS Pension Scheme, particularly in relation to retirement dates and the clarity of communications regarding retirement information.

The NHS Business Services Authority (NHSBSA) administers the NHS Pension Scheme in accordance with the scheme regulations and publishes clear guidance to support members applying for ill-health retirement, including Tier 2 benefits. The guidance sets out the eligibility criteria, the two‑tier structure of ill‑health benefits, and the steps members must follow. This guidance is available on the NHSBSAs website at the following link:https://www.nhsbsa.nhs.uk/member-hub/applying-ill-health-pension-benefits.The NHSBSA publishes detailed information on normal pension ages, the definition of permanent incapacity, and the enhancements associated with Tier 2 benefits, helping members understand how retirement dates and entitlements are determined. Processing turnaround times are also published and regularly updated so that members and employers are kept informed throughout the process. The processing times are available from the following link:https://www.nhsbsa.nhs.uk/current-processing-times-nhs-pensions.The NHSBSA keeps this material under regular review to ensure it remains clear and accessible and works closely with employers to support accurate and timely communication with scheme members.

If he will make an assessment of the adequacy of the level of funding allocated for research into chronic pain disorders.

The Department funds research through the National Institute for Health and Care Research (NIHR) including research into chronic pain disorders. Between 2020/21 and 2024/25, the NIHR invested £39.4 million in direct research funding in this area. Further information on that research can be seen at the following link: https://nihr.opendatasoft.com/pages/homepage/ The NIHR provides an online service called Be Part of Research, which promotes participation in health and social care research by allowing users to search for relevant studies and register their interest. At the current time, there are 41 studies actively recruiting for participants on many aspects of chronic pain. Further information is available at the following link: https://bepartofresearch.nihr.ac.uk/results/search-results?query=chronic%20pain&location= The NIHR’s infrastructure also provides support for the country’s leading experts to develop and deliver high-quality translational, clinical, and applied research that is funded by the NIHR’s research programmes, other public funders of research, charities, and the life sciences industry, including many aspects of chronic pain. Further information is available at the following link: https://nihr.opendatasoft.com/explore/dataset/nihr-infrastructure-supported-projects/table/?q=Chronic+Pain&disjunctive.centre&disjunctive.pi_full_name&disjunctive.research_theme&disjunctive.financial_year&disjunctive.infrastructure_scheme

If he will make an assessment of the adequacy of the provision of NHS-funded programmes for pain management, with particular relevance to those designed for chronic pain conditions.

The Department recognises the significant impact that chronic pain has on individuals and the importance of ensuring that National Health Service‑funded pain management services are effective, accessible and evidence‑based. Integrated care boards (ICBs) commission a range of multidisciplinary pain management programmes across primary, community, and specialist care to help people manage persistent pain. These services include pharmacological and non‑pharmacological interventions, such as physiotherapy, psychological therapies, and supported self‑management.When commissioning pain management services, ICBs should have regard to the chronic pain guideline published by the National Institute for Health and Care Excellence (NICE), reference code NG193, as NICE’s evidence‑based recommendations set out nationally recognised best practice for assessing and treating chronic pain, helping to ensure that commissioned services are safe, effective, and aligned with the highest clinical standards.The Getting It Right First Time Chronic Pain workstream, introduced in 2025, is reviewing pain services across all care settings to identify unwarranted variation and improve access, equity, and outcomes for people living with chronic pain. This work is aligned with wider NHS and Government plans to promote integrated, proactive, and person‑centred long‑term condition management.Through the 10‑Year Health Plan, the Government is expanding community‑based services, strengthening multidisciplinary care models, and improving access to diagnostics and specialist input, all of which support better management of long‑term conditions such as chronic pain. These measures will contribute to improving the adequacy and consistency of NHS‑funded pain management services across England.

What discussions his Department has had with the Department for Science and Technology about the potential for a respiratory Modern Service Framework to strengthen the UK’s life sciences ecosystem by scaling up the adoption of new medicines and innovations for lung conditions.

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.NHS England and the Department of Health and Social Care are working with the Department for Science, Innovation and Technology to explore innovation and policy prioritisation in respiratory health, including the cross‑Government alignment that may be required.

What assessment his Department has made of (a) the prevalence of respiratory disease and (b) the number of emergency hospital admissions for respiratory conditions in the Tiverton and Minehead constituency compared with national averages; and what steps he is taking to help ensure respiratory health is prioritised nationally, including through the introduction of a Modern Service Framework for respiratory care.

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.Data is available for emergency finished admission episodes where there was a primary diagnosis of 'respiratory conditions’. Data for Tiverton and Minehead is shown in the table.Activity in English NHS Hospitals and English NHS commissioned activity in the independent sectorWestminster Parliamentary Constituency of Residence (Office for National Statistics)2024/25 (August 2024 to March 2025)2025/26 (April 2025 to November 2025, provisional)Tiverton and Minehead995790England608,449423,588Source: Hospital Episode Statistics, NHS England Available data on trends in respiratory conditions can be found on the Department of Health and Social Care Fingertips website. Data is not available by parliamentary constituency, but is available at regional, county, unitary authority and integrated care board level. Information for Somerset is available at the following link:https://fingertips.phe.org.uk/search/Respiratory#page/1/gid/1/pat/15/ati/502/are/E06000066/iid/40701/age/163/sex/4/cat/-1/ctp/-1/yrr/1/cid/4/tbm/1The Government has committed to delivering three big shifts that our National Health Service needs to be fit for the future: from hospital to community; from analogue to digital; and from sickness to prevention. All of these are relevant to improving respiratory health in all parts of the country.Through our community diagnostic centres (CDCs), we are building capacity for respiratory testing and enabling people to get diagnosed closer to home. 101 CDCs across the country now offer out-of-hours services, 12 hours a day, seven days a week, meaning patients can access vital diagnostic tests around busy working lives. This is alongside action being taken to expand capacity and improve the quality of pulmonary rehabilitation services to support patients living with respiratory conditions.

What assessment he has made of the adequacy of training for GPs and emergency healthcare staff to understand chronic pain conditions.

Employers in the health system are responsible for ensuring that their staff are trained to the required standards to deliver appropriate treatment for patients.General practitioners are responsible for ensuring their own clinical knowledge remains up-to-date and for identifying learning needs as part of their continuing professional development. This activity should include taking account of new research and developments in guidance, such as that produced by the National Institute for Health and Care Excellence (NICE), to ensure that they can continue to provide high quality care to all patients.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. In 2012 the GMC introduced revalidation which supports doctors in regularly reflecting on how they can develop or improve their practice, gives patients confidence doctors are up to date with their practice, and promotes improved quality of care by driving improvements in clinical governance.To support healthcare professionals in the assessment and management of chronic pain, the NICE has published guidance on this topic, which can be found at the following link:https://www.nice.org.uk/guidance/ng193The guidance includes recommendations for healthcare professionals on how to carry out a person-centred assessment when an individual presents with chronic pain, how to develop a care and support plan for a patient with chronic pain, and how to manage flare-ups of chronic pain. The guidance also includes recommendations on both pharmacological and non-pharmacological management options for chronic pain.

If he will ensure women's health services are included in the Neighbourhood Health Service.

The 10-Year Health Plan set out our ambition for high autonomy to be the norm across every part of the country. Integrated care boards (ICBs) are responsible for commissioning services that meet the healthcare needs of their local population and which have the freedom to do so, and this includes women's health hubs and delivering the direction of the Women's Health Strategy. The Government is backing ICBs to do this through significant funding, with the Spending Review 2025 prioritising health and increasing investment across the health and social care system. The Government is encouraging ICBs to further expand the coverage of women’s health hubs and supporting them to use the learning from the women’s health hub pilots to improve local delivery of services to women and girls.We have announced our commitment to deliver 250 Neighbourhood Health Centres through the NHS Neighbourhood Rebuild Programme, with 120 delivered by 2030, and with rollout starting in the areas of greatest need where healthy life expectancy is lowest.We expect neighbourhood teams and services to be designed in a way that reflects the specific needs of local populations, which may include women’s health services. While the focus on personalised, coordinated care will be consistent, that will mean the service will look different in different places across the country.

What steps his Department is taking to reduce levels of burnout of NHS staff.

The health and wellbeing of all National Health Service staff is a top priority.  NHS organisations have a responsibility to create supportive working environments for staff, ensuring they have the conditions they need to thrive, including access to high quality health and wellbeing support.At a national level, NHS staff have access to the SHOUT helpline for crisis support alongside the Practitioner Health service for more complex mental health and wellbeing support, including trauma and addiction.The Government is committed to publishing a 10 Year Workforce Plan which will have a focus on supporting our hardworking and dedicated healthcare professionals. This includes the development of a new set of staff standards for modern employment and the roll-out of Staff Treatment Hubs that will ensure staff have access to high quality support for occupational health, including support for mental health and back conditions.

If he will make an assessment of the potential impact of an increase in urgent care Units of Dental Activity on trends in the level of the provision of routine and preventative NHS dental care.

We recognise that urgent, routine, and preventative dental care is important and we are taking steps to address this.We are committed to delivering fundamental reform of the dental contract before the end of this Parliament. As a first step, on 16 December we published the Government’s response to the public consultation on quality and payment reforms to the National Health Service dental contract. The changes will be introduced from April 2026, and an impact assessment will be published. The proposals are intended to make it easier for those who need dental care and treatment by requiring all dental practices to provide an agreed amount of urgent and unscheduled care which is accessible to all who need it, irrespective of whether they have been to the practice before. Further information is available at the following link: https://www.gov.uk/government/consultations/nhs-dentistry-contract-quality-and-payment-reforms/outcome/government-response-to-consultation-on-nhs-dentistry-contract-quality-and-payment-reformsWe have invested £11 million in 147 local authorities in 2025/26, alongside an innovative partnership with Colgate-Palmolive, to rollout a national targeted supervised toothbrushing programme for three to five-year-olds. This will reach up to 600,000 children targeted in the 20% most deprived areas of England to reduce inequalities.

What recent progress his Department has made on implementing the Dame Barbara Windsor Dementia Goals programme.

The Dame Barbara Windsor Dementia Goals programme, with up to £150 million expected to be allocated to, or aligned with it, aims to speed up the development of new treatments for dementia and neurodegenerative conditions by accelerating innovations in biomarkers, clinical trials, and implementation. This is co-chaired by Hilary Evans-Newton CBE and Professor Nadeem Sarwar.So far, the programme has invested approximately £100 million into biomarker innovation projects, experimental medicine studies, and clinical trial infrastructure. This covers a broad range of biomarker technologies and studies to help researchers, patients, and industry partners work together to better understand how dementia begins and progresses. This amount also supports the Medical Research Council’s Dementia Trials Accelerator which aims to embed more innovation in how clinical trials are designed and delivered in order to increase the speed and quality, while driving down the cost of large-scale trials, as well as the National Institute for Health and Care Research’s UK Dementia Trials Network which seeks to speed up early-stage clinical trials.The programme is now setting up the Neurodegeneration Initiative, which will be a globally unique, not-for-profit, industry led, public-private partnership with charitable status, that will work together across the Government, industry, academia, the National Health Service, and third sector, and will deliver the programme’s remaining objectives.

What steps his Department is taking to improve early cancer diagnosis rates.

Early cancer diagnosis is a key priority for the Government, as the chances of survival are higher if cancer is diagnosed at an early stage.The Department recognises that cancer patients are often waiting too long for referral and treatment. As the first step to ensuring early diagnosis and treatment, NHS England has delivered an extra 100,000 operations, scans, and appointments each week since the start of this administration. This is supported by an increase in capacity to meet the demand for diagnostic services through investment in new magnetic resonance imaging and computed tomography scanners. The Government is investing an extra £26 billion in the National Health Service and is opening up community diagnostic centres at evening and weekends, to help diagnose cancer earlier.In the new year we will publish a National Cancer Plan. The plan will include further details on how the Government will improve outcomes for cancer patients, as well as speeding up diagnosis and treatment, ensuring patients have access to the latest treatments and technology and ultimately driving up this country’s cancer survival rates.

What steps his department is taking to help ensure trusts have sufficient access to operational capital funding to repair buildings, replace old equipment, and provide a suitable environment for patients.

The Government is committed to delivering a National Health Service that is fit for the future through our 10-Year Health Plan, and we recognise the importance of supporting NHS trusts to manage and maintain their estates using operational capital allocations.The Government’s recently published 10 Year Infrastructure Strategy set out 10-year maintenance budgets for the public estate, confirming £6 billion per year for the maintenance and repair of the NHS estate up to 2034/35.Within this overall figure, the Government is providing over £4 billion in operational capital in 2025/26 and has now allocated a further £15.6 billion directly to providers over the following four years, from 2026/27 to 2029/30. Providers have also been given further five-year operational capital planning assumptions, covering 2030/31 to 2034/35, allowing them to plan longer term with confidence and accelerate investment decisions aligned to local priorities, including repairs, maintenance, and ensuring suitable patient environments.In addition to operational capital, the Estates Safety Fund, established in 2025/26, will continue, with £6.75 billion investment over the next nine years to target the most critical building repairs and ensure safe environments for healthcare delivery.

What steps he is taking to reduce the amount paid by his Department in clinical negligence costs.

The rising costs of clinical negligence claims against the National Health Service in England are of great concern to the Government. Costs have more than doubled in the last 10 years and are forecast to continue rising, putting further pressure on NHS finances.As announced in the recently published 10-Year Health Plan for England, David Lock KC will be providing expert policy advice on the rising legal costs and how we can improve patients’ experiences of clinical negligence claims, ahead of a review by the Department in the autumn. The results of David Lock’s work will inform future policy making in this area. No decisions on policy have been taken at this point.

What steps he is taking to ensure that NHS contracts with hospices reflect the (a) cost of the services provided and (b) the needs of local populations.

Integrated care boards (ICBs) are responsible for the commissioning of palliative care and end of life care services, to meet the needs of their local populations. To support ICBs in this duty, NHS England has published statutory guidance and service specifications. NHS England has also developed a palliative care and end of life care dashboard, which brings together all relevant local data in one place.Whilst the majority of palliative care and end of life care is provided by National Health Service staff and services, we recognise the vital part that voluntary sector organisations also play.The amount of funding charitable hospices receive varies by ICB area, and will, in part, be dependent on the breadth of palliative care, including specialist palliative care, and end of life care provision within each ICB catchment area.

What steps his Department is taking to improve the quality of maternity care.

While there are outstanding examples of care in NHS maternity services, we know this is not the experience that all women have, and there are significant issues that need addressing.The Secretary of State for Health and Social Care recently announced an independent Investigation into NHS maternity and neonatal services to understand the systemic issues behind why so many women, babies and families experience unacceptable care. It began its work this summer and will produce an initial set of national recommendations by December 2025. The Secretary of State also announced the establishment of a National Maternity and Neonatal Taskforce that will use the recommendations from the Investigation to develop a national plan, with families and partners, to drive improvements across maternity and neonatal care.We are also taking a set of immediate action to start delivering the changes needed.These include actions to boost accountability and safety as part of the Government’s mission to build an NHS fit for the future, and actions to hold the system to account. Specific actions include embedding a system to better identify safety concerns, rolling out a programme to all trusts to tackle discrimination and racism, and new best practice standards in maternal mortality. Although significantly more action is required, there has been some good progress made in a range of areas. They include:- Achieving full population coverage of Specialist Perinatal Mental Health Services for women with or at risk of mental health issues;- Rollout to every Trust in England of the Saving Babies Lives Care Bundle, helping to reduce still births and pre-term birth;- As of June 2025, there are 24,888 full time equivalent midwives working in NHS Trusts and other core organisations in England. This is an increase of 1,326 (5.6%) compared to June 2024. There are also over 3,000 full time equivalent Obstetrics and gynaecology’ consultants working in NHS Trusts and other core organisations in England. This is over 100 (4.8%) more compared to June 2024; and- Nationally rolling out a new programme to reduce avoidable brain injuries in childbirth, following a successful pilot.

Whether he plans to increase the proportion of NHS funding allocated to dentistry over the remainder of this Parliament.

The Department settlement announced at the 2025 Spending Review means that annual National Health Service day-to-day spending will increase by £29 billion in real terms, a £53 billion cash increase, by 2028/29 compared to 2023/24. This will take the NHS resource budget to £226 billion by 2028/29, the equivalent to a 3% average annual real terms growth rate over the Spending Review period. The details of budget allocations within departments are still being determined. The Department is working to provide the detail and certainty needed on future funding and spending plans, including for NHS dentistry.NHS planning guidance for 2025/26 confirms that dental budgets are ringfenced. Planning guidance also confirms that improving access to urgent dental appointments is a key national priority.

How much has been spent on primary care NHS dental services per head of population in England in real terms in each of the last 10 years (a) inclusive and (b) exclusive of the patient charge revenue.

Dental expenditure and patient charge revenue data is published each year in NHS England’s annual accounts. The annual accounts for 2024/25 have not yet been published, and so the latest published accounts data is for 2023/24.The following table shows the expenditure per head of population in England in real terms, inclusive and exclusive of patient charge revenue:Financial yearPrice per head of population, real terms at 2023/4 prices Inclusive of patient charge revenueExclusive of patient charge revenue2014/15£74.36£57.262015/16£77.92£60.422016/17£66.34£48.632017/18£65.71£47.702018/19£63.46£44.862019/20£65.22£47.322020/21£61.26£55.692021/22£62.13£49.422022/23£56.04£42.192023/24£53.87£40.41Notes:in 2016/17, NHS England’s accounts recorded a significant fall in dental services due to the improved allocation of costs between primary care and secondary dental services. The figures for earlier years are therefore not directly comparable;the population has been based on the England population mid-year estimate time series, published by the Office for National Statistics. Further information is available at the following link: https://www.ons.gov.uk/peoplepopulationandcommunity/populationandmigration/populationestimates/timeseries/enpop/pop; andconversion to real terms costs has been calculated using gross domestic product deflator rates as per the latest publication, in June 2025. Further information is available at the following link: https://www.gov.uk/government/statistics/gdp-deflators-at-market-prices-and-money-gdp-june-2025-quarterly-national-accounts.

Whether NHS dental services will receive increased funding from the Spending Review.

The Department settlement announced at the 2025 Spending Review means that annual National Health Service day-to-day spending will increase by £29 billion in real terms, a £53 billion cash increase, by 2028/29 compared to 2023/24. This will take the NHS resource budget to £226 billion by 2028/29, the equivalent to a 3% average annual real terms growth rate over the Spending Review period. The details of budget allocations within departments are still being determined. The Department is working to provide the detail and certainty needed on future funding and spending plans, including for NHS dentistry.NHS planning guidance for 2025/26 confirms that dental budgets are ringfenced. Planning guidance also confirms that improving access to urgent dental appointments is a key national priority.