Written questions by Paul.

If he will make an assessment of the potential merits of running long term studies in to the impact on women's bodies of egg retrieval.

The Human Fertilisation and Embryology Authority (HFEA)’s Scientific and Clinical Advances Advisory Committee (SCAAC) recently reviewed the published evidence of health outcomes for those having fertility treatment, including egg donors. The last 10 years of evidence were reviewed and the HFEA will update relevant information on its website as needed.The HFEA also set out strict requirements in its Licence Conditions and Code of Practice relating to the information that must be given before egg retrieval takes place in United Kingdom licensed fertility clinics, whether for the patient’s own use or to donate to others. This includes information about the potential immediate or longer-term health risks and the psychological consequences of being a donor, as well as offering counselling to everyone involved.

What assessment his Department has made of the potential impact of £985 per cycle payments to egg donors on the level of incentive to women from the poorest backgrounds to donate eggs because of financial need.

The compensation rate for egg donation is set by the Human Fertilisation and Embryology Authority (HFEA), as provided for in the Human Fertilisation and Embryology Act 1990. The HFEA has advised that the donor compensation levels originally set in 2011 followed a thorough ethical review, which identified a set of principles that ensured altruism remained at the heart of donation and that there were not any unjustifiable barriers to donation. The HFEA has advised that the increase in donor compensation from 1 October 2024 to £985 per cycle reflects the rise in inflation since the compensation rates were first introduced in 2011.Academic research in the United Kingdom has consistently found that donating eggs and sperm is driven by altruism, and HFEA published data shows that egg and sperm donors in England from 2011 to 2020 lived in similar or more affluent socio-economic areas than the general population.

What steps his Department is taking to ensure newly qualified nurses are not prevented from accessing band 5 roles within the NHS due to (a) experience requirements and (b) such roles only being advertised internally.

Decisions about recruitment are a matter for individual National Health Service employers, who manage this at a local level to ensure they have the staff they need to deliver safe and effective care.NHS England is working with employers, universities, and regional nursing leads to ensure support is in place to help graduating nurses find a role as soon as possible after qualification, aiding their transition into the workplace.

How much the average cost of healthcare was for (a) male prisoners and (b) female prisoners in HMP Downview in the last 12 months.

HMP Downview is a women’s prison. The average cost of healthcare per female prisoner at HMP Downview for 2024/25 was £11,765.

What steps he is taking to help improve the capacity of sexual health (a) drop in clinics and (b) services in Reigate constituency.

Local authorities in England, including East Sussex County Council which covers Reigate, are funded through a ring-fenced Public Health Grant to commission comprehensive, open access sexual health services. Therefore, it is the responsibility of local authorities to decide on spending priorities, such as drop-in clinics and general services, based on the blend of services that best suits the needs of their population.For 2025/26, we are increasing funding through the grant to £3.858 billion. This is a cash increase of £198 million compared to 2024/25, providing local authorities with an average 5.4% cash increase and 3.0% real terms increase. This represents a significant turning point for local public health services, marking the biggest real-terms increase after a period of reduced spending between 2016 and 2024.

What steps he is taking to help support GP practices to acquire larger premises.

General practice (GP) contractors are responsible for securing the premises from which to deliver their contracted services. Should practice premises be deemed too small, GPs may make an application to integrated care boards for capital funding grants for repurposing existing underutilised space, or expansion of the existing site, or seek agreement for the GP practice to relocate to a different building.One of the core objectives of the 10-Year Health Plan is enabling people to access care closer to home and in the community. In autumn 2024, we announced £102 million of additional capital funding for GP estates upgrades in 2025/26. This will support improved use of existing buildings and space, boosting productivity and enabling practices to deliver more patient appointments.There may be revenue solutions to premises needs, dependent on the budgetary capacity of the local commissioner. Commissioners can work closely with local authorities, other system providers, and the One Public Estate Programme to identify existing premises for the potential delivery of healthcare services.

With reference to his Department's response to the consultation on hub and spoke dispensing, last updated on 13 May 2024, what his planned timetable is for introducing the legislative amendments outlined in his Department's response.

The policy proposals, consultation, and response were published under the previous administration. Following the General Election, the Government has reviewed the proposals. The Department is working towards introducing legislation to enable hub and spoke dispensing between different legal entities this year. This change will be enabled via amendments to both primary and secondary legislation, and is subject to the usual Parliamentary processes.

Pursuant to the Answer of 15 October 2024 to Question 7682 on Cancer: Medical Treatments, when he plans to publish the updated NHS Commercial Framework for New Medicines.

NHS England published its updated Commercial Framework for New Medicines on 29 January 2025. The publication can be found here: NHS England » NHS commercial framework for new medicines

If his Department will take steps to help ensure that emergency services are provided with up to date information on the (a) location and (b) status of defibrillators installed at train stations.

The Government is committed to improving access to automated external defibrillators (AEDs) in public spaces and reducing inequalities in access to these life saving devices. Following the depletion of the existing AED fund, launched in in September 2023, the Government approved a further £500,000 in August 2024 to fulfil existing applications to the fund.The Department does not hold data on AEDs installed in train stations or whether those AEDs are registered on The Circuit, a national defibrillator and ambulance service database, operated independently by the British Heart Foundation in collaboration with the National Health Service.However, AEDs procured through the Department’s AED fund, once installed, are required to be registered on The Circuit. Upon registration, contact details are provided for the nominated AED guardian or guardians who are local to the defibrillator’s location and conduct checks when required. The registered guardian receives an automatic email or SMS text message notification if the defibrillator has potentially been used, therefore prompting the guardian to conduct a check. The Circuit records the potential use of each registered defibrillator. The registered guardian of the defibrillator will automatically be contacted if their AED is potentially used, and may therefore require replacement pads. In addition, The Circuit will also send out an automatic notification to the guardian approximately three months before the AED battery or pads expire.

If his Department will take steps to ensure that all defibrillators installed at train stations are (a) registered and (b) visible on The Circuit national defibrillator network website.

The Government is committed to improving access to automated external defibrillators (AEDs) in public spaces and reducing inequalities in access to these life saving devices. Following the depletion of the existing AED fund, launched in in September 2023, the Government approved a further £500,000 in August 2024 to fulfil existing applications to the fund.The Department does not hold data on AEDs installed in train stations or whether those AEDs are registered on The Circuit, a national defibrillator and ambulance service database, operated independently by the British Heart Foundation in collaboration with the National Health Service.However, AEDs procured through the Department’s AED fund, once installed, are required to be registered on The Circuit. Upon registration, contact details are provided for the nominated AED guardian or guardians who are local to the defibrillator’s location and conduct checks when required. The registered guardian receives an automatic email or SMS text message notification if the defibrillator has potentially been used, therefore prompting the guardian to conduct a check. The Circuit records the potential use of each registered defibrillator. The registered guardian of the defibrillator will automatically be contacted if their AED is potentially used, and may therefore require replacement pads. In addition, The Circuit will also send out an automatic notification to the guardian approximately three months before the AED battery or pads expire.

Whether any funding previously allocated to the Dental Recovery Plan has been withdrawn.

We are currently reviewing the Dental Recovery Plan that was published on 7 February 2024 and the policies that can be taken forward effectively and within National Health Service budgets. It is clear the plan did not go far enough and so we are also working on further measures, prioritising initiatives that will see the biggest impact on access to NHS dental care.Dental budgets remain ringfenced as per the 2024/25 revenue and contracting guidance, and integrated care boards should continue to seek to invest the full amount in dental activity.

Whether his Department plans to take steps to encourage further negotiation between (a) NICE, (b) Daiichi Sankyo Company, Limited and (c) AstraZeneca on the supply of Enhertu.

Decisions on whether new medicines should be routinely funded by the National Health Service in England are made on the basis of recommendations from the National Institute for Health and Care Excellence (NICE), following an evaluation of a treatment’s costs and benefits. These are very difficult decisions to make, and it is important that they are made independently, and on the basis of the available evidence.The NICE published guidance in July 2024 on the use of Enhertu for the treatment of HER-2 low metastatic and unresectable breast cancer, and was unfortunately unable to recommend it for routine NHS funding. I understand that the NICE and NHS England have sought to apply as much flexibility as they can in their considerations of Enhertu for HER2-low breast cancer, and have made it clear to the companies that their pricing of the drug remains the only obstacle to access.Earlier this year, ministers met with the manufacturers of Enhertu, AstraZeneca, and Daiichi Sankyo, to encourage them to re-engage in commercial discussions with NHS England. Despite the NICE and NHS England offering unprecedented flexibilities, the companies were unable to offer Enhertu at a cost-effective price. The NICE’s guidance will therefore remain unchanged. Although the deadline for a rapid review has now passed, the NICE has reassured me that the door remains open for the companies to enter into a new NICE appraisal, if they are willing to offer Enhertu at a cost-effective price.

If he will introduce regulations to ensure that a pharmacist is always present in an open pharmacy to facilitate the sale of pharmacy medicines,

Pharmacy regulations already require that a registered pharmacy business can only operate and be open to the public, to sell or supply prescription only medicines or pharmacy medicines, when a responsible pharmacist, the pharmacist legally responsible for the safe and effective running of an individual pharmacy, is signed in. The regulations stipulate that the responsible pharmacist may be absent from the pharmacy for a maximum of two hours during the pharmacy business hours, for example to have a meeting with a general practice, attend training, or to have a lunch or a rest break. The sale of general sales list medicines, such as some aspirin and paracetamol products, may continue in the absence of the responsible pharmacist.Case law and professional guidance dictates that the final sale or supply of prescription only medicines and pharmacy medicines requires a pharmacist to be on the registered premise, and either directly aware of the transactions or interruptible, so as to be able to intervene in a sale or supply.

What short-term steps his Department is taking to help support hospices to maintain levels of service; and whether his Department is taking long-term steps to reform funding for hospices.

Most hospices are charitable, independent organisations which receive some statutory funding from the National Health Service. The amount of funding each charitable hospice receives varies both within and between integrated care board (ICB) areas. This will vary depending on demand in that ICB area but will also be dependent on the totality and type of palliative and end of life care provision from both NHS and non-NHS services, including charitable hospices, within each ICB area.We do understand that, financially, times are difficult for many voluntary and charitable organisations, including hospices, due to a range of concurrent cost pressures. I recently met NHS England and discussions have begun on how to reduce inequalities and variation in access to, and the quality of, palliative and end of life care. We will consider next steps on palliative and end of life care, including funding, in the coming months.Additionally, we have committed to develop a 10-Year Health Plan to deliver an NHS fit for the future, by driving three shifts in the way health care is delivered. We will carefully be considering policies, including those that impact people with palliative and end of life care needs, with input from the public, patients, health staff and our stakeholders as we develop the plan. More information about how to input into the 10-Year Health Plan is available at the following link:https://change.nhs.uk/en-GB/

What steps he plans to take to ensure all women across England with ovarian cancer get access to the best possible treatment.

NHS England runs the Help Us Help You campaigns to raise public awareness, increase knowledge of cancer symptoms, and address barriers to acting on them to encourage people to come forward as soon as possible to see their general practitioner. Previous phases of the campaigns have focused on abdominal symptoms which, among other abdominal cancers, can be indicative of ovarian cancer. The Department continues to work with NHS England to identify which tumour types future campaigns should focus on.NHS England and other National Health Service organisations, nationally and locally, also publish information on the signs and symptoms of many different types of cancer, including ovarian cancer. This information can be found at various sources, including the NHS website.To ensure women have access to the best treatment for ovarian cancer, NHS England commissioned an audit on ovarian cancer. The aim of the audit is to provide timely evidence for cancer service providers of where patterns of care in England may vary to increase consistency of access to treatments, and help stimulate improvements in cancer treatment and outcomes for patients.The Department also invests in health research through the National Institute for Health and Care Research (NIHR). The NIHR has funded six research projects into screening for ovarian cancer since 2018, with a combined total funding value of £3.8 million, including looking at the impact and effectiveness of different kinds of testing and screening, and the effectiveness of treatment options.

Whether he plans to launch a campaign to raise public awareness of the symptoms of ovarian cancer.

NHS England runs the Help Us Help You campaigns to raise public awareness, increase knowledge of cancer symptoms, and address barriers to acting on them to encourage people to come forward as soon as possible to see their general practitioner. Previous phases of the campaigns have focused on abdominal symptoms which, among other abdominal cancers, can be indicative of ovarian cancer. The Department continues to work with NHS England to identify which tumour types future campaigns should focus on.NHS England and other National Health Service organisations, nationally and locally, also publish information on the signs and symptoms of many different types of cancer, including ovarian cancer. This information can be found at various sources, including the NHS website.To ensure women have access to the best treatment for ovarian cancer, NHS England commissioned an audit on ovarian cancer. The aim of the audit is to provide timely evidence for cancer service providers of where patterns of care in England may vary to increase consistency of access to treatments, and help stimulate improvements in cancer treatment and outcomes for patients.The Department also invests in health research through the National Institute for Health and Care Research (NIHR). The NIHR has funded six research projects into screening for ovarian cancer since 2018, with a combined total funding value of £3.8 million, including looking at the impact and effectiveness of different kinds of testing and screening, and the effectiveness of treatment options.

For what reason his Department's Notification of Child Death Form asks about the gender with which the child identified at the time of their death in cases where the child was over 10; and whether his Department consulted on that change.

The Notification of Child Death Form, part of the National Child Mortality Database, continues to capture the sex of the child for anyone under the age of 18 years old, in line with sex being a protected characteristic under the Equality Act 2010.Although questions relating to gender identity already existed within one part of the National Child Mortality Database collection, specifically for suicide and self-harm, the change in October expanded these questions to all deaths. This was to capture the language used by young people and their families to improve system learning and to support the prevention of future deaths. It was not subject to public consultation.

If he will take steps to ensure that the new NHS Commercial Framework allows for increased use of indication-specific pricing agreements to support patient access to future cancer innovations.

As part of the 2024 Voluntary Scheme for Branded Medicines Pricing, Access and Growth, NHS England committed to undertake two consultations on amendments to the NHS Commercial Framework for New Medicines. The first of these launched on 31 July 2024 for eight weeks. The proposed amendments would make the framework more explicit about the circumstances in which NHS England will consider indication specific pricing mechanisms. They would also align the framework with the Competition and Markets Authority statement on combination medicines.NHS England and the Department engaged with key stakeholders throughout the consultation period, and NHS England intend to publish an updated NHS Commercial Framework for New Medicines by the end of 2024.

If his Department will publish a strategy for ensuring people living with (a) Crohn’s disease and (b) other forms of inflammatory bowel disease are able to access treatment in a timely manner.

NHS England’s Getting It Right First Time Programme on gastroenterology aims to reduce variations in care, increase early diagnosis and proactive management of Crohn’s disease and colitis, and increase access to inflammatory bowel disease (IBD) specialist nurses. The National institute for Health and Care Excellence has also produced a range of guidance on IBD, and Crohn’s disease and colitis, to support early diagnosis and effective management of these conditions. It ensures that the care provided to people with IBD is based on the best available evidence. In the last two years, the National Institute for Health and Care Excellence has recommended four new drugs for the treatment of moderate to severe Crohn’s disease and ulcerative colitis, including Upadacitinib, Risankizumab, Mirikizumab, and Etrasimod. NHS England’s National Bladder and Bowel Health Project is delivering better care for people with IBD, with a focus on developing clinical pathways. NHS England commissions specialised colorectal services nationally to support equity of access to high-quality treatment for patients with IBD requiring complex surgery. This work is supported within NHS England by the clinical leadership of the Specialised Colorectal Services Clinical Reference Group, which is made up of experts in surgery, medicine, radiology, pathology, and nursing, alongside patient and public voice representatives. To raise awareness of IBD among general practitioners and other primary care staff, the Royal College of General Practitioners has produced an Inflammatory Bowel Disease Toolkit. The toolkit outlines when to suspect IBD, the appropriate investigative tests and diagnostic tools for IBD, how to manage a flare-up of symptoms and how to support patients with IBD.

Whether he plans to review the list of conditions for exemption from prescription charges; and if he will make an assessment of the potential merits of including cystic fibrosis on that list.

There are no current plans to review the list of medical conditions that entitle someone to apply for a medical exemption certificate. 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 cystic fibrosis 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, 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.