Written questions by Foord.

With reference to the UK Resilience Academy's Exercising Best Practice Guidance, whether external expert observers and evaluators have been involved in Exercise Pegasus; and what steps he is taking to incorporate independent assessments by expert observers and evaluators into the UK's pandemic preparedness plans.

Trained observers and evaluators participated throughout Exercise PEGASUS, the largest simulation of a pandemic in United Kingdom history. These observers and evaluators provided an external view on the decisions and actions taken by participants, supported by other evaluation methods, including focus groups to ‘red team’ or challenge participant decisions, surveys, and structured ‘debriefs’ with participants themselves.The Department aims to have flexible, adaptable, and scalable capabilities that can respond to any infectious disease or other threat, along all routes of transmission rather than relying on plans for specific threats.Our health and care sector plans and our overall pandemic preparedness approach will continue to evolve in response to new scientific and clinical advice, as well as lessons learned, including learning from the UK COVID-19 Inquiry and Exercise PEGASUS. Exercise PEGASUS used a variety of mechanisms to provide challenges to current arrangements for pandemic response. Exercise PEGASUS has provided valuable experience which is being used to inform the pandemic preparedness strategy and response plans.

With reference to Recommendations 6 and 7 of Module 1 of the UK Covid 19 Inquiry, what steps he is taking to (1) gather and (2) publish findings, lessons and recommendations within the recommended 3 month window; and whether he will publish an action plan based on the findings from Exercise Pegasus.

Live participation in Exercise PEGASUS has now concluded, although a fourth phase, centred around recovery, is planned to be exercised in 2026. A published post-exercise report will include learning and findings from this and all preceding phases and this will be delivered in due course following detailed evaluation. The United Kingdom uses a Lead Government Department model to cover all phases of emergency planning, response, recovery, and risk assessment. Ministers within the Department, as the Lead Government Department for a pandemic response, will continue to actively consider the implementation of the findings from Exercise PEGASUS.

If he will take steps to publish a national strategy for palliative and end of life care.

The Department and NHS England are currently looking at how to improve the access, quality, and sustainability of all-age palliative care and end of life care in line with the 10-Year Health Plan.Additionally, we are supporting the hospice sector with a £100 million capital funding boost for eligible adult and children’s hospices in England to ensure they have the best physical environment for care.We are also providing £26 million in revenue funding to support children and young people’s hospices for 2025/26. I am pleased to confirm the continuation of circa £26 million, adjusted for inflation, for the next three financial years, 2026/27 to 2028/29 inclusive, to be distributed again via integrated care boards. This amounts to approximately £80 million over the next three years.

Whether his Department has made an assessment of the reasons for the price differential between (a) ciclosporin and (b) other generic immunosuppressant drugs sold in UK pharmacies compared to the same drugs available overseas; and if he will take steps to review (i) NHS procurement and (ii) pricing arrangements to ensure better value for money.

The Department has made no assessment of the reasons for the price difference between ciclosporin and other generic immunosuppressant drugs sold in United Kingdom pharmacies compared to other countries.The UK has well established mechanisms to control the level of spend on branded medicines. The voluntary scheme for branded medicines pricing, access, and growth and the statutory scheme for branded medicines, control the growth in sales of branded medicines, and the National Institute for Health and Care Excellence’s evaluations ensure that spend on new medicines represents a clinically and cost-effective use of National Health Service resources.For generic medicines, the Government’s policy is freedom of pricing. Community pharmacies buy the drugs they need to dispense against NHS prescriptions and are reimbursed for these according to the prices and ‘rules’ as set out in the Drug Tariff. The reimbursement arrangements include an amount of medicines margin in 2025/26, as allowed for as part of Community Pharmacy Contractual Framework funding. The system incentivises pharmacy contractors to source items as cheaply as possible, so they individually get to keep more medicine margin. This leads to competition and downward pressure on selling prices, which in turn leads to lower reimbursement prices and lower costs to the NHS.

When the Minister of State for Care plans to respond to the letter from the hon. Member for Honiton and Sidmouth dated 18 March 2025 on NHS dentistry in the South West.

I replied to the hon. Member on 25 June 2025.

What steps his Department taking to ensure that maternity hospitals are adequately staffed to ensure high quality care for pregnant women in Devon.

The Government is committed to tackling the retention and recruitment challenges that face the National Health Service. Bringing in the staff we need will take time, but this is an absolute priority for the Government.NHS England is leading a range of initiatives to boost retention of existing staff and ensure that the NHS remains an attractive career choice for new recruits. This includes building a compassionate and inclusive culture, supporting staff wellbeing, and promoting flexible working opportunities.Targeted retention work for midwives is being undertaken by NHS England, led by the Chief Nursing Officer. This work contains a range of measures, including creation of a midwifery and nursing retention self-assessment tool, mentoring schemes, strengthened advice and support on pensions, and embedding flexible retirement options. NHS England has also invested in unit-based retention leads which, alongside investment in workforce capacity, has seen a reduction in vacancy, leaver, and turnover rates.Decisions around local recruitment remain the responsibility of individual NHS trusts, who are responsible for ensuring they have the right number of staff in place, with the right skill mix, to deliver safe and effective care.

If he will make an estimate of the number of people requiring osseointegration transfemoral surgery in England.

Using the available data, we are unable to identify the number of people currently waiting for osseointegration transfemoral surgery in England.Regardless of why patients are waiting for treatment, the Government has committed to reducing waiting times and ensuring that we return to the National Health Service constitutional standard, that 92% of patients wait no longer than 18 weeks from referral to treatment by March 2029. We have already made progress, delivering on our commitment to provide an additional two million appointments and publishing our Elective Reform Plan, which details how we will go further to reduce waiting times, increase productivity, and improve patient experience.

If he will set out a timeline for implementation of measures to improve miscarriage care recommended in the Pregnancy Loss Review published on 22 July 2023.

The Government recognises that experiencing a miscarriage can be an extremely difficult time, and we are determined to make sure that all women and babies receive safe, personalised, and compassionate care, particularly when things go wrong. We will ensure that we listen to women and their families, and learn lessons from recent inquiries and investigations, including the Pregnancy Loss Report.Since publication we have launched the Baby Loss Certificate Service, updated the Human Tissue Authority Guidance on the sensitive handling of pregnancy remains, and NHS England has published a new policy to support National Health Service employees and provide managers with advice on how to support people affected by baby loss, including paid leave.

What assessment he has made of the potential merits of allowing carers to receive covid-19 vaccinations on the NHS.

The Government is committed to protecting those most vulnerable to COVID-19 through vaccination, as guided by the independent Joint Committee on Vaccination and Immunisation (JCVI). On 13 November 2024, the JCVI published advice on the COVID-19 vaccination programme covering vaccination in 2025 and spring 2026. This advice is available at the following link:https://www.gov.uk/government/publications/covid-19-vaccination-in-2025-and-spring-2026-jcvi-advice/jcvi-statement-on-covid-19-vaccination-in-2025-and-spring-2026#:~:text=the%20JCVI%20webpage.-,Advice%20on%20vaccination%20in%20spring%202025,care%20home%20for%20older%20adultsThe Government is considering this advice carefully and will respond in due course.

What assessment he has made of the potential impact of calorie labelling on menus on (a) obesity, (b) the prevalence of eating disorders and (c) other issues.

Legislation requiring large businesses in England, those with 250 or more employees, to display calorie information on non-prepacked food and soft drinks came into force in 2022. It aims to support consumers to make healthier choices for themselves and their families when eating out or getting a takeaway, with clear information about the calorie content of potential purchases. It may also encourage businesses to reformulate and provide lower calorie options, helping to create a healthier food environment.The published impact assessment estimated that by lowering calorie consumption amongst people living with overweight or obesity, the policy would produce National Health Service savings of £430 million and social care savings of £477 million over 25 years.We continue to evaluate the impact of the Out of Home Calorie Labelling Regulations, including on people living with eating disorders. We will publish a post-implementation review within five years of implementation which will consider the effectiveness of the policy.

What criteria are used to prioritise patients on NHS dental waiting lists; and whether older people are given priority.

The Government plans to tackle the challenges for patients trying to access National Health Service dental care with a rescue plan to provide 700,000 more urgent dental appointments and to recruit new dentists to the areas that need them most.Patients in England are not registered with an NHS dental practice, and there is no single waiting list, although many NHS dental practices do tend to see patients regularly and may operate local waiting list arrangements. There is no geographical restriction on which practice a patient may attend. NHS dentists are required to keep their NHS website profiles up to date so that patients can find a dentist more easily. This includes information on whether they are accepting new patients. In circumstances where patients are unable to access an urgent dental appointment directly through an NHS dental practice, they should contact NHS 111.The responsibility for commissioning primary care, including dentistry, to meet the needs of the local population has been delegated to all integrated care boards (ICBs) across England. For Honiton and Sidmouth constituency, this is the NHS One Devon ICB.

What assessment he has made of the potential impact of the level of access to NHS dentistry on diagnosis rates of routine mouth cancers.

No specific assessment has been made of the potential impact of the level of access to National Health Service dentistry on the diagnosis rates of routine mouth cancers. Dentists and other dental professionals, including hygienists, routinely check the soft tissues of a patient’s mouth for signs of cancer during dental visits, and as part of the check-up will make an assessment and record of an individual’s oral cancer risk.Dentists will prioritise patients at a higher risk of oral cancer for more frequent recall and review, in line with the National Institute for Health and Care Excellence’s guidance. Members of the public who are worried about their oral health in relation to cancer should seek advice from their dentist or general practitioner. Patients with symptoms of concern should be assessed and offered an urgent dental appointment based upon clinical need, in line with advice from NHS England.

What recent assessment he has made of the adequacy of the condition of NHS hospital equipment.

The Darzi review made it clear that the NHS has been starved of capital, with outdated scanners and is 15 years behind the independent sector in its use of technology.We will make the NHS fit for the future, replacing outdated equipment and providing hospitals with the latest technology.This will provide quicker, more effective, efficient diagnosis and a better experience for patients.