Written questions by Holden.

Whether his Department provides unconscious bias training; and whether his Department plans to provide unconscious bias training to staff from NHS England when that organisation is abolished.

The Department aligns itself to the Civil Service Equality, Diversity and Inclusion approach to learning and to the use of evidence led interventions. The Department does not provide unconscious bias training to its staff, and there are no current plans to provide unconscious bias training for NHS England staff.

Pursuant to the Answer of 19 May to Question 51955 on Electronic Cigarettes: Young People, what estimate he has made of the number of very high puff-count vaping devices which (a) are refillable and rechargeable and (b) contain a replaceable coil are available on the UK market.

The ban on the sale and supply of single-use vapes came into force on Sunday 1 June. It is therefore too early to make a reliable estimate of the number of high-puff count vaping devices which are refillable, reusable, and which contain a replaceable coil.However, we are aware of a number of high-puff count vapes that are not captured by the single-use vape ban. The Department is taking powers through the Tobacco and Vapes Bill that will enable regulation of any high puff vape that is not captured by the ban. The bill provides powers on product features that allows the Government to regulate the size of a tank or refill container, and the amount of liquid that can be included, as well as powers to standardise the size and shape of vapes, and to further restrict liquid availability. In addition, the bill contains powers that allow us to regulate the amount of nicotine in a puff, so the Government is able to restrict the nicotine not only in the tank, but also the nicotine that can be emitted in the vapour.The Government will consider this issue further as part of its secondary legislation programme after Royal Assent of the bill.

What steps he is taking to support dementia-friendly adaptations in pubs and hospitality venues.

We want people with dementia to live well and remain independent for as long as possible in their communities.Through the Dementia Friendly Communities programme, we are making society more inclusive, with communities and organisations committing to support people to continue to do the things they want to do, including going to the pub or attending hospitality venues, for as long as possible.For example, we continue to support initiatives, such as the Alzheimer’s Society’s Dementia Support initiative, which link people, their families, and carers with local support services.

Pursuant to the Answer of 7 April 2025 to Question 40621 on DHSC: Translation Services, if he will list the foreign languages that were translated into in that year; and what publications were translated into foreign languages.

During 2024, translation services work by the Department, for languages other than English, comprised a translation of the Health and Care Act 2022 from English into Welsh and a translation of the consultation document for the Healthy Start initiative from English into Welsh.

With reference to the publication entitled DHSC register of board members' interests, 2024 to 2025, published on 16 January 2025, who the health and social care related clients of A.M. Strategy Ltd are.

Declarations of interest, and any updates to them, are published in the Register of Interests in the Department’s Annual Report and Accounts, and on the GOV.UK website, in alignment with Government policy.

With reference to his Department's press release entitled New DHSC Permanent Secretary Appointed, published on 22 April 2025, whether the new Permanent Secretary was appointed by (a) open and fair competition, (b) temporary appointment and (c) exception.

The Department launched a fair and open competition to appoint a Permanent Secretary in January 2025. As a result of this process, Samantha Jones was found to be an appointable candidate for this role. However, during the recruitment process it was announced that NHS England would be brought back into the Department. This significantly changed the scale and objectives required of this role. In light of these changes the Civil Service Commission agreed a three-year fixed term appointment by exception, on the Senior Civil Service Model contract.

What assessment his Department has made of the potential impact of the lower price point of very high puff-count vapes on youth vaping.

The Department has not made a direct assessment of the potential impact of the lower price point of high puff-count vapes on youth vaping. However, it is incredibly worrying that 25% of 11 to 15 year old had tried vaping, as of 2023. To address this, the Tobacco and Vapes Bill will ban the advertising of vaping and nicotine products, as well as sponsorship agreements which promote them. It also provides powers to limit flavours, packaging, and displays, and provides powers that allow the Government to regulate the tank sizes and refill containers, and the amount of liquid that can be included. The Government intends to consult on these issues soon after Royal Assent.The Department for Environment Food and Rural Affairs is introducing a ban on single-use vapes, which is defined as a vape that is neither refillable nor rechargeable, and if it has a coil, the coil must be replaceable. This will capture most “big puff” vapes currently on the market.Alongside this, and to discourage non-smokers and young people from taking up vaping, the Government will be introducing the Vaping Products Duty, which will come into force from 1 October 2026. The duty will be set at a single flat rate of £2.20 per 10 millilitre on all vaping liquid.

What estimate he has made of the number of redundancies arising from the abolition of NHS England.

Ministers and senior Department officials will work with the new executive team at the top of NHS England, led by Sir Jim Mackey, to lead the formation of a new joint centre.The abolition of NHS England will strip out the unnecessary bureaucracy and cut the duplication that comes from having two organisations doing the same job. We will empower staff to focus on delivering better care for patients, driving productivity up, and getting waiting times down. As part of these changes, we intend to reduce the headcount across the Department and NHS England, with further details to become available as we take the programme forward.These changes are no reflection of the tireless work carried out by talented professionals across the health sector. These changes are about forming a more agile and efficient system, in the interests of patients and the public.

Whether his Department plans to extend the swap to stop scheme for smoking cessation; and whether he plans to allocate ring-fenced funding for a future extension of that scheme.

The Swap to Stop scheme provides local services with vape starter kits to support smokers to quit, alongside behavioural support. The Swap to Stop scheme was launched in November 2023, and has provided local services with vape starter kits to the value of £3.2 million in 2023/24 and £17 million in 2024/25. This funding is ringfenced and is supplementary to the additional £70 million of ringfenced funding for Local Stop Smoking Services, along with existing funding through the Public Health Grant.The extension of the Swap to Stop scheme for the coming year, 2025/26, was recently announced, with up to £19 million of funding available. Future settlements for this programme are being considered as part of the Spending Review.

How much funding for local stop smoking services was allocated to swap to stop schemes in (a) 2023 and (b) 2024; and how much funding for local stop smoking services his Department plans to allocate to swap to stop schemes in (i) 2025 and (ii) 2026.

The Swap to Stop scheme provides local services with vape starter kits to support smokers to quit, alongside behavioural support. The Swap to Stop scheme was launched in November 2023, and has provided local services with vape starter kits to the value of £3.2 million in 2023/24 and £17 million in 2024/25. This funding is ringfenced and is supplementary to the additional £70 million of ringfenced funding for Local Stop Smoking Services, along with existing funding through the Public Health Grant.The extension of the Swap to Stop scheme for the coming year, 2025/26, was recently announced, with up to £19 million of funding available. Future settlements for this programme are being considered as part of the Spending Review.

How often the NHS has made use of Private and Voluntary ambulances in the last five years; whether the NHS is planning to reduce or increase their use; and what is the estimated impact of their use on costs to his Department.

The requested information is not held. National Health Service ambulance trusts may procure support from private ambulance services during periods of peak demand to supplement the NHS’ ambulance fleet. Ambulance availability is therefore monitored on a daily basis by each NHS ambulance trust.With regard to expenditure on private ambulance services, NHS England does not collect this data, as decisions to engage private emergency ambulance support are made at the frontline operational level.

What steps he is taking to tackle regional disparities in access to community-based eating disorder treatments in (a) rural areas and (b) general.

NHS England is working with the integrated care boards with the aim of increasing the capacity of eating disorder services, to provide community and day treatment services. By improving care in the community, the National Health Service aims to improve outcomes and recovery, reduce rates of relapse, prevent children’s eating disorders continuing into adulthood and, if admission is required as a very last resort, reduce the length of time that people have to stay in hospital.NHS England has commissioned the Royal College of Psychiatrists to deliver a national, all-age eating disorders audit. This aims to drive improvement in the identification and appropriate management of eating disorders, and the quality and consistency of services for all ages in England. This will help ensure that services across the country, including in rural areas, are safe, effective, patient centred, timely, efficient, and equitable.In addition, NHS England is currently refreshing the guidance on children and young people's eating disorders to highlight the importance of awareness and the early recognition of eating disorders within schools, colleges, primary care, and broader children and young peoples’ mental health services.

What steps he is taking to expand intensive (a) community and (b) day treatments for eating disorders across NHS Integrated Care Systems.

NHS England is working with the integrated care boards with the aim of increasing the capacity of eating disorder services, to provide community and day treatment services. By improving care in the community, the National Health Service aims to improve outcomes and recovery, reduce rates of relapse, prevent children’s eating disorders continuing into adulthood and, if admission is required as a very last resort, reduce the length of time that people have to stay in hospital.NHS England has commissioned the Royal College of Psychiatrists to deliver a national, all-age eating disorders audit. This aims to drive improvement in the identification and appropriate management of eating disorders, and the quality and consistency of services for all ages in England. This will help ensure that services across the country, including in rural areas, are safe, effective, patient centred, timely, efficient, and equitable.In addition, NHS England is currently refreshing the guidance on children and young people's eating disorders to highlight the importance of awareness and the early recognition of eating disorders within schools, colleges, primary care, and broader children and young peoples’ mental health services.

Whether he plans to ensure that the Medicines and Healthcare products Regulatory Agency uses (a) placenta-on-a-chip and (b) other modern test methods in drug testing.

In the development of new medicines, the Medicines and Healthcare products Regulatory Agency (MHRA) does not, itself, carry out experimental studies. Its role is to review reports of studies supplied by drug developers characterising safety and potential efficacy of the drug; these can include placenta-on-a chip, or other methods using human cells.To be able to make such judgements, MHRA staff need to maintain and develop their knowledge about modern testing methods and to this end, MHRA staff have contributed to organising and have attended meetings where these methods are discussed. For instance, Agency staff contributed to a multi-stakeholder meeting in London in November 2024 organised in conjunction with the National Council for the 3Rs and with the Association of the British Pharmaceutical Industry for which a publication is now under preparation. MHRA staff will attend the Microphysiological Systems World Summit in Brussels in June 2025, where drug testing methods will be a major topic of discussion.The MHRA’s own laboratory activities include the independent testing of certain biological products, for example, vaccines and anti-toxins, to ensure they meet acceptable standards prior to each batch being released for use. In the small number of products where this work currently relies on use of animals, development of acceptable, validated, alternatives is a major priority; the numbers of animals used in our regulatory science has more than halved in the last 10 years.

Pursuant to the Answer of 20 January 2025 to Question 24256 on Electronic Cigarettes: Young People, whether the Tobacco and Vapes Bill will restrict the size of vape tanks.

Whilst nicotine vapes are already subject to tank size requirements, the Tobacco and Vapes Bill goes further and covers all types of vapes, both nicotine and non-nicotine, and consumer nicotine products.As stated in our previous answer, the bill provides powers on product features that allow the Government to regulate the size of a tank or refill container, and the amount of liquid that can be included, as well as powers to standardise the size and shape of vapes, and to further restrict liquid availability.Subject to consultation, regulation making powers in the Government’s bill will allow us to amend or place additional requirements and limits on vape tank sizes, and the size of refill tanks. The Government will consider this issue further as part of its secondary legislation programme after Royal Assent.

If he will publish a table of the number of (a) doctors, (b) registered nurses and (c) medical scientists were employed as locums in each (i) month and (ii) year since 2021 and what the total cost was for each group in each of those (A) months and (B) years.

The Department does not hold the information requested. NHS England publishes quarterly information on total agency and bank expenditure by National Health Service providers as part of financial reporting, which is available at the following link:https://www.england.nhs.uk/publication/financial-performance-reportsThe 2025/26 NHS Planning Guidance states that trusts should reduce their agency spend by a minimum of 30% and bank spend by a minimum of 10%. The accompanying Revenue Finance and Contracting Guidance sets the ambition that agency spend should be eliminated in the coming years.

If he will publish a table of the total amount spent on (a) primary, (b) secondary, (c) tertiary and (d) community care in the NHS in each of the last 5 financial years.

NHS England does not routinely collect expenditure data against the categories requested. However, the table attached shows the total spend in billions for specialised services, primary medical care, community services, continuing care, acute services, core mental health services, and others, as well as total integrated care board and direct commissioning spend, from 2015/16 to 2023/24.

How many and what proportion of Child Death Overview Panels cited consanguinity as the (a) primary and (b) secondary cause of death of children in each of the last 30 years.

The Child Death Review Statutory and Operational Guidance (England) sets out as a statutory requirement that, ‘When a child dies, in any circumstances, it is important for parents and families to understand what has happened and whether there are any lessons to be learned.’ The guidance is available at the following link:https://assets.publishing.service.gov.uk/media/637f759bd3bf7f154876adbd/child-death-review-statutory-and-operational-guidance-england.pdfThese reviews are conducted by child death overview panels (CDOPs), who have a statutory obligation to notify the National Child Mortality Database (NCMD) within 48 hours of a child’s death using a child death notification form, which is available at the following link:https://www.gov.uk/government/publications/child-death-reviews-forms-for-reporting-child-deathsThe form includes a question about ‘Further family background’ which asks whether the children’s parents are related to each other. The forms are submitted to NCMD who collate the data to produce reports, including its annual data report. Its latest annual report summarised information about child deaths in England up to 31 March 2024 and the findings of reviews carried out by a CDOP on or before 31 March 2024. The report is available at the following link:https://www.ncmd.info/publications/child-death-review-data-release-2024/For the first time, this report included information on the number of reviews where specific contributory or modifiable factors were identified. Contributory factors may have contributed to vulnerability, ill health or death, while modifiable factors may have contributed to the death of the child and might, by means of a locally or nationally achievable intervention, be modified to reduce the risk of future deaths. Of 3,176 reviews taking place in the year ending 31 March 2024 where contributory factors were identified, 128 reviews, or 4%, identified consanguinity as a contributory factor. Of 1,120 reviews taking place in the year ending 31 March 2024 where modifiable factors were identified and data was available, 16 reviews, or 1%, identified consanguinity as a modifiable factor.

What assessment he has made of the potential impact of provisions within the Tobacco and Vapes Bill on trends in the level of usage of very high puff-count vapes among young people.

Selling nicotine vapes to children under 18 years old is illegal. Yet due to the branding and advertising of vapes to children, one-in-four children aged between 11 and 15 years old tried vaping in 2023. The health advice is clear, that vaping is never recommended for children or non-smokers. Single-use vapes are playing a significant role in the rise of youth vaping; in 2024, 54% of current vapers aged between 11 and 17 years old in Great Britain were using them, increasing from 7.7% in 2021. The Department of Health and Social Care is aware of the issues regarding ‘big-puff’ vapes, including those raised in the study referenced. The Department for Environment, Food and Rural Affairs has laid legislation to ban the sale of single-use disposable vapes in England from 1 June 2025. Most ‘big puff’ vapes currently on the market are neither refillable or rechargeable, which means that they will be captured by the Department for Environment, Food and Rural Affairs’ forthcoming ban. The Tobacco and Vapes Bill will ban the advertising and sponsorship of all vapes and nicotine products. It will also provide regulation making powers to limit the flavours and packaging of vapes and nicotine products, as well as how these products are displayed. The Bill also provides powers that allow the Government to regulate the size of a tank or refill container, and the amount of liquid that can be included, as well as powers to standardise the size and shape of vapes, and to further restrict liquid availability. In addition, the Bill contains powers that allow us to regulate the amount of nicotine in a puff, so the Government is able to restrict the nicotine not only in the tank, but also the nicotine that can be emitted in the vapour. Future vaping regulations will be accompanied by impact assessments when the secondary legislation is laid.

What assessment his Department has made of the potential impact of very high-puff count vapes on trends in the level of youth vaping.

Selling nicotine vapes to children under 18 years old is illegal. Yet due to the branding and advertising of vapes to children, one-in-four children aged between 11 and 15 years old tried vaping in 2023. The health advice is clear, that vaping is never recommended for children or non-smokers. Single-use vapes are playing a significant role in the rise of youth vaping; in 2024, 54% of current vapers aged between 11 and 17 years old in Great Britain were using them, increasing from 7.7% in 2021. The Department of Health and Social Care is aware of the issues regarding ‘big-puff’ vapes, including those raised in the study referenced. The Department for Environment, Food and Rural Affairs has laid legislation to ban the sale of single-use disposable vapes in England from 1 June 2025. Most ‘big puff’ vapes currently on the market are neither refillable or rechargeable, which means that they will be captured by the Department for Environment, Food and Rural Affairs’ forthcoming ban. The Tobacco and Vapes Bill will ban the advertising and sponsorship of all vapes and nicotine products. It will also provide regulation making powers to limit the flavours and packaging of vapes and nicotine products, as well as how these products are displayed. The Bill also provides powers that allow the Government to regulate the size of a tank or refill container, and the amount of liquid that can be included, as well as powers to standardise the size and shape of vapes, and to further restrict liquid availability. In addition, the Bill contains powers that allow us to regulate the amount of nicotine in a puff, so the Government is able to restrict the nicotine not only in the tank, but also the nicotine that can be emitted in the vapour. Future vaping regulations will be accompanied by impact assessments when the secondary legislation is laid.