Written questions by Lowe.

What the cost to the public purse was of feasibility studies conducted by their Department for projects that did not proceed in the last five years.

The information requested is not held in this format in the Department’s accounts system and can only be obtained at disproportionate cost.

What steps he is taking to ensure that patients in Great Yarmouth receive equal access to NHS services.

As part of the 10-Year Health Plan we are focusing the role of integrated care boards (ICBs) on strategic commissioning to improve population health. NHS England has published the Strategic Commissioning Framework which supports the development of care models that are better matched to local needs, improved access to appropriate services, and a stronger focus on population health and reducing inequalities. As outlined in our 10-Year Health Plan, neighbourhood health plans will be created, including for the Norfolk and Waveney ICB, which covers Great Yarmouth.

Whether his Department has direct oversight of financial efficiencies at the James Paget Trust.

The East of England Regional Team has detailed and regular engagement with the James Paget University Hospitals NHS Foundation Trust to discuss both their financial position and, more specifically, the delivery of their financial efficiencies. The monthly financial position and progress in delivering efficiencies is a key aspect of the monthly System Financial Review meetings with the trust’s Chief Finance Officer, alongside the integrated care board and other trusts within the local system.As of October 2025, the James Paget University Hospitals Trust is on track to deliver against its agreed efficiency target.

What assessment he has made of the impact of staff parking charges on recruitment and morale at James Paget Hospital.

No assessment has been made of the impact of staff parking charges on recruitment and morale at James Paget Hospital.The health and wellbeing of National Health Service staff is a top priority, and all NHS organisations have a responsibility to create supportive working environments for staff, ensuring they have the conditions they need to thrive.As set out in the 10-Year Health Plan, we will work with the Social Partnership Forum to introduce a new set of staff standards for modern employment, covering issues such as access to healthy meals, support to work healthily and flexibly, and tackling violence, racism, and sexual harassment in the workplace.All NHS hospitals in England are expected to follow the published NHS Car Parking Guidance. The guidance makes clear that where hospital car parking charges exist, they should be reasonable for the area.In addition, free hospital car parking is already in place for ‘in-need’ groups, and this includes NHS staff working overnight.

What assessment he has made of the level of ambulance handover delays at James Paget Hospital in each of the past three years.

NHS England publishes monthly data on ambulance handovers, including at the James Paget University Hospitals NHS Foundation Trust over the past three years. This information is available at the following link:https://www.england.nhs.uk/statistics/statistical-work-areas/ambulance-quality-indicators/ambulance-management-informationIn addition, weekly handover data split by day is also published as part of national winter reporting. This information is available at the following link:https://www.england.nhs.uk/statistics/statistical-work-areas/uec-sitrepWe are working closely with the trust and system partners to deliver ongoing, evidence-based improvement to ambulance handovers. Key actions include the Release and Respond Programme since December 2024, which targets long delays and supports rapid handovers, new protocols for managing hospital capacity and safe patient flow, enhanced discharge planning and long length-of-stay reviews, Same Day Emergency Care investment enabling same-day assessment and treatment, and enhanced geriatrician support for early assessment and frailty management.These initiatives are already delivering positive results with the average handover time reducing by 27 minutes in November 2025 compared to November 2024. Furthermore, current four-hour performance for November stands at 73.4%, up 10.3% from last November.

Whether he plans to provide additional funding to (i) James Paget Hospital and (ii) Northgate Hospital to help support (a) local residents and (b) its seasonal tourist population.

Integrated care boards (ICBs) are responsible for commissioning and funding the care delivered by healthcare providers, including the James Paget University Hospitals NHS Foundation Trust and the Norfolk and Suffolk NHS Foundation Trust. The amount of funding received by each provider is based on the NHS Payment Scheme, which is a set of rules, prices, and guidance that determine how the providers of National Health Service funded healthcare are paid for the services they deliver.NHS England is responsible for determining the allocation of financial resources to ICBs. The process of setting funding allocations is informed by the Advisory Committee on Resource Allocation, an independent committee that provides advice to NHS England on setting the target formula which impacts how allocations are distributed over time according to factors such as demography, morbidity, deprivation, and the unavoidable cost of providing services in different areas.NHS England produces a technical guide to allocation formulae, with the 2025/26 edition available at the following link:https://www.england.nhs.uk/wp-content/uploads/2025/02/PRN01601-technical-guide-to-allocation-formulae-and-convergence-for-2025-to-2026-revenue-allocations.pdfThe edition covering 2026/27 to 2028/29 allocations will be published in due course.The NHS also has an operational pressures escalation levels (OPEL) framework which provides a standardised approach to support an effective, integrated, and coordinated response to acute trust operational pressures. This includes actions locally, regionally, and nationally that support the depressurising of services and ensure patient safety. Further information about the OPEL framework is published by NHS England, and is available at the following link:https://www.england.nhs.uk/long-read/integrated-opel-framework-2024-to-2026/#escalation-and-actions-in-response-to-operational-risks-and-pressures

How much (i) James Paget University Hospitals NHS Foundation Trust and (ii) Norfolk and Waveney Community Health and Care NHS Trust spent on external consultants in each of the last three financial years.

The following table shows the amount spent by James Paget University Hospitals NHS Foundation Trust and Norfolk and Waveney Community Health and Care NHS Trust for the last three financial years: 2022/232023/242024/25James Paget University Hospitals NHS Foundation Trust£360,455£181,287£154,043Norfolk and Waveney Community Health and Care NHS Trust£45,467£1,684£19,752 The information is published in their annual report and accounts on their websites, where further detail is available.

What steps he is taking to ensure that coastal hospitals such as the James Paget receive adequate NHS capital and revenue funding.

We remain committed to delivering all schemes within the New Hospital Programme, including James Paget, which will continue through the Spending Review 2025. The programme is funded for five-year waves of investment, averaging around £3 billion a year from 2030.Integrated care boards (ICBs) are responsible for commissioning and funding the care delivered by healthcare providers, including the James Paget University Hospitals NHS Foundation Trust. The amount of funding received by each provider is based on the NHS Payment Scheme, which is a set of rules, prices, and guidance that determine how the providers of National Health Service-funded healthcare are paid for the services they deliver.NHS England is responsible for determining the allocation of financial resources to ICBs. The process of setting funding allocations is informed by the Advisory Committee on Resource Allocation, an independent committee that provides advice to NHS England on setting the target formula which impacts how allocations are distributed over time according to factors such as demography, morbidity, deprivation, and the unavoidable cost of providing services in different areas. There are a range of adjustments made in the core ICB allocations formula that account for the fact that the cost of providing health care may vary between rural and urban areas.ICB allocations for 2025/26 were published on 30 January 2025 and allocations for 2026/27 to 2027/28 were published on 17 November. These are available at the following links respectively:https://www.england.nhs.uk/publication/allocation-of-resources-2025-26/https://www.england.nhs.uk/publication/allocation-of-resources-2026-27-to-2027-28/The Norfolk and Waveney ICB, which currently covers the James Paget University Hospitals NHS Foundation Trust, received an uplift to its recurrent core services allocation of 3.85% in 2025/26.Following announced mergers due to take effect from 1 April 2026, a new NHS Norfolk and Suffolk ICB will cover James Paget University Hospitals NHS Foundation Trust from 2026/27. The new ICB will see its recurrent core services allocation uplifted by 3.05% in 2026/27 and 3.29% in 2027/28.Budget 2025 confirmed a rise in the Department’s capital budgets to £15.2 billion by the end of the Spending Review period. This includes over £4 billion in operational capital in 2025/26, with a further £16.9 billion to be allocated to ICBs and providers over the following four years. James Paget University Hospitals NHS Foundation Trust has been allocated £46.8 million in operational funding for the period 2026/27 to 2029/30.

What assessment he has made of the adequacy of the number of GPs in Great Yarmouth constituency.

As of 31 October 2025, there were 66 full time equivalent (FTE) doctors in general practice (GP) in the Great Yarmouth Constituency. The median number of FTE doctors per 10,000 registered patients was 5.5, compared to the England median of 5.6.Since October 2024 we have funded primary care networks with an additional £160 million to recruit recently qualified GPs through the Additional Roles Reimbursement Scheme. Over 2,600 individual GPs have now been recruited, preventing them from graduating into unemployment. This was a measure to respond to feedback from the profession and to help solve an immediate issue of GP unemployment.We have committed to training thousands more GPs across the country which will increase capacity and take the pressure off those currently working in the system.

If he will provide funding to help increase staffing levels at (a) James Paget University Hospital and (b) Northgate Hospital.

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.Funding provided to NHS trusts, including James Paget University Hospital and Northgate Hospital, is not ringfenced for specific items such as staffing levels. Hospitals receive funding allocations which they can use at their discretion, based on local priorities.The 10 Year Workforce Plan will ensure the NHS has the right people in the right places, with the right skills to care for patients, when they need it.

If his Department will provide emergency funding to areas with the most severe dental shortages, including Great Yarmouth.

We are aware of the challenges faced in accessing a dentist, particularly in more rural and coastal areas such as Great Yarmouth.In 2024/25, the Government invested around £3.7 billion on primary care dentistry. We want to ensure that every penny we allocate for dentistry is spent on dentistry, and that the ringfenced dental budget is spent on the patients who need it most.The responsibility for commissioning primary care services, including National Health Service dentistry, to meet the needs of the local population has been delegated to the integrated care boards (ICBs) across England. For the Great Yarmouth constituency, this is the NHS Norfolk and Waveney ICB.We have asked ICBs to commission extra urgent dental appointments across the country, with appointments more heavily weighted towards those areas where they are needed the most.ICBs are also recruiting dentists through the Golden Hello scheme. This recruitment incentive will see dentists receiving payments of £20,000 to work in those areas that need them most for three years.We are committed to delivering fundamental reform of the dental contract before the end of this Parliament. As a first step, we published the Government’s response to the public consultation on shorter term improvements to the NHS dental contract on 16 December 2025. The changes will be introduced from April 2026. These reforms will put patients with the greatest needs first while incentivising urgent care and complex treatments. 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-reforms

What information his Department holds on the number of children in Great Yarmouth constituency that were unable to access an NHS dental appointment in the last 12 months.

Data is not held on the number of children in the Great Yarmouth constituency that were unable to access a National Health Service dental appointment in the last 12 months.The data for the Norfolk and Waveney Integrated Care Board, which includes the Great Yarmouth constituency, shows that 55% of children were seen by an NHS dentist in the previous 12 months up to June 2025, compared to 57% in England. This year, resources have also been provided to Norfolk County Council to support 5,605 children through the national supervised toothbrushing programme.On 16 December, we published the Government’s response to the public consultation on interim improvements to the NHS dental contract. The changes will be introduced from April 2026. These reforms will put patients with greatest need first, incentivising urgent care and complex treatments, and will reduce clinically unnecessary check-ups. More 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-reforms

What assessment he has made of the potential impact of the number of NHS dentists currently working in Great Yarmouth constituency on patients' access to urgent care.

We are determined to rebuild NHS dentistry, but it will take time and there are no quick fixes. Strengthening the workforce is key to our ambitions.The 10 Year Workforce Plan will ensure that the National Health Service has the right people in the right places, with the right skills to care for patients, when they need it.We have asked integrated care boards (ICBs) to commission extra urgent dental appointments to make sure that patients with urgent dental needs can get the treatment they require. ICBs have been making extra appointments available from April 2025.These appointments are available across the country, with specific expectations for each region. These appointments are more heavily weighted towards those areas where they are needed the most.ICBs are also recruiting posts through the Golden Hello scheme. This recruitment incentive will see dentists receiving payments of £20,000 to work in those areas that need them most for three years.We are committed to reforming the dental sector and we will deliver fundamental contract reform before the end of this Parliament. As a first step, we published the Government’s response to the public consultation on shorter term improvements to the NHS dental contract on 16 December 2025. The changes will be introduced from April 2026. These reforms will put patients with the greatest needs first while incentivising urgent care and complex treatments.

For the total spend on (i) LinkedIn membership fees (ii) other subscriptions by his Department in the last financial year.

There were no transactions (subscription costs or otherwise) identified with LinkedIn as a supplier in the 2024/25 financial year.The total subscription fees identified for the 2024/25 financial year was £832,046.14. This figure excludes membership of the World Health Organisation which is considered a subscription for accountancy purposes.The response relates to the core department only and does not include information relating to the department’s arm’s-length bodies.

Whether NHS England or NHSBSA have identified any gaps or inconsistencies in national prescribing or outcomes data relating to puberty blockers in under-18s.

In March 2024, NHS England published a suite of documentation relating to its decision to remove gonadotrophin releasing hormone analogues as a routine treatment option in the National Health Service for children under 18 years old with gender dysphoria. This documentation included a review of the published evidence, which concluded that there is very limited evidence about safety, risks, benefits, and outcomes for the use of this medication in children with gender dysphoria. Restrictions on the sale and supply of these medicines via private and NHS prescriptions were introduced in May 2024. In line with the findings and recommendations of the Cass Review, NHS England and the National Institute for Health and Care Research have commissioned a carefully designed clinical trial to assess the relative benefits and harms of puberty suppressing hormones on young people’s physical, social, and emotional well-being.With regard to national prescribing data, the Government holds information relating to NHS prescriptions of gonadotropin hormone-releasing hormone agonists for all purposes for children aged 17 years old and under that were prescribed and dispensed in community pharmacies or general practices in England in each year from 2015/16 to September 2025. The NHS Business Services Authority does not hold patient data prior to April 2015. The Government does not hold data for prescriptions dispensed within secondary care, prisons, or other detention centres, or private prescriptions other than controlled drugs.

What instructions his Department issued to NHS regional gender hubs on prescribing restrictions.

In March 2024, NHS England published its clinical policy on puberty suppressing hormones for children and young people who have gender incongruence and/or gender dysphoria.This set out that puberty supressing hormones are not available as a routine commissioning treatment option for the treatment of children and young people who have gender incongruence and/or gender dysphoria.

Whether any NHS regional gender hubs have prescribed puberty blockers to patients under 18 since the publication of the Cass Review.

From 1 April 2024, NHS England adopted a new clinical commissioning policy that prevents the newly established Children and Young People's Gender Services from initiating prescriptions for gonadotrophin releasing hormone analogues for the purpose of puberty suppression.

Whether the Department holds complete archived referral, assessment, prescribing, and safeguarding data from the former Tavistock Gender Identity Development Service; and whether the Department will publish an aggregated historical summary.

NHS England, as the responsible commissioner of the service at the time, will hold some relevant data, of the type and nature that would routinely be reported through the commissioning process. This would not include patient identifiable information.

What evidence NICE has identified as the basis for its clinical assessment of puberty blockers for gender dysphoria; and whether NICE has undertaken (a) scoping and (b) evaluation exercises since 2015.

The National Institute for Health and Care Excellence (NICE) has not developed guidance on, or made a clinical assessment of, puberty blockers for gender dysphoria. In 2020, NICE developed two evidence summaries:Gonadotrophin releasing hormone analogues for children and adolescents with gender dysphoria; andGender-affirming hormones for children and adolescents with gender dysphoria.These summaries were commissioned by NHS England and developed by NICE to an NHS England process. They helped inform the Cass review.

What aggregated safety data, including adverse-event summaries, the MHRA has recorded relating to the use of puberty blockers in under-18s since 2010; and whether the Department has been informed of any safety signals during that period.

The Medicines and Healthcare products Regulatory Agency (MHRA) is responsible for ensuring medicines, medical devices, and blood components for transfusion meet applicable standards of safety, quality, and efficacy. The MHRA rigorously assesses available data, including from the Yellow Card scheme, and seeks advice from their independent advisory committee, the Commission on Human Medicines, where appropriate to inform regulatory decisions.Puberty blockers are also known as gonadotrophin-releasing hormone (GnRH) analogues. These medicines are licenced for conditions such as young children who enter puberty too early, also known as precocious puberty, prostate cancer, and endometriosis. The use of GnRH analogues to suppress puberty in children and young people with gender dysphoria is off-label prescribing. This means that the use of these medicines for this purpose is outside of the licensed uses, and as such the benefits and risks of the medicine for use in this specific population have not been assessed. The MHRA does not regulate off-label use.The MHRA has received three United Kingdom suspected adverse drug reaction reports in which a GnRH analogue has been reported as being used in a child or young person for the purpose of puberty suppression in gender dysphoria. The GnRH analogues included in this search were buserelin, leuprorelin, goserelin, gonadorelin, nafarelin, and triptorelin. Please note it is not mandatory to provide information on indication when submitting an adverse drug reaction report.It is important to note that a reaction reported to the Yellow Card scheme does not necessarily mean it has been caused by the medicine, only that the reporter had a suspicion it may have. Underlying or concurrent illnesses may be responsible, or the events could be coincidental.The MHRA has not identified any safety signals which concern the off-label use of the GnRH analogues for the purpose of puberty suppression in gender dysphoria. However, we acknowledge that there is a clear lack of clinical evidence for the safety and efficacy of using these medicines for gender incongruence and/or dysphoria in those aged 18 years old and under. That is why NHS England and the National Institute for Health and Care Research have commissioned a carefully designed clinical trial to assess the relative benefits and harms of puberty suppressing hormones on young people’s physical, social, and emotional well-being.