Written questions by Bool.

What the annual cost of treating (a) patients over 18 and (b) children with Diabetic Ketoacidosis is.

A central mission of the Government is to build a health and care system that is fit for the future. Tackling preventable ill health, such as type 2 diabetes, is crucial. Shifting the focus from treatment to prevention is one of three shifts for the Government’s mission for a National Health Service that is fit for the future, and is a cornerstone of supporting people to live healthier lives.Preventing diabetes, like obesity, is a complex issue and requires multi-faceted action across both the public and private sector. Prevention involves collaboration across the public and private sectors to tackle underlying issues such obesity, poor diets, and lifestyle issues.The Department is taking steps to prevent type 2 diabetes through programmes such as the NHS Health Check, England’s flagship cardiovascular disease prevention programme for those aged between 40 and 74 years old, which aims to identify people at risk of developing type 2 diabetes, as well as heart disease, stroke, kidney disease, and some cases of dementia, and to signpost them to behavioural support such as weight management and clinical treatment if needed.Once identified, those at risk of developing type 2 diabetes can also be referred by their general practitioner into the Healthier You NHS Diabetes Prevention Programme. The programme is highly effective, cutting the risk of developing type 2 diabetes by 37% for people completing the programme, compared to those who do not attend.The annual costs of treating patients over 18 years old and children with diabetic ketoacidosis is not available, as this data is not routinely collected and/or analysed nationally.

Pursuant to the Answer of 9 July 2025 to Question 64957 on Prescriptions: Terminal Illnesses, if he will make an assessment of the cost to the public purse of the requirement for patients to renew their medical exemption certificate every five years for (a) all patients, (b) terminally ill patients and (c) patients with Type 1 diabetes.

The Department has made no assessment of the cost to the public purse of the requirement for patients, including terminally ill patients and patients with type 1 diabetes, to renew their medical exemption certificate every five years.Between 1 June 2024 and 1 July 2025, 50,330 people received a Penalty Charge Notice after claiming a medical exemption certificate on a National Health Service prescription.There has been one prosecution in relation to non-payment of NHS prescription charges, which was in 2019. Data that specifically identifies patients with a terminal illness in relation to prosecutions, fines, or investigations under the 1999 Health Act for fraudulent prescription charge exemptions is not held. Data is recorded based on a qualifying medical condition which entitles someone to apply for a medical exemption certificate.

If he will make an estimate of the potential cost to the public purse of a universal, paediatric Type 1 Diabetes screening programme.

In the United Kingdom, national screening programmes are introduced based on the recommendations of the UK National Screening Committee (UK NSC), an independent scientific advisory committee which advises ministers and the National Health Service in all four countries on all aspects of population and targeted screening, and which supports implementation. A proposal for screening for neonatal diabetes mellitus was submitted to the UK NSC via its 2021 annual call process. An evidence-mapping exercise was conducted at that time which concluded that there was not sufficient evidence to recommend screening for this condition. The UK NSC received a submission via its 2024 annual call process to consider screening for autoimmune type 1 diabetes through blood testing. The committee requested further information from the submitter, and this is now in the process of being reviewed. Further information on the annual call process is available at the following link: https://www.gov.uk/government/publications/uk-nsc-annual-call-submitting-a-screening-proposal/uk-nsc-annual-call-how-to-submit-a-proposal The UK NSC is aware of the ELSA study that is looking at screening children for type 1 diabetes and looks forward to receiving the results of this study in due course. When the UK NSC makes a recommendation to introduce any screening programme they consider the cost effectiveness of the programme, and the Department estimates the cost of implementing the recommendation before ministers agree to the recommendation. Therefore, if the UK NSC makes a recommendation to screen for type 1 diabetes, a cost assessment will be made.

What assessment he has made of the potential implications for his policies of the ELSA Diabetes screening study; and whether he has made an assessment of the potential merits of scaling it to a universal programme.

In the United Kingdom, national screening programmes are introduced based on the recommendations of the UK National Screening Committee (UK NSC), an independent scientific advisory committee which advises ministers and the National Health Service in all four countries on all aspects of population and targeted screening and supports implementation. The UK NSC is aware of the ELSA study that is looking at screening children for type 1 diabetes and looks forward to receiving the results of this study when the trial is complete.

What assessment Department has made of the cost to the public purse of the requirement that (a) all and (b) terminally ill patients should renew their Medical Exemption Certificates every five years.

The Department has made no assessment of the cost to the public purse of the requirement for patients to renew their medical exemption certificate every five years.

What assessment his Department has made of the adequacy of data protection laws in ensuring that legitimate complaints processes are dealt with effectively by health bodies.

The handling of patient complaints in the National Health Service is governed by the Local Authority Social Services and National Health Service Complaints (England) Regulations 2009. These regulations set out in law the minimum standards NHS organisations must adhere to in respect of their complaint handling arrangements.There are strong protections in law to ensure that health and care information is used in a safe, secure, and legal way, and these must be observed in any complaints process. These include: the UK General Data Protection Regulation; the Data Protection Act 2018, which establishes a legal framework for processing personal information and keeping it secure, and for only using it for the purposes for which it was collected; the Human Rights Act 1998, which requires public bodies to respect the private life of an individual, including protecting any information held about them; and the common law duty of confidentiality.

What assessment his Department has made of the (a) adequacy and (b) accessibility of transport services for (i) older and (ii) disabled patients attending NHS hospital appointments in rural areas.

As set out in the Plan for Change, we will ensure that 92% of patients return to waiting no longer than 18 weeks from referral to treatment by March 2029, a standard which has not been met consistently since September 2015. The Government is clear that reforming elective care must be done equitably and inclusively for all adults, children, and young people.We know there is also geographical variation in waiting times. It is important that patients, including older and disabled patients, do not miss or cancel hospital appointments due to a lack of affordable and/or accessible transport options in their area.This is why the Elective Reform Plan, published January 2025, committed to reviewing existing national health inequalities improvement initiatives to develop them and increase their uptake. Specifically, the plan committed to reviewing local patient transport services and improving the signposting to and the accessibility of them for patients, to make it easier for vulnerable groups to travel to and access appointments.This includes improving the accessibility, awareness, and efficiency of The Healthcare Travel Costs Scheme, with a focus on reducing health inequalities and improving the patient experience.

What steps his Department is taking to ensure that patients do not (a) miss and (b) cancel hospital appointments due to a lack of (i) affordable and (ii) accessible transport options.

As set out in the Plan for Change, we will ensure that 92% of patients return to waiting no longer than 18 weeks from referral to treatment by March 2029, a standard which has not been met consistently since September 2015. The Government is clear that reforming elective care must be done equitably and inclusively for all adults, children, and young people.We know there is also geographical variation in waiting times. It is important that patients, including older and disabled patients, do not miss or cancel hospital appointments due to a lack of affordable and/or accessible transport options in their area.This is why the Elective Reform Plan, published January 2025, committed to reviewing existing national health inequalities improvement initiatives to develop them and increase their uptake. Specifically, the plan committed to reviewing local patient transport services and improving the signposting to and the accessibility of them for patients, to make it easier for vulnerable groups to travel to and access appointments.This includes improving the accessibility, awareness, and efficiency of The Healthcare Travel Costs Scheme, with a focus on reducing health inequalities and improving the patient experience.

Pursuant to the Answer of 12 June 2025 to Question 56077 on Farmer: Mental Health, what steps his Department is taking to ensure that the 8,500 new mental health support workers include specialists trained to address the unique mental health needs of farming and rural populations.

As part of our mission to build a National Health Service that is fit for the future and that is there when people need it, we are recruiting 8,500 mental health workers across child and adult mental health services to help ease pressure on busy services. It is the responsibility of employers to ensure that their employees are trained and have the appropriate skills for the roles into which they have been appointed.We are working with NHS England on a refreshed workforce plan, which will revolve around the three shifts to deliver our 10-Year Health Plan: moving more care from hospitals to communities; making better use of technology in health and care; and focusing on preventing sickness, not just treating it.

What discussions he has had with NHS England and the UK National Screening Committee on the (a) feasibility and (b) cost-effectiveness of implementing a universal screening programme for type 1 diabetes.

In the United Kingdom, national screening programmes are introduced based on the recommendations of the UK National Screening Committee (UK NSC), an independent scientific advisory committee which advises ministers and the National Health Service in all four countries on all aspects of population and targeted screening, and which supports implementation. A proposal for screening for neonatal diabetes mellitus was submitted to the UK NSC via its 2021 annual call process. An evidence-mapping exercise was conducted at that time which concluded that there was not sufficient evidence to recommend screening for this condition. The UK NSC received a submission via its 2024 annual call process to consider screening for autoimmune type 1 diabetes through blood testing. The committee requested further information from the submitter, and this is now in the process of being reviewed. Further information on the annual call process can be found at the following link: https://www.gov.uk/government/publications/uk-nsc-annual-call-submitting-a-screening-proposal/uk-nsc-annual-call-how-to-submit-a-proposal The UK NSC is aware of the ELSA study that is looking at screening children for type 1 diabetes, and looks forward to receiving the results of this study in due course.

What assessment his Department has made of the potential impact of introducing a universal screening programme for type 1 diabetes on the incidence of diabetic ketoacidosis in children and young adults.

In the United Kingdom, national screening programmes are introduced based on the recommendations of the UK National Screening Committee (UK NSC), an independent scientific advisory committee which advises ministers and the National Health Service in all four countries on all aspects of population and targeted screening, and which supports implementation. A proposal for screening for neonatal diabetes mellitus was submitted to the UK NSC via its 2021 annual call process. An evidence-mapping exercise was conducted at that time which concluded that there was not sufficient evidence to recommend screening for this condition. The UK NSC received a submission via its 2024 annual call process to consider screening for autoimmune type 1 diabetes through blood testing. The committee requested further information from the submitter, and this is now in the process of being reviewed. Further information on the annual call process can be found at the following link: https://www.gov.uk/government/publications/uk-nsc-annual-call-submitting-a-screening-proposal/uk-nsc-annual-call-how-to-submit-a-proposal The UK NSC is aware of the ELSA study that is looking at screening children for type 1 diabetes, and looks forward to receiving the results of this study in due course.

Whether his Department plans to include universal type 1 diabetes screening in the forthcoming 10-year plan for preventing chronic disease.

The 10-Year Health Plan will deliver the three big shifts 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 preventing and managing conditions such as diabetes in all parts of the country.More tests and scans delivered in the community and better joint working between services will support the management of conditions, including diabetes, closer to home.The plan will draw directly from the extensive engagement we have undertaken with the public, patients, and staff, including those in the diabetes care sector. We are in the final stages of working on the plan and will publish it shortly.

What steps his Department is taking to ensure that Integrated Care Boards are (a) adequately resourced and (b) trained to commission effective care pathways for patients with aplastic anaemia.

Working under the UK Rare Diseases Framework, the Government is committed to improving the lives of those living with rare diseases, such as aplastic anaemia.The majority of the treatment pathway for aplastic anaemia is an integrated care board commissioning responsibility. Hematopoietic stem cell transplant (HSCT) is an NHS England specialised commissioned service that covers aplastic anaemia, and NHS England has published two national service specifications, one for adults and one for children. The HSCT specifications set out the standards that the providers of the service must meet, which includes access to a range of multidisciplinary staff, including psychological support and nurse specialists trained in communication and counselling.

What assessment he has made of the effectiveness of the NHS England Genomics Education Programme in improving healthcare professional awareness and understanding of (a) aplastic anaemia and (b) other rare diseases.

Working under the UK Rare Diseases Framework, the Government is committed to improving the lives of those living with rare diseases, such as aplastic anaemia.NHS England’s flagship GeNotes resource, developed by NHS England's Genomics Education Programme, is aimed at healthcare professionals in order to continue their growth, and has more than 500 resources featured across nine specialties. Aplastic anaemia is not currently included in GeNotes. The Genomics Education Programme is also developing a range of training and educational resources on rare diseases, to include rare diseases in United Kingdom health professional education and training frameworks. Work continues to expand the programme’s coverage.

Whether his Department plans to include information on aplastic anaemia on the NHS website; and what criteria is used to determine which rare diseases are featured.

Working under the UK Rare Diseases Framework, the Government is committed to improving the lives of those living with rare diseases, such as aplastic anaemia.There are over 7,000 rare diseases, often needing highly specialised input, and so the National Health Service website is not always the most appropriate platform to disseminate such information. At this stage there are no plans to add aplastic anaemia to the website.

When he plans to publish the 10 Year Plan for the NHS.

Our 10 Year Health Plan will make the NHS fit for the future with three key shifts: hospital to community, analogue to digital, and treatment to prevention.It will deliver the Prime Minister’s Plan for Change and will be published shortly.

Whether his Department has commissioned research into the potential impact of toxic emissions from battery storage fires near residential areas on public health.

The Department has not formally commissioned research into this topic. However, on 14 March 2025, the Environment Agency published the paper, Net zero: Environmental and social implications of energy storage technologies: summary, which is available at the following link: https://www.gov.uk/government/publications/net-zero-environmental-and-social-implications-of-energy-storage-technologies/net-zero-environmental-and-social-implications-of-energy-storage-technologies-summary On 3 June 2025, a paper was also placed in the House of Commons library which has details of Battery energy storage systems; this is available at the following link: https://researchbriefings.files.parliament.uk/documents/CBP-7621/CBP-7621.pdf Despite the UK Health Security Agency (UKHSA) not currently undertaking research per se on fires involving lithium ion batteries, UKHSA draws upon previously published Public Health England guidance on products of combustion, for example, Combustion products: a toxicological review, which is available at the following link:https://www.gov.uk/government/publications/combustion-products-a-toxicological-reviewIn addition, practical guidance has been developed by the Waste Industry Safety and Health forum, Fire Risk and Lithium Batteries at Waste Transfer, Recycling and Recovery Operations, which is available at the following link:https://www.wishforum.org.uk/wp-content/uploads/2020/05/INFO-08.pdf

What assessment he has made of the adequacy of GP appointment availability in South Northamptonshire.

The Government is determined to work with the National Health Service to fix the front door of our health service and ensure everyone can access general practitioner (GP) appointments, including in South Northamptonshire. In October 2024, we invested £82 million into the Additional Roles Reimbursement Scheme to support the recruitment of 1,700 newly qualified GPs across England, helping to increase appointment availability and improve care for thousands of patients We delivered an £889 million uplift in funding for 2025/26, with general practice now receiving a growing share of NHS resources. Additionally, the new £102 million Primary Care Utilisation and Modernisation Fund will upgrade more than a thousand GP surgeries across England, helping to improve productivity.

What assessment his Department has made of the potential impact of NHS dental contract reforms on rural patient access.

We are aware of the challenges faced in accessing a dentist, particularly in more rural and coastal areas. This is why we have launched the Golden Hello scheme which will see up to 240 dentists receiving payments of £20,000 to work in those areas that need them most for three years.To rebuild dentistry in the long term, we will reform the dental contract with the sector, with a shift to focus on prevention and the retention of National Health Service dentists. There are no perfect payment systems and careful consideration needs to be given to any potential changes to the complex dental system so that we deliver a system better for patients and the profession.We are continuing to meet the British Dental Association and other representatives of the dental sector to discuss how we can best deliver our shared ambition to improve access for NHS dental patients.

What steps his Department is taking to reduce ambulance response times in South Northamptonshire.

The Government recognises the pressures on the National Health Service and the impact this is having on ambulance response times, including in South Northamptonshire.We are determined to turn things around, our 10-Year Health Plan will be published in summer 2025, setting out major NHS reforms to move healthcare from hospital to the community, analogue to digital and sickness to prevention.The NHS Urgent and emergency care plan 2025/26, published on 6 June 2025, requires health systems to focus on those areas likely to have the biggest impact on urgent and emergency care services this year. The plan includes actions that will reduce category 2 ambulance response times to 30 minutes and reduce ambulance handovers to 45 minutes, helping to get 550,000 more ambulances back on the road.