Written questions by Hall.

Whether his Department has had recent discussions with Eli Lilly on the cost of Mounjaro.

The Department has held various discussions with Eli Lilly regarding the recent list price increase of Mounjaro. NHS England has worked with Eli Lilly to ensure the list price increase will not affect National Health Service commissioning of tirzepatide in England as a treatment for eligible diabetes and obesity patients in the NHS.We remain committed to the rollout of this medicine as a weight loss treatment based on clinical priority. This will enable 220,000 eligible people to access the medication over the first three years. The initial eligibility criteria will be for people with a body mass index of 40 or more in addition to four or more qualifying comorbidities.Scotland, Wales and Northern Ireland have also entered equivalent agreements to maintain their current commissioning approaches.Pricing in the private market is a matter for Eli Lilly and for private providers. Private patients who are impacted by price increases should discuss any concerns with their private provider. This includes their options regarding payment plans, alternative treatments, and/or stopping or tapering off their current medication. Eli Lilly is working with private providers to support continued patient access.

When he plans to expand prescribing of GLP-1 medications beyond specialist weight-management services.

National Institute for Health and Care Excellence (NICE) guidance on the first two GLP-1 medicines licensed for the treatment of obesity, namely liraglutide under various brand names and semaglutide with brand name Wegovy, restricted their use to specialist weight management services. These services are primarily delivered in secondary care.NICE recommended that tirzepatide, with brand name Mounjaro, could be used for the treatment of obesity in eligible patients without a restriction on its setting. This means tirzepatide can be used in specialist weight management services but can also be prescribed in primary care by general practitioners (GPs) and other competent prescribers. From 23 June 2025, tirzepatide started to become available in primary care so the expansion beyond specialist services is underway.Integrated care boards (ICBs) are the National Health Service organisations responsible for arranging the provision of health services within their area in line with local population need and taking account of relevant guidance. ICBs have had to develop new care pathways to ensure that patients can access these medicines via their GP with appropriate wraparound support. NHS England has been working closely with ICBs to support the safe and effective roll out of tirzepatide in primary care. It has identified the groups of people to be prioritised in each phase of the initial rollout; helped develop local treatment models; provided funding support and regular communication channels to ICBs; and set up an interim, centrally funded ‘wraparound care service’, known as the ‘Healthier You: Behavioural Support for Obesity Prescribing’, for patients to be referred into, with a procurement underway for a longer-term offer.

What recent progress his Department has made on the implementation of the Oliver McGowan mandatory training on learning disability and autism across the NHS and social care workforce.

On 19 June 2025, the Department laid a Code of Practice in Parliament which sets out how providers can meet the statutory requirement for learning disability and autism training.Over three million people have completed the e-learning package, the first part of the Oliver McGowan Mandatory Training on Learning Disability and Autism (Oliver’s Training). National Health Service providers have reported that approximately 520,000 people have completed either Tier 1 or Tier 2 of Oliver’s Training. At the end of August 2025, 2,850 people have been trained to deliver Oliver’s Training and have been added to the Approved Trainer list.Data on completion of Oliver’s Training by the NHS is held locally and is reported to NHS England by the integrated care boards. This data does not differentiate between completion by frontline staff and other NHS and social care staff and is instead focussed on the overall completion of Tier 1 and Tier 2.The Department will be providing funding in autumn 2025 to support rollout of Oliver’s Training to the adult social care sector, via the same online claims service as the Learning and Development Support Scheme.

Whether the forthcoming National Cancer Plan for England will include targets to improve the timeliness of diagnosis of blood cancers.

Early diagnosis is a key focus of the National Cancer Plan. It is a priority for the Government to support the National Health Service to diagnose cancer, including blood, as early and quickly as possible, and to treat it faster, to improve outcomes.To tackle late diagnoses of blood cancers, the NHS is implementing non-specific symptom pathways for patients who present with symptoms such as weight loss and fatigue, which do not clearly align to a tumour type. Blood cancers are one of the most common cancer types diagnosed through these pathways.We will get the NHS diagnosing blood cancer earlier and treating it faster, and we will support the NHS to increase capacity to meet the demand for diagnostic services through investment, including for magnetic resonance imaging and computed tomography scanners.The National Cancer Plan will include further details on how we will improve outcomes for cancer patients, including speeding up diagnosis and treatment, ensuring patients have access to the latest treatments and technology, and ultimately drive up this country’s cancer survival rates.

What plans he has to improve early diagnosis of bowel cancer in patients under 50.

The latest available data, from 2022, showed that there were 2,648 diagnoses of bowel cancer in people under the age of 50 years old. It is a priority for the Government to support the National Health Service to diagnose cancer, including bowel cancer at all ages, as early as possible.Beginning this year, the NHS expanded its bowel cancer screening program by lowering the eligibility age to 50 years old to ensure earlier diagnosis for those at risk. NHS England also runs the Help Us Help You campaigns to increase knowledge of cancer symptom and to address barriers to acting on them, encouraging people to come forward as soon as possible to see their general practitioner. The bowel cancer campaign urged people to take up the offer of bowel screening when invited.Furthermore, an NHS testing programme is helping to diagnose thousands of people with a genetic condition, Lynch Syndrome, that increases the chance of developing certain cancers, including bowel cancer. The national programme ensures that all people diagnosed with bowel cancer are offered genomic testing, along with their relatives, to help detect any cancers early and start timely treatment as needed.The National Cancer Plan will include further details on what will be done to improve outcomes for cancer patients, as well as speeding up diagnosis and treatment, ensuring patients have access to the latest treatments and technology, including for bowel cancer patients.

What recent estimate he has made of the annual number of bowel cancer patients diagnosed under the age of 50.

The latest available data, from 2022, showed that there were 2,648 diagnoses of bowel cancer in people under the age of 50 years old. It is a priority for the Government to support the National Health Service to diagnose cancer, including bowel cancer at all ages, as early as possible.Beginning this year, the NHS expanded its bowel cancer screening program by lowering the eligibility age to 50 years old to ensure earlier diagnosis for those at risk. NHS England also runs the Help Us Help You campaigns to increase knowledge of cancer symptom and to address barriers to acting on them, encouraging people to come forward as soon as possible to see their general practitioner. The bowel cancer campaign urged people to take up the offer of bowel screening when invited.Furthermore, an NHS testing programme is helping to diagnose thousands of people with a genetic condition, Lynch Syndrome, that increases the chance of developing certain cancers, including bowel cancer. The national programme ensures that all people diagnosed with bowel cancer are offered genomic testing, along with their relatives, to help detect any cancers early and start timely treatment as needed.The National Cancer Plan will include further details on what will be done to improve outcomes for cancer patients, as well as speeding up diagnosis and treatment, ensuring patients have access to the latest treatments and technology, including for bowel cancer patients.

What assessment he has made of the potential impact of mid-year efficiency requirements as set out by NHS partners on the sustainability of hospice services.

Palliative care services are included in the list of services an integrated care board (ICB) must commission. This promotes a more consistent national approach and supports commissioners in prioritising palliative and end of life care. While no specific assessment has been made at the national level, ICBs are responsible for the commissioning of palliative and end of life care services, to meet the needs of their local populations, which includes consideration of the potential impact of any efficiency requirements on the provision of services to patients.To support ICBs in this duty, NHS England has published statutory guidance and service specifications.

What steps he plans to take to improve early diagnosis of bowel cancer through the National Cancer Plan.

Early diagnosis of cancers, including bowel cancer, is a key focus of the National Cancer Plan. We are committed to transforming diagnostic services and will support the National Health Service to increase diagnostic capacity to meet the demand for diagnostic services through investment in new capacity, including magnetic resonance imaging and computed tomography scanners.The National Cancer Plan, due to be published later this year, will build on the shifts in care set out in the 10-Year Health Plan to diagnose cancers earlier. Through the 10-Year Health Plan, we will make it easier for people to access cancer screening, diagnostic, and treatment in patients’ local areas, backed by the latest technology.The UK Bowel Cancer Screening Programme is undergoing several updates to its standards aimed at improving coverage, accessibility, and early detection. This includes updated performance thresholds, and improved accessibility of bowel cancer screening faecal immunochemical test kits for people who are blind or partially sighted.

Whether he has made an assessment of the adequacy of advertising standards for fertility clinics recruiting egg donors.

The Human Fertilisation and Embryology Authority (HFEA), the United Kingdom’s fertility sector regulator, sets out strict requirements in its Licence Conditions and Code of Practice in relation to the recruitment of donors and the information that must be given to egg donors in advance of donating at United Kingdom licensed fertility clinics. 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.The HFEA’s Code of Practice states that advertising should be designed with regard to the sensitive issues involved in recruiting donors and should follow the Advertising Standards Authority (ASA) codes. This includes that advertising or publicity aimed at recruiting gamete or embryo donors, or encouraging donation, should not refer to the possibility of financial gain or similar advantage, although it may refer to compensation permitted under relevant HFEA Directions.The ASA and HFEA issued a joint enforcement notice in 2021 to ensure fertility clinics and others are aware of the advertising rules, which remains in place.

What steps his Department is taking to help improve access to NHS dental care.

The responsibility for commissioning primary care services, including National Health Service dentistry, to meet the needs of local populations has been delegated to integrated care boards (ICBs) across England. For Warrington South constituency, this is NHS Cheshire and Merseyside ICB.We will deliver 700,000 extra urgent dental appointments per year, and ICBs have been making extra appointments available from 1 April 2025. NHS Cheshire and Merseyside ICB is expected to deliver 46,617 additional urgent dental appointments as part of the scheme.ICBs are 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 contract, with a shift to focus on prevention and the retention of NHS dentists.

What steps his Department is taking to help improve (a) awareness and (b) recognition of postural tachycardia syndrome among NHS clinicians.

To improve awareness of postural tachycardia syndrome (PoTS) among healthcare professionals, and specifically general practitioners, the Royal College of General Practitioners provides training on PoTS as part of its Syncope toolkit, which is available at the following link:https://elearning.rcgp.org.uk/course/view.php?id=500 It is the responsibility of local integrated care boards to work with clinicians, service users and patient groups to develop services and care pathways that are convenient and meet the needs of patients with PoTS.The National Institute for Health and Care Excellence has published a clinical knowledge summary on the clinical management of blackouts and syncope, providing advice for clinicians in the United Kingdom on best practice in the assessment and diagnosis of PoTS. This was last updated in November 2023 and is available at the following link:https://cks.nice.org.uk/topics/blackouts-syncope/diagnosis/assessment/

Whether his Department plans to introduce mandatory suicide prevention training for all frontline NHS staff.

There are no current plans to introduce mandatory training for NHS frontline staff on suicide prevention.On 4 April 2025, NHS England published Staying Safe from Suicide: Best Practice Guidance for Safety Assessment, Formulation and Management. This requires all mental health practitioners to align their practice to latest evidence in suicide prevention. The guidance is available at the following link: https://www.england.nhs.uk/long-read/staying-safe-from-suicide/.Pre-registration (qualifying) training for registered mental health staff is expected to contain appropriate suicide prevention training.Training for NHS staff is being developed based on the Staying Safe from Suicide Guidance in the form of an eLearning session. This will commence in September 2025 and will be available to all mental health practitioners across all sectors including the NHS, voluntary, community, social enterprises and the independent sector.

What steps his Department is taking to improve average ambulance response times for Category (a) 1 and (b) 2 incidents.

Our Urgent and Emergency Care (UEC) Delivery Plan for 2025/26 commits to reducing ambulance response times for Category 2 incidents to 30 minutes on average this year. We are also tackling unacceptable ambulance handover delays by introducing a maximum 45-minute standard, ensuring ambulances are released more quickly and get back on the road to treat patients.Backed by almost £450 million, the UEC Delivery Plan will deliver around 40 new Same Day Emergency Care and Urgent Treatment Centres – which treat and discharge patients in the same day, avoiding unnecessary admissions to hospital and in turn reducing handover delays. This is alongside upgrading hundreds of ambulances as part of the investment to improve the speed and quality of care for those most in need.We have already seen improvements in response times across the country. The latest national figures show that Category 1 incidents were responded to in an average of 7 minutes 56 seconds, and Category 2 incidents in 28 minutes 40 seconds. This is faster than 8 minutes 15 seconds and 33 minutes 24 seconds respectively in July 2024.

What assessment his Department has made of the potential impact of waiting times for gynaecology treatment on women’s health outcomes; and what steps he is taking to improve access to timely care.

The Government is committed to prioritising women’s health as we build a National Health Service fit for the future. Our focus is on turning the commitments in the Women's Health Strategy into tangible action, such as providing emergency hormonal contraception free of charge at pharmacies on the NHS from October 2025; setting out how we will eliminate cervical cancer by 2040 through the new cervical cancer plan; and taking urgent action to tackle gynaecology waiting lists through the Elective Reform Plan.As set out in the Plan for Change, we have committed to return to the NHS constitutional standard that 92% of patients, including women waiting for gynaecological care, wait no longer than 18 weeks from referral to treatment by March 2029. We provided additional investment in the Autumn Budget that has enabled us to fulfil our pledge to deliver over two million more elective care appointments early. More than double that number, 4.9 million more appointments, have now been delivered.The Elective Reform Plan, published in January, sets out the reform we will undertake to return to the 18-week standard, and to ensure patients have the best possible experience while they wait. This includes commitments to offer patients care closer to home, in the community, including piloting gynaecology pathways in community diagnostic centres for patients with unscheduled bleeding on hormone replacement therapy. We have also committed to increasing the relative funding available to support gynaecology procedures with the largest waiting lists.We know the vital role general practitioners (GPs) have to play in the Government’s mission to tackle NHS waiting lists. This is why we have expanded the Advice and Guidance scheme, investing £80 million to keep patients off the waiting list, with GPs working more closely with hospital specialists to access expert advice to make sure patients can access timely, high quality care.

What assessment he has made of the potential impact of the quality of (a) infrastructure and (b) property in NHS facilities on (i) patient safety and (ii) service delivery.

The safety of NHS staff and patients is a top priority for the Government, and we recognise that delivering high quality NHS healthcare services requires safe, sustainable, and effective infrastructure and facilities. Lord Darzi’s investigation considered the impact of NHS infrastructure, estates and capital funding on the NHS, and found that capital investment has been neglected, with the hospital estate left to crumble.Repairing and rebuilding our healthcare estate is a vital part of our ambition to create an NHS that is fit for the future through our 10-Year Health Plan. The Government’s recently published 10-Year Infrastructure Strategy set out 10-year maintenance budgets for the public estate, confirming £6 billion per year for maintenance and repair of the NHS estate up to 2034/35. Within this, the 2025 Spending Review settlement announced a total capital investment of £30 billion over five years in day-to-day maintenance and repair of the NHS estate, with over £5 billion specifically allocated to address the most critical building repairs.In 2025/26, this includes a £750 million Estates Safety Fund which will deliver vital safety improvements, enhance patient and staff environments, and reduce disruptions to NHS clinical services.

What assessment he has made of the potential impact of reintroducing private finance through public private partnerships for neighbourhood health centres on the NHS; and how those proposals differ from previous private finance initiative models.

As set out in the 10 Year Health Plan, the Department, alongside the National Infrastructure and Service Transformation Authority, is working on a business case to look at the feasibility of using a public private partnership (PPP) model for Neighbourhood Health Centres, with a decision expected in the Autumn Budget.Any new PPP models will be subject to market testing and will build on lessons learned from past government experience, models currently in use, and the March 2025 National Audit Office report, ‘Lessons Learned: private finance for infrastructure’.The Department conducted a successful preliminary market engagement exercise over summer 2025, and this is feeding into the business case.

Whether he has made an assessment of the comparative cost to the NHS of (a) hospice inpatient beds and (b) acute hospital beds for palliative care patients.

While the majority of palliative care and end of life care is provided by National Health Service staff and services, we recognise the vital part that voluntary sector organisations, including charitable hospices, also play in providing support to people at the end of life and those important to them. As charitable hospices are independent, autonomous organisations, they are free to set their own wages and some associated costs, and the Department does not hold or collect this information.

What steps he is taking to help ensure that the 10-Year Plan for Health promotes equitable access to (a) palliative and (b) end of life care.

One of the three ‘shifts’ that the 10 Year Health Plan will deliver is around the Government’s determination to shift healthcare out of hospitals and into the community, to ensure patients and their families receive personalised care in the most appropriate setting. Palliative care and end of life care services will have a big role to play in that shift and were highlighted in the plan as being an integral part of neighbourhood teams.I have tasked officials to look at how to improve the access, quality, and sustainability of all- age palliative and end of life care in line with the 10 Year Health Plan.Officials will present further proposals to ministers over the coming months, outlining the drivers and incentives that are required in palliative care and end of life care to enable the shift from hospital to community, including as part of neighbourhood health teams.To support integrated care boards (ICBs) in the commissioning of palliative care and end of life care services, NHS England has published statutory guidance and service specifications. The guidance makes specific reference to commissioners defining how their services will meet population needs 24/7 and includes a priority action for ensuring that staff, patients, and carers can access the care and advice they need, whatever time of day.National Institute for Health and Care Excellence (NICE) guidance on the service delivery of end of life care for adults also includes recommendations about 24/7 access to care. Although NICE guidance is not mandatory, there is an expectation that commissioners and service providers take the guidelines into account when making decisions about how to best meet the needs of their local communities.The Government and the National Health Service will closely monitor the shift towards the strategic commissioning of palliative care and end of life care services to help ensure that services remove variation in access and quality, although some variation may be appropriate to reflect both innovation and the needs of local populations.

Whether he plans to introduce a 24/7 single point of access for palliative and end of life care (a) advice, (b) guidance and (c) support, following the publication of the 10-Year Plan for Health.

One of the three ‘shifts’ that the 10 Year Health Plan will deliver is around the Government’s determination to shift healthcare out of hospitals and into the community, to ensure patients and their families receive personalised care in the most appropriate setting. Palliative care and end of life care services will have a big role to play in that shift and were highlighted in the plan as being an integral part of neighbourhood teams.I have tasked officials to look at how to improve the access, quality, and sustainability of all- age palliative and end of life care in line with the 10 Year Health Plan.Officials will present further proposals to ministers over the coming months, outlining the drivers and incentives that are required in palliative care and end of life care to enable the shift from hospital to community, including as part of neighbourhood health teams.To support integrated care boards (ICBs) in the commissioning of palliative care and end of life care services, NHS England has published statutory guidance and service specifications. The guidance makes specific reference to commissioners defining how their services will meet population needs 24/7 and includes a priority action for ensuring that staff, patients, and carers can access the care and advice they need, whatever time of day.National Institute for Health and Care Excellence (NICE) guidance on the service delivery of end of life care for adults also includes recommendations about 24/7 access to care. Although NICE guidance is not mandatory, there is an expectation that commissioners and service providers take the guidelines into account when making decisions about how to best meet the needs of their local communities.The Government and the National Health Service will closely monitor the shift towards the strategic commissioning of palliative care and end of life care services to help ensure that services remove variation in access and quality, although some variation may be appropriate to reflect both innovation and the needs of local populations.

What steps he is taking to provide funding certainty to hospices beyond this financial year, in the context of the 10-year plan for palliative and end-of-life care.

One of the three ‘shifts’ that the 10 Year Health Plan will deliver is around the Government’s determination to shift healthcare out of hospitals and into the community, to ensure patients and their families receive personalised care in the most appropriate setting. Palliative care and end of life care services will have a big role to play in that shift and were highlighted in the plan as being an integral part of neighbourhood teams.I have tasked officials to look at how to improve the access, quality, and sustainability of all- age palliative and end of life care in line with the 10 Year Health Plan.Officials will present further proposals to ministers over the coming months, outlining the drivers and incentives that are required in palliative care and end of life care to enable the shift from hospital to community, including as part of neighbourhood health teams.To support integrated care boards (ICBs) in the commissioning of palliative care and end of life care services, NHS England has published statutory guidance and service specifications. The guidance makes specific reference to commissioners defining how their services will meet population needs 24/7 and includes a priority action for ensuring that staff, patients, and carers can access the care and advice they need, whatever time of day.National Institute for Health and Care Excellence (NICE) guidance on the service delivery of end of life care for adults also includes recommendations about 24/7 access to care. Although NICE guidance is not mandatory, there is an expectation that commissioners and service providers take the guidelines into account when making decisions about how to best meet the needs of their local communities.The Government and the National Health Service will closely monitor the shift towards the strategic commissioning of palliative care and end of life care services to help ensure that services remove variation in access and quality, although some variation may be appropriate to reflect both innovation and the needs of local populations.