Written questions by Barclay.

What steps the Department is taking to help raise public and clinical awareness of the BEST4 Screening trial and to support eligible patients to participate in capsule sponge testing for early detection of Barrett’s oesophagus.

The Department funds research and research infrastructure through the National Institute for Health and Care Research (NIHR). The NIHR is funding the BEST4 trial with over £3 million funding contributed through the NIHR Health Technology Assessment Programme and a further £3 million funding from Cancer Research UK. This includes funding for the research team to engage with the patient community.The study is also supported by NIHR Research Delivery Network (RDN) portfolio adoption to enable the recruitment of eligible participants and support research delivery. The NIHR RDN is raising awareness of the trial and supporting eligible patients to participate through National Health Service Research text messaging, providing secure mobile screening vans and engaging clinicians to connect them with the study.Additionally, recruitment for the BEST4 trial is being supported by Be Part of Research, a free service that allows people across the UK to find and sign up to research relevant to them. The NIHR has also supported the trial with proactive communications, including a news item on 08/04/2025.

Whether he was made aware of conclusion 1 in the Sixty-second Report of the Committee of Public Accounts entitled Faulty energy efficiency installations, HC 1229, prior to the decision to appoint a new Permanent Secretary in his Department.

The Ministry of Defence Permanent Secretary was appointed following an external competition and approval from the Prime Minister.The Department for Energy Security and Net Zero will respond to the Public Accounts Committee report (HC 1229) in the usual way.

With reference to the establishment of the Jean Bishop Centre in Hull in 2018, whether his Department has conducted a cost–benefit analysis of a more integrated model of service for elderly patients.

Our 10-Year Health Plan sets out our vision for a Neighbourhood Health Service, delivering truly integrated, proactive, and personalised care closer to where people live and work. There are substantial benefits to this more integrated approach to health and adult social care. Please see the 10-Year Health Plan Impact Assessment for further information, which is available at the following link:https://www.gov.uk/government/publications/impact-statement-10-year-health-plan-for-englandThe Department is committed to this approach, recognising that an immediate priority for the National Health Service in developing Neighbourhood Health Services is to support individuals with complex needs, especially older people, those living with frailty, and those at the end of life. We expect neighbourhood teams and services to be designed in a way that reflects the specific needs of local populations, including services for elderly people.

With reference to his Department's letter to the Rt hon. Member for North East Cambridgeshire, reference: PQW/24-25/2025/16500/16507/16511/16512/16514/16521, dated 20 August 2025, and the oral contribution of the Minister for the Armed Force during the Second Reading of the Armed Forces Bill on 26 January 2026, Official Report, column 706, how much was the total reserve spending for each of the last five years, including the main categories of spending beyond pay and and bounty payments; and if he will set out the expected total reserve spending for the remaining years of this Parliament.

The Government has committed to spending 2.6% of GDP on defence from 2027, and we have set the ambition to reach 3% in the next Parliament, subject to economic and fiscal conditions. Over this Spending Review period, this Government will invest over £270 billion in cash terms in defence. This is the largest sustained increase in spending since the Cold War. The Strategic Defence Review outlined an ambition to increase the number of Active Reserves by 20% when funding allows, enhancing surge capacity and demonstrating the UK's readiness to defend itself. Total spending on Reserve Forces between 2023-24 and 2024-25 is not managed centrally, with each Service determining expenditure based on its specific operational requirements. In relation to spending plans in 2025-26, we do not routinely place figures relating to planned expenditure in the public domain as they are subject to change.

If he will make an assessment of the compatibility of (a) comments made in the SDSR on funding for a 20 per cent increase the reserves with (b) comments made by the Parliamentary Under-Secretary of State at col.705 in Hansard volume 779 on 26 January 2026 on funding for the reserves.

I am grateful for the contribution of our Reserve Forces, who help the UK Armed Forces meet the threats we face at home and abroad, with the scale, skills, agility and connection to society that we need in a cost‑effective way. The diversity of knowledge, skills and experience that Reserves bring from their civilian and military careers is an invaluable strength. The Strategic Defence Review set out a clear mandate to strengthen the UK’s Reserve Forces as an integral part of the Whole Force. Building on this, the Government is taking decisive action through the Armed Forces Bill to strengthen the UK’s Strategic Reserve – former Service personnel with an ex‑Regular and Recall Reserve liability – ensuring Defence can draw on their valuable skills and experience in times of crisis. The Bill introduces measures that will strengthen readiness and resilience, including changes to recall liability across the Regular and Volunteer Reserves. These measures will increase the maximum age for recall, align recall liability across all three Services, and provide greater flexibility to recall personnel for warlike preparations, in addition to circumstances of national danger or emergency. Alongside these legislative measures, Defence has increased funding for the Reserve Forces, reflecting their growing importance to our national security and our commitment to ensuring they can be used more effectively. Taken together, these reforms will re‑energise our connection with the Strategic Reserve, increase the Active Reserve, and ensure Defence can rapidly mobilise a broad pool of experienced personnel with critical skills – including in cyber, intelligence, medicine and communications – during periods of heightened threat or transition to war. This approach complements our highly capable Volunteer Reserves and aligns with the steps many NATO allies are taking to strengthen their own resilience.

What assessment has been made of the potential implications for his polices of the change in the number of available hospice beds in England over the last 12 months.

No formal assessment has been made of the potential implications for the Department’s policies of the change in the number of available hospice beds in England over the last 12 months.However, we do recognise the difficult and challenging financial situation that many hospices are facing due to a range of concurrent cost pressures and that, as a result, some hospices have had to reduce the services they offer and the number of inpatient beds.We have been supporting the hospice sector with a £100 million capital funding boost for eligible adult and children’s hospices in England to ensure they have the best physical environment for care. We can now confirm we are providing a further £25 million in capital funding for hospices to spend in 2025/26.We also recently announced that we are providing approximately £80 million of revenue funding for children and young people’s hospices in England over the next three financial years, from 2026/27 to 2028/29, giving them stability to plan ahead and focus on what matters most, caring for their patients.The Government is developing a Palliative Care and End-of-Life Care Modern Service Framework (MSF) for England. As part of the MSF, we will consider contracting and commissioning arrangements. We recognise that there is currently a mix of contracting models in the hospice sector. By supporting integrated care boards to commission more strategically, we can move away from grant and block contract models. In the long term, this will aid sustainability and help hospices’ ability to plan ahead.

How much his Department has spent on the reserves in 2024-25 and 2023-24, broken down by RDEL, CDEL and TDEL; and how much it plans to spend in 2025-26, broken down by RDEL, CDEL and TDEL.

The Government has committed to spending 2.6% of GDP on defence from 2027, and we have set the ambition to reach 3% in the next Parliament, subject to economic and fiscal conditions. Over this Spending Review period, this Government will invest over £270 billion in cash terms in defence. This is the largest sustained increase in spending since the Cold War. The Strategic Defence Review outlined an ambition to increase the number of Active Reserves by 20% when funding allows, enhancing surge capacity and demonstrating the UK's readiness to defend itself. Total spending on Reserve Forces between 2023-24 and 2024-25 is not managed centrally, with each Service determining expenditure based on its specific operational requirements. In relation to spending plans in 2025-26, we do not routinely place figures relating to planned expenditure in the public domain as they are subject to change.

What estimate she has made of the cost of the £1,000 tax free allowance for (a) trading and (b) property income in each of the last three years for which figures are available.

The tax-free allowances simplify the tax system and keep low levels of casual income out of taxation. Individuals with trading income or property income at £1,000 or below are not required to report the income and the use of allowances to HMRC through Self Assessment (SA). As a result, HMRC cannot provide a total estimate on the number of people using the allowances and the cost of the allowances.More information on the tax free allowances can be found at:Tax-free allowances on property and trading income - GOV.UK”

What estimate she has made of the number of people using the £1,000 tax free allowance for (a) trading and (b) property income in each of the last three years for which figures are available.

The tax-free allowances simplify the tax system and keep low levels of casual income out of taxation. Individuals with trading income or property income at £1,000 or below are not required to report the income and the use of allowances to HMRC through Self Assessment (SA). As a result, HMRC cannot provide a total estimate on the number of people using the allowances and the cost of the allowances.More information on the tax free allowances can be found at:Tax-free allowances on property and trading income - GOV.UK”

What estimate he has made of non-government spending by (a) individuals, (b) companies and (c) charities on preventative health services in the most recent year for which figures are available.

Non-Government spending on preventative health care is estimated in the UK Health Accounts published by the Office for National Statistics, on a United Kingdom basis. The following table shows the preventive healthcare spending by method of financing for the UK, for 2023, based on the current prices and not adjusted for inflation:Financing method2023Out-of-pocket spending£3,046,000,000Company spending£476,000,000Health insurance, individual and corporate, spending£352,000,000Charity spending£157,000,000Source: UK Health Accounts, Office for National StatisticsNotes:information relating to the breakdown of insurance claims and revenues for non-Government healthcare providers is typically less granular than Government spending. Preventive spending is reported where it is possible to distinguish services within available datasets, so could represent an underestimate;company financed healthcare mostly concerns occupational healthcare services;preventive spending financed through health insurance and out-of-pocket spending largely relates to preventive dental care, for instance dental check-ups;the estimates concern services that are provided by charities for free, or below market rates, to consumers. It does not include services that are sold by charities at market rates, nor those commissioned by and paid for by the Government; andcharity spending relates to a variety of services, the largest being education and health promotion programmes operated by charities.Estimates do not exactly match the three categories requested, as health insurance spending is from a mixture of individual and corporate policies.

Food and Rural Affairs, what plans the Government has to introduce a replacement for the UK Fruit and Vegetable Aid Scheme to ensure continued investment in UK horticulture and maintain competitiveness with European growers.

Future support for the horticulture sector is being considered alongside Defra’s work to simplify and rationalise agricultural grant funding, ensuring that grants deliver the most benefit for food security and taxpayer value. Our new Farming and Food Partnership Board, bringing together industry and government leaders, will also develop tailored growth plans for sectors including horticulture. We are already doing a great deal to support the sector. Of at least £200 million allocated to The Farming Innovation Programme (FIP) through to 2030, to date nearly £40 million—representing 26% of total awards—has been granted to research projects benefiting the sector offering targeted opportunities for fruit and vegetable businesses to become more profitable, resilient, and sustainable. Further opportunities for farmer and grower led trials to test ideas and solutions are also now available in FIP via ADOPT grants. Wider Government support includes: our five-year extension to the Seasonal Worker visa route, providing much needed stability and certainty to businesses; as well as extending the easement on import checks on medium risk fruit and vegetables ahead of the new SPS agreement deal with the EU.

If she will provide a list of all transport schemes given approval to progress following the Spending Review which had a lower benefit cost ratio score than the Ely Area Rail Capacity Enhancement.

The Ely Area Capacity Enhancement (EACE) scheme was paused by the previous government in 2021, and no further funding was allocated to develop, update, or progress the EACE business case. As a result, there has been no ongoing work from which to produce a current or up-to-date benefit–cost ratio, meaning there is no basis upon which to provide the comparisons requested.

What is being done to improve the regulatory approval process for personalised medicines to treat cancer.

The Medicines and Healthcare products Regulatory Agency (MHRA) has completed a public consultation on its draft guideline on individualised mRNA cancer immunotherapies, a new type of personalised cancer treatment. These technologies use cutting-edge science such as artificial intelligence to design a medicine tailored to each patient’s unique tumour profile.We received positive responses from across the life sciences community, the National Health Service, patient groups, academics, and international regulators. Feedback recognised the United Kingdom’s leadership in this area, while calling for greater clarity in some aspects of the guideline.In response, we will refine the guideline to ensure regulatory expectations are clearly articulated, without hampering innovation. This will facilitate faster access to these promising new therapies, while upholding our standards of safety, quality, and efficacy. The final version of the guideline will be published in the coming months, with future updates anticipated as the regulatory experience evolves in this rapidly developing field.

How many community diagnostic centres were open at the end of (a) 2022-23, (b) 2023-24, (c) 2024-25, and are expected to be at the end of (d) 2025-26.

The following table sets out the number of community diagnostic centres (CDCs) which had started delivering activity, namely having gone live, and which were fully operational, delivering all modalities proposed in their approved business cases, from permanent facilities, from 2022/23 to 2024/25:Financial year endNumber of CDCs delivering CDC activity.Fully operational (delivering all planned tests from permanent facilities and location)2022/23104102023/24163542024/251701012025/26 (including planned numbers)170128 (current number based on delivery reporting November 2025) 154 (expected year end point based on latest delivery plans)Source: NHS EnglandNotes:The table includes CDCs operating from temporary capacity while the permanent CDC build is completed.For 2025/26, the numbers include CDC sites which are anticipated to be fully operational by the end of March 2026 based on current delivery plans.The Elective Reform Plan sets out that the Government will deliver additional CDC capacity in 2025/26 by expanding several existing CDCs and building up to five new CDCs. The locations of both new and expanded CDC schemes will be confirmed in due course. This is funded as part of £600 million of capital investment for diagnostics in 2025/26, which my rt. Hon. Friend, the Chancellor of the Exchequer, set out in her June 2025 statement.The plan also commits to opening more CDCs 12 hours per day, seven days a week, meaning patients can access vital diagnostic tests around busy working lives. Upon entering office in July 2024, 63 CDCs were offering at least one diagnostic service out of hours, available to patients 12 hours a day, seven days a week.The latest position at the end of November 2025 is that 101 CDCs are offering at least one service to this standard, an increase of 38 from July 2024. By the end of March 2026, this number is currently planned to increase to 116.

How many patients have received checks under the NHS Targeted Lung Health Check and NHS Lung Cancer Screening Programme per month in each of the last three years.

The National Health Service is currently rolling out the National Lung Cancer Screening Programme to people with a history of smoking. The following table shows the number of participants who attended an appointment through the NHS Lung Cancer Screening Programme each month, between April 2022 and September 2025: 2022202320242025JanuaryNA244313819049260FebruaryNA271933838143158MarchNA278623569041974April11565208393619538596May14773211634023142980June15630274694021447289July17391296464765848012August17499286904088442756September17921297384685551898October194772636747881Data not availableNovember222922548247888Data not availableDecember181932818740828Data not availableAnnual Total/Annual Total to Date154741317067500895405923Source: the NHS England Lung Cancer Screening Programme.

What has his department identified as the drivers of the recent trend in specialised commissioning high cost devices as noted in the NHS England Financial performance update of 22 September 2025.

The most significant driver of the growth in the expenditure noted in the financial update is an increased volume in clinical activity and the use of implantable devices to treat patients. This has been driven by the overall growth in elective activity as part of the elective care recovery programme.

What the annual NHS total workforce growth (a) was annually from 2022/23 onwards and (b) is projected to be over the next three years.

NHS England publishes monthly Hospital and Community Health Services (HCHS) workforce statistics for England. These include staff employed by hospital trusts and integrated care boards but excludes staff working for other providers such as in primary care or social care. This data is drawn from the Electronic Staff Record, the human resources system for the National Health Service, and is available at the following link: https://digital.nhs.uk/data-and-information/publications/statistical/nhs-workforce-statistics The most recent published workforce data can be found within the July 2025, which includes selected preliminary statistics for August 2025, section of the publication, within the file Preliminary - NHS HCHS Workforce Statistics, Trusts and core organisations – data tables, August 2025. Within this file, a time series of the total full time equivalent (FTE) and headcount staffing levels for NHS trusts and organisations across England can be found in worksheet 1.In the new year, we will publish a 10 Year Workforce plan, which will ensure the NHS has the right people in the right places, with the right skills to care for patients, when they need it.

What estimate his Department has made of the costs of the Employment Rights Bill to the NHS.

No estimate of costs has been made of the Employment Rights Bill to the National Health Service. NHS terms and conditions of service currently provide employees with entitlements above the statutory minimum requirements, reflecting the sector’s commitment to supporting its workforce and maintaining high standards of employment practice.The changes to the Employment Rights Bill are designed to enhance protections for employees, proving greater job security and clarity around employment terms. The Government’s commitment to deliver reforms to improve working conditions and promote fair treatment in the workplace is set out by the Plan to Make Work Pay. Good, well paid work will mean a healthier and happier workforce which in turn eases pressure on the NHS..

What the projected slippage is against efficiency plans across integrated care systems in the current financial year.

For 2025/26, there is an efficiency and savings target of approximately £11,076 million across all integrated care systems. At month six, the projected delivery for the year remains all but on track against the total efficiency and savings target, with a forecasted shortfall of £5.7 million. The table below sets out the efficiencies and savings delivered by systems since 2022: 2022/232023/242024/25Efficiencies and savings delivered by systems (£bn)5.07.38.7

What current unbudgeted pressures his Department is aware of within its spending plans.

The 2025 Spending Review was published on 11 June by HM Treasury and sets out departmental budgets for day‑to‑day spending until 2028/29, and until 2029/30 for capital investment. The 2025 Spending Review is available at the following link: https://www.gov.uk/government/publications/spending-review-2025-document The Department is now underway with a financial planning exercise to allocate budgets within those financial years. Spending plans will be set out in the Main Supply Estimates when published in due course by HM Treasury.