Written questions by Farron.

Pursuant to the Answer of 10 May 2023 to Question 183643 on Public Health, what methodologies were used to estimate the costs to the NHS for each of the five risk factors specified.

The applicable methodologies for the National Health Service cost attributed to each of the risk factors outlined are explained in the following reports.The estimated air pollution related costs to the NHS can be found in the Public Health England report ‘Estimation of costs to the NHS and social care due to the health impacts of air pollution: summary report’ , from 2018, which is available at the following link:https://www.gov.uk/government/publications/air-pollution-a-tool-to-estimate-healthcare-costsAn estimate of the NHS and healthcare costs of alcohol from 2021/22, produced by the Institute of Alcohol Studies, can be found at the following link:https://www.ias.org.uk/factsheet/economy/Estimated obesity related costs to the NHS can be found in the Frontier Economics report for NESTA, published in July 2025, ‘The Economic and Productivity Costs of Obesity and Overweight in the UK’, which is available at the following link:https://media.nesta.org.uk/documents/The_economic_and_productivity_costs_of_obesity_and_overweight_in_the_UK_.pdfEstimated Hypertension related costs to the NHS can be found in the Optimity Matrix Cost-effectiveness review of blood pressure interventions, ‘A Report to the Blood Pressure System Leadership Board’, published November 2014, available at the following link:https://cleanair.london/app/uploads/vdocuments.site_cost-effectiveness-review-of-blood-pressure-cost-effectiveness-review-of-blood.pdfThe most recent estimated smoking related costs to the NHS can be found in the press release, ‘New figures show cost of smoking to society in England dwarfs tobacco tax revenue’. This is available at the following link:https://ash.org.uk/media-centre/news/press-releases/new-figures-show-cost-of-smoking-to-society-in-england-dwarfs-tobacco-tax-revenue

How many attributable deaths there were from fine particulate matter, PM2.5, were there in (a) East Midlands, (b) East of England, (c) Greater London, (d) North East, (e) North West, (f) South East, (g) South West, (h) West Midlands, (i) Yorkshire and the Humber, and (j) England in each year since 2018 using COMEAP's latest methodology.

The number of deaths attributable to fine particulate air pollution (PM2.5) is not annually calculated for each region. The current estimate of attributable deaths in the United Kingdom for 2019 was 29,000 to 43,000 deaths for adults aged 30 years old and over.The fraction of mortality attributable to particulate air pollution is annually calculated for each region and represents the percentage of annual deaths from all causes in those aged 30 years old and over, attributed to PM2.5. This indicator is calculated using the Committee on the Medical Effects of Air Pollutants’ updated concentration-response-function, and figures for the years 2018 to 2023 are available at the following link:https://fingertips.phe.org.uk/profile/public-health-outcomes-framework/data#page/4/gid/1000043/pat/15/par/E92000001/ati/6/are/E12000004/iid/93861/age/230/sex/4/cat/-1/ctp/-1/yrr/1/cid/4/tbm/1/page-options/ovw-do-0_car-do-0Estimates for 2024 will be available later in 2026.

When he will update the Health and Technical Memorandum 03-01 for the latest technical standards.

Published guidance on ventilation in healthcare settings includes the Health Technical Memorandum 03-01: Specialised ventilation for healthcare premises. It gives comprehensive advice and guidance on the legal requirements, design implications, maintenance, and operation of specialised ventilation in healthcare premises providing acute care. Further information is available at the following link:https://www.england.nhs.uk/publication/specialised-ventilation-for-healthcare-buildings/NHS England will update Health Technical Memorandums, including HTM 03-01, when necessary.

If he will make an assessment of the potential implications for his policies of the press notice by the Royal College of Physician of 13 November 2025, which called for a UK-wide public health campaign on air pollution.

Clean air is a key part of our shift from ‘sickness to prevention’ as per the 10-Year Health Plan for England, which sets out action to further improve the quality of the air we breathe.Alongside the 10-Year Health Plan, the Department for Environment, Food and Rural Affairs’ Environmental Improvement Plan, published in December 2025, outlines commitments to improve the communication of air quality information.Government action is being informed by the recommendations from the Air Quality Information System review report published in 2025, which specifically considered ways to increase public awareness about air pollution.We will continue to work closely with the Department for Environment, Food and Rural Affairs to reduce the health harms of air pollution and to help make air quality part of everyday conversations.

How much did (a) Health Education England and (b) NHS England pay Hill Dickinson in (i) costs and (ii) fees for legal services between 2012 and 2023.

As a parent organisation, including commissioning support units but excluding integrated care boards, NHS England has spent approximately £8 million including VAT with Hill Dickinson between 2012/13 and 2022/23. Approximately 90% of these costs were spent on legal or professional fees.Please note that this figure includes the NHS Trust Development Authority and Monitor, which merged to become NHS Improvement in 2016, as well as the two months of NHS Digital following its merger with NHS England from 1 February 2023.Health Education England, which was merged into NHS England on 1 April 2023, spent £5.2 million with Hill Dickinson between 2012/13 and 2022/23. We do not hold a breakdown of this spend.

If he will publish the annual figures for payments made to each of NHS Resolution's panel law firms since the current legal framework came into effect in March 2022; and, in each case, what proportion of these payments were attributable to (a) medical negligence claims and (b) other claims.

NHS Resolution (NHSR) manages clinical negligence and other claims against the National Health Service in England. The information to the question requested is not published by NHSR on its website. NHSR does publish annual statistics, however, which are available at the following link:https://resolution.nhs.uk/resources/annual-statistics/The second table in the document attached also shows the total spend for NHSR on NHS legal costs.NHSR has also responded to individual enquiries under Freedom of Information for payments made to panel law firms, which can be found on its website at the following link:https://resolution.nhs.uk/?s=FOI+Panel+firm+costs

Whether he has had recent discussions with the Chancellor of the Exchequer on (a) the potential cost-effectiveness of expanding access to radiotherapy treatment and (b) other funding relating to radiotherapy cancer treatments.

There have not been any recent discussions relating to the cost-effectiveness and funding of radiotherapy. However, the Government remains committed to supporting the use of radiotherapy as a crucial cancer treatment. We have already invested £70 million in replacing outdated radiotherapy machines across the National Health Service with new, cutting-edge technology that will speed up treatment for thousands of patients.Additionally, the Government will also continue to support the NHS to deliver a wide range of cancer treatment services, as we work towards our aim of diagnosing and treating cancer more quickly.

Whether his Department has made an estimate of the number of cancer patients who will require radiotherapy as part of their treatment in each year to 2035.

The number of patients diagnosed with and receiving treatment for cancer is increasing. We expect that these numbers will continue to rise, and consequently that more patients will require radiotherapy as part of their treatment.The most recently available data shows that between 2021/22 and 2022/23 the number of attendances of patients attending hospital to receive radiotherapy treatment increased from 1,532,846 to 1,635,373, an increase of 6.7%.

Whether his Department has made an assessment of (a) international approaches to national cancer plans and (b) previous UK cancer plans, in the context of his planned national cancer plan.

As part of development for the National Cancer Plan, the Department has engaged with international counterparts to consider their approaches to national cancer strategies. This includes engagement with Denmark to discuss the lessons learned from their cancer plans.The Department has also considered previous UK cancer plans and submissions to the previous 10 Year Cancer Plan and Major Conditions Strategy call for evidence to inform the development of the upcoming National Cancer Plan.

What steps he has taken to train more GPs in Cumbria.

The Government has committed to training thousands more general practitioners (GPs) and has increased the number of available GP training places by an additional 250 from September 2025. This brings the total number of GP training places to 4,250 per year.As of 31 August 2025, there were 89.8 full-time equivalent GPs in training grades working in practices in Cumberland and Westmorland and Furness.We will publish a refreshed Long Term Workforce Plan to deliver the transformed health service we will build over the next decade, to treat patients on time again.The 2018 to 2020 medical school expansion created new medical schools in regions where doctors were hard to recruit and where inequalities were high, and focussed on where there were medical specialty shortages, which includes GPs and psychiatry.Current and future expansions to post-graduate training, including foundation training and GP specialty training, have been planned on the basis of relative need, balanced with the ability of locations to support trainees.

What steps his Department has taken to deliver 50 new neighbourhood health centres by the end of this Parliament; and whether any will be built in Cumbria.

The Government is committed to delivering a National Health Service that is fit for the future, and we recognise that delivering high quality NHS healthcare requires the right infrastructure in the right places.That is why over the course of our 10-Year Health Plan, we aim to establish a Neighbourhood Health Centre in every community, transforming healthcare access by bringing historically hospital-based services into communities and addressing wider determinants of health through services like debt advice, employment support, and obesity management programmes.Nationwide coverage will take time, but we are starting in the areas of greatest need where healthy life expectancy is lowest, including rural towns and communities with higher deprivation levels, using public capital to update and refurbish existing, under-used buildings.We recently announced the places that will form wave 1 of the National Neighbourhood Health Implementation Programme (NNHIP), after a rigorous assessment of applications against the core criteria. The first wave of the NNHIP covers 43 sites across England, from Cornwall and the Isles of Scilly in the south-west to Sunderland in the north-east, ensuring that communities nationwide benefit from this new model of care.

What steps he is taking to help reduce travel times for cancer patients in rural areas requiring radiotherapy treatment.

We recognise that for those in rural communities, the particular treatment they need may not be available at their local hospital, which would mean that travel to a specialist centre or specialist centres would be required, in order to receive the best care possible. The Government aims to ensure that each radiotherapy treatment centre is accessible to the highest number of patients possible, as well as being easily reached by the staff who work there.The National Health Service runs schemes to provide financial assistance for travel to a hospital, or other NHS premises, for specialist NHS treatment or diagnostics tests, when referred by a doctor or other primary healthcare professional.This includes the NHS Healthcare Travel Costs Scheme, which provides financial assistance to patients who do not have a medical need for transport, but who require assistance with the costs of travelling to receive certain NHS services.

Pursuant to the Answer of 13 October 2025 to Question 77309 on Cancer, when the Cancer Operational Taskforce was established; what its remit is; who the members of the Taskforce are; and who it reports to.

The Department does not hold the information requested as the Cancer Operational Taskforce is a local initiative.The National Cancer Plan will include further details on how the National Health Service will improve care for cancer patients in all parts of England. Having consulted with key stakeholders and patient groups, the plan will be published early in the new year.

If he will provide additional funding for social care services to help support patients to (a) leave hospitals and (b) be treated at home.

The Government is committed to ensuring that people can leave hospital promptly and receive care in their own homes where appropriate.For 2025/26 approximately £9 billion has been made available through the Better Care Fund (BCF) to enable integrated care boards and local authorities to deliver better joined-up care. One of the objectives of the BCF is to support the shift of services from hospital to home.From 2026/27, the BCF will be reformed to provide consistent joint funding for services that are essential for integrated health and social care, including rehabilitation and recovery support.

Care if he will bring forward proposals for reducing hospital waiting lists in Cumbria.

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 across all regions, including Cumbria. Work to reduce waiting lists in Cumbria is already underway, with the National Health Service implementing the Elective Reform Plan to increase capacity and improve patient access as quickly as possible. The region of Cumbria is covered by two integrated care boards (ICBs). The NHS Lancashire and South Cumbria ICB is reducing waiting times in the Cumbria region through a dedicated programme on referral and demand management. It is also transforming care pathways to ensure patients receive high-quality treatment in the most appropriate setting, prioritising community and neighbourhood care to reduce hospital pressures. The NHS North East and North Cumbria ICB is also implementing a range of demand management strategies to reduce waiting lists in Cumbria. These include redesigning outpatient pathways with community-based services, virtual clinics, straight-to-test models, and focusing on one-stop clinics. It is also prioritising workforce training to improve referral quality, and meeting regularly with the trust to monitor progress towards meeting the constitutional standard. As of August 2025, 18-week Referral-to-Treatment performance for the NHS Lancashire and South Cumbria ICB was 60.7% and for the NHS North East And North Cumbria ICB was 70.2%.

If his Department will allocate funding to ensure that every patient at the Royal Preston Hospital who requires radiotherapy treatment is able to access it.

Decisions about funding for radiotherapy treatment are taken at a local National Health Service level, rather than by the Department, and there are no plans to change this.All cancer patients have access to radiotherapy treatment. Decisions about cancer treatment are typically made by clinicians and multidisciplinary teams of healthcare professionals.

Whether he plans to allocate additional funding to radiotherapy treatment in the North West of England.

Decisions about funding for radiotherapy treatment are taken at a local National Health Service level, rather than by the Department, and there are no plans to change this.All cancer patients have access to radiotherapy treatment. Decisions about cancer treatment are typically made by clinicians and multidisciplinary teams of healthcare professionals.

What assessment he has made of the adequacy of the state of repair of the Royal Lancaster Infirmary.

As part of the management of their estate, National Health Service trusts regularly assess the physical condition of their estate. NHS England’s annual Estates Returns Information Collection collects data from trusts on the quality of their estate annually, including the projected cost of bringing all the buildings on each NHS site into acceptable condition, recorded as backlog maintenance. The latest published data on backlog maintenance, for 2024/25, is available at the following link:https://digital.nhs.uk/data-and-information/publications/statistical/estates-returns-information-collection/summary-page-and-dataset-for-eric-2024-25Hospitals in the New Hospital Programme, including the Royal Lancaster Infirmary, continue to receive support for maintenance and repairs. In addition to operational capital, the University Hospitals of Morecambe Bay NHS Foundation Trust has been provided with £3.3 million from the 2025/26 Estates Safety Fund for works at the Royal Lancaster Infirmary.

If he will take steps to reduce ward work in portacabins at the Royal Lancaster Infirmary.

National Health Service trusts make decisions locally on their use of temporary facilities, in line with delivering clinical services.Any temporary facility must meet the same Health Building Notice and Health Technical Memorandum safety, environmental, fire, clinical, and other standards as a permanent healthcare building.

What his Department’s budget is for funding the Royal Preston Hospital and Royal Lancaster Infirmary in 2026-27.

The New Hospital Programme: plan for implementation was published on 20 January 2025 and sets out a credible, deliverable plan for the schemes in the New Hospital Programme (NHP). This plan will be delivered through five-year waves of investment and is backed by up to £15 billion over each consecutive five-year wave, averaging £3 billion a year from 2030. Further information on the plan for implementation is available at the following link: https://www.gov.uk/government/publications/new-hospital-programme-review-outcome As wave 3 schemes, the Royal Lancaster Infirmary and the Royal Preston Hospital have been paused. No further funding will be available from the NHP until pre-construction activity begins from 2030. The NHP is committed to ensuring both schemes are fully resourced when this time comes. The standard process for confirming the total funding amount for major infrastructure projects involves the review and approval of a Full Business Case. All trusts in the programme have previously received indicative funding allocations to support planning, however these are commercially sensitive. An equality impact assessment was carried out for the review into the NHP and included assessing the extent to which service users might be impacted by these delivery proposals, with specific reference to the impact that these might have on relevant protected characteristics. This was laid in the House Library and published on 20 January 2025, and is available at the following link: https://www.gov.uk/government/publications/new-hospital-programme-review-outcome/new-hospital-programme-equality-impact-assessment