Written questions by Morton.

What steps the UK Health Security Agency is taking through Strategic Commissioning Group to support Birmingham City Council in tackling the public health risks associated with household waste.

The UK Health Security Agency (UKHSA) has issued standard public health guidance to Birmingham City Council regarding the risks associated with household waste, with the aim of minimising the potential health impacts on residents. This guidance is available on the Birmingham City Council website, at the following link:https://www.birmingham.gov.uk/info/20009/waste_and_recycling/3020/waste_and_recycling_industrial_action_-_faq_for_residents/6The UKHSA is an active member of the multi-agency Strategic Coordinating Group and has contributed to the risk assessment concerning the potential health effects of uncollected waste. The UKHSA will continue providing expert advice and support to Birmingham City Council for as long as necessary.In addition, the UKHSA is closely monitoring infection rates, including leptospirosis, which could be influenced by the accumulation of refuse. As of now, there has been no reported increase in leptospirosis cases among Birmingham residents since the industrial action began.The Department for Environment, Food and Rural Affairs and the Environment Agency have published statutory guidance on the Waste Duty of Care: Code of Practice, which is available at the following link:https://www.gov.uk/government/publications/waste-duty-of-care-code-of-practice/waste-duty-of-care-code-of-practice

With reference to the Spending Review 2025, CP 1336, published on 11 June 2025, whether he considered increasing revenue funding for end of life care as part of the Spending Review.

As part of the Spending Review, on 11 June, my Rt. Hon. Friend, the Chancellor of the Exchequer announced a record investment in the health and social care system. Across the Spending Review period, from 2026/27 to 2028/29, the National Health Service in England will receive a 3% real terms growth in day-to-day spending, the equivalent to a £29 billion real terms increase in annual resource budgets.At this stage, it is still too early to say how much funding will be allocated to palliative care and end of life care, as this will be worked through in the coming weeks.The Government wants a society where every person receives high-quality, compassionate care from diagnosis through to the end of life, which is why we are 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 are also providing £26 million of revenue funding for children and young people’s hospices for 2025/26.We are also working to make sure the palliative care and end of life care sector is sustainable in the long term and are determined to shift more healthcare out of hospitals and into the community through our 10-Year Health Plan.

If he will make an assessment of the number of older people with unmet health and care needs in Aldridge-Brownhills constituency.

Direct estimates of unmet health and care need at a local level are not available. Assessing unmet health and care need is complex, particularly as it is multi-faceted, and validated data is not always available at a constituency level. For national level insights, please see Age UK’s State of Health and Care of Older People in England 2024 report, which is available at the following link:https://www.ageuk.org.uk/discover/2024/september/state-of-health-and-care-of-older-people-in-england-2024/We have launched a 10-Year Health Plan to which will set out a long-term vision to reform the National Health Service and make it fit for the future. Addressing healthcare inequity is a core focus of the 10-Year Health Plan, to ensure the NHS is there for anyone who needs it, whenever they need it.

What steps he is taking to ensure the UK’s health security against (a) malaria, (b) tuberculosis and (c) HIV/AIDS.

The UK Health Security Agency (UKHSA) holds data on all malaria cases diagnosed in the United Kingdom by the Malaria Reference Laboratory (MRL) and Public Health Scotland. The MRL’s extensive service to users in the UK includes: malaria diagnosis; epidemiological data; prophylaxis advice to health professionals; and technical advice on methodology and laboratory procedures. Almost all malaria cases diagnosed in the UK are associated with recent travel to an endemic area, and the UKHSA is working with the African Diaspora Malaria Initiative to reduce the burden of malaria in particularly affected groups. Where cases are identified as having no recent travel history, a full investigation is undertaken by the UKHSA. A standard approach to managing these cases is under development.Information regarding malaria cases diagnosed in the UK is published on GOV.UK website, with annual reports and statistics on malaria imported to the UK available, respectively, at the following two links:https://www.gov.uk/government/publications/malaria-in-the-uk-annual-reporthttps://www.gov.uk/government/publications/imported-malaria-in-the-uk-statisticsThe UKHSA and NHS England’s joint tuberculosis (TB) action plan for England details actions to achieve a 90% reduction in people with TB by 2035, aligned with World Health Organization elimination targets. The plan is available at the following link:https://www.gov.uk/government/publications/tuberculosis-tb-action-plan-for-england/tuberculosis-tb-action-plan-for-england-2021-to-2026#priority-2-prevent-tb.The UK pre-entry TB screening programme operates in 102 countries, to reduce the importation of TB by screening applicants for long term visas from high TB incidence countries. People are screened in line with the UK Tuberculosis Technical Instructions, which are available at the following link:https://assets.publishing.service.gov.uk/media/5cd18ae5e5274a34ee7f0275/UK_tuberculosis_technical_instructions_version_7.pdfActive TB can be prevented by identifying, testing, and treating people with TB infection. People who are close contacts of individuals with infectious TB are also tested for infection, so they can be treated before the disease develops.The NHS England national latent TB testing programme for migrants from high incidence countries operates in 27 of the 42 integrated care board areas in England.In March 2025, NHS England and The Royal National Orthopaedic Hospital published a Getting it Right First Time review of TB services, which included a series of recommendations to reduce unwarranted variation in clinical practice and improve care, especially to underserved populations. The report is available at the following link:https://www.england.nhs.uk/wp-content/uploads/2025/03/girft-review-of-tuberculosis-national-report.pdfThe UKHSA, in collaboration with key stakeholders, is leading work to develop a new national action plan for 2026 to 2031, including a call for evidence.The Government is committed to ending new transmissions of HIV in England by 2030. The Department, the UKHSA, NHS England, and partners are developing the new HIV Action Plan for England, which we aim to publish this year.

What preparations he is making for the potential impact of conflict abroad on the NHS.

The Department of Health and Social Care works closely with NHS England and the Ministry of Defence to understand the impacts of international conflict on domestic healthcare delivery. This includes exercising existing plans such as the Reception Arrangements for Ministry of Defence Patients, which supports the return of injured personnel for treatment by the National Health Service. We also actively monitor the wider impacts of conflicts including emerging threats to medical supply resilience. We work in partnership with industry and the wider health system to support robust planning to mitigate these risks. The Department of Health and Social Care has established processes in place to manage disruption to the NHS.The Department also provides medical aid to conflict-affected areas to reduce the impact of humanitarian crises in the region and beyond. For example, in 2023 the Department assisted with coordinating aid for displaced civilians in Gaza. Essential supplies included 76,800 surplus trauma kits, 1,350 water filters, and 2,560 solar lights.

What assessment he has made of the potential impact of repatriating patients with antimicrobial resistance from conflict zones on (a) UK citizens and (b) the NHS.

The Department recognises conflict as a major driver of antimicrobial resistance (AMR), posing significant risks to populations in fragile and conflict-affected states, the wider global community, and the United Kingdom. In response, the Department of Health and Social Care is working closely with the Foreign, Commonwealth and Development Office to raise global awareness and understanding of this growing threat. The Government does not routinely repatriate patients from conflict zones, and where these have taken place, it has been under exceptional circumstances, or at the individual's expense to reduce avoidable burdens on UK taxpayers.Evidence indicates that inward migration from countries with a high prevalence of AMR is likely contributing to the rising AMR burden in the UK, which includes the risk of multidrug-resistant (MDR) tuberculosis (TB). To address this risk, there is a UK pre-entry screening programme for migrants coming for more than six months from countries with high incidence of TB. This will include countries with high incidence of MDR disease. Further information on the evidence is available at the following link:https://pmc.ncbi.nlm.nih.gov/articles/PMC6032478/The UK Health Security Agency does not currently undertake routine surveillance of AMR specifically in patients repatriated from conflict zones, but remains committed to strengthening surveillance of drug-resistant infections more broadly regardless of source, to ensure early detection and to enable a rapid response to emerging threatsThe National Health Service is a residency-based system, which means that people who do not live here on a lawful, settled basis must contribute to the cost of their care. However, some of the most vulnerable people arriving in the UK, including refugees and some asylum seekers, do not pay for NHS treatment.

Whether he has made an assessment of the potential impact of (a) fly-tipping and (b) uncollected rubbish on public health.

The UK Health Security Agency (UKHSA) has not made an assessment of the potential impact of fly-tipping and uncollected rubbish on public health.During specific incidents, for instance with the Birmingham City Council, the UKHSA has provided standard guidance to the local authority on the public health risk associated with household waste. The UKHSA is also part of a multi-agency response Strategic Commissioning Group (SCG), and has contributed to a risk assessment concerning the potential health impacts of uncollected waste. The UKHSA will continue to provide advice and support to Birmingham City Council, as part of this SCG.The Department for Environment Food and Rural Affairs and the Environment Agency produce the Statutory guidance for Waste duty of care: code of practice, which is available at the following link:https://www.gov.uk/government/publications/waste-duty-of-care-code-of-practice/waste-duty-of-care-code-of-practiceGuidance for waste planning policy is published by the Ministry of Housing, Communities and Local Government, and is available at the following link:https://www.gov.uk/guidance/waste

What assessment he has made of the potential impact of the upcoming increase to employers National Insurance contributions on hospices.

We have taken necessary decisions to fix the foundations in the public finances at the Autumn Budget, enabling the Spending Review settlement of a £22.6 billion increase in resource spending for the Department from 2023/24 outturn to 2025/26.The employer National Insurance contribution rise will be implemented in April 2025, and planning guidance published on 30 January 2025 sets out the funding available to integrated care boards, and the overall approach to funding providers in the next financial year. It takes into account a variety of pay and non-pay factors and pressures on providers of secondary healthcare, including charitable hospices. Further information on the planning guidance is available at the following link: https://www.england.nhs.uk/publication/2025-26-priorities-and-operational-planning-guidance/ We are supporting the hospice sector with a £100 million capital funding boost for adult and children’s hospices in England, to ensure they have the best physical environment for care. We are pleased to confirm that the Government has released the first £25 million tranche of that funding, with Hospice UK kindly allocating and distributing the money to hospices throughout England. An additional £75 million will be available from April 2025.We are also providing £26 million of revenue funding to support children and young people’s hospices for 2025/26.

What steps his Department is taking to ensure that hospice care services across England are sufficiently funded; and what assessment he has made of the potential impact of an ageing population on demand for palliative care services.

Whilst the majority of palliative and end of life care is provided by National Health Service staff and services, we recognise the vital part that voluntary sector organisations, including hospices, also play in providing support to people at end of life and their loved ones.Most hospices are charitable, independent organisations which receive some statutory funding for providing NHS services. The amount of funding each charitable hospice receives varies both within and between integrated care board (ICB) areas. This will vary depending on demand in that ICB area but will also be dependent on the totality and type of palliative and end of life care provision from both NHS and non-NHS services, including charitable hospices, within each ICB area.We are pleased to confirm that the Government has released the first £25 million tranche of the £100 million capital funding, with Hospice UK kindly allocating and distributing the money to hospices throughout England. An additional £75 million will be available from April. We are also providing £26 million revenue funding to support children and young people’s hospices for 2025/26. This is a continuation of the funding which until recently was known as the children and young people’s hospice grant.No formal assessment has been made of the potential impact of an ageing population on demand for palliative care services, but we know that currently approximately 600,000 people die per year in the United Kingdom. We are aware that the Office for National Statistics has projected that, by 2040, approximately 800,000 people a year will die in the UK, meaning that, the number of people needing palliative and end of life care is expected to increase by 42% by then.

What assessment he has made of the (a) financial and (b) social impact of hospices on the (i) health and (ii) social care sectors.

Whilst the majority of palliative and end of life care is provided by National Health Service staff and services, we recognise the vital part that voluntary sector organisations, including hospices, also play in providing support to people at the end of life, and their loved ones.Palliative and end of life care are broad, holistic approaches, provided through a range of professionals and providers, and generalists and specialists across the NHS, social care, and voluntary sector organisations, including hospices. Therefore, the financial and social impacts of hospices on the broader health and care sectors are difficult to measure because the relevant consultations and tasks are not always coded as palliative or end of life care.We are supporting the hospice sector with a £100 million capital funding boost for adult and children’s hospices, to ensure they have the best physical environment for care, and £26 million of revenue funding to support children and young people’s hospices. We will set out the details of the funding allocation and dissemination in the coming weeks.I am meeting with the major hospice and palliative and end of life care stakeholders early in February 2025 to discuss potential solutions on longer-term sector sustainability.

Pursuant to the Answer of 20 November 2024 to Question 13775 on Hospices: Children, what his timescale is for announcing funding arrangements for the Children's Hospice Grant for 2025/26.

We are aware that clarity on the 2025/26 funding arrangements is needed to help children’s hospices, as they confirm their budgets. I have met NHS England, Together for Short Lives, and one of the co-chairs of the All-Party Parliamentary Group for Children Who Need Palliative Care, Lord Balfe, and discussed these issues at length.The Department is working to confirm funding arrangements as a matter of urgency.