Written questions by Morello.

What recent assessment he has made of the (a) availability and (b) accessibility of NHS ear wax removal services in West Dorset constituency.

Integrated care boards (ICBs) have a statutory responsibility to commission cost-effective healthcare to meet the needs of their local population. This includes the arrangement of services for ear wax removal.Across the West Dorset area, the NHS Dorset ICB is responsible for commissioning ear wax removal services in line with the recommendations for ear wax removal as set out in guidance produced by the National Institute for Health and Care Excellence (NICE), which is available at the following link:https://www.nice.org.uk/guidance/ng98/chapter/RecommendationsManual ear syringing is no longer advised by the NICE due to the risks associated with it, such as trauma to their ear drum or infection, so general practitioners (GPs) will often recommend home treatment remedies to alleviate ear wax build-up.However, in line with the NICE’s guidance, a person may require ear wax removal treatment if the build-up of earwax is linked with hearing loss. A GP could then consider referring the patient into audiology services, which ICBs are responsible for commissioning.When ICBs exercise their functions, including commissioning healthcare services such as ear wax removal, they have a duty to reduce inequalities between people with respect to their ability to access health services, and to reduce inequalities between patients with respect to the outcomes achieved for them by the provision of health services.

Whether his Department plans to review the allocation of funding to Integrated Care Boards to address regional disparities in GP availability.

NHS England is responsible for funding allocations to integrated care boards. This process is independent of the Government, and NHS England takes advice on the underlying formula from the independent Advisory Committee on Resource Allocation.We are investing an additional £889 million through the GP Contract to reinforce the front door of the National Health Service, bringing total spend on the GP Contract to £13.2 billion in 2025/26. This is the biggest increase in over a decade, and we are pleased that the General Practitioners Committee England is supportive of the contract changes.

What recent estimate his Department has made of the levels of respiratory diseases in West Dorset constituency.

In the West Dorset area, which includes the Sherborne, Mid Dorset, and Jurassic primary care networks, there are 8,617 patients with asthma, and 2,490 patients with chronic obstructive pulmonary disease (COPD). A systematic review published in 2021 highlighted the global variation in the diagnosis of pulmonary fibrosis, and it is estimated that NHS Dorset could have between five and 25 people who suffer from pulmonary fibrosis.The Dorset Respiratory Network has made significant progress in improving care for people with asthma, COPD, and other respiratory conditions, over the last few years. With Respiratory Champions now supporting 15 of the 18 primary care networks, local expertise has been strengthened, ensuring better access to care. A key focus has been enhancing diagnosis and management, which includes the increased use of fractional exhaled nitric oxide testing and a targeted drive to reduce over-reliance on short-acting reliever inhalers. These efforts have led to better outcomes for patients and a reduction in unnecessary hospital visits.Local pulmonary rehabilitation (PR) teams have expanded their reach, delivering more PR classes across a wider range of locations in Dorset. This is helping more people manage their condition effectively, improve their quality of life, and reduce hospitalisation risks. Alongside this, an online platform has been launched, providing healthcare professionals with resources, training, and updates, ensuring the latest guidance is easily accessible. A new quarterly newsletter keeps clinicians informed of National Health Service updates, best practice, and innovations in respiratory care.As part of the Reducing Hospital Admissions and Enhancing Care initiatives, targeted projects have employed a review of medication use to ensure the most effective treatments are available. There is also work on improving diagnosis rates through better access to essential tests and exploring digital solutions to help people manage their conditions at home.Smoking cessation is one of the most effective ways to reduce respiratory disease and improve long-term health. In the first three quarters of 2024/25, over 6,000 people in Dorset quit smoking through support from the Council's smoking cessation programmes, the National Swap to Stop initiative and the NHS Treating Tobacco Dependency offer.By expanding innovation, improving accessibility, and strengthening collaboration across healthcare teams, the Dorset Respiratory Network is delivering tangible improvements in respiratory health. Their work is helping people across the county breathe easier, stay healthier, and reduce their reliance on hospital care, ensuring better outcomes for patients and a more sustainable NHS for the future.

What steps he is taking to help reduce the incidence of respiratory diseases in West Dorset constituency.

In the West Dorset area, which includes the Sherborne, Mid Dorset, and Jurassic primary care networks, there are 8,617 patients with asthma, and 2,490 patients with chronic obstructive pulmonary disease (COPD). A systematic review published in 2021 highlighted the global variation in the diagnosis of pulmonary fibrosis, and it is estimated that NHS Dorset could have between five and 25 people who suffer from pulmonary fibrosis.The Dorset Respiratory Network has made significant progress in improving care for people with asthma, COPD, and other respiratory conditions, over the last few years. With Respiratory Champions now supporting 15 of the 18 primary care networks, local expertise has been strengthened, ensuring better access to care. A key focus has been enhancing diagnosis and management, which includes the increased use of fractional exhaled nitric oxide testing and a targeted drive to reduce over-reliance on short-acting reliever inhalers. These efforts have led to better outcomes for patients and a reduction in unnecessary hospital visits.Local pulmonary rehabilitation (PR) teams have expanded their reach, delivering more PR classes across a wider range of locations in Dorset. This is helping more people manage their condition effectively, improve their quality of life, and reduce hospitalisation risks. Alongside this, an online platform has been launched, providing healthcare professionals with resources, training, and updates, ensuring the latest guidance is easily accessible. A new quarterly newsletter keeps clinicians informed of National Health Service updates, best practice, and innovations in respiratory care.As part of the Reducing Hospital Admissions and Enhancing Care initiatives, targeted projects have employed a review of medication use to ensure the most effective treatments are available. There is also work on improving diagnosis rates through better access to essential tests and exploring digital solutions to help people manage their conditions at home.Smoking cessation is one of the most effective ways to reduce respiratory disease and improve long-term health. In the first three quarters of 2024/25, over 6,000 people in Dorset quit smoking through support from the Council's smoking cessation programmes, the National Swap to Stop initiative and the NHS Treating Tobacco Dependency offer.By expanding innovation, improving accessibility, and strengthening collaboration across healthcare teams, the Dorset Respiratory Network is delivering tangible improvements in respiratory health. Their work is helping people across the county breathe easier, stay healthier, and reduce their reliance on hospital care, ensuring better outcomes for patients and a more sustainable NHS for the future.

What assessment his Department has made of the potential impact of Integrated Care Board funding levels on GP recruitment and retention in West Dorset constituency.

General practitioner (GP) retention initiatives are funded though System Development Funds within Primary Care Transformation budgets at an integrated care board (ICB) level. This year, within the NHS Dorset ICB, that funding has supported:a fellowship programme offered across all staff groups, with most successful candidates being from within the GP staff group and with one applicant being from West Dorset;a coaching and mentoring programme, with 14 GPs having signed up;Lantum, a locum platform used across Dorset; andfunding for the General Practice Alliance to represent the voice of GPs and to carry out initiatives that support the sustainability of GPs in Dorset.This year, the NHS Dorset ICB also received a one-off funding grant for health and wellbeing within GPs from NHS England. This funding is being used to pilot an Employee Assistance Programme, recruit a Social Prescriber fellow to support international medical graduates, and provide health and wellbeing training. An NHS Dorset and Dorset GP Education Centre taskforce to increase GP training placements has identified West Dorset as an opportunity for growth.

What steps his Department is taking to ensure that Integrated Care Boards receive adequate funding to improve access to GP services in rural areas.

NHS England is responsible for funding allocations to integrated care boards (ICBs). In allocating budgets, it has two aims: equal opportunity of access for equal need, and reducing health inequalities. This process is independent of government, and NHS England takes advice on the underlying formula from the independent Advisory Committee on Resource Allocation.General practices receive ‘global sum’ funding for providing core services, comprising approximately 50-60% of practice income. The global sum is a capitated payment calculated based on the size of a practice’s registered list of patients, weighted using the Carr-Hill formula. Through the Carr-Hill formula, payments to practices are adjusted in consideration of several factors, including geographical location of a practice. This includes accounting for the additional costs of delivering services in rural areas, and in areas where staff costs are higher.Although practices receive most of their funding through the contract, after contract payments have been made, ICBs can also use remaining funds from their primary care allocation as discretionary spend for general practice. ICBs can also opt to use their wider funding outside of their primary care allocation to invest in general practice services. This can be directed to best address local need, as determined by the ICB.

What (a) guidance and (b) support his Department has made available to healthcare professionals on the management of patients impacted by pancreatic enzyme replacement therapy medications shortages.

The Department is continuing to engage with all suppliers of pancreatic enzyme replacement therapy (PERT) to boost production to mitigate the supply issue. Through this work we have managed to secure additional volumes of PERT for 2025. The Department has also reached out to specialist importers who have sourced unlicensed stock to assist in covering the remaining gap in the market. In December 2024, the Department issued further management advice to healthcare professionals. This directs clinicians to consider these unlicensed imports when licensed stock is unavailable and includes actions for integrated care boards to ensure local mitigation plans are put in place and implemented. The Department, in collaboration with NHS England, has created a webpage to include the latest update on PERT availability and easily accessible advice on the prescribing and ordering of alternative PERT products.We expect normal supply to resume in 2026 but will remain focused on pushing manufacturers to shorten this timeline. The Department also has frequent conversations with representatives from the impacted patient groups so that they are informed on the supply situation and the mitigation actions being taken.

What discussions his Department has had with pharmaceutical manufacturers on resolving supply chain issues with pancreatic enzyme replacement therapy medications; and what his planned timetable is for the restoration of normal supply levels.

The Department is continuing to engage with all suppliers of pancreatic enzyme replacement therapy (PERT) to boost production to mitigate the supply issue. Through this work we have managed to secure additional volumes of PERT for 2025. The Department has also reached out to specialist importers who have sourced unlicensed stock to assist in covering the remaining gap in the market. In December 2024, the Department issued further management advice to healthcare professionals. This directs clinicians to consider these unlicensed imports when licensed stock is unavailable and includes actions for integrated care boards to ensure local mitigation plans are put in place and implemented. The Department, in collaboration with NHS England, has created a webpage to include the latest update on PERT availability and easily accessible advice on the prescribing and ordering of alternative PERT products.We expect normal supply to resume in 2026 but will remain focused on pushing manufacturers to shorten this timeline. The Department also has frequent conversations with representatives from the impacted patient groups so that they are informed on the supply situation and the mitigation actions being taken.

If he will take steps to ensure a continuous supply of pancreatic enzyme replacement therapy medications.

The Department is continuing to engage with all suppliers of pancreatic enzyme replacement therapy (PERT) to boost production to mitigate the supply issue. Through this work we have managed to secure additional volumes of PERT for 2025. The Department has also reached out to specialist importers who have sourced unlicensed stock to assist in covering the remaining gap in the market. In December 2024, the Department issued further management advice to healthcare professionals. This directs clinicians to consider these unlicensed imports when licensed stock is unavailable and includes actions for integrated care boards to ensure local mitigation plans are put in place and implemented. The Department, in collaboration with NHS England, has created a webpage to include the latest update on PERT availability and easily accessible advice on the prescribing and ordering of alternative PERT products.We expect normal supply to resume in 2026 but will remain focused on pushing manufacturers to shorten this timeline. The Department also has frequent conversations with representatives from the impacted patient groups so that they are informed on the supply situation and the mitigation actions being taken.

What assessment his Department has made of the potential impact of shortages of pancreatic enzyme replacement therapy medications on patients.

The Department is continuing to engage with all suppliers of pancreatic enzyme replacement therapy (PERT) to boost production to mitigate the supply issue. Through this work we have managed to secure additional volumes of PERT for 2025. The Department has also reached out to specialist importers who have sourced unlicensed stock to assist in covering the remaining gap in the market. In December 2024, the Department issued further management advice to healthcare professionals. This directs clinicians to consider these unlicensed imports when licensed stock is unavailable and includes actions for integrated care boards to ensure local mitigation plans are put in place and implemented. The Department, in collaboration with NHS England, has created a webpage to include the latest update on PERT availability and easily accessible advice on the prescribing and ordering of alternative PERT products.We expect normal supply to resume in 2026 but will remain focused on pushing manufacturers to shorten this timeline. The Department also has frequent conversations with representatives from the impacted patient groups so that they are informed on the supply situation and the mitigation actions being taken.

If he will make an assessment of the level of availability of funding for newly qualified midwives at Dorset County Hospital NHS Foundation Trust.

Decisions on the level of funding available for hiring newly qualified midwives is a matter for individual National Health Service trusts. Trusts manage their recruitment at a local level to ensure they have the right number of staff in place, with the right skill mix, to deliver safe and effective care.While we have no plans to make a specific assessment of Dorset County Hospital NHS Foundation Trust, we are committed to recruiting the staff the NHS needs across all parts of the country to get patients seen on time. In summer 2025, we will publish a refreshed Long Term Workforce Plan to ensure the NHS has the right people, in the right places, with the right skills to deliver the care patients need when they need it.

What steps his Department is taking to ensure that newly qualified midwives in Dorset can secure employment at local NHS trusts upon completing their training.

Decisions about the employment of newly qualified midwives is a matter for individual National Health Service trusts, including in Dorset. Trusts manage their recruitment at a local level to ensure they have the right number of staff in place, with the right skill mix, to deliver safe and effective care.In summer 2025, we will publish a refreshed Long Term Workforce Plan to ensure the NHS has the right people, in the right places, with the right skills to deliver the care patients need when they need it.

What assessment his Department has made of the average cost to student midwives of (a) unpaid clinical placement hours and (b) student loan debt; and whether he has made a recent assessment of the potential merits of providing additional financial support to student midwives.

No such assessment has been made. Students undertaking pre-registration midwifery courses can access support from Student Finance England (SFE). This includes payment for tuition fees, a partially means-tested loan for living costs and, where applicable, other grants, such as for childcare.The Government has announced that the maximum loans and grants for living and other costs from SFE will increase by forecast inflation, by 3.1% for the 2025/26 academic year, based on the RPIX inflation index.In addition to support provided by SFE, eligible midwifery students receive a non-repayable grant of £5,000 per year via the NHS Learning Support Fund. Further financial support is also available for childcare, dual accommodation costs, and travel.Funding arrangements are reviewed annually ahead of the start of each academic year.

What recent estimate his Department has made of the number of NHS dentists accepting new patients in West Dorset constituency.

As of 4 February 2025, in the West Dorset constituency, there were 15 National Health Service dentist practices, with two showing as ‘accepting new child patients when availability allows’ and two showing as ‘accepting new adult patients when availability allows’.This data is sourced from the Find a Dentist website and is matched to constituencies based on the postcode data shown on the website, which is available at the following link:https://www.nhs.uk/service-search/find-a-dentist

What assessment his Department has made of the availability of speech and language therapy services in rural areas.

It is the responsibility of integrated care boards to make available appropriate provision to meet the health and care needs of their local population, including speech and language therapy services in rural areas.

What recent steps his Department has taken to reduce waiting times for an endometriosis diagnosis.

The Government is committed to prioritising women’s health and improving the diagnosis times for gynaecological conditions, including endometriosis.We have taken urgent action to tackle gynaecology waiting lists through the Elective Reform Plan. In gynaecology, the plan supports innovative models offering patients care closer to home, and piloting gynaecology pathways in community diagnostic centres.Endometriosis is also included in the core curriculum for general practitioners, and for obstetricians and gynaecologists. The General Medical Council is introducing the Medical Licensing Assessment for most incoming doctors, including all medical students graduating from academic year 2024/25 and onwards. Within this assessment are several topics relating to women’s health, including endometriosis. This will encourage a better understanding of endometriosis among doctors as they start their careers in the United Kingdom.Clinical guidelines support healthcare professionals to diagnose and treat conditions. In November 2024 the National Institute for Health and Care Excellence published updated recommendations on the diagnosis, management and treatment of endometriosis, which are available at the following link:https://www.nice.org.uk/guidance/ng73

What steps his Department is taking to increase the number of NHS orthodontist appointments available in West Dorset constituency.

The responsibility for commissioning specialised orthodontic services is delegated to the integrated care boards (ICBs) across England. For the West Dorset constituency, this is the NHS Dorset ICB. In order to support the ICBs in the execution of their duties, NHS England has published a number of documents, including a clinical policy to support the commissioning of orthodontic activity, which is available at the following link: https://www.england.nhs.uk/publication/clinical-standards-for-dental-specialties-orthodontics/ More widely, the Government plans to tackle the challenges for patients trying to access National Health Service dental care with a rescue plan to provide 700,000 more urgent dental appointments and recruit new dentists to the areas that need them most. 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 NHS dentists.

What steps he is taking to increase the number of children attending NHS dental services in West Dorset constituency.

The Government plans to tackle the challenges for patients trying to access National Health Service dental care with a rescue plan to provide 700,000 more urgent dental appointments and recruit new dentists to areas that need them most. The most common reason children aged five to nine are admitted to hospital is for tooth decay. We will work with local authorities and the NHS to introduce supervised tooth brushing for children aged between three and five years old in the most deprived communities. These programmes are proven to reduce tooth decay and to boost good practices at home.The responsibility for commissioning primary care services, including NHS dentistry, to meet the needs of the local population has been delegated to integrated care boards (ICBs) across England. For West Dorset constituency, this is Dorset ICB.

What steps he is taking to improve adult attendance at NHS dental services in West Dorset constituency.

The Government plans to tackle the challenges for patients trying to access National Health Service dental care with a rescue plan to provide 700,000 more urgent dental appointments and recruit new dentists to the areas that need them most. To rebuild dentistry in the long term and increase access to NHS dental care, we will reform the dental contract, with a shift to focus on prevention and the retention of NHS dentists.The responsibility for commissioning primary care services, including NHS dentistry, to meet the needs of the local population has been delegated to the integrated care boards (ICBs) across England. For the West Dorset constituency, this is the NHS Dorset ICB.

What assessment his Department has made of the causes of reductions in the percentage of adults attending NHS dental appointments in West Dorset constituency.

The Government plans to tackle the challenges for patients trying to access National Health Service dental care with a rescue plan to provide 700,000 more urgent dental appointments and recruit new dentists to the areas that need them most. To rebuild dentistry in the long term and increase access to NHS dental care, we will reform the dental contract, with a shift to focus on prevention and the retention of NHS dentists.The responsibility for commissioning primary care services, including NHS dentistry, to meet the needs of the local population has been delegated to the integrated care boards (ICBs) across England. For the West Dorset constituency, this is the NHS Dorset ICB.