Written questions by Morello.

What steps his Department is taking to help ensure that people diagnosed with secondary breast cancer have timely access to (a) new and (b) innovative treatments in West Dorset constituency.

Improving early diagnosis, access to treatments, and support across England are key priorities for the Government for all cancer types, including for those living with secondary breast cancer in West Dorset and rural constituencies.To ensure that people diagnosed with secondary breast cancer have timely access to new and innovative treatments, NHS England commissioned a National Audit of Metastatic Breast Cancer, which provides timely evidence for cancer service providers of where patterns of care in England may vary. The purpose of the audit was to identify information to increase the consistency of access to treatments and help stimulate improvements in cancer treatment and outcomes for patients. The National Health Service is now acting on those findings, including for patients in West Dorset.NHS England is responsible for funding allocations to integrated care boards (ICBs), including those in Dorset and rural constituencies. This process is independent of Government, and NHS England takes advice on the underlying formula from the independent Advisory Committee on Resource Allocation. ICB’s are responsible for commissioning healthcare which best meets the needs of their local populations, including treatment and support for secondary breast cancer.To improve early diagnosis rates all over the country, including in West Dorset and rural areas, the Department and NHS England are improving public awareness of cancer signs and symptoms, streamlining referral routes, and increasing the availability of diagnostic capacity through the roll-out of more community diagnostic centres. The Department is also committed to improving waiting times for cancer treatment, so that people with cancer, including secondary breast cancer, can get access to the care they need more quickly. The NHS is now delivering an extra 40,000 operations, scans, and appointments each week, as the first step to ensuring early diagnosis and faster treatment.

What recent discussions he has had with NHS Trusts on improving access to helipads for emergency air ambulance services.

No such discussions have been held. Air ambulances form a vital part of the emergency response to patients in critical need. The Department of Health and Social Care continues to work closely with NHS England and the Department for Transport to ensure that there is appropriate helipad accessibility available for air ambulances across the country.

Whether his Department plans to allocate additional funding to Integrated Care Boards to help improve (a) support and (b) treatment for people living with secondary breast cancer in (i) Dorset and (ii) rural constituencies.

Improving early diagnosis, access to treatments, and support across England are key priorities for the Government for all cancer types, including for those living with secondary breast cancer in West Dorset and rural constituencies.To ensure that people diagnosed with secondary breast cancer have timely access to new and innovative treatments, NHS England commissioned a National Audit of Metastatic Breast Cancer, which provides timely evidence for cancer service providers of where patterns of care in England may vary. The purpose of the audit was to identify information to increase the consistency of access to treatments and help stimulate improvements in cancer treatment and outcomes for patients. The National Health Service is now acting on those findings, including for patients in West Dorset.NHS England is responsible for funding allocations to integrated care boards (ICBs), including those in Dorset and rural constituencies. This process is independent of Government, and NHS England takes advice on the underlying formula from the independent Advisory Committee on Resource Allocation. ICB’s are responsible for commissioning healthcare which best meets the needs of their local populations, including treatment and support for secondary breast cancer.To improve early diagnosis rates all over the country, including in West Dorset and rural areas, the Department and NHS England are improving public awareness of cancer signs and symptoms, streamlining referral routes, and increasing the availability of diagnostic capacity through the roll-out of more community diagnostic centres. The Department is also committed to improving waiting times for cancer treatment, so that people with cancer, including secondary breast cancer, can get access to the care they need more quickly. The NHS is now delivering an extra 40,000 operations, scans, and appointments each week, as the first step to ensuring early diagnosis and faster treatment.

Whether research has been (a) commissioned and (b) supported by his Department on the potential impact of exposure to Debendox during pregnancy.

The Department, through the National Institute for Health and Care Research, is not currently funding research into the potential impact of exposure to Debendox during pregnancy.

What assessment his Department has made of the potential impact of the introduction of car parking charges on (a) access to outdoor walking spaces and (b) public health.

Car parking charges for publicly-owned car parks are primarily a matter for local authorities. Local actions can encourage sustainable travel choices and reduce car dependency, potentially enhancing air quality and promoting active lifestyles, and local authorities are responsible for assessing the impacts of their policies.The Government recognises the importance of providing access to the outdoors for people’s health and wellbeing, and has committed to creating nine new national river walks and three new national forests in England, expanding access to the great outdoors.

What steps his Department is taking to improve early diagnosis and treatment options for people with secondary breast cancer in rural areas such as West Dorset.

Improving early diagnosis, access to treatments, and support across England are key priorities for the Government for all cancer types, including for those living with secondary breast cancer in West Dorset and rural constituencies.To ensure that people diagnosed with secondary breast cancer have timely access to new and innovative treatments, NHS England commissioned a National Audit of Metastatic Breast Cancer, which provides timely evidence for cancer service providers of where patterns of care in England may vary. The purpose of the audit was to identify information to increase the consistency of access to treatments and help stimulate improvements in cancer treatment and outcomes for patients. The National Health Service is now acting on those findings, including for patients in West Dorset.NHS England is responsible for funding allocations to integrated care boards (ICBs), including those in Dorset and rural constituencies. This process is independent of Government, and NHS England takes advice on the underlying formula from the independent Advisory Committee on Resource Allocation. ICB’s are responsible for commissioning healthcare which best meets the needs of their local populations, including treatment and support for secondary breast cancer.To improve early diagnosis rates all over the country, including in West Dorset and rural areas, the Department and NHS England are improving public awareness of cancer signs and symptoms, streamlining referral routes, and increasing the availability of diagnostic capacity through the roll-out of more community diagnostic centres. The Department is also committed to improving waiting times for cancer treatment, so that people with cancer, including secondary breast cancer, can get access to the care they need more quickly. The NHS is now delivering an extra 40,000 operations, scans, and appointments each week, as the first step to ensuring early diagnosis and faster treatment.

Whether his Department has made an assessment of the potential impact of helipad accessibility on patient outcomes in air ambulance transfers.

No such discussions have been held. Air ambulances form a vital part of the emergency response to patients in critical need. The Department of Health and Social Care continues to work closely with NHS England and the Department for Transport to ensure that there is appropriate helipad accessibility available for air ambulances across the country.

If he will make an assessment of the potential merits of bringing forward legislative proposals to protect the use of the title Child Psychotherapist.

Titles can only be protected for statutorily regulated professions. The title of ’child psychotherapist’ is not currently protected in law in the United Kingdom and the Government has no plans to regulate child psychotherapists. No discussions have taken place with charities on protecting the title of ‘child psychotherapist’.

Whether he has had discussions with charities on the potential merits of protecting the title Child Psychotherapist.

Titles can only be protected for statutorily regulated professions. The title of ’child psychotherapist’ is not currently protected in law in the United Kingdom and the Government has no plans to regulate child psychotherapists. No discussions have taken place with charities on protecting the title of ‘child psychotherapist’.

What assessment his Department has made of the potential impact of the potential loss of (a) the Global Surgery Network and (b) other National Institute for Health and Care Research funded global health research networks on the UK’s role in international health research.

The Department of Health and Social Care funds high quality applied global health research through the National Institute for Health and Care Research (NIHR) and in collaboration with UK and international funders. This funding is supported by the UK’s Official Development Assistance (ODA) budget. In February 2025, the Prime Minister made the announcement to reduce ODA to the equivalent of 0.3% of Gross National Income (GNI) by 2027. Following this announcement, and the outcome of the 2025 Spending Review, the Department has taken the decision to focus new ODA research funding on global health security and particular diseases of poverty. The NIHR-funded Global Health Research Unit on Global Surgery was originally awarded over £6.9 million in Global Health Research’s inaugural Units call in 2017 and, following a second NIHR funding competition, received a further award of £7 million in 2021 to establish a sustainable network of surgical research. This latest award is due to conclude in June 2026, and we have been clear that we will honour all ongoing research commitments. No assessment has been made yet regarding the potential impact of the potential loss of the Global Surgery Network and other NIHR funded global health research networks on the UK’s role in international health research. The Department continues to recognise the critical importance of global health research to drive the health and well-being of the poorest and most vulnerable. Any updates on our funding opportunities will be reflected on the NIHR website.

What assessment his Department has made of the scope of responsibilities for the revised physician associate role.

The principle question of the Leng Review was to assess whether the roles of physician assistants and physician assistants in anaesthesia, still legally known as anaesthesia associates and physician associates, are safe and effective. The review’s findings were clear that, with changes in line with its recommendations, there remains a place for these roles to continue as supportive, complementary members of medical teams. The Government has accepted all 18 of the review’s recommendations.NHS England has published a letter and a Frequently Asked Questions document, setting out what the accepted recommendations mean for employees and employers, both in the immediate and longer term. The Frequently Asked Questions document is available at the following link:https://www.england.nhs.uk/wp-content/uploads/2025/07/leng-review-nhs-england-faqs-on-actions-for-nhs-organisations.pdfThe Leng Review’s recommendations are far reaching and require cross-system partnership working to be considered, planned, and delivered effectively. We will work with NHS England, royal colleges, unions, and other relevant stakeholders as we develop a clear implementation plan to address the review’s 18 recommendations. Further information on implementation will be set out in due course.

What is his proposed timeline for implementing changes to the scope of practice for physician associates.

The principle question of the Leng Review was to assess whether the roles of physician assistants and physician assistants in anaesthesia, still legally known as anaesthesia associates and physician associates, are safe and effective. The review’s findings were clear that, with changes in line with its recommendations, there remains a place for these roles to continue as supportive, complementary members of medical teams. The Government has accepted all 18 of the review’s recommendations.NHS England has published a letter and a Frequently Asked Questions document, setting out what the accepted recommendations mean for employees and employers, both in the immediate and longer term. The Frequently Asked Questions document is available at the following link:https://www.england.nhs.uk/wp-content/uploads/2025/07/leng-review-nhs-england-faqs-on-actions-for-nhs-organisations.pdfThe Leng Review’s recommendations are far reaching and require cross-system partnership working to be considered, planned, and delivered effectively. We will work with NHS England, royal colleges, unions, and other relevant stakeholders as we develop a clear implementation plan to address the review’s 18 recommendations. Further information on implementation will be set out in due course.

Whether his Department has issued guidance to local authorities on the treatment of Small Self-Invested Pensions in financial assessments.

Where local authorities decide to charge for the provision of care and support, they must follow the Care Act 2014 and the Care and Support (Charging and Assessment of Resources) Regulations 2014, and they must act under the Care and Support Statutory (CASS) guidance.The responsibility for interpreting and applying the law and the CASS guidance rests with local authorities.The treatment of private pension income in financial assessments is set out in Annex C of the CASS guidance. Pension income is generally treated as part of a person’s income when conducting financial assessments for adult social care, unless the regulations specifically disregard it.

What plans his Department has to increase access to specialist breast cancer nurses for patients with secondary breast cancer in West Dorset.

The Department of Health and Social Care will publish a refreshed Workforce Plan to deliver the transformed health service it will build over the next decade, and treat patients on time again. The Plan will ensure that the National Health Service has the right people, including breast cancer nurses in West Dorset, to ensure patients are cared for by the right professional, when and where they need it.NHS England is investing in structured career development and education support. The Aspirant Cancer Career and Education Development (ACCEND) programme provides a nationally agreed framework for capability, career development and education for nurses, allied health professionals and support workforce working in cancer care. This is also beneficial for the training and development of specialist nurses working in breast cancer care.

If his Department will consider reimbursing MSc training costs for physician associates who are no longer able to work in their profession.

The principle question of the Leng Review was to assess whether the roles of physician assistants and physician assistants in anaesthesia, still legally known as anaesthesia associates and physician associates, are safe and effective. The review’s findings were clear that, with changes in line with its recommendations, there remains a place for these roles to continue as supportive, complementary members of medical teams.Whilst decisions about recruitment are a matter for individual National Health Service employers at a local level, physician assistants, and physician assistants in anaesthesia, will continue to play an important role in the NHS.Our forthcoming 10 Year Workforce Plan will look at how to get the right people, in the right places, with the right skills to deliver the best care, and we will consider the findings of the Leng Review when developing the plan.There are no plans to reimburse training costs or provide financial compensation to physician assistants.

Whether his Department plans to provide financial compensation to physician associates made redundant as a result of changes to clinical guidance.

The principle question of the Leng Review was to assess whether the roles of physician assistants and physician assistants in anaesthesia, still legally known as anaesthesia associates and physician associates, are safe and effective. The review’s findings were clear that, with changes in line with its recommendations, there remains a place for these roles to continue as supportive, complementary members of medical teams.Whilst decisions about recruitment are a matter for individual National Health Service employers at a local level, physician assistants, and physician assistants in anaesthesia, will continue to play an important role in the NHS.Our forthcoming 10 Year Workforce Plan will look at how to get the right people, in the right places, with the right skills to deliver the best care, and we will consider the findings of the Leng Review when developing the plan.There are no plans to reimburse training costs or provide financial compensation to physician assistants.

What assessment he has made of the potential impact of recent Royal College of General Practitioners guidance on levels of redundancies among GP physician associates.

The principle question of the Leng Review was to assess whether the roles of physician assistants and physician assistants in anaesthesia, still legally known as anaesthesia associates and physician associates, are safe and effective. The review’s findings were clear that, with changes in line with its recommendations, there remains a place for these roles to continue as supportive, complementary members of medical teams.Whilst decisions about recruitment are a matter for individual National Health Service employers at a local level, physician assistants, and physician assistants in anaesthesia, will continue to play an important role in the NHS.Our forthcoming 10 Year Workforce Plan will look at how to get the right people, in the right places, with the right skills to deliver the best care, and we will consider the findings of the Leng Review when developing the plan.There are no plans to reimburse training costs or provide financial compensation to physician assistants.

What discussions his Department has had with private providers on patient protection from rapid increases in the cost of weight loss drugs.

As we shift the focus from treatment to prevention through our 10 Year Health Plan, we are determined to bring revolutionary modern treatments to everyone who needs them, not just those who can afford to pay.NHS England has worked with Eli Lilly to ensure that the list price increase will not affect National Health Service commissioning of tirzepatide in England as a treatment for eligible patients, and 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. Not everyone who wants tirzepatide will be able to access it at first, and 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.

What steps his Department is taking to regulate sudden price increases in privately purchased weight loss drugs.

As we shift the focus from treatment to prevention through our 10 Year Health Plan, we are determined to bring revolutionary modern treatments to everyone who needs them, not just those who can afford to pay.NHS England has worked with Eli Lilly to ensure that the list price increase will not affect National Health Service commissioning of tirzepatide in England as a treatment for eligible patients, and 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. Not everyone who wants tirzepatide will be able to access it at first, and 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.

What discussions his Department has had with NHS Dorset Integrated Care Board on improving (a) dementia diagnosis and (b) care pathways in West Dorset constituency.

The Department of Health and Social Care engages regularly with integrated care boards (ICBs) on a number of matters, including dementia.Through such engagement, we are aware that GPs and frailty teams are being supported by the ICB and Memory Assessment Services (MAS) to start using the Diagnosing Advanced Dementia Mandate (DiADeM) diagnostic tool within the care home population. Patients and their carers are referred to the support offered by partner charity Help and Care’s wider community services on acceptance to the MAS, so they can be matched with appropriate support and information while they wait for an assessment and possible diagnosis.The post-diagnosis Dementia Coordinator service is then made directly available when the person receives a dementia diagnosis for more long-term coordinated support response and information around living well with the condition. This is and will be a pan-Dorset service, providing equity across the county.Under the Government’s 10-Year Health Plan, those living with dementia will benefit from improved care planning and better services. We will deliver the first ever Modern Service Framework for Frailty and Dementia to deliver rapid and significant improvements in quality of care and productivity.