Written questions by Maguire.

Whether his Department has had discussions with HM Treasury on the potential merits of introducing ringfenced, multi-year capital funding upgrading for breast screening equipment, including digital breast tomosynthesis, to help ensure equitable access to modern breast screening technology.

The Government is committed to providing quality and timely care and treatment to people with breast cancer, including through equitable access to modern breast screening technology. The NHS Breast Screening Programme is seeing improvement in uptake nationally with annual data from NHS England for 2024/25 showing 70.6% of women attending their appointment.Digital mammography, which offers high quality images, currently remains the primary screening tool for the programme. At present, digital breast tomosynthesis (DBT) is an optional tool in the assessment of screen detected soft tissue breast abnormalities following mammography.In 2025, the UK National Screening Committee (UK NSC), who advises the Government on all screening matters, set up a working group of breast cancer screening experts to help it consider new and emerging evidence and developments that could further improve the United Kingdom’s breast screening programme. This includes exploring DBT in addition to other tests and technologies, to detect breast cancer in women with dense breast tissue. Other modalities are magnetic resonance imaging, ultrasonography, using either hand-held or automated modalities, and contrast-enhanced mammography.If, following this work, the UK NSC makes a recommendation regarding DBT, my Rt Hon. Friend, the Secretary of State for Health and Social Care, would be asked to make a decision on whether to accept the recommendation, alongside wider policy and operational advice.Service providers are responsible for purchasing and maintenance of breast screening equipment, and where there are issues and updates are required, they apply to the local capital investment programmes or the funding available in the current Spending Review period via the NHS England National Diagnostics Transformation Programme.

What criteria the Department used to determine which providers were included in the Neighbourhood Health Framework; and what assessment he has made of the potential impact of the exclusion of optometrists from the list of providers on eye health.

The Neighbourhood Health Framework is designed to provide clarity and consistency to integrated care boards (ICBs), local authorities, and their partners, in developing and scaling neighbourhood health.General practice, primary care, pharmacies, mental health providers, community health services, social care services, local authorities, and civil society partners are included, to illustrate how services can work together to shift care from hospital to communities, improve access, and provide proactive, holistic care for people with complex needs. This is not an exhaustive list and does not prescribe which providers must be involved locally.No specific criteria were used to determine which providers were included in the framework. The framework does not prevent other providers, including optometrists, from being part of neighbourhood health services.The framework outlines the national minimum aims and objectives of Neighbourhood Health Services. It is important that reforms are locally led, as ICBs and local authorities are best placed to design services that make sense for their local populations. Local systems can therefore choose to go further than the minimum, including in relation to optometry.ICBs are already able to commission enhanced services from high street optometrists including minor and urgent eye care services and glaucoma referral filtering services.

What his criteria are for introducing digital breast tomosynthesis into the NHS breast screening programme.

The Government is committed to providing quality and timely care and treatment to people with breast cancer, including through equitable access to modern breast screening technology. The NHS Breast Screening Programme is seeing improvement in uptake nationally with annual data from NHS England for 2024/25 showing 70.6% of women attending their appointment.Digital mammography, which offers high quality images, currently remains the primary screening tool for the programme. At present, digital breast tomosynthesis (DBT) is an optional tool in the assessment of screen detected soft tissue breast abnormalities following mammography.In 2025, the UK National Screening Committee (UK NSC), who advises the Government on all screening matters, set up a working group of breast cancer screening experts to help it consider new and emerging evidence and developments that could further improve the United Kingdom’s breast screening programme. This includes exploring DBT in addition to other tests and technologies, to detect breast cancer in women with dense breast tissue. Other modalities are magnetic resonance imaging, ultrasonography, using either hand-held or automated modalities, and contrast-enhanced mammography.If, following this work, the UK NSC makes a recommendation regarding DBT, my Rt Hon. Friend, the Secretary of State for Health and Social Care, would be asked to make a decision on whether to accept the recommendation, alongside wider policy and operational advice.Service providers are responsible for purchasing and maintenance of breast screening equipment, and where there are issues and updates are required, they apply to the local capital investment programmes or the funding available in the current Spending Review period via the NHS England National Diagnostics Transformation Programme.

What conversations he has had with Business and Trade colleagues regarding improving employment conditions for those in the mental health sector.

My Rt Hon. Friend, the Secretary of State for Health and Social Care, meets regularly with colleagues in the Department of Business and Trade to discuss a range of topics.We are committed to making the National Health Service the best place to work by supporting and retaining our hardworking and dedicated healthcare professionals, including those working in the mental health sector. The 10 Year Workforce Plan will set out how we will deliver this change by making sure that staff are better treated, have more fulfilling roles, and hope for the future.We are taking a number of steps to improve working conditions for NHS staff, including the development of a new set of staff standards for modern employment. The standards will focus on the areas that we know matter the most to staff, including: supporting line management; improving staff health and wellbeing; promoting flexible working; violence prevention and reduction; and tackling racism and sexual safety.

What steps he is taking to improve working conditions including pay for those in the mental health sector.

We are committed to making the National Health Service the best place to work by supporting and retaining our hardworking and dedicated healthcare professionals, including those working in the mental health sector. The 10 Year Workforce Plan will set out how we will deliver this change by making sure that staff are better treated, have more fulfilling roles, and hope for the future.We are taking a number of steps to improve working conditions for NHS staff including the development of a new set of staff standards for modern employment. The standards will focus on the areas that we know matter the most to staff, including: supporting line management; improving staff health and wellbeing; promoting flexible working; violence prevention and reduction; and tackling racism and sexual safety.On 5 February we received the NHS Pay Review Body report and on 12 February we accepted their independent recommendation for a 3.3% consolidated headline pay award for 2026/27. For the first time in six years, this pay increase for NHS Agenda for Change staff will be in April pay packets, demonstrating our commitment to getting money to NHS staff earlier than in previous years. Additionally, on 17 March, we received the Review Body on Doctors’ and Dentists’ Remuneration’s report and on 20 March accepted their independent recommendations for a headline pay increase of 3.5% for doctors and 3.75% increase to the pay element of high-street dental contracts and community dental service dentists.

Whether he has made an assessment of the potential merits of including eligibility for an NHS sight test in the GP learning disability annual health check programme.

Free National Health Service sight tests are provided by community optometrists to eligible groups, including children, people aged 60 years old and over, people on low incomes, and those at risk of diabetic retinopathy and glaucoma.Children and young people with learning disabilities and/or autism are also eligible for free NHS sight tests, where integrated care boards are commissioning a service within a special educational setting.Adults may qualify under existing exemptions, including being in receipt of income-related benefits or through the NHS low-income scheme.

Whether decisions on mandatory and additional General Ophthalmic Services contract fees are subject to an Equality Impact Assessment.

Decisions on mandatory and additional General Ophthalmic Services contract fees are informed by an Equality Impact Assessment, in line with the Public Sector Equality Duty.

What steps his Department is taking to develop national guidelines for PICA.

I refer the Hon. Member to the answer I gave to the Hon. Member for Mid Dunbartonshire on 9 February 2026 to Question 110183.

What assessment he has made of trends in the level of inequalities in access to primary eye care.

Integrated care boards (ICBs) are responsible for commissioning primary and secondary eye care services to meet the needs of their local population. National Health Service sight tests are widely available across the country, with no known access issues. ICBs can also commission enhanced eye care services in the community.ICBs are required to work with local authorities to assess the current and future health, care, and wellbeing needs of their local population. They will then set out in joint local health and wellbeing strategies how they will meet those needs, which should include addressing any identified inequalities in accessing services.

What funding is currently available to Integrated Care Boards to deliver community‑level engagement programmes aimed at increasing awareness and early detection of prostate cancer in high‑risk groups.

While the Department does not ring-fence integrated care board (ICB) funding exclusively for prostate cancer public awareness campaigns, community-level engagement programmes aimed at increasing awareness and early detection are supported via broader communication programmes, working in partnership with charities and local Cancer Alliances.To increase knowledge of cancer symptoms, and to address barriers to acting on them, the National Health Service has run Help Us Help You campaigns. These campaigns focused on recognising a range of symptoms, as well as encouraging body awareness, to help people spot symptoms across a wide range of cancers, including prostate cancer, at an earlier stage. NHS England and other NHS organisations, nationally and locally, publish information on the signs and symptoms of many different types of cancer, including prostate cancer. This information can be found at sources including the NHS website, which is available at the following link:https://www.nhs.uk/The National Cancer Plan, published in February 2026, is backed by significant funding committed by the Government at the Spending Review, including £200 million next year for local Cancer Alliances. Alliances are encouraged to allocate a proportion of this funding to the delivery of local early diagnosis plans, to drive progress on data-led priorities. This can include work to support the diagnosis of prostate cancer, but it will vary by alliance depending on local need. In 2025/26, several alliances have undertaken work to support awareness and earlier diagnosis of prostate cancer.

What assessment his Department has made of implementing NHS support pathways for PICA.

No assessment has been made on implementing National Health Service support pathways for PICA. For adults and children, individuals presenting with PICA are assessed and supported according to their individual clinical needs and circumstances. In most cases, care is arranged locally through services commissioned by NHS integrated care boards.The Government is focused on strengthening support for people with eating disorders more broadly, including through new national guidance for children and young people’s eating disorder services, improving early identification and intervention, and ensuring staff across mental and physical health services have the training needed to recognise and respond safely to eating disorders wherever people present.

What steps his Department is taking to help increase awareness of PICA.

No assessment has been made on implementing National Health Service support pathways for PICA. For adults and children, individuals presenting with PICA are assessed and supported according to their individual clinical needs and circumstances. In most cases, care is arranged locally through services commissioned by NHS integrated care boards.The Government is focused on strengthening support for people with eating disorders more broadly, including through new national guidance for children and young people’s eating disorder services, improving early identification and intervention, and ensuring staff across mental and physical health services have the training needed to recognise and respond safely to eating disorders wherever people present.

What assessment he has made of the potential merits of integrating reforms to the Carr-Hill Formula with the GMS contract.

The first phase of the Carr-Hill review is expected to conclude in March 2026. Subject to ministerial decision, further work would be undertaken to technically develop and model any proposed changes to the formula.   Findings from the review will be published in due course by the National Institute for Health and Care Research. Members of Parliament will be updated once the review findings are available.Implementation of any new funding approach would be subject to ministerial decision and consultation with the General Practice Committee for England of the British Medical Association, in the context of the available funding and our commitment to substantively reform the General Medical Services Contract within this Parliament.

With reference to the Design for Life roadmap, what progress has been made in reducing NHS equipment wastage.

NHS England has been working on reducing waste and its associated carbon since publication of the NHS Clinical Waste Strategy in 2023.NHS England’s Estates Returns Information Collection (ERIC) is a mandatory annual data collection for all National Health Service trusts in England that captures waste metrics in waste type tonnages and not specific items of waste. ERIC figures to 2025 show a reduction of 41,000 tonnes of carbon.The latest reporting year, 1 April 2024 to 31 March 2025, which covers the period during which the Design for Life Roadmap was launched, in October 2024, saw a reduction of 10,000 tonnes of carbon from waste.To supplement this work, since publication of the roadmap, the Department has conducted a series of pilots across a range of different medical products and equipment, with most demonstrating waste savings, in carbon terms, from switching to reusable alternatives. The full report can be found on the Centre for Sustainable Healthcare’s website, who were our partner on these pilots, at the following link:https://sustainablehealthcare.org.uk/activity/reusable-medtech-in-the-nhs-pioneering-sustainable-healthcare/.The Department is building on this work with a dedicated Priority Adoption Working Group, which includes clinical and procurement professionals, to identify the products with the strongest case for safe, immediate transitions to reusables across the NHS, to drive further waste, and cost, savings at scale. NHS England is supporting this work, alongside its own initiatives to reduce the overuse of products and waste. For example, through the Five years of a greener NHS: progress and forward look, the NHS has committed to reduce single-use glove and gown use by 25% by 2030, with further information available at the following link:https://www.england.nhs.uk/long-read/five-years-greener-nhs-progress-forward-look/

What percentage of NHS funding was spent on private contacts in each year between 2022 and 2025.

The table attached shows the overview and breakdown of National Health Service spending on non-NHS providers from 2022/23 to 2024/25. The table is taken from the House of Commons Research Briefing on NHS funding and expenditure, using data from the Department’s Care Annual Reports and Accounts, with further information available at the following link:https://researchbriefings.files.parliament.uk/documents/SN00724/SN00724.pdf#

With reference to the Design for Life roadmap, how much equipment has been diverted from waste since the roadmap was launched.

NHS England has been working on reducing waste and its associated carbon since publication of the NHS Clinical Waste Strategy in 2023.NHS England’s Estates Returns Information Collection (ERIC) is a mandatory annual data collection for all National Health Service trusts in England that captures waste metrics in waste type tonnages and not specific items of waste. ERIC figures to 2025 show a reduction of 41,000 tonnes of carbon.The latest reporting year, 1 April 2024 to 31 March 2025, which covers the period during which the Design for Life Roadmap was launched, in October 2024, saw a reduction of 10,000 tonnes of carbon from waste.To supplement this work, since publication of the roadmap, the Department has conducted a series of pilots across a range of different medical products and equipment, with most demonstrating waste savings, in carbon terms, from switching to reusable alternatives. The full report can be found on the Centre for Sustainable Healthcare’s website, who were our partner on these pilots, at the following link:https://sustainablehealthcare.org.uk/activity/reusable-medtech-in-the-nhs-pioneering-sustainable-healthcare/.The Department is building on this work with a dedicated Priority Adoption Working Group, which includes clinical and procurement professionals, to identify the products with the strongest case for safe, immediate transitions to reusables across the NHS, to drive further waste, and cost, savings at scale. NHS England is supporting this work, alongside its own initiatives to reduce the overuse of products and waste. For example, through the Five years of a greener NHS: progress and forward look, the NHS has committed to reduce single-use glove and gown use by 25% by 2030, with further information available at the following link:https://www.england.nhs.uk/long-read/five-years-greener-nhs-progress-forward-look/

How many NHS services were outsourced to private contracts in Surrey in each year between 2022 and 2025.

Integrated care boards are responsible for commissioning local National Health Services and contracting with providers, including in Surrey. Information is not routinely collected by the Department on the number of services outsourced to private providers in Surrey.

How many health visitors were employed by the NHS in England in each year since 2020.

The number of health visitors working in National Health Service trusts and other core organisations in England is published monthly by NHS England as part of their NHS Workforce Statistics Collection. The data can be found in the link below within the file: NHS HCHS Workforce Statistics, Trusts and core organisations - data tables, December 2025, at the following link: https://digital.nhs.uk/data-and-information/publications/statistical/nhs-workforce-statistics/december-2025Within this Excel file, the relevant information can be found in Tab 6, titled Nurses and Health Visitors, Midwives and Support to Doctors, Nurses and Midwives by Staff Group, Care Setting and Level – Full Time Equivalent (FTE) and Headcount.The data includes staff employed by NHS trusts and other core NHS organisations and will therefore exclude staff directly employed by primary care, general practitioner surgeries, local authorities, and other providers such as community interest companies and private providers.Local authorities have been responsible for commissioning health visiting services since 2015. These services may be commissioned from NHS trusts as well as other providers. The Department does not hold staffing information for non-NHS providers.

What assessment he has made of the effectiveness of Shared Care Agreements for patients prescribed ADHD medication by an independent sector provider under a) NHS Right to Choose and b) privately funded arrangements.

Shared care within the National Health Service refers to a voluntary arrangement whereby a specialist may transfer responsibility for aspects of a patient’s care, such as prescription of medication, to the patient’s general practitioner (GP). Decisions regarding shared care agreements are made locally, and the General Medical Council has made it clear that GPs are not contractually obliged to enter shared care agreements and may decline requests on clinical or capacity grounds. No specific assessment has been made of the effectiveness of shared care agreements with independent sector providers for patients prescribed attention deficit hyperactivity disorder (ADHD) medication. NHS England established an ADHD taskforce bringing together people with lived experience with experts from across sectors to better understand the challenges in accessing timely and equitable support. In addition, on 4 December 2025 my Rt Hon. Friend, the Secretary of State for Health and Social Care, announced an independent review into the prevalence and support for mental health conditions, ADHD, and autism, which will inform our approach to ensuring appropriate support is in place.

What assessment his Department has made of the potential impact of the pausing of Shared Care Agreements for ADHD on patients.

Shared care within the National Health Service refers to a voluntary arrangement whereby a specialist may transfer responsibility for aspects of a patient’s care, such as prescription of medication, to the patient’s general practitioner (GP). Decisions regarding shared care agreements are made locally, and the General Medical Council has made it clear that GPs are not contractually obliged to enter shared care agreements and may decline requests on clinical or capacity grounds. No specific assessment has been made of the effectiveness of shared care agreements with independent sector providers for patients prescribed attention deficit hyperactivity disorder (ADHD) medication. NHS England established an ADHD taskforce bringing together people with lived experience with experts from across sectors to better understand the challenges in accessing timely and equitable support. In addition, on 4 December 2025 my Rt Hon. Friend, the Secretary of State for Health and Social Care, announced an independent review into the prevalence and support for mental health conditions, ADHD, and autism, which will inform our approach to ensuring appropriate support is in place.