Written questions by Maguire.

With reference to the GP Contract 2026/27, how many more GPs are needed to fulfil the contract obligation that patients deemed clinically urgent must be dealt with on the same day.

As a result of actions taken by the Government, we have the highest number of fully qualified general practitioners (GPs) since 2015. As of 31 December, there are also over 43,000 full time equivalent direct patient care staff working in GPs. We are investing £485 million in GPs in 2026/27, bringing the total spend on the GP Contract to over £13.8 billion. This builds on the £1.1 billion boost in investment in 2025/26. Following feedback from the 2026/27 GP Contract consultation, we are introducing a practice-level GP reimbursement scheme which ringfences and repurposes £292 million of funding from the current Capacity and Access Payment. This funding will be available to practices to hire additional GPs or fund additional sessions from existing GPs to support clinical same day urgent access in GPs. This aims to strengthen capacity, access, and improve patient satisfaction, whilst also addressing GP unemployment and underemployment. As part of the 2026/27 GP Contract, we are increasing the flexibility of the Additional Roles Reimbursement Scheme (ARRS) by removing the restriction that ARRS funding can only be used for recently qualified GPs, increasing the maximum reimbursement amount for GP roles to reflect experience, and enabling primary care networks to recruit a broader range of ARRS roles, where agreed with the commissioner. We are not defining “clinically urgent” from the centre. GP staff are trained and experienced in recognising which patients need to be seen quickly.

With reference to the GP Contract 2026/27, what cost benefit analysis his Department conducted in relation to the bonus GP practices in England will be paid to prescribe patients weight loss drugs.

The 2026/27 GP Contract introduces new incentives through the Quality and Outcomes Framework (QOF) for general practitioners to prescribe weight loss drugs. At this stage, the Department has not made quantified estimates of net costs to the National Health Service over one-, five- or ten-year periods specifically attributable to these QOF indicators. The National Institute for Health and Care Excellence’s technology appraisal considered the clinical effectiveness and cost effectiveness of tirzepatide at a population level, and the QOF changes are intended to support appropriate implementation of that guidance. QOF is an established lever for supporting the roll out of evidence-based care in general practice. Data gathered through QOF this year will be used to understand the impact of the new QOF obesity indicators on patient pathways and service use, and this evidence may inform future assessment of costs and benefits over time.

With reference to the bonus GP practices in England will be paid to prescribe patients weight loss drugs, what estimate his Department has made of the expected level of potential savings for the NHS over a one year, five year and 10 year period.

The 2026/27 GP Contract introduces new incentives through the Quality and Outcomes Framework (QOF) for general practitioners to prescribe weight loss drugs. At this stage, the Department has not made quantified estimates of net costs to the National Health Service over one-, five- or ten-year periods specifically attributable to these QOF indicators. The National Institute for Health and Care Excellence’s technology appraisal considered the clinical effectiveness and cost effectiveness of tirzepatide at a population level, and the QOF changes are intended to support appropriate implementation of that guidance. QOF is an established lever for supporting the roll out of evidence-based care in general practice. Data gathered through QOF this year will be used to understand the impact of the new QOF obesity indicators on patient pathways and service use, and this evidence may inform future assessment of costs and benefits over time.

With reference to the GP Contract 2026/27, what estimate his Department has made of the level of cost savings for the NHS in relation to the bonus GP practices in England will be paid to prescribe patients weight loss drugs.

The 2026/27 GP Contract introduces new incentives through the Quality and Outcomes Framework (QOF) for general practitioners to prescribe weight loss drugs. At this stage, the Department has not made quantified estimates of net costs to the National Health Service over one-, five- or ten-year periods specifically attributable to these QOF indicators. The National Institute for Health and Care Excellence’s technology appraisal considered the clinical effectiveness and cost effectiveness of tirzepatide at a population level, and the QOF changes are intended to support appropriate implementation of that guidance. QOF is an established lever for supporting the roll out of evidence-based care in general practice. Data gathered through QOF this year will be used to understand the impact of the new QOF obesity indicators on patient pathways and service use, and this evidence may inform future assessment of costs and benefits over time.

What estimate his Department has made of the number of GPs that will be needed to ensure that patients deemed clinically urgent are dealt with on the same day.

As a result of actions taken by the Government, we have the highest number of fully qualified general practitioners (GPs) since 2015. As of 31 December, there are also over 43,000 full-time equivalent (FTE) direct patient care staff working in GPs. We are investing £485 million into GPs in 2026/27, bringing the total spend on the GP Contract to over £13.8 billion. This builds on the £1.1 billion boost in investment in 2025/26. Following feedback from the 2026/27 GP Contract consultation, we are introducing a practice-level GP reimbursement scheme which ringfences and repurposes £292 million of funding from the current Capacity and Access Payment. This funding will be available to practices to hire additional GPs or fund additional sessions from existing GPs to support clinical same day urgent access in GPs. This aims to strengthen capacity, access, and improve patient satisfaction, whilst also addressing GP unemployment and underemployment. As part of the 26/27 GP Contract, we are increasing the flexibility of the Additional Roles Reimbursement Scheme (ARRS) by removing the restriction that ARRS funding can only be used for recently qualified GPs, increasing the maximum reimbursement amount for GP roles to reflect experience, and enabling primary care networks to recruit a broader range of ARRS roles, where agreed with the commissioner. We are not defining “clinically urgent” from the centre. GP staff are trained and experienced in recognising which patients need to be seen quickly.

What assessment his Department has made of the potential impact of paying GPs a bonus to prescribe patients weight loss drugs on savings to the NHS over a (a) one, (b) five year and (c) 10 year period.

The 2026/27 GP Contract introduces new incentives through the Quality and Outcomes Framework (QOF) for general practitioners to prescribe weight loss drugs. At this stage, the Department has not made quantified estimates of net costs to the National Health Service over one-, five- or ten-year periods specifically attributable to these QOF indicators. The National Institute for Health and Care Excellence’s technology appraisal considered the clinical effectiveness and cost‑effectiveness of tirzepatide at a population level, and the QOF changes are intended to support appropriate implementation of that guidance. QOF is an established lever for supporting the roll out of evidence-based care in general practice. Data gathered through QOF this year will be used to understand the impact of the new QOF obesity indicators on patient pathways and service use, and this evidence may inform future assessment of costs and benefits over time.

What steps his Department is taking to help support community pharmacies from the potential impact of changes to the living wage, national insurance and business rates.

The Government recognises that pharmacies are an integral ‘front door’ to the National Health Service, staffed by highly trained and skilled healthcare professionals.In 2025/26, funding for the core community pharmacy contractual framework has been increased to £3.073 billion. This represents the largest uplift in funding of any part of the NHS, over 19% across 2024/25 and 2025/26. Additional funding is also available, for example for pharmacies delivering Pharmacy First consultations and flu and COVID-19 vaccinations.The Department will shortly consult with Community Pharmacy England on any proposed changes to reimbursement and remuneration of pharmacy contractors for 2026/27. As part of this we will consider financial pressures on the sector.

With reference to the National Cancer Plan, what steps his Department is taking to help ensure that there will be enough pathologists to support the Plan’s delivery.

The National Cancer Plan sets out how we will strengthen the cancer workforce, including for diagnostics, such as pathology. The plan sets out sustainable workforce growth, focused not on simply expanding numbers but on ensuring staff are properly trained, supported, and able to work at the top of their skills.The plan sets out how we will support pathologists to work more efficiently through a £604 million investment in digital diagnostics, including digital pathology, and £96 million in the automation of histopathology, as well as further investment in digital technology and artificial intelligence. Expansion of advanced clinical practice for scientists will also improve the efficiency and effectiveness of the pathology workforce as a whole.The 10 Year Workforce Plan will be published in spring, setting out further action to create a workforce able to deliver the transformed service set out in the 10-Year Health Plan.

What comparative assessment his Department has made of trends in the level of (a) respiratory disease and (b) the number of emergency hospital admissions for respiratory conditions in (i) Epsom and Ewell constituency and (ii) nationally; and what steps he is taking to ensure respiratory health is prioritised nationally, including through the introduction of a Modern Service Framework for respiratory care.

The Government will consider long-term conditions for future waves of modern service frameworks (MSFs), including respiratory conditions. The criteria for determining other conditions for future MSFs will be based on where there is potential for rapid and significant improvements in the quality of care and productivity. After the initial wave of MSFs is complete, the National Quality Board will determine the conditions to prioritise for new MSFs as part of its work programme.Provisional data is available for emergency Finished Admission Episodes (FAEs) where there was a primary diagnosis of 'respiratory conditions’. The following table shows the number of emergency FAEs with a primary diagnosis of respiratory conditions for Epsom and Ewell and for England, for activity in English National Health Service hospitals and English NHS commissioned activity in the independent sector, for 2024/25 and 2025/26:Westminster Parliamentary Constituency of Residence2024/25 (August 2024 to March 2025)2025/26 (April 2025 to November 2025)Epsom and Ewell670530England608,449423,588Source: Hospital Episode Statistics, NHS England.Available data on trends in respiratory conditions can be found on the Department’s Fingertips dataset. Data is not available by parliamentary constituency. Data is available at regional, county, unitary authority, and integrated care board level. Information for Surrey can be found at the following link:https://fingertips.phe.org.uk/search/respiratory#page/1/gid/1/pat/15/ati/502/are/E10000030/iid/40701/age/163/sex/4/cat/-1/ctp/-1/yrr/1/cid/4/tbm/1The Government has committed to delivering three big shifts that our NHS needs to be fit for the future: from hospital to community; from analogue to digital; and from sickness to prevention. All of these are relevant to improving respiratory health in all parts of the country.Through our community diagnostic centres, we are building capacity for respiratory testing and enabling people to get diagnosed closer to home. 101 community diagnostic centres across the country now offer out of hours services, 12 hours a day, seven days a week, meaning patients can access vital diagnostic tests around busy working lives. This is alongside action being taken to expand capacity and improve the quality of pulmonary rehabilitation services to support patients living with respiratory conditions.

What steps his Department is taking to help improve digital infrastructure and IT connectivity for community care in primary care settings.

In 2026/27, and as per the Medium Term Planning Framework – delivering change together 2026/27 to 2028/29, all integrated care boards and community health services providers must identify and act on productivity opportunities, including ensuring teams have the digital tools and equipment they need to connect remotely to health systems and patients, and expanding point-of-care testing in the community.Through the Community Health Services Data Plan (2024/25-2026/27), work is underway to improve the quality, relevance, and timeliness of community health service data and, in turn, improve the patient experience in community health services.In addition, our 10-Year Health Plan will help put services at the heart of the community and expand digital tools to manage health, including through the Single Patient Record. It will give patients real control over a single, secure, and authoritative account of their data and enable more coordinated, personalised, and predictive care. It will improve clinical outcomes, make decision-making more informed, and speed up the delivery of care.

What his Department’s timeline is for deciding on the second wave of Modern Service Frameworks; and whether respiratory conditions will be considered.

Modern service frameworks will define an aspirational, long-term outcome goal for a major condition and then identify the best evidenced interventions and the support for delivery. Early priorities will include cardiovascular disease, severe mental illness, and the first ever service framework for frailty and dementia.The Government will consider other long-term conditions for future waves of modern service frameworks, including respiratory conditions. The criteria for determining other conditions for future modern service frameworks will be based on where there is potential for rapid and significant improvements in quality of care and productivity. After the initial wave of MSFs is complete, the National Quality Board will determine the conditions to prioritise for new MSFs as part of its work programme.

With reference to the publication of the National Cancer Plan, if he will present the Plan's annual summary of progress to the House.

A reformed National Cancer Board, jointly chaired by the Department and an independent representative, will track progress and provide regular updates to ministers.Across the life of the plan, ministers will publish an annual summary of progress, along with a more in-depth report after three years to assess where the plan may need updating and refreshing.The annual summary will be available publicly and I will update the House when it is published.

What discussions he has had with the Secretary of State for Education and the Home Secretary on the Child Protection Authority consultation.

Ministers meet regularly through the Keeping Children Safe Ministerial Board and the Inter-Ministerial Group on Child Sexual Abuse, where the Child Protection Authority (CPA) is regularly discussed. Both of these groups will continue to monitor progress on the delivery of the CPA.

What steps his Department is taking to decrease treatment wait times for patients with metastatic ocular melanoma.

The Department remains committed to ensuring that cancer patients, including those with metastatic ocular melanoma, have timely access to treatment and tailored medical support. The Government supports Scott Arthur’s Private Members Bill on rare cancers which will make it easier for clinical trials into rare cancers to take place in England by ensuring the patient population can be easily contacted by researchers. This will ensure that the National Health Service will remain at the forefront of medical innovation and is able to provide patients with the newest, most effective treatment options, and ultimately boost survival rates.The forthcoming National Cancer Plan will include further details on how we will improve outcomes for patients with cancer, as well as speeding up diagnosis and treatment, ensuring patients have access to the latest treatments and technology, and ultimately driving up this country’s cancer survival rates. This will benefit all cancer patients, including metastatic ocular melanoma patients.

What discussions he has had with NHS England on the publication date for the draft commissioning policy for Chemosaturation therapy.

The Department and the National Health Service in England are committed to ensuring that cancer patients have timely access to treatment and tailored medical support. In 2016, NHS England concluded that there was insufficient evidence to make chemosaturation treatment available to patients on the NHS. NHS England is currently in the early stages of policy development for chemosaturation to treat metastatic uveal melanoma where surgery to remove or destroy affected cells and tissue in the liver is not feasible.National Institute for Health and Care Excellence (NICE) guidance recommends that chemosaturation can be used for patients with secondary liver metastases resulting from a primary ocular melanoma, provided special arrangements are in place. A special arrangements recommendation states that clinicians using the procedure should inform the clinical governance lead in their trust, tell the patient about the uncertainties regarding the safety and efficacy of the procedure, and collect further data by means of audit or research. NICE is in the process of updating its guidance, with final guidance expected on 15 October 2026. The first committee meeting, to discuss the evidence, is expected to take place on 16 April 2026. Further information is available at the following link:https://www.nice.org.uk/guidance/indevelopment/gid-ipg10448

What assessment he has made of the potential merits of removing the exceptionality requirement for Individual Funding Requires for Chemosaturation therapy and comparable intervention for people whose lives are at risk.

The Department and the National Health Service in England are committed to ensuring that cancer patients have timely access to treatment and tailored medical support. In 2016, NHS England concluded that there was insufficient evidence to make chemosaturation treatment available to patients on the NHS. NHS England is currently in the early stages of policy development for chemosaturation to treat metastatic uveal melanoma where surgery to remove or destroy affected cells and tissue in the liver is not feasible.National Institute for Health and Care Excellence (NICE) guidance recommends that chemosaturation can be used for patients with secondary liver metastases resulting from a primary ocular melanoma, provided special arrangements are in place. A special arrangements recommendation states that clinicians using the procedure should inform the clinical governance lead in their trust, tell the patient about the uncertainties regarding the safety and efficacy of the procedure, and collect further data by means of audit or research. NICE is in the process of updating its guidance, with final guidance expected on 15 October 2026. The first committee meeting, to discuss the evidence, is expected to take place on 16 April 2026. Further information is available at the following link:https://www.nice.org.uk/guidance/indevelopment/gid-ipg10448

What steps his Department is taking to deliver safe staffing levels for midwives.

The Government is committed to tackling the retention and recruitment challenges that face the National Health Service. NHS England is leading a range of initiatives to boost retention of existing staff and ensure it remains an attractive career choice for new recruits. This includes the new Graduate Guarantee for nurses and midwives to ensure there are enough positions for every newly qualified midwife in England.As of October 2025, there were 25,281 full time equivalent midwives working in NHS trusts. This is an increase of 878, or 3.6%, compared to October 2024.We are also developing a new 10 Year Workforce Plan which will set out how the NHS workforce will align with the future direction of healthcare reform set out in the 10-Year Health Plan.

What steps his Department is taking to improve maternity estates and clear the fixable maintenance backlog.

We are investing over £131 million through the 2025/26 Estates Safety Fund to address critical safety risks on the maternity estate, enabling better care for mothers and their newborns. The funded works will deliver vital safety improvements, enhance patient and staff environments, and support National Health Service productivity by reducing disruptions across NHS clinical services.Improving the standard of maternity and neonatal departments is also a core component of the New Hospital Programme. 11 of the 16 hospitals that are expected to begin construction between 2025 and 2030 will be rebuilding maternity and women and children’s services.

What steps his Department is taking to expand ophthalmology services to help early detection of Glaucoma.

NHS sight tests play a vital role in the early detection of glaucoma. Integrated care boards (ICBs) can also commission community-based glaucoma services, which support earlier identification, ongoing monitoring and management, helping to prevent avoidable sight loss.Some ICBs are already using a Single Point of Access to speed up the referral and triage of patients between primary and secondary care.In addition, the Getting It Right First Time programme is developing best practice guidance for glaucoma services, to support the consistent adoption of high standards of care from detection onwards.

With reference to his Department's press release of 21 February 2025 entitled Dental patients to benefit from 700,000 extra urgent appointments, how many of the additional urgent care appointments were purchased in 2025 by integrated care board.

The following table shows the number of National Health Service urgent treatments delivered each year between 2020/21 and 2024/25:Financial yearNumber of urgent dental treatments delivered2024/253,658,2732023/243,674,7102022/233,785,9522021/223,819,2262020/213,646,868Source: NHS Business Services Authority, Dental statistics - England 2024/25, avaiable at the following link: https://www.nhsbsa.nhs.uk/statistical-collections/dental-england/dental-statistics-england-202425 Comparable monthly data on the number of urgent dental appointments delivered is not published. We have asked integrated care boards (ICBs) to commission extra urgent dental appointments to make sure that patients with urgent needs can get the treatment they require. ICBs have been making extra appointments available from April 2025.Appointments are available across the country, with specific expectations for each region. These appointments are more heavily weighted towards those areas where they are needed the most. The Surrey Heartlands ICB, which includes the Epsom and Ewell constituency, has been asked to deliver 6,585 additional urgent dental appointments as part of the scheme.Data on delivery of urgent dental care, including additional delivery, will be published annually as part of the NHS Dental Statistics England Official Statistics series. These statistics are released each August and are the primary source of data on the delivery of NHS dental care.