Written questions by Maguire.

What steps he is taking to expand access to community-based NHS hearing health services.

Integrated care boards (ICBs) have a statutory responsibility to commission cost-effective healthcare to meet the needs of their local population, and this includes community-based hearing services.The Medium-Term Planning Framework sets a clear target for systems to work to in order to reduce long waits for community health services, and this includes community audiology services. By 2028/29, at least 80% of community health services activity should take place within 18 weeks. In addition, Standardising Community Health Services sets out an overview of core community health services that ICBs should consider when planning for their local populations to support improved commissioning and delivery of community health services, including community-based hearing services.

What steps his Department is taking to support suppliers with extended GP online consultation hours.

General practices (GPs) have been required to offer and promote an online consultation tool to their registered patients since 2021. The change introduced in October 2025 regarding online access explicitly requires that all modes of contacting the practice are available at least during core hours, from 08:00 to 18:30. This means parity for walk-in, phone, and online access. This requirement builds on policies that have been in place for several years to encourage the shift to modern GPs.To support suppliers, NHS England sets clear functionality and accessibility standards for digital tools used in primary care. These standards enable suppliers to develop consistent and high-quality digital solutions, including online consultation tools.The recent online access requirement mainly impacts practices rather than suppliers, as it focuses on ensuring existing online consultation tools remain available during core hours rather than introducing new tools. NHS England provided extensive support to practices in the lead up to the introduction of these requirements and continues to do so. This includes reaching out to any practices that are struggling to help them to prepare, including providing guidance, webinars, case studies, and bringing in GPs and practice staff who are experts in service redesign and improvement in GP services.

What assessment he has made of the potential merits of commissioning a national framework mandating ICBs to commission NHS community audiology services on a self-referral basis that include wax removal.

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.The current availability of self-referral and direct access to audiology services depends on local commissioning arrangements and service protocols, including ICB commissioning. Currently, self-referral to audiology services is usually for those with age related hearing loss.NHS England is working with ICBs to support greater standardisation of self-referral arrangements and to assess opportunities to bring more of the self-referral process into the NHS App and website in future where appropriate.

What steps she is taking to help decarbonise refrigerated transport.

The Department for Transport continues to work with the Department for Energy Security and Net Zero (DESNZ) and the Department for Environment, Food and Rural Affairs (Defra) on an Off-Road Machinery Decarbonisation Strategy, which includes transport refrigeration units (TRUs). This strategy will set out how off-road machinery can further decarbonise while maintaining competitiveness, attracting investment and supporting growth. To support this, we are reviewing the findings of a multi-year research project commissioned to ZEMO Partnership into the emissions from diesel-powered auxiliary engines, including from TRUs used on heavy goods vehicles. Alongside this, the Transport Industrial Commercial Refrigeration project, funded through the DESNZ Net Zero Innovation Portfolio, is expected to publish a roadmap that includes transport refrigeration in Spring 2026. The Department will review the roadmap and consider its implications.

If he will provide an update on the renewal of the Women’s Health Strategy and confirm if there will be an opportunity for organisations to contribute to the updated strategy.

Publishing a renewed Women’s Health Strategy next year will ensure the momentum from our recent achievements continues and is fully aligned with the 10-Year Health Plan. We will identify and remove enduring barriers to high-quality care, such as decreasing wait times for diagnosis and ensuring professionals listen to women and respond to their needs.We are currently engaging with external partners to inform the renewal of the strategy, bringing together voices from across Government, NHS England, public health, mental health, women’s health advocacy, and employment policy alongside women with lived experience of women’s health conditions.

What steps his Department is taking to improve the discharge process for patients in Surrey who are medically fit to leave hospital.

The Urgent and Emergency Care plan for 2025/26 identifies reducing delays in hospital discharge as a key priority. Further information on the Urgent and Emergency Care plan for 2025/26 is available at the following link:https://www.england.nhs.uk/long-read/urgent-and-emergency-care-plan-2025-26/Hospitals are expected to eliminate discharge delays of more than 48 hours caused by in-hospital issues, to work with local authorities to tackle the longest delays, starting with those over 21 days, and to profile discharges by pathway to support local planning. In addition to this, we published a new policy framework on 30 January 2025 for the £9 billion Better Care Fund policy framework 2025 to 2026, which requires the National Health Service and local authorities to jointly agree local goals for reducing discharge delays. Further information on the Better Care Fund policy framework 2025 to 2026 is available at the following link:https://www.gov.uk/government/publications/better-care-fund-policy-framework-2025-to-2026We are working with trusts, integrated care systems, and local authorities to share and embed best practice and to help them to use performance data more effectively to address their discharge delays. The Local Government Association has published a range of guidance documents and high impact change models to support improvements to hospital flow and discharge processes, which can be found at the following link:https://www.local.gov.uk/our-support/partners-care-and-health/better-care-fund-support-programme-2025-26Officials held a call on 18 July 2025 with the Epsom and St. Helier Trust regarding the trust’s discharge challenges and proposed actions to improve the situation.

What assessment his Department has made of the potential merits of creating a permanent and protected ICB role for the appointed Women’s Health Champion in every Integrated Care System.

Integrated care boards are responsible for the planning, commissioning, and delivery of women’s health services, including oversight of the dedicated Women’s Health Champion role.The network of women’s health champions brings together senior leaders in women’s health from integrated care systems and local authorities to share best practice to improve women’s health outcomes across the life course and reduce health inequalities. The role is a voluntary commitment, and the Government has no plans to change this.

What assessment his Department has made of making patient records owned by the patient.

Health records are not owned by patients, as the providers of care who create and maintain the records are the data controllers, although all patients have the right to access their records under the Data Protection Act 2018. Patients also have the legal right to ask for factual inaccuracies to be amended.The general practice (GP) record can be viewed online on the NHS App, or by logging onto the National Health Service website. Individuals can alternatively contact their practice to view their record. To view a hospital record, individuals can ask the trust where they are a patient.As part of the 10-Year Health Plan, we are developing a single patient record which will give patients greater control over their records, and act as a patient passport to seamless care. It will provide a single, secure, and authoritative account of their data by bringing together all of a patient’s medical information from different records in one place, for example GP and hospital data, and patients will be able to view the record securely on the NHS App and add their own data, for example from a wearable device.

What assessment his Department has made of the potential merits of embedding routine and cross-system commissioning and provision of post-pregnancy contraception in post-partum care.

No assessment has been made. The renewed Women’s Health Strategy will set out how the Government will take the next steps to improve women's healthcare as part of the 10-Year Health Plan and create a system that listens to women. Steps to improve contraception access are being fully considered as part of the renewal.

What steps his Department is taking to ensure the NHS, ICBs and local authorities collaboratively commission women’s health and contraceptive services.

Local integrated care systems are responsible for the collaborative commissioning of women’s health and contraceptive services.The Women’s Health Programme Board provides direction and strategic oversight to NHS England’s Women’s Health Programme.The board monitors progress and delivery of the Women’s Health Programme, and delivers the ambitions of the Women’s Health Strategy, reflecting the vision to improve health outcomes, reduce disparities, and amplify women’s voices in healthcare.The board is also responsible for ensuring alignment with wider interdependencies, including the 10-Year Health Plan, and neighbourhood health models, as well as ensuring the delivery, oversight, and performance management of women’s health provision are consistent across the seven regions of England.

If his Department will implement civilian harm tracking for explosive ordnance-related incidents in military operations.

The UK has robust targeting policies, practices and processes to ensure that all military operations are conducted in full compliance with our legal obligations and in a manner that reflects the UK’s clear commitment to the protection of civilians. UK forces observe all practicable precautions, conducting rigorous assessments before and after striking a target. The Ministry of Defence analyses all UK military activity, investigating any credible reports that UK actions may have caused civilian harm.The UK are proud signatories of the 2022 Political Declaration on use of Explosive Weapons in Populated Areas and are party to Protocol Five of the Convention on Certain Conventional Weapons.Our existing practices are some of the most robust and transparent globally and are kept under close review, including for the potential impact of new methods and technologies.

What the unit cost per day is for NHS (a) elective, (b) non-elective, (c) high dependency and (d) standard ward beds.

The following table shows the bed day cost for elective and non-elective admissions, for 2024/25:Financial yearQuestionPoint of delivery descriptionBed day cost2024/25ElectiveElective Inpatient£1,1982024/25Non electiveNon Elective Long Stay£7912024/25Non electiveNon Elective Short Stay£806Source: National Cost Collection Patient Level Cost dataset for admitted patient care. Point of delivery, cost and length of stay data submitted to the dataset by National Health Service providers in the latest financial year, 2024/25.NHS England does not hold the data to calculate the bed day cost for high dependency and standard ward beds.

What steps his Department is taking to ensure annual statutory reviews for people in care are undertaken.

Under the Care Act 2014, local authorities must keep care and support plans under review, respond to reasonable requests for review, and update plans when circumstances change, involving the individual drawing on care and support, and their carer, if applicable, throughout.Local authorities should establish systems that allow the proportionate monitoring of both care and support plans to ensure that needs are continuing to be met. In the absence of any request of a review, or any indication that circumstances may have changed, the local authority should conduct a periodic review of the plan. It is the expectation that local authorities should conduct a review of the plan no later than every 12 months after the plan is first agreed or last reviewed.The Care Quality Commission (CQC) is assessing how local authorities in England are meeting the full range of their duties under Part 1 of the Care Act 2014, including how local authorities assess the needs of individuals who draw on care and support. The assessments identify local authorities’ strengths and areas for improvement, facilitating the sharing of good practice and helping us to target support where it is most needed. If the CQC identifies that a local authority has failed or is failing to discharge its duties under the Care Act to an acceptable standard, my Rt Hon. Friend, the Secretary of State for Health and Social Care, has powers to intervene. Reports are made available on the CQC’s website, at the following link:www.cqc.org.uk/care-services/local-authority-assessment-reports

Commonwealth and Development Affairs, what assessment her Department has made of the impact of reducing humanitarian aid funding in Africa on landmine disposal.

The UK Government's Global Mine Action Programme has been funding clearance and risk education for over a decade, including in Africa, protecting lives and livelihoods, and supporting our broader humanitarian and development goals. In addition, the Foreign Secretary recently announced a further £4 million in funding for the United Nations Mine Action Service to help clear the estimated 7,500 tonnes of unexploded munitions which have been preventing the safe passage of aid into Gaza. Future allocations to demining activity will be announced in the usual way in due course.

Commonwealth and Development Affairs, what assessment her Department has made of the potential merits of implementing a global programme supporting civilian victims of landmines.

The UK Government's Global Mine Action Programme has been funding clearance and risk education for over a decade, including in Africa, protecting lives and livelihoods, and supporting our broader humanitarian and development goals. In addition, the Foreign Secretary recently announced a further £4 million in funding for the United Nations Mine Action Service to help clear the estimated 7,500 tonnes of unexploded munitions which have been preventing the safe passage of aid into Gaza. Future allocations to demining activity will be announced in the usual way in due course.

What assessment his Department has made of the potential implications for its policies of the Adult Oral Health survey published on 9 December 2025.

The Adult Oral Health Survey 2023 provides the first picture of adult oral health in England for more than a decade. It provides further evidence of the need for dental contract reform.We are taking forward significant changes to the National Health Service dental contract. The reforms will prioritise patients with urgent dental needs and those requiring complex treatments, and will come in from April 2026. We are committed to fundamental reform of the NHS dental contract by the end of this Parliament, with a focus on improving access, promoting prevention, and rewarding dentists fairly.The Government is also focussed on prevention of poor dental health through our supervised toothbrushing programme to reach up to 600,000 children in the 20% most deprived areas of England, and by expanding community water fluoridation to the North East of England. This intervention will reach an additional 1.6 million people and will reduce tooth decay and inequalities in dental health, particularly in children and vulnerable adults.

Commonwealth and Development Affairs, what conversations she has had with her international counterparts on (a) the impact of global aid cuts to humanitarian aid and (b) the impact those cuts will have on landmine disposal.

The UK Government's Global Mine Action Programme has been funding clearance and risk education for over a decade, including in Africa, protecting lives and livelihoods, and supporting our broader humanitarian and development goals. In addition, the Foreign Secretary recently announced a further £4 million in funding for the United Nations Mine Action Service to help clear the estimated 7,500 tonnes of unexploded munitions which have been preventing the safe passage of aid into Gaza. Future allocations to demining activity will be announced in the usual way in due course.

Commonwealth and Development Affairs, if her Department will undertake a review of its explosive ordinance policies.

The UK Government's Global Mine Action Programme has been funding clearance and risk education for over a decade, including in Africa, protecting lives and livelihoods, and supporting our broader humanitarian and development goals. In addition, the Foreign Secretary recently announced a further £4 million in funding for the United Nations Mine Action Service to help clear the estimated 7,500 tonnes of unexploded munitions which have been preventing the safe passage of aid into Gaza. Future allocations to demining activity will be announced in the usual way in due course.

What steps his Department is taking to reduce the number of adults with tooth decay.

The Government is proceeding with the reforms to the National Health Service dental contract. These will be introduced from April 2026 so that patients with gum disease or tooth decay will be better able to get long-term treatment through new clinical treatment pathways. Further information is available at the following link:https://www.gov.uk/government/consultations/nhs-dentistry-contract-quality-and-payment-reformsWe are also committed to fundamental reform of the NHS dental contract by the end of this Parliament, with a focus on improving access, promoting prevention, and rewarding dentists fairly.Sugar consumption is the main cause of tooth decay. We are taking measures to reduce sugar consumption, which will have a positive effect on improving children’s oral health. Following the Strengthening the Soft Drinks Industry Levy (SDIL) consultation, we will reduce the current lower threshold at which the SDIL applies from five grams of total sugar per 100 millilitres to 4.5 grams of total sugar per 100 millilitres and will remove the current exemption for milk-based drinks.We are expanding community water fluoridation to the North East of England. This intervention is expected to reach an additional 1.6 million people and will reduce tooth decay and inequalities in dental health.We have published guidance on how dental health professionals can improve the oral and general health of their patients, including preventative interventions. This can be viewed at the following link: https://www.gov.uk/government/publications/delivering-better-oral-health-an-evidence-based-toolkit-for-preventionGuidance for local service commissioners on better oral health of vulnerable older people is also available at the following link: https://www.gov.uk/government/publications/commissioning-better-oral-health-for-vulnerable-older-people

What assessment his Department has made of the potential merits of implementing a mandatory care marker for care workers on their GP record.

The Department has not undertaken a formal assessment of introducing a mandatory care marker for those employed as care workers on general practice records. Any request for new coding would need to consider the purpose and proportionality of the introduction for employed care staff, and the impact on general practice.There are existing SNOMED, the structured clinical vocabulary for use in an electronic health record, and clinical term codes which can be used to indicate a person’s unpaid caring role on their health record.