Written questions by Gilmour.

How much has been spent on primary care NHS dental services per head of population in England in real terms in each of the last 10 years (a) inclusive and (b) exclusive of the patient charge revenue.

Dental expenditure and patient charge revenue data is published each year in NHS England’s annual accounts. The annual accounts for 2024/25 have not yet been published, and so the latest published accounts data is for 2023/24.The following table shows the expenditure per head of population in England in real terms, inclusive and exclusive of patient charge revenue:Financial yearPrice per head of population, real terms at 2023/4 prices Inclusive of patient charge revenueExclusive of patient charge revenue2014/15£74.36£57.262015/16£77.92£60.422016/17£66.34£48.632017/18£65.71£47.702018/19£63.46£44.862019/20£65.22£47.322020/21£61.26£55.692021/22£62.13£49.422022/23£56.04£42.192023/24£53.87£40.41Notes:in 2016/17, NHS England’s accounts recorded a significant fall in dental services due to the improved allocation of costs between primary care and secondary dental services. The figures for earlier years are therefore not directly comparable;the population has been based on the England population mid-year estimate time series, published by the Office for National Statistics. Further information is available at the following link: https://www.ons.gov.uk/peoplepopulationandcommunity/populationandmigration/populationestimates/timeseries/enpop/pop; andconversion to real terms costs has been calculated using gross domestic product deflator rates as per the latest publication, in June 2025. Further information is available at the following link: https://www.gov.uk/government/statistics/gdp-deflators-at-market-prices-and-money-gdp-june-2025-quarterly-national-accounts.

What assessment he has made of the potential impact of trends in the level of investment in rural VCSE infrastructure on inequalities in access to (a) GP, (b) mental health, (c) community and (d) other essential healthcare services in rural localities; and what steps he plans to take with local VCSE partners to reduce these inequalities.

The Department recognises the voluntary, community, and social enterprise (VCSE) sector as a valuable partner in improving people’s health and wellbeing.The Government is committed to resetting the relationship with civil society and to unlock its potential. We want civil society to be an equal, expert partner, integral to the delivery of the Government’s 10-Year Health Plan. The implementation of the Neighbourhood Health Service brings care closer to people’s homes and integrates services across the statutory and VCSE sectors.

Whether his Department is taking steps to establish a ring-fenced research fund for studying the reproductive safety of sodium valproate.

The Department, through the National Institute for Health Research (NIHR), commissions a range of research to improve maternal and neonatal health outcomes. For example, the NIHR is currently funding a £2.7 million award which aims to improve outcomes, for both mother and baby, in pregnant women with epilepsy through early identification of women and their babies at risk of complications, and to promote safe antiepileptic drug (AED) use.The NIHR welcomes funding applications for research into any aspect of human health and care, including AEDs such as sodium valproate. These applications are subject to peer review and judged in open competition, with awards being made on the basis of the importance of the topic to patients and health and care services, value for money, and scientific quality. Welcoming applications to all NIHR programmes enables maximum flexibility both in terms of the amount of research funding a particular area can be awarded, and the type of research which can be funded.

Whether the forthcoming (a) NHS Long Term Workforce Plan and (b) National Neighbourhood Health Implementation Programme will include policies on staffing in rural areas.

The 10 Year Workforce Plan will be published later this year. We will work with partners to make sure we have the right people, in the right places, with the right skills, to ensure the National Health Service has access to the workforce it needs to treat those that require care, treatment, and diagnosis across all our communities, including remote, rural, and coastal communities.The National Neighbourhood Health Implementation Programme was launched on 3 July 2025, to support systems across the country to test new ways of working, share learning, and scale what works. We expect neighbourhood teams and services to be designed in a way that reflects the specific needs of local populations. While we will be clear on the outcomes we expect, we will give significant licence to tailor the approach to local need. While the focus on personalised, coordinated care will be consistent, that will mean the service will look different in rural communities, coastal towns, or deprived inner cities.

What steps he is taking to ensure the (a) sustainable funding and (b) fair commissioning of (i) hospice and (ii) palliative care services take into account the higher cost of delivering services in rural areas.

Palliative care services are included in the list of services an integrated care board (ICB) must commission. To support ICBs in this duty, NHS England has published statutory guidance and service specifications. The statutory guidance states that ICBs must work to ensure that there is sufficient provision of care services to meet the needs of their local populations, which can include hospice services available within the ICB catchment. The statutory guidance also outlines areas for consideration when commissioning, including improving equity of access and reducing inequity in outcomes and experiences.Whilst the majority of palliative and end of life care is provided by National Health Service staff and services, we recognise the vital part that voluntary sector organisations, including hospices, also play in providing support to people at the end of life and their loved ones.Most hospices are charitable, independent organisations which receive some statutory funding for providing NHS services. The amount of funding each charitable hospice receives varies both within and between ICB areas. This will vary depending on demand in that ICB area but will also be dependent on the totality and type of palliative and end of life care provision from both NHS and non-NHS services, including charitable hospices, within each ICB area.The Government and the NHS will closely monitor the shift towards the strategic commissioning of palliative and end of life care services to ensure that the future state of services reduces variation in access and quality, although some variation may be appropriate to reflect both innovation and the needs of local populations.The Department is currently exploring how to improve the access, quality, and sustainability of all-age palliative and end of life care in line with the 10-Year Health Plan. Officials will present further proposals to ministers over the coming months, outlining how to operationalise the required shifts in palliative care and end of life care to enable the shift from hospital to community, including as part of neighbourhood health teams.

What assessment he has made of the adequacy of regulations on the (a) composition, (b) marketing and (c) labelling of commercial infant and toddler foods.

Children’s early years provide an important foundation for their future health and strongly influences many aspects of wellbeing in later life.It is vital that we maintain the highest standards for foods consumed by babies and infants, which is why we have regulations in place that set nutritional, compositional, and labelling standards for commercial baby food. These ensure that the ingredients used in commercial baby food are suitable for the nutritional needs of infants and require businesses to ensure labelling in clear and not misleading. The regulations also set labelling standards to ensure consumers have clear and accurate information about the products they buy.We continue to keep these regulations under review to ensure they reflect the latest scientific and dietary guidelines.

What steps he plans to take to reduce NHS staff burnout.

The health and wellbeing of National Health Service staff is a top priority. NHS organisations have a responsibility to create supportive working environments for staff, ensuring they have the conditions they need to thrive, including access to high quality health and wellbeing support.As set out in the 10-Year Health Plan, we will roll out Staff Treatment hubs to ensure all staff have access to high quality occupational health support, including for mental health.To further support this ambition, we will work with the Social Partnership Forum to introduce a new set of staff standards for modern employment, covering issues such as access to healthy meals, support to work healthily and flexibly, and tackling violence, racism, and sexual harassment in the workplace.

What assessment his Department has made of the contribution of Community Interest Companies to the provision of day care services for people with early-stage dementia.

The Government is committed to ensuring that families have the support that they need. The provision of dementia health care services is the responsibility of local integrated care boards and may include day care services.Local authorities are best placed to understand and plan for the needs of their population, which is why, under the Care Act 2014, local authorities are tasked with the duty to shape their care market to meet the diverse needs of all people.Our health system has struggled to support those with complex needs, including those with dementia. Under the 10-Year 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.

What assessment he has made of the potential role of family hubs in (a) neighbourhood health and (a) the delivery of integrated community-based health services.

The 10-Year Health Plan outlined proposals for a new Neighbourhood Health Service, which embodies our preventative principle, that care should happen as locally as it can. Neighbourhood health services will build on, and will coordinate with Best Start Family Hubs and Start for Life services to continue to integrate children’s services, National Health Services, and public health.The Neighbourhood Health Service will mean that millions of patients are treated and cared for closer to their home by new teams of health professionals, providing easier, more convenient access to a full range of healthcare services on people’s doorsteps.The impact of Family Hubs and Start for Life services will take time to be realised. The current Family Hubs and Start for Life programme is subject to two national, independent evaluations to understand its implementation and impact.

What steps he is taking to prioritise UK-trained resident doctors in the allocation of specialist training posts; and what steps he is taking to increase the number of such funded posts.

As set out in our 10-Year Health Plan published on 3 July, we will work across Government to prioritise United Kingdom medical graduates for foundation training, and to prioritise UK medical graduates and other doctors who have worked in the National Health Service for a significant period for specialty training. Over the next three years we will also create 1,000 new specialty training posts with a focus on specialties where there is greatest need. We will set out the next steps in due course.We will publish a new 10 Year Workforce Plan later this year to deliver the transformed health service we will build over the next decade and treat patients on time again.

Whether he plans to make the NHS chickenpox vaccination available to all children.

The Government is considering the Joint Committee on Vaccination and Immunisation’s recommendation, published in November 2023, to introduce a varicella, also known as chickenpox, programme into the immunisation schedule for children.It is important that any proposed change to the childhood immunisation schedule is comprehensively assessed to maintain the high standards of the United Kingdom’s world-leading vaccination programmes and ensure the best value for money for taxpayers.The Government will make a final decision about whether to introduce a chickenpox programme, including the eligibility and timing of any potential programme, when this work has concluded.

What steps his Department is taking to help tackle trends in the level of ketamine abuse among young people.

The Department takes seriously the threat ketamine use poses to young people. Local authorities are responsible for providing drug treatment services based on the needs of their local populations, and this includes services to support ketamine users. In addition to the Public Health Grant, in 2025/26 the Department is providing a total of £310 million in additional targeted grants to improve drug and alcohol services and wider recovery support, including housing and employment. Local authorities, Combating Drugs Partnerships, and treatment providers lead on prevention, harm reduction, and treatment interventions, which includes awareness raising. Widespread action is already in progress through local and regional initiatives. Many of the national treatment providers, as well as local areas, have developed bespoke awareness-raising resources and approaches in response to ketamine, and a number have held events for professionals working in the field. In addition to this, the Department recently cascaded a briefing to local authorities and treatment systems on data on ketamine use and guidance on prevention, harm reduction, and treatment interventions. Department of Health and Social Care and Home Office ministers have written to festival organisers, asking them to work closely with police and health partners on their harm reduction and first aid measures, which includes highlighting the dangers of ketamine. The Department has also worked with the National Police Chiefs’ Council on a joint letter and advice for the police and local authorities about festivals, drugs, and alcohol, to minimise the risk of harm to individuals at these events. Statutory guidance on relationships, sex, and health education requires all primary and secondary schools to ensure that pupils know the key facts and risks associated with drug use, as well as how to manage influences and pressure, and keep themselves healthy and safe. The Department has worked with the Personal, Social, Health and Economic Education Association to develop the lesson plans on drugs and alcohol and commissioned an update of the resources, which was published at the end of last year. The Government has a drug information and advice service called Talk to FRANK, which aims to reduce drug misuse and its harms by increasing awareness, particularly for young people and parents. Talk to FRANK offers easy to read information on the risks of using ketamine, including bladder problems, and mixing it with other substances, as well as basic harm reduction advice. As a result of additional funding, and in response to increased prevalence, the treatment system is responding, and the proportion of children and young people under the age of 18 years old accessing help in relation to ketamine has increased from under 1% in 2015/16 to 9% in November 2024.

What recent assessment he has made of the adequacy of the availability of training for social care staff to (a) understand and (b) address the needs of brain injury survivors.

We intend to develop an acquired brain injury (ABI) Action or Delivery Plan, with input from NHS England and other Government departments, to be published in autumn 2025. The 10-Year Health Plan will provide the overarching plan for the future of the National Health Service, and a subsequent ABI Plan would then focus on specific actions and deliverables for ABI against the backdrop of the 10-Year Health Plan.Community rehabilitation for people with neurological conditions is named as one the integrated care board-funded core components of community health services. Further information on Standardising community health services planning guidance is available at the following link:https://www.england.nhs.uk/long-read/standardising-community-health-services/The Department launched the Adult Social Care Learning and Development Support Scheme (LDSS) in September 2024, providing funding for eligible care staff to complete courses and qualifications. The scheme is backed by up to £12 million this financial year.We have published a list of over 200 training courses and qualifications which are eligible for funding from the LDSS, including training to enable staff to support care users with specific needs and medical conditions. It also includes qualifications to enhance quality of care more broadly, including the new Level 2 Adult Social Care Certificate (L2ASCC).The L2ASCC is an accredited occupational qualification for all eligible non-regulated care staff aged 19 years old and over. It is based on the Care Certificate standards and ensures that those working in the sector have the right skills to provide the right care for individuals who draw on care and support.While brain injuries are not explicitly mentioned, the L2ASCC and the Care Certificate standards provide a foundation of knowledge and skills necessary to support individuals in the adult social care sector safely and effectively.

What steps he plans to take to provide financial support for local community-based (a) rehabilitation and (b) reablement services for brain injury survivors.

We intend to develop an acquired brain injury (ABI) Action or Delivery Plan, with input from NHS England and other Government departments, to be published in autumn 2025. The 10-Year Health Plan will provide the overarching plan for the future of the National Health Service, and a subsequent ABI Plan would then focus on specific actions and deliverables for ABI against the backdrop of the 10-Year Health Plan.Community rehabilitation for people with neurological conditions is named as one the integrated care board-funded core components of community health services. Further information on Standardising community health services planning guidance is available at the following link:https://www.england.nhs.uk/long-read/standardising-community-health-services/The Department launched the Adult Social Care Learning and Development Support Scheme (LDSS) in September 2024, providing funding for eligible care staff to complete courses and qualifications. The scheme is backed by up to £12 million this financial year.We have published a list of over 200 training courses and qualifications which are eligible for funding from the LDSS, including training to enable staff to support care users with specific needs and medical conditions. It also includes qualifications to enhance quality of care more broadly, including the new Level 2 Adult Social Care Certificate (L2ASCC).The L2ASCC is an accredited occupational qualification for all eligible non-regulated care staff aged 19 years old and over. It is based on the Care Certificate standards and ensures that those working in the sector have the right skills to provide the right care for individuals who draw on care and support.While brain injuries are not explicitly mentioned, the L2ASCC and the Care Certificate standards provide a foundation of knowledge and skills necessary to support individuals in the adult social care sector safely and effectively.

Whether training is available through the NHS for school nurses on managing allergies and administering adrenaline auto-injectors.

The Nursing and Midwifery Council (NMC) sets the standards for education preparation for school nurses, who are registered nurses that undertake a post-graduate Specialist Public Health Nurse qualification with an NMC-approved university. School nurses will then also undertake any mandatory training required by their employer, as appropriate to their role. Section 100 of the Children and Families Act 2014 places a duty on schools to make arrangements for supporting pupils with medical conditions. Schools should ensure they are aware of any pupils with medical conditions, and should have policies and processes in place to ensure these can be well managed. This includes allergies. The policy should also set out how staff will be supported in carrying out their role to support pupils, including how training needs are assessed and how training is commissioned and provided. Any member of school staff providing support to a pupil with medical needs should have received suitable training. NHS England has also produced the Healthy School Child e-learning programme, which is available at the following link: https://www.e-lfh.org.uk/programmes/healthy-school-child/ This programme is designed for healthcare professionals, including school nurses, working with children aged between five and 12 years old. Module 5 of the e-learning programme includes sessions on asthma, eczema, and other allergies.

What steps he is taking to ensure that deafblind people can access care needs assessments.

Under the Care Act 2014 and Care and Support (Assessment) Regulations 2014, local authorities are responsible for ensuring deafblind people in their area access the right care and support. This includes making contact with and keeping a record of all deafblind people in their area and ensuring that needs assessments are carried out by a person who has specific training and expertise relating to individuals who are deafblind. In addition, under the Equality Act (2010), local authorities must make reasonable adjustments to ensure that disabled people are not disadvantaged.The Government recognises the many challenges facing the adult social care system and is taking steps to improve access to adult social care. We have launched an independent commission into adult social care as part of our critical first steps towards delivering a National Care Service. The commission will make clear recommendations to define and build an adult social care system that will meet the current and future needs of our population. The commission will consider older people’s care and support for working age disabled adults separately, recognising that these services meet different needs.In the interim, the Care Quality Commission (CQC) are assessing how well local authorities in England are performing against their duties under Part 1 of the Care Act 2014, including their duties relating to the access and provision of care and support for deafblind people. Support for deafblind people will form part of the CQC’s overall assessment of local authorities’ delivery of adult social care. In that context, the CQC will report when there is something to highlight, for example, something being done well, innovative practice or an area for improvement. If the CQC identifies a local authority has failed or is failing its functions to an acceptable standard, my Rt. Hon. friend, the Secretary of State for Health and Social Care, has powers to intervene. The CQC has published over forty local authority ratings and reports, which are available at the following link: https://www.cqc.org.uk/care-services/local-authority-assessment-reports

What steps he is taking to help ensure that social care reform tackles barriers faced by (a) disabled people with complex needs and (b) deafblind people.

The Government is taking forward a package of reforms to enable more people to live independently for longer, including older adults, disabled people, and those with complex needs. For example, in 2025/26, we are providing up to £3.7 billion of additional funding for social care authorities, including an £880 million increase in the Social Care Grant.We are also providing £172 million across this and the last financial year, for approximately 15,000 home adaptations, and are introducing new national standards and trusted guidance for care technologies such as remote monitoring. In addition, to strengthen the workforce, we are legislating for the first ever Fair Pay Agreement for care workers and are providing a £2,000 uplift to the Carer’s Allowance.We have also launched an independent commission into adult social care as part of our critical first steps towards delivering a National Care Service. The commission will work with people who draw on care and support, their families, staff, and the wider sector to build a system that meets the current and future needs of our population. These improvements will help support the quality of adult social care for all who draw on it, including disabled people with complex needs and deafblind people.

If his Department will make an assessment of the adequacy of the online NHS Dentist checker information.

National Health Service dentists are required to update their NHS website profiles at least every 90 days to ensure patients have up-to-date information on where they can access care. This includes information on whether they are accepting new patients.Integrated care boards can review which practices in their area have not updated their profile in a 90-day period, and work with practices to ensure websites are up to date.Patients in England are not registered with an NHS dental practice, although many NHS dental practices do tend to see patients regularly. There is no geographical restriction on which practice a patient may attend.

Whether he has made an assessment of the potential merits of consulting with experts from the voluntary support sector during the (a) planning for and (b) piloting of mental health support teams in schools.

As set out in the NHS Operational Planning Guidance 2025/26, integrated care boards are responsible for planning and implementing mental health support teams. Since the inception of the programme, guidance to local commissioners has been to engage with local partners including the voluntary sector in planning for mental health support teams, mapping local support, and through representation in local governance.

If his Department will make an assessment of the effectiveness of the Pharmacy First initiative in relation to reducing the workload for GP surgeries.

National Health Service pharmaceutical services delivered in community pharmacy are subject to evaluations to assess various outcomes such as clinical appropriateness and impacts on other parts of the NHS. The National Institute of Health and Care Research is conducting an evaluation of Pharmacy First to assess how the service has been implemented across England, including impacts on prescribing in the general practice (GP) setting, use of hospitals and how the service has impacted access and cost for different patient groups.From July 2024 to February 2025, over 1.7 million Pharmacy First clinical pathway consultations were delivered by community pharmacies. In the same period, over 1.5 million minor illness referrals and 1.4 million consultations for urgent medical supplies were delivered by community pharmacies in England to support patients and help to alleviate the pressure on GP surgeries.Pharmacy First compliments and enhances the already wide range of services offered by community pharmacy including the provision of health advice and sale of over-the-counter medicines for a wider range of minor illness to support patients to selfcare rather than attend a GP, helping to increase access to care for patients closer to home in their communities.