Written questions by Holden.

Pursuant to the Answer of 20 January 2025 to Question 24256 on Electronic Cigarettes: Young People, whether the Tobacco and Vapes Bill will restrict the size of vape tanks.

Whilst nicotine vapes are already subject to tank size requirements, the Tobacco and Vapes Bill goes further and covers all types of vapes, both nicotine and non-nicotine, and consumer nicotine products.As stated in our previous answer, the bill provides powers on product features that allow the Government to regulate the size of a tank or refill container, and the amount of liquid that can be included, as well as powers to standardise the size and shape of vapes, and to further restrict liquid availability.Subject to consultation, regulation making powers in the Government’s bill will allow us to amend or place additional requirements and limits on vape tank sizes, and the size of refill tanks. The Government will consider this issue further as part of its secondary legislation programme after Royal Assent.

If he will publish a table of the total amount spent on (a) primary, (b) secondary, (c) tertiary and (d) community care in the NHS in each of the last 5 financial years.

NHS England does not routinely collect expenditure data against the categories requested. However, the table attached shows the total spend in billions for specialised services, primary medical care, community services, continuing care, acute services, core mental health services, and others, as well as total integrated care board and direct commissioning spend, from 2015/16 to 2023/24.

If he will publish a table of the number of (a) doctors, (b) registered nurses and (c) medical scientists were employed as locums in each (i) month and (ii) year since 2021 and what the total cost was for each group in each of those (A) months and (B) years.

The Department does not hold the information requested. NHS England publishes quarterly information on total agency and bank expenditure by National Health Service providers as part of financial reporting, which is available at the following link:https://www.england.nhs.uk/publication/financial-performance-reportsThe 2025/26 NHS Planning Guidance states that trusts should reduce their agency spend by a minimum of 30% and bank spend by a minimum of 10%. The accompanying Revenue Finance and Contracting Guidance sets the ambition that agency spend should be eliminated in the coming years.

How many and what proportion of Child Death Overview Panels cited consanguinity as the (a) primary and (b) secondary cause of death of children in each of the last 30 years.

The Child Death Review Statutory and Operational Guidance (England) sets out as a statutory requirement that, ‘When a child dies, in any circumstances, it is important for parents and families to understand what has happened and whether there are any lessons to be learned.’ The guidance is available at the following link:https://assets.publishing.service.gov.uk/media/637f759bd3bf7f154876adbd/child-death-review-statutory-and-operational-guidance-england.pdfThese reviews are conducted by child death overview panels (CDOPs), who have a statutory obligation to notify the National Child Mortality Database (NCMD) within 48 hours of a child’s death using a child death notification form, which is available at the following link:https://www.gov.uk/government/publications/child-death-reviews-forms-for-reporting-child-deathsThe form includes a question about ‘Further family background’ which asks whether the children’s parents are related to each other. The forms are submitted to NCMD who collate the data to produce reports, including its annual data report. Its latest annual report summarised information about child deaths in England up to 31 March 2024 and the findings of reviews carried out by a CDOP on or before 31 March 2024. The report is available at the following link:https://www.ncmd.info/publications/child-death-review-data-release-2024/For the first time, this report included information on the number of reviews where specific contributory or modifiable factors were identified. Contributory factors may have contributed to vulnerability, ill health or death, while modifiable factors may have contributed to the death of the child and might, by means of a locally or nationally achievable intervention, be modified to reduce the risk of future deaths. Of 3,176 reviews taking place in the year ending 31 March 2024 where contributory factors were identified, 128 reviews, or 4%, identified consanguinity as a contributory factor. Of 1,120 reviews taking place in the year ending 31 March 2024 where modifiable factors were identified and data was available, 16 reviews, or 1%, identified consanguinity as a modifiable factor.

What assessment his Department has made of the potential impact of very high-puff count vapes on trends in the level of youth vaping.

Selling nicotine vapes to children under 18 years old is illegal. Yet due to the branding and advertising of vapes to children, one-in-four children aged between 11 and 15 years old tried vaping in 2023. The health advice is clear, that vaping is never recommended for children or non-smokers. Single-use vapes are playing a significant role in the rise of youth vaping; in 2024, 54% of current vapers aged between 11 and 17 years old in Great Britain were using them, increasing from 7.7% in 2021. The Department of Health and Social Care is aware of the issues regarding ‘big-puff’ vapes, including those raised in the study referenced. The Department for Environment, Food and Rural Affairs has laid legislation to ban the sale of single-use disposable vapes in England from 1 June 2025. Most ‘big puff’ vapes currently on the market are neither refillable or rechargeable, which means that they will be captured by the Department for Environment, Food and Rural Affairs’ forthcoming ban. The Tobacco and Vapes Bill will ban the advertising and sponsorship of all vapes and nicotine products. It will also provide regulation making powers to limit the flavours and packaging of vapes and nicotine products, as well as how these products are displayed. The Bill also provides powers that allow the Government to regulate the size of a tank or refill container, and the amount of liquid that can be included, as well as powers to standardise the size and shape of vapes, and to further restrict liquid availability. In addition, the Bill contains powers that allow us to regulate the amount of nicotine in a puff, so the Government is able to restrict the nicotine not only in the tank, but also the nicotine that can be emitted in the vapour. Future vaping regulations will be accompanied by impact assessments when the secondary legislation is laid.

What assessment he has made of the potential impact of provisions within the Tobacco and Vapes Bill on trends in the level of usage of very high puff-count vapes among young people.

Selling nicotine vapes to children under 18 years old is illegal. Yet due to the branding and advertising of vapes to children, one-in-four children aged between 11 and 15 years old tried vaping in 2023. The health advice is clear, that vaping is never recommended for children or non-smokers. Single-use vapes are playing a significant role in the rise of youth vaping; in 2024, 54% of current vapers aged between 11 and 17 years old in Great Britain were using them, increasing from 7.7% in 2021. The Department of Health and Social Care is aware of the issues regarding ‘big-puff’ vapes, including those raised in the study referenced. The Department for Environment, Food and Rural Affairs has laid legislation to ban the sale of single-use disposable vapes in England from 1 June 2025. Most ‘big puff’ vapes currently on the market are neither refillable or rechargeable, which means that they will be captured by the Department for Environment, Food and Rural Affairs’ forthcoming ban. The Tobacco and Vapes Bill will ban the advertising and sponsorship of all vapes and nicotine products. It will also provide regulation making powers to limit the flavours and packaging of vapes and nicotine products, as well as how these products are displayed. The Bill also provides powers that allow the Government to regulate the size of a tank or refill container, and the amount of liquid that can be included, as well as powers to standardise the size and shape of vapes, and to further restrict liquid availability. In addition, the Bill contains powers that allow us to regulate the amount of nicotine in a puff, so the Government is able to restrict the nicotine not only in the tank, but also the nicotine that can be emitted in the vapour. Future vaping regulations will be accompanied by impact assessments when the secondary legislation is laid.

What assessment he has made of the potential implications for his policies of the Material Focus study entitled Big puff vapes are surging onto the market adding to the vape environmental crisis, published on 16 December 2024, and whether he plans to take steps to tackle the popularity of high puff-count vapes amongst 16 to 34 year olds.

Selling nicotine vapes to children under 18 years old is illegal. Yet due to the branding and advertising of vapes to children, one-in-four children aged between 11 and 15 years old tried vaping in 2023. The health advice is clear, that vaping is never recommended for children or non-smokers. Single-use vapes are playing a significant role in the rise of youth vaping; in 2024, 54% of current vapers aged between 11 and 17 years old in Great Britain were using them, increasing from 7.7% in 2021. The Department of Health and Social Care is aware of the issues regarding ‘big-puff’ vapes, including those raised in the study referenced. The Department for Environment, Food and Rural Affairs has laid legislation to ban the sale of single-use disposable vapes in England from 1 June 2025. Most ‘big puff’ vapes currently on the market are neither refillable or rechargeable, which means that they will be captured by the Department for Environment, Food and Rural Affairs’ forthcoming ban. The Tobacco and Vapes Bill will ban the advertising and sponsorship of all vapes and nicotine products. It will also provide regulation making powers to limit the flavours and packaging of vapes and nicotine products, as well as how these products are displayed. The Bill also provides powers that allow the Government to regulate the size of a tank or refill container, and the amount of liquid that can be included, as well as powers to standardise the size and shape of vapes, and to further restrict liquid availability. In addition, the Bill contains powers that allow us to regulate the amount of nicotine in a puff, so the Government is able to restrict the nicotine not only in the tank, but also the nicotine that can be emitted in the vapour. Future vaping regulations will be accompanied by impact assessments when the secondary legislation is laid.

If his Department will publish (a) the business case for and (b) analysis held of the Genetic Risk Equity project.

There is not a business case for the project and therefore there is no plan to publish one. The project was approved through the maternity transformation programme board and business planning and prioritisation processes.The project expert reference group has engaged with pilot sites throughout implementation and qualitative feedback has informed development of Phase 2 of the programme. There will be an evaluation of the project due in spring 2025 that will include quantitative and qualitative analyses. The intention is to publish this.

Pursuant to the Answer of 9 January 2025 to Question 22100 on Genetics: Diseases, how many additional (a) midwives and (b) close relative neonatal nurses were provided for the Genetic Risk Equity project; and what proportion of funding that represented.

There were an additional 3.8 working time equivalent (WTE) midwives and 1 WTE neonatal nurse in post in 2024/25. Staff costs represented 22% of project costs, or 59% if full recruitment to funded posts was secured.

Whether (a) Ministers and (b) officials in his Department have had meetings with representatives of the British Society for Genetic Medicine in the last 30 years.

In the last 30 years, officials in the Department of Health and, later, the Department of Health and Social Care, have had meetings with representatives of the British Society for Genetic Medicine. As far as can be determined, ministers have also had meetings with representatives of the British Society for Genetic Medicine.

Pursuant to the Answer of 8 January 2025 to Question 21699 on Gonorrhoea: Health Services, what data his Department holds on the cost of treating gonorrhoea to the NHS; and if he will publish that data.

The data on the cost of treating gonorrhoea to the National Health Service is not held centrally. This is because most gonorrhoea infections are treated with antibiotics in sexual health services using funding from the Local Authority Public Health Grant. In 2023, there were 85,223 diagnoses of gonorrhoea in sexual health services in England.For infections and complications requiring treatment in secondary care, the UK Health Security Agency estimates that the cost to the NHS of treating gonorrhoea in secondary care in 2022/23 was approximately £2,000 per in-patient admission. Data on the number of admissions is not held centrally.

Pursuant to the Answer of 3 January 2025 to Question 19417 on Genetics: Diseases, how much funding was provided by NHS England to the Genetic Risk Equity project; and what that funding was used for.

The project began in 2022/23, with total spend being £2.7 million. The following table showing the breakdown by year and to the nearest £100,000:YearSpend (£)2024/251,000,0002023/241,000,0002022/23700,000Source: NHS EnglandNote: The funding was spent on additional midwifery capacity, genomics associates, neonatal nurses (2024/25 only) and genetic literacy/public health outreach. 5% was spent on project management and evaluation.

Whether additional powers will be made available to law enforcement officers to penalise (a) barber shops, (b) off-licences, (c) bookmakers, (d) pubs and (e) other non-grocery and non-newsagent premises illegally selling tobacco products as a result of the implementation of a generational ban on tobacco sales.

The Tobacco and Vapes Bill will put us on track to a smoke-free United Kingdom, helping to reduce around 80,000 preventable deaths and reduce the burden on the National Health Service and on the taxpayer.Whilst the published impact assessment on the Bill makes no specific assessment of the potential impact on the illegal sale of tobacco products in non-grocery and non-newsagent premises, we expect most retailers who sell tobacco, regardless of the type of business, to comply with the new and existing measures in the Bill. Further impact assessments will be prepared in advance of secondary legislation, including for a future licensing scheme, which aims to crack down on rogue retailers.The Bill takes bold action to strengthen enforcement and crack down on rogue retailers who break the law regardless of the type of business. It introduces new £200 fixed penalty notices (FPNs), in England and Wales, to support Trading Standards Officers to take swifter enforcement action by issuing on-the-spot fines rather than needing to go through lengthy court processes. Trading Standards will be able to issue a £200 FPN for a range of offences, including to anyone who illegally sells tobacco products to someone underage.The Bill also provides powers for Ministers in England, Wales, and Northern Ireland to introduce a licensing scheme for the retail sale of tobacco products, herbal smoking products, cigarette papers, vaping, and nicotine products. The licensing scheme will support legitimate businesses, act as a deterrent to rogue retailers and provide enforcement agencies with further opportunities to bring penalties against these retailers. We will consult on the details of the licensing scheme ahead of introducing regulations, including the types of business which may hold a licence and the licence conditions.

What assessment he has made of the potential impact of the Tobacco and Vapes Bill on the illegal sale of tobacco products in (a) non-grocery and (b) non-newsagent premises.

The Tobacco and Vapes Bill will put us on track to a smoke-free United Kingdom, helping to reduce around 80,000 preventable deaths and reduce the burden on the National Health Service and on the taxpayer.Whilst the published impact assessment on the Bill makes no specific assessment of the potential impact on the illegal sale of tobacco products in non-grocery and non-newsagent premises, we expect most retailers who sell tobacco, regardless of the type of business, to comply with the new and existing measures in the Bill. Further impact assessments will be prepared in advance of secondary legislation, including for a future licensing scheme, which aims to crack down on rogue retailers.The Bill takes bold action to strengthen enforcement and crack down on rogue retailers who break the law regardless of the type of business. It introduces new £200 fixed penalty notices (FPNs), in England and Wales, to support Trading Standards Officers to take swifter enforcement action by issuing on-the-spot fines rather than needing to go through lengthy court processes. Trading Standards will be able to issue a £200 FPN for a range of offences, including to anyone who illegally sells tobacco products to someone underage.The Bill also provides powers for Ministers in England, Wales, and Northern Ireland to introduce a licensing scheme for the retail sale of tobacco products, herbal smoking products, cigarette papers, vaping, and nicotine products. The licensing scheme will support legitimate businesses, act as a deterrent to rogue retailers and provide enforcement agencies with further opportunities to bring penalties against these retailers. We will consult on the details of the licensing scheme ahead of introducing regulations, including the types of business which may hold a licence and the licence conditions.

Pursuant to the Answer of 23 December 2024 to Question 19416 on Maternity Services: Nurses, if his Department will make an estimate of the number of close relative marriage neonatal nurses there are in the NHS; and if he will publish this data.

The Department has no plans to make such an estimate.

What assessment he has made of the potential impact of the implementation of a generational ban on tobacco sales on trends in the level of (a) counterfeit cigarettes and (b) contraband cigarettes being consumed in the UK.

I refer the hon. Member to the answer I gave to the hon. Member for Bridlington and The Wolds on 11 December 2024 to Question UIN 17992.

How many cases of gonorrhoea have been diagnosed in each of the last 30 years.

The following table shows the number of gonorrhoea diagnoses in sexual health services in England between 1994 and 2023:YearNumber of gonorrhoea diagnoses19949,63119959,890199611,828199712,332199812,457199915,450200020,297200122,198200224,123200323,346200420,669200517,632200617,191200717,119200814,985200916,141201016,839201121,090201226,909201331,200201437,150201541,290201636,545201744,839201856,690201971,133202050,678202149,321202279,268202385,223Source: UK Health Security Agency

What the (a) average and (b) maximum cost to the NHS was of untreated gonorrhoea in the latest year for which data is available; and what assessment he has made of the impact of this on the NHS.

The information requested is not held centrally.

What information his Department holds on the (a) cost and (b) incidence of cousin marriage.

The Government has not carried out an assessment of health costs resulting from cousin marriage. The Department also does not hold data on the incidence of cousin marriage.

What recent progress his Department has made on providing a new gonorrhoea vaccine through the NHS.

On 10 November 2023, the Joint Committee on Vaccination and Immunisation (JCVI) issued advice on standing up a targeted, routine vaccination programme for the prevention of gonorrhoea.Officials across the Department, the UK Health Security Agency, and NHS...