Written questions by Farron.

What information his Department holds on air pollution impacting people's health in relation to (a) ambient air and (b) indoor air in England.

The Department and the UK Health Security Agency have published a range of information and evidence on health impacts of air pollution, to support action to reduce exposure to harmful emissions.The Chief Medical Officer’s Annual Report 2022: Air Pollution sets out a detailed overview of this evidence of the impact on health of both indoor and ambient air quality. The report can be accessed at the following link:https://www.gov.uk/government/publications/chief-medical-officers-annual-report-2022-air-pollution

What discussions he has had with Cabinet colleagues on delivering national targets for ambient air including by sharing data.

Department of Health and Social Care ministers engage regularly with ministerial colleagues on air quality. The 10-Year Health Plan for England details action the Government will take to reduce the health harms of air pollution. This includes the Department for Environment, Food and Rural Affairs’ refreshed Environmental Improvement Plan which sets out action to further improve air quality in England including through revised interim targets.

If he will set out the types of health impacts of poor (a) ambient and (b) indoor air quality by (i) geography and (ii) socioeconomic groups.

Ambient and indoor air pollution are harmful to health in the United Kingdom. Long-term exposure to air pollution, over years or lifetimes, reduces life expectancy, mainly due to cardiovascular and respiratory diseases, dementia and lung cancer. Short-term exposure, over hours or days, to elevated levels of air pollution can also cause a range of health impacts, including effects on lung function, exacerbation of asthma, increases in respiratory and cardiovascular hospital admissions, and mortality. Some groups may be more affected by air pollution exposure due to their location or socioeconomic background, but the types of health impacts from exposure to poor air quality in indoor and ambient settings remains similar. A combination of high ambient air pollution levels and substandard housing in income-deprived areas, pre-existing health issues, and lifestyle factors contribute to a disproportionate burden of air-pollution-related ill health among more deprived groups.

What assessment he has made of the potential impact of poor air quality in (a) ambient air and (b) indoor air on different age groups of people in England.

Poor air quality is a major public health risk in the United Kingdom. An estimated 29,000 to 43,000 deaths were attributable to long-term exposure to ambient air pollution in the UK in 2019 among adults aged 30 years old and over.Indoor residential exposure to damp and mould was associated with approximately 5,000 cases of asthma and 8,500 lower respiratory infections among children, those who are aged between zero to 14 years old, and adults, those who are aged between 15 to 49 years old, in England in 2019.The UK Health Security Agency (UKHSA) contributed to a report by the Royal College of Physicians in 2025. This contained data on new cases of mortality, myocardial infarction, asthma, lung cancer, and other conditions, attributable to a range of air pollutants in 2019 and predicted for 2040, among children, those over 30 years old, over 60 years old, and at all ages. The report is available at the following link:https://www.rcp.ac.uk/policy-and-campaigns/policy-documents/a-breath-of-fresh-air-responding-to-the-health-challenges-of-modern-air-pollution/The Department’s 10-Year Health Plan sets out how the Government will act to reduce the health harms of air pollution. This includes action to reduce harm from ambient air pollution and tackling poor indoor air by improving the standard of rented homes with relation to damp and mould.

Whether he plans to take steps to allow NHS professionals to view the health records of ex-military patients from their time in military service.

The Defence Medical Services (DMS) provide primary healthcare for serving personnel. All serving personnel will have a Defence Health Record which records their healthcare through their military service, whether provided by DMS or the National Health Service.Serving personnel are provided with a medical care summary and a patient’s full Defence Health Record are transferred on request from their NHS general practitioner (GP). These are then available to be used and viewed as part of the individual’s medical records. These would also form part of digital records available via the NHS App and held by the respective veteran patient.To improve the transfer of healthcare information, DMS is working towards a greater interoperability with NHS systems and the electronic transfer of medical records from DMS to NHS GPs.

Whether research is being conducted into the potential association between Gabapentin use and the development of attentional amnestic disorders or other cognitive impairments.

Gabapentin is authorised to treat epilepsy and peripheral neuropathic pain, or nerve pain. The known side effects of gabapentin are outlined in the product information, the Summary of Product Characteristics (SPC) for healthcare professionals, and the Patient Information Leaflet which is provided in each pack of the medicine.The SPC states that in the treatment of peripheral neuropathic pain, such as painful diabetic neuropathy and post-herpetic neuralgia, efficacy and safety have not been examined in clinical studies for treatment periods longer than five months. If a patient requires the medication for longer than five months to treat peripheral neuropathic pain, the treating physician should assess the patient's clinical status and determine the need for additional therapy. Epilepsy normally requires long-term treatment and the SPC states that the dosage for gabapentin should be determined by the treating physician according to the clinical response and side effects experienced by the individual patient.The product information for gabapentin lists amnesia as a common side effect and mental impairment as an uncommon side effect. Dementia is not a known side effect of gabapentin.Gabapentin can cause drug dependence, and the product information includes warnings that patients treated with gabapentin should be monitored for symptoms of misuse, abuse, or dependence. After discontinuation of short- and long-term treatment with gabapentin, withdrawal symptoms have been observed, and gabapentin should be discontinued gradually over a minimum of one week.As with all medicines, the safety of gabapentin is kept under continual review by the Medicines and Healthcare products Regulatory Agency using a number of data sources including reports of suspected side effects through the Yellow Card Scheme, data from marketing authorisation holders, and research published in the scientific literature.

What steps are being taken to inform patients and healthcare professionals about the potential long-term risks of Gabapentin use.

Gabapentin is authorised to treat epilepsy and peripheral neuropathic pain, or nerve pain. The known side effects of gabapentin are outlined in the product information, the Summary of Product Characteristics (SPC) for healthcare professionals, and the Patient Information Leaflet which is provided in each pack of the medicine.The SPC states that in the treatment of peripheral neuropathic pain, such as painful diabetic neuropathy and post-herpetic neuralgia, efficacy and safety have not been examined in clinical studies for treatment periods longer than five months. If a patient requires the medication for longer than five months to treat peripheral neuropathic pain, the treating physician should assess the patient's clinical status and determine the need for additional therapy. Epilepsy normally requires long-term treatment and the SPC states that the dosage for gabapentin should be determined by the treating physician according to the clinical response and side effects experienced by the individual patient.The product information for gabapentin lists amnesia as a common side effect and mental impairment as an uncommon side effect. Dementia is not a known side effect of gabapentin.Gabapentin can cause drug dependence, and the product information includes warnings that patients treated with gabapentin should be monitored for symptoms of misuse, abuse, or dependence. After discontinuation of short- and long-term treatment with gabapentin, withdrawal symptoms have been observed, and gabapentin should be discontinued gradually over a minimum of one week.As with all medicines, the safety of gabapentin is kept under continual review by the Medicines and Healthcare products Regulatory Agency using a number of data sources including reports of suspected side effects through the Yellow Card Scheme, data from marketing authorisation holders, and research published in the scientific literature.

Whether prescribing guidelines for Gabapentin include warnings about potential risks associated with extended use.

There are a number of resources available to prescribers to advise them on the potential risks associated with extended use of gabapentin.The British National Formulary (BNF) for adults provides healthcare professionals with a range of information on the selection, prescribing, dispensing, and administration of medicines. The BNF monograph for gabapentin provides information on the cautions and side effects relating to use of the medicine. The BNF also provides important safety information, such as advice from the Medicines and Healthcare products Regulatory Agency on the risks associated with use of gabapentin.In addition, the known side effects of gabapentin are outlined in the product information, the Summary of Product Characteristics for healthcare professionals, and the Patient Information Leaflet which is provided in each pack of the medicine. These provide prescribers with special warnings and precautions regarding the use of gabapentin to inform decision-making.

What assessment has been made of the potential impact of prolonged use of Gabapentin on long-term neurological risks, including dementia and brain damage.

Gabapentin is authorised to treat epilepsy and peripheral neuropathic pain, or nerve pain. The known side effects of gabapentin are outlined in the product information, the Summary of Product Characteristics (SPC) for healthcare professionals, and the Patient Information Leaflet which is provided in each pack of the medicine.The SPC states that in the treatment of peripheral neuropathic pain, such as painful diabetic neuropathy and post-herpetic neuralgia, efficacy and safety have not been examined in clinical studies for treatment periods longer than five months. If a patient requires the medication for longer than five months to treat peripheral neuropathic pain, the treating physician should assess the patient's clinical status and determine the need for additional therapy. Epilepsy normally requires long-term treatment and the SPC states that the dosage for gabapentin should be determined by the treating physician according to the clinical response and side effects experienced by the individual patient.The product information for gabapentin lists amnesia as a common side effect and mental impairment as an uncommon side effect. Dementia is not a known side effect of gabapentin.Gabapentin can cause drug dependence, and the product information includes warnings that patients treated with gabapentin should be monitored for symptoms of misuse, abuse, or dependence. After discontinuation of short- and long-term treatment with gabapentin, withdrawal symptoms have been observed, and gabapentin should be discontinued gradually over a minimum of one week.As with all medicines, the safety of gabapentin is kept under continual review by the Medicines and Healthcare products Regulatory Agency using a number of data sources including reports of suspected side effects through the Yellow Card Scheme, data from marketing authorisation holders, and research published in the scientific literature.

What measures are in place to monitor patients on Gabapentin for signs of neurological or cognitive decline during treatment.

Gabapentin is authorised to treat epilepsy and peripheral neuropathic pain, or nerve pain. The known side effects of gabapentin are outlined in the product information, the Summary of Product Characteristics (SPC) for healthcare professionals, and the Patient Information Leaflet which is provided in each pack of the medicine.The SPC states that in the treatment of peripheral neuropathic pain, such as painful diabetic neuropathy and post-herpetic neuralgia, efficacy and safety have not been examined in clinical studies for treatment periods longer than five months. If a patient requires the medication for longer than five months to treat peripheral neuropathic pain, the treating physician should assess the patient's clinical status and determine the need for additional therapy. Epilepsy normally requires long-term treatment and the SPC states that the dosage for gabapentin should be determined by the treating physician according to the clinical response and side effects experienced by the individual patient.The product information for gabapentin lists amnesia as a common side effect and mental impairment as an uncommon side effect. Dementia is not a known side effect of gabapentin.Gabapentin can cause drug dependence, and the product information includes warnings that patients treated with gabapentin should be monitored for symptoms of misuse, abuse, or dependence. After discontinuation of short- and long-term treatment with gabapentin, withdrawal symptoms have been observed, and gabapentin should be discontinued gradually over a minimum of one week.As with all medicines, the safety of gabapentin is kept under continual review by the Medicines and Healthcare products Regulatory Agency using a number of data sources including reports of suspected side effects through the Yellow Card Scheme, data from marketing authorisation holders, and research published in the scientific literature.

Which public health factors created the 10 largest direct cost impacts on the NHS in 2024; and how much the NHS spent in 2024 on tackling the health impacts of the following public health factors: (a) air pollution, (b) alcoholism, (c) obesity, (d) excessive salt consumption and (e) smoking.

Global Burden of Disease data considers the top ten public health factors in the United Kingdom in 2023 in order of importance to be: tobacco, high body mass index, dietary risks, high fasting plasma glucose, high blood pressure, high alcohol use, high cholesterol, occupational risks, kidney dysfunction, and drug use. Further information on the Global Burden of Disease data is available at the following link:https://vizhub.healthdata.org/gbd-compare/The following table shows the various estimates of the cost to the National Health Service of the five factors specified:Risk factorEstimated NHS costSource of EstimateAir Pollution£1.6 billion for fine particulate matter and nitrogen dioxide combined between 2017 and 2025.Public Health England Agency, 2018Alcohol£4.9 billion annuallyInstitute of Alcohol Studies, 2021/22Obesity£9.3 billion annuallyFrontier Economics & NESTA, 2025Hypertension (excessive salt consumption is linked to an increased risk of hypertension)£2.1 billion annuallyOptimity Matrix (commissioned by Public Health England), 2014Smoking£1.8 billion annuallyAction on Smoking and Health, 2025 Comparisons of costs should not be made between these estimates because of the different methodologies used in their construction.

What discussions his Department has had with ‘Heating, ventilation and air conditioning’ (HVAC) professionals and facilities managers to understand how they reduce air pollution in dwellings and non-domestic buildings while minimising energy use and heat loss.

The Department and the UK Health Security Agency engage with a range of stakeholders on ways to reduce the health impacts of both indoor and outdoor air pollution.This includes engagement by officials with relevant bodies in the United Kingdom and internationally, such as the Chartered Institution of Building Services Engineers and the Air Infiltration and Ventilation Centre, which operates under the International Energy Agency, on issues related to indoor air quality, including ventilation.

How many people died from smoking in England in each year since 2021.

The latest estimates for smoking-attributable mortality in England are for the period 2017 to 2019. The Smoking Profile, produced by the Department, reports 191,903 smoking-attributable deaths of people aged 35 years old and over in the period 2017 to 2019 in England, which is just under 64,000 deaths each year. Further information on the Smoking Profile is available at the following link:https://fingertips.phe.org.uk/profile/tobacco-control/data#page/1/gid/1938132887/pat/159/par/K02000001/ati/15/are/E92000001/yrr/1/cid/4/tbm/1

Pursuant to the Answer of 10 May 2023 to Question 183643 on Public Health, what methodologies were used to estimate the costs to the NHS for each of the five risk factors specified.

The applicable methodologies for the National Health Service cost attributed to each of the risk factors outlined are explained in the following reports.The estimated air pollution related costs to the NHS can be found in the Public Health England report ‘Estimation of costs to the NHS and social care due to the health impacts of air pollution: summary report’ , from 2018, which is available at the following link:https://www.gov.uk/government/publications/air-pollution-a-tool-to-estimate-healthcare-costsAn estimate of the NHS and healthcare costs of alcohol from 2021/22, produced by the Institute of Alcohol Studies, can be found at the following link:https://www.ias.org.uk/factsheet/economy/Estimated obesity related costs to the NHS can be found in the Frontier Economics report for NESTA, published in July 2025, ‘The Economic and Productivity Costs of Obesity and Overweight in the UK’, which is available at the following link:https://media.nesta.org.uk/documents/The_economic_and_productivity_costs_of_obesity_and_overweight_in_the_UK_.pdfEstimated Hypertension related costs to the NHS can be found in the Optimity Matrix Cost-effectiveness review of blood pressure interventions, ‘A Report to the Blood Pressure System Leadership Board’, published November 2014, available at the following link:https://cleanair.london/app/uploads/vdocuments.site_cost-effectiveness-review-of-blood-pressure-cost-effectiveness-review-of-blood.pdfThe most recent estimated smoking related costs to the NHS can be found in the press release, ‘New figures show cost of smoking to society in England dwarfs tobacco tax revenue’. This is available at the following link:https://ash.org.uk/media-centre/news/press-releases/new-figures-show-cost-of-smoking-to-society-in-england-dwarfs-tobacco-tax-revenue

How many attributable deaths there were from fine particulate matter, PM2.5, were there in (a) East Midlands, (b) East of England, (c) Greater London, (d) North East, (e) North West, (f) South East, (g) South West, (h) West Midlands, (i) Yorkshire and the Humber, and (j) England in each year since 2018 using COMEAP's latest methodology.

The number of deaths attributable to fine particulate air pollution (PM2.5) is not annually calculated for each region. The current estimate of attributable deaths in the United Kingdom for 2019 was 29,000 to 43,000 deaths for adults aged 30 years old and over.The fraction of mortality attributable to particulate air pollution is annually calculated for each region and represents the percentage of annual deaths from all causes in those aged 30 years old and over, attributed to PM2.5. This indicator is calculated using the Committee on the Medical Effects of Air Pollutants’ updated concentration-response-function, and figures for the years 2018 to 2023 are available at the following link:https://fingertips.phe.org.uk/profile/public-health-outcomes-framework/data#page/4/gid/1000043/pat/15/par/E92000001/ati/6/are/E12000004/iid/93861/age/230/sex/4/cat/-1/ctp/-1/yrr/1/cid/4/tbm/1/page-options/ovw-do-0_car-do-0Estimates for 2024 will be available later in 2026.

When he will update the Health and Technical Memorandum 03-01 for the latest technical standards.

Published guidance on ventilation in healthcare settings includes the Health Technical Memorandum 03-01: Specialised ventilation for healthcare premises. It gives comprehensive advice and guidance on the legal requirements, design implications, maintenance, and operation of specialised ventilation in healthcare premises providing acute care. Further information is available at the following link:https://www.england.nhs.uk/publication/specialised-ventilation-for-healthcare-buildings/NHS England will update Health Technical Memorandums, including HTM 03-01, when necessary.

If he will make an assessment of the potential implications for his policies of the press notice by the Royal College of Physician of 13 November 2025, which called for a UK-wide public health campaign on air pollution.

Clean air is a key part of our shift from ‘sickness to prevention’ as per the 10-Year Health Plan for England, which sets out action to further improve the quality of the air we breathe.Alongside the 10-Year Health Plan, the Department for Environment, Food and Rural Affairs’ Environmental Improvement Plan, published in December 2025, outlines commitments to improve the communication of air quality information.Government action is being informed by the recommendations from the Air Quality Information System review report published in 2025, which specifically considered ways to increase public awareness about air pollution.We will continue to work closely with the Department for Environment, Food and Rural Affairs to reduce the health harms of air pollution and to help make air quality part of everyday conversations.

How much did (a) Health Education England and (b) NHS England pay Hill Dickinson in (i) costs and (ii) fees for legal services between 2012 and 2023.

As a parent organisation, including commissioning support units but excluding integrated care boards, NHS England has spent approximately £8 million including VAT with Hill Dickinson between 2012/13 and 2022/23. Approximately 90% of these costs were spent on legal or professional fees.Please note that this figure includes the NHS Trust Development Authority and Monitor, which merged to become NHS Improvement in 2016, as well as the two months of NHS Digital following its merger with NHS England from 1 February 2023.Health Education England, which was merged into NHS England on 1 April 2023, spent £5.2 million with Hill Dickinson between 2012/13 and 2022/23. We do not hold a breakdown of this spend.

If he will publish the annual figures for payments made to each of NHS Resolution's panel law firms since the current legal framework came into effect in March 2022; and, in each case, what proportion of these payments were attributable to (a) medical negligence claims and (b) other claims.

NHS Resolution (NHSR) manages clinical negligence and other claims against the National Health Service in England. The information to the question requested is not published by NHSR on its website. NHSR does publish annual statistics, however, which are available at the following link:https://resolution.nhs.uk/resources/annual-statistics/The second table in the document attached also shows the total spend for NHSR on NHS legal costs.NHSR has also responded to individual enquiries under Freedom of Information for payments made to panel law firms, which can be found on its website at the following link:https://resolution.nhs.uk/?s=FOI+Panel+firm+costs

Whether he has had recent discussions with the Chancellor of the Exchequer on (a) the potential cost-effectiveness of expanding access to radiotherapy treatment and (b) other funding relating to radiotherapy cancer treatments.

There have not been any recent discussions relating to the cost-effectiveness and funding of radiotherapy. However, the Government remains committed to supporting the use of radiotherapy as a crucial cancer treatment. We have already invested £70 million in replacing outdated radiotherapy machines across the National Health Service with new, cutting-edge technology that will speed up treatment for thousands of patients.Additionally, the Government will also continue to support the NHS to deliver a wide range of cancer treatment services, as we work towards our aim of diagnosing and treating cancer more quickly.