Written questions by Collins.

Whether his Department will take steps to prioritise the reform of funding for (a) palliative and (b) end-of-life care in the NHS 10-year plan.

We want a society where every person receives high-quality, compassionate care from diagnosis through to the end of life. The Government is determined to shift more healthcare out of hospitals and into the community, to ensure patients and families receive the care they need when and where they need it, including those who need palliative and end of life care. As part of the work to develop a 10-Year Health Plan, we have been carefully considering policies, including those that impact people with palliative and end of life care needs, with input from the public, patients, health staff, and our partners, including the hospice sector.

Whether his Department plans to include lung health in the NHS 10-Year Health Plan.

The 10-Year Health Plan will deliver the three big shifts our National Health Service needs to be fit for the future: from hospital to community; from analogue to digital; and from sickness to prevention. All of these are relevant to improving respiratory health in all parts of the county. More tests and scans delivered in the community will allow earlier diagnosis, better joint working between services, and greater use of apps and wearable technology will all help people manage their long-term conditions, including respiratory conditions, closer to home. Earlier diagnosis of conditions will help prevent deterioration and improve survival rates. Taking action to reduce the causes of the biggest killers, such as enabling a smoke free generation, can further help prevent lung conditions.

What plans his Department have to extend the Start for Life programme beyond the 75 upper-tier local authorities that currently receive funding.

In 2025/26, £57 million will be made available to 75 local authorities with high levels of deprivation to provide a range of Start for Life services. Funding for future years is being considered as part of the forthcoming Spending Review.

How much his Department spent on ovarian cancer research in the latest period for which data is available.

Research is crucial in tackling cancer, which is why the Department invests £1.6 billion each year on research through its research delivery arm, the National Institute for Health and Care Research (NIHR), with cancer being one of the largest areas of spend, at over £133 million in 2023/24, reflecting its high priority. The NIHR has funded 17 research projects into ovarian cancer for the period 2019/20 to 2023/24, with a combined total funding value of £6.4 million, and enabled 109 clinical research studies into ovarian cancer to take place in the National Health Service in 2023/24.Examples of NIHR investments in ovarian cancer research include the ROCkeTS study, which aims to identify the best diagnostic tests for ovarian cancer. The NIHR has also funded the MR in Ovarian Cancer, or MROC, study, which studies the impact of multiparametric magnetic resonance imaging on the staging and management of patients with ovarian cancer.The NIHR continues to welcome high quality funding applications for research into any aspect of human health and care, including ovarian cancer research.

What steps his Department is taking to help prevent (a) staff shortages in and (b) the closure of local pharmacies.

The Government recognises that pharmacies play a vital role in our healthcare system. We are committed to expanding the role of pharmacies and better utilising the skills of pharmacists and pharmacy technicians. Employers clearly have a key role in retaining staff and making jobs in community pharmacy attractive. To support employers, NHS England has provided a number of fully funded national training opportunities for pharmacists and pharmacy technicians to help support private contractors to deliver quality National Health Services, including Pharmacy First.We have now concluded the consultation on funding for 2024/25 and 2025/26, and have agreed with Community Pharmacy England to increase the community pharmacy contractual framework to £3.073 billion. This deal represents the largest uplift in funding of any part of the NHS, over 19% across 2024/25 and 2025/26. This shows a commitment to rebuilding the sector.

What steps his Department is taking to provide additional support for families affected by members with Duchenne muscular dystrophy.

The Government is committed to improving the lives of those living with rare diseases, such as Duchenne Muscular Dystrophy. Under the England Rare Diseases Action Plan 2025, we remain focused on delivering against the four key priorities set out in the UK Rare Diseases Framework. The 2025 England Rare Diseases Action Plan was published on 28 February 2025 and is available at the following link:https://www.gov.uk/government/publications/england-rare-diseases-action-plan-2025We know that people living with rare conditions, and their families and carers, often struggle to access mental health and psychological support. Mental health services should be offered based on need and should not exclude anyone because of a particular physical health or neurological diagnosis. The NHS Genomics Education Programme has this year published new resources on rare diseases and mental health, aimed at healthcare professionals. It has also developed a communications tool to help healthcare professionals with sensitive conversations, to ensure that patients and families feel supported throughout the diagnosis of a rare condition.Many people struggle to access reliable information on rare diseases, and we recognise the important role patient support groups can play in developing reliable and easy to access information. In this year’s action plan we have set out the steps we are taking to support organisations to get the information they produce accredited under the Patient Information Forum’s trusted information creator scheme.To enhance specialist care, NHS England is supporting multi-system disorder clinics to reduce appointments and ease care coordination for families.

What steps his Department is taking to help tackle shortages of medication for (a) Parkinson's and (b) epilepsy.

The Department is working hard with industry to help resolve intermittent supply issues with some epilepsy medications. As a result of ongoing activity and intensive work, including directing suppliers to expedite deliveries, most issues, including with carbamazepine, lamotrigine, and oxcarbazepine presentations, have been resolved.We are currently aware of an ongoing supply issue with all strengths of topiramate tablets from one manufacturer. This supply issue is expected to resolve by the end of May 2025. We are also aware of a shortage of phenobarbital 15 milligram tablets from one manufacturer with the resupply date to be confirmed. In both cases, alternative suppliers are in stock with sufficient supply to support patients. These issues have been communicated to the National Health Service.The Department is aware of supply constraints with one supplier of amantadine 100 milligram capsules used in the management of Parkinson’s disease, however stocks remain available from alternative suppliers to cover demand. The Department has also been notified of a discontinuation of apomorphine (APO-go PFS) 50 milligram/10 millilitre pre-filled syringes from April 2025. Alternative formulations of apomorphine remain available for patients, and management guidance has been issued to the NHS.

What steps his Department is taking to improve early diagnosis of endometriosis.

The Government is committed to prioritising women’s health, and we are making progress to ensure that women with endometriosis receive a timely diagnosis and effective treatment.Clinical guidelines support healthcare professionals to diagnose and treat conditions. In November 2024, the National Institute for Health and Care Excellence updated its guideline on the diagnosis and management of endometriosis. This includes updated recommendations that for women with symptoms of endometriosis, initial pharmacological treatment should take place in primary care, and that this can take place in parallel with additional investigations and referral to secondary care if needed. This will help women receive more timely treatment. The guideline is available at the following link:https://www.nice.org.uk/guidance/ng73We have taken urgent action to tackle gynaecology waiting lists through the Elective Reform Plan. In gynaecology, the plan supports innovative models offering patients care closer to home, and piloting gynaecology pathways in community diagnostic centres. Alongside the plan we published a new partnership agreement between the National Health Service and the independent sector, which will help cut gynaecology waiting lists faster.Additionally, to provide quicker access for patients to common surgical hub procedures such as a laparoscopy, which can be used to diagnose and treat endometriosis, we have committed to opening 17 new and expanded surgical hubs by June 2025 and ramping up the number of hubs over the next three years.

What steps his Department is taking to improve the training of healthcare employees in recognising symptoms of endometriosis.

The Government is committed to prioritising women’s health and improving the diagnosis, treatment and ongoing care for gynaecological conditions including endometriosis.National Institute for Health and Care Excellence (NICE) guidelines support healthcare professionals to diagnose and treat conditions. In November 2024, NICE published updated recommendations on the diagnosis, management and treatment of endometriosis. This can be accessed through the following link:https://www.nice.org.uk/guidance/ng73Endometriosis is included in the core curriculum for general practitioners, and for obstetricians and gynaecologists. The General Medical Council has introduced the Medical Licensing Assessment for most incoming doctors, including all medical students graduating from academic year 2024/25 and onwards. Within this assessment are several topics relating to women’s health, including endometriosis. This will encourage a better understanding of endometriosis among doctors as they start their careers in the United Kingdom.

Whether he plans to review the Women’s Health Strategy.

The Government is committed to prioritising women’s health as we build a National Health Service fit for the future.Our focus is on turning the commitments in the Women's Health Strategy into tangible actions, for instance by providing emergency hormonal contraception free of charge at pharmacies on the NHS from October 2025, taking urgent action to tackle gynaecology waiting lists through the Elective Reform Plan, and setting out how we will eliminate cervical cancer by 2040 through the new cervical cancer plan.

If he will make an assessment of the adequacy of (a) commissioning funding of integrated care boards and (b) other funding provided to hospice services.

Palliative care services are included in the list of services an integrated care board (ICB) must commission. ICBs are responsible for commissioning palliative and end of life care services to meet the needs of their local populations. To support ICBs in this duty, NHS England has published statutory guidance which outlines areas for consideration when commissioning.Additionally, although not statutory, the National Institute for Health and Care Excellence has published guidance on the service delivery of end of life care. There is an expectation that commissioners and service providers take the guidelines into account when making decisions about how to best meet the needs of their local communities.Most hospices are charitable, independent organisations which receive some statutory funding for providing National Health 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.NHS England has a legal duty to annually assess the performance of each ICB in respect of each financial year and to publish a summary of its findings. This assessment must assess how well the ICB has discharged its functions.We are, at a national level, also supporting the hospice sector with a £100 million capital funding boost for adult and children’s hospices in England to ensure they have the best physical environment for care. The Government has released the first £25 million tranche of the £100 million of capital funding, with Hospice UK kindly allocating and distributing the money to hospices throughout England. An additional £75 million will be allocated in the coming weeks for use in 2025/26.Additionally, we are providing £26 million of revenue funding to support children and young people’s hospices for 2025/26. This is a continuation of the funding which until recently was known as the children and young people’s hospice grant. NHS England has now communicated the details of the 2025/26 funding allocation and dissemination to individual hospices.In February, I met with key palliative and end of life care and hospice stakeholders, with a focus on long-term sector sustainability within the context of our 10-Year Health Plan.

What steps his Department is taking to support GPs in diagnosing ovarian cancer.

The Government is committed to supporting the National Health Service to diagnose cancer, including ovarian cancer, earlier and faster.We are improving public awareness of cancer signs and symptoms, streamlining referral routes, and increasing the availability of diagnostic capacity through the roll-out of more community diagnostic centres. We are also investing an additional £889 million in general practice (GP) to reinforce the front door of the NHS, bringing total spend on the GP Contract to £13.2 billion in 2025/26.In October 2024, we invested £82 million into the Additional Roles Reimbursement Scheme, which has enabled the recruitment of over 1,500 recently qualified GPs across England, which will increase the number of appointments delivered and care for thousands of patients.We are committed to ensuring that GPs have the right training and systems to identify cancer. The Department will continue to look at opportunities to utilise artificial intelligence to transform diagnostic performance and ultimately bring down waiting times. The National Cancer Plan will include further details on how we will improve outcomes for cancer patients, including for rare and less common cancers. It will aim to speed up diagnosis and treatment and will ensure that all patients have access to the latest treatments and technology.

What steps his Department is taking to help reduce the cost of dental care for (a) low income families and (b) pensioners.

The Government plans to tackle the challenges for patients trying to access National Health Service dental care with a rescue plan to provide 700,000 more urgent dental appointments and recruit new dentists to areas that need them most.The responsibility for commissioning primary care, including dentistry, to meet the needs of the local population has been delegated to all integrated care boards across England. Free NHS dental care is available to people who meet the following criteria: - under 18 years old, or under 19 years old and in full-time education;- pregnant or have had a baby in the previous 12 months;- being treated in an NHS hospital and the treatment is carried out by the hospital dentist, although patients may have to pay for any dentures or bridges; or- receiving low-income benefits, or under 20 years old and a dependant of someone receiving low-income benefits.Support is also available through the NHS Low Income Scheme for those patients who are not eligible for an exemption or a full remission of dental patient charges. Further information is available at the following link:https://www.nhs.uk/nhs-services/dentists/who-is-entitled-to-free-nhs-dental-treatment-in-england/

What steps his Department is taking to help increase the number of available NHS dental appointments in Harpenden and Berkhamsted constituency.

I refer the hon. Member to the answer I gave on 14 April 2025 to Question 44281.

What steps he is taking to help improve staffing levels at GP surgeries to ensure ring timely access to women's health services.

The Government committed to recruiting over 1,000 recently qualified general practitioners (GPs) through an £82 million boost to the Additional Roles Reimbursement Scheme over 2024/25, as part of an initiative to address GP unemployment and secure the future pipeline of GPs. Since 1 October 2024, 851 full-time equivalent (FTE) GPs have been recruited through the scheme.In addition, for GPs employed by practices directly, as of January 2025, there were 573 more fully qualified, FTE GPs working in practices in England compared to July 2024. The recruitment boost, part of the Government’s Plan for Change, will help to end the scandal of patients struggling to see a doctor, easing pressure on GPs and cutting waiting times. Alongside changes to the GP Contract for 2025/26, these additional GPs will help end the 8:00am scramble for appointments which so many patients currently endure every day.The Government is committed to prioritising women’s health as we reform the National Health Service. Women's health is included the Royal College of General Practitioners’ curriculum for trainee GPs, including gynaecology, menopause, sexual health, and breast health.

Whether the 2025/26 NHS Payment Scheme applies a currency model to commission (a) palliative and (b) end-of-life care services.

Palliative care services are included in the list of services an integrated care board (ICB) must commission. This promotes a more consistent national approach and supports commissioners in prioritising palliative and end of life care. To support ICBs in this duty, NHS England has published statutory guidance and service specifications.  ICBs are responsible for commissioning palliative and end of life care services to meet the needs of their local populations.Details of currency models for the last year of life and end of life care were published as supporting documents to the 2025/26 NHS Payment Scheme. This supporting document is available at the following link:https://www.england.nhs.uk/publication/2025-26-nhs-payment-scheme/#heading-3The currencies are not directly linked to payment for 2025/26, but providers and commissioners should ensure that all data items for the currency models are collected. The currencies should be used to inform ICB commissioning plans and to support service planning and local benchmarking, as well as evaluating service provision.

What discussions he has had with the Secretary of State for Justice on reviewing the eligibility of unpaid carers for (a) legal aid and (b) advocacy; and what assessment he has made of the potential merits of increasing funding for respite breaks for unpaid carers.

To be eligible for legal aid, which includes advice, assistance, and advocacy, where applicable, generally an applicant’s legal matter must be in scope for legal aid, and they must pass both a merits and a means test. The merits test, for civil legal aid, and the interests of justice test, for criminal legal aid, assess the merits of the case, including the likelihood of success, and the benefit to the applicant. The means test assesses an applicant’s financial eligibility. Unpaid carers that meet the eligibility criteria are eligible for legal aid.On the potential merits of increasing funding for respite breaks for unpaid carers, local authorities have duties to support people caring for their family and friends. The Care Act 2014 requires local authorities to deliver a wide range of sustainable, high-quality care and support services, including support for carers.The Better Care Fund includes funding that can be used for carer support, including short breaks and respite services. Local areas determine how the money is best used to support carers, depending on local need and with reference to their statutory responsibilities.Ministers regularly engage with colleagues in other Government departments on a range of issues.

What steps his Department is taking to help improve (a) rates of early diagnosis, (b) access to treatment and (c) specialist care for people with Duchenne Muscular Dystrophy.

The Government is committed to improving the lives of those living with rare diseases, such as Duchenne muscular dystrophy (DMD), by supporting earlier diagnosis, improving access to treatment, and enhancing specialist care. Under the England Rare Diseases Action Plan 2025, we remain focused on delivering against the four key priorities set out in the UK Rare Diseases Framework. The 2025 England Rare Diseases Action Plan was published on 28 February 2025, and is available at the following link:https://www.gov.uk/government/publications/england-rare-diseases-action-plan-2025.To support earlier diagnosis, we are digitalising the National Genomic Test Directory to improve access to genomic testing, and have established eight Genomic Networks of Excellence to standardise services and speed up diagnoses.We are improving access to treatment for rare conditions like DMD by reforming clinical trial regulations through the Medicines and Healthcare products Regulatory Agency (MHRA), which facilitates the development and approval of new therapies.Progress is also being made on repurposing existing medicines and advancing new therapies, to expand treatment options. The National Institute for Health and Care Excellence (NICE) plays a key role by making recommendations on which licensed medicines should be routinely funded by the National Health Service, based on an assessment of their costs and benefits. The NICE has recently published guidance recommending vamorolone as an option for treating DMD in people aged four years old and older, and the NHS in England is legally required to fund treatment for eligible patients in line with the NICE’s recommendations. The NICE is currently appraising givinostat, which received a conditional marketing authorisation from the MHRA in December 2024 for treating DMD in patients aged six years old and over, to see if it can be recommended for routine funding on the NHS.To enhance specialist care, NHS England is supporting multi-system disorder clinics to reduce appointments and ease care coordination for families. Research is underway to improve service integration, and five new Rare Disease Collaborative Networks have been launched to strengthen specialist support across the NHS.

If will make it his policy that unpaid carers are the central focus of the Independent Commission into Adult Social Care.

We are launching an independent commission chaired by Baroness Louise Casey into adult social care as part of our critical first steps towards delivering a National Care Service.The commission is independent. We expect it will engage unpaid carers as part of a national conversation on what adult social care should achieve for people. This will produce recommendations that address major challenges and drive meaningful reform to better meet the needs of everyone, including unpaid carers.

Whether his Department plans to provide additional funding for fracture liaison services to help increase the (a) coverage and (b) quality of those services.

Fracture Liaison Services (FLS) are a globally recognised care model and can reduce the risk of refracture for people at risk of osteoporosis by up to 40%. They can play a vital role in improving quality of life and increasing the number of years that can be lived in good health.We remain committed to rolling out FLS across every part of the country by 2030.In the meantime, we are investing in high-tech DEXA scanners, which are expected to provide an extra 29,000 scans to ensure that people with bone conditions get diagnosed earlier.