Question to the Department of Health and Social Care:

To ask His Majesty's Government what plans they have to expand public awareness campaigns for prostate cancer, following the prediction by the Lancet Commission of a surge in cases.

Answered by Lord Markham - Parliamentary Under-Secretary (Department of Health and Social Care)

Prostate cancer is the most common cancer in men in the United Kingdom, and currently has no screening programme. The recently announced TRANSFORM trial aims to find the best way to screen for prostate cancer. This study is led by Prostate Cancer UK and supported by £42 million of Government funding.

In March 2024, NHS England implemented the Faster Diagnosis Standard (FDS), setting a target of a maximum 28 day wait from urgent suspected general practice or screening referral to patients being told they have cancer, or that cancer is ruled out. To achieve this target, NHS England is streamlining cancer pathways by introducing best-practice timed pathways for prostate cancer, so that those suspected of having prostate cancer receive a multi-parametric magnetic resonance imaging scan first, which ensures only those men most at risk of having cancer undergo an invasive biopsy. As well as diagnosing patients faster, NHS England is working to diagnose patients at an earlier stage, through the ambitions set out in the NHS Long-Term Plan, to diagnose 75% of cancers at stages one and two by 2028.

NHS England takes steps to raise awareness of prostate cancer, where there are opportunities to do so. For example, NHS England partners with Cancer Alliances, charities, and local representatives to reach people through projects in the heart of their communities. Cancer Alliances have also been undertaking action to alert at-risk groups about prostate cancer. This is determined at a local level, and so will vary depending on local needs and priorities.

The Government has made significant strides in enabling the use of artificial intelligence (AI) systems to support the diagnosis of many types of cancer, including prostate. The AI in Health and Care Award was established, aiming to accelerate the testing and development of AI technologies that align with the NHS Long Term Plan. The award represents a substantial investment in the future of healthcare technology, with £113 million already allocated to support 86 AI technologies. Three of these projects specifically relate to prostate cancer, one of which is the Paige prostate cancer detection tool, developed by the University of Oxford. This AI-based diagnostic software aids in the interpretation of pathology sample images, facilitating more efficient detection, grading, and quantification of cancer in prostate biopsies. The Chancellor’s recent budget announcement on 6 March 2024 includes a £3.4 billion investment to reform how the National Health Service works, including on the use of technologies such as AI.

Finally, although no specific assessment of the Lancet Commission published 4 April 2024 has been made, the Department will work with NHS England to review the details.

Question to the Department of Health and Social Care:

To ask His Majesty's Government, what plans they have to use artificial intelligence systems to support the diagnosis of prostate cancer, as recommended by the Lancet Commission in research published on 4 April.

Answered by Lord Markham - Parliamentary Under-Secretary (Department of Health and Social Care)

Prostate cancer is the most common cancer in men in the United Kingdom, and currently has no screening programme. The recently announced TRANSFORM trial aims to find the best way to screen for prostate cancer. This study is led by Prostate Cancer UK and supported by £42 million of Government funding.

In March 2024, NHS England implemented the Faster Diagnosis Standard (FDS), setting a target of a maximum 28 day wait from urgent suspected general practice or screening referral to patients being told they have cancer, or that cancer is ruled out. To achieve this target, NHS England is streamlining cancer pathways by introducing best-practice timed pathways for prostate cancer, so that those suspected of having prostate cancer receive a multi-parametric magnetic resonance imaging scan first, which ensures only those men most at risk of having cancer undergo an invasive biopsy. As well as diagnosing patients faster, NHS England is working to diagnose patients at an earlier stage, through the ambitions set out in the NHS Long-Term Plan, to diagnose 75% of cancers at stages one and two by 2028.

NHS England takes steps to raise awareness of prostate cancer, where there are opportunities to do so. For example, NHS England partners with Cancer Alliances, charities, and local representatives to reach people through projects in the heart of their communities. Cancer Alliances have also been undertaking action to alert at-risk groups about prostate cancer. This is determined at a local level, and so will vary depending on local needs and priorities.

The Government has made significant strides in enabling the use of artificial intelligence (AI) systems to support the diagnosis of many types of cancer, including prostate. The AI in Health and Care Award was established, aiming to accelerate the testing and development of AI technologies that align with the NHS Long Term Plan. The award represents a substantial investment in the future of healthcare technology, with £113 million already allocated to support 86 AI technologies. Three of these projects specifically relate to prostate cancer, one of which is the Paige prostate cancer detection tool, developed by the University of Oxford. This AI-based diagnostic software aids in the interpretation of pathology sample images, facilitating more efficient detection, grading, and quantification of cancer in prostate biopsies. The Chancellor’s recent budget announcement on 6 March 2024 includes a £3.4 billion investment to reform how the National Health Service works, including on the use of technologies such as AI.

Finally, although no specific assessment of the Lancet Commission published 4 April 2024 has been made, the Department will work with NHS England to review the details.

Question to the Department of Health and Social Care:

To ask His Majesty's Government what assessment they have made of the Lancet Commission on prostate cancer, published 4 April 2024.

Answered by Lord Markham - Parliamentary Under-Secretary (Department of Health and Social Care)

Prostate cancer is the most common cancer in men in the United Kingdom, and currently has no screening programme. The recently announced TRANSFORM trial aims to find the best way to screen for prostate cancer. This study is led by Prostate Cancer UK and supported by £42 million of Government funding.

In March 2024, NHS England implemented the Faster Diagnosis Standard (FDS), setting a target of a maximum 28 day wait from urgent suspected general practice or screening referral to patients being told they have cancer, or that cancer is ruled out. To achieve this target, NHS England is streamlining cancer pathways by introducing best-practice timed pathways for prostate cancer, so that those suspected of having prostate cancer receive a multi-parametric magnetic resonance imaging scan first, which ensures only those men most at risk of having cancer undergo an invasive biopsy. As well as diagnosing patients faster, NHS England is working to diagnose patients at an earlier stage, through the ambitions set out in the NHS Long-Term Plan, to diagnose 75% of cancers at stages one and two by 2028.

NHS England takes steps to raise awareness of prostate cancer, where there are opportunities to do so. For example, NHS England partners with Cancer Alliances, charities, and local representatives to reach people through projects in the heart of their communities. Cancer Alliances have also been undertaking action to alert at-risk groups about prostate cancer. This is determined at a local level, and so will vary depending on local needs and priorities.

The Government has made significant strides in enabling the use of artificial intelligence (AI) systems to support the diagnosis of many types of cancer, including prostate. The AI in Health and Care Award was established, aiming to accelerate the testing and development of AI technologies that align with the NHS Long Term Plan. The award represents a substantial investment in the future of healthcare technology, with £113 million already allocated to support 86 AI technologies. Three of these projects specifically relate to prostate cancer, one of which is the Paige prostate cancer detection tool, developed by the University of Oxford. This AI-based diagnostic software aids in the interpretation of pathology sample images, facilitating more efficient detection, grading, and quantification of cancer in prostate biopsies. The Chancellor’s recent budget announcement on 6 March 2024 includes a £3.4 billion investment to reform how the National Health Service works, including on the use of technologies such as AI.

Finally, although no specific assessment of the Lancet Commission published 4 April 2024 has been made, the Department will work with NHS England to review the details.

Question to the Department of Health and Social Care:

To ask His Majesty's Government, further to recent research conducted by the Lancet Commission, what steps they plan to take to address the projected surge in prostate cancer cases.

Answered by Lord Markham - Parliamentary Under-Secretary (Department of Health and Social Care)

Prostate cancer is the most common cancer in men in the United Kingdom, and currently has no screening programme. The recently announced TRANSFORM trial aims to find the best way to screen for prostate cancer. This study is led by Prostate Cancer UK and supported by £42 million of Government funding.

In March 2024, NHS England implemented the Faster Diagnosis Standard (FDS), setting a target of a maximum 28 day wait from urgent suspected general practice or screening referral to patients being told they have cancer, or that cancer is ruled out. To achieve this target, NHS England is streamlining cancer pathways by introducing best-practice timed pathways for prostate cancer, so that those suspected of having prostate cancer receive a multi-parametric magnetic resonance imaging scan first, which ensures only those men most at risk of having cancer undergo an invasive biopsy. As well as diagnosing patients faster, NHS England is working to diagnose patients at an earlier stage, through the ambitions set out in the NHS Long-Term Plan, to diagnose 75% of cancers at stages one and two by 2028.

NHS England takes steps to raise awareness of prostate cancer, where there are opportunities to do so. For example, NHS England partners with Cancer Alliances, charities, and local representatives to reach people through projects in the heart of their communities. Cancer Alliances have also been undertaking action to alert at-risk groups about prostate cancer. This is determined at a local level, and so will vary depending on local needs and priorities.

The Government has made significant strides in enabling the use of artificial intelligence (AI) systems to support the diagnosis of many types of cancer, including prostate. The AI in Health and Care Award was established, aiming to accelerate the testing and development of AI technologies that align with the NHS Long Term Plan. The award represents a substantial investment in the future of healthcare technology, with £113 million already allocated to support 86 AI technologies. Three of these projects specifically relate to prostate cancer, one of which is the Paige prostate cancer detection tool, developed by the University of Oxford. This AI-based diagnostic software aids in the interpretation of pathology sample images, facilitating more efficient detection, grading, and quantification of cancer in prostate biopsies. The Chancellor’s recent budget announcement on 6 March 2024 includes a £3.4 billion investment to reform how the National Health Service works, including on the use of technologies such as AI.

Finally, although no specific assessment of the Lancet Commission published 4 April 2024 has been made, the Department will work with NHS England to review the details.

Question to the Department of Health and Social Care:

To ask His Majesty's Government what plans they have to prioritise research into variation of the prevalence of prostate cancer among different ethnic groups.

Answered by Lord Markham - Parliamentary Under-Secretary (Department of Health and Social Care)

The Department welcomes the recently announced TRANSFORM trial which aims to save thousands of men each year by finding the best way to screen for prostate cancer across all ethnic groups. It will be spread across the United Kingdom, although final decisions on specific locations are yet to be taken. Men will be invited to participate via their general practices. This study, led by Prostate Cancer UK and supported by the Government among others, will also aim to address some of the inequalities that exist in prostate cancer diagnosis today by ensuring that one in ten of the trial participants will be black men, who are three times overrepresented compared to the population of men aged between 45 and 75 years old as based on 2021 census data.

More broadly, the National Institute for Health and Care Research (NIHR) funds research in response to proposals received from scientists and commissioned calls rather than allocating funding to specific disease areas. It welcomes funding applications for research into any aspect of human health, including prostate cancer. Applications are subject to peer review and judged in open competition, with awards being made based on the importance of the topic to patients and health and care services, value for money and scientific quality.

In addition, to raise awareness of prostate cancer in this group, Leicester’s Centre for BME Health has developed a toolkit in partnership with the NIHR with guidance on how to start conversations about prostate cancer and overcome barriers to diagnosis.

Question to the Department of Health and Social Care:

To ask His Majesty's Government whether they have made an assessment of the impact of rural pharmacy closures on access to primary care.

Answered by Lord Markham - Parliamentary Under-Secretary (Department of Health and Social Care)

It is the statutory duty of every local authority in England to undertake pharmaceutical needs assessments for their areas including those that are rural in nature, every three years, to ensure provision continues to meet their population’s needs. Integrated care boards have regard to those assessments when commissioning services and where a pharmacy closure impacts on the access to services, a new contractor can apply to open a pharmacy in the area.

Patients who struggle to access pharmacy premises can access pharmacy services remotely through any of the over 400 online pharmacies that are contractually required to deliver medicines free of charge. Alternatively, in some rural areas, doctors are permitted to dispense medication to patients.

The Pharmacy Access scheme provides additional funding to pharmacies in the areas where there are fewer pharmacies.

Question to the Department for Environment, Food and Rural Affairs:

To ask His Majesty's Government when the new Sustainable Farming Incentive and Countryside Stewardship actions can be added to areas already in the Higher Level Stewardship (HLS) agreement, particularly in upland areas where the HLS agreement has a linked Upland Entry Level Stewardship agreement.

Answered by Lord Douglas-Miller - Parliamentary Under-Secretary (Department for Environment, Food and Rural Affairs)

We plan to roll out the new combined Sustainable Farming Incentive and Countryside Stewardship offer during 2024, with applications opening from the summer. We will publish more information about this, and how farmers will be able to apply, ahead of applications opening. This will include setting out how farmers with existing Higher Level Stewardship, Countryside Stewardship and Sustainable Farming Incentive agreements will be able to access the new offer.

Question to the Department for Environment, Food and Rural Affairs:

To ask His Majesty's Government when farmers in existing Higher Level Stewardship, Countryside Stewardship and Sustainable Farming Incentive agreements can transfer to the new offer.

Answered by Lord Douglas-Miller - Parliamentary Under-Secretary (Department for Environment, Food and Rural Affairs)

We plan to roll out the new combined Sustainable Farming Incentive and Countryside Stewardship offer during 2024, with applications opening from the summer. We will publish more information about this, and how farmers will be able to apply, ahead of applications opening. This will include setting out how farmers with existing Higher Level Stewardship, Countryside Stewardship and Sustainable Farming Incentive agreements will be able to access the new offer.

Question to the Department for Environment, Food and Rural Affairs:

To ask His Majesty's Government when guidance for the Sustainable Farming Incentive online application portal will be set out.

Answered by Lord Douglas-Miller - Parliamentary Under-Secretary (Department for Environment, Food and Rural Affairs)

We plan to roll out the new combined Sustainable Farming Incentive and Countryside Stewardship offer during 2024, with applications opening from the summer. We will publish more information about this, and how farmers will be able to apply, ahead of applications opening. This will include setting out how farmers with existing Higher Level Stewardship, Countryside Stewardship and Sustainable Farming Incentive agreements will be able to access the new offer.

Question to the Department for Environment, Food and Rural Affairs:

To ask His Majesty's Government when they will publish further information on the combined Sustainable Farming Incentive and Countryside Stewardship offer.

Answered by Lord Douglas-Miller - Parliamentary Under-Secretary (Department for Environment, Food and Rural Affairs)

We plan to roll out the new combined Sustainable Farming Incentive and Countryside Stewardship offer during 2024, with applications opening from the summer. We will publish more information about this, and how farmers will be able to apply, ahead of applications opening. This will include setting out how farmers with existing Higher Level Stewardship, Countryside Stewardship and Sustainable Farming Incentive agreements will be able to access the new offer.

Question to the Department for Environment, Food and Rural Affairs:

To ask His Majesty's Government when farmers will be able to apply for the new combined Sustainable Farming Incentive and Countryside Stewardship offer.

Answered by Lord Douglas-Miller - Parliamentary Under-Secretary (Department for Environment, Food and Rural Affairs)

We plan to roll out the new combined Sustainable Farming Incentive and Countryside Stewardship offer during 2024, with applications opening from the summer. We will publish more information about this, and how farmers will be able to apply, ahead of applications opening. This will include setting out how farmers with existing Higher Level Stewardship, Countryside Stewardship and Sustainable Farming Incentive agreements will be able to access the new offer.

Question to the Home Office:

To ask His Majesty's Government, further to the Written Answer by Lord Sharpe of Epsom on 27 February (HL2409), when the Government-funded feasibility study on estimating the prevalence of female genital mutilation and forced marriage in England and Wales will be published.

Answered by Lord Sharpe of Epsom - Parliamentary Under-Secretary (Home Office)

As part of our commitment in the Violence Against Women and Girls Strategy 2021, the Home Office commissioned the University of Birmingham in April 2023 to conduct a feasibility study to examine whether it is possible to develop prevalence estimates for both Female Genital Mutilation and Forced Marriage.

Given the hidden nature of these crimes and lack of robust estimates, knowing more about the individuals that experience it disproportionately will allow us to make more effective, evidence-based interventions.

We have now received the final report and are reviewing the findings to determine next steps.

Question to the Department of Health and Social Care:

To ask His Majesty's Government what plans they have to put in place policies that encourage breastfeeding, including supportive work environments where women are able to breastfeed or express milk.

Answered by Lord Markham - Parliamentary Under-Secretary (Department of Health and Social Care)

The Government’s vision, set out in the policy paper, The Best Start for Life: A Vision for the 1,001 Critical Days, is that every parent and carer has access to high quality infant feeding services in their local area. A copy of the paper is attached.

Through the Family Hubs and Start for Life Programme, we are investing £50 million in infant feeding services, enabling participating local authorities to design and deliver a blended offer of advice and support in line with local needs. The investment is being used to increase the range of advice and specialist support available, helping to ensure all mothers and families can meet their breastfeeding goals. We are also using programme investment to increase the capacity of the National Breastfeeding Helpline so that a greater number of families are able to access this support. In March 2024, we launched a trial of extended helpline opening hours so that support and advice will be available at any time of the day or night, every day of the year.

Regulations are in place that require employers to provide a suitable area for breastfeeding mothers. This must be hygienic and private so they can express milk if they choose to and include somewhere to store their milk.

Question to the Department of Health and Social Care:

To ask His Majesty's Government what assessment they have made of the link between women’s increasing consumption of alcohol and incidences of breast cancer.

Answered by Lord Markham - Parliamentary Under-Secretary (Department of Health and Social Care)

Public Health England’s evidence review, ‘The Public Health Burden of Alcohol and the Effectiveness and Cost-Effectiveness of Alcohol Control Policies’, which was published in 2016 and updated in 2018, found there is strong evidence for an association between alcohol consumption and female breast cancer, and that for breast cancer, any level of drinking increases your risk so there is no ‘safe’ level of drinking. A copy of the review is attached.

The Government believes in informing and empowering citizens and has a responsibility to provide the most up to date, clear information to enable people to make informed choices about their drinking. The 2016 United Kingdom Chief Medical Officers’ low risk drinking guidelines provide the public with the most up to date scientific information and highlight the risk of a range of health problems, including breast cancer, from alcohol consumption.

Question to the Department of Health and Social Care:

To ask His Majesty's Government what assessment they have made of the long-term financial viability of community pharmacies in rural areas.

Answered by Lord Markham - Parliamentary Under-Secretary (Department of Health and Social Care)

The below table shows the total number of community pharmacies that have closed and opened in rural areas in England, as defined by the Department for Environment, Food and Rural Affairs’ Guide to applying the Rural Urban Classification to data, each year from 2019 to 2023:

Community pharmacies are private businesses, contracted to provide National Health Service pharmaceutical services. My Rt hon. Friend, the Secretary of State for Health and Social Care is responsible for ensuring that patients can access medicines, and the Department is monitoring changes to the market closely. In areas where there are fewer pharmacies, the Pharmacy Access Scheme provides financial support to the pharmacies that are present.

Every three years, local authorities in England undertake pharmaceutical needs assessments for their areas, to ensure provision continues to meet their population’s needs. Integrated care boards have regard to those assessments when commissioning services, and where a pharmacy closure impacts access to services, a new contractor can apply to open a pharmacy in the area.

When a local pharmacy closes, patients can choose to access pharmaceutical services through any alternative pharmacy, including any of the over 400 distance selling pharmacies that are required to deliver medicines to patients free of charge. In some rural areas, doctors are permitted to dispense medicines.

Question to the Department of Health and Social Care:

To ask His Majesty's Government how many community pharmacies in rural areas closed in (1) 2019, (2) 2020, (3) 2021, (4) 2022, and (5) 2023.

Answered by Lord Markham - Parliamentary Under-Secretary (Department of Health and Social Care)

The below table shows the total number of community pharmacies that have closed and opened in rural areas in England, as defined by the Department for Environment, Food and Rural Affairs’ Guide to applying the Rural Urban Classification to data, each year from 2019 to 2023:

Community pharmacies are private businesses, contracted to provide National Health Service pharmaceutical services. My Rt hon. Friend, the Secretary of State for Health and Social Care is responsible for ensuring that patients can access medicines, and the Department is monitoring changes to the market closely. In areas where there are fewer pharmacies, the Pharmacy Access Scheme provides financial support to the pharmacies that are present.

Every three years, local authorities in England undertake pharmaceutical needs assessments for their areas, to ensure provision continues to meet their population’s needs. Integrated care boards have regard to those assessments when commissioning services, and where a pharmacy closure impacts access to services, a new contractor can apply to open a pharmacy in the area.

When a local pharmacy closes, patients can choose to access pharmaceutical services through any alternative pharmacy, including any of the over 400 distance selling pharmacies that are required to deliver medicines to patients free of charge. In some rural areas, doctors are permitted to dispense medicines.

Found: Prayers were read by the Lord Bishop of St Albans. 1 The Lord Bishop of Lincoln Stephen David the Lord

Found: Prayers were read by the Lord Bishop of St Albans. 1 The Lord Bishop of Lincoln Stephen David the Lord