Asked by: Freddie van Mierlo (Liberal Democrat - Henley and Thame)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health and Social Care, what steps he is taking to ensure that private providers of physiotherapy services to the NHS (a) provide value for money and (b) do not operate with excessive profit margins.
Answered by Karin Smyth - Minister of State (Department of Health and Social Care)
Throughout its history, the National Health Service has always worked with non-NHS healthcare providers to deliver essential services to patients, especially at times of operational pressures. The overall proportion of health spending on independent sector providers has not increased significantly over recent years. In 2013/14, 6.1% of total health spending, or £6.5 billion, was spent on purchase of healthcare from independent sector providers. In 2023/24, this was 6.8% or £12.4 billion.
The Provider Selection Regime is a set of rules for procuring health care services in England, giving decision-makers the flexibility they need to arrange services that best promote the interests of patients, the taxpayer, and the population. As part of the Provider Selection Regime, commissioners need to be transparent in their decision making to ensure that there is proper scrutiny and accountability of decisions made about NHS services.
Rates of payment for physiotherapy services are set at a local level. Pursuant to the Government’s public interest test, NHS bodies are not obliged to accept any bids submitted by external suppliers unless they clearly demonstrate value for money and deliver against the aims and objectives of a business cases. It is expected that any outsourced services are delivered in a way that improves quality, ensures greater stability and longer-term investment in the workforce, and delivers better value for money as part of broader commitments on procurement.
Asked by: Freddie van Mierlo (Liberal Democrat - Henley and Thame)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health and Social Care, what steps he is taking to return the dementia diagnosis rate to its target level.
Answered by Stephen Kinnock - Minister of State (Department of Health and Social Care)
To support recovery of the dementia diagnosis rates, we have developed a memory service dashboard to support commissioners and providers with appropriate data and enable targeted support where needed.
We have funded an evidence-based improvement project to fund two trusts in each region, totalling 14 sites, to pilot the Diagnosing Advanced Dementia Mandate protocol. Learning is currently being shared and promoted with regional and local partners following an impact assessment of the pilots.
The Office for Health Improvement and Disparities’ Dementia Intelligence Network has developed a tool for local systems to enable investigation into local variation in diagnosis and take informed action to enhance diagnosis rates.
We have also published the D100: Assessment Tool Pathway programme, which brings together multiple resources into a single, consolidated tool. The tool continues the work of the Dementia Care Pathway, covering all elements of the Well Pathway, including Diagnosing Well.
The D100: Pathway Assessment Tool launched in April 2025 and is available at the following link:
Asked by: Freddie van Mierlo (Liberal Democrat - Henley and Thame)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health and Social Care, what discussions he has had with the Secretary of State for Work and Pensions on the potential merits of expanding eligibility for free prescriptions to include everyone in receipt of Universal Credit.
Answered by Karin Smyth - Minister of State (Department of Health and Social Care)
No discussions have been held between my Rt Hon. Friend, the Secretary of State for Health and Social Care and my Rt Hon. Friend, the Secretary of State for Work and Pensions on expanding eligibility to all claimants in receipt of Universal Credit. The Department keeps the earnings thresholds for free prescriptions under review on an annual basis.
Approximately 89% of prescription items dispensed in community pharmacy in England are free of charge, and for the first time in three years prescription charges have been frozen, meaning around 40% of the population will save money on their prescriptions.
Asked by: Freddie van Mierlo (Liberal Democrat - Henley and Thame)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health and Social Care, if he will make it his policy to review the adequacy of the earnings criteria for free prescriptions.
Answered by Karin Smyth - Minister of State (Department of Health and Social Care)
No discussions have been held between my Rt Hon. Friend, the Secretary of State for Health and Social Care and my Rt Hon. Friend, the Secretary of State for Work and Pensions on expanding eligibility to all claimants in receipt of Universal Credit. The Department keeps the earnings thresholds for free prescriptions under review on an annual basis.
Approximately 89% of prescription items dispensed in community pharmacy in England are free of charge, and for the first time in three years prescription charges have been frozen, meaning around 40% of the population will save money on their prescriptions.
Asked by: Freddie van Mierlo (Liberal Democrat - Henley and Thame)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health and Social Care, what assessment he has made of the adequacy of (a) funding and (b) the availability of trained staff for GP practices to perform blood tests for children.
Answered by Stephen Kinnock - Minister of State (Department of Health and Social Care)
Overall, ensuring adequate general practice (GP) provision is the responsibility of the integrated care boards (ICBs).
GPs are independent businesses, providing primary care services, based on a National Health Service GP Contract, to their local populations. Most commonly, GPs are run by GP partners who, alongside other GPs and healthcare staff, are responsible for running their own practice. This allows them to have relative autonomy in deciding how to provide contracted services, and provides opportunities for innovation.
Local enhanced services, such as blood tests, are negotiated and agreed locally, and are commissioned by ICBs to fit the needs of the local population. GPs can choose whether or not they would like to participate in providing these services. These services can vary in scope and funding across the country.
Asked by: Freddie van Mierlo (Liberal Democrat - Henley and Thame)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health and Social Care, what steps he is taking to encourage Hormone Replacement Therapy implant manufacturers to apply for UK licenses.
Answered by Karin Smyth - Minister of State (Department of Health and Social Care)
The Medicines and Healthcare products Regulatory Agency (MHRA) and the Department have kept ministers informed of the ongoing issues in the manufacturing of unlicenced products used as medicines for hormone replacement therapy (HRT) implants.
Regular discussions with the importer of the unlicenced medicines have been held, and the Medicines Supply team in the Department are actively looking at both licenced and other sources, to ensure an ongoing supply of appropriate products.
The MHRA welcomes these applications and has processes in place to review applications for HRT implants, as soon as they are received.
Asked by: Freddie van Mierlo (Liberal Democrat - Henley and Thame)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health and Social Care, what steps he is taking to ensure access to licenced Hormone Replacement Therapy implants for women.
Answered by Karin Smyth - Minister of State (Department of Health and Social Care)
There are currently no licensed United Kingdom suppliers of oestrogen and testosterone hormone replacement therapy (HRT) implants in the UK, and companies are free to decide what they market.
The Department is working closely with the Medicines and Healthcare products Regulatory Agency to ensure safe access to these products. As part of this, we have also reached out to specialist importers who can source unlicensed medicines in order to find HRT implants for UK patients.
Asked by: Freddie van Mierlo (Liberal Democrat - Henley and Thame)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health and Social Care, what discussions he has had with the Medicines and Healthcare products Regulatory Agency on encouraging manufacturers to apply for UK licenses for Hormone Replacement Therapy implants.
Answered by Karin Smyth - Minister of State (Department of Health and Social Care)
The Medicines and Healthcare products Regulatory Agency (MHRA) and the Department have kept ministers informed of the ongoing issues in the manufacturing of unlicenced products used as medicines for hormone replacement therapy (HRT) implants.
Regular discussions have been held with the importer of the unlicenced medicines, and the Medicines Supply team in the Department are actively looking at licenced alternatives to ensure ongoing supply.
A medicine can only become licensed if an application is made for such a licence, usually by the manufacturer, and the MHRA is only able to grant a marketing authorisation after the supporting data has been assessed to demonstrate its quality, safety, and efficacy for the conditions it is intended to treat, and to confirm that it has an acceptable balance of risk and benefit. In our role as the medicines regulator, we are not in a position to solicit for new product licence applications.
However, the MHRA welcomes marketing authorisation applications for HRT implants and has processes in place to review applications as soon as they are received. In addition, manufacturers can seek scientific advice on their product from the MHRA at any stage of development.
Asked by: Freddie van Mierlo (Liberal Democrat - Henley and Thame)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health and Social Care, if he will make an assessment of the potential merits of expanding the criteria for medical exemption certificates to include everyone with a (a) disability and (b) chronic illness.
Answered by Karin Smyth - Minister of State (Department of Health and Social Care)
The Department has no plans to expand the criteria for medical exemption certificates.
Individuals with qualifying medical conditions or with a continuing physical disability which prevents them from leaving their residence without the help of another person are entitled to apply for a medical exemption certificate.
People may also be exempt from prescription charges depending on their age, whether they are in qualifying full-time education, whether they are pregnant or have recently given birth, or whether they are in receipt of certain benefits or a war pension.
People who do not qualify for an exemption and who need many prescription items could save money with a prescription prepayment certificate, which allows people to claim as many prescriptions as they need for a set cost. People on a low income can seek help under the NHS Low Income Scheme.
Asked by: Freddie van Mierlo (Liberal Democrat - Henley and Thame)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health and Social Care, what steps he is taking to help support UK-based research into new forms of treatment for dementia.
Answered by Ashley Dalton - Parliamentary Under-Secretary (Department of Health and Social Care)
The Department delivers dementia research via the National Institute for Health and Care Research (NIHR). Government funders are investing in dementia research across all areas, from causes, diagnosis and prevention to treatment, care and support, including for carers.
The NIHR is investing almost £50 million to the UK Dementia Trials Network, which will deliver a coordinated network of early phase dementia trial sites. This will be complemented by the £20 million Dementia Clinical Trials Accelerator, designed to position the United Kingdom as the destination of choice for late phase clinical trials in dementia and neurodegenerative diseases.
The NIHR welcomes funding applications for research into any aspect of human health and care, including dementia. These 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. Welcoming applications on dementia to all NIHR programmes enables maximum flexibility both in terms of amount of research funding a particular area can be awarded, and the type of research which can be funded.
The Government’s Dame Barbara Windsor Dementia Goals programme, with almost £150 million expected to be allocated to, or aligned with it, aims to speed up the development of new treatments for dementia by accelerating innovations in biomarkers, clinical trials and implementation. Some of this will be delivered through the Neurodegeneration Initiative which the programme is establishing, which will be a globally unique, not-for-profit, industry led public-private partnership that will work together across government, industry, academia, the National Health Service and third sector to deliver its objectives, including UK research organisations.
So far, the programme has invested £13 million into a range of biomarker innovation projects, many of which are being delivered by UK small and medium enterprises and UK research organisations.