Asked by: Rupert Lowe (Independent - Great Yarmouth)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health and Social Care, what was the total annual NHS expenditure on GnRH analogue puberty blockers for under-18s in each financial year since 2010.
Answered by Zubir Ahmed - Parliamentary Under-Secretary (Department of Health and Social Care)
Gonadotropin-releasing hormone (GnRH) agonists or ‘puberty blockers’ are used to treat several medical conditions in children and young people. These can include precocious puberty, some forms of cancer, and endometriosis. They have also been used outside of their licenced indication to treat gender dysphoria.
There is no central registry that provides the total number of children in England who have been prescribed GnRH agonists through the National Health Service since 2010.
The following table shows the number of identifiable patients and total net ingredient cost for NHS prescriptions of GnRH agonists for all purposes for children aged 17 years old and under that were prescribed and dispensed in community pharmacies or general practices in England in each year from 2015/2016 to September 2025:
Financial year | The unique number of identified patients aged 17 years old and under who received an NHS prescription of GnRH for all purposes | The total net ingredient cost of prescriptions known to be issued to those aged 17 and under who received an NHS prescription of GnRH for all purposes |
2015/16 | 885 | £621,033.41 |
2016/17 | 987 | £692,927.42 |
2017/18 | 1,047 | £772,767.71 |
2018/19 | 1,072 | £806,393.82 |
2019/20 | 1,048 | £781,151.72 |
2020/21 | 936 | £703,531.55 |
2021/22 | 864 | £607,597.80 |
2022/23 | 849 | £586,845.56 |
2023/24 | 746 | £525,321.93 |
2024/25 | 622 | £449,611.72 |
2025/2026 | 432 | £219,338.73 |
Source: ePACT2, which sources data from the NHS Business Services Authority’s Information Services Data Warehouse.
Note: the net ingredient cost is the basic price of a product excluding VAT. It does not take account of discounts, rebates, dispensing costs, fees, and allowances paid to pharmacists and appliance contractors for the service they provide to the NHS, or prescription charge income received, where the single charge or Prescription Prepayment Certificate fee is paid, or foregone where prescriptions are dispensed free of charge.
The NHS Business Services Authority does not hold patient data prior to April 2015. This data excludes dispensing in secondary care and other settings, and private prescriptions.
Asked by: Rupert Lowe (Independent - Great Yarmouth)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health and Social Care, whether any NHS Trusts (a) employ specialist staff or (b) operate dedicated services to address genetic disorders associated with consanguinity.
Answered by Zubir Ahmed - Parliamentary Under-Secretary (Department of Health and Social Care)
The National Health Service in England supports patients with a variety of conditions related to genetics. NHS England is piloting and evaluating new models of care to improve the equity of access to genetic services for the small proportion of couples at increased genetic risk due to close relative marriage. NHS England is funding additional capacity in several professions, including midwifery, genomics associates, and neonatal nurses, in nine pilot sites through the Genetic Risk Equity Project. 3.8 whole time equivalent (WTE) midwives and one WTE neonatal nurse were in post in 2024/25 to deliver the Genetic Risk Equity Project.
Asked by: Rupert Lowe (Independent - Great Yarmouth)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health and Social Care, how many NHS staff there are whose responsibilities include addressing genetic disorders associated with consanguinity.
Answered by Zubir Ahmed - Parliamentary Under-Secretary (Department of Health and Social Care)
The National Health Service in England supports patients with a variety of conditions related to genetics. NHS England is piloting and evaluating new models of care to improve the equity of access to genetic services for the small proportion of couples at increased genetic risk due to close relative marriage. NHS England is funding additional capacity in several professions, including midwifery, genomics associates, and neonatal nurses, in nine pilot sites through the Genetic Risk Equity Project. 3.8 whole time equivalent (WTE) midwives and one WTE neonatal nurse were in post in 2024/25 to deliver the Genetic Risk Equity Project.
Asked by: Rupert Lowe (Independent - Great Yarmouth)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health and Social Care, how many patients aged under 18 have been prescribed GnRH analogue puberty blockers through the NHS in each year since 2010.
Answered by Zubir Ahmed - Parliamentary Under-Secretary (Department of Health and Social Care)
Gonadotropin-releasing hormone (GnRH) agonists or ‘puberty blockers’ are used to treat several medical conditions in children and young people. These can include precocious puberty, some forms of cancer, and endometriosis. They have also been used outside of their licenced indication to treat gender dysphoria.
There is no central registry that provides the total number of children in England who have been prescribed GnRH agonists through the National Health Service since 2010.
The following table shows the number of identifiable patients and total net ingredient cost for NHS prescriptions of GnRH agonists for all purposes for children aged 17 years old and under that were prescribed and dispensed in community pharmacies or general practices in England in each year from 2015/2016 to September 2025:
Financial year | The unique number of identified patients aged 17 years old and under who received an NHS prescription of GnRH for all purposes | The total net ingredient cost of prescriptions known to be issued to those aged 17 and under who received an NHS prescription of GnRH for all purposes |
2015/16 | 885 | £621,033.41 |
2016/17 | 987 | £692,927.42 |
2017/18 | 1,047 | £772,767.71 |
2018/19 | 1,072 | £806,393.82 |
2019/20 | 1,048 | £781,151.72 |
2020/21 | 936 | £703,531.55 |
2021/22 | 864 | £607,597.80 |
2022/23 | 849 | £586,845.56 |
2023/24 | 746 | £525,321.93 |
2024/25 | 622 | £449,611.72 |
2025/2026 | 432 | £219,338.73 |
Source: ePACT2, which sources data from the NHS Business Services Authority’s Information Services Data Warehouse.
Note: the net ingredient cost is the basic price of a product excluding VAT. It does not take account of discounts, rebates, dispensing costs, fees, and allowances paid to pharmacists and appliance contractors for the service they provide to the NHS, or prescription charge income received, where the single charge or Prescription Prepayment Certificate fee is paid, or foregone where prescriptions are dispensed free of charge.
The NHS Business Services Authority does not hold patient data prior to April 2015. This data excludes dispensing in secondary care and other settings, and private prescriptions.
Asked by: Rupert Lowe (Independent - Great Yarmouth)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health and Social Care, whether he plans to provide additional funding to (i) James Paget Hospital and (ii) Northgate Hospital to help support (a) local residents and (b) its seasonal tourist population.
Answered by Karin Smyth - Minister of State (Department of Health and Social Care)
Integrated care boards (ICBs) are responsible for commissioning and funding the care delivered by healthcare providers, including the James Paget University Hospitals NHS Foundation Trust and the Norfolk and Suffolk NHS Foundation Trust. The amount of funding received by each provider is based on the NHS Payment Scheme, which is a set of rules, prices, and guidance that determine how the providers of National Health Service funded healthcare are paid for the services they deliver.
NHS England is responsible for determining the allocation of financial resources to ICBs. The process of setting funding allocations is informed by the Advisory Committee on Resource Allocation, an independent committee that provides advice to NHS England on setting the target formula which impacts how allocations are distributed over time according to factors such as demography, morbidity, deprivation, and the unavoidable cost of providing services in different areas.
NHS England produces a technical guide to allocation formulae, with the 2025/26 edition available at the following link:
The edition covering 2026/27 to 2028/29 allocations will be published in due course.
The NHS also has an operational pressures escalation levels (OPEL) framework which provides a standardised approach to support an effective, integrated, and coordinated response to acute trust operational pressures. This includes actions locally, regionally, and nationally that support the depressurising of services and ensure patient safety. Further information about the OPEL framework is published by NHS England, and is available at the following link:
Asked by: Rupert Lowe (Independent - Great Yarmouth)
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 patients in Great Yarmouth receive equal access to NHS services.
Answered by Karin Smyth - Minister of State (Department of Health and Social Care)
As part of the 10-Year Health Plan we are focusing the role of integrated care boards (ICBs) on strategic commissioning to improve population health. NHS England has published the Strategic Commissioning Framework which supports the development of care models that are better matched to local needs, improved access to appropriate services, and a stronger focus on population health and reducing inequalities.
As outlined in our 10-Year Health Plan, neighbourhood health plans will be created, including for the Norfolk and Waveney ICB, which covers Great Yarmouth.
Asked by: Rupert Lowe (Independent - Great Yarmouth)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health and Social Care, whether his Department has direct oversight of financial efficiencies at the James Paget Trust.
Answered by Karin Smyth - Minister of State (Department of Health and Social Care)
The East of England Regional Team has detailed and regular engagement with the James Paget University Hospitals NHS Foundation Trust to discuss both their financial position and, more specifically, the delivery of their financial efficiencies. The monthly financial position and progress in delivering efficiencies is a key aspect of the monthly System Financial Review meetings with the trust’s Chief Finance Officer, alongside the integrated care board and other trusts within the local system.
As of October 2025, the James Paget University Hospitals Trust is on track to deliver against its agreed efficiency target.
Asked by: Rupert Lowe (Independent - Great Yarmouth)
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 level of ambulance handover delays at James Paget Hospital in each of the past three years.
Answered by Karin Smyth - Minister of State (Department of Health and Social Care)
NHS England publishes monthly data on ambulance handovers, including at the James Paget University Hospitals NHS Foundation Trust over the past three years. This information is available at the following link:
In addition, weekly handover data split by day is also published as part of national winter reporting. This information is available at the following link:
https://www.england.nhs.uk/statistics/statistical-work-areas/uec-sitrep
We are working closely with the trust and system partners to deliver ongoing, evidence-based improvement to ambulance handovers. Key actions include the Release and Respond Programme since December 2024, which targets long delays and supports rapid handovers, new protocols for managing hospital capacity and safe patient flow, enhanced discharge planning and long length-of-stay reviews, Same Day Emergency Care investment enabling same-day assessment and treatment, and enhanced geriatrician support for early assessment and frailty management.
These initiatives are already delivering positive results with the average handover time reducing by 27 minutes in November 2025 compared to November 2024. Furthermore, current four-hour performance for November stands at 73.4%, up 10.3% from last November.
Asked by: Rupert Lowe (Independent - Great Yarmouth)
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 impact of staff parking charges on recruitment and morale at James Paget Hospital.
Answered by Karin Smyth - Minister of State (Department of Health and Social Care)
No assessment has been made of the impact of staff parking charges on recruitment and morale at James Paget Hospital.
The health and wellbeing of National Health Service staff is a top priority, and all NHS organisations have a responsibility to create supportive working environments for staff, ensuring they have the conditions they need to thrive.
As set out in the 10-Year Health Plan, we will work with the Social Partnership Forum to introduce a new set of staff standards for modern employment, covering issues such as access to healthy meals, support to work healthily and flexibly, and tackling violence, racism, and sexual harassment in the workplace.
All NHS hospitals in England are expected to follow the published NHS Car Parking Guidance. The guidance makes clear that where hospital car parking charges exist, they should be reasonable for the area.
In addition, free hospital car parking is already in place for ‘in-need’ groups, and this includes NHS staff working overnight.
Asked by: Rupert Lowe (Independent - Great Yarmouth)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health and Social Care, how much (i) James Paget University Hospitals NHS Foundation Trust and (ii) Norfolk and Waveney Community Health and Care NHS Trust spent on external consultants in each of the last three financial years.
Answered by Karin Smyth - Minister of State (Department of Health and Social Care)
The following table shows the amount spent by James Paget University Hospitals NHS Foundation Trust and Norfolk and Waveney Community Health and Care NHS Trust for the last three financial years:
| 2022/23 | 2023/24 | 2024/25 |
James Paget University Hospitals NHS Foundation Trust | £360,455 | £181,287 | £154,043 |
Norfolk and Waveney Community Health and Care NHS Trust | £45,467 | £1,684 | £19,752 |
The information is published in their annual report and accounts on their websites, where further detail is available.