Asked by: Zöe Franklin (Liberal Democrat - Guildford)
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 potential impact of (a) lowering the minimum age for routine breast screening to 40 and (b) offering annual screening on (i) early detection rates, (ii) patient outcomes and (iii) demand on NHS screening services.
Answered by Sharon Hodgson
We are guided by the independent scientific advice of the UK National Screening Committee (UK NSC) on all screening matters. It is only where there is robust evidence that an offer to screen provides more good than harm that a screening programme is recommended.
As screening programmes can also cause harms, each of the adult screening programmes has both an upper and lower age range, within which there is good scientific evidence that the benefits of screening outweigh the harms.
The NHS Breast Screening Programme does not currently offer screening to women younger than the age of 50 years old for breast cancer due to the lower risk of women under this age developing breast cancer, and the fact that women below 50 years old tend to have denser breasts tissue. The density of breast tissue reduces the ability of getting an accurate mammogram, the accepted screening test for breast cancer.
There is therefore a risk of unnecessary treatment and distress for women who do not have breast cancer but would be subjected to invasive and painful medical treatments and diagnostic tests.
We are in line with most European countries, most of whom screen women between the ages of 50 and 69 years old.
The UK NSC recognises that screening programmes are not static and that, over time, they may need to change to be more effective. Work is underway within the breast screening programme to investigate the possibility of routinely screening below the currently recommended age. The AgeX research trial has been looking at the effectiveness of offering some women one extra screen between the ages of 47 and 49 years old.
It is the biggest trial of its kind ever to be undertaken and will provide robust evidence about the effectiveness of screening in this age group, including the benefit and harms. The UK NSC will review the publication of the AgeX trial when it reports.
The UK NSC welcomes any new evidence which suggests the case for a new or modified screening programme via its open call. Any person or organisation can submit a proposal for a new screening topic during the UK NSC’s three-month open call process which will next run from 1 July 2026 to 30 September 2026.
Asked by: Zöe Franklin (Liberal Democrat - Guildford)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health and Social Care, what progress has been made towards delivering the Government's commitment to provide universal access to Fracture Liaison Services by 2030; and when he plans to publish a timetable setting out the key milestones for implementation.
Answered by Sharon Hodgson
Our 10-Year Health Plan committed to rolling out Fracture Liaison Services across every part of the country by 2030.
Integrated care boards (ICBs) remain well placed to make decisions according to local need.
The Renewed Women’s Health Strategy sets an expectation that ICBs prioritise community-based models when commissioning new fracture prevention services.
Asked by: Zöe Franklin (Liberal Democrat - Guildford)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health and Social Care, when he plans to publish the implementation plan for delivering the Government's commitment to provide universal access to Fracture Liaison Services across England by 2030.
Answered by Sharon Hodgson
Our 10-Year Health Plan committed to rolling out Fracture Liaison Services across every part of the country by 2030.
Integrated care boards (ICBs) remain well placed to make decisions according to local need.
The Renewed Women’s Health Strategy sets an expectation that ICBs prioritise community-based models when commissioning new fracture prevention services.
Asked by: Zöe Franklin (Liberal Democrat - Guildford)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health and Social Care, what steps his Department is taking to improve early and equitable access to diagnosis and treatment for people living with ataxia.
Answered by Preet Kaur Gill
The Government is committed to improving the lives of those living with rare diseases, including rare ataxias, under the UK Rare Diseases Framework. We published the fifth annual England action plan in February 2026, where we report on the steps we have taken to advance the priorities of the framework, including getting a diagnosis faster and improving access to specialist care, treatments, and drugs.
NHS England has revised the national service specification for specialised neurology following extensive consultation. The service specification was published on 13 August 2025 and includes guidance on both specialised and core neurology services. The specification includes an Annex which provides greater clarity for neurology sub-specialties, including the categories of both movement disorders and neurogenetics, into which ataxias fall.
Additionally, the national specialised commissioning neurology transformation programme has developed guidance as part of an integrated care system toolkit, specifically to support the implementation of the service specification. Every specialised neurology centre could and should see patients with ataxias.
NHS England commissions two highly specialised services for patients with Ataxia telangiectasia: an adult service provided by Royal Papworth Hospital NHS Foundation Trust; and a paediatric service provided by Nottingham University Hospitals NHS Trust. NHS England also commissions the Ataxia Telangiectasia Society to support patient access to these services.
NHS England also supports patients through a range of Rare Disease Collaborative Networks (RDCNs), which seek to improve care, expertise, and patient outcomes for people living with rare diseases. The Rare Ataxia RDCN was established in 2025 and is working to increase professional and public awareness of ataxia, improve geographical equity of referrals, and strengthen collaboration with patient organisations, including Ataxia UK.
Asked by: Zöe Franklin (Liberal Democrat - Guildford)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health and Social Care, what consideration he has given to (a) introducing safeguards and (b) reviewing legislation relating to the circumcision of infants and minors for non-medical reasons.
Answered by Preet Kaur Gill
Departmental officials will be engaging with stakeholders, particularly in Muslim and Jewish communities, regarding non-statutory measures to improve patient safety relating to the circumcision of male infants and minors for non-medical reasons.
Asked by: Zöe Franklin (Liberal Democrat - Guildford)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health and Social Care, what steps his Department is taking to ensure that strategic commissioners, including Surrey Heartlands and NHS Sussex, have the commissioning flexibility and tools required to attract new NHS dental providers into areas where NHS dental provision does not adequately meet local population need.
Answered by Stephen Kinnock - Secretary of State for Wales
Integrated care boards (ICBs) are responsible for commissioning primary care services, including National Health Service dentistry and orthodontic services, to meet the needs of the local population. For the Guildford constituency, this is the Surrey Heartlands ICB.
Since 2024, a minimum unit of dental activity (UDA) value of £28 is in place to support practices with historically low UDA rates. ICBs have the flexibility to influence the UDA rate locally, which may help to support local interventions. The current differential UDA rates across England also allow providers to use differing pay rates for associate dentists to reflect the local market rates.
NHS England expects local commissioners to manage dental contracts actively and responsively, working with dental providers to redistribute contracted activity where appropriate and to rebase consistently underperforming contracts, helping to maximise the delivery of NHS dental care and improve access for patients.
Commissioners can use flexible commissioning where they identify a need that cannot be met effectively through the provision of mandatory services. In doing so, they must satisfy themselves that these arrangements are appropriate and offer good value for money. NHS England published guidance on flexible commissioning in 2023, which is available at the following link:
Asked by: Zöe Franklin (Liberal Democrat - Guildford)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health and Social Care, what steps his Department is taking to reduce the gap in healthy life expectancy between the country’s most and least deprived communities.
Answered by Sharon Hodgson
The Government’s 10-Year Health Plan sets out our ambitious commitment to halve the healthy life expectancy gap between the richest and poorest regions. We know that reducing the gap will require action on challenges that are more prevalent in areas with lower healthy life expectancy. This is why, for example, we are taking action to tackle the obesity crisis and delivered the world-leading Tobacco and Vapes Act to support our ambition for a future smoke-free United Kingdom.
Reducing this gap is not just a health challenge, which is why we are also taking a range of cross-Government action to tackle health inequality. This includes the introduction of Awaab’s Law, ensuring landlords will have to fix significant damp and mould hazards, and legislating for a new statutory health and health inequalities duty for strategic authorities.
Asked by: Zöe Franklin (Liberal Democrat - Guildford)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health and Social Care, if he will set out the contractual requirements that apply to independent sector providers delivering NHS-funded cataract surgery, including whether they are required to accept an appropriate case mix rather than lower-complexity patients.
Answered by Karin Smyth - Minister of State (Department of Health and Social Care)
Independent sector providers are commissioned and managed by integrated care boards (ICBs) under the terms of the NHS Standard Contract which applies the same standards of oversight and regulation as are applied to National Health Service providers.
In the 10-Year Health Plan for England, we set out we would not tolerate ‘gaming’ the national payment tariff to cherry pick the simplest, most profitable cases. ICBs are expected to monitor this, and act decisively where they identify problems as part of a wider duty to safeguard and ensure value for taxpayer money.
Asked by: Zöe Franklin (Liberal Democrat - Guildford)
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 support community pharmacies to improve accessibility for people who are deaf, hard of hearing, or living with dual sensory loss; and whether he is taking steps to support the provision of reasonable adjustments, including hearing loops, to ensure patients can safely access advice and treatment.
Answered by Stephen Kinnock - Secretary of State for Wales
The Department recognises the importance of ensuring community pharmacy services are safe and accessible to all patients, including those with sensory impairments.
In addition to legal requirements under the Equality Act 2010 and the Human Rights Act 1998, pharmacy businesses have a duty to comply with the General Pharmaceutical Council’s (GPhC) standards for registered pharmacy premises. This requires pharmacies to provide an environment that is safe and accessible for all, taking reasonable steps to remove barriers for patients with disabilities. These standards emphasise the need for pharmacies to make adjustments to facilities and services, such as providing accessible entrances, hearing loops, and assistance for individuals with mobility or sensory challenges.
To support community pharmacies in meeting their legal duties, the GPhC has issued equality guidance for pharmacies, which outlines best practices for supporting patients with a range of needs. NHS England is also rolling out a Reasonable Adjustment Digital Flag which enables the recording of key information about a disabled patient and the reasonable adjustments to care and treatment that they need, to ensure support can be tailored appropriately and equitably. This is being rolled out nationally across all healthcare settings and will help community pharmacies spot when a patient may need extra support.
Asked by: Zöe Franklin (Liberal Democrat - Guildford)
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 regional variation in access to children’s hospice services; and what steps he is taking to ensure equitable provision across England.
Answered by Stephen Kinnock - Secretary of State for Wales
Whilst the majority of palliative care and end-of-life care is provided by National Health Service staff and services, we recognise the vital part that voluntary sector organisations, including children and young people’s hospices, also play in providing support to children at the end of life, as well as their loved ones.
We recognise that there is variation in access to children and young people’s hospice services across England. This reflects a range of factors, including the way in which the independent hospice sector has historically developed, which was largely not planned with a view to ensure even geographical coverage or to prioritise areas of greatest need based on demographics. However, it is worth recognising that hospices are not the sole providers of palliative care and end of life care, much of which is provided by NHS statutory services.
Palliative care services are included in the list of services an integrated care board (ICB) must commission. To support ICBs in this duty, NHS England has published statutory guidance and service specifications. The statutory guidance states that ICBs must work to ensure that there is sufficient provision of care services to meet the needs of their local populations, which can include hospice services available within the ICB catchment.
We supported the hospice sector in England with a £125 million capital funding boost for adult, and children and young people’s hospices to ensure they have the best physical environment for care. We are also providing approximately £80 million of revenue funding for children and young people’s hospices over three financial years, from 2026/27 to 2028/29, giving them the stability they need to plan ahead.
For the long-term, the Government is developing a Modern Service Framework (MSF) for Palliative Care and End-of-Life Care for England, with a planned publication date of Autumn 2026. Through our MSF, we will closely monitor the shift towards the strategic commissioning of palliative care and end-of-life care services to ensure that services reduce variation in access and quality, and we will also consider contracting and commissioning arrangements as part of this work.