Underinvestment in Primary Prevention

#34 —

Health and Social Care Committee

Recommendation: Throughout our inquiry we have seen examples where time and time again policy that has been designed to protect and improve children’s health and the health of the population is delayed or diluted in the face of threats from the …

Response Pending

#33 —

Health and Social Care Committee

Recommendation: A more strategic and holistic view of food policy that seeks to improve the healthiness of food and the food environment is needed. The government should either extend the scope of existing regulation or create new regulation to ensure that …

Response Pending

#32 —

Health and Social Care Committee

Recommendation: The current regulatory framework does not create a level playing field across all settings where food is purchased, largely ignores the out-of-home sector, has a blind spot around delivery apps and is littered with loopholes that ultimately undermine the intended …

Response Pending

#31 —

Health and Social Care Committee

Recommendation: The Food Standards Agency’s role should be expanded to cover the healthiness of food, as well as food safety. It should report to Parliament on progress towards healthier food production and on meeting targets for healthy food sales. This expanded …

Response Pending

#30 —

Health and Social Care Committee

Recommendation: The government needs to build and fund a more robust enforcement regime for existing and upcoming regulation, which should include: a. improved, ring-fenced funding and an improved training offer for local authority trading standards and environmental health teams to improve …

Response Pending

#29 —

Health and Social Care Committee

Recommendation: We are concerned by the lack of enforcement of policies and recommend the government review the extent to which its policies are being enforced and, in its response to us, set out detail on resources available for enforcement. (Recommendation, Paragraph …

Response Pending

#28 —

Health and Social Care Committee

Recommendation: Policies to support a reduction in the consumption of HFSS foods stand no chance of success if they are not strongly enforced. Businesses need to be clear that there will be consequence for failing to meet their legal requirements to …

Response Pending

#27 —

Health and Social Care Committee

Recommendation: The Food (Promotion and Placement) (England) Regulations 2021 should be updated no later than January 2027 to: a. include a requirement to place fruits and vegetables in prominent instore locations like checkouts and store entrances; and b. extend the definition …

Response Pending

#26 —

Health and Social Care Committee

Recommendation: It is concerning that HFSS foods continue to feature prominently on pages on retailer websites that are not covered by existing regulations, particularly special offers pages. We know that price is a driver of shopping habits and so believe that …

Response Pending

#25 —

Health and Social Care Committee

Recommendation: Existing regulation could be better used to play a more active role in building healthier retail environments. While we are encouraged that changing shop layouts is one of the government’s suggested ways of achieving healthier sales, given there will likely …

Response Pending

#24 —

Health and Social Care Committee

Recommendation: A holistic, consistent and watertight approach to restricting the exposure of children to all HFSS advertising needs to be developed. It should include: 56 a. bringing brand and range advertising into the scope of existing regulations as soon as possible …

Response Pending

#23 —

Health and Social Care Committee

Recommendation: On a local level, some local authorities are working hard to improve their own food environment through bans to outdoor advertising, but they are severely limited due to only being able to target council-owned assets. To ensure a consistent approach, …

Response Pending

#22 —

Health and Social Care Committee

Recommendation: Advertising methods are changing quickly, with the rising prominence of social media advertising, digital advertising, sport sponsorship, online gaming and direct marketing through app notification. Existing regulations do not adequately address these forms of advertising. Further delay to strengthening restrictions …

Response Pending

#21 —

Health and Social Care Committee

Recommendation: The evidence is clear: advertising impacts on the consumption of HFSS foods. The government has already accepted this to some degree given the action already taken to restrict exposure to HFSS advertising, but it must be bolder. Its current approach …

Response Pending

#20 —

Health and Social Care Committee

Recommendation: Working with the Office for Health Improvement and Disparities and directors of public health, we call on the government to: a. develop clearer definitions for the terms “hot food takeaway”, “fast- food outlet” and “reasonable walking distance” and develop guidance …

Response Pending

#13 —

Health and Social Care Committee

Recommendation: We therefore repeat the recommendation previously made by Sir Henry Dimbleby that the government should establish a “Community Eatwell” programme to provide healthy eating support to families and individuals on low incomes experiencing food-related ill health. The government should also …

Response Pending

#12 —

Health and Social Care Committee

Recommendation: Local projects to support access to healthier foods are doing fantastic work in their communities and seeing real results, using local knowledge and building strong community relationships to drive change. Community projects need to be a core part of any …

Response Pending

#3 —

Health and Social Care Committee

Recommendation: The government should also commit to regularly reviewing and updating the nutrient profile model so that we do not go another 22 years, or more, between updates. Reviewing and implementing an updated nutrient profiling model on a 10-year cycle would …

Response Pending

#2 —

Health and Social Care Committee

Recommendation: The 2018 nutrient profiling model should be implemented as soon as possible, and certainly no later than by the end of 2027. The government will hear a lot of representations against this, but should hold firm. While we are aware …

Response Pending

#4 —

Culture, Media and Sport Committee

Recommendation: We recognise the importance of ‘horizon-scanning’ work to ensuring people maintain and increase their activity levels, which in turn will boost their resilience to the virus. However, smaller organisations are unlikely to have the resources 56 Impact of COVID-19 on …

Gov response: Sporting Future identified the huge opportunity that the digital agenda presents for sport and physical activity. Using data to make people more aware of activity opportunities available to them has continued to be a key …

Position Not Stated

#14 —

Health and Social Care Committee

Recommendation: As part of its national health and care recovery plan, we recommend that the Government sets out the contribution that public health services will make, and ensures that this contribution is backed with a level of funding that acknowledges their …

Gov response: Partially accept. The Government recognises the crucial importance of effective public health services in supporting local populations, and the negative impact that the pandemic has had on health inequalities. Public health services are vital in …

Partially Accepted

#24 — Overall NHS productivity remains low despite increased elective activity and community investments.

Public Accounts Committee

Recommendation: Despite carrying out 15% more elective activity than before the pandemic, the NHS is less productive overall once the activities of mental health trusts, community trusts and GPs are considered.42 NHSE told us that, while government has had a long-term …

Gov response: 6.2 NHS investment in primary medical care and community services (including continuing care) increased faster than overall ICB spend in 2023-24. 6.3 DHSC and NHSE have prioritised mental health in its plans for 2025-26, requiring …

Not Addressed

#22 — Inadequate definition and tracking of prevention spending impedes accurate assessment of policy progress.

Public Accounts Committee

Recommendation: Currently, NHSE does not even track spend and activity on prevention by ICBs at local levels, due to unavailability of data and the lack of consistency about what counts as prevention spending. While DHSC funds some prevention activities that sit …

Gov response: 5.4 Prevention is one of the 'three shifts' the Secretary of State has set out as strategic ambitions for the health systemin England. Measures for supporting the prevention shift are being considered in context of …

Not Addressed

#21 — DHSC believes prevention requires cultural and legislative change, not solely additional resource allocation.

Public Accounts Committee

Recommendation: DHSC told us it did not view providing more resources, or redirecting them from elsewhere, as a substantive part of the solution to the lack of progress with prevention. Instead, it considers that a shift towards prevention might be achieved …

Gov response: 5.4 Prevention is one of the 'three shifts' the Secretary of State has set out as strategic ambitions for the health systemin England. Measures for supporting the prevention shift are being considered in context of …

Not Addressed

#20 — Progress on health prevention hindered by acute care focus and reduced public health grants.

Public Accounts Committee

Recommendation: Senior ICB leaders reported to the National Audit Office a continued lack of progress with the government’s long-standing aim to move towards preventing ill health rather than treating it. One of the most important reasons cited by ICBs has been …

Gov response: 5.4 Prevention is one of the 'three shifts' the Secretary of State has set out as strategic ambitions for the health systemin England. Measures for supporting the prevention shift are being considered in context of …

Not Addressed

#13 — DHSC acknowledges long-term healthcare shifts but prioritises immediate acute service pressures.

Public Accounts Committee

Recommendation: DHSC and NHSE told us that they were fully supportive of the new government’s aims to shift healthcare spending from treatment towards prevention, from hospitals to the community, and from analogue to digital. However, DHSC contended that these shifts would …

Gov response: 2.2 The underlying financial position of the NHS providers and systems is significantly improved in 2024-25 compared to 2023-24 with an end of year deficit of around £600 million compared to £1.5 billion in the …

Not Addressed

#6 — Ensure greater NHSE funding for community services, preventing redirection to hospitals.

Public Accounts Committee

Recommendation: NHSE’s long-held ambition to move more care from hospitals to the community has stalled. There would have been more investment and progress in mental health and community services, particularly GP surgeries and dental services, in 2023–24 had NHSE not redirected …

Gov response: The government is considering this recommendation. care) increased faster than overall ICB spend in 2023-24. DHSC and NHSE have prioritised mental health in its plans for 2025-26, requiring ICBs to meet the Mental Health Investment …

Under Consideration

#5 — Define government health prevention spending and increase flexible funding for local systems.

Public Accounts Committee

Recommendation: Given the constraints on public spending, it is highly likely that re- focusing attention from sickness to prevention cannot be achieved without re-allocating existing NHS funds in the same direction. Senior ICB leaders report a continued lack of progress with …

Gov response: The government is considering this recommendation. ambitions for the 10 Year Health Plan. Funding for 2026-27 onwards will be determined following Spending Review Phase 2 and will be aligned to support the delivery of the …

Under Consideration

#12 — Government commits to preventative oral healthcare measures including supervised toothbrushing and water fluoridation

Public Accounts Committee

Recommendation: The new government’s commitment to contract reform includes reference to a focus on prevention,27 and also to a programme of supervised toothbrushing for three, four, and five–year olds “most in need”.28 Tooth decay is a leading cause of hospital admissions …

Gov response: 1.8 The government agrees with the Committee’s recommendation. Recommendation implemented: December 2024 1.9 The Plan for Change has already set out the government’s commitment to addressing the main underlying drivers of ill-health and tackling persistent …

Accepted

#14 — Spending shifts from preventative to late intervention services, increasing later costs and worsening outcomes.

Public Accounts Committee

Recommendation: MHCLG recognises the importance of investing in prevention but also the challenge of funding it when finances are constrained.34 Preventative services help stop, delay or reduce the need for statutory services and can help to deliver better outcomes.35 Over the …

Gov response: 3.1 The government agrees with the Committee’s recommendation. Recommendation implemented 3.2 As outlined in HM Treasury’s Permanent Secretary’s letter to the Committee on 7 August 2025, the government’s approach to public sector reform is informed …

Accepted

#11 — Prioritise funding and support for local preventative services to reduce acute service demand.

Housing, Communities and Local Government Committee

Recommendation: The Ministry must prioritise funding and support for local preventative services to fix the foundations, reduce the demand for acute services, and bring down costs in the longer term. (Recommendation, Paragraph 50)

Gov response: 21. Reform and prevention are critical if we are to turn around the cycle of system failure and cost escalation. This Government is reforming services, including children’s social care, homelessness and rough sleeping, special educational …

Response Not Attributed

#10 — Temporary central government funding is required to rebuild damaged preventative services.

Housing, Communities and Local Government Committee

Recommendation: Rebuilding and strengthening damaged preventative services will require temporary increases in central government funding before the demand for acute services starts to drop. (Conclusion, Paragraph 49)

Gov response: 21. Reform and prevention are critical if we are to turn around the cycle of system failure and cost escalation. This Government is reforming services, including children’s social care, homelessness and rough sleeping, special educational …

Response Not Attributed

#14 — Fund urgent research into FGM reconstructive surgery effectiveness, with NHS provision if proven beneficial.

Women and Equalities Committee

Recommendation: The Government should facilitate and fund research into the effectiveness of reconstructive surgery for FGM survivors as a matter of priority. If evidence indicates that the surgery is effective, then the NHS should provide it. (Recommendation, Paragraph 44) Estimating the …

Gov response: We agree this is an important area of research and are in the process of taking the recommendation forward. The National Institute for Health and Care Research (NIHR) is developing a call in this area …

Accepted

#13 — Government obstructs FGM reconstructive surgery by failing to fund necessary research.

Women and Equalities Committee

Recommendation: Many women who have undergone FGM seek reconstructive surgery to reverse FGM as far as possible. It is clear that the NHS is equipped to perform this surgery as it delivers it for other medical conditions. We acknowledge that the …

Gov response: We agree this is an important area of research and are in the process of taking the recommendation forward. The National Institute for Health and Care Research (NIHR) is developing a call in this area …

Accepted

#73 — Refocus High Needs Block funding towards early intervention and identification in mainstream settings.

Education Committee

Recommendation: The High Needs Block should be refocused to enable and incentivise earlier intervention. Currently, a significant proportion of this funding is directed towards supporting high-cost, specialist provision once needs have escalated. While such provision is vital for some, a more …

Gov response: Supporting children with SEND is central to the early years agenda. The government recognises the important role the early years sector plays in early intervention to ensure the right support is put in place for …

Partially Accepted

#72 — Prioritise strategic funding deployment for early intervention in SEND to improve outcomes.

Education Committee

Recommendation: Funding must be strategically deployed to deliver the best outcomes for children and young people with SEND. This should include prioritised investment in early intervention. Timely and targeted support is essential 170 and can prevent some needs such as speech …

Gov response: Supporting children with SEND is central to the early years agenda. The government recognises the important role the early years sector plays in early intervention to ensure the right support is put in place for …

Accepted

#32 — Increase government support for grassroots initiatives enabling Muslim women's participation in social activity.

Women and Equalities Committee

Recommendation: The Government should increase its support for community-led grassroots initiatives aimed at supporting Muslim women and girls to participate in social activity. (Recommendation, Paragraph 118) 54

Gov response: 85. The Government recognises the importance of community-led initiatives in fostering social cohesion and bringing people together. By supporting locally driven programmes we aim to strengthen community connection and cohesion to build resilience. These initiatives …

Position Not Stated

#13 — Commission community pharmacies to provide HIV-prevention PrEP and all routine adult and child immunisations.

Health and Social Care Committee

Recommendation: In the shorter term, and in light of the large body of evidence and long-running calls for these services to be offered in community pharmacy settings, we recommend that NHS England commissions community pharmacies to provide the HIV-prevention medication PrEP …

Gov response: The committee raises an interesting and valuable point. HIV is a key priority for the Government, and we have commissioned a new HIV Action Plan for 2025-30, to achieve no new HIV transmissions with England …

Partially Accepted

#22 —

Health and Social Care Committee

Recommendation: We recommend that the Department’s “national movement campaign” include targeted messaging aimed at the least active and people approaching older age. These messages should demonstrate how movement can be incorporated into daily habits, use relatable role models and focus on …

Response Pending

#13 —

Housing, Communities and Local Government Committee

Recommendation: It is time for the Government to invest so the country can build 90,000 social rent homes a year. We appreciate that even with the funding we set out below, any programme will take time to scale up, but we …

Gov response: The Government recognises the need to increase housing supply across all tenures. The Chancellor announced a £12bn investment in Affordable Housing at the Budget in March 2020, which will provide new homes up to 2025/26. …

Partially Accepted

#13 —

Health and Social Care Committee

Recommendation: The pandemic has had a negative impact on health inequalities and highlighted the crucial importance of effective public health services in supporting local populations. Public health services are therefore vital allies in tackling the backlog, and we are surprised at …

Gov response: Partially accept. The Government recognises the crucial importance of effective public health services in supporting local populations, and the negative impact that the pandemic has had on health inequalities. Public health services are vital in …

Accepted

#24 — Diagnostics require further investment and greater integration across the entire health system.

Public Accounts Committee

Recommendation: Lord O’Neill told us that although DHSC and its arm’s-length bodies have done a decent job in some key areas, they have not really progressed diagnostics. He is of the view that diagnostics should be embedded across the entire health …

Gov response: 4.1 The government agrees with the Committee’s recommendation. Target implementation date: Spring 2027 4.2 The government is working to fulfil Outcome 6 of the NAP, which commits to cross- sector working to develop diagnostics as …

Accepted

#5 — Pensioners face increased health risks and unsustainable care demand without a preventative, whole-system approach

Work and Pensions Committee

Recommendation: As pensioners are generally on a fixed income, they face challenges responding to cost-of-living increases. Those on low incomes are likely to respond by cutting back on food, energy use and social interactions, adding to existing health risks. Various social …

Gov response: The Government recognise that pensioner poverty is often the result of compounding disadvantages that start long before retirement which is why state support is provided accordingly. For example, we have increased the National Living Wage …

Response Not Attributed

#30 —

Work and Pensions Committee

Recommendation: We welcome the Minister’s recognition that the different parts of government—including DWP and the NHS—are ‘in this together.’ As we said in our Pensioner Poverty report, a whole system approach to prevention is needed if the government is to achieve …

Response Pending

#21 —

Health and Social Care Committee

Recommendation: The government must start a national conversation about ageing which talks about getting older in a more positive way, challenges assumptions about unavoidable and irreversible decline and motivates people to remain active. (Conclusion, Paragraph 74)

Response Pending

#26 —

Culture, Media and Sport Committee

Recommendation: We recommend that the Government make physical education a core subject within the national curriculum. (Recommendation, Paragraph 76)

Gov response: The Government is focusing on improving quality, clarity and consistency through curriculum reform, wider school sport policy and targeted support for schools, an approach expected to deliver more meaningful impact without the complexity of legislative …

Position Not Stated

#2 —

Culture, Media and Sport Committee

Recommendation: We recognise the pressures on the public finances. Investing in sport, however, by creating a more active population, will eventually lead to significant savings, particularly in the health and welfare budgets. We recommend that the Government increase the 0.3% (£3.8 …

Gov response: We are committed to delivering sustained investment into sport and recreation, ensuring funding is targeted at the least active communities. At least £400 million will be invested in new and upgraded grassroots sport facilities over …

Position Not Stated

#1 —

Culture, Media and Sport Committee

Recommendation: The evidence shows that funding community sport and physical activity is an investment with high returns, including savings on healthcare costs, productivity gains, and wider wellbeing benefits. The consequences of under‑investment are costly. Ageing infrastructure, higher operating costs, and reduced …

Gov response: This funding is alongside the £400 million we will invest over the next four years to transform grassroots facilities for the communities that need it most, as well as the more than £250 million Exchequer …

Accepted

#3 —

Culture, Media and Sport Committee

Recommendation: The cessation of community sport countrywide during lockdown has hit under- represented groups the hardest. While we welcome the announcement that some recreational sports teams can now resume play, we are concerned about gyms and leisure centres. These facilities act …

Gov response: to be active. It is important that leisure centres remain accessible for people from all backgrounds as we make efforts to return to normality after the Covid-19 lockdown period. Outdoor swimming pools have been able …

Position Not Stated

#1 —

Housing, Communities and Local Government Committee

Recommendation: The failure to properly fund children’s and adult social care, especially adult social care, is the single biggest threat facing local government financial resilience. Given that the cost of providing social care consumes between 60% and 70% of the budgets …

Gov response: Since the start of the pandemic, we have committed over £12 billion in financial support to councils to tackle the impacts of COVID-19, including over £6 billion of un-ringfenced grants (£4.6 billion for 2020/21 and …

Accepted