Written questions by Maguire.

If his Department will make an assessment of the potential merits of taking additional steps to improve the quality of life of people living with Myalgic Encephalomyelitis.

We are committed to improving care and support for people with myalgic encephalomyelitis / chronic fatigue syndrome (ME/CFS). We recognise how devastating the symptoms can be, and the significant impact they can have on patients and their families.We aim to publish the final ME/CFS delivery plan by the end of June 2025, where one of the key themes is bettering the lives of those living with this debilitating disease, as well as boosting research, and improving attitudes and education.The responses to the interim delivery plan consultation, along with continued close engagement with the Government, National Health Service and external stakeholders, will inform the development of the final ME/CFS delivery plan, which will include actions to improve quality of life.

What assessment his Department has made of the potential impact of patients' (a) blindness and (b) partial sightedness on levels of attendance at (i) GP and (ii) hospital appointments.

The Department has made no formal assessment of the impact of visual impairment on levels of attendance. However, we are aware of the challenges that visual impairments can present when accessing healthcare services.Under the Equality Act (2010), health and social care organisations must make reasonable adjustments to ensure that disabled people, including blind and partially sighted people, are not disadvantaged. To make it easier for disabled people to use health services, there is work underway in NHS England to ensure that staff in health settings know if they need to make reasonable adjustments. This includes the development of a Reasonable Adjustment Digital Flag, which enables the recording of key information about a patient, and their reasonable adjustment needs, in health records to ensure support can be tailored appropriately.Since 2016, all National Health Service organisations and publicly funded social care providers have been expected to meet the Accessible Information Standard (AIS). The standard details the recommended approach to supporting the information and communication support needs of patients and carers with a disability, impairment, or sensory loss, including blind and partially sighted people. NHS England has been undertaking a review of the AIS to help ensure that the communication needs of people with a disability, impairment, or sensory loss are met in health and care provision. A revised AIS will be published in due course. In the meantime, the current AIS remains in force and therefore there should not be a gap in provision for people using services.

What steps his Department is taking to improve the accessibility of health services for (a) blind and (b) partially sighted people in North Cornwall constituency.

Integrated care boards are responsible for commissioning services to meet the needs of their local population, including blind and partially sighted people.Under the Equality Act (2010), health and social care organisations must make reasonable adjustments to ensure that disabled people are not disadvantaged. To make it easier for disabled people to use health services, there is work underway in NHS England to ensure that staff in health settings know if they need to make reasonable adjustments. This includes rolling out a Reasonable Adjustment Digital Flag, which enables the recording of key information about a patient, and their reasonable adjustment needs, in health records to ensure support can be tailored appropriately.Since 2016, all National Health Service organisations and publicly funded social care providers are expected to meet the Accessible Information Standard (AIS), which details the recommended approach to supporting the information and communication support needs of patients and carers with a disability, impairment, or sensory loss, including blind and partially sighted people. NHS England has been undertaking a review of the AIS to help ensure that the communication needs of people with a disability, impairment, or sensory loss are met in health and care provision. A revised AIS will be published in due course. In the meantime, the current AIS remains in force and therefore there should not be a gap in provision for people using services.

Food and Rural Affairs, if he will bring forward legislative proposals to criminalise the failure to prevent dumping of sewage into public waterways by water companies.

For too long, water companies have discharged unacceptable levels of sewage into our rivers, lakes and seas. Storm Overflows are strictly regulated by the Environment Agency (EA). Where breaches are found, EA will not hesitate to hold companies to account. The Water (Special Measures) Act 2025, signed into law on 24 February, marks the most significant increase in the water industry regulators’ enforcement powers in a decade. The Act increases criminal liability for water executives who break the law. It also delivers new powers for Ofwat to make rules to ban the payment of bonuses for water bosses where water companies fail to meet specified standards, including standards in relation to the environment, and requires water and sewerage companies to develop statutory Pollution Incident Reduction Plans, driving increased transparency and a stronger preventative approach. Beyond this new legislation, we are also carrying out a full review of the water sector. The Independent Water Commission, led by Sir Jon Cunliffe, will make recommendations to shape further action to transform how our water system works and clean up our waterways for good. A public Call for Evidence closed on 23 April, with all interested parties invited to share their views. The review's final recommendations will be published and shared with the UK and Welsh Governments this summer. The government is also committed to taking a systematic approach to improving drainage and wastewater systems. This means looking at the bigger picture – how these systems affect the environment, local communities, and other key priorities like flood prevention, economic growth, and urban development. By doing this, we can make sure policies and services work better together to deliver real benefits for people and nature.

What steps his Department is taking to support charities who help (a) blind and (b) visually-impaired people.

The Health and Wellbeing Alliance is the mechanism through which the Department, NHS England, and the UK Health Security Agency work together with voluntary, community, and social enterprise sector organisations to drive the transformation of the health and care systems, promote equality, address health inequalities, and help people, families, and communities to achieve and maintain wellbeing.

Communities and Local Government, if she will make an assessment of the potential merits of undertaking a review of the Mobile Homes Act 2013 to help support full time residential park-home owners.

A review of the effectiveness of the Mobile Homes Act 2013 was undertaken in 2017 and it made a number of recommendations. Most have been implemented, such as the introduction of a fit and proper person test and changes to the pitch fee review inflationary index from the Retail Price Index to the Consumer Price Index.

With reference to paragraph 2.44 of the Autumn Budget 2024, published on 30 October 2024, HC295, what discussions his Department (a) has had and (b) plans to have with representatives of (i) breweries and (ii) consumers on the consultation on encouraging small brewers to retain and expand their access to pubs.

At the Autumn Budget, the Chancellor announced that the government would consult on ways to encourage small brewers to retain and expand their access to UK pubs.We are undertaking commercially confidential discussions with a wide range of market participants to gain a better understanding of the supply, sale and dispense of cask and keg beers, together with the nature of competition between brewers, including local/small suppliers.We will then discuss the findings with competition and markets experts before considering further steps.

What steps his Department is taking to increase accessibility of GP appointments in rural areas.

We acknowledge the urgent challenge of ensuring that rural areas have the resources to continue serving their patients. To address this, we are increasing capacity in general practice (GP) by recruiting more GPs, ensuring rural areas have the necessary workforce to provide integrated, patient-centred services. We have invested £82 million into the Additional Roles Reimbursement Scheme, which has enabled the recruitment of over 1,500 recently qualified GPs across England since October 2024. This will increase the number of available appointments, secure the future pipeline of GPs, and alleviate the pressure on those currently working in the system. We’ve also delivered the biggest boost to GP funding in years, an £889 million uplift, with GPs now receiving a growing share of National Health Service resources. For the first time in four years, the General Practitioners Committee England backed the new 2025/26 contract, which includes key reforms to improve access to GPs, like making sure patients can request appointments online throughout core hours.

What assessment her Department has made of the potential merits of requiring academy trusts to publish full budgets.

All academy trusts must publish an annual report and accounts, which are audited by a registered statutory auditor. As part of their annual reports and accounts, academy trusts must also publish details of their objectives, achievements and future plans, including what they have done to promote value for money in support of these projects. In addition, financial information on individual schools, including a breakdown of their income and expenditure, is available on GOV.UK through the Schools Financial Benchmarking and Insight Tool, at: https://financial-benchmarking-and-insights-tool.education.gov.uk/.

If she will make an assessment of the potential merits of introducing a cap on the proportion of academy trust budgets that can be spent on senior leadership salaries.

The department sets out its expectations on pay for academies and academy trusts in the Academy Trust Handbook (ATH), which is published on GOV.UK, and available at: https://assets.publishing.service.gov.uk/media/66a3909aab418ab055592dda/Academy_trust_handbook_2024_FINAL.pdf. The ATH requires that:An academy trust’s board of trustees ensures its decisions, when setting levels of executive pay, including salary and any other benefits, follow a robust evidence-based process.Academy trusts’ decisions on pay must be a reasonable and defensible reflection of the individual’s role and responsibilities.No individual can be involved in deciding their remuneration.Academy trusts must be transparent on pay and publish the number of employees whose benefits exceed £100,000 on their websites in £10,000 bandings. Where employees are also trustees, this information must be disclosed in £5,000 bandings. In addition, the department’s ‘Setting executive salaries’ guidance outlines the key contextual factors that trusts should be considering when setting or reviewing executive salaries. This guidance is published on GOV.UK and is available at: https://www.gov.uk/government/publications/setting-executive-salaries-guidance-for-academy-trusts/setting-executive-salaries-guidance-for-academy-trusts.

What steps her Department is taking to improve road safety for vulnerable road users.

This Government treats road safety with the utmost seriousness, and we are committed to reducing the numbers of those killed and injured on our roads. My Department is developing our road safety strategy and will set out more details in due course.

Communities and Local Government, whether her Department plans to issue guidance to local authorities in rural areas with high levels of (a) executive housing and (b) second homes on revising the (i) points and (ii) banding systems used to allocate social housing.

Local Authorities are responsible for designing and managing their own housing allocations policies to meet local need within the framework of legislation under which certain categories of people must be given priority. Social housing allocations guidance can be found here. The Department has no plans to issue additional guidance to local authorities in rural areas.

What steps her Department is taking to support nurseries with the cost of providing the expanded funded childcare hours.

It is our ambition that all families have access to high-quality, affordable and flexible early education and care, giving every child the best start in life. This is key to the government’s Plan for Change, which starts with reaching the milestone of a record number of children being ready for school. That also means ensuring the sector is financially sustainable and confident as it continues to deliver entitlements and high-quality early years provision going forward.That is why, despite tough decisions to get public finances back on track, the government is continuing to prioritise and invest, supporting early education and childcare providers with the costs they face. In the 2025/26 financial year alone, the department plans to spend over £8 billion on early years entitlements. We have also announced the largest ever uplift to the early years pupil premium, increasing the rate by over 45% compared to 2024/25 financial year, equivalent to up to £570 per eligible child per year.In addition, the department is providing £75 million for the early years expansion grant to support the sector as it prepares to deliver the final phase of expanded childcare entitlements from September 2025, recognising the significant level of expansion needed and the effort and planning this will require. We are also providing £25 million of funding to support public sector employers with increased National Insurance contributions through the early years National Insurance Contributions grant.

What assessment she has made of the potential impact of the number of nurseries that have withdrawn from the childcare funding scheme citing cost pressures on early years provision.

It is our ambition that all families have access to high-quality, affordable and flexible early education and care, giving every child the best start in life. This is key to the government’s Plan for Change, which starts with reaching the milestone of a record number of children being ready for school. That also means ensuring the sector is financially sustainable and confident as it continues to deliver entitlements and high-quality early years provision going forward.Local authorities are required by legislation to provide sufficient childcare places for children in their local area who require childcare. This includes children with special educational needs and disabilities and children in rural areas. Local authorities are also required to report annually to councillors on how they are meeting their duty to secure sufficient childcare and to make this report available and accessible to parents.The department has regular contact with each local authority in England about their sufficiency of childcare and any issues they are facing. Where local authorities report sufficiency challenges, we discuss what action they are taking to address those issues and, where needed, support the local authority with any specific requirements through our childcare sufficiency support contract. At present, no local authorities are reporting they are unable to meet their sufficiency duty.In the 2025/26 financial year alone, this government plans to spend over £8 billion on early years entitlements. The department has also announced the largest ever uplift to the early years pupil premium, increasing the rate by over 45% compared to the 2024/25 financial year, raising it to the equivalent to up to £570 per eligible child per year.On top of this, the department is providing further supplementary funding of £75 million for the early years expansion grant to support the sector in providing the additional places and workforce needed by September 2025.

What assessment she has made of the adequacy of the funding provided to early years providers for meeting the cost of a nursery place.

It is our ambition that all families have access to high-quality, affordable and flexible early education and care, giving every child the best start in life. This is key to the government’s Plan for Change, which starts with reaching the milestone of a record number of children being ready for school. That also means ensuring the sector is financially sustainable and confident as it continues to deliver entitlements and high-quality early years provision going forward.That is why, despite tough decisions to get public finances back on track, the government is continuing to prioritise and invest, supporting early education and childcare providers with the costs they face. In the 2025/26 financial year alone, the department plans to spend over £8 billion on early years entitlements. We have also announced the largest ever uplift to the early years pupil premium, increasing the rate by over 45% compared to 2024/25 financial year, equivalent to up to £570 per eligible child per year.In addition, the department is providing £75 million for the early years expansion grant to support the sector as it prepares to deliver the final phase of expanded childcare entitlements from September 2025, recognising the significant level of expansion needed and the effort and planning this will require. We are also providing £25 million of funding to support public sector employers with increased National Insurance contributions through the early years National Insurance Contributions grant.

Communities and Local Government, if her Department will make an assessment of the potential merits of requiring housing developers to consult with water companies at every stage when building new homes, in the context of establishing sewage infrastructure.

As set out in Paragraph 7 of the National Planning Policy Framework (NPPF), the purpose of the planning system is to contribute to the achievement of sustainable development, including the provision of homes, commercial development and supporting infrastructure in a sustainable manner. Sustainable development should be pursued both through the preparation and implementation of local development plans, and the application of policies in the framework.The government is clear that housing must come with appropriate infrastructure, including appropriate water infrastructure. We believe that strategic issues such as water capacity are best dealt with at a strategic level through the plan-making process, rather than through individual planning applications.A key function of local development plans is to guide development to the most suitable and sustainable locations and to ensure that the associated infrastructure requirements are addressed. Effective co-operation early in the plan-making process is essential to ensuring not only that housing and infrastructure need is appropriately planned for, but that they are aligned with each other. The NPPF makes it clear that local planning authorities should collaborate with each other and with other public bodies, including infrastructure providers, to identify relevant strategic matters to be addressed, including providing for sustainable water supplies.Water companies are under a statutory duty to provide new water and sewerage connections to residential properties, as well as planning to meet the needs of growth as part of water resource management plans, and drainage and wastewater management plans. The water resources planning guidance published by the government set out how those companies should forecast demand for water based on existing customers and planned levels of household and non-household growth, with the number of planned developments being based on published local plans.Relevant planning practice guidance sets out that good design and mitigation measures should be secured during development, both through site-specific and non-site-specific policies on water infrastructure. The revised NPPF published on 12 December 2024 makes clear that developments of all sizes should use sustainable drainage techniques when the development could have drainage impacts and should have appropriate maintenance arrangements in place. We continue to explore whether more needs to be done to ensure sustainable drainage technologies are taken up more widely in new development, either through planning policy or by commencing schedule 3 to the Flood and Water Management Act 2010, and a decision on the best way forward will be made in the coming months.Ensuring that we take a strategic spatial planning approach to the management of water, including tackling pollution and managing pressures on the water environment at a catchment, regional and national scale, is a core objective of the ongoing independent review into the regulatory system of the water sector, launched in October 2024 by the UK and Welsh Governments. The review is expected to report next year, and we will carefully consider its findings.

What steps his Department plans to take to help increase the availability of GP appointments in North Cornwall constituency.

We are committed to improving capacity and access to local services across the country, including in the North Cornwall constituency. North Cornwall sits within the NHS Cornwall and Isles of Scilly Integrated Care Board. Since June 2024, there has been an 18.2% increase in appointments delivered, higher than the national average increase of 17.8% in the same period. In October 2024, we injected £82 million into the Additional Roles Reimbursement Scheme to enable the recruitment of 1,000 newly qualified general practitioners (GPs) across England, which will increase the number of appointments delivered, and care for thousands of patients The Government has delivered the biggest boost to GP funding in years, an £889 million uplift, with GPs now receiving a growing share of National Health Service resources. For the first time in four years, the General Practitioners Committee England backed the new 2025/26 contract, which includes key reforms to improve access, for instance by making sure patients can request appointments online throughout core hours.

Whether she has made a recent assessment of the adequacy of legal aid provision.

This Government has inherited a justice system in crisis, and the previous administration left the legal aid sector is under significant strain. We are committed to restoring our justice system and ensuring the long-term sustainability of the legal aid sector. We recently concluded a consultation on uplifts to some areas of civil legal aid fees. Once fully implemented, this would inject an additional £20 million into the sector each year. We are currently reviewing consultation responses and will publish the Government response in due course. We will continue to consider the fees paid in other categories of civil legal aid, and the wider themes from the Review, in order to support the long-term sustainability of the civil legal aid sector. On criminal legal aid, in November 2024 we announced our response to the Crime Lower consultation, confirming an uplift to the lowest police station fees, introducing a new Youth Court fee scheme, and paying for travel time in certain circumstances. Together, these changes amount to a £24 million investment for criminal legal aid providers. In addition, in December 2024, we announced that criminal legal aid solicitors will receive up to £92 million more a year to help address the ongoing challenges in the criminal justice system, subject to consultation. We are also committed to continuing to work with the criminal legal aid profession, including the Bar, on further opportunities for reform this Parliament and to support the overall sustainability, diversity, and efficiency of the system.

Communities and Local Government, what support her Department has made available to residents facing increases in management fees by (a) landlords and (b) management companies.

I refer the hon. Member to the Written Ministerial Statement made on 21 November 2024 (HCWS244).

Whether her Department plans to make an assessment of the potential impact of off-payroll working IR35 reforms on (a) self-employed workers and (b) small businesses.

The off-payroll working rules, also known as IR35, do not apply to the genuinely self employed. They are designed to ensure that individuals working like employees but through their own company, pay broadly the same income tax and National Insurance contributions (NICs) as those who are directly employed. On 27 February 2025, HMRC published updated internal analysis on the impacts of the 2021 reform. HMRC has previously published external research looking at the impacts of the reform to the off-payroll working rules in the private and voluntary sectors, which were introduced in April 2021.