Written questions by Thomas.

What recent assessment his Department has made of the adequacy of the provision of (a) treatment and (b) care for children and young adults with (i) PANS and (ii) PANDAS.

Information on the number of children and young adults with paediatric acute-onset neuropsychiatric syndrome (PANS) and paediatric autoimmune neuropsychiatric disorder associated with streptococcus (PANDAS) is not collected at present as there are no internationally agreed criteria to identify these conditions. The PANS PANDAS Steering Group is currently working on a consensus for case identification to support a national survey. Due to the emerging nature of the evidence base there is currently a lack of consensus on what good clinical practice and training on PANS and PANDAS may look like, and no assessments have therefore been made.

If he will make an assessment of the adequacy of the the availability of training programmes on (a) PANS and (b) PANDAS for NHS staff.

Information on the number of children and young adults with paediatric acute-onset neuropsychiatric syndrome (PANS) and paediatric autoimmune neuropsychiatric disorder associated with streptococcus (PANDAS) is not collected at present as there are no internationally agreed criteria to identify these conditions. The PANS PANDAS Steering Group is currently working on a consensus for case identification to support a national survey. Due to the emerging nature of the evidence base there is currently a lack of consensus on what good clinical practice and training on PANS and PANDAS may look like, and no assessments have therefore been made.

If he will hold discussions with the National Institute for Health and Care Excellence on the development of guidelines for PANS and PANDAS.

Decisions on topics for new or updated guidance from the National Institute for Health and Care Excellence (NICE) are considered through an established NICE prioritisation process with decisions overseen by a prioritisation board, chaired by NICE’s Chief Medical Officer.NICE’s prioritisation board considered the development of guidance on paediatric acute-onset neuropsychiatric syndrome and paediatric autoimmune neuropsychiatric disorder associated with streptococcus in November 2024 and concluded that there is insufficient evidence in this area to develop useful guidance.

What steps his Department is taking to reduce geographical cost differences for (a) abiraterone and (b) similar drugs in England.

The procurement of abiraterone for secondary care is currently part of NHS England’s generic wave tender structure. NHS England tenders two regions out of six at a time to encourage competition and to ensure supply chain resilience, awarding the top two compliant suppliers onto the framework each time. Prices may vary between regions, but within NHS England’s terms and conditions there is a price review mechanism whereby any price changes can be matched/applied in other regions. Also, within the tender there is a price limiter criterion which is applied so that only bids that are in line with market norms will be compliant.

What steps his Department is taking to ensure that veterans who leave the armed forces can access NHS dental care.

We are working to improve access to National Health Service dentistry, which will also benefit our valued members of the Armed Forces community, including our respected veterans who have spent their careers defending our country.We are committed to reforming the dental contract, with a shift to focus on prevention and the retention of NHS dentists. The Government’s ambition is to deliver fundamental contract reform before the end of this Parliament. Veterans will be able to benefit from the improved access these changes bring.We are also supporting more than 1,500 children in British military families overseas through our supervised toothbrushing programme. Free NHS dental care is available to people who meet the following criteria:under 18 years old, or under 19 years old and in full-time education;pregnant or have had a baby in the previous 12 months;being treated in an NHS hospital and the treatment is carried out by the hospital dentist, although patients may have to pay for any dentures or bridges;receiving low-income benefits, or under 20 years old and a dependant of someone receiving low-income benefits; and/orreceiving War Pension Scheme payments, or Armed Forces Compensation Scheme payments and the treatment is for your accepted disability.

What recent assessment his Department has made of the geographic differences in the cost of abiraterone for high-risk prostate cancer patients in England.

The procurement of abiraterone for secondary care is currently part of NHS England’s generic wave tender structure. NHS England tenders two regions out of six at a time to encourage competition and to ensure supply chain resilience, awarding the top two compliant suppliers onto the framework each time. Prices may vary between regions, but within NHS England’s terms and conditions there is a price review mechanism whereby any price changes can be matched/applied in other regions. Also, within the tender there is a price limiter criterion which is applied so that only bids that are in line with market norms will be compliant.

What steps his Department is taking to expand dental services in rural areas.

We are aware of the challenges faced in accessing a dentist, particularly in more rural areas.The responsibility for commissioning primary care services, including National Health Service dentistry, to meet the needs of the local population has been delegated to integrated care boards (ICBs) across England.ICBs are recruiting posts through the Golden Hello scheme. This recruitment incentive will see dentists receiving payments of £20,000 to work in those areas that need them most for three years.We are committed to reforming the dental contract, with a shift to focus on prevention and the retention of NHS dentists. The Government’s ambition is to deliver fundamental contract reform before the end of this Parliament.

What steps his Department is taking to ensure that elderly people have reliable access to dental care.

The responsibility for commissioning primary care services, including National Health Service dentistry, to meet the needs of the local population has been delegated to integrated care boards (ICBs) across England. This includes considering the needs of elderly populations. The ICB for the Tewkesbury constituency is Gloucestershire ICB.We know that as people age, they tend to move to rural and coastal areas where the challenges in accessing NHS dentistry are exacerbated. We have introduced the Golden Hellos scheme which will see dentists receiving payments of £20,000 to work in those areas that need them most for three years.ICBs may commission specialised dental services including domiciliary care for elderly people living in care homes. The National Institute for Health and Care Excellence (NICE) guideline on oral health in care homes sets out several recommendations for care homes to help maintain and improve oral health and ensure timely access to dental treatment for their residents. The Government expects care homes to be following NICE guidance and recommendations in this area.

If he will make an assessment of the potential implications for his policies of recent incidents involving known risk items being accessed by mental health patients with the knowledge of NHS staff.

On 4 April 2025, NHS England published its ‘Staying Safe from Suicide: Best Practice Guidance for Safety Assessment, Formulation and Management'. This promotes a shift towards a more holistic, person-centred approach rather than relying on risk prediction, which is unreliable because suicidal thoughts can change quickly. Instead, it recommends using a method based on understanding each person’s situation and managing their safety.The purpose of this guidance is to enable mental health practitioners to adopt best practice principles in working with people of all ages to stay safe from suicide. This guidance also has a section covering confidentiality and the law and refers to the consensus statement for information sharing and suicide prevention. The guidance is available at the following link:https://www.england.nhs.uk/long-read/staying-safe-from-suicide/Work is also underway to make training available to all mental health practitioners to incorporate the principles of this guidance into their practice. This training was recently launched and is available via an e-learning module. This complements existing local training on suicide prevention, and a number of other national e-learning products that are already available.The National Confidential Inquiry into Suicide and Safety in Mental Health has been commissioned through the NHS England Culture of Care programme to support every provider of National Health Service commissioned inpatient services to move to personalised safety planning in line with evidence.In addition to this, the Health Services Safety Investigations Body’s (HSSIB) investigation into mental health inpatient settings identified important concerns and safety recommendations that can help us to improve mental health care, protect patients and the public and create a safe working environment for staff. We are in the process of formally responding to all the recommendations for the Department made within these reports. NHS England will be publishing guidance in response to the HSSIB’s recommendations defining the therapeutic relationship and guidance on responding to the use of non-anchored ligature points.

What recent assessment he has made of rates of sexual assault incidents perpetrated by mental health staff conducting Mental Health Act Section 17 escort duties or similar protective observations.

It is wholly unacceptable for any patient or member of staff to experience violence or harassment of any kind in National Health Service settings, and all organisations must take robust and compassionate action to prevent it. The Government is committed to supporting and challenging the system to ensure a safe environment for our staff and patients.Although no direct assessment of policy implications on rates of sexual assaults has been made, in September 2023, the Sexual Safety Charter was launched by NHS England with the aim of promoting a zero-tolerance approach towards sexual misconduct in the workplace. Every NHS trust and integrated care board (ICB) have since signed up to the Charter and are actively working to implement its ten principles to tackle unwanted, inappropriate or harmful sexual behaviour in the workplace.In October 2024, NHS England launched a new national sexual misconduct people policy framework and training to help staff right across the NHS to ensure they are taking the right steps in recognising, reporting and acting on sexual misconduct at work. The new framework outlines how those working in the health service should recognise, report and act on sexual misconduct in the workplace, against staff or patients. The framework is available at the following link:https://www.england.nhs.uk/publication/national-people-sexual-misconduct-policy-framework/NHS England is currently measuring the uptake of framework across all trusts and ICBs, including gathering key feedback about its impact and effectiveness so far. Feedback will be used to identify areas where organisations need support in implementing to achieve a sexual safety culture.Several tools and resources have been developed by NHS England for trusts and ICBs to adopt and take further actions on sexual misconduct. This includes the first-ever NHS-wide training on sexual misconduct awareness, now available to the entire workforce, including mental health staff conducting Mental Health Act Section 17 escort duties.NHS England has recently written to providers and asked them to take further steps to identify potential perpetrators of sexual misconduct and to redouble efforts to protect staff and patients.

Whether his Department plans to hold discussions with leaders of mental health services on meeting the requirements of the statutory duty of candour.

The Government is supportive of the review it inherited into the effectiveness of the statutory duty of candour for health and social care providers. Our aim is to ensure that all providers, including mental health trusts, and their leaders act upon the duty consistently and effectively to improve openness, coupled with effective enforcement by the Care Quality Commission.The review included a call for evidence, and the Government published its findings on 26 November 2024. These findings are available at the following link:https://www.gov.uk/government/publications/findings-of-the-call-for-evidence-on-the-statutory-duty-of-candour/findings-of-the-call-for-evidence-on-the-statutory-duty-of-candourThe Government also launched a public consultation on 26 November 2024, on proposals to regulate National Health Service managers. This sought views on making managers, including those in mental health providers, accountable for ensuring that the statutory duty is correctly followed in their organisation. In finalising the review on the statutory duty of candour, we are considering our proposals on candour set out in the Government’s response to the consultation, which was published on 21 July 2024, and other areas including recommendations made by the Infected Blood Inquiry. The consultation response is available at the following link:https://www.gov.uk/government/consultations/leading-the-nhs-proposals-to-regulate-nhs-managers/outcome/leading-the-nhs-proposals-to-regulate-nhs-managers-consultation-response

What recent assessment he has made of the potential implications for his policies of rates of sexual assault incidents at inpatient mental health hospitals.

It is wholly unacceptable for any patient or member of staff to experience violence or harassment of any kind in National Health Service settings, and all organisations must take robust and compassionate action to prevent it. The Government is committed to supporting and challenging the system to ensure a safe environment for our staff and patients.Although no direct assessment of policy implications on rates of sexual assaults has been made, in September 2023, the Sexual Safety Charter was launched by NHS England with the aim of promoting a zero-tolerance approach towards sexual misconduct in the workplace. Every NHS trust and integrated care board (ICB) have since signed up to the Charter and are actively working to implement its ten principles to tackle unwanted, inappropriate or harmful sexual behaviour in the workplace.In October 2024, NHS England launched a new national sexual misconduct people policy framework and training to help staff right across the NHS to ensure they are taking the right steps in recognising, reporting and acting on sexual misconduct at work. The new framework outlines how those working in the health service should recognise, report and act on sexual misconduct in the workplace, against staff or patients. The framework is available at the following link:https://www.england.nhs.uk/publication/national-people-sexual-misconduct-policy-framework/NHS England is currently measuring the uptake of framework across all trusts and ICBs, including gathering key feedback about its impact and effectiveness so far. Feedback will be used to identify areas where organisations need support in implementing to achieve a sexual safety culture.Several tools and resources have been developed by NHS England for trusts and ICBs to adopt and take further actions on sexual misconduct. This includes the first-ever NHS-wide training on sexual misconduct awareness, now available to the entire workforce, including mental health staff conducting Mental Health Act Section 17 escort duties.NHS England has recently written to providers and asked them to take further steps to identify potential perpetrators of sexual misconduct and to redouble efforts to protect staff and patients.

Food and Rural Affairs, what recent discussions his Department has had with relevant stakeholders on potential changes to legislation that would help increase the number of companies that are able to donate surplus food to (a) food banks and (b) soup kitchens.

No discussions have taken place with stakeholders on legislative changes to increase the number of companies able to donate food surplus. Defra's Food and Drink Waste Hierarchy outlines how all businesses should deal with food surplus and waste, preventing food surplus where possible and redistributing any surplus should it arise. Following this hierarchy will help businesses to minimise the environmental impact of food and drink waste and maximise the value of food and drink surplus, for example by donating to food banks or soup kitchens.Defra funds the UK Food and Drink Pact, a voluntary agreement with industry to tackle food waste, managed by the Waste and Resources Action Programme (WRAP). Through the Pact, we support the Food Waste Reduction Roadmap, which helps businesses to identify and measure their surplus and waste and take steps to reduce it. This Target Measure Act (TMA) approach enables food businesses to get more surplus to redistributors. Defra also engages a working group of supply chain and redistribution sector organisations to develop best practice and overcome barriers to redistribution.

Whether the child poverty strategy will look beyond the 10-year timeframe.

The Child Poverty Taskforce is progressing work to publish a Child Poverty Strategy in the autumn that will deliver fully funded measures to tackle the structural and root causes of child poverty. Our focus is on bringing about an enduring reduction in child poverty in this parliament, as part of a 10-year Strategy for lasting change, thereby reversing the trend that is seeing forecasts of child poverty continuing to increase. More details, including on the timeframes, will be set out in the strategy publication.

What recent assessment her Department has made of the potential merits of introducing legislation to give local authorities enforcement powers over pavement parking.

The Government fully understands the problems that vehicles parked on the pavement can cause for pedestrians. This is particularly the case in certain locations and for certain people, such as those with mobility or sight impairments, those pushing prams or pushchairs, and wheelchair users. The Department has been considering all the views expressed in response to the 2020 pavement parking consultation and is currently working through the policy options and the appropriate means of delivering them. We will announce the next steps and publish our formal response in due course.In the meantime, local authorities can make use of existing powers to manage pavement parking, and it is up to them to decide where to restrict pavement parking and what enforcement is appropriate.

What recent assessment his Department has made of the adequacy of the Honours System in terms of (a) fairness, (b) equity and (c) and value.

The Cabinet Office Honours team is working to make the honours system truly representative of UK society, in line with the Prime Minister’s priorities for the honours system. As part of this work, we have recently established a new independent Diversity and Outreach Committee which will assist the committee process in delivering an honours system which is properly diverse and reflective of UK society. In addition to ongoing work, every five years, a report to Parliament is published on the Operation of the UK Honours System. This report sets out progress and key developments to our work to improve the integrity and fairness in, and access to, the Honours System. The most recent report was published in May 2023 and can be viewed here. The next report is due to be published in 2028.

What recent assessment her Department has made of (a) trends in the level of pavement parking in rural areas and (b) the potential impact of this on (i) wheelchair users (ii) parents with pushchairs and (iii) partially sighted people.

The Government fully understands the problems that vehicles parked on the pavement can cause for pedestrians. This is particularly the case in certain locations and for certain people, such as those with mobility or sight impairments, those pushing prams or pushchairs, and wheelchair users. The Department has been considering all the views expressed in response to the 2020 pavement parking consultation and is currently working through the policy options and the appropriate means of delivering them. We will announce the next steps and publish our formal response in due course.In the meantime, local authorities can make use of existing powers to manage pavement parking, and it is up to them to decide where to restrict pavement parking and what enforcement is appropriate.

Whether her Department plans to respond to the 2020 consultation on Pavement parking: options for change.

The Government fully understands the problems that vehicles parked on the pavement can cause for pedestrians. This is particularly the case in certain locations and for certain people, such as those with mobility or sight impairments, those pushing prams or pushchairs, and wheelchair users. The Department has been considering all the views expressed in response to the 2020 pavement parking consultation and is currently working through the policy options and the appropriate means of delivering them. We will announce the next steps and publish our formal response in due course.In the meantime, local authorities can make use of existing powers to manage pavement parking, and it is up to them to decide where to restrict pavement parking and what enforcement is appropriate.

What recent assessment her Department has made of trends in the level of Universal Credit childcare costs.

No such assessment has been made. The Universal Credit Childcare element expenditure and forecast statistics can be found in row 18 of the ‘Universal Credit and equivalent’ tab, published here: Benefit expenditure and caseload tables 2025 - GOV.UK Further information, including Universal Credit childcare element statistics and supplementary data tables, are also published and available here: Universal Credit statistics, 29 April 2013 to 10 July 2025 - GOV.UK

What steps her Department is taking to increase the availability of driving tests in rural areas.

The Driver and Vehicle Standards Agency’s (DVSA) main priority is upholding road safety standards while it works hard to reduce car practical driving test waiting times.On the 18 December last year, DVSA published measures to bring down car practical driving test waiting times across the country. This included the recruitment of driving examiners (DEs), and DVSA continues to run recruitment campaigns as part of this.On the 23 April, the Secretary of State for Transport appeared before the Transport Select Committee and announced that DVSA will take further actions including the reintroduction of overtime pay incentives, and a call for volunteers from those currently in other roles (but qualified to examine) to carry out practical driving tests.Further information on these actions and progress on the plan can be found on GOV.UK at: www.gov.uk/government/news/transport-secretary-acts-to-make-thousands-of-extra-driving-tests-available-each-month. DVSA is committed to providing its customers, including those in rural areas, with the best service possible. DVSA continually reviews its estate to ensure it represents good value for money and is efficient.