Written questions by Bloore.

Whether he plans to review the safety measures and responsibilities of local authorities on water crossings.

Under the Highways Act 1980, local highway authorities are responsible for the maintenance and safety of the highway network in their area, which may include bridges, fords and other types of river crossing. The Act does not set out specific standards of safety or maintenance for these assets. It is for each individual local highway authority to assess which parts of its network need repair and what standards should be applied, based upon their local knowledge and circumstances, and the Government has no plans to change this. The Department does, however, plan to update its guidance to local highway authorities on the management of their highway networks. As part of this it will consider whether more guidance is needed on the management of river crossings.

What steps he is taking to promote the use of Prescription Prepayment Certificates.

The NHS Business Services Authority (NHS BSA) promotes prescription prepayment certificates (PPCs) as part of a wider communications plan for all of the Help with Health Costs services that it delivers. The NHS BSA and the National Health Service use social media, online resources, media releases, and healthcare bulletins to promote the PPC to professionals and patients, to ensure both groups are aware of their availability.

What assessment he has made of the potential impact of the affordability of prescriptions on people with long-term conditions.

Approximately 89% of prescription items are dispensed free of charge in the community in England. There are a wide range of exemptions from prescription charges already in place, for which those with long-term conditions may be eligible, to support the affordability of prescriptions. Eligibility depends on the patient’s age, whether they are in qualifying full-time education, whether they are pregnant or have recently given birth, or whether they are in receipt of certain benefits or a war pension.People on low incomes can apply for help with their health costs through the NHS Low Income Scheme. Prescription prepayment certificates (PPCs) are also available. PPCs allow people to claim as many prescriptions as they need for a set cost, with three month and 12-month certificates available, and PPCs can be paid for in 10 direct debit instalments.

What steps he is taking to improve health outcomes for survivors of acquired brain injuries.

The Government wants a society where every person, including those with a long-term condition such as an acquired brain injury (ABI), receives high-quality, compassionate continuity of care, with their families and carers supported.We will change the National Health Service so that it becomes not just a sickness service, but able to prevent ill health in the first place. This will help us be better prepared for the change in nature of disease and allow our services to focus more on the management of chronic, long-term conditions, like ABI, including rehabilitation where appropriate.The National Institute for Health and Care Excellence is currently developing guidance ‘Rehabilitation for chronic neurological disorders including acquired brain injury’, which is expected to be published on 16 July 2025. More information is available at the following link:https://www.nice.org.uk/guidance/indevelopment/gid-ng10181I met the original proponent of the ABI strategy, my Hon. Friend, Sir Chris Bryant MP, on 27 November 2024 to discuss ABI and we had a very fruitful discussion about what might be achievable in the both the short term and the longer term. Sir Chris remains a huge advocate for those that have suffered an ABI and I fully agree with him that the Government should, and importantly will, do more, including showcasing those areas that have effectively integrated post-hospital care and support, including rehabilitation, to other areas where patients are not getting the care and support they deserve.A decision on next steps on ABI at the national level will be taken in due course.Meanwhile, we have committed to develop a 10-year plan to deliver an NHS fit for the future. We will be carefully considering input from the public, patients, health staff, and our stakeholders as we develop the plan over the coming months. The engagement process has been launched and I would encourage stakeholders to engage with that process to allow us to fully understand what is not working as well as it should and what the potential solutions are, including on ABI. More information is available at the following link:https://change.nhs.uk/en-GB/

Whether she plans to review the list price at which motorists are required to pay additional car tax.

The Expensive Car Supplement is an additional VED charge for new cars with a list price of £40,000 or more, which is payable in year 2 – 6 of a car’s lifecycle. As set out at Autumn Budget 2024, the government recognises the disproportionate impact of the current VED Expensive Car Supplement threshold for those purchasing zero emission cars and will consider raising the threshold for zero emission cars only at a future fiscal event, to make it easier to buy electric cars.

What his Department's timetable is for the commencement of dentist contract renegotiations.

To rebuild dentistry in the long term and increase access to National Health Service dental care, we will reform the dental contract, with a shift to focus on prevention and the retention of NHS dentists.There are no perfect payment systems and careful consideration needs to be given to any potential changes to the complex dental system so that we deliver a system better for patients and the profession. We continue to meet the British Dental Association and other representatives of the dental sector to discuss how we can best deliver our shared ambition to improve access for NHS dental patients.

Media and Sport, whether she plans to incentivise the building of television and film studios in the (a) regions and (b) West Midlands.

We are already incentivising film and TV production in the UK, with UK-wide funding programmes, infrastructure investment, competitive tax reliefs and direct support for independent British content.The British Film Commission (BFC) is supporting the growth of the UK’s seven geographic production hubs to ensure that the combination of infrastructure, stage space and crew in those locations is set up to attract and accommodate even more major inward investment. Further funding for the BFC for 2025/26 was confirmed at the Autumn Budget.Beyond the seven established hubs, there are many more areas across the UK brimming with potential and ambition which the Government will continue to support. In the West Midlands, Birmingham is becoming a very successful cultural hub enriched by recent investments including the BBC and Netflix at Digbeth Loc Studios. At the Autumn Budget, £25 million was confirmed for the new Crown Works Studio in Sunderland via the North East Combined Mayoral Authority.

What assessment he has made of the potential implications for his policies of Getting It Right First Time's guidance entitled Heavy Menstrual Bleeding, published in October 2021; and whether he plans to implement their recommendations.

The Getting It Right First Time’s (GIRFT) 2021 report into maternity and gynaecology identified a key barrier in treating heavy menstrual bleeding as the commissioning arrangements for contraceptive and sexual health services. The report recommended the lifting of restrictions on providing long-acting reversible contraception (LARC) for non-contraceptive purposes, such as treatment for heavy menstrual bleeding.The commissioning of LARC is a decision for individual integrated care boards, who can decide whether to offer LARC through general practices or sexual health services, or both, based on an assessment of population need.Additionally, £25 million has been invested by the Department to support the development of at least one pilot women’s health hub in every integrated care system, and work is ongoing with NHS England to provide this. Women’s health hubs bring together healthcare professionals and existing services to address fragmentation in reproductive health care and remove the barriers women face accessing treatment. Providing care and treatment for heavy menstrual bleeding is a core service of the hubs, and this includes treatment with LARCs.

What recent assessment her Department has made of trends in the standard of writing in (a) primary schools, (b) secondary schools and (c) universities since 2015.

High and rising school standards are at the heart of the government’s mission to break down barriers to opportunity and give every child the best life chances. The government has established an independent Curriculum and Assessment Review which will seek to deliver, amongst other things, an excellent foundation in core subjects of reading, writing and maths. The review group will publish an interim report early in 2025 setting out their interim findings and confirming the key areas for further work. The final review with recommendations will be published in autumn 2025. In the meantime, the department will continue to consider how to best support writing standards at all ages.At the end of the academic year in which children turn five, which is usually reception year, each child’s level of development must be assessed against the 17 early learning goals set out in the early years foundation stage (EYFS) statutory framework. In the 2022/23 academic year, just 71% of children met the expected level of development in writing. The EYFS reforms were introduced in September 2021. As part of those reforms, the EYFS Profile was significantly revised. It is therefore not possible to directly compare assessment outcomes with earlier years.In 2024, the key stage 2 national curriculum assessments in England showed that 72% of pupils met the expected standard in writing. The method of assessing writing changed in 2017/18, when 78% of pupils met the expected standard, therefore 2024 results are not directly comparable to 2015. In 2015, 87% of pupils achieved a level 4 or above in the writing teacher assessment.The English language GCSE aims to provide all students with robust foundations in reading and good written English, and with the language and literary skills which are required for further study and work. While 50% of this GCSE assesses writing, the results do not directly reflect changes in the standard of writing over time, due to the way GCSEs are graded using comparable outcomes. In 2024, 61.6% of pupils entering the exam achieved a grade 4 or above. GCSEs were reformed for teaching in schools from September 2015 onwards, with first examinations in summer 2017, when 70.8% of pupils achieved a grade 4 or above.The government takes very seriously the need for high academic standards in higher education (HE), as does the Office for Students (OfS), the independent regulator of HE in England. HE providers are autonomous organisations, responsible for ensuring the standards of students' work. However, the OfS explored the standard of writing in a sample of providers in its 2021 report 'Assessment practices in English higher education providers: Spelling, punctuation and grammar', which sets out the OfS’s view that students should be assessed on spelling, punctuation and grammar in order to maintain quality and protect standards.As part of the OfS's ‘B4 Registration’ condition, HE providers must establish academic regulations that are designed to ensure the effective assessment of technical proficiency in the English language in a manner which appropriately reflects the level and content of the applicable HE course.

Innovation and Technology, what discussions he has had with (a) civil society and (b) animal protection organisations on ending animal testing.

The Government is committed to supporting the use of alternative methods to the use of animals in science and the Labour Manifesto includes a commitment to “partner with scientists, industry, and civil society as we work towards the phasing out of animal testing”, which is a long-term goal. The government will be consulting civil society and animal protection organisations as this process unfolds.

If he will publish a cancer strategy which includes measures on tackling (a) pancreatic and (b) other less survivable cancers.

The Health Mission sets the objective of building a National Health Service fit for the future. As part of that work, and in response to Lord Darzi’s report, we have launched an extensive programme of engagement to develop a 10-Year Health Plan to reform the NHS. The plan will set out a bold agenda to deliver on the three big shifts, from hospital to community, from analogue to digital, and from sickness to prevention.In addition, following publication of the 10-Year Health Plan, we will develop a new national cancer plan, which will include further details on how we will improve outcomes for cancer patients, including those with pancreatic and other less survivable cancers.We are now in discussions about what form that plan should take, and what its relationship to the 10-Year Health Plan and the Government’s wider Health Mission should be, and will provide updates on this in due course.NHS England is delivering a range of interventions that are expected to improve early diagnosis and treatment for patients with suspected and diagnosed pancreatic cancer. This includes providing a route into pancreatic cancer surveillance for patients at inherited high-risk, to identify lesions before they develop into cancer, and diagnose cancers sooner.In March 2024, NHS England published guidance for providers and systems to implement a timed Hepato-Pancreato-Biliary cancer pathway with the aim of ensuring that patients with some suspected tumour types, including suspected pancreatic cancer, receive a diagnosis or have cancer ruled out within 28 days of urgent referral.

If she will take steps to abolish all Child Maintenance Service for parents with care who are victim-survivors of domestic abuse.

The Department has recently concluded a public consultation on policy changes. This included proposals to remove the Direct Pay service (where parents pay each other directly) and managing all CMS cases in one service to allow the CMS to tackle non-compliance faster. The consultation also sought views on how victims and survivors of domestic abuse can be better supported to use CMS and whether removing Direct Pay completely would benefit victims and survivors of domestic abuse. This follows the Child Support Collection (Domestic Abuse) Act receiving Royal Assent in June 2023, which recognised that Direct Pay may not always be appropriate for victims and survivors of domestic. Removing Direct Pay would mean all maintenance payments would be monitored and transferred within the scheme. As all payments would flow via CMS, the CMS would be able to automatically identify any that were missed, late or partial and immediately take action to re-establish compliance. This would also reduce the ability for perpetrators of domestic abuse to exploit the communication channel needed for direct pay to function for the purposes of abuse; and prevent abusers from inflicting economic control and coercion through withholding CM payments. Feedback from the consultation is being considered and a Government response will be published in due course.

With reference to the recommendations of the report by the Getting It Right First Time programme entitled Maternity and Gynaecology, published in September 2021, what steps his Department is taking to provide primary care practitioners with (a) training and (b) other resources to deliver long-acting reversible contraception as part of treatment options for women with heavy menstrual bleeding.

The 2021 Getting It Right First Time national report for maternity and gynaecology recommended that clinical commissioning groups, now integrated care boards (ICBs), commission contraceptive and sexual health services to provide intrauterine devices, which are a form of long-acting reversible contraception (LARC) for heavy menstrual bleeding, in relevant cases. ICBs may commission sexual health services or general practices (GPs) to offer LARC as a locally enhanced service to their local population. It is for ICBs to decide on commissioning arrangements for their area, based on an assessment of local need.The Department is continuing to work with NHS England to support the establishment of at least one pilot women’s health hub in every integrated care system, following a £25 million investment. A core service offered by hubs is treatment for heavy menstrual bleeding and provision of LARC. By providing an enhanced and more specialist service through hubs in the community, they enable women to be more effectively diagnosed and treated promptly in the community. The hubs also provide a centre for the training and support to GPs to help with upskilling, and reduce variation in the care that women can expect to receive.Other training and guidance are available for primary care practitioners. For example, the Royal College of General Practitioners has developed a Women’s Health Library, drawing together educational resources and guidelines on women’s health, so primary healthcare professionals have the most up-to-date information for their patients. The Faculty of Sexual and Reproductive Healthcare also offers a range of contraception qualifications that healthcare professionals can undertake.

What assessment his Department has made of the potential impact of increasing access to long-acting reversible contraception for heavy menstrual bleeding in primary care on (a) waiting times and (b) demand for secondary care gynaecology services.

The National Institute for Health and Care Excellence’s guideline on heavy menstrual bleeding recommends an intrauterine system or hormonal coil, which is a form of long-acting reversible contraception (LARC), as a first line treatment. In the women’s health strategy call for evidence, held in 2021, we heard about the challenges women faced accessing LARCs for the management of menstrual problems.A cost benefit analysis on women’s health hubs conducted by the Department estimated that if 50% of LARC procedures for gynaecology were provided in women’s health hubs, it would produce a net saving of £1.8 million, and reduce pressures on secondary care gynaecology services. The cost benefit analysis is available at the following link:https://www.gov.uk/government/publications/womens-health-hubs-information-and-guidance/womens-health-hubs-cost-benefit-analysis#cost-benefit-analysis-assumptionsThe Department is continuing to work with NHS England to support the establishment of at least one pilot women’s health hub in every integrated care system, following a £25 million investment. Pilot women’s health hubs provide intermediate and streamlined care in the community, which reduces pressures on services such as secondary care referrals and general practice appointments. A core service offered by hubs is treatment for heavy menstrual bleeding, and the fitting or removal of a LARC. Cutting waiting lists, including for gynaecology, is a key part of our Health Mission and a top priority for the Government.

What discussions his Department has had with NHS England on (a) renewing the national maternity safety ambitions beyond 2025 and (b) amending those ambitions to include reducing inequalities.

The Government is committed to ensuring that all women and babies received safe, personalised, equitable, and compassionate care. I am urgently considering, with my officials and NHS England, the immediate action needed across maternity and neonatal services to improve outcomes and address the stark inequalities that persist for women and babies, including what targets are needed.This includes consideration of what comes beyond the national maternity safety ambition, ensuring that we take an evidence-based approach, and that any targets set are women and baby-centred and focused on tackling inequalities.

What steps she is taking to ensure that students can continue to study applied general qualifications from September 2025.

The government is committed to ensuring that all young people can access a range of high quality vocational and technical qualifications which supports them to develop the skills they need to thrive at work and throughout life, including applied general qualifications. This is at the heart of the government’s missions to break down the barriers to opportunity and to boost economic growth.The government is currently conducting a review of level 3 qualifications focusing on those set to lose funding from 31 July 2025, which includes applied general qualifications. The outcomes of the review will be reported by the end of the year.Additionally, the independent Curriculum and Assessment Review, will ensure meaningful, rigorous and high-value pathways for all at ages 16 to 19, with access to qualifications and training that will provide the skills they need to seize opportunity.

What steps she is taking with the Secretary of State for Health and Social Care to improve the (a) safeguarding and (b) wellbeing of children with allergies in schools.

Section 100 of the Children and Families Act 2014 places a duty on maintained schools, academies and pupil referral units to make arrangements for supporting pupils with medical conditions. This includes allergies.The accompanying statutory guidance, 'Supporting pupils at school with medical conditions', makes clear to schools what is expected of them in taking reasonable steps to fulfil their legal obligations and to meet the individual needs of pupils with medical conditions. Schools should ensure they are aware of any pupils with medical conditions and have policies and processes in place to ensure these can be well managed. This guidance can be accessed here: https://www.gov.uk/government/publications/supporting-pupils-at-school-with-medical-conditions--3.'Supporting pupils at school with medical conditions' includes guidance on individual healthcare plans and specifies that they should ensure that the school assesses and manages risks to the child’s education, health and social wellbeing, and minimises disruption.The department included a reminder to schools of these duties in its regular schools’ email bulletin in both March and September 2024. In the same communication we also alerted schools to the newly created Schools Allergy Code. The Code was developed by The Allergy Team, Independent Schools’ Bursars Association and the Benedict Blythe Foundation, who are all trusted voices on the matter of allergies. The department has now also added a link to the Code to its online allergy guidance, which can be accessed here: https://www.gov.uk/government/publications/school-food-standards-resources-for-schools/allergy-guidance-for-schools.The Department for Health and Social Care (DHSC) have produced guidance on the use of adrenaline auto-injectors in schools here: https://www.gov.uk/government/publications/using-emergency-adrenaline-auto-injectors-in-schools. DHSC have also produced guidance on emergency inhalers in schools, including the purchase of spares, which can be accessed here: https://www.gov.uk/government/publications/emergency-asthma-inhalers-for-use-in-schools.

Whether he plans to introduce a National Brain Tumour Strategy.

Ministers regularly meet with a wide range of cancer partners, including brain cancer charities and patient groups. Ministers also regularly meet with teams from the National Health Service, including clinical specialists where this is appropriate. These meetings are valuable opportunities to discuss raising awareness, screening, treatments, innovation, and the care experiences of people living with cancer.The Department, NHS England, and the National Institute for Health Care and Research (NIHR) are taking several steps to help improve outcomes for brain tumour patients. NHS England is committed to ensuring that all cancer patients are offered Holistic Needs Assessment and Personalised Care and Support Planning, ensuring care is focused on what matters most to each person. As well as this, all patients, including those with secondary cancers, will have access to the right expertise and support, including a Clinical Nurse Specialist or other support worker.Further to this, in September 2024, the NIHR announced new research funding opportunities for brain cancer research, spanning both adult and paediatric populations. This includes a national NIHR Brain Tumour Research Consortium, to ensure the most promising research opportunities are made available to adult and child patients, and a new funding call to generate high quality evidence in brain tumour care, support, and rehabilitation. We will get the NHS diagnosing cancer, including brain tumours, on time, diagnosing it earlier, and treating it faster, so more patients survive this horrible set of diseases, and we will improve patients’ experience across the system.

How many Primary Care Networks have used the Additional Roles Reimbursement Scheme to fund enhanced practice nurse roles to deliver specialist dementia nursing support in primary care.

NHS England does not hold this information centrally. The provision of dementia health care services is the responsibility of local integrated care boards (ICBs). NHS England would expect ICBs to commission services based on local population needs, taking account of the National Institute for Health and Care Excellence’s guidelines.The Additional Role Reimbursement Scheme aims to grow and diversify the general practice workforce. The scheme provides funding for additional roles in primary care networks, to help create bespoke multi-disciplinary teams.

What estimate he has made of the number of specialist dementia nurses working in Acute Trusts.

NHS England does not hold this information centrally. The provision of dementia health care services is the responsibility of local integrated care boards (ICBs). NHS England would expect ICBs to commission services based on local population needs, taking account of the National Institute for Health and Care Excellence’s guidelines.