Written questions by Mierlo.

Pursuant to the Answer of 15 July to Question 66814 on Health Services: Oxfordshire, what steps he is taking to ensure that Oxford University Hospitals NHS Foundation Trust is able to recruit and retain midwives in the context of efficiency savings.

The Government is committed to ensuring the National Health Service can both recruit and retain staff. We recently announced the Graduate Guarantee for nurses and midwives, which will ensure that there are enough positions available for every newly qualified midwife in England, and includes £8 million to support the temporary conversion of vacant maternity support worker posts to band 5 registered midwifery roles.Additionally, NHS England is undertaking targeted retention programme for midwives, led by the Chief Nursing Officer. This includes: a midwifery and nursing retention self-assessment tool; mentoring schemes; strengthened advice and support on pensions and flexible retirement options; and the publication of menopause policies and guidance. NHS England has also invested in unit-based leads in every trust who focus on retention and provide pastoral support to midwives. This initiative, alongside investment in workforce capacity, has seen a reduction in vacancy, leaver and turnover rates.

Pursuant to the Answer of 27 January to Question 25553 on Methylphenidate Shortages, if he will make an assessment of the adequacy of the current supply of methylphenidate for ADHD.

The Department has worked closely with industry stakeholders, and, following extensive collaborative efforts, previous issues have been resolved and all strengths of lisdexamfetamine, atomoxetine capsules, atomoxetine oral solution, guanfacine prolonged-release tablets and methylphenidate prolonged-release tablets and prolonged-release capsules are now available.We continue to support the NHS England Attention Deficit Hyperactivity Disorder (ADHD) taskforce, which brings together expertise from the National Health Service, education, and justice sectors to coordinate a system-wide response to rising demand. In collaboration with NHS England’s national ADHD data improvement plan, we are developing future growth forecasts to support improved demand planning. These forecasts will be shared with industry to help ensure a more responsive and sustainable supply of ADHD medicines.In parallel, we are also engaging with new suppliers for ADHD medicines to increase supply capacity and resilience.The Department also maintains and regularly updates a list of currently available and unavailable ADHD products on the Specialist Pharmacy Service website. This resource supports prescribers and dispensers in making informed decisions with patients. The list is available at the following link:www.sps.nhs.uk/articles/prescribing-available-medicines-to-treat-adhd

Pursuant to the Answer of 14 July 2025 to Question 64336 on Vamorolone, what the consequences are for (a) Integrated Care Boards and (b) NHS Trusts for not making NICE recommended medicines available within 90 days of publication of relevant guidance.

Commissioners have a statutory responsibility to make funding available for a medicine or treatment recommended by a National Institute of Health and Care Excellence (NICE) technology appraisal (TA) or highly specialised technology evaluation (HST) within the timeframe recommended in that guidance, usually within three months of the TA or HST being published.Under the National Health Service Constitution, patients have a right to receive all medicines and treatments recommended by NICE if they and their healthcare professional think that the medicine is right for them. In practical terms, the effect of this legal obligation and the NHS constitution is that all NICE-approved treatments must be included in local formularies for use in line with the TA or HST recommendations and with no additional funding or formulary restrictions.The only exception is if the technology is not relevant to the care provided by the organisation; for example, cancer treatments would not need to be included in the formulary of a mental health trust, and treatments for dementia would not need to be included in the formulary of a specialist children’s hospital. There is no provision to take affordability into account when adding NICE-approved medicines to local formularies.NHS enforcement guidance relating to its statutory accountability and oversight role, under the NHS Act 2006, the 2012 Act and the 2022 Act is available at the following link:https://www.england.nhs.uk/long-read/nhs-enforcement-guidance/The evolving NHS operating model will strengthen capabilities and clarify roles in overseeing performance. As set out in the 10-Year Health Plan for England, we will move to a Single National Formulary (SNF) for medicines within the next two years. The SNF will play a role in driving rapid and equitable adoption of clinically and cost-effective innovations.

What discussions she has had with the new Chair of the Equality and Human Rights Commission on her priorities for the Commission.

Dr Mary-Ann Stephenson was confirmed as the next Chair of the EHRC. She will begin her term as EHRC Chair in December and will meet regularly with the Minister for Women and Equalities as part of her role.

What steps his Department is taking to ensure that the impact on carers is included in NICE technology appraisals for rare and progressive diseases.

NICE’s technology appraisal process allows its independent committees to take societal benefits, such as health-related quality-of-life for carers and impact on personal social services, into account. NICE’s methods are set out in its published health technology evaluations manual, which is available at the following link:https://www.nice.org.uk/process/pmg36.Evaluations should consider all health effects for patients, and, when relevant, carers. When presenting health effects for carers, evidence should show when the condition is associated with a substantial effect on carer’s health-related quality of life and how the technology affects carers. This applies for all therapies, including therapies for rare diseases. NICE appraisals specifically consider health-related quality of life, for both patients and carers, rather than quality of life as a whole.

What steps his Department is taking to ensure that NICE appraisals for (a) Duchenne muscular dystrophy and (b) other rare, progressive conditions take into account urgency of access.

The National Institute for Health and Care Excellence (NICE) aims wherever possible to issue guidance on new medicines close to the time of licensing to ensure that patients can benefit from rapid access to clinically and cost-effective new medicines. NICE’s ability to do so is contingent on the company notifying NICE of its launch plans at an early stage and providing a timely evidence submission.The Life Sciences Sector Plan sets out the measures we are taking that will mean that patients are able to access medicines three to six months faster, including improved alignment between decisions from the Medicines and Healthcare products Regulatory Agency and NICE guidance publication.The Life Sciences Sector Plan is available at the following link:https://assets.publishing.service.gov.uk/media/688c90a8e8ba9507fc1b090c/Life_Sciences_Sector_Plan.pdf

What recent assessment she has made of the UKVI waiting times for answering enquiries regarding (a) UK passports and (b) British National status.

For customer enquiries made to the Passport Adviceline, in August, the average speed to answer passport related calls was 16 seconds.

What assessment he has made of the adequacy of (a) criminal and (b) civil measures to increase compliance with child maintenance payments.

69% of Paying Parents due to pay via the Collect & Pay service actually paid some maintenance during the calendar quarter ending March 2025. This compares with 65% during the quarter ending March 2023. In the year to March 2025, the CMS arranged around £1.5 billion in child maintenance payments. The Child Maintenance Service (CMS) believes current enforcement powers are sufficient and substantial enough to encourage paying parents to comply. The CMS requires paying parents to pay their maintenance on time, to avoid accrual of arrears. Where a paying parent fails to pay on time or in full, the CMS aims to take immediate action to recover the debt and re-establish compliance. When a paying parent does not make maintenance payments on time or in full, the CMS will initially negotiate a payment that is feasible for the parent to pay. If this is unsuccessful and the paying parent is employed, the CMS will request that ongoing child maintenance payments be deducted directly from their salary by issuing what we call a Deductions from Earnings Order (DEO). A DEO instructs an employer to make deductions from the paying parent’s earnings and pay the amounts to the CMS who will pass this onto the receiving parent. The CMS also has powers to deduct maintenance from a wide range of bank accounts including joint and business accounts. The CMS has a range of strong “civil” enforcement powers that can be used against those who consistently refuse to meet their obligations to provide financial support to their children including holding or obtaining driving licenses and passports and forcing the sale of a property. These powers are designed to act as a deterrent and encourage parents to pay their liability. Powers are used effectively and produce positive results. In many cases, once an application to the courts has been made, paying parents have either paid their liability or agreed to a repayment plan. Planned reforms to the Direct Pay service will allow the CMS to tackle non-compliance faster as monitoring all payments would enable the CMS to immediately identify any missed, late or partial payments and take swift enforcement action.

Food and Rural Affairs, whether she has had discussions with the Environment Agency on their decision to remove opposition to new housing developments that would be connected to the Oxford Sewage treatment works in Oxfordshire.

A multidisciplinary EA team worked with Thames Water to develop a strategic approach to managing wastewater capacity challenges in Oxford. This provided a framework for the EA to no longer object to developments, instead providing clear advice on the risks and how the regulatory process is now ensuring water quality is protected and environmental objectives would be met. Following this outcome, the EA are continuing to engage with local authorities, Thames Water and developers through quarterly meetings to track delivery of the improvements to the Oxford STW and ensure wastewater capacity is delivered in this critical growth area.

Food and Rural Affairs, if he has made an assessment of the adequacy of the diversions on the Thames path due to the closure of (a) Marsh Lock bridge and (b) Temple Footbridge.

We recognise the importance of National Trails as crucial connectors, not only for visitors keen to complete the trails, but as valued community pathways supporting local businesses and residents. We understand that the Thames Path National Trail Partnership are continuing to work with the Environment Agency, landowners and other partners to progress work at both locations to support the accessibility and safety of the trail. Thames Path diversions are managed by the organisation responsible for the asset that has created the need for the diversion. Although the ownership for Marsh Lock Bridge is unclear, the Environment Agency led the diversion work relating to Marsh Lock Bridge and Temple Footbridge for which they are responsible. The Environment Agency sought advice from the Local Authority on the safest route available to the public using other existing highways and once agreed, the Local Authority issue a Temporary Traffic Regulation Order which authorises the diversion. Alternative viable diversion routes will be considered by the Environment Agency and the relevant Local Authority if they become available for use.

Food and Rural Affairs, if he will make an assessment of the potential impact of trends in levels of funding allocated to National Trails since 2018 on those trails.

The Government remains committed to enhancing access to nature and will continue to work closely with Natural England, National Trails UK and relevant partners to understand and respond to the needs of our National Trails. We know it requires significant efforts and commitment from local authorities and trail partnerships to keep our trails accessible to the public. The Government will continue to work with Natural England and our partners in support of our National Trails and to ensure that the public can confidently access our trail network. Despite the challenging fiscal environment, Defra has committed to supporting National Trails UK with a continuation of Protected Landscapes Partnership funding, individual grant, and Access for All funding. There are no current plans to assess National Trails specifically against year-on-year funding.

Food and Rural Affairs, what steps he is taking to improve the condition of (a) the Thames path, (b) The Ridgeway and (c) other National Trails.

The Government remains committed to enhancing access to nature and recognises the importance of National Trails as crucial links between urban and rural settings, allowing people to get closer to nature and experience the natural world. In addition to the continued delivery of the King Charles III England Coast Path and Coast to Coast National Trails, Defra has supported the creation of National Trails UK (NTUK) and provided funding to aid in its establishment. We anticipate that NTUK will improve the long-term management and sustainability of National Trails, improve the capacity for National Trails to engage people currently not accessing nature and test new ideas and ways of working as a family of National Trails. We are also delivering the £33m ‘Access for All’ programme, which consists of a package of targeted measures in our protected landscapes, national trails, forests and the wider countryside to make access to green and blue spaces more inclusive.

Food and Rural Affairs, pursuant to the Answer of 28 January 2025 to Question 25560 on National Trails UK: Finance, what his timetable is for announcing the funding settlement for (a) National Trails UK, (b) the Thames Path National Trail and (c) The Ridgeway National Trail in 2024/25.

Funding settlements to National Trails UK are not announced, and individual National Trails are not funded separately. In 24/25 NTUK received a combination of funding through the Protected Landscapes Partnership, direct grants and Access for All funding.

Which NHS Trusts will be involved in the Rapid National Investigation into maternity and neonatal services.

On 14 August 2025, my Rt Hon. Friend, the Secretary of State for Health and Social Care, announced the appointment of Baroness Amos as Chair of the Independent Maternity and Neonatal Investigation, with further information available at the following link:https://www.gov.uk/government/news/baroness-amos-to-spearhead-maternity-and-neonatal-investigation#The investigation will carry out rapid reviews of up to ten trusts with specific issues. The Chair is working closely with families to finalise the terms of reference, including the selection criteria to select the trusts, which will be announced as soon as possible.

What steps he is taking to help (a) ensure that energy consumers receive a reliable electricity supply and (b) reduce power cuts due to issues with the electricity distribution network.

Maintaining a secure electricity supply is a key priority for Government. DESNZ works closely with industry to continually improve and maintain the resilience the energy infrastructure, networks and assets to reduce vulnerabilities, and ensure an effective response to actual or potentially disruptive incidents. Ownership of a Distribution Network Operator (DNO) requires appropriate levels of investment to ensure power flows reliably, safely and securely. All DNOs are regulated by Ofgem, which sets annual targets for customer interruptions and customer minutes lost; DNOs must report their performance against these measures to Ofgem which rewards or penalises operators appropriately.

Whether he has made an assessment of the potential merits of revising the compensation scheme for electricity consumers to include compensation for the inconvenience caused by power cuts of shorter duration where these occur repeatedly.

The Government expects energy companies to deliver the best support to customers. Ofgem monitors and enforces the Guaranteed Standards of Performance. Ofgem also regularly reviews and updates their compensation arrangements. The most recent changes were made following the Storm Arwen Review which came into effect on 1 September 2023 and enable higher levels of compensation at more regular intervals. Ofgem regulates Distribution Network Operators through a price control process, which includes incentives to reduce the frequency and duration of power interruptions. For the next price control period (2028–2033), Ofgem is reviewing whether amendments are required to minimise repeated or prolonged interruptions.

Whether he has made a recent assessment of the level of efficiency across government in answering correspondence from members of the public.

The Cabinet Office works with Government departments and agencies to monitor the quality and timeliness of correspondence, providing support and guidance as necessary.

What recent assessment she has made of the potential impact of the tax-free childcare system on levels of administration for early years providers.

HMRC continually assesses the administrative impact of Tax-Free Childcare (TFC) on childcare providers, including those focused on early years provision, via customer feedback and internal system reviews. For many providers, once they have registered for TFC they will receive TFC payments made by parents directly into their bank account, just as they would when receiving non-TFC payments. In 2024, HMRC improved the administration for childcare providers by streamlining the TFC registration process and introducing a mechanism for TFC payments to be made via external payment providers used by some childcare providers. These changes are designed to improve the registration and payment functions of TFC, making the service more user friendly, efficient and accessible.

Whether her Department has provided guidance to local authorities on (a) forecasting and (b) meeting childcare demand in areas of rapid population growth.

It is the department’s ambition that all families have access to high quality, affordable and flexible early education and care, giving every child the best start in life and delivering on our Plan for Change. The government is boosting availability and increasing access to childcare for families through the school-based nurseries programme, including school-led provision and private, voluntary and independent providers operating from school sites.The key measure of sufficiency is whether the supply of available places is sufficient to meet the requirements of parents and children. We have 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 the local authority is taking and, where needed, support the local authority with any specific requirements through our childcare sufficiency support contract.Childcare Works, a government-supported initiative designed to help local authorities, schools, and early years providers deliver our childcare reforms, additionally provides one-to-one targeted support for local authorities who need it, alongside a wider package of support for all local authorities to support them to deliver the childcare expansion programme.

What steps her Department is taking to ensure that (a) early years and (b) childcare infrastructure keeps pace with housing growth in (i) rural and (ii) semi-rural areas.

It is the department’s ambition that all families have access to high quality, affordable and flexible early education and care, giving every child the best start in life and delivering on our Plan for Change. The government is boosting availability and increasing access to childcare for families through the school-based nurseries programme, including school-led provision and private, voluntary and independent providers operating from school sites.The key measure of sufficiency is whether the supply of available places is sufficient to meet the requirements of parents and children. We have 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 the local authority is taking and, where needed, support the local authority with any specific requirements through our childcare sufficiency support contract.Childcare Works, a government-supported initiative designed to help local authorities, schools, and early years providers deliver our childcare reforms, additionally provides one-to-one targeted support for local authorities who need it, alongside a wider package of support for all local authorities to support them to deliver the childcare expansion programme.