Written questions by Naish.

What steps her Department is taking to address the difference in home fee status eligibility for siblings who are both British nationals where one child benefits from Withdrawal Agreement protections and another does not due to the timing of their university entry after 2028.

UK nationals and their children living in the European Economic Area (EEA) or Switzerland, who wish to study in the UK, will be eligible for automatic home fee status and student support for courses starting up to seven years from the end of the transition period.The seven-year period ensures that eligible UK nationals and their children, whose normal place of residence is in the EEA or Switzerland but wish to undertake higher education in England, will still be able to access home fee status and student financial support immediately on their return to the UK during this time.From 1 January 2028, UK nationals and their children must normally have been ordinarily resident in the UK and Islands (Channel Islands and the Isle of Man) for at least three years immediately before the start of their course to qualify for automatic home fee status and student support.

What assessment her Department has made of the potential impact of home tuition fee eligibility rules on British citizens who relocated to EU member states while the UK was part of the European Union; and whether she plans to review these rules to account for decisions made whilst the UK was still a member of the EU.

UK nationals and their children living in the European Economic Area (EEA) or Switzerland, who wish to study in the UK, will be eligible for automatic home fee status and student support for courses starting up to seven years from the end of the transition period.The seven-year period ensures that eligible UK nationals and their children, whose normal place of residence is in the EEA or Switzerland but wish to undertake higher education in England, will still be able to access home fee status and student financial support immediately on their return to the UK during this time.From 1 January 2028, UK nationals and their children must normally have been ordinarily resident in the UK and Islands (Channel Islands and the Isle of Man) for at least three years immediately before the start of their course to qualify for automatic home fee status and student support.

Whether her Department has made an assessment of the potential (a) merits of calculating maintenance loans through net rather than gross household income and (b) impact of that change on single parental income households.

Entitlement to partially means-tested undergraduate loans for living costs is based on the income of the student’s household.The income used is the total income on which a person is charged income tax at step 1 of the calculation in Section 23 of the Income Tax Act 2007, before the deductions made by HMRC from step 2 onwards of Section 23.The use of income charged to tax in the household income assessment applies a standard measure of income to calculate a student’s entitlement to living costs support and allows all students to be assessed consistently and fairly. It also ensures that the most support is paid to students from the lowest income families, including those with single parents, who need it most and who are historically under-represented in higher education. It is not intended to be an exact calculation of disposable income for each household.Information on income is available from HMRC and allows around 1.3 million assessments a year to be carried out quickly and efficiently each year by Student Finance England.Maximum grants and loans for living and other costs for the 2025/26 academic year have been increased by forecast inflation, 3.1%, based on the RPIX inflation index.

Pursuant to the answer of 16 October 2024 to UIN 8287, what the status is of the proposed rural design guide; and when that guide will be completed.

Following consultation with stakeholders, Active Travel England’s Rural Design Guidance is currently in its final development stages and is expected to be published by the end of the year.

With reference to Question 8287answered on 16 October 2024, what is the (a) status of the best practice guide to community consultation and engagement and (b) when this guide will be completed.

Following consultation with stakeholders, Active Travel England’s Rural Design Guidance is currently in its final development stages and is expected to be published by the end of the year.

Communities and Local Government, whether the forthcoming Leasehold and Commonhold Reform Bill will include provisions to (a) regulate the use of estate rentcharges on freehold properties, (b) limit enforcement powers available to estate rentcharge holders under Section 121 of the Law of Property Act 1925 and (c) provide homeowners with a statutory right to vary estate rentcharge deeds to remove disproportionate enforcement mechanisms.

The use of Sections 121 and 122 of the Law of Property Act 1925 to enforce rent arrears is draconian and wholly inappropriate given alternative means for rentcharge arrears are available. We will publish an ambitious draft Leasehold and Commonhold reform Bill before the end of the year.

Communities and Local Government, what assessment his Department has made of the potential merits of changing planning laws to ensure developments with full planning permission are (a) completed on time and (b) not able to exist with minimal work on them.

Local planning authorities (LPAs) already have a wide range of enforcement powers, with strong penalties for non-compliance, which they can use in instances where development has not taken place in accordance with the relevant planning consent. These enforcement powers include the power to issue a completion notice which requires a developer to complete their development if it is left uncompleted. It is for LPAs themselves to decide how and when they use their powers depending on the circumstances of each case. On 25 May, the government published a Planning Reform Working Paper: Speeding Up Build Out (which can be found on gov.uk here) inviting views on further action the government should take to speed up homes being built. On the same day, we launched a technical consultation on implementing measures to improve the transparency of build rates from new residential development, which includes proposals to implement provisions in Section 113 of the LURA on the power to decline to determine applications. The consultation can be found on gov.uk here. Subject to the outcome of the consultation, the government intends bring forward the regulations to implement these measures at the earliest practical opportunity with the new build out reporting framework coming into force from 2026. The consultations closed on 7 July and responses are currently being analysed.

Communities and Local Government, what assessment he has made of the potential impact of Section 121 of the Law of Property Act 1925 powers on freehold homeowners' ability to sell properties subject to estate rent charges; and whether he has plans to restrict or remove such powers in relation to estate rent charges.

The use of Sections 121 and 122 of the Law of Property Act 1925 to enforce rent arrears is draconian and wholly inappropriate given alternative means for rentcharge arrears are available. We will publish an ambitious draft Leasehold and Commonhold reform Bill before the end of the year.

What steps he is taking to help reduce elective care waiting times (a) in general and (b) for joint replacement surgery.

The Government is committed to putting patients first and tackling waiting lists as part of our Health Mission. We exceeded our pledge to deliver an extra two million appointments, tests, and operations in our first year of Government, delivering 5.2 million additional appointments between July 2024 and June 2025. This marks a vital first step to delivering on our commitment to return to the National Health Service constitutional standard that 92% of patients wait no longer than 18 weeks from referral to consultant-led treatment by March 2029.The Department is taking a range of steps to reduce waiting times for surgery, including joint replacement surgery. There are currently 123 surgical hubs operational across England, and we are committed to expanding the number of hubs over the next three years to increase surgical capacity and deliver faster access to common procedures. Surgical hubs have been shown to deliver approximately 20% increased productivity in the hubs compared to trusts without a dedicated elective hub on site.The Getting it Right First time (GIRFT) programme published detailed guidance for hip and knee replacements in July 2023 and has been supporting trusts through a multidisciplinary team made up of anaesthetic, surgical, and allied health professional colleagues. Additionally, GIRFT is leading a community musculoskeletal programme, supporting improvements in the early stages of the pathway, to ensure that only those patients who require surgery are referred into secondary care, and that their condition is optimised for surgery as far as possible at the point of referral. Further information on the GIRFT programme is available at the following link:https://gettingitrightfirsttime.co.uk/

What steps he is taking to increase access to weight loss injections for long-term conditions.

Weight loss injections are currently recommended for use on the National Health Service for the treatment of obesity and/or type 2 diabetes. To be routinely used in the NHS in England, a medicine normally needs a marketing authorisation from the Medicines and Healthcare Products Regulatory Agency (MHRA) that shows it is safe and efficacious, and then a positive National Institute for Health and Care Excellence (NICE) appraisal to show if it is a clinically and cost-effective use of NHS resources. NICE is currently developing guidance on the use of semaglutide for the prevention of cardiovascular disease and, subject to licensing, liver fibrosis, without cirrhosis, caused by metabolic dysfunction-associated steatohepatitis.Most recently, NICE recommended semaglutide, brand name Wegovy, and tirzepatide, brand name Mounjaro, as treatments for obesity, in adults with a high body mass index and at least one weight-related comorbidity such as type 2 diabetes, hypertension, and/or cardiovascular disease.Until recently, these medicines were only available in specialist weight management services. From 23 June tirzepatide started to become available in primary care. This will help to increase access. Access is being prioritised for those with the highest clinical need first. The NHS will look at different service models including digital and community options and the roll out will be sped up if possible. As set out in the Government’s new 10-Year Health Plan, we are committed to expanding access to these medicines and will work closely with industry and local systems to test new models of care and identify innovative ways to do this.

What progress he has made on meeting the 18-week treatment targets in the Elective Reform Plan.

Tackling waiting lists is a key part of our Health Mission. We have exceeded our pledge to deliver an extra two million operations, scans, and appointments, having delivered 5.2 million additional appointments between July 2024 and June 2025. This marks a vital first step to delivering on the commitment that 92% of patients will wait no longer than 18 weeks from referral to consultant-led treatment, in line with the National Health Service constitutional standard, by March 2029.The Elective Reform Plan, published in January 2025, sets out the productivity and reform efforts needed to return to the constitutional standard. Planning Guidance for 2025/26 sets a target that 65% of patients wait no longer than 18 weeks by March 2026, with every trust expected to deliver a minimum 5% improvement on current performance over that period.Since April, when the Elective Reform Plan came in to effect, the percentage of patient pathways that involved waits of less than 18 weeks for treatment has improved by 2%, rising from 59.8% to 61.8% as of the end of September. This is the best performance since June 2022. The referral-to-treatment waiting list decreased to 7.39 million in September 2025, a reduction of 231,854 since the start of July 2024. But we know there is still much more to do, and we will continue to support NHS trusts to deliver our targets through innovation, sharing best practice to increase productivity and efficiency, and ensuring the best value is delivered.

Whether he has made an assessment of the potential merits of removing the use of body mass index thresholds to determine eligibility for joint replacement surgery.

The Department has made no specific assessment of the potential merits of removing the use of body mass index (BMI) thresholds to determine eligibility for joint replacement surgery. It is the responsibility of individual integrated care boards to determine policies for their local area.As with all surgery, BMI would be considered as part of a holistic, personalised perioperative evaluation of the risks versus clinical need for joint replacement surgery of an individual patient. However, BMI should not be considered in isolation and in and of itself should not act as a barrier to surgery.As part of the NHS Elective Reform Plan there is a commitment to expand access to the NHS Digital Weight Management Programme for patients waiting for hip and knee surgery.

If he will make and assessment of the adequacy of funding for the voluntary sector through the Crisis Resilience Fund.

No assessment has been made on the adequacy of funding for the voluntary sector through the Crisis Resilience Fund. The Government is providing £842 million per year (£1 billion including Barnett consequential) to reform crisis support, which represents the first ever multi-year settlement for locally delivered crisis support. Whilst funding will be going directly to local authorities, the voluntary and community sector will play a pivotal role in delivery of the fund

What steps his Department is taking to ensure that the Child Maintenance Service do not send arrears letters to people who pay on time.

Robust processes are in place to ensure correspondence issued by the Child Maintenance Service (CMS) is accurate and reflects each customer’s payment status. CMS systems monitor compliance of expected payments and where payments are not made in full and on time, arrears or missed payment notifications will be issued. Where a payment has been made in full and on time, no arrears letter should be sent. The CMS are committed to modernising and regularly reviews processes and updates guidance to staff to minimise errors and improve accuracy.

What steps his Department is taking to help reduce Child Maintenance Service (a) response and (b) decision times.

The Child Maintenance Service (CMS) has made significant strides through its Service Modernisation and Digital Transformation Programmes, improving response times and expanding online services for separated parents. It has optimised digital channels and self-service options, reducing caseworker involvement in many processes and speeding up outcomes for customers. Staff support has also improved through upgraded training and operational guidance. Communication with customers is quicker and clearer thanks to greater use of SMS, email, and simplified letters. As the demand for the service continues to grow, CMS is actively reviewing resources and recruiting to meet future needs. It regularly gathers feedback through the Customer Experience Survey and uses this insight to identify areas for improvement. Its focus remains on delivering efficient, accessible services while continuing to review, evaluate, and enhance tools, processes, and customer experience as part of the ongoing Service Modernisation Programme.

What steps his Department is taking to (a) research the causes of ankyloglossia and (b) improve early diagnosis of that condition.

The Department funds health and care research through the National Institute for Health and Care Research (NIHR). The NIHR funds clinical, public health, and social care research and works in partnership with the National Health Service, universities, local government, other research funders, patients, and the public. The NIHR welcomes proposals for research into a range of conditions, including ankyloglossia, at the following link: https://www.nihr.ac.uk/get-involved/suggest-a-research-topic

What steps his Department is taking to ensure the Child Maintenance Service provides proof, if requested, of calculations of collection fees.

The Department is committed to ensuring transparency in the operation of the Child Maintenance Service (CMS). The CMS provides two service types: Direct Pay, where parents arrange payments between themselves, and Collect and Pay, where the CMS calculates the liability and manages the transfer of funds. Collection fees only apply to the Collect and Pay service. A fee of 20% is added to what the paying parent needs to pay, while 4% is deducted from maintenance paid to receiving parents. For cases on the Collect and Pay service, details of what collection fees apply and how they are calculated are included in notifications sent to customers whenever there is a change to their child maintenance calculation. Customers can also view additional information about their payments and child maintenance calculation by accessing their online Child Maintenance account.

Whether his Department has made an assessment of the potential merits of publishing a national strategy for (a) palliative and (b) end of life care.

The Government is developing a Palliative Care and End of Life Care Modern Service Framework for England. I refer the hon. member to the Written Ministerial Statement HCWS1087 I gave to the House on 24 November 2025.The MSF will drive improvements in the services that patients and their families receive at the end of life and will enable integrated care boards to address challenges in access, quality, and sustainability through the delivery of high-quality, personalised care. This will be aligned with the ambitions set out in the recently published 10-Year Health Plan.

What steps he is taking to ensure that hospice contracts reflect the (a) cost of the services they provide and (b) needs of their local populations.

Integrated care boards (ICBs) are responsible for commissioning palliative care services to meet the reasonable needs of their population, which can include hospice services available within the ICB catchment. To support ICBs in this duty, NHS England has published statutory guidance and a service specification.The Government is developing a Palliative Care and End of Life Care Modern Service Framework for England, due to be published in Spring 2026. I refer the hon. Member to the Written Ministerial Statement HCWS1087 I gave to the House on 24 November 2025. Additionally, we are supporting the hospice sector with a £100 million capital funding boost for eligible adult and children’s hospices in England to ensure they have the best physical environment for care.   St Michael’s Hospice in Hereford is receiving £667,020 from this funding. We are also committing £80 million for children’s and young people’s hospices over the next three financial years, giving them stability to plan ahead and focus on what matters most, caring for their patients.

What assessment he has made of the potential merits of increasing funding for the specialist (a) care, (b) advice and (c) assessment provided by hospices.

Integrated care boards (ICBs) are responsible for commissioning palliative care services to meet the reasonable needs of their population, which can include hospice services available within the ICB catchment. To support ICBs in this duty, NHS England has published statutory guidance and a service specification.The Government is developing a Palliative Care and End of Life Care Modern Service Framework for England, due to be published in Spring 2026. I refer the hon. Member to the Written Ministerial Statement HCWS1087 I gave to the House on 24 November 2025. Additionally, we are supporting the hospice sector with a £100 million capital funding boost for eligible adult and children’s hospices in England to ensure they have the best physical environment for care.   St Michael’s Hospice in Hereford is receiving £667,020 from this funding. We are also committing £80 million for children’s and young people’s hospices over the next three financial years, giving them stability to plan ahead and focus on what matters most, caring for their patients.