Written questions by Shannon.

What steps he is taking to reduce regional inequalities in access to eye care services.

Integrated care boards, as commissioners of primary and secondary eye care services, are required to work with local authorities to assess the current and future health, care, and wellbeing needs of their local populations. They will then set out, in joint local health and wellbeing strategies, how they will meet those needs, and this could include addressing any identified inequalities in accessing services. Understanding patient demographics is an essential step in identifying and tackling health inequalities. The Elective Reform Plan included a commitment to publish waiting list information broken down by demographics to allow for greater visibility of potential health inequalities. Further information on the Elective Reform Plan is available at the following link: https://www.england.nhs.uk/publication/reforming-elective-care-for-patients/ This enables local health services to understand the demographics of the patients on their waiting list to better tailor services to their needs. Data on the demographics of the elective waiting list for week ending 28 September 2025 is available at the following link: https://www.england.nhs.uk/statistics/statistical-work-areas/rtt-waiting-times/wlmds/ This data shows referral to treatment waiting times from the Waiting List Minimum Data Set for ophthalmology split by age, sex, deprivation, and ethnicity. The Public Health Outcomes Framework Eye Health Indicator also continues to track the rate of sight loss for age-related macular degeneration, glaucoma, and diabetic retinopathy. This information is available to commissioners and can be used to drive improved local outcomes and interventions.

Media and Sport, what steps she is taking to help uphold the right to free speech.

DCMS has responsibility for protecting media freedom, which is protected under the Article 10 of the European Convention on Human Rights, which sets out the right to freedom of expression. An integral part of DCMS's work to support media freedom is working with partners to tackle threats to journalist safety and protect journalistic freedoms. DCMS and Home Office Ministers co-chair the National Committee for the Safety of Journalists, which convenes criminal justice, civil society and media partners to tackle journalist safety and oversees a National Action Plan for the Safety of Journalists.

How many active legal cases are open against the NHS.

NHS Resolution (NHSR) manages clinical negligence and other claims against the National Health Service in England.NHSR handles negligence claims on behalf of the members of their indemnity schemes. The indemnity schemes are divided into clinical and non-clinical negligence schemes.Clinical negligence schemes:the Clinical Negligence Scheme for Trusts (CNST) handles all clinical negligence claims against member NHS bodies where the incident in question took place on or after 1 April 1995, or when the body joined the scheme if that is later;the Clinical Negligence Scheme for General Practice (CNSGP) covers clinical negligence claims for incidents occurring in general practice on or after 1 April 2019;the Existing Liabilities Scheme for General Practice (ELSGP) covers historic NHS clinical negligence of staff of GP members of participating medical defence organisations occurring before 1 April 2019;The Clinical Negligence Scheme for Coronavirus (CNSC) meets clinical negligence liabilities arising from NHS services provided in response to the coronavirus pandemic where no other indemnity or insurance arrangements are in place already to cover such liabilities.DHSC Clinical (DH CL) covers clinical negligence liabilities that have transferred to the Secretary of State for Health and Social Care following the abolition of any relevant health bodies;The Existing Liabilities Scheme (ELS) covers clinical negligence claims against NHS organisations for incidents occurring before 1 April 1995; and Non clinical negligence schemes:the Liabilities to Third Parties Scheme (LTPS) covers non-clinical claims such as public and employers’ liability;the Property Expenses Schemes (PES) covers ‘first party’ losses such as property damage and theft, for incidents on or after 1 April 1999; andDHSC Non-clinical (DH Liab) covers non-clinical negligence liabilities that have transferred to the Secretary of State for Health and Social Care following the abolition of any relevant health bodies.NHSR has provided the attached information:Table 1: Number of Clinical and Non-Clinical Claims received between Financial Years '2006/07' and '2024/25' where the status of the claim was open as at 31/03/2025. Broken down by Scheme (as noted above).Table 2: Number of Clinical and Non-Clinical Claims and Incidents received between Financial Years '2006/07' and '2024/25' where the status was 'Open' or 'Incident' as at 31/03/2025. Broken down by Scheme (as noted above).Note: NHSR defines an ‘open’ claim as one where NHSR is yet to settle or claims that have settled but remain open, where NHSR are yet to agree costs. NHSR has not included cases which are settled but remain open due to ongoing periodical order payments.The distinction between Table 1 and Table 2 is that Table 2 includes incidents reported to NHSR that have not yet progressed to a formal notification of claim. NHSR encourages its members and beneficiaries to report such incidents directly, even prior to the receipt of a claim.

If she will take steps to reduce the cost of the firearms licence application fee.

Increased firearms licensing fees were introduced on 5 February 2025, enabling full cost recovery for police forces and fulfilling a manifesto commitment.Firearms licensing fees were last updated in 2015 and had fallen significantly below the cost of delivering the service. We will keep the level of fees under close review.

Commonwealth and Development Affairs, what diplomatic steps she is taking to encourage a resolution to the border dispute between Thailand and Cambodia.

I refer the Hon Member to the answer given on 15th September to question 75809.

What information his Department holds on the proportion of ambulance call-outs that were related to (a) drug and (b) alcohol use in each of the last five years.

This information is not held centrally.

What discussions he has had with the Royal College of Nursing on pay.

Annual pay awards for staff on Agenda for Change contracts in England, including nurses, are decided by the Government following receipt of recommendations made by the independent NHS Pay Review Body (NHSPRB). The Government accepted the 2025/26 recommendations in full, and in July, the Government asked the NHSPRB to begin the 2026/27 pay round. Relevant stakeholders are invited to submit evidence to the NHSPRB to inform its deliberations.My Rt Hon. Friend, the Secretary of State for Health and Social Care, has met with the Royal College of Nursing (RCN) on multiple occasions since taking office, as have I, to discuss working conditions for National Health Service staff, including pay, and is always open to talking to unions about how they can work with the Government to support the NHS workforce. Officials continue to engage with the RCN on pay and contractual matters through the NHS Staff Council.

Commonwealth and Development Affairs, what discussions she has had with her counterparts in the US on relations with China.

The UK regularly discusses foreign policy with the US at all levels, including issues relating to China.

What information his Department holds on the number of people aged under 21 who have been diagnosed as legally deaf in the last 12 months.

The information requested is not held centrally.The Office for National Statistics collates data on deaf adults, but not on deaf children. It estimates in its 2022/23 annual population survey that 1,235,855 adults aged 16 years old and over in the United Kingdom have difficulty in hearing. These statistics are available at the following link:https://www.ons.gov.uk/aboutus/transparencyandgovernance/freedomofinformationfoi/ukhearingpopulationfordeafandhardofhearingstatisticsHowever, other organisations have data or estimates of the number of deaf children and young people. For example, the Consortium for Research into Deaf Education, which brings together a range of organisations with an interest in improving the educational outcomes achieved by deaf children, identified in its 2024 report that there were 54,321 deaf children reported by services across the UK, a 3% increase since 2023. The report is available at the following link:https://cms.ndcs.org.uk/sites/default/files/2025-05/CRIDE%20UK%20-%202024.pdfNHS audiology services are locally commissioned, and the responsibility for meeting the needs of non-hearing people lies with local NHS commissioners. We expect local commissioning to be informed by the best available evidence, relevant National Institute for Health and Care Excellence guidelines, and guidance issued by NHS England. In 2019, NHS England, with input from the National Deaf Children’s Society, produced a guide for commissioner and health and local authority providers who support children and young people with hearing loss. This guide is available at the following link:https://www.england.nhs.uk/wp-content/uploads/2019/11/what-works-chswg-guide.pdf

Whether he plans to remove parental (a) income and (b) education levels as factors in cases of maternity clinical negligence.

The rising costs of clinical negligence claims against the National Health Service in England are of great concern to the Government. Costs have more than doubled in the last 10 years and are forecast to continue rising, putting further pressure on NHS finances.As announced in the recently published 10-Year Health Plan for England, David Lock KC will be providing expert policy advice on the rising legal costs and how we can improve patients’ experience of clinical negligence claims, ahead of a review by the Department in the autumn. The results of David Lock’s work will inform future policy making in this area. No decisions on policy have been taken at this point.

What steps he is taking to ensure that the (a) pricing and (b) reimbursement system for multi-indication medicines does not disadvantage patients with (i) rare and (ii) ultra-rare conditions.

I refer the Hon. Member to the answers my Rt Hon. Friend, the Minister of State for Health gave on 1 September 2025 to Questions 69240, 69241, and 69242.

What assessment he has made of the potential impact of the requirement in the NHS England Commercial Framework for New Medicines for medicines to provide value at-or-below NICE’s cost-effectiveness threshold on access to treatments for (a) rare and (b) ultra-rare disease patients .

I refer the Hon. Member to the answers my Rt Hon. Friend, the Minister of State for Health gave on 1 September 2025 to Questions 69240, 69241, and 69242.

If his Department will make an assessment of the potential merits of NHS England providing formal agreements in principle to pharmaceutical companies that commercial flexibility may be granted for multi-indication medicines (a) prior to and (b) pending the outcome of NICE evaluations.

I refer the Hon. Member to the answers my Rt Hon. Friend, the Minister of State for Health gave on 1 September 2025 to Questions 69240, 69241, and 69242.

If he will take steps to ensure that companies involved in major (a) governance and (b) accountability failures are subject to enhanced scrutiny before providing critical public services.

Government efficiency, transparency and accountability are key pillars of the Procurement Act 2023 which came into force this year. The Act establishes a new exclusions framework that makes it easier to exclude suppliers who have underperformed in the delivery of other public contracts or acted improperly in procurement. The Act has also created a debarment list which will publicly list suppliers who must or may be excluded from contracts. The new Central Digital Platform is also improving accessibility to procurement data, ensuring accountability and enabling the public and stakeholders to scrutinise spending decisions and track procurement outcomes.

Commonwealth and Development Affairs, what assessment she has made of the potential implications for her policies of the attack on a Christian prayer house in Koto Tangah District, Indonesia, in July 2025; and what steps she is taking to help ensure the (a) protection of Christian communities and (b) promotion of religious freedom in that country.

The Government champions freedom of religion or belief for all abroad, and we continue to engage with Indonesian counterparts on the restriction of those freedoms, including the reported attacks on a Christian prayer house in Koto Tangah District. We welcome the Indonesian Minister for Human Rights' response to the incident, in which he emphasised the importance of religious diversity in Indonesia.The month after the attack, the UK's Human Rights Ambassador, Eleanor Sanders, met the Minister in question to discuss religious freedoms, and also met Civil Society Organisations supporting religious tolerance in Indonesia. We will continue to work with the Indonesian Government and Civil Society partners on these issues.

Whether her Department has made an estimate of the number of commercial airline pilots the UK will need to train each year to provide the workforce required (a) at current levels and (b) to meet anticipated levels of future demand.

As the UK aviation sector operates predominantly in the private sector, it is for individual airlines to recruit and train pilots to meet today’s demand and the demand of the future. I therefore welcome the funded pilot training programmes that British Airways, TUI and Jet2.com have introduced, that will ensure a sustainable pipeline of future pilots.

What steps he is taking to extend funding for advice and guidance services for GPs to other parts of primary care.

The Department currently has no plans to introduce funding for Advice and Guidance Enhanced Services for community pharmacy, dental practices, or opticians. Most referrals to specialist services come from general practices (GPs), who have a primary role in the management of patient health and care in the community.In 2025/26, the Government introduced the General Practice Advice and Guidance Enhanced Service, which makes provision for GPs to claim a £20 fee for each new advice and guidance request, to recognise the key role they play in delivering on the Government’s commitments to shift care from hospital to community and to return to the 18-week Referral to Treatment constitutional standard by March 2029.

Whether she has made a recent assessment of trends in levels of fatigue among pilots flying in UK airspace.

There are stringent regulations in place to prevent pilot fatigue. The risk of flight crew fatigue is managed under the flight time limitation regulations which limit the number of hours pilots can be on duty.  The Civil Aviation Authority (CAA), as the UK’s independent aviation safety regulator, monitors and oversees UK Airlines’ management of flight time limitation requirements and how these impact pilot fatigue.

Whether his Department has made an estimate of the funding required for local authorities to ensure the enforcement of proposed new minimum energy efficiency standards in the private rented sector.

Local authorities are key to enforcement and my department has engaged with them extensively throughout policy development. Government is already taking steps to empower local authorities, including proposing increasing the maximum fine to £30,000 per-property per-breach, carrying out significant improvements to the Exemptions Register, and introducing a Landlord Database through the Renters’ Rights Bill. These steps will better enable local authorities to identify non-compliant properties in their area and take action to support landlords to comply.

Communities and Local Government, whether his Department has made an assessment of the potential merits of introducing tenants' protections from eviction after landlords have accessed grants to improve energy efficiency.

The government recently consulted on increasing minimum energy efficiency standards in the domestic private rented sector. The consultation included proposals for rented homes to achieve Energy Performance Certificate C or equivalent by 2030. The consultation closed in May this year and DESNZ are currently reviewing responses ahead of publishing a response. The government is committed to protecting and improving the rights of tenants. The Renters’ Rights Bill will put in place new regulations to protect tenants. This includes providing stronger protections to ensure that tenants are able to appeal excessive above-market rents, abolishing Section 21 ‘no fault evictions’, and moving to a simpler tenancy structure where all assured tenancies ae periodic. These measures provide more security for tenants and enable them to challenge poor practice and unfair rent increases without fear of eviction.