Written questions by Robertson.

Communities and Local Government, if he will make an assessment of the level of independence of the complaint review process within the Local Government and Social Care Ombudsman.

The legal powers underpinning the Local Government and Social Care Ombudsman’s investigations are invested in the Ombudsman themselves and they have personal authority in the investigation of complaints. I therefore have no remit to interfere with the Ombudsman’s investigatory work. This independence rightly keeps central government at arm’s length from the service that the Ombudsman provides to members of the public; a service which is an important element of the overarching local government accountability system.

Whether the Government intends to provide Start for Life funding to new local authority areas.

The 10-Year Health Plan sets out an ambitious agenda to how we will improve the nation’s health by creating a new model of care that is fit for the future.We recognise that local authorities are ambitious, seeking to deliver universal support to families and prevent escalating need. We are committed to delivering the 10-Year Health Plan ambition to match Healthy Babies, formerly Start for Life, to Best Start Family Hubs over the next decade.

How the decision to prioritise continuation funding for the existing 75 Start for Life local authority areas aligns with the commitment in the 10-Year Health Plan for England to expand Start for Life services across all communities.

The 10-Year Health Plan sets out an ambitious agenda to how we will improve the nation’s health by creating a new model of care that is fit for the future.We recognise that local authorities are ambitious, seeking to deliver universal support to families and prevent escalating need. We are committed to delivering the 10-Year Health Plan ambition to match Healthy Babies, formerly Start for Life, to Best Start Family Hubs over the next decade.

What assessment he has made of regional variation in access to NICE-approved medicines across Integrated Care Systems.

No assessment has been made by my Rt Hon. Friend, the Secretary of State for Health and Social Care. National Institute for Health and Care Excellence (NICE) guidance on adoption of innovative medicines in local formularies states that once a NICE technology appraisal recommends a medicine, it must be included in a local formulary within 90 days, providing it is clinically appropriate and relevant to the services provided by the organisation, or 30 days for Early Access to Medicines Scheme medicines. This NICE guidance is available at the following link:https://www.nice.org.uk/guidance/mpg1/chapter/Recommendations#local-formulary-scopeLocal formularies exist at various levels of the health service, but most frequently appear at integrated care board (ICB) level. It is the responsibility of local medicines optimisation teams and formulary committees to ensure they are meeting these targets.At a national level, the Innovation Scorecard and Estimates Report is a publication which reports on the use of medicines and medicine groupings in the National Health Service in England, which have been positively appraised by NICE. It can be used by local NHS organisations to monitor progress in implementing NICE Technology Appraisal recommendations. Further information on the Innovation Scorecard and Estimates Report is available at the following link:https://app.powerbi.com/view?r=eyJrIjoiOWVkZmY1MDEtOWQzMS00YzU1LWJkZmYtMTc2NGQ2MTZkYjc2IiwidCI6ImNmNmQwNDgyLTg2YjEtNGY4OC04YzBjLTNiNGRlNGNiNDAyYyJ9In line with commitments made in 2024 Voluntary Scheme for Branded Medicines Pricing, Access, and Growth, NHS England, NICE, and the NHS Business Services Authority are further developing the Innovation Scorecard and Estimates Report to better track variation in the uptake of NICE recommended medicines between ICBs.The 10-Year Health Plan and Life Sciences Sector Plan set out a commitment to move to a Single National Formulary for medicines within the next two years. The overall aim of the Single National Formulary will be to drive rapid and equitable adoption of clinically- and cost-effective innovations.

What proportion of NICE technology appraisals have been terminated in each year since 2019; and what assessment he has made of the reasons for these terminations.

The follow table shows the proportion of National Institute for Health and Care Excellence (NICE) technology appraisals that have been terminated in each year since 2019:YearTerminations as a percentage of each year2019/2017.54%2020/2120.00%2021/2219.39%2022/2322.77%2023/2418.47%2024/2518.18%Source: NICE.NICE is an independent body and my Rt Hon. Friend, the Secretary of State for Health and Social Care, has made no assessment of the reasons for the terminations of technology appraisals.NICE strives to get the best care to patients fast, and to ensure value for the taxpayer. The aligned NICE and Medicines and Healthcare products Regulatory Agency pathway, set out in the 10-Year Health Plan, will allow us to bring medicines to patients three to six months sooner. NICE continues to support and work with companies to identify the best time to submit appraisals and to ensure they have a clear understanding of NICE’s methods and processes, to try to avoid terminations.Sometimes companies withdraw from the NICE appraisal process which means NICE cannot continue to evaluate the treatment. Companies can choose to do this for different reasons, including the treatment not being put forward at a cost-effective price, supply issues and incomplete evidence.

If he will publish data on how many Activity Management Plans have been issued by NHS Integrated Care Boards to (a) NHS Trusts and (b) independent providers, how many reduced procedures that will cause between November 2025 and March 2026; and what justifications were provided by ICBs for issuing each AMP.

The specific information requested is not held by the Department. Activity management plans are contractual mechanisms within the NHS Standard Contract, used by integrated care boards (ICBs) to manage elective activity and financial control. They can be implemented when providers exceed their indicative activity plans, helping commissioners and providers plan demand, capacity, and expenditure. This information is therefore held at individual ICB level.

When he plans to publish data collected by his Department on the use of corridor care.

The provision of clinical care in corridors is unacceptable, and we are committed to ending its practice in the National Health Service. Furthermore, our Urgent and Emergency Care Plan for 2025/26 commits to publishing data on the prevalence of corridor care for the first time.NHS England has been working with trusts to put in place new reporting arrangements regarding the use of corridor care to drive improvement and data transparency. The data quality is currently being reviewed, and we expect to publish the information shortly.We are introducing new clinical operational standards for the first 72 hours of care, setting clear expectations for timely reviews and specialist input, further supporting our efforts to eliminate corridor care and improve patient experience.

What assessment his Department has made of the potential impact on the roll-out of Best Start Family Hubs and wider neighbourhood health integration if local authorities without existing Start for Life funding are unable to establish core services.

Delivering integrated, joined-up health, education, and family support is at the heart of our ambition to raise the healthiest generation of children ever.Healthy Babies, formerly Start for Life, funding is helping families during the critical 1,001 days, and as a result parents have said they are more confident in feeding their babies and have better perinatal mental health because of this support. We continue to assess how we can best support early-years service integration across the country and remain committed to working with delivery partners locally to achieve this.Healthy Babies is one element of our broader commitment to supporting babies, children and families. From April 2026, Best Start Family Hubs will expand to every single local authority, backed by over £500 million to reach up to half a million more children and families. This funding will help all local authorities to integrate a range of statutory and non-statutory health and family services.Best Start Family Hubs will form part of the architecture of the Neighbourhood Health Service. Through the shifts from hospital to community and treatment to prevention, we will further strengthen integration and join-up of services, helping to ensure that babies and their families can get the support they need, when and where they need it.

What assessment his Department has made of equity of access to to Start for Life services, including infant feeding, perinatal mental health and parent-infant relationship support across England.

Delivering integrated, joined-up health, education, and family support is at the heart of our ambition to raise the healthiest generation of children ever.Healthy Babies, formerly Start for Life, funding is helping families during the critical 1,001 days, and as a result parents have said they are more confident in feeding their babies and have better perinatal mental health because of this support. We continue to assess how we can best support early-years service integration across the country and remain committed to working with delivery partners locally to achieve this.Healthy Babies is one element of our broader commitment to supporting babies, children and families. From April 2026, Best Start Family Hubs will expand to every single local authority, backed by over £500 million to reach up to half a million more children and families. This funding will help all local authorities to integrate a range of statutory and non-statutory health and family services.Best Start Family Hubs will form part of the architecture of the Neighbourhood Health Service. Through the shifts from hospital to community and treatment to prevention, we will further strengthen integration and join-up of services, helping to ensure that babies and their families can get the support they need, when and where they need it.

What assessment he has made of the month-by-month progress that will be needed to be compliant with the NHS' 92 per cent 18-week target by March 2029; and what progress has been made to date in 2025-26.

We are committed to returning by March 2029 to the National Health Service constitutional standard that 92% of patients wait no longer than 18 weeks from referral to consultant-led treatment.NHS England’s 2025/26 priorities and operational planning guidance sets a national target to:improve the percentage of patients waiting no longer than 18 weeks to 65% nationally by March 2026; andevery trust is expected to deliver a minimum 5% improvement by March 2026.The NHS Medium Term Planning Framework sets out plans for 2026/27 to 28/29, with the expectation that local NHS organisations improve access and performance standards across core services over the next three years. This includes a target that 70% of patients wait no longer than 18 weeks by March 2027.A number of providers have already made significant improvements in their referral to treatment performance according to published data, including within 2025/26, which demonstrates the progress we asked the system to deliver is possible.

What recent discussions he has had with local authorities about the funding of hospice services, including those providing end-of-life care for dementia patients.

The Department has not had any recent discussions with local authorities about the funding of hospice services.Palliative care services are included in the list of services an integrated care board (ICB) must commission. To support ICBs in this duty, NHS England has published statutory guidance and service specifications. The statutory guidance states that ICBs must work to ensure that there is sufficient provision of care services to meet the needs of their local populations, which can include hospice services available within the ICB catchment.Local authorities don't have direct responsibility for end of life care. However, statutory guidance encourages local authorities to prioritise integration activity in areas where there is evidence that effective integration of services materially improves people’s wellbeing, for example, end of life care.As the majority of hospices are independent charitable organisations, neither the Government nor NHS England collect data on their financial accounts. As such, we do not hold data on the proportion of the total income that hospices receive that is provided by central Government.In December 2024, we announced a £100 million capital funding boost for adult and children’s hospices in England. We are pleased to say that this capital funding has just been increased by a further £25 million. The Government will consider contracting and commissioning as part of developing the forthcoming Palliative Care and End of Life Care Modern Service Framework for England. We recognise that there is currently a mix of contracting models in the hospice sector. By supporting ICBs to commission more strategically, we can move away from grant and block contract models. In the long term, this will aid sustainability and help hospices’ ability to plan ahead.

What proportion of hospice funding for dementia end-of-life care is provided by central government and local authorities; and whether he plans to increase statutory funding for hospices.

The Department has not had any recent discussions with local authorities about the funding of hospice services.Palliative care services are included in the list of services an integrated care board (ICB) must commission. To support ICBs in this duty, NHS England has published statutory guidance and service specifications. The statutory guidance states that ICBs must work to ensure that there is sufficient provision of care services to meet the needs of their local populations, which can include hospice services available within the ICB catchment.Local authorities don't have direct responsibility for end of life care. However, statutory guidance encourages local authorities to prioritise integration activity in areas where there is evidence that effective integration of services materially improves people’s wellbeing, for example, end of life care.As the majority of hospices are independent charitable organisations, neither the Government nor NHS England collect data on their financial accounts. As such, we do not hold data on the proportion of the total income that hospices receive that is provided by central Government.In December 2024, we announced a £100 million capital funding boost for adult and children’s hospices in England. We are pleased to say that this capital funding has just been increased by a further £25 million. The Government will consider contracting and commissioning as part of developing the forthcoming Palliative Care and End of Life Care Modern Service Framework for England. We recognise that there is currently a mix of contracting models in the hospice sector. By supporting ICBs to commission more strategically, we can move away from grant and block contract models. In the long term, this will aid sustainability and help hospices’ ability to plan ahead.

How many NICE appraisals were terminated in the five-year period from 2019 to 2024, and how this compares with the preceding five-year period.

The following table shows the number of National Institute for Health and Care Excellence (NICE) appraisals that were terminated between 2019 and 2024, and between 2014 and 2019:PeriodNumber of terminated appraisalsTerminated appraisals as a percentage of total appraisals2019 to 20248219%2014 to 2019267%Source: NICE.NICE data shows that terminated appraisals increased in 2019/20 and stabilised with no increasing trend thereafter. This followed NICE’s 2019 commitment to review all new active substances and significant indications. This required industry to submit topics which might otherwise not have been in NICE's work programme. NICE’s data shows that the proportion of terminations has been stable over the last five years, and that terminations reflect that not all products/indications will likely be clinically and cost effective. NICE will continue to monitor terminations with a view to best continuing to support access to clinically and cost-effective medicines for patients in England.

What assessment he has made of Activity Management Plans issued by NHS Integrated Care Boards and their impact on the NHS’ adherence with its constitutional access standards and patient choice rules.

Integrated care boards (ICBs) have existing contractual powers to manage activity by providers, which were enhanced in 2025/26 with central support for setting and managing activity. The NHS Standard Contract includes the ability to set Indicative Activity Plans (IAPs) to help providers and commissioners plan demand, capacity, and expenditure. While not binding, if activity exceeds the agreed plan, and therefore the funding agreed, an Activity Management Plan (AMP) can be agreed to bring activity back in line.The provision and use of IAPs and AMPs is designed to deliver the activity levels required to achieve the goal of at least 65% of patients waiting no longer than 18 weeks for treatment by March 2026 whilst also living within financial budgets set for 2025/26.Any planning assumptions based on waiting times need to support commissioners’ overall duties to the populations they serve and our waiting time targets, including our commitment to return to the 18-week standard. AMPs allow commissioners and providers to work together to manage elective activity within agreed performance and financial targets, all whilst working towards improving patient waiting times overall. Patients have a legal right to choose where they go for their first appointment when referred to consultant-led care as an outpatient. ICBs are responsible for ensuring that their processes comply with the legal right to choose. Since the publication of the Partnership Agreement in January 2025, the independent sector has delivered approximately 200,000 additional treatments compared to the same period last year.

What assessment he has made of the impact of Activity Management Plans issued by NHS Integrated Care Boards on the commitment made in the NHS/Independent Sector Partnership Agreement signed in January 2025 to enable increased independent sector elective activity to reduce waiting times.

Integrated care boards (ICBs) have existing contractual powers to manage activity by providers, which were enhanced in 2025/26 with central support for setting and managing activity. The NHS Standard Contract includes the ability to set Indicative Activity Plans (IAPs) to help providers and commissioners plan demand, capacity, and expenditure. While not binding, if activity exceeds the agreed plan, and therefore the funding agreed, an Activity Management Plan (AMP) can be agreed to bring activity back in line.The provision and use of IAPs and AMPs is designed to deliver the activity levels required to achieve the goal of at least 65% of patients waiting no longer than 18 weeks for treatment by March 2026 whilst also living within financial budgets set for 2025/26.Any planning assumptions based on waiting times need to support commissioners’ overall duties to the populations they serve and our waiting time targets, including our commitment to return to the 18-week standard. AMPs allow commissioners and providers to work together to manage elective activity within agreed performance and financial targets, all whilst working towards improving patient waiting times overall. Patients have a legal right to choose where they go for their first appointment when referred to consultant-led care as an outpatient. ICBs are responsible for ensuring that their processes comply with the legal right to choose. Since the publication of the Partnership Agreement in January 2025, the independent sector has delivered approximately 200,000 additional treatments compared to the same period last year.

How many NICE positive recommendations in each year since 2023 were issued as optimised decisions; and what proportion of the eligible patient population was able to access those medicines on the NHS.

The following table shows the number of National Institute for Health and Care Excellence (NICE) recommendations since 2023 that have been issued as optimised decisions:YearNumberPercentage of all publications excluding terminations2023/243748%2024/253343%2025/262144%Source: NICENotes:the data for 2025/26 is for the year so far; anddata includes all Cancer Drugs Fund and Innovative Medicines Fund recommendations.The Government does not hold data on the proportion of the eligible patient population able to access those medicines on the National Health Service. Some data may be available via the innovation scorecard and estimates report, available at the following link:https://app.powerbi.com/view?r=eyJrIjoiOWVkZmY1MDEtOWQzMS00YzU1LWJkZmYtMTc2NGQ2MTZkYjc2IiwidCI6ImNmNmQwNDgyLTg2YjEtNGY4OC04YzBjLTNiNGRlNGNiNDAyYyJ9This is a publication which reports on the use of medicines and medicine groupings in the NHS in England which have been positively appraised by NICE, including some NICE optimised decisions.

What proportion of unpaid tax liabilities is written off each year; and according to what criteria HMRC determines when a tax debt will no longer be pursued.

HMRC is committed to closing the tax gap further and tackling non-compliant behaviours such as tax evasion, tax avoidance, criminal attacks, error, failure to take reasonable care, hidden economy activity, legal interpretation issues, and non-payment. In 2024 to 2025, HMRC’s compliance work contributed to record tax revenues of £875.9 billion, collecting and protecting £48 billion of tax that would have gone unpaid if HMRC hadn’t stepped in – up from £41.8 billion the previous year. At the Autumn Budget 2025, the government announced a package of measures that will raise a further £2.4 billion in additional tax revenues in 2029 to 2030. This builds on announcements at Autumn Budget 2024 (£6.5 billion), and Spring Statement 2025 (over £1 billion) and brings the total revenue from closing the tax gap announced this Parliament to £10 billion in 2029 to 2030. HMRC pursues unpaid tax liabilities through a number of routes. Those who have not paid will be subject to initial telephone and letter campaigns to encourage swift payment. HMRC also uses private sector debt collection agencies to pursue outstanding amounts. Cases will move between these different stages of the debt collection process as part of being worked. Where payments remain outstanding, HMRC has a range of enforcement powers to address the small minority of taxpayers who deliberately refuse to pay or engage, such as taking control of goods, recovering debt through county court proceedings, and applying to make a company or person insolvent. HMRC also publishes its Annual Report and Accounts on GOV.UK, which reports on its annual tax losses and sets out the limited circumstances in which a debt may no longer be pursued. HMRC records its debt cases by tax regime, rather than customer type, and does not organise cases by specifically which stage of the debt collection process it is at.

How much tax revenue is currently outstanding from taxpayers known to be liable but not under active enforcement action by HMRC.

HMRC is committed to closing the tax gap further and tackling non-compliant behaviours such as tax evasion, tax avoidance, criminal attacks, error, failure to take reasonable care, hidden economy activity, legal interpretation issues, and non-payment. In 2024 to 2025, HMRC’s compliance work contributed to record tax revenues of £875.9 billion, collecting and protecting £48 billion of tax that would have gone unpaid if HMRC hadn’t stepped in – up from £41.8 billion the previous year. At the Autumn Budget 2025, the government announced a package of measures that will raise a further £2.4 billion in additional tax revenues in 2029 to 2030. This builds on announcements at Autumn Budget 2024 (£6.5 billion), and Spring Statement 2025 (over £1 billion) and brings the total revenue from closing the tax gap announced this Parliament to £10 billion in 2029 to 2030. HMRC pursues unpaid tax liabilities through a number of routes. Those who have not paid will be subject to initial telephone and letter campaigns to encourage swift payment. HMRC also uses private sector debt collection agencies to pursue outstanding amounts. Cases will move between these different stages of the debt collection process as part of being worked. Where payments remain outstanding, HMRC has a range of enforcement powers to address the small minority of taxpayers who deliberately refuse to pay or engage, such as taking control of goods, recovering debt through county court proceedings, and applying to make a company or person insolvent. HMRC also publishes its Annual Report and Accounts on GOV.UK, which reports on its annual tax losses and sets out the limited circumstances in which a debt may no longer be pursued. HMRC records its debt cases by tax regime, rather than customer type, and does not organise cases by specifically which stage of the debt collection process it is at.

What steps her Department is taking to ensure that regional domestic ferry operators are supported to meet the goals of the Maritime Decarbonisation Strategy.

The Maritime Decarbonisation Strategy sets out a pathway to zero emissions by 2050, and interim goals in 2030 and 2040. To support the sector transition to zero, and near-zero, emission fuels, the Strategy sets out a number of key policies including; expanding the UK Emissions Trading Scheme to maritime, the introduction of fuel regulations, taking action to reduce emissions at berth, taking proportionate measures to reduce emissions from smaller vessels and increasing the efficiency of maritime operations. Support is available to the maritime sector for decarbonisation through our UK SHORE Research and Development programme. Over 300 projects across the UK have been supported to date, including those that support the decarbonisation of domestic ferries. In September, I announced a further £448 million of funding for innovation through this programme, including additional rounds of the Clean Maritime Demonstration Competitions, and a second round of the Zero Emission Vessels and Infrastructure competition. We aim to launch the first two of these competitions in Spring 2026 and they will run until 2030.

What measures HMRC has in place to prevent deliberate non-payment of tax by those who are liable but expect not to be pursued.

HMRC is committed to closing the tax gap further and tackling non-compliant behaviours such as tax evasion, tax avoidance, criminal attacks, error, failure to take reasonable care, hidden economy activity, legal interpretation issues, and non-payment. In 2024 to 2025, HMRC’s compliance work contributed to record tax revenues of £875.9 billion, collecting and protecting £48 billion of tax that would have gone unpaid if HMRC hadn’t stepped in – up from £41.8 billion the previous year. At the Autumn Budget 2025, the government announced a package of measures that will raise a further £2.4 billion in additional tax revenues in 2029 to 2030. This builds on announcements at Autumn Budget 2024 (£6.5 billion), and Spring Statement 2025 (over £1 billion) and brings the total revenue from closing the tax gap announced this Parliament to £10 billion in 2029 to 2030. HMRC pursues unpaid tax liabilities through a number of routes. Those who have not paid will be subject to initial telephone and letter campaigns to encourage swift payment. HMRC also uses private sector debt collection agencies to pursue outstanding amounts. Cases will move between these different stages of the debt collection process as part of being worked. Where payments remain outstanding, HMRC has a range of enforcement powers to address the small minority of taxpayers who deliberately refuse to pay or engage, such as taking control of goods, recovering debt through county court proceedings, and applying to make a company or person insolvent. HMRC also publishes its Annual Report and Accounts on GOV.UK, which reports on its annual tax losses and sets out the limited circumstances in which a debt may no longer be pursued. HMRC records its debt cases by tax regime, rather than customer type, and does not organise cases by specifically which stage of the debt collection process it is at.