Written questions by Reynolds.

What assessment his Department has made of the potential impact of proposed changes to employer National Insurance contributions on the number of available GP appointments.

Primary care providers, including general practices (GPs), are valued independent contractors who provide nearly £20 billion worth of National Health Services. Every year we consult with each sector both about what services they provide, and the money providers are entitled to in return under their contract. As in previous years, the issue of National Insurance contribution changes will be dealt with as part of that process. We will shortly begin discussions on the annual GP Contract.

Communities and Local Government, what steps she is taking to help secure the financial sustainability of (a) the Royal Borough of Windsor & Maidenhead and (b) all local councils.

This Government recognises that council funding has been under pressure since 2010. Any council that has unmanageable pressures and is concerned about its financial position should approach the department.We will provide councils with more stability and certainty through moving towards multi-year funding settlements and by ending wasteful competitive bidding pots. This will ensure councils can plan their finances for the future properly, delivering better value for money for taxpayers. Future local authority funding decisions will be a matter for the next Spending Review and Local Government Finance Settlement in which we are engaged.Department officials continue to engage regularly with the Royal Borough of Windsor and Maidenhead regarding its financial position.

What steps his Department is taking to reduce waiting lists for heart care treatments, in the context of recent statistics published by the British Heart Foundation on trends in the number of premature deaths from heart and circulatory diseases.

Tackling waiting lists is a key part of our Health Mission. The waiting list at the end of July stood at 7.62 million patient pathways, with 417,864 incomplete pathways waiting for treatment for cardiology.We will deliver an extra 40,000 operations, scans, and appointments per week, including in cardiology services, as a First Step in our commitment to ensuring patients can expect to be treated within 18 weeks.We will be supporting NHS Trusts to deliver these through innovation, sharing best practice to increase productivity and efficiency, and ensuring the best value is delivered.This government is committed to putting patients first. This means making sure that patients across all specialities, including cardiology, are seen on time and ensuring that people have the best possible experience during their care.

What steps he is taking to improve the water quality of rivers.

After 14 years of Conservative failure, we share the public’s fury at the levels of sewage being released into our rivers, lakes and seas.That is why this Government has introduced legislation to put the water companies under special measures to end their disgraceful behaviour. But this is not all we are doing.We will outline further legislation to fundamentally transform how the water industry is run and speed up the delivery of upgrades to our sewage infrastructure to clean up our waterways for good.