Written questions by Vickers.

How many planned outpatient admissions expressed as a total number and as a percentage of all outpatient admissions were a) cancelled by hospitals and NHS authorities, b) cancelled by patients and c) cancelled because patients did not attend in each of the last three years.

Appointments cancelled by hospitals or other National Health Service authorities do not appear in statistics as completed appointments. For admitted patients, the Department does not hold data on the cause of cancellations or where patients did not attend their operation.Data on the number of last-minute cancelled operations is published by NHS England. Last minute means on the day the patient was due to arrive, after the patient has arrived in hospital or on the day of the operation or surgery. It does not include cancelled operations before the day of the operation. Data is available by year and quarter and includes the number of cancellations and the percentage these represent of total elective admissions. This is available at the following link, within the ‘Time Series’ report:https://www.england.nhs.uk/statistics/statistical-work-areas/cancelled-elective-operations/cancelled-ops-data/For outpatient appointments, data on cancellations and patients that did not attend their appointment is published by NHS England. Data is available by year and includes the number of cancellations, whether these were hospital or patient cancellations, and the percentage these represent of total elective admissions. This is available on the following link, within "Hospital Outpatient Activity, 2024-25: Report Tables":https://digital.nhs.uk/data-and-information/publications/statistical/hospital-outpatient-activity/2024-25

Whether appointments cancelled by hospitals or other NHS authorities appear in statistics as completed appointments.

Appointments cancelled by hospitals or other National Health Service authorities do not appear in statistics as completed appointments. For admitted patients, the Department does not hold data on the cause of cancellations or where patients did not attend their operation.Data on the number of last-minute cancelled operations is published by NHS England. Last minute means on the day the patient was due to arrive, after the patient has arrived in hospital or on the day of the operation or surgery. It does not include cancelled operations before the day of the operation. Data is available by year and quarter and includes the number of cancellations and the percentage these represent of total elective admissions. This is available at the following link, within the ‘Time Series’ report:https://www.england.nhs.uk/statistics/statistical-work-areas/cancelled-elective-operations/cancelled-ops-data/For outpatient appointments, data on cancellations and patients that did not attend their appointment is published by NHS England. Data is available by year and includes the number of cancellations, whether these were hospital or patient cancellations, and the percentage these represent of total elective admissions. This is available on the following link, within "Hospital Outpatient Activity, 2024-25: Report Tables":https://digital.nhs.uk/data-and-information/publications/statistical/hospital-outpatient-activity/2024-25

Communities and Local Government, what discussions his Department has had with freehold investors and their representatives on the (a) content and (b) timing of the draft Leasehold and Commonhold Reform Bill since July 2024.

Officials in my Department engage regularly with representatives of freeholders, leaseholders, managing agents and other professional bodies with an interest in the leasehold sector in England and Wales.The draft Commonhold and Leasehold Reform Bill was published yesterday, and I refer the hon. Member to the Written Ministerial Statement made (HCWS1278).

What assessment he has made of trends in the prevalence of chronic kidney disease in England over the last ten years; and what he expects the trends to be over the next decade.

Data on chronic kidney disease (CKD) prevalence nationally and locally is available at the following link:https://fingertips.phe.org.uk/search/chronic%20kidney%20disease#page/4/gid/1/pat/159/par/K02000001/ati/15/are/E92000001/iid/258/age/168/sex/4/cat/-1/ctp/-1/yrr/1/cid/4/tbm/1 NHS England’s Renal Clinical Network Specification states that the patient population in England with advanced kidney disease requiring renal replacement therapy is growing at a rate of 3% per annum. NHS England’s Renal Clinical Network Specification is available at the following link:https://www.england.nhs.uk/wp-content/uploads/2024/05/PRN231110-renal-clinical-network-specification-2023-.pdfTo tackle this, NHS England is delivering a comprehensive programme to improve the diagnosis, treatment, and outcomes of people with kidney disease. NHS England has published a renal services transformation toolkit to support earlier identification of CKD and to strengthen management across the whole patient pathway. Eight commissioned regional renal clinical networks are implementing this toolkit, in collaboration with providers, with a clear focus on improving early diagnosis, slowing disease progression, and reducing the number of patients reaching advanced stages of kidney disease. This work is supported nationally by the Renal Clinical Reference Group. NHS England is also supporting the Department and key kidney organisations to identify further opportunities to enhance prevention, diagnosis, treatment, and long‑term outcomes for people living with kidney disease.

What assessment he has made of the adequacy of the capacity of renal services, including dialysis and transplantation services, to meet current and projected patient demand.

Data on chronic kidney disease (CKD) prevalence nationally and locally is available at the following link:https://fingertips.phe.org.uk/search/chronic%20kidney%20disease#page/4/gid/1/pat/159/par/K02000001/ati/15/are/E92000001/iid/258/age/168/sex/4/cat/-1/ctp/-1/yrr/1/cid/4/tbm/1 NHS England’s Renal Clinical Network Specification states that the patient population in England with advanced kidney disease requiring renal replacement therapy is growing at a rate of 3% per annum. NHS England’s Renal Clinical Network Specification is available at the following link:https://www.england.nhs.uk/wp-content/uploads/2024/05/PRN231110-renal-clinical-network-specification-2023-.pdfTo tackle this, NHS England is delivering a comprehensive programme to improve the diagnosis, treatment, and outcomes of people with kidney disease. NHS England has published a renal services transformation toolkit to support earlier identification of CKD and to strengthen management across the whole patient pathway. Eight commissioned regional renal clinical networks are implementing this toolkit, in collaboration with providers, with a clear focus on improving early diagnosis, slowing disease progression, and reducing the number of patients reaching advanced stages of kidney disease. This work is supported nationally by the Renal Clinical Reference Group. NHS England is also supporting the Department and key kidney organisations to identify further opportunities to enhance prevention, diagnosis, treatment, and long‑term outcomes for people living with kidney disease.

What recent progress he has made in improving access to kidney transplantation, including reducing waiting times and increasing rates of living and deceased organ donation.

NHS Blood and Transplant (NHSBT) is the organisation responsible for organ donation services in the United Kingdom. Figures on the number of patients active on the kidney transplant waiting list and median waiting times are available at the following link:https://nhsbtdbe.blob.core.windows.net/umbraco-assets-corp/36811/section-5-kidney-activity.pdfThe Department, along with NHSBT, continues to take action to improve access to kidney transplantation. This includes high profile, year-round campaigns including Living Donation Week, Organ Donation Week, and World Kidney Day, and partnerships with charities and community groups to promote living donation, the UK Living Kidney Sharing Scheme (UKLKSS) and the importance of declaring wishes on the Organ Donation Register (ODR). In addition, the Living Donor Futures programme, launching this early this year, will look at how NHSBT can support the growth of living donor programmes locally and within the UKLKSS. Further information on the UKLKSS is available at the following link: https://www.odt.nhs.uk/living-donation/uk-living-kidney-sharing-scheme/;The Department-led Implementation Steering Group for Organ Utilisation is working to maximise the potential for organ transplantation, aiming to reduce waiting times and improve access. This includes the initiation of a national programme of Assessment and Recovery Centres (ARCs) by NHSBT, which will utilise innovation to enhance the assessment, evaluation, and utilisation of donor organs. Pilot ARCs are set to begin in early 2026. Further information on the Implementation Steering Group for Organ Utilisation is available at the following link: https://www.odt.nhs.uk/odt-structures-and-standards/clinical-leadership/implementation-steering-group-for-organ-utilisation/Additionally, the Organ Donation Joint Working Group recently published recommendations to improve organ donation consent rates, increase societal action for organ donation, and increase the pool of potential donors in their report this January. The recommendations are available at the following link:https://nhsbtdbe.blob.core.windows.net/umbraco-assets-corp/38066/odjwg-report.pdf

What steps he is taking to improve early detection of kidney disease in primary care, particularly for patients with known risk factors such as autoimmune conditions, diabetes and hypertension.

Data on chronic kidney disease (CKD) prevalence nationally and locally is available at the following link:https://fingertips.phe.org.uk/search/chronic%20kidney%20disease#page/4/gid/1/pat/159/par/K02000001/ati/15/are/E92000001/iid/258/age/168/sex/4/cat/-1/ctp/-1/yrr/1/cid/4/tbm/1 NHS England’s Renal Clinical Network Specification states that the patient population in England with advanced kidney disease requiring renal replacement therapy is growing at a rate of 3% per annum. NHS England’s Renal Clinical Network Specification is available at the following link:https://www.england.nhs.uk/wp-content/uploads/2024/05/PRN231110-renal-clinical-network-specification-2023-.pdfTo tackle this, NHS England is delivering a comprehensive programme to improve the diagnosis, treatment, and outcomes of people with kidney disease. NHS England has published a renal services transformation toolkit to support earlier identification of CKD and to strengthen management across the whole patient pathway. Eight commissioned regional renal clinical networks are implementing this toolkit, in collaboration with providers, with a clear focus on improving early diagnosis, slowing disease progression, and reducing the number of patients reaching advanced stages of kidney disease. This work is supported nationally by the Renal Clinical Reference Group. NHS England is also supporting the Department and key kidney organisations to identify further opportunities to enhance prevention, diagnosis, treatment, and long‑term outcomes for people living with kidney disease.

Communities and Local Government, what assessment his Department has made of the potential impact of the timing of the publication of the draft Leasehold and Commonhold Reform Bill on leaseholders.

As per our manifesto commitment, this government is taking the steps necessary to finally bring the feudal leasehold system to an end in this Parliament. Publication of the draft Commonhold and Leasehold Reform Bill was delayed by a matter of weeks to finalise elements of policy and drafting. The draft Bill was published yesterday, and I refer the hon. Member to the Written Ministerial Statement made (HCWS1278).

Communities and Local Government, for what reason the publication of the draft Leasehold and Commonhold Reform Bill was delayed.

As per our manifesto commitment, this government is taking the steps necessary to finally bring the feudal leasehold system to an end in this Parliament. Publication of the draft Commonhold and Leasehold Reform Bill was delayed by a matter of weeks to finalise elements of policy and drafting. The draft Bill was published yesterday, and I refer the hon. Member to the Written Ministerial Statement made (HCWS1278).

Whether his Department plans to develop a national service framework or equivalent long-term strategy for the prevention, diagnosis and treatment of kidney disease.

As announced in the 10-Year Health Plan, as well as an overall quality strategy, the National Quality Board is overseeing the development of a new series of service frameworks to accelerate progress in conditions where there is potential for rapid and significant improvements in quality of care and productivity.Early priorities include cardiovascular disease, severe mental illness, and the first ever service framework for frailty and dementia. The Government will consider other long-term conditions with significant health and economic impacts for future waves of modern service frameworks.

Food and Rural Affairs, with reference to the press release entitled England’s peatlands mapped for first time in major step towards their recovery, published on 12 May 2025, whether her Department's assessment of the proportion of peatland that is degraded was based on (a) land management definitions and (b) testing the health of peat.

The England Peat Map has not assessed peatland as degraded or not and so cannot determine the proportions of degraded peatland in each category mentioned. Work is currently ongoing to incorporate England Peat Map outputs into the Greenhouse Gas Inventory, which will help assess the carbon emissions from England’s peatlands.

Food and Rural Affairs, how much and what proportion of peatland assessed as degraded is (a) lowland farmland in the Fens,(b) other lowland cropland, (c) grassland, (d) modified heather dominated upland, (e) woodland and (f) land used for peatland extraction; and what proportion of carbon emissions is produced by each category.

The England Peat Map (EPM) does not classify peatlands by land-management definitions or directly test peat health. It provides a detailed national map of peat extent and depth, vegetation and land cover, upland drainage channels, and bare peat—features that are strong indicators of condition. The Department’s statement that “around 80% of England’s peatlands are in dry and degraded states” reflects widely accepted UK-wide estimates and is consistent with analysis of the EPM. This figure (80%) is cited by the International Union for the Conservation of Nature in its UK Peatland Strategy and Commission of Inquiry on Peatlands. It is also referenced by the Office for National Statistics. The figure was neither produced by Natural England nor derived from the EPM. However, analysis of the EPM does show that around 80% of England’s peatlands are associated with vegetation and land use cover associated with drier habitats, such as bare peat, arable land, and heather-dominated vegetation.

What steps his Department is taking to help ensure timely postal deliveries by Royal Mail.

Last year, I met the CEOs of Royal Mail and its parent company and raised concerns about Royal Mail’s performance. They reported continued targeted action to improve reliability. I will continue to raise concerns with Royal Mail if the company’s quality of service does not improve.It is for Ofcom, as the independent regulator of postal services, to set and monitor Royal Mail’s service standards and decide how to use its powers to investigate and take enforcement action should Royal Mail fail to achieve its obligations without good justification.In October last year, Ofcom fined Royal Mail £21 million for failing to meet its quality of service targets and has told Royal Mail it must urgently publish and implement a credible plan that delivers major and continuous improvement.

What steps his Department are taking to allow frontline workers such as Teachers, Teaching Assistants and all school workers access to the Free Flu Vaccine Programme.

Eligibility for a free National Health Service flu vaccine is guided, each year, by advice and recommendations from the independent Joint Committee on Vaccination and Immunisation (JCVI). The JCVI keeps all vaccination programmes under review.The aim of the flu vaccination programme is to protect those most at risk from serious illness and hospitalisation. Those eligible to receive a free flu vaccine on the NHS this autumn and winter are: pregnant women;all children aged two or three years old;children with certain long-term health conditions, aged six months to less than 18 years old;primary school aged children, from reception to Year 6;secondary school aged children, from Year 7 to Year 11;all children in clinical risk groups aged from six months to under 18 years old;everyone aged 65 years old and over;individuals aged 18 to under 65 years old with certain long-term health conditions;care home residents;carers in receipt of carer's allowance, or those who are the main carer of an elderly or disabled person; andthose living with people who are immunocompromised. Individuals, such as teachers, teaching assistants and school workers, who meet these criteria are eligible for a free NHS flu vaccine. Frontline health and social care workers can access the flu vaccine through their employer. Anyone who is unsure about their eligibility can consult their general practitioner, practice nurse, or pharmacist. Pregnant women can also consult their midwife. The NHS website contains further information on eligibility, and is avaiable at the following link: https://www.nhs.uk/vaccinations/flu-vaccine/

What steps are being taken to ensure that data on paediatric traumatic brain injury diagnoses is collected consistently across the NHS to support the development of the Acquired Brain Injury Action Plan.

Awaiting answer.

What assessment she has made of the potential impact for the Exchequer of VAT non-compliance by overseas sellers posing as UK businesses on online marketplaces.

HMRC’s best estimate is that in 2021/22 there was £150 million of overseas seller non-compliance occurring through online marketplaces as referenced by the National Audit Office report entitled ‘Tackling tax evasion in high street and online retail’ published in September 2024.

When she plans to publish the outcome of the review of the VAT Deemed Reseller rules announced in April 2025.

The Government has and will continue to engage with stakeholders to understand the impact of any changes to online marketplace liability rules on both platforms and sellers. Certified analysis by the Office for Budget Responsibility (OBR) estimates the current online marketplace liability rules, together with the abolishment of Low Value Consignment relief, will raise £1.8 billion per annum by 2026-27. HMRC has an overall compliance strategy which focuses on addressing all forms of non-compliance. The most recent published VAT gap shows a continued downward trend, falling from 13.7% to 5.4% between tax years 2005/06 and 2023/24.

What assessment has the Government has made of the potential impact that extending VAT Deemed Reseller rules to include UK sellers could have to closing the tax gap.

The Government has and will continue to engage with stakeholders to understand the impact of any changes to online marketplace liability rules on both platforms and sellers. Certified analysis by the Office for Budget Responsibility (OBR) estimates the current online marketplace liability rules, together with the abolishment of Low Value Consignment relief, will raise £1.8 billion per annum by 2026-27. HMRC has an overall compliance strategy which focuses on addressing all forms of non-compliance. The most recent published VAT gap shows a continued downward trend, falling from 13.7% to 5.4% between tax years 2005/06 and 2023/24.

What evaluation has been undertaken of access to specialist educational provision for children with acquired brain injuries; and whether additional support is planned for emerging specialist schools such as those in Stockton-on-Tees.

Children who have had a brain injury can be affected in different ways. Some brain injuries will result in a special educational need (SEN) or a medical need, whilst others may affect a child in other ways. In whatever way a brain injury manifests, it is essential that the pupil’s individual needs are identified and supported appropriately. Schools must make arrangements to support their pupils with medical conditions and must make reasonable adjustments to their practices, procedures and policies and not discriminate against their disabled pupils. The governing body should ensure that sufficient staff have received suitable training and are competent before they take on responsibility to support children with medical conditions. They should also ensure that any members of school staff who provide support to pupils with medical conditions, or those with SEN, are able to access information and other teaching support materials as needed. Mainstream schools must use their best endeavours to meet the special educational needs of their pupils, which includes those with acquired brain injury. Where needs are more complex the school may request the local authority to conduct an education, health and care needs assessment.

What steps are being taken to improve early identification of cognitive, behavioural, and emotional needs arising from acquired brain injury in children, particularly within school settings.

Children who have had a brain injury can be affected in different ways. Some brain injuries will result in a special educational need (SEN) or a medical need, whilst others may affect a child in other ways. In whatever way a brain injury manifests, it is essential that the pupil’s individual needs are identified and supported appropriately. Schools must make arrangements to support their pupils with medical conditions and must make reasonable adjustments to their practices, procedures and policies and not discriminate against their disabled pupils. The governing body should ensure that sufficient staff have received suitable training and are competent before they take on responsibility to support children with medical conditions. They should also ensure that any members of school staff who provide support to pupils with medical conditions, or those with SEN, are able to access information and other teaching support materials as needed. Mainstream schools must use their best endeavours to meet the special educational needs of their pupils, which includes those with acquired brain injury. Where needs are more complex the school may request the local authority to conduct an education, health and care needs assessment.