Written questions by Welsh.

What assessment his Department has made of the potential impact of the price increase of mounjaro on people accessing weight loss medication.

As we shift the focus from treatment to prevention through our 10 Year Health Plan, we are determined to bring revolutionary modern treatments to everyone who needs them, not just those who can afford to pay.NHS England has worked with Eli Lilly to ensure that the list price increase will not affect National Health Service commissioning of tirzepatide in England as a treatment for eligible patients, and we remain committed to the rollout of this medicine as a weight loss treatment based on clinical priority. This will enable 220,000 eligible people to access the medication over the first three years. Not everyone who wants tirzepatide will be able to access it at first, and the initial eligibility criteria will be for people with a body mass index of 40 or more in addition to four or more qualifying comorbidities.Scotland, Wales, and Northern Ireland have also entered equivalent agreements to maintain their current commissioning approaches.Pricing in the private market is a matter for Eli Lilly and for private providers. Private patients who are impacted by price increases should discuss any concerns with their private provider. This includes their options regarding payment plans, alternative treatments, and/or stopping or tapering off their current medication. Eli Lilly is working with private providers to support continued patient access.

What steps his Department is taking to ensure that tirzepatide remains at an affordable rate for people not prescribed the medication through the NHS.

As we shift the focus from treatment to prevention through our 10 Year Health Plan, we are determined to bring revolutionary modern treatments to everyone who needs them, not just those who can afford to pay.NHS England has worked with Eli Lilly to ensure that the list price increase will not affect National Health Service commissioning of tirzepatide in England as a treatment for eligible patients, and we remain committed to the rollout of this medicine as a weight loss treatment based on clinical priority. This will enable 220,000 eligible people to access the medication over the first three years. Not everyone who wants tirzepatide will be able to access it at first, and the initial eligibility criteria will be for people with a body mass index of 40 or more in addition to four or more qualifying comorbidities.Scotland, Wales, and Northern Ireland have also entered equivalent agreements to maintain their current commissioning approaches.Pricing in the private market is a matter for Eli Lilly and for private providers. Private patients who are impacted by price increases should discuss any concerns with their private provider. This includes their options regarding payment plans, alternative treatments, and/or stopping or tapering off their current medication. Eli Lilly is working with private providers to support continued patient access.

What assessment his Department has made of the adequacy of access to hearing services in rural areas.

NHS audiology services are locally commissioned, and the responsibility for prioritising primary care audiology lies with local NHS Service Commissioners. NHS England is supporting the integrated care boards (ICBs) to make informed decisions about the provision of audiology services so that they can provide consistent, high quality, and integrated care.

What steps his Department is taking to reduce waiting lists for (a) appointments and (b) assessments for hearing services.

Cutting elective care waiting times, including for hearing services, is a key priority for this government. We have now exceeded our pledge to deliver an extra 2 million operations, scans, and appointments, having now delivered 4.6 million additional appointments.We are committed to transforming diagnostic services and will support the NHS to increase capacity to meet the demand, including for audiology services such as hearing tests. Our Elective Reform Plan commits to transform and expand diagnostic services and speed up waiting times for tests.NHS England is supporting provider organisations and integrated care boards (ICBs) who are the commissioners of audiology services to improve performance and reduce waiting lists for appointments and assessments for hearing services. This includes capital investment to upgrade audiology facilities in NHS Trusts, expanding audiology testing capacity via Community Diagnostic Centres, and direct support through a national audiology improvement collaborative.

Whether he has made an assessment of the potential merits of introducing a cap on the amount of self-funding for care payable by any person.

The Government inherited a commitment to implement charging reforms in October 2025, including a cap on personal care costs. Regrettably, funding for these reforms had not been guaranteed, preparations for full rollout were not on track, and thus it was impossible to deliver these reforms by October.This Government remains committed to reforming the adult social care sector and we have launched an independent commission into adult social care as part of our critical first steps towards delivering a National Care Service. The Terms of Reference are sufficiently broad to enable Baroness Casey to independently consider how to build a social care system fit for the future, including considering the affordability of care costs if she sees fit.

What steps his Department is taking to improve support for people leaving hospital and moving to a care home.

The statutory hospital discharge guidance sets out that people leaving hospital, including those who will be moving to a care home, should be supported throughout the discharge process and post discharge. The discharge process should be person-centred, strengths based, and driven by choice, dignity, and respect. Individuals should be supported to make fully informed decisions, in conjunction with their wider family or unpaid carers.Local areas should have agreed protocols for collaborating with onward care providers regarding the individual’s hospital discharge through care transfer hubs, including agreed pathways for raising and resolving any concerns post-discharge.In 2025/26, there is £9 billion available through the Better Care Fund. Integrated care boards and local authorities should jointly plan how to use this funding to meet local health and care needs, including after discharge.

What steps her Department is taking to reduce the backlog of driving tests in Sherwood Forest constituency.

The Driver and Vehicle Standards Agency’s (DVSA) main priority is upholding road safety standards while it works hard to reduce car practical driving test waiting times.On the 23 April, the Secretary of State for Transport appeared before the Transport Select Committee and announced that DVSA will take further actions to reduce waiting times for all customers across Great Britain.Further information on these actions and progress of DVSA’s plan to reduce driving test waiting times, which was announced in December 2024, can be found on GOV.UK. From previous recruitment campaigns for driving test centres that serve the Sherwood Forest constituency, three new driving examiners (DE) have completed their training and are now conducting tests. One at Ashfield and two at Nottingham (Colwick) DTCs.From recent recruitment campaigns, a potential DE is currently undertaking training for Ashfield DTC. DVSA has also made offers to eight potential DEs, two for Ashfield, three for Worksop and three for Nottingham (Colwick) who will start their training at the earliest opportunity.DVSA will be undertaking another recruitment campaign and will again advertise for posts in the local area.

What assessment his Department has made of the potential merits of increasing training opportunities for manufacturers (a) installing and (b) maintaining biomass heating products.

The Government takes a proactive role in developing the skills base needed for the transition to low carbon heating, through the provision of targeted support in line with workforce requirements. Commercially available training opportunities exist for those involved in the installation and/or maintenance of biomass heating products and the government continues to work with industry stakeholders to monitor the efficacy of these provisions.

Food and Rural Affairs, what steps his Department is taking to tackle littering; and whether his Department has made an assessment of the potential merits of encouraging companies to increase (a) customer education on littering and (b) development of biodegradable packing.

Litter is a blight on our communities and the environment. Local councils are responsible for keeping streets clear of litter and have been given enforcement powers to help them do so. The Government is targeting some of the most commonly littered items to reduce the presence of these on our streets. The sale of single-use vapes was banned on 1 June and a Deposit Return Scheme (DRS) will go live in England, Northern Ireland, and Scotland in October 2027. The DRS will introduce a redeemable deposit on single-use in-scope drinks containers which can be redeemed when the empty container is returned. Litter composition data indicates that 55% of litter by volume is made up of containers in-scope of DRS. DRS will significantly reduce this form of litter. The UK is a leading voice in the negotiations for a new international, legally binding treaty on plastic pollution and has taken an ambitious stance at all sessions of the Intergovernmental Negotiating Committee (INC). We have called for an agreement that addresses the full lifecycle of plastics, in order to end plastic pollution by 2040. The UK will continue to work with other countries, including as a member of the High Ambition Coalition to End Plastic Pollution, to reach an ambitious agreement at the resumed session in August 2025. We have not made an assessment of the potential merits of encouraging companies to increase customer education on littering or on developing more biodegradable packaging. We remain concerned that many types of plastic labelled as biodegradable do not actually break down in the natural environment, and that people may be more likely to litter these items.

Whether her Department has considered the potential merits of using income from tax obtained by the sale of (a) tobacco, (b) alcohol and (c) gambling on prevention education.

The allocations of all revenues received by the Government are decided in the round alongside broader fiscal and economic objectives. Widespread hypothecation of tax revenues can undermine the Government’s ability to flexibly manage the public finances.

What assessment her Department has made of the potential impact of changes to Inheritance Tax on the Valuation Office Agency’s processing of cases; and whether her Department plans to take steps to help mitigate any increase in demand.

Inheritance Tax (IHT) is the responsibility of HMRC. In matters involving the valuation of land and buildings, HMRC will refer cases to the Valuation Office Agency (VOA) for a specialist view. HMRC decides whether to refer particular property valuation cases to VOA. Any changes in demand are managed by HMRC and VOA’s existing joint governance groups, which oversee volumes of referrals to VOA across IHT and all other heads of tax. On 28 April 2025, the government announced that VOA’s functions will be brought into HMRC by the end of this financial year. This will combine the expertise and experience of both organisations in policy, valuations and programme delivery to support government to deliver change more quickly and effectively, including forthcoming policy changes to IHT.

What assessment her Department has made of the potential impact of the transition to an online- only application process for the Blue Badge scheme has made on (a) neurodiverse people and (b) people with disabilities.

The Government has no current plans to make Blue Badge applications online-only. For online applications, the Department for Transport works continuously to improve online badge applications so they are quicker and easier for applicants. This includes undertaking specific research and testing to identify innovative improvements to the online application process. The service also undergoes regular accessibility and assurance testing to guarantee compliance with the Government’s digital standards.

What assessment she has made of the potential impact of the proposed increase in employer National Insurance contributions on early years providers.

A Tax Information and Impact Note (TIIN) was published alongside the introduction of the Bill containing the changes to employer NICs. The TIIN sets out the impact of the policy on the exchequer, the economic impacts of the policy, and the impacts on individuals, businesses, and civil society organisations, as well as an overview of the equality impacts.Early years providers play a crucial role in driving economic growth. The Government has committed to delivering the expansion of government-funded childcare and opening 3,000 new school-based nurseries in this parliament. At the Budget, the Chancellor announced that total funding will rise to over £8 billion in 2025-26 to support providers. On top of this, the Department for Education confirmed an additional £75 million of funding in 2025-26 to support the sector deliver the final phase of expanded childcare entitlements from September 2025. Alongside this, rates for the early years pupil premium have also been increased by over 45%, equivalent to up to £570 per eligible child per year.

What steps his Department is taking to tackle the NHS backlog for ADHD assessments in (a) Sherwood Forest and (b) Nottinghamshire.

It is the responsibility of integrated care boards (ICBs) in England to make available appropriate provision to meet the health and care needs of their local population, including assessments for attention deficit hyperactivity disorder (ADHD), in line with relevant National Institute for Health and Care Excellence guidelines.NHS England has established an ADHD taskforce which is working to bring together those with lived experience with experts from the National Health Service, education, charity, and justice sectors. The taskforce is working to get a better understanding of the challenges affecting those with ADHD, including timely and equitable access to services and support, with the final report expected in the summer.In conjunction with the taskforce, NHS England has carried out detailed work to develop an ADHD data improvement plan to inform future service planning. NHS England has also conducted detailed work to understand the provider and commissioning landscape, capturing examples from ICBs who are trialling innovative ways of delivering ADHD services. NHS England is using this information to support systems to tackle ADHD waiting lists and provide support to address people’s needs.The Nottingham and Nottinghamshire ICB advises that it is working with Nottinghamshire Healthcare NHS Foundation Trust to review current waiting lists and develop an improvement plan to reduce waiting times. These improvements include streamlining the referral, triage and assessment processes and improving data quality. The current service pathway has been reviewed and options for improvement have been developed, these are being progressed locally during 2025 and aim to improve the pathway, including pre-assessment and post-assessment support.

If his Department will make an assessment of the potential merits of extending the eligibility criteria for the covid-19 vaccination from Autumn 2025 to include people with severe lung conditions.

The independent Joint Committee for Vaccination and Immunisation (JCVI) advises the Department on the approach to vaccination and immunisation programmes. The primary aim of the national COVID-19 vaccination programme remains the prevention of severe illness, involving hospitalisations and deaths, arising from COVID-19. On 13 November 2024, the JCVI published advice on the COVID-19 vaccination programme, covering vaccination in 2025 and spring 2026. This advice is available at the following link:https://www.gov.uk/government/publications/covid-19-vaccination-in-2025-and-spring-2026-jcvi-advice/jcvi-statement-on-covid-19-vaccination-in-2025-and-spring-2026The Government is considering the JCVI’s advice for autumn 2025 carefully, and will respond in due course.

If she will make an assessment of the potential merits of assessing money received from the settlement of an estate claim to be treated in line with money received from a (a) personal injury claim and (b) special compensation scheme settlement for cases related to (i) maternity and (ii) death of a baby for the purposes of Universal Credit entitlements.

We have no plans to change the Universal Credit capital rules to disregard the settlement payments from estates for cases related to (i) maternity and (ii) death of a baby for the purposes of Universal Credit entitlements.

What steps her Department is taking to help tackle illegal off road biking in Sherwood Forest constituency.

Tackling anti-social behaviour is a top priority for this Government and a key part of our Safer Streets Mission.On 27 November 2024, the Government announced proposals to give the police greater powers to clamp down on off-road bikes and other vehicles involved in anti-social behaviour, with officers no longer required to issue a warning before seizing vehicles.This will allow the police to quickly remove anti-social vehicles which are bringing misery to city centres and pedestrian areas. These powers will be included in the forthcoming Crime and Policing Bill.

What steps his Department is taking to improve safety within maternity services.

The Government continues to work with the National Health Service as it delivers its three-year plan for maternity and neonatal services. The plan sets out how the NHS will make maternity and neonatal care safer, more personalised, and more equitable for women, babies, and families.As part of the delivery plan, an updated version of the ‘Saving Babies Lives Care Bundle’ is being rolled out across England, which is a package of interventions aimed to reduce stillbirths, neonatal brain injury, neonatal death, and preterm birth, as well as initiatives to reduce inequalities. Additionally, 14 Maternal Medicine Networks have been developed across England to ensure that women with chronic and acute medical problems related to pregnancy have access to specialist management and care.Additional funding has also been provided for Maternity and Neonatal Voice Partnerships to ensure local voices are used to inform decisions and services. All local leadership teams are taking part in a Perinatal Culture and Leadership Programme, helping them to develop and maintain a positive safety culture.The Government is also currently piloting a training programme to help avoid brain injury in childbirth to improve safety for mothers and their babies. If successful, national rollout is expected to commence this year.While good progress has been made, the Government recognises that there are real issues within maternity services. Whilst change will not happen overnight, we are determined to go further to ensure all women and babies receive the care they deserve, and we have committed to providing support to trusts failing on maternity care, recruit thousands of new midwives, and tackle the unacceptable inequalities that exist.

Whether he has made an assessment of the potential merits of bringing forward legislation to end male primogeniture for baronetage.

The Government recognises that baronetcies, like other hereditary titles, can usually only be inherited by male heirs. However, the Government is prioritising on delivering its manifesto commitments, including reform of the House of Lords.

Whether her Department has made an assessment on the potential merits of extending eligibility for the zero-rate VAT for charities to include flood defence equipment.

To protect the country from the devastating impacts of flooding, the Government has committed £2.4 billion over the next two years to improve flood resilience by maintaining, repairing and building flood defences. Through this funding the Government provides direct support to communities facing flooding, and therefore we have no plans to change the VAT treatment of flood defence equipment for charities. VAT is a broad-based tax on consumption and the 20 per cent standard rate applies to most goods and services. VAT is the UK’s second largest tax forecast to raise £171 billion in 2024/25. Taxation is a vital source of revenue that helps to fund vital public services including schools and hospitals.