Written questions by Maskell.

What discussions she has had with the Secretary of State for Health and Social Care on the potential impact of fetal alcohol spectrum disorder on SEND provision.

The government is prioritising early, local support for families by strengthening family services and access to high quality early education for children with additional needs. Officials from the Department of Health and Social Care and the Department for Education are working together through the 10 Year Health Plan, Best Start Family Hubs, Healthy Babies and neighbourhood health. New clinical guidelines on alcohol treatment released in November includes guidance on supporting mothers to reduce alcohol use to improve maternal outcomes.

Whether his Department plans to issue guidance to Integrated Care Boards on commissioning speech and language therapy services for people with primary progressive aphasia.

The Government is committed to improving care for everyone with dementia, which is why we have funded the work of Dementia 100: Assessment Tool Pathway programme. This brings together multiple resources into a single, consolidated tool and will help simplify best practice. A number of experts, including those with expertise in speech and language therapy and dementia care, provided independent, desktop analysis of the tool and this invaluable feedback was integrated into the tool. The D100: Pathway Assessment Tool can be found at the following link:https://www.rcpsych.ac.uk/improving-care/nccmh/service-design-and-development/dementia-100-pathway-assessment-toolWe will also deliver the first ever Modern Service framework for Frailty and Dementia to deliver rapid and significant improvements in quality of care and productivity. This will be informed by phase one of the independent commission into adult social care, which is expected this year. The Frailty and Dementia Modern Service Framework will seek to reduce unwarranted variation and narrow inequality for those living with dementia and will set national standards for dementia care and redirect National Health Service priorities to provide the best possible care and support.We are committed to publishing an interim product in September this year to feed into NHS and local government planning cycles, and will aim to publish the full modern service framework by the end of this calendar year as recommended by Baroness Casey.

What steps his Department is taking to ensure access to speech and language therapy for people with primary progressive aphasia.

The provision of dementia health care services is the responsibility of local integrated care boards (ICBs) and may include speech and language therapy. We expect ICBs to commission services based on local population needs, taking account of National Institute for Health and Care Excellence guidelines.Patients can be referred to a speech and language therapist at any time after a diagnosis. The therapist will assess speech, language, and communication difficulties and how they are affecting the patient or making everyday life difficult. They can also help with eating, drinking, and swallowing difficulties.

What steps he is taking to ensure equal access to palliative care.

We know there are inequalities in access to palliative care and end of life care, and the Government is looking at how best to reduce these.Integrated care boards (ICBs) are responsible for the commissioning of palliative care and end of life care services, to meet the needs of their local populations. NHS England has published statutory guidance which outlines areas for consideration when commissioning services, which makes reference to improving equity of access and reducing inequity in outcomes and experience. This includes the completion of an Equalities and Health Inequalities Impact Assessment and action plan.NHS England has also developed a palliative care and end of life care dashboard, which brings together all relevant local data in one place. The dashboard helps commissioners understand the palliative care and end of life care needs of their local population, enabling ICBs to put plans in place to address and track the improvement of health inequalities.Additionally, the National Institute for Health and Care Research Policy Research Unit in Palliative and End of Life Care has been recently extended for a further two years to run to the end of 2028, delivering high-quality policy research to help improve palliative care and end-of-life care, and tackle inequalities.Through our Modern Service Framework on Palliative Care and End of Life Care, due for publication later this year, we will closely monitor the shift towards the strategic commissioning of palliative care and end-of-life care services to ensure that services reduce variation in access and quality.

What discussions he has had with ICBs on determining funding required to meet palliative care needs.

Integrated care boards (ICBs) are responsible for commissioning palliative care and end-of-life care services to meet the reasonable needs of their local populations, including hospice provision. To support ICBs in this duty, NHS England has published statutory guidance and service specifications.As set out in NHS England’s Strategic Commissioning Framework and Medium Term Planning Guidance, both published last year, ICBs are expected to understand current and projected total service utilisation and the associated costs for people at the end of life, create an overall plan to more effectively manage the needs of these high-priority cohorts, and significantly reduce avoidable unplanned admissions.Through the development of the Palliative Care and End of Life Care Modern Service Framework (MSF), the Department and NHS England are working with the sector to support ICBs to commission more strategically, including considering future contracting and commissioning arrangements. This shift aims to move away from grant-based and historic block contract models towards a more sustainable approach that ensures funding aligns with the needs identified by ICBs.

How he plans to deliver the MSF on Palliative Care.

The Government is developing a Palliative Care and End of Life Care Modern Service Framework (MSF) for England. We will publish an interim update in spring 2026, ahead of the full MSF in Autumn 2026.The MSF will drive improvements in the services that patients and their families receive at the end of life and enable integrated care boards to address challenges in access, quality and sustainability through the delivery of high-quality, personalised care. This will be aligned with the ambitions set out in the last year’s 10-Year Health Plan. Through our MSF, we will closely monitor the shift towards the strategic commissioning of palliative care and end-of-life care services to ensure that services reduce variation in access and quality.The MSF will put in place a clear and effective mechanism to deliver a fundamental improvement to the care provided. This will enable adoption of evidence-based interventions that are proven to make a difference to patients and their families. Examples include earlier identification of need, care delivered closer to home by integrated generalist and specialist teams, and strengthened out-of-hours community health support, including dedicated telephone advice.

How is he assessing the performance of ICBs and their delivery on population health.

The NHS Oversight Framework provides a consistent and transparent approach to assessing National Health Service organisations. The framework will be reviewed in 2026/27 to incorporate work to implement the NHS operating model and to take account of the ambitions and priorities in the 10-Year Health Plan. Further information is available at the following link:https://www.england.nhs.uk/nhs-oversight-framework/NHS England has a legal duty under the National Health Service Act 2006, as amended by the Health Service and Care Act, to undertake an annual performance assessment of each integrated board. Further information is available at the following link:https://www.england.nhs.uk/long-read/annual-assessment-of-integrated-care-boards-2024-25-supporting-guidance/The latest summary of assessments is available at the following link:https://www.england.nhs.uk/long-read/annual-assessment-of-integrated-care-board-performance-2024-25-summary-report/

Whether her Department has undertaken a review of the tuition fee-based funding model for higher education.

The government set out its plans for tuition fees as part of the Post-16 Education and Skills White Paper, published on 20 October 2025.To provide long-term certainty over future funding for the sector so that it can focus on reform, we will increase tuition fee caps for all higher education (HE) providers in line with forecast inflation in 2026/27 and 2027/28 and then legislate when parliamentary time allows to increase tuition fee caps automatically for future academic years.Maximum fee limits for undergraduate courses in the 2026/27 and 2027/28 academic years will increase by forecast inflation of 2.71% (to £9,790) and 2.68% (to £10,050) respectively, based on the retail price index (exclusive of mortgage interest payments).In future years, we will link inflationary fee uplifts to judgements on HE providers’ quality and restrict fee income where high quality cannot be demonstrated.

What discussions she has had with Vice Chancellors on the impact of Government policy on university finances.

Higher education (HE) providers are independent from government and as such are responsible for managing their finances and ensuring their business models provide long-term sustainability.However, this government is committed to helping put the HE sector on a secure financial footing so that it can face the challenges of the next decade. Our decision to raise tuition fees annually in line with inflation, alongside refocusing the Office for Students (OfS) on monitoring the sector’s financial health, demonstrates this commitment.Although the OfS is responsible for monitoring the sector’s financial sustainability, the government has a strong interest in understanding the sector’s level of risk. My department continues to engage closely with the OfS, other government departments and sector representative groups, as well as individual providers, to better understand the changing financial landscape.

Whether there is a mechanism in place for Integrated Care Boards to respond to correspondence from Members of Parliament.

Integrated care boards (ICBs) are statutory bodies as established under the NHS Act 2006 amended by the Health and Care Act 2022. As such they must follow their own internal governance, accountability, and decision-making requirements. How ICBs follow these requirements when replying to correspondence is managed by the ICB.

What criteria is being used to determine the replacement for the Carr-Hill funding formula.

The first phase of the Carr-Hill review is expected to conclude in March 2026. Subject to ministerial decision, further work would be undertaken to technically develop and model any proposed changes to the formula. Findings from the review will be published in due course by the National Institute for Health and Care Research. Members of Parliament will be updated once the review findings are available.Implementation of any new funding approach would be subject to ministerial decision and consultation with the General Practice Committee for England of the British Medical Association, in the context of the available funding and our commitment to substantively reform the General Medical Services Contract within this Parliament.

What public funding has been allocated to union-led workplace learning in each of the past five years.

I refer the Hon. Member to the answer I gave on 13 March 2026 to Question UIN 117323.

How will GPs identify and refer patients for palliative care following the retiring of the Palliative Care Register.

In 2025/26, the Quality and Outcomes Framework incentive payment for maintaining a palliative care register was retired, meaning general practices (GPs) no longer receive a payment for this activity. However, the use of palliative care registers did not cease, with GPs still able to actively maintain and use their register as part of good clinical practice, including proactive identification, personalised care, and support planning and ongoing reviews.Early identification of someone who has palliative and end-of-life care needs is vital. There are tools to aid clinicians in identifying those approaching the end of life, for example the Supportive and Palliative Care Indicators Tool and the EARLY toolkit, which are available, respectively, at the following two links: https://www.spict.org.uk/the-spict/ https://www.england.nhs.uk/north-west/north-west-coast-strategic-clinical-networks/our-networks/palliative-and-end-of-life-care/for-professionals/early-toolkit-for-primary-care/ The number of people identified as having palliative care and end-of-life care needs has risen, from 290,433 in 2022/23 to 356,543 in 2024/25. Timely and equitable identification of palliative care and end-of-life care needs will be a key element of our Palliative Care and End-of-Life Care Modern Service Framework (MSF). NHS England and the Department are working closely with a wide range of stakeholders on the development of the MSF, looking at how we can enable more proactive assessment of palliative care need and subsequent access to services and personalised care and support, including advance care planning.

What steps he is taking to ensure that patients are referred early for assessments for palliative care.

In 2025/26, the Quality and Outcomes Framework incentive payment for maintaining a palliative care register was retired, meaning general practices (GPs) no longer receive a payment for this activity. However, the use of palliative care registers did not cease, with GPs still able to actively maintain and use their register as part of good clinical practice, including proactive identification, personalised care, and support planning and ongoing reviews.Early identification of someone who has palliative and end-of-life care needs is vital. There are tools to aid clinicians in identifying those approaching the end of life, for example the Supportive and Palliative Care Indicators Tool and the EARLY toolkit, which are available, respectively, at the following two links: https://www.spict.org.uk/the-spict/ https://www.england.nhs.uk/north-west/north-west-coast-strategic-clinical-networks/our-networks/palliative-and-end-of-life-care/for-professionals/early-toolkit-for-primary-care/ The number of people identified as having palliative care and end-of-life care needs has risen, from 290,433 in 2022/23 to 356,543 in 2024/25. Timely and equitable identification of palliative care and end-of-life care needs will be a key element of our Palliative Care and End-of-Life Care Modern Service Framework (MSF). NHS England and the Department are working closely with a wide range of stakeholders on the development of the MSF, looking at how we can enable more proactive assessment of palliative care need and subsequent access to services and personalised care and support, including advance care planning.

What was the number of redundancies announced in higher education over the past year.

I refer my hon. Friend, the Member for York Central to the answer of 11 March 2026 to Question 117322.

Whether the NHS Workforce Plan will include clinicians required for Palliative Medicine in (a) acute, (b) community and (c) hospice settings.

The 10 Year Workforce Plan will set out action to create a workforce ready to deliver the transformed service set out in the 10-Year Health Plan. This includes shifting care from hospitals to community settings. We are working through how the plan will articulate the changes for different professional groups.The scope of the 10 Year Workforce Plan is the National Health Service workforce. However, we know that for this shift to be meaningful, multi-disciplinary working and effective integration will be vital for many services, including palliative care.

If she will review the financial situation of Higher Education institutions.

Higher education (HE) providers are independent from government and as such are responsible for managing their finances and ensuring their business models provide long-term sustainability.However, this government is committed to helping put the HE sector on a secure financial footing so that it can face the challenges of the next decade. Our decision to raise tuition fees annually in line with inflation, alongside refocusing the Office for Students (OfS) on monitoring the sector’s financial health, demonstrates this commitment.Although the OfS is responsible for monitoring the sector’s financial sustainability, the government has a strong interest in understanding the sector’s level of risk. My department continues to engage closely with the OfS, other government departments and sector representative groups, as well as individual providers, to better understand the changing financial landscape.

If he will make an estimate of the costs involved in maintaining the building and grounds of Bootham Park Hospital.

Bootham Park Hospital site is a Grade I listed heritage asset and therefore requires significant ongoing management. The costs associated with maintaining the buildings and grounds have been £5.5 million since 2018, which covers maintenance, security, and insurance across the site, as well as the upkeep of areas that remain operational, including the chapel used by the York and Scarborough Teaching Hospitals NHS Foundation Trust, and the work required to maintain safe public access through parts of the site. NHS Property Services continues to progress plans to sell the site, which would bring these ongoing holding costs to an end.

What assessment she has made of the potential impact of her Department's immigration criteria on the number of international students attending universities in (a) the UK and (b) York.

The new International Education Strategy reflects the positive impact of international students. It confirms our continued commitment to welcoming students who meet the requirements to study in the UK.The system must, however, ensure that international students make a positive contribution to the communities in which they study. The ‘Restoring control over the immigration system’ White Paper contains measures that will achieve a reduction in net migration, whilst maintaining the UK’s globally competitive position and boosting our skills base.The department expects the UK to remain an attractive study destination. The most recent data shows that applications from Sponsored Study visa main applicants in the year ending January 2026 were 2 per cent higher than the previous year. The data is available at: https://www.gov.uk/government/statistics/monthly-entry-clearance-visa-applications-january-2026/monthly-entry-clearance-visa-applications-january-2026.Whilst we recognise international students’ value, reliance on international fee income is a risk to some providers' income. HE providers must ensure their business models provide long-term sustainability.

What recent estimate she has made of the financial return to the UK economy of public investment in higher education.

Graduates make a significant economic and financial contribution to the UK economy. A report commissioned by Universities UK and published in 2024 suggests that the UK higher education sector contributes around £265 billion to the UK economy and that every £1 of public funding invested in the sector’s teaching activities generated a total of some £13 in wider economic impact across the UK.The Universities UK commissioned report can be found here: https://www.universitiesuk.ac.uk/sites/default/files/field/downloads/2024-09/LE-UUK-Impact-of-university-TL-and-RI-Final-Report.pdf.