Written questions by Paul.

What steps he is taking with Cabinet colleagues to help ensure that UK public bodies in Scotland implement the For Women Scotland Ltd v The Scottish Ministers Supreme Court judgment.

The Equality and Human Rights Commission has shared its updated draft statutory code of Practice for Services, Public Functions and Associations with my Right Honourable Friend, the Minister for Women and Equalities. She will consider it fully and make a decision in due course. It is important we take the time to get this right. The Code of Practice will apply to service providers, public bodies and associations across Great Britain. It is for the Scottish Government, of course, to ensure that its own public bodies comply with their legal obligations under the Equality Act 2010.

What criteria his Department uses to determine placement of transgender young people within the Children and Young People's Estate.

I refer the hon. Member to the answer I gave on 4 November 2025 to Question 85613.

How many sexual assaults of female prisoners by biologically male prisoners took place in HMP Downview in (a) 2016, (b) 2017, (c) 2018 and (d) 2019.

There were no recorded sexual assaults of female prisoners by biologically male prisoners at HMP & YOI Downview, during the specified periods.

What decisions his Department has made on the (a) scope and (b) timeline of the review of transgender prisoner policy following the Supreme Court judgment in For Women Scotland Ltd v The Scottish Ministers.

We are reviewing transgender prisoner policy following the For Women Scotland Supreme Court ruling. Alongside this, the Office for Equality and Opportunity is currently reviewing the Equality and Human Rights Commission’s draft updated Code of Practice on single sex spaces.If the Code is approved, it will be laid before Parliament in due course. We are working closely with the Office for Equality and Opportunity on this, and will come forward with our updated policy on transgender prisoners once this process has concluded.

What recent steps his Department has taken to ensure (a) equality of access to and (b) quality of healthcare provision across the (i) women’s and (ii) Children and Young People's estate.

To improve health and social care outcomes for all women in prison and upon their release, NHS England and His Majesty’s Prison and Probation Service commissioned the National Women’s Prisons Health and Social Care Review. The review’s report identified a number of recommendations to improve equity and quality of care to meet the specific needs of women in prison.A wide range of actions to implement these recommendations are taking place at establishment, regional, and national levels, backed by £21 million across three years, and overseen by the Joint Women's Prison Health and Social Care Review Implementation Programme Board.The health issues facing those detained in the children and young people secure estate are systematically kept under review through regular health and wellbeing needs assessments and the Healthcare Standards for Children and Young People in Secure Settings.The Framework for Integrated Care operates in the children and young people secure estate as a coherent structure for a comprehensive, trauma-informed system of care that focuses on individualised care rather than on separate labels, diagnoses, or interventions.NHS England has also commissioned the three-year Benchmarking Project, aimed at assessing and supporting the implementation of the Healthcare Standards for Children and Young People in Secure Settings.Further work is underway to identify where the existing pathway in the children and young people secure estate requires enhancement to better support the placement, management, and care of all girls in secure settings. This work will be informed by evidence and best practice and will be developed with experts to test the most appropriate model of care.

What the average waiting time is for routine mental health appointments across the prison estate in England.

The information requested is not held centrally. As part of the formal prisoner induction process, all prisoners undergo health screening that incorporates a mental health assessment. The secondary care mental health assessment is carried out by a mental health professional. Routine assessments are carried out within five working days. Where an individual is in a state of mental health crisis, presents with rapidly escalating needs, or is at risk of immediate harm to themselves or others, an urgent assessment should be undertaken within 48 hours.

Whether his Department has identified service gaps in the provision of primary care, mental health, dentistry and substance misuse services at HMP/YOI Downview.

Primary care, mental health, dentistry, and substance misuse services at HMP/YOI Downview are delivered under the national specification for integrated healthcare. As part of the commissioning monitoring processes outlined in the NHS Strategic Commissioning Framework, which covers all National Health Service commissioned services, including health and justice, providers are measured against the mandatory performance indicators within the national specification and any potential inconsistencies in service delivery are identified. Independent processes are also embedded within service delivery monitoring. These include annual healthcare needs assessments, equality impact assessments, Independent Monitoring Board reports, Care Quality Commission reports and inspections, and user experience consultations. An annual user experience has also been carried out across all prisons in the South East.

What recent assessment her Department has made of the potential merit of allowing nannies to offer funded hours under the Free Childcare for Working Parents programme.

It is the government’s ambition that all families have access to high-quality, affordable and flexible early education and care, giving every child the best start in life and delivering on our Plan for Change. Nannies are an unregulated part of the sector because they are employed by parents to provide care to children in their home. Parents alone are responsible for deciding the services that a nanny provides, which may or may not include early education. Parents also arrange the payment of income tax and National Insurance contributions and organise security checks for those that they employ. For this reason, successive governments have not engaged in private arrangements between the two parties. Officials remain in touch with the National Nanny Association and we keep all such policies under review.

What assessment his Department has made of the potential impact of the requirement to obtain a medical exemption certificate before being eligible to claim free prescriptions on people with chronic illnesses.

The Department has made no assessment.The exemption certificate provides the patient with evidence to demonstrate to dispensers that they are entitled to have the National Health Service cover the cost of their prescriptions. The exemption certificate requirement also allows for the verification of claims for exemption, and for fraud to be identified and pursued.It is straightforward to apply for a medical exemption certificate; the patient should ask their doctor for form FP92A. The form includes guidance on how to complete it and who can authorise it. A healthcare professional (HCP), e.g. a hospital doctor or general practitioner (GP), or at the GP’s discretion a member of the GP’s practice who can access medical records, must authorise the application to confirm the patient has the qualifying condition. If a patient is unable to complete the form themselves then a relative or HCP can complete it on their behalf and insert their name in the signature box.

What assessment his Department has made of the effectiveness of issuing penalty charge notices as a deterrent against improper claims of free NHS prescriptions.

From November 2024 to October 2025, the NHS Business Service Authority issued 47,058 penalty charge notices (PCNs) to people who claimed a medical exemption but were found to have no exemption in place when checked. Of these, 21,328 were eased, for various reasons including the patient subsequently applying for an exemption successfully. The number of easements in this category cannot be confirmed. Of the 47,058 PCNs issued 3,583 people received multiple PCNs.Although the Department has made no formal assessment of the effectiveness of issuing PCNs as a deterrent against improper claims, the fact that the vast majority who receive one PCN do not go on to receive another would, in my opinion, suggest a potential deterrent effect.

How many NHS penalty charges for incorrectly claimed free prescriptions have been issued to individuals who qualified for but did not hold NHS medical exemption certificates in the last 12 months.

From November 2024 to October 2025, the NHS Business Service Authority issued 47,058 penalty charge notices (PCNs) to people who claimed a medical exemption but were found to have no exemption in place when checked. Of these, 21,328 were eased, for various reasons including the patient subsequently applying for an exemption successfully. The number of easements in this category cannot be confirmed. Of the 47,058 PCNs issued 3,583 people received multiple PCNs.Although the Department has made no formal assessment of the effectiveness of issuing PCNs as a deterrent against improper claims, the fact that the vast majority who receive one PCN do not go on to receive another would, in my opinion, suggest a potential deterrent effect.

With reference to page 8 of the Independent Monitoring Board's report entitled Annual report of the Independent Monitoring Board at HMP/YOI Downview, published on 3 September 2025, when he plans to respond to the questions on the main areas for development.

My noble friend Lord Timpson wrote to the Chair of the IMB on 27 October 2025, setting out the Ministry of Justice’s response to the report. It can be accessed at: Downview 2024-25 annual report - ministerial response - Independent Monitoring Boards.

Whether he has had discussions with (a) Surrey County Council and (b) Surrey Police on child safeguarding following the conviction of Stephen Ireland.

Child sexual abuse is an abhorrent crime that no child should ever have to endure. We recognise the lifelong impact it can have on victims and survivors and remain committed to strengthening our response to this abuse.The department holds regular meetings with Surrey County Council to discuss a wide range of topics including child protection and safeguarding. While we do not comment on if individual cases have been raised, we are aware of the serious concerns raised following the conviction of Stephen Ireland and continue to work closely with local authorities to ensure robust safeguarding practices are in place.In addition, the government published its progress update on tackling child sexual abuse on 9 April, which responds to the 20 recommendations from the final report of the Independent Inquiry into Child Sexual Abuse. Work is underway on several key recommendations, including legislating for mandatory reporting and establishing a child protection authority with a consultation set to be published before the end of 2025.

How many sexual assaults of female prisoners by biological male prisoners have taken place in HMP Downview in (a) 2023, (b) 2024 and (c) 2025.

Prisoners on E Wing are held separately from other prisoners at HMP & YOI Downview. They may only access the regime of the wider prison if risk assessed as being safe to do so, and under the supervision of prison staff.Transgender prisoners at all prisons are subject to local risk management arrangements. These are determined by the establishment and take into account risks that may be posed by the prisoner and risks they may face from other prisoners. Since policy was strengthened in 2019, there have been no sexual assaults committed by transgender women in women’s prisons.With regard to the changes to supervision noted in the Independent Monitoring Board’s Annual Report: E wing prisoners continue to be subject to supervision at all times. Following individual risk assessments carried out by the prison, it was determined that additional prison officer supervision was not necessary to manage risk in each case.In contrast with the adult estate, the Children and Young People Estate includes mixed gender settings. Placement decisions are based on the young person’s identified needs and the risks they may present to themselves and others at the time of placement. Young people who have been identified as transgender will normally be placed in a mixed gender setting, where staff are skilled at safeguarding and supervising boys and girls in the same establishment. If a transgender young person identifying as a girl were assessed as being too high risk for management in a mixed gender setting, that young person would be placed in a male-only part of the estate, where their transgender needs would be supported. A transgender young person identifying as a boy would only be placed in a mixed gender site, not in a male-only establishment.A review of transgender prisoner policy in the light of the Supreme Court ruling in For Women Scotland Ltd vs. The Scottish Ministers is in progress.

With reference to the Independent Monitoring Board's report entitled Annual report of the Independent Monitoring Board at HMP/YOI Downview, published on 3 September 2025, what steps he is taking to safeguard biological female prisoners where biological male prisoners are not subject to constant sight and sound supervision by a dedicated prison officer on a one to one basis during shared activities at (a) HMP/YOI Downview and (b) other prisons and (c) other young offenders institutions; and what guidance he intends to issue on this matter.

Prisoners on E Wing are held separately from other prisoners at HMP & YOI Downview. They may only access the regime of the wider prison if risk assessed as being safe to do so, and under the supervision of prison staff.Transgender prisoners at all prisons are subject to local risk management arrangements. These are determined by the establishment and take into account risks that may be posed by the prisoner and risks they may face from other prisoners. Since policy was strengthened in 2019, there have been no sexual assaults committed by transgender women in women’s prisons.With regard to the changes to supervision noted in the Independent Monitoring Board’s Annual Report: E wing prisoners continue to be subject to supervision at all times. Following individual risk assessments carried out by the prison, it was determined that additional prison officer supervision was not necessary to manage risk in each case.In contrast with the adult estate, the Children and Young People Estate includes mixed gender settings. Placement decisions are based on the young person’s identified needs and the risks they may present to themselves and others at the time of placement. Young people who have been identified as transgender will normally be placed in a mixed gender setting, where staff are skilled at safeguarding and supervising boys and girls in the same establishment. If a transgender young person identifying as a girl were assessed as being too high risk for management in a mixed gender setting, that young person would be placed in a male-only part of the estate, where their transgender needs would be supported. A transgender young person identifying as a boy would only be placed in a mixed gender site, not in a male-only establishment.A review of transgender prisoner policy in the light of the Supreme Court ruling in For Women Scotland Ltd vs. The Scottish Ministers is in progress.

With reference to the HMPPS Offender Equalities Annual Report 2022-2023, published on 30 November 2023, how many of the 225 transgender prisoners who reported their legal gender as male were convicted of a sexual offence.

Of the 225 transgender prisoners who reported their legal gender as male, 126 had been convicted of a sexual offence: this includes both contact and non-contact sexual offences. Offence data were not available for ten individuals.HMPPS’s allocation policy is under review following the Supreme Court judgment in For Women Scotland Ltd vs. The Scottish Ministers. The policy will be updated to take account of this in due course.

What information his Department holds on whether any female prisoners held at HMP Downview have been sexually assaulted by biological male prisoners.

Prisoners on E Wing are held separately from other prisoners at HMP & YOI Downview. They may only access the regime of the wider prison if risk assessed as being safe to do so, and under the supervision of prison staff.Transgender prisoners at all prisons are subject to local risk management arrangements. These are determined by the establishment and take into account risks that may be posed by the prisoner and risks they may face from other prisoners. Since policy was strengthened in 2019, there have been no sexual assaults committed by transgender women in women’s prisons.With regard to the changes to supervision noted in the Independent Monitoring Board’s Annual Report: E wing prisoners continue to be subject to supervision at all times. Following individual risk assessments carried out by the prison, it was determined that additional prison officer supervision was not necessary to manage risk in each case.In contrast with the adult estate, the Children and Young People Estate includes mixed gender settings. Placement decisions are based on the young person’s identified needs and the risks they may present to themselves and others at the time of placement. Young people who have been identified as transgender will normally be placed in a mixed gender setting, where staff are skilled at safeguarding and supervising boys and girls in the same establishment. If a transgender young person identifying as a girl were assessed as being too high risk for management in a mixed gender setting, that young person would be placed in a male-only part of the estate, where their transgender needs would be supported. A transgender young person identifying as a boy would only be placed in a mixed gender site, not in a male-only establishment.A review of transgender prisoner policy in the light of the Supreme Court ruling in For Women Scotland Ltd vs. The Scottish Ministers is in progress.

With reference to the Independent Monitoring Board's report entitled Annual report of the Independent Monitoring Board at HMP/YOI Downview, published on 3 September 2025, what steps he is taking to ensure acutely mentally unwell prisoners are swiftly (a) identified and (b) given care in an appropriate facility at (a) HMP/YOI Downview, (b) other prisons and (c) other young offenders institutions.

NHS England commissions prison health care services for HMP/YOI Downview and every other prison and young offenders institution in England. Every prison has onsite health care services including primary care, mental health, dentistry, and substance misuse teams. The National Service Specification for integrated mental health sets out how patients within secure settings, who require support for their mental wellbeing, should receive the same level of healthcare as people in the community, both in terms of the range of interventions available to them, in order to meet their needs, and the quality and standards of those interventions. This includes access to crisis intervention and crisis prevention for those at high risk of self-harm and suicide, where such behaviours relate to poor emotional wellbeing and/or minor psychiatric morbidity. Access to mental health provision is available to every person in prison at any stage of their sentence, beginning at the point of entry. NHS England commissions first night reception screening to have a registered nurse/practitioner review patients’ medical history to address any immediate health needs and risks and to ensure medication is made available as soon as possible and that onward referrals to onsite healthcare teams, including mental health services, for both urgent face to face appointments, within 24 hours, and routine face to face appointments, within five working days, are made. Outside of reception screening, people in prison can be referred or can self-refer to mental health services, within those timeframes. When someone is acutely unwell, they can be transferred from prisons and other places of detention to hospital for treatment, under the Mental Health Act, within the target transfer period of 28 days. The Mental Health Bill, currently going through Parliament, introduces a statutory 28-day time limit within which agencies must seek to ensure individuals who meet the criteria for detention under the act are transferred to hospital for treatment. NHS England’s South East Health and Justice team is funding a transfer and remissions co-ordinator from January 2025, to improve, where possible, safe, effective, and efficient transfers to hospital level treatment and interventions. NHS England is reviewing the National Integrated Prison Service Specification to ensure it continues to meet the needs of the prison population.

Whether his Department plans to provide additional support for women who face additional prescription costs due to (a) menorrhagia and (b) other menstrual issues caused by (i) miscarriage and (ii) other significant traumas.

There are no plans to review the support available to women facing these issues.A maternity exemption certificate can be applied for as soon as a healthcare professional has confirmed that the patient is pregnant or has given birth, including still-birth, in the previous twelve months, and this provides exemption from prescription costs until 12 months after the due date. The certificate remains valid if the patient has a miscarriage. The certificate is automatically backdated one month from the date the application is received by the NHS Business Services Authority.If a patient is not entitled to the maternity exemption, they can purchase a prescription prepayment certificate (PPC), which allows them to claim as many prescriptions as they need for a set cost. A three-monthly PPC, costing £32.05, or an annual PPC, costing £114.50, will save people money if they need four or more items in three months or 12 or more items in 12 months. To help spread the cost, people can pay for an annual PPC by ten monthly direct debits. A holder of a 12-month certificate can get all the prescriptions they need for just over £2 per week.Approximately 40% of the population are currently liable to pay the prescription charge though approximately 89% of the items dispensed in the community are dispensed free of charge.

With reference to the Policy Exchange report entitled In absentia parentis, published on 24 August 2025, what steps her Department is taking to ensure that local authorities have up-to-date safeguarding policies for gender-questioning children who are children in care.

Local authorities and social care practitioners are required to support children in a way that meets their needs and best interests. This support will look different on an individual case basis. In considering their safeguarding policies and how best to support children questioning their gender, leaders and practitioners should be led by the guidance and regulations most relevant to their setting or role. They can also be informed by the evidence and principles set out in the Cass Review. Further resources on support for children questioning their gender can be found via the NHS here: https://www.genderreferralservice.nhs.uk/.