Written questions by Thomas.

What steps her Department is taking to support male victims of domestic violence.

We recognise that men and boys experience abusive and violent crimes, such as stalking, domestic abuse, and sexual violence. That is why we are committed to ensuring male victims and survivors get the support they need. We are working tirelessly across government to deliver the Violence Against Women and Girls Strategy as soon as possible, which will set out commitments for all victims, including for men and boys that are victims of abuse. We know that male victims may face different barriers to accessing support. The Home Office and Ministry of Justice fund specialist services for victims of these crimes, including services for male victims, such as Respect, Galop, SignHealth, Hourglass, and Mankind UK. This includes the Men’s Advice Line, run by Respect, which offers vital support to male victims of domestic abuse.

Food and Rural Affairs, what recent assessment her Department has made of the adequacy of the Environmental Land Management payment scheme in supporting farmers with a clear roadmap to 2030.

This Government has committed a record £11.8 billion allocation to deliver sustainable farming and food production over this parliament. This includes increasing spend on nature-friendly farming including Environmental Land Management schemes to £2 billion by 28/29. As a result of the Government’s determination to get more farmers to participate, there are now 50,000 farm businesses and half of all farmed land now managed under our schemes – with more money being spent through these schemes than at any point. We are now working with farmers, farming and environmental organisations to develop the Farming Roadmap, which will set the course of farming in England for the next 25 years. It will set out how farming will, must and can evolve in response to changing markets, technologies, and environmental pressures - and how government will support that transition.We are committed to an ongoing process of iterating and maturing the Roadmap as we learn from farmers what they need to succeed.

Food and Rural Affairs, what discussions she has had with Cabinet colleagues on integrating nature risks into broader security and risk planning.

Nature risks are recognised in the Government’s National Security Strategy 2025: Security for the British People in a Dangerous World. Its implementation will ensure these risks inform security and risk planning across Government. Together with my Cabinet colleagues the Deputy Prime Minister David Lammy, and Secretary of State for Energy Security and Net Zero Ed Miliband, I was pleased to attend the recent Countdown to COP30: mobilising action for climate and nature event hosted by the Natural History Museum. My ministerial team and I look forward to continuing cross- government discussions as we prepare for the 30th United Nations climate change conference in Bélem, Brazil.

What assessment has she made of the volume of cases waiting to be considered by the Valuation Office Agency.

The VOA is meeting the majority of its performance targets. In the areas where it isn’t, it has robust service recovery plans in place. These include moving staff to where there is the greatest customer demand and upskilling its workforce in a wider range of casework, to ensure greater flexibility. It continues to prioritise any cases where a customer is facing financial hardship. The VOA proactively contacts customers, through direct email or automated updates sent as cases progress through a service. The VOA reports monthly on performance to the HMRC Executive Committee and Board. The decision to move the VOA’s functions into HMRC next year will strengthen direct accountability to ministers. Integration is being carefully managed by a joint HMRC and VOA team, with detailed transition plans in place and appropriate oversight from my department.

Communities and Local Government, what steps he is taking with the Minister for Defence to ensure that veterans in receipt of means-tested support who are living in areas with district councils are not disadvantaged by the move to unitary authorities.

There will be no changes to how we expect councils to continue to support the armed forces community throughout the local government reorganisation process.By abolishing two-tier local government across England, we will set up strong unitary councils that will improve public services, bringing them under one roof, improving join up with local partners, and making life easier for local residents.We are committed to working with the Minister for Defence and across government to make sure unitarisation improves public services for all residents, including the armed forces community.

What steps her Department is taking to ensure the Valuation Office Agency processes cases in a timely manner.

The VOA is meeting the majority of its performance targets. In the areas where it isn’t, it has robust service recovery plans in place. These include moving staff to where there is the greatest customer demand and upskilling its workforce in a wider range of casework, to ensure greater flexibility. It continues to prioritise any cases where a customer is facing financial hardship. The VOA proactively contacts customers, through direct email or automated updates sent as cases progress through a service. The VOA reports monthly on performance to the HMRC Executive Committee and Board. The decision to move the VOA’s functions into HMRC next year will strengthen direct accountability to ministers. Integration is being carefully managed by a joint HMRC and VOA team, with detailed transition plans in place and appropriate oversight from my department.

What steps her Department is taking to help people track the progress of cases pending with the Valuation Office Agency.

The VOA is meeting the majority of its performance targets. In the areas where it isn’t, it has robust service recovery plans in place. These include moving staff to where there is the greatest customer demand and upskilling its workforce in a wider range of casework, to ensure greater flexibility. It continues to prioritise any cases where a customer is facing financial hardship. The VOA proactively contacts customers, through direct email or automated updates sent as cases progress through a service. The VOA reports monthly on performance to the HMRC Executive Committee and Board. The decision to move the VOA’s functions into HMRC next year will strengthen direct accountability to ministers. Integration is being carefully managed by a joint HMRC and VOA team, with detailed transition plans in place and appropriate oversight from my department.

What steps her Department is taking to help mitigate the potential impact of moving the Valuation Office Agency into HMRC on the timely processing of cases.

The VOA is meeting the majority of its performance targets. In the areas where it isn’t, it has robust service recovery plans in place. These include moving staff to where there is the greatest customer demand and upskilling its workforce in a wider range of casework, to ensure greater flexibility. It continues to prioritise any cases where a customer is facing financial hardship. The VOA proactively contacts customers, through direct email or automated updates sent as cases progress through a service. The VOA reports monthly on performance to the HMRC Executive Committee and Board. The decision to move the VOA’s functions into HMRC next year will strengthen direct accountability to ministers. Integration is being carefully managed by a joint HMRC and VOA team, with detailed transition plans in place and appropriate oversight from my department.

What steps her Department is taking to help tackle anti-social behaviour in large housing developments.

Tackling anti-social behaviour (ASB) is a top priority for this Government, and a key part of our Safer Streets Mission.We understand that ASB causes great harm and misery to our communities, and, if left unchecked, can lead to more serious offending.When tenants commit anti-social behaviour (ASB) it can cause misery for housemates, neighbours, and the wider community. While we are clear that it’s better to resolve issues without eviction, regaining possession is sometimes necessary, and landlords should have the tools they need to keep people safe.That is why the Renters’ Rights Bill will shorten the notice period for the existing mandatory eviction ground, with landlords being able to make a claim to the court immediately in all cases of anti-social behaviour.The Bill also amends the matters that judges must consider when deciding whether to award possession under the discretionary ground. This will ensure judges give particular regard to whether tenants have engaged with efforts to resolve their behaviour and the impact on other tenants within HMOs.The Anti-social Behaviour, Crime and Policing Act 2014 gives social landlords, the police and local authorities have a range of powers and tools to tackle housing related ASB, including a Civil Injunction under Section 1 of that Act, and local agencies are expected to use those powers promptly and proportionately, putting the needs of victims at the heart of their response.We will crack down on those making neighbourhoods feel unsafe and unwelcoming by introducing the new Respect Order, which local authorities will be able to apply for and which will carry tough sanctions and penalties for persistent adult offenders.

What steps he is taking to ensure equality of access to tofersen by people diagnosed with SOD1 motor neurone disease across England.

The National Institute for Health and Care Excellence (NICE) is the independent body responsible for developing authoritative, evidence-based recommendations for the National Health Service on whether new medicines represent a clinically and cost-effective use of resources. The NHS in England is legally required to fund medicines recommended by NICE, normally within three months of the publication of final guidance.NICE has selected tofersen for treating amyotrophic lateral sclerosis caused by the superoxide dismutase – 1 (SOD1) gene mutations as a topic for guidance development through its Highly Specialised Technology (HST) programme. The HST programme appraises medicines for the treatment of very rare, and often very severe diseases, and evaluates whether they can be considered a clinically and cost-effective use of NHS resources. NICE has not yet been able to start the evaluation of tofersen as it is unable to issue guidance on the use of the technology without receiving an evidence submission about the technology’s clinical and cost-effectiveness from the marketing authorisation holder. Therefore, NICE is ready to review tofersen via its HST programme, as soon as Biogen indicates that it is ready to start the NICE evaluation.I am aware that the marketing authorisation holder has established early access programmes (EAPs) through which some patients are currently accessing tofersen. Participation in company-led schemes is decided at an individual NHS trust level and under these programmes, the cost of the drug is free to both patients taking part in it, and to the NHS, but NHS trusts must still cover the administration costs and must provide clinical resources to deliver the EAP. No assessment has been made of regional variation in access to tofersen through the programme.NHS England has published guidance for integrated care systems (ICS) on free of charge medicines schemes, providing advice on potential financial, resourcing, and clinical risks. ICSs should use the guidance to help determine whether to implement any of these schemes, including assessing suitability and any risks in the short, medium, and long term. The guidance is available at the following link:https://www.england.nhs.uk/long-read/free-of-charge-foc-medicines-schemes-national-policy-recommendations-for-local-systems/

What recent assessment his Department has made of the adequacy of the provision of (a) treatment and (b) care for children and young adults with (i) PANS and (ii) PANDAS.

Information on the number of children and young adults with paediatric acute-onset neuropsychiatric syndrome (PANS) and paediatric autoimmune neuropsychiatric disorder associated with streptococcus (PANDAS) is not collected at present as there are no internationally agreed criteria to identify these conditions. The PANS PANDAS Steering Group is currently working on a consensus for case identification to support a national survey. Due to the emerging nature of the evidence base there is currently a lack of consensus on what good clinical practice and training on PANS and PANDAS may look like, and no assessments have therefore been made.

If he will make an assessment of the adequacy of the the availability of training programmes on (a) PANS and (b) PANDAS for NHS staff.

Information on the number of children and young adults with paediatric acute-onset neuropsychiatric syndrome (PANS) and paediatric autoimmune neuropsychiatric disorder associated with streptococcus (PANDAS) is not collected at present as there are no internationally agreed criteria to identify these conditions. The PANS PANDAS Steering Group is currently working on a consensus for case identification to support a national survey. Due to the emerging nature of the evidence base there is currently a lack of consensus on what good clinical practice and training on PANS and PANDAS may look like, and no assessments have therefore been made.

What information his Department holds on the number of children and young adults with (a) PANS and (b) PANDAS.

Information on the number of children and young adults with paediatric acute-onset neuropsychiatric syndrome (PANS) and paediatric autoimmune neuropsychiatric disorder associated with streptococcus (PANDAS) is not collected at present as there are no internationally agreed criteria to identify these conditions. The PANS PANDAS Steering Group is currently working on a consensus for case identification to support a national survey. Due to the emerging nature of the evidence base there is currently a lack of consensus on what good clinical practice and training on PANS and PANDAS may look like, and no assessments have therefore been made.

If he will hold discussions with the National Institute for Health and Care Excellence on the development of guidelines for PANS and PANDAS.

Decisions on topics for new or updated guidance from the National Institute for Health and Care Excellence (NICE) are considered through an established NICE prioritisation process with decisions overseen by a prioritisation board, chaired by NICE’s Chief Medical Officer.NICE’s prioritisation board considered the development of guidance on paediatric acute-onset neuropsychiatric syndrome and paediatric autoimmune neuropsychiatric disorder associated with streptococcus in November 2024 and concluded that there is insufficient evidence in this area to develop useful guidance.

What steps his Department is taking to ensure that veterans who leave the armed forces can access NHS dental care.

We are working to improve access to National Health Service dentistry, which will also benefit our valued members of the Armed Forces community, including our respected veterans who have spent their careers defending our country.We are committed to reforming the dental contract, with a shift to focus on prevention and the retention of NHS dentists. The Government’s ambition is to deliver fundamental contract reform before the end of this Parliament. Veterans will be able to benefit from the improved access these changes bring.We are also supporting more than 1,500 children in British military families overseas through our supervised toothbrushing programme. Free NHS dental care is available to people who meet the following criteria:under 18 years old, or under 19 years old and in full-time education;pregnant or have had a baby in the previous 12 months;being treated in an NHS hospital and the treatment is carried out by the hospital dentist, although patients may have to pay for any dentures or bridges;receiving low-income benefits, or under 20 years old and a dependant of someone receiving low-income benefits; and/orreceiving War Pension Scheme payments, or Armed Forces Compensation Scheme payments and the treatment is for your accepted disability.

What steps his Department is taking to reduce geographical cost differences for (a) abiraterone and (b) similar drugs in England.

The procurement of abiraterone for secondary care is currently part of NHS England’s generic wave tender structure. NHS England tenders two regions out of six at a time to encourage competition and to ensure supply chain resilience, awarding the top two compliant suppliers onto the framework each time. Prices may vary between regions, but within NHS England’s terms and conditions there is a price review mechanism whereby any price changes can be matched/applied in other regions. Also, within the tender there is a price limiter criterion which is applied so that only bids that are in line with market norms will be compliant.

What recent assessment his Department has made of the geographic differences in the cost of abiraterone for high-risk prostate cancer patients in England.

The procurement of abiraterone for secondary care is currently part of NHS England’s generic wave tender structure. NHS England tenders two regions out of six at a time to encourage competition and to ensure supply chain resilience, awarding the top two compliant suppliers onto the framework each time. Prices may vary between regions, but within NHS England’s terms and conditions there is a price review mechanism whereby any price changes can be matched/applied in other regions. Also, within the tender there is a price limiter criterion which is applied so that only bids that are in line with market norms will be compliant.

What steps his Department is taking to expand dental services in rural areas.

We are aware of the challenges faced in accessing a dentist, particularly in more rural areas.The responsibility for commissioning primary care services, including National Health Service dentistry, to meet the needs of the local population has been delegated to integrated care boards (ICBs) across England.ICBs are recruiting posts through the Golden Hello scheme. This recruitment incentive will see dentists receiving payments of £20,000 to work in those areas that need them most for three years.We are committed to reforming the dental contract, with a shift to focus on prevention and the retention of NHS dentists. The Government’s ambition is to deliver fundamental contract reform before the end of this Parliament.

What steps his Department is taking to ensure that elderly people have reliable access to dental care.

The responsibility for commissioning primary care services, including National Health Service dentistry, to meet the needs of the local population has been delegated to integrated care boards (ICBs) across England. This includes considering the needs of elderly populations. The ICB for the Tewkesbury constituency is Gloucestershire ICB.We know that as people age, they tend to move to rural and coastal areas where the challenges in accessing NHS dentistry are exacerbated. We have introduced the Golden Hellos scheme which will see dentists receiving payments of £20,000 to work in those areas that need them most for three years.ICBs may commission specialised dental services including domiciliary care for elderly people living in care homes. The National Institute for Health and Care Excellence (NICE) guideline on oral health in care homes sets out several recommendations for care homes to help maintain and improve oral health and ensure timely access to dental treatment for their residents. The Government expects care homes to be following NICE guidance and recommendations in this area.

If he will make an assessment of the potential implications for his policies of recent incidents involving known risk items being accessed by mental health patients with the knowledge of NHS staff.

On 4 April 2025, NHS England published its ‘Staying Safe from Suicide: Best Practice Guidance for Safety Assessment, Formulation and Management'. This promotes a shift towards a more holistic, person-centred approach rather than relying on risk prediction, which is unreliable because suicidal thoughts can change quickly. Instead, it recommends using a method based on understanding each person’s situation and managing their safety.The purpose of this guidance is to enable mental health practitioners to adopt best practice principles in working with people of all ages to stay safe from suicide. This guidance also has a section covering confidentiality and the law and refers to the consensus statement for information sharing and suicide prevention. The guidance is available at the following link:https://www.england.nhs.uk/long-read/staying-safe-from-suicide/Work is also underway to make training available to all mental health practitioners to incorporate the principles of this guidance into their practice. This training was recently launched and is available via an e-learning module. This complements existing local training on suicide prevention, and a number of other national e-learning products that are already available.The National Confidential Inquiry into Suicide and Safety in Mental Health has been commissioned through the NHS England Culture of Care programme to support every provider of National Health Service commissioned inpatient services to move to personalised safety planning in line with evidence.In addition to this, the Health Services Safety Investigations Body’s (HSSIB) investigation into mental health inpatient settings identified important concerns and safety recommendations that can help us to improve mental health care, protect patients and the public and create a safe working environment for staff. We are in the process of formally responding to all the recommendations for the Department made within these reports. NHS England will be publishing guidance in response to the HSSIB’s recommendations defining the therapeutic relationship and guidance on responding to the use of non-anchored ligature points.