Written questions by Mierlo.

How many patients have accessed Vamorolone since it was given NICE approval for Duchenne Muscular Dystrophy; what assessment he has made of the adequacy of availability of Vamorolone to patients with DMD in that period; and whether the NHS had fully implemented the NICE recommendation by the April 2025 deadline.

The National Institute for Health and Care Excellence (NICE) published its technology appraisal, titled Vamorolone for treating Duchenne muscular dystrophy in people 4 years and over, on 16 January 2025. NHS England routinely commissioned vamorolone in line with the guidance, from 16 April 2025.When a patient is started on vamorolone, the prescribing clinician submits an electronic prior approval form, confirming that NICE’s recommendation criteria are met. NICE’s costing report, included in the technology appraisal, suggested that 1,390 people expected to receive vamorolone in 2025/26. The NICE’s technology appraisal is available at the following link:https://www.nice.org.uk/guidance/ta1031/resources/resource-impact-summary-report-15239352925/chapter/Resource-impact-summary-reportThere is only 10 full weeks of data available since routine commissioning commenced in mid-April, and over this period there have been 32 prior approval forms submitted. Whilst submission of a form is not confirmation that treatment has begun, this is used as a proxy indication for the number of patients starting treatment.

Whether he has made an assessment of the adequacy of the provision of 24/7 palliative care in Oxfordshire: and what steps he is taking to extend provision of this service.

We want a society where every person receives high-quality, compassionate care from diagnosis through to the end of life. The Government will shift the focus of healthcare out of the hospital and into the community, to ensure patients and their families receive personalised care in the most appropriate setting. Palliative care and end of life care services will have a big role to play in that shift.Palliative care services are included in the list of services that integrated care boards (ICBs), including the NHS Buckinghamshire, Oxfordshire and West Berkshire ICB, must commission. This promotes a more consistent national approach and supports commissioners in prioritising palliative care and end of life care. To support ICBs in this duty, NHS England has published statutory guidance and service specifications, with further information on both available, respectively, at the following two links:https://www.england.nhs.uk/publication/palliative-and-end-of-life-care-statutory-guidance-for-integrated-care-boards-icbs/https://www.england.nhs.uk/publication/service-specifications-for-palliative-and-end-of-life-care-adults/The statutory guidance makes specific reference to commissioners defining how their services will meet population needs 24/7 and includes a priority action for ensuring that staff, patients, and carers can access the care and advice they need, whatever time of day.Earlier this year, I met with key palliative care and end of life care and hospice stakeholders, in a roundtable format, with a focus on long-term sector sustainability within the context of our forthcoming 10-Year Health Plan.

Food and Rural Affairs, what progress he has made on designating nine new National River walks; and if he will make an assessment of the merits of establishing a new chalk stream river walk in the Chiltern National Landscape.

The Government is progressing plans to designate nine new National River Walks across England, one in each region, to enhance access to nature. We are currently considering possible locations for the River Walks as well as several delivery options and will provide more information once we are in a position to do so.

Food and Rural Affairs, if he will take steps to implement the Catchment Based Approached (a) Chalk Stream Restoration Strategy 2021 and (b) Chalk Stream Strategy Implementation Plan 2023.

The Catchment Based Approach (CaBA) group has led fantastic work in developing the Chalk Stream Restoration Strategy and Implementation Plan, and I particularly want to thank them for all their great work in restoring these important habitats. Restoring our chalk streams to better ecological health is a core ambition of our overall programme of work to clean up rivers, lakes and seas for good. Alongside our programme of reforms, Water companies will invest £2 billion over the next 5 years to deliver more than 1,000 targeted actions for chalk stream restoration as part of our Plan for Change. The government is investing £1.8 million through the Water Restoration Fund and Water Environment Improvement Fund for locally led chalk stream clean-up projects across affected regions. Our Storm Overflows Discharge Reduction Plan ensures chalk streams are prioritised for improvement as part of the record £11 billion investment to improve nearly 3,000 storm overflows nationwide.

What assessment he has made of the merits of reforming GP licensing; and whether he will make it his policy to protect GPs from unaffordable costs when a practice fails financially.

Most general practices (GPs) are run by general, unlimited liability partnerships. Limited liability partnerships are currently not permitted as business vehicles for General Medical Services or Personal Medical Services contractors. However, limited companies can be used to manage financial risks in a partnership. GP partnerships may also manage liabilities through indemnities and different forms of insurance. As independent contractors and small business owners, these are decisions for GP partners to make, with legal and accounting advice.We have committed to substantive GP Contract reform within this Parliament following acceptance of the 2025/26 contract by the General Practitioners Committee England. As part of this, we expect to consider a breadth of topics, which may include updates to the partnership model.We are investing an additional £889 million in GPs, to reinforce the front door of the National Health Service and to bring back the family doctor, bringing the total spend on the GP Contract to £13.2billion in 2025/26. This is the biggest increase in over a decade, and means we are reversing the recent trend by allocating a rising share of total NHS resources to GPs.

What assessment he has made of the potential merits of reforming GP licensing; and if he will develop plans to protect GPs from costs when practices fail financially.

We have committed to substantive GP contract reform within Parliament following acceptance of the 2025/26 contract by the England general practitioners committee of the British Medical Association. As part of this, we expect to consider a breadth of topics, which may include updates to the partnership model.Practices with a General Medical Services contract are eligible for rent reimbursements, with different terms depending on the ownership or occupation arrangements for the property, as set out in the Premises Costs Directions 2024. The commissioner has discretion to provide further financial assistance if other costs rise exponentially, such as service charges, all budget-dependent.

What criteria his Department has used to determine the allocation of repair funds to the Royal Berkshire Hospital.

The £750 million Estates Safety Fund is part of the overall 2025/26 capital allocation announced by the Chancellor at the Autumn Budget 2024.The £750 million was divided between integrated care systems (ICSs) through indicative funding allocations as part of the NHS Capital Guidance 2025/26. Each system’s indicative allocation represents a proportion of the £750 million based on need, taking into account levels of critical infrastructure risk, incidents and returns to the recent maternity estates survey.Due to the diverse needs of the National Health Service estate, a flexible approach has been taken to ensure national and regional priorities are addressed effectively. ICSs worked with their local systems to identify and prioritise which schemes would be funded at which sites from their provisional allocations to deliver maximum safety benefits. The value of these schemes determined the financial allocations to NHS trusts.

Innovation and Technology, when he plans to respond to the correspondence of 14 May 2025 from the hon. Member for Henley and Thame on Bullitt Group UK.

The Secretary of State has responded to the Member’s earlier letter.

What steps he is taking to ensure that private providers of physiotherapy services to the NHS (a) provide value for money and (b) do not operate with excessive profit margins.

Throughout its history, the National Health Service has always worked with non-NHS healthcare providers to deliver essential services to patients, especially at times of operational pressures. The overall proportion of health spending on independent sector providers has not increased significantly over recent years. In 2013/14, 6.1% of total health spending, or £6.5 billion, was spent on purchase of healthcare from independent sector providers. In 2023/24, this was 6.8% or £12.4 billion.The Provider Selection Regime is a set of rules for procuring health care services in England, giving decision-makers the flexibility they need to arrange services that best promote the interests of patients, the taxpayer, and the population. As part of the Provider Selection Regime, commissioners need to be transparent in their decision making to ensure that there is proper scrutiny and accountability of decisions made about NHS services.Rates of payment for physiotherapy services are set at a local level. Pursuant to the Government’s public interest test, NHS bodies are not obliged to accept any bids submitted by external suppliers unless they clearly demonstrate value for money and deliver against the aims and objectives of a business cases. It is expected that any outsourced services are delivered in a way that improves quality, ensures greater stability and longer-term investment in the workforce, and delivers better value for money as part of broader commitments on procurement.

What steps she is taking to ensure that children with (a) diabetes and (b) other medical needs are able to access wraparound care provided by (i) breakfast, (ii) after school and (iii) holiday clubs.

All children and families should be able to access the benefits of wraparound care around the school day and term time. This is why the department is investing in new free universal breakfast clubs and new and expanded before and after school places through the wraparound childcare programme, alongside the Holiday Activities and Food (HAF) programme.Under the Equality Act 2010, schools and providers of wraparound and holiday care must make reasonable adjustments for children with disabilities and medical conditions. In addition, section 100 of the Children and Families Act 2014 places a duty on maintained schools, academies and pupil referral units to make arrangements for supporting pupils with medical conditions.The department’s guidance on wraparound, breakfast clubs and HAF programmes is clear that schools and providers should be aware of any medical requirements of pupils and encourages providers to review the ‘Supporting pupils at school with medical conditions’ statutory guidance, which can be accessed here: https://assets.publishing.service.gov.uk/media/5ce6a72e40f0b620a103bd53/supporting-pupils-at-school-with-medical-conditions.pdf. Although the duty does not extend to out of school setting providers, this guidance contains information that may be useful in considering how to best support children with medical conditions.

Communities and Local Government, whether her Department plans to (a) review and (b) strengthen the provisions of the Localism Act 2011 relating to the community right to bid; and if she will make an assessment of the potential impact of doing so on (i) long-term vacant commercial properties and (ii) support for communities seeking to preserve assets of community value.

As part of the English Devolution Bill, the government has committed to legislate for a strong new ‘right to buy’ for valued community assets, replacing the current ‘right to bid’ that was introduced in the Localism Act 2011. This will give real power to local people to preserve a wide range of assets that are important to them and help to end the blight of empty properties on our high street. We are currently finalising the policy and will announce more details, including its impact, in due course.

What recent assessment he has made of the effectiveness of the LGBT Financial Recognition Scheme.

As of 9 June 2025, the LGBT Financial Recognition Scheme (FRS) had distributed £2.2 million in payments, prioritising elderly applicants and those with serious health conditions to ensure timely support for those most in need. The first payments were issued within 15 weeks of the scheme going live, and while some complex cases require additional time, the Ministry of Defence (MOD) is committed to ensuring all eligible individuals receive the support they are entitled to. The MOD is actively monitoring and assessing application data to evaluate the Scheme’s progress and continues to work with stakeholders, including local councils, the NHS, LGBT and military charities, and Veterans’ networks, to raise awareness and provide support. To date, £90,000 in grants has been allocated to charities, such as Fighting With Pride, to assist Veterans with their applications and ensure the scheme is accessible. The MOD remains focused on addressing challenges, such as processing complex cases and improving outreach, and will continue to monitor the Scheme’s performance to ensure it meets its objectives of recognising and supporting those affected by the historic ban.

Communities and Local Government, whether her Department plans to take steps to improve protections for (a) pubs and (b) other community assets against (i) long-term commercial vacancy and (ii) speculative planning applications.

Through the forthcoming English Devolution Bill, we will introduce a ‘right to buy’ for valued community assets, such as pubs and other spaces. This will give communities stronger powers to secure these assets if they go up for sale.Long-term vacant pubs may also be eligible for a High Street Rental Auction.Where planning permission is sought to change the use of community facilities, the National Planning Policy Framework is clear that local planning decisions should guard against the unnecessary loss of valued community facilities and services.

Food and Rural Affairs, what steps he plans to take to ensure the (a) safe and (b) smooth passage of vessels along the Thames during (i) Henley Royal Regatta week and (ii) other events which attract international visitors to the town.

As the navigation authority for the non-tidal River Thames, the Environment Agency (EA) plays a key role in supporting the safe and successful delivery of over 200 river-based events each year. These events contribute significantly to the cultural heritage and public enjoyment of the River Thames, while the EA remains committed to upholding the public right of navigation and ensuring the river remains open to traffic. The EA has a long-standing and constructive relationship with the event organisers of Henley Royal Regatta. Working together, they’ve developed and implemented local navigation measures that provide a dedicated racing lane for competition and a separate channel for passing vessels. This approach ensures that competitors, commercial operators, and leisure users can all share the river safely and effectively throughout the event. The EA also maintains a visible presence on-the-water during the Regatta, working closely with professional partners including Thames Valley Police and Oxfordshire Fire and Rescue Service. This coordinated effort helps to ensure compliance with navigation rules and supports the safety of all river users. Drawing on all its operational experience, the EA is confident that this year’s Henley Royal Regatta, along with all other events along the Thames, will proceed smoothly and safely.

What guidance Active Travel England have issued on the use of compulsory purchase order powers for active travel routes.

To date Active Travel England has not issued any guidance on the use of compulsory purchase order powers. A range of approaches to establishing rural active travel routes will be set out in guidance due to be published later this year, including case studies on the use of compulsory purchase orders.

Media and Sport, when she plans to respond to the letter from the hon. Member for Henley and Thame of 13 March 2025 on the honours list.

A response was sent to the hon. Member for Henley and Thame on Monday 9th June 2025. I apologise for the delay.

Media and Sport, what discussions she has had with British Rowing on ensuring the safety of British athletes.

The safety, wellbeing and welfare of everyone taking part in sport is absolutely paramount. National Governing Bodies (NGBs) are responsible for the regulation of their sports and for ensuring that appropriate measures are in place to protect participants from harm.The Government is aware of the deeply concerning recent media reports in relation to rowing. We have not spoken directly to British Rowing, but have raised this with UK Sport and Sport England, who are both monitoring the situation. UK Sport has also confirmed they are in contact with British Rowing and encourage any member of staff or athlete on Olympic and Paralympic performance programmes to report allegations of unacceptable behaviour to Sport Integrity, their confidential reporting line.

Innovation and Technology, what recent discussions he has had with Ofcom on the regulation of gaming companies under the Online Safety Act 2023.

The Government engages regularly with Ofcom to discuss implementation of the Online Safety Act.Game services are in scope of the Online Safety Act if they allow users to post content online or to interact with each other. The Act requires all user-to-user services, including in-scope gaming platforms, to have systems and processes in place to remove illegal content. In July, in-scope services will also need to take steps to protect children from harmful content.

Pursuant to the Answer of 15 May 2024 to Questions 51723 and 51724 on Active Travel: Construction, if he will make an assessment of the effectiveness of using compulsory purchase orders to progress active travel routes; and if he will collate data on how many local authorities have used compulsory purchase orders for this purpose.

The Department currently has no plans to make an assessment of the effectiveness of compulsory purchase order powers in progressing active travel schemes or produce a centralised record of their use by local authorities. Compulsory purchase for active travel has a high bar with a requirement for public authorities to demonstrate a compelling case in the public interest. An alternative approach to creating new active travel routes is public path creation under the Highways Act 1980, rather than outright purchase of the land through a compulsory acquistion. Active Travel England will set out further guidance on a range of approaches to establishing rural active travel routes in the Design Guidance that will be published later in the year.

What steps she is taking to ensure children are educated about online safety in PSHE lessons.

As part of statutory relationships and health education in primary schools and relationships, sex and health education in secondary schools, pupils are taught about online safety and harms. This includes being taught about the implications of sharing private or personal data (including images) online, harmful content and contact, cyberbullying and the risks associated with over-reliance on social media. The full statutory guidance for primary schools can be found here: https://www.gov.uk/government/publications/relationships-education-relationships-and-sex-education-rse-and-health-education/relationships-education-primary.The full statutory guidance for secondary schools can be found here: https://www.gov.uk/government/publications/relationships-education-relationships-and-sex-education-rse-and-health-education/relationships-and-sex-education-rse-secondary.The department is currently reviewing the statutory relationships, sex and health education (RSHE) curriculum. We are looking carefully at the consultation responses, considering the evidence and talking to key stakeholders before issuing revised guidance.