Written questions by Mierlo.

If he will make an assessment of the potential impact of the time taken by integrated care boards to add new National Institute for Health and Care Excellence-recommended medicines to their formularies on the ability of NHS patients to access new treatments.

The National Institute for Health and Care Excellence (NICE) makes recommendations for the National Health Service on whether new licensed medicines should be routinely funded by the NHS based on an assessment of their costs and benefits. The NHS in England is legally required to fund medicines recommended in a NICE technology appraisal, usually within three months of final guidance.The NICE has published guidance on the adoption of medicines in local formularies which states that once a NICE technology appraisal recommends a medicine, it must be included in a local formulary within three months, providing it is clinically appropriate and relevant to the services provided by the organisation, or within 30 days for Early Access to Medicines Scheme medicines.As part of the commitments made in the 2024 voluntary scheme for branded medicines pricing, access and growth (2024 VPAG), NHS England agreed to the development of a local formulary national minimum dataset within the first half of the 2024 VPAG, to increase visibility of local variation in the implementation of NICE guidance, identify where variation in local formularies may be creating barriers to access, and to confirm to NHS England when a NICE recommended treatment has been placed on a local formulary.NHS England also agreed to use the dataset to inform a report, which will be published no less frequently than annually, identifying unwarranted variation between national guidance and local formularies.

What criteria his Department has used to determine which integrated care boards should merge.

NHS England has asked the integrated care boards (ICBs) to act primarily as strategic commissioners of health and care services, and to reduce the duplication of responsibilities within their structure, with the expectation of achieving a 50% cost reduction in their running cost allowance. NHS England provided additional guidance to ICBs, National Health Service trusts, and NHS foundation trusts on 1 April 2025, where ICBs were tasked with developing plans by the end of May setting out how they will manage their resources to deliver across their priorities. This letter can be found at the following link:https://www.england.nhs.uk/long-read/working-together-in-2025-26-to-lay-the-foundations-for-reform/Details of how ICBs will work together to share functions and agree clustering arrangements to deliver services and meet local needs may emerge following the publication the plans.Ministers and the Department will work with the new transformation team at the top of NHS England, led by Sir Jim Mackey, to ensure ICBs continue to fulfil their future functions effectively, within the running costs cap, and unlock the benefit of working at scale to deliver better care for patients.

How many active travel routes in England have used Compulsory Purchase Order powers to facilitate their construction.

The Department for Transport has not made an assessment of the effectiveness of compulsory purchase order powers in progressing active travel schemes and there is currently no centralised record of how many active travel schemes in England have relied on these powers. Local authorities can use their compulsory purchase powers for a wide range of purposes in order to facilitate specific schemes, including active travel routes.

What assessment her Department has made of the effectiveness of Compulsory Purchase Order powers in progressing active travel schemes.

The Department for Transport has not made an assessment of the effectiveness of compulsory purchase order powers in progressing active travel schemes and there is currently no centralised record of how many active travel schemes in England have relied on these powers. Local authorities can use their compulsory purchase powers for a wide range of purposes in order to facilitate specific schemes, including active travel routes.

What information has been provided to him on the reason for the delay on publication of the National Institute for Health and Care Research research brief that will inform the UK National Screening Committee’s in-service evaluation of newborn screening for Spinal Muscular Atrophy.

My Rt Hon. Friend, the Secretary of State for Health and Social Care has been kept informed of the plans being developed for the in-service evaluation of newborn screening for spinal muscular atrophy, including the National Institute for Health and Care Research’s brief. The Department is working with NHS England on the deliverability of the in-service evaluation. The roll out and timeline will be confirmed after the conclusion of the 2025 Spending Review.

Food and Rural Affairs, pursuant to the Answer of 27 November 2024 to Question 15607 on Water: Standards and with reference to Henley Swim's announcement entitled Henley Swim stops trading, published on 2 May 2025, what steps he has taken on reopening applications for new bathing water designations.

This Government supports the innovative approaches being taken to trial new charges aiming to make bills fairer and more affordable. All companies plan to trial new charging structures by 2030 and some of them plan to introduce them more widely for additional customers if the trials are successful. Companies can design their charges to provide benefits and incentives in a range of ways. As the water regulator, Ofwat regulates the charging trials by issuing rules that require companies to set fair charges for all customers, and to ensure all trials are consistent with good practice principles. Information on Ministerial meetings are published quarterly on GOV.UK.

Food and Rural Affairs, pursuant to the Answer of 27 November 2024 to Question 15605 on Water: Standards and with reference to Henley Swim's announcement entitled Henley Swim stops trading, published on 2 May 2025, what recent assessment he has made of the economic impact on river-based leisure businesses of sewage in waterways.

This Government supports the innovative approaches being taken to trial new charges aiming to make bills fairer and more affordable. All companies plan to trial new charging structures by 2030 and some of them plan to introduce them more widely for additional customers if the trials are successful. Companies can design their charges to provide benefits and incentives in a range of ways. As the water regulator, Ofwat regulates the charging trials by issuing rules that require companies to set fair charges for all customers, and to ensure all trials are consistent with good practice principles. Information on Ministerial meetings are published quarterly on GOV.UK.

Food and Rural Affairs, what progress Natural England have made on the proposed expansion of the Chilterns Area of Outstanding Beauty; and if he will set out a timeline for a consultation on that expansion.

The Department is aware that Natural England in light of pressure on their budgets have taken the hard decision to stop work on the Chilterns boundary review. It had yet to reach the stage of sharing proposed ‘candidate areas’ publicly and as a result of having to stop the project there is no longer a planned timeline for the public consultation. Natural England are in contact with the affected partners to work through the implications of this decision over the coming weeks. Natural England continues to recognise the value landscape designations bring to people and nature and remain committed to maximising that value over the long term.

Pursuant to the Answer of 7 March 2025 to Question 35541 on Hormone Replacement Therapy, what discussions he has had with the Medicines and Healthcare products Regulatory Agency on the adequacy of the process for applying for UK licenses for HRT implant manufacturers.

The processes of the Medicines and Healthcare products Regulatory Agency (MHRA) are now performing within the expected timelines, and are meeting company commitments. Guidance has been updated on 3 April 2024 to aid the rapid approval of medicines, ensuring that quality, safety, and efficacy assessments are completed.The assessment of hormone replacement therapy products falls within these overall processes, and we are working closely with Department’s medicines supply to ensure the early flagging of issues, so they can be resolved by either companies or the MHRA.

Pursuant to the Answer of 7 March 2025 to Question 35541 on Hormone Replacement Therapy, what discussions he has had with the Medicines and Healthcare products Regulatory Agency on the adequacy of the number of (a) manufacturers that produce and (b) importers of HRT implants.

Oestrogen and testosterone hormone replacement therapy (HRT) implants are not licenced in the United Kingdom. The Department is working closely with the Medicines and Healthcare products Regulatory Agency (MHRA) to ensure safe access to these products. We have also reached out to specialist importers who can source unlicensed medicines in order to find alternative sources of both HRT implants for UK patients. We will continue to work closely with the MHRA, and the National Health Service to ensure suitable alternatives are available for patients.The MHRA has held regular discussions with the importer of the unlicenced medicine and the Department is actively looking at this to ensure ongoing supply from this and other sources. Stakeholder groups, including the Patient Safety Commissioner and the British Menopause Society, have also been kept actively informed.

Pursuant to the Answer of 7 March 2025 to Question 35541 on Hormone Replacement Therapy, what discussions he has had with the Medicines and Healthcare products Regulatory Agency on encouraging manufacturers to apply for a UK license for HRT implants.

Oestrogen and testosterone hormone replacement therapy (HRT) implants are not licenced in the United Kingdom. The Department is working closely with the Medicines and Healthcare products Regulatory Agency (MHRA) to ensure safe access to these products. We have also reached out to specialist importers who can source unlicensed medicines in order to find alternative sources of both HRT implants for UK patients. We will continue to work closely with the MHRA, and the National Health Service to ensure suitable alternatives are available for patients.The MHRA has held regular discussions with the importer of the unlicenced medicine and the Department is actively looking at this to ensure ongoing supply from this and other sources. Stakeholder groups, including the Patient Safety Commissioner and the British Menopause Society, have also been kept actively informed.

Whether she is taking steps with her EU counterparts to help (a) improve the accessibility and (b) increase the use of UK blue parking badges in the EU.

The Department for Transport has ongoing discussions with individual countries regarding continued recognition of the UK Blue Badge across the European Union (EU).

What information the UK National Screening Committee has provided on the (a) format, (b) scale and (c) duration of the upcoming in-service evaluation of newborn screening for Spinal Muscular Atrophy in the NHS.

The UK National Screening Committee (UK NSC) is working with the spinal muscular atrophy (SMA) partnership board to scope out the potential shape of the in-service evaluation into SMA. The partnership board includes clinicians, academics, patient representatives, the National Institute for Health and Research (NIHR), NHS England, and the UK NSC. The final decision on the exact format, scale, and duration will be determined following a successful NIHR tendering process. The timescale for the implementation of the SMA in-service evaluation will not be confirmed until after the 2025 Spending Review.The UK NSC is aware that screening for SMA and severe combined immunodeficiency uses the same test, and as such there may be saving opportunities through economies of scale, if the two conditions are determined to be suitable for a screening programme. This is still under consideration by the committee.

What assessment he has made of the potential merits of launching newborn screening for Spinal Muscular Atrophy alongside the upcoming launch of newborn screening for severe combined immunodeficiency.

The UK National Screening Committee (UK NSC) is working with the spinal muscular atrophy (SMA) partnership board to scope out the potential shape of the in-service evaluation into SMA. The partnership board includes clinicians, academics, patient representatives, the National Institute for Health and Research (NIHR), NHS England, and the UK NSC. The final decision on the exact format, scale, and duration will be determined following a successful NIHR tendering process. The timescale for the implementation of the SMA in-service evaluation will not be confirmed until after the 2025 Spending Review.The UK NSC is aware that screening for SMA and severe combined immunodeficiency uses the same test, and as such there may be saving opportunities through economies of scale, if the two conditions are determined to be suitable for a screening programme. This is still under consideration by the committee.

What recent discussions he has had with the UK National Screening Committee on timelines for implementing in-service evaluation of newborn screening for spinal muscular atrophy.

The UK National Screening Committee (UK NSC) is working with the spinal muscular atrophy (SMA) partnership board to scope out the potential shape of the in-service evaluation into SMA. The partnership board includes clinicians, academics, patient representatives, the National Institute for Health and Research (NIHR), NHS England, and the UK NSC. The final decision on the exact format, scale, and duration will be determined following a successful NIHR tendering process. The timescale for the implementation of the SMA in-service evaluation will not be confirmed until after the 2025 Spending Review.The UK NSC is aware that screening for SMA and severe combined immunodeficiency uses the same test, and as such there may be saving opportunities through economies of scale, if the two conditions are determined to be suitable for a screening programme. This is still under consideration by the committee.

Food and Rural Affairs, if he will bring forward legislative proposals to prevent overseas private equity investment in Thames Water.

There are no plans to introduce any such legislation at this time. More broadly, the Independent Water Commission is actively considering whether reforms are needed across the water industry, including with respect to economic regulation of water companies. Within this, the Commission is considering regulation of water companies’ financial resilience, investment and competition. The Commission is expected to publish its recommendations, following which the Government expects to bring forward further actions to ensure the water industry is delivering for customers and the environment.

Food and Rural Affairs, if he will ensure that Ofwat's enforcement case investigation into Thames Water is (a) performed and (b) concluded in a timely manner.

It is not appropriate for the Government to comment on an ongoing investigation. We have a system of independent environmental and economic regulation, and the recently introduced Water (Special Measures) Act provides the most significant increase in enforcement powers for the regulators in a decade, giving them the teeth they need to take tougher action against water companies in the next investment period. This includes powers for Ofwat to set rules on remuneration, governance, and financial reporting. The Government will continue to work with regulators to hold water companies to account on poor performance and to drive improvements which benefit customers and the environment.

What discussions she has had with (a) hon. Members and (b) the trade associations who contributed to the volumetric concrete mixers review prior to announcing the findings.

My Department engaged with hon. Members and industry stakeholders through correspondence prior to the announcement. Additionally, industry and interested parties were given the opportunity to present views and evidence on this topic as part of the Call for Evidence between October and December 2023.The call for evidence sought views on three potential options on weight limits for Volumetric Concrete Mixers (VCMs). The following factors were considered: reduction in payload per journey, increased waste, and increased vehicle mileage. Information received did not provide any compelling evidence for permitting a weight limit exemption specifically for VCMs. As part of its consideration of the evidence, the Department for Transport has assessed the potential environmental impacts in accordance with the Environment Act 2021 which requires Ministers of the Crown to have ‘due regard’ to the environmental principles policy statement when making policy.Current exemptions to weight limits for VCMs will expire in 2028. This policy is being maintained.

If she will make an estimate of the impact of cutting weights of Volumetric Concrete Mixers on (a) lorry miles on concrete deliveries, (b) lorry journeys on concrete deliveries and (c) the tonnage of CO2 produced by lorry making concrete deliveries.

My Department engaged with hon. Members and industry stakeholders through correspondence prior to the announcement. Additionally, industry and interested parties were given the opportunity to present views and evidence on this topic as part of the Call for Evidence between October and December 2023.The call for evidence sought views on three potential options on weight limits for Volumetric Concrete Mixers (VCMs). The following factors were considered: reduction in payload per journey, increased waste, and increased vehicle mileage. Information received did not provide any compelling evidence for permitting a weight limit exemption specifically for VCMs. As part of its consideration of the evidence, the Department for Transport has assessed the potential environmental impacts in accordance with the Environment Act 2021 which requires Ministers of the Crown to have ‘due regard’ to the environmental principles policy statement when making policy.Current exemptions to weight limits for VCMs will expire in 2028. This policy is being maintained.

Communities and Local Government, what percentage of the new 1,500,000 homes will be (a) social housing and (b) affordable housing.

The government has not set an affordable housing target to date, but we are committed to delivering the biggest increase in social and affordable housebuilding in a generation. At Spring statement, the government announced an immediate injection of £2 billion to support delivery of the biggest boost in social and affordable housebuilding in a generation and contribute to our ambitious Plan for Change milestone of building 1.5 million safe and decent homes in this Parliament. Further detail can be found in the Written Ministerial Statement made on 25 March 2025 (HCWS549). The investment made at Spring statement follows the £800 million in new in-year funding which has been made available for the 2021-26 Affordable Homes Programme and that will support the delivery of up to 7,800 new homes, with more than half of them being Social Rent homes. We will set out set details of new investment to succeed the 2021-26 Affordable Homes Programme at the Spending Review. This new investment will deliver a mix of homes for sub-market rent and homeownership, with a particular focus on delivering homes for social rent. The government has also announced the £450m third round of the Local Authority Housing Fund, followed by an uplift of £50m, enabling councils to grow their housing stock. We also confirmed a range of new flexibilities for councils and housing associations, both within the Affordable Homes Programme and in relation to how councils can use their Right to Buy receipts. Having reduced Right to Buy discounts to their pre-2012 regional levels, we have allowed councils to retain 100% of the receipts generated by Right to Buy sales. The government recognise that Registered Providers need support to build their capacity and make a greater contribution to affordable housing supply. Between 30 October 2024 and 23 December 2024, the government consulted on a new 5-year social housing rent settlement, to give Registered Providers the certainty they need to invest in new social and affordable housing. The revised National Planning Policy Framework published on 12 December 2024 includes a number of changes that make the planning system more supportive of affordable housing, in particular Social Rent homes. These include new Golden Rules for development on the Green Belt. Prior to development plan policies for affordable housing being updated in accordance with the revised NPPF, the affordable housing contribution required to satisfy the ‘Golden Rules’ is 15 percentage points above the highest existing affordable housing requirement that would otherwise apply to the development, subject to a cap of 50%. We estimate that under this model, the median Green Belt local planning authority affordable housing requirement will be 50%.