Written questions by Mierlo.

Pursuant to to the answers of 5 and 17 October 2025 to Questions 77387 and 86538, what progress he has made on ensuring a reliable supply of testosterone and oestrogen HRT implants.

We are continuing to work closely with the Medicines and Healthcare products Regulatory Agency (MHRA) to ensure safe access to these products. We have reached out to Specialist Importers who can source unlicensed medicines in order to find alternative sources of both oestrogen and testosterone hormone replacement therapy (HRT) implants, which are not licenced in the United Kingdom. We are engaging with companies globally to source supplies of HRT implants for UK patients. We are aware of a Specialist Importer who is able to source unlicensed testosterone implants. The decision to prescribe an unlicensed imported medicine sits with the prescriber. We are also engaging with companies globally to source supplies of HRT implants for UK patients. The MHRA has been working closely with current importers of the product and are also looking to encourage other applications for a licenced medicinal product. As oestrogen and testosterone HRT implants are not licenced in the UK, the MHRA is encouraging applications to supply products through the licenced medicines route.

Food and Rural Affairs, (a) what estimate she has made of the proportion of the £104 billion investment package that will be funded through higher customer bills rather than through water company capital investment and (b) what safeguards will be put in place to protect consumers from bill increases linked to the £104 billion investment programme.

The Government has secured a record £104 billion investment package to upgrade England’s water infrastructure by 2030. This investment will be funded through a combination of water company capital investment and customer bills, but the precise split cannot yet be confirmed. Affordability must be at the core of any future investment plans, and proposed bill impacts will be assessed through the statutory impact assessment for the Water Reform Bill. The Government have already taken action to protect customers. Funding for vital infrastructure is now ringfenced so it can only be spent on upgrades that benefit consumers and the environment. Where companies fail to deliver promised investment, they will be required to return money to customers through lower bills. Alongside this, we are strengthening safeguards for households, including reforms to WaterSure, expanding social tariff support, and introducing a new independent Water Ombudsman to ensure complaints are resolved quickly and fairly.

Food and Rural Affairs, when her department will confirm plans for the Environment Agency to hold a separate, stand alone bridges construction and maintenance budget to run alongside budgets for Locks & Weirs.

Environment Agency owned bridges along the non-tidal Thames are part of the overall Navigation infrastructure. Construction and maintenance allocations for the Environment Agency’s Navigation assets has already been set for the current Spending Review period. This includes Locks, Weirs, Bridges and their associated assets. The Environment Agency is also developing a partnership funding mechanism to accelerate specific bridge refurbishment projects. This will increase the overall amount of bridge construction and maintenance that the Environment Agency can deliver and help towards creating a sustainable Navigation service.

How much funding was allocated to dementia research by (a) the National Institute for Health and Care Research and (b) UK Research and Innovation in each of the last five years.

Government responsibility for delivering dementia research is shared between the Department of Health and Social Care, with research delivered via the National Institute for Health and Care Research (NIHR), and the Department for Science, Innovation and Technology, with research delivered via UK Research and Innovation (UKRI).The table in the document attached shows the NIHR and UKRI’s spend data for dementia research across the five financial years from 2020/21 to 2024/25Spend for dementia research is calculated retrospectively, with a time lag due to annual reporting cycles, therefore 2024/25 is the most recent year we have data for. The Department does not centrally hold data on dementia research funding from other public bodies, and 2024/25 data from UKRI is still being confirmed.The NIHR welcomes funding applications for research into any aspect of human health and care, including dementia. These applications are subject to peer review and judged in open competition, with awards being made on the basis of the importance of the topic to patients and health and care services, value for money and scientific quality. Welcoming applications on dementia to all NIHR programmes enables maximum flexibility both in terms of the amount of research funding a particular area can be awarded, and the type of research which can be funded.

Whether he plans to reform powers in relation to Strategic Litigation Against Public Participation cases.

The Government implemented the Strategic Litigation Against Public Participation (SLAPPs) measures in the Economic Crime and Corporate Transparency Act 2023 (ECCTA) in June 2025, which provides protection against SLAPPs relating to economic crime. While this was a positive first step, we are considering all options for reform to ensure that all types of SLAPPs are addressed comprehensively.

Which (a) professional bodies and (b) legal organisations his Department consulted prior to the publication of proposals to restrict jury trials; and what alternative measures his Department has considered to reduce the Crown Court backlog.

In developing his recommendations, Sir Brian Leveson and his expert advisers, including Professor David Ormerod, engaged with many external bodies and organisations with invaluable expertise of our Criminal Justice System including criminal legal organisations, charities, academics, and members of the judiciary. A full list is at Annex C of Part 1 of his report. When considering Sir Brian’s recommendations and developing our proposals, I have engaged regularly with stakeholders and relevant sectors including but not limited to representatives from the legal sector (Law Society, Bar Council, Criminal Bar Association), victims and victims representatives (the Victims Commissioner, the Domestic Abuse Commissioner, Rape Crisis), judiciary (Circuit leaders, Judicial leadership), magistracy (Magistrates’ Association, Magistrates’ Leadership Executive), non-governmental organisations (Appeal, JUSTICE, Transform Justice), court staff in criminal courts around the country (Wood Green, Snaresbrook, Kingston, Southwark, Telford, Birmingham etc) and similar international jurisdictions. For example, I met judges and visited courts in Canada, which uses types of judge-only trial. We welcome the recommendations made in Part 1 of Sir Brian’s Review, which provided the blueprint for reform. Sir Brian’s recommendations were ambitious, but he also recognised that the Government might need to take his recommendations further to address the scale of the challenge we are facing. We have three levers for restoring stability and confidence in the criminal courts system – investment, modernisation, and structural reform. Pursuing any one of these levers in isolation would not be enough to meet projected demand into the courts, let alone address the rising caseload. The Government has already invested heavily in the system – in record sitting days, court buildings and technology, and in legal professionals. On 4 February 2026, Sir Brian published Part 2 of his Independent Review of the Criminal Courts, which makes recommendations to improve the efficiency of the criminal courts. We will urgently consider the proposals set out, alongside Sir Brian’s remaining recommendations from Part 1, and respond to them in due course.

What assessment he has made of the potential impact of trends in the number of court sitting days on the Crown Court backlog.

We have funded 112,250 Crown Court sitting days this financial year – 5,000 more than the previous Government and a record number. The Deputy Prime Minister has made clear that sitting days will continue to increase in both the Crown and magistrates’ courts. As our latest published projections show, demand by 2030 is forecast to be 7% higher in the Crown Court than current levels. This means the courts would need to sit 139,000 days just to keep up with demand and even that would not enable us to reduce the backlog. The system is not able to deliver that number – there are insufficient prosecutors, defence barristers and judges to keep up with the demand. As a benchmark, the Lady Chief Justice has said that the maximum the judiciary could presently sit is around 113,000 sitting days. Therefore, even with record-breaking investment in sitting days, the Crown Court backlog will continue to grow, leaving people waiting for longer and longer for justice. That is why we are pulling every lever we have – investment, reform and efficiency – to turn the tide on the backlog and begin to deliver justice for victims.

What assessment he has made of the potential impact of the length of time medical malpractice legal proceedings take to complete on (a) families and (b) staff.

NHS Resolution handles claims for compensation against National Health Service providers of healthcare and has a strategic priority to keep patients and healthcare staff out of litigation to minimise distress. To achieve this, NHS Resolution deploys a range of dispute resolution techniques including mediation, resolution meetings, and early neutral evaluation, and aims to resolve claims promptly and fairly. As a result, the percentage of cases resolving without litigation has continued to increase, reaching 83% of clinical claims in 2024/25. Each case must be, however, considered on its own merits in line with the prevailing law with appropriate investigation into legal liability and the amount of compensation due. Court involvement remains necessary for those who lack capacity and may also be required to determine points of law or where there is conflicting evidence.

Food and Rural Affairs, with reference to her Department's White Paper entitled A New Vision for Water, published on 20 January 2026, what assessments he has made of the potential impact of the proposed joined‑up local planning measures on the prevention of surface‑to‑foul water misconnections in new housing developments.

In the White Paper Defra has committed to delivering an enhanced, better joined up regional water planning function. This will enable a more holistic, coordinated approach to water environment and supply planning which supports delivery of national strategic objectives such as the economic growth mission, housing building targets and nature recovery, whilst enabling regional and local priorities to be realised. Defra is engaging a range of stakeholders to understand what works well, and where there are challenges with water sector planning, within the current river basin planning system. This engagement is helping us test emerging thinking, identifying opportunities to strengthen planning and delivery and ensure policy development is informed by practical experience as well as evidence and analysis. Property owners are legally responsible for resolving misconnected pipework on their property; public misconnections are the responsibility of water companies. Should misconnections not be resolved, the responsible party can be prosecuted; in some cases, local authorities and water companies can access private property to fix misconnections and then recover their costs from the owner.

Communities and Local Government, what assessment he has made of the potential merits of extending the Freedom of Information Act 2000 to cover housing associations in England.

This government is committed to increasing transparency and accountability in the social rented sector.In September 2025, we directed the Regulator of Social Housing to introduce new Social Tenant Access to Information Requirements (STAIRs) for private registered providers (PRPs) of social housing, including housing associations, to enable residents to request information about their housing management. From October 2026, PRPs will be required to proactively publish information relating to the management of their social housing. From April 2027, they will also be required to respond to information requests from tenants.We carefully considered the case for bringing PRPs of social housing within the scope of the Freedom of Information Act 2000 but ultimately decided that a bespoke scheme would be the most effective and proportionate way of ensuring that all social tenants can access information about the management of their homes.The divergences from FOI, such as specifying that only tenants and their representatives can access information and that information requests must relate to issues relevant to the management of social housing, are proportionate for PRPs in their capacity as private businesses.

Communities and Local Government, if he will set out the mechanisms for leaseholders and shared ownership tenants to challenge unexpected or excessive maintenance charges; and whether his Department plans to (a) strengthen enforcement or (b) provide additional support for those in dispute with housing associations.

Most shared owners have a landlord who is a member of the Housing Ombudsman Service. Tenants can therefore take complaints about service charges, not including fees, to the Ombudsman.The new Social and Affordable Homes Programme places new expectations on shared ownership providers to improve customer experience. These include giving greater consideration to long-term customer affordability and increasing transparency and fairness on costs.I otherwise refer the hon. Member to the Written Ministerial Statement made on 4 July 2025 (HCWS780).

Communities and Local Government, whether his Department plans to review the practices of housing associations in relation to the application of maintenance charges for shared ownership properties; and what steps he will take to ensure charges (a) reflect actual services delivered and (b) are communicated in plain language.

Most shared owners have a landlord who is a member of the Housing Ombudsman Service. Tenants can therefore take complaints about service charges, not including fees, to the Ombudsman.The new Social and Affordable Homes Programme places new expectations on shared ownership providers to improve customer experience. These include giving greater consideration to long-term customer affordability and increasing transparency and fairness on costs.I otherwise refer the hon. Member to the Written Ministerial Statement made on 4 July 2025 (HCWS780).

Communities and Local Government, what steps his Department is taking to ensure transparency and fairness in the calculation and application of maintenance charges for shared ownership properties; and whether he will assess the potential merits of introducing clearer guidance to prevent unexpected or disproportionate costs being passed on to (a) leaseholders and (b) part-buy, part-rent tenants.

Most shared owners have a landlord who is a member of the Housing Ombudsman Service. Tenants can therefore take complaints about service charges, not including fees, to the Ombudsman.The new Social and Affordable Homes Programme places new expectations on shared ownership providers to improve customer experience. These include giving greater consideration to long-term customer affordability and increasing transparency and fairness on costs.I otherwise refer the hon. Member to the Written Ministerial Statement made on 4 July 2025 (HCWS780).

What estimate he has made of the number of patients whose treatment has been delayed as a result of restrictions placed on private providers delivering NHS services.

Reducing waiting lists is a key part of the Government’s Health Mission, and we are committed to putting patients first by ensuring that they are seen on time and that they have the best possible experience of care. Since the Government came into office, the waiting list for routine appointments, operations, and procedures in England has now been cut by 312,369. This is despite 30.1 million referrals onto the waiting list.Integrated care boards have existing contractual powers to manage activity by providers, which were enhanced in 2025/26 with central support for setting and managing activity. Commissioners’ use of these powers support systems to live within their means and deploy better financial discipline than previous years where systems have overspent. As these powers are exercised by local systems, no national assessment has been made.We expect use of activity management provisions by local systems to support efforts achieving the goal of at least 65% of patients waiting no longer than 18 weeks for treatment by March 2026 whilst living within financial budgets set for 2025/26.All trusts are expected to have their own safeguards to ensure that patients waiting for planned care are triaged, and that appointments take place according to clinical priority and the length of time patients have waited, avoiding risk of serious complications.

What steps his Department is taking to ensure that the 18-week waiting time target can be met.

The Government is committed to returning, by March 2029, to the National Health Service constitutional standard that 92% of patients wait no longer than 18 weeks from referral to consultant-led treatment.In November 2025, performance against the standard was at 61.8%, 2.6% higher than a year earlier. Since the Government came into office, the waiting list for routine appointments, operations, and procedures in England has now been cut by 312,369 despite 30.1 million referrals being added onto the waiting list.As set out in the Elective Reform Plan, we’ve set ambitious targets, and are investing in modernisation, and reforming and simplifying pathways, increasing surgical and diagnostic capacity, and empowering patients with faster and more convenient access to care. We’ve made good progress, through there remains lots more to do.We will empower patients by giving them more choice and control, reform delivery by working more consistently, and in many cases differently, to deliver more elective care, ensure care takes place in the right place, and implement robust and regular oversight of performance with clear expectations.In September last year, we announced a new “online hospital”, through NHS Online, which will help to reduce patient waiting times, delivering the equivalent of up to 8.5 million appointments and assessments in its first three years, four times more than an average trust, while enhancing patient choice and control over their care. The first patients will be able to use the service from 2027.We are investing £6 billion of additional capital over five years for diagnostic, elective, urgent, and emergency capacity in the NHS. This includes £1.65 billion of capital funding in 2025/26 to support both immediate winter capacity and infrastructure transformation, for instance new surgical hubs, community diagnostic centres, and beds to increase capacity for elective and emergency care.

What assessment he has made of the potential impact of activity management plans on patient waiting times for elective surgery.

Integrated care boards have existing contractual powers to manage activity by providers, which were enhanced in 2025/26 with central support for setting and managing activity. The NHS Standard Contract includes the ability to set Indicative Action Plans (IAPs) to help providers and commissioners plan demand, capacity, and expenditure. While not binding, if activity exceeds the agreed plan, and therefore the funding agreed, an Activity Management Plan (AMP) can be agreed to bring activity back in line.The provision and use of IAPs and AMPs is designed to deliver the activity levels required to achieve the goal of at least 65% of patients waiting no longer than 18 weeks for treatment by March 2026 whilst also living within financial budgets set for 2025/26.Any planning assumptions based on waiting times need to support commissioners’ overall duties to the populations they serve and our waiting time targets, including our commitment to return to the 18 week standard. AMPs allow commissioners and providers to work together to manage elective activity within agreed performance and financial targets, all whilst working towards improving patient waiting times overall.

What steps the Department is taking to ensure that individuals who applied to purchase voluntary National Insurance contributions through the International Pensions Centre before the April 2025 deadline and experienced delays in their processing are not disadvantaged.

Telephony demand from individuals seeking to pay Voluntary National Insurance Contributions (VNICs) ahead of the 6th April 2025 deadline was significant. In response, DWP provided routes for individuals to register their interest in paying VNICs. DWP introduced an online call-back form, a route for citizens to register their interest over the telephone and where possible, individuals were sent confirmation text messages. Where individuals registered an interest to pay VNICs on or before the April 2025 deadline, the Department is honouring pre-deadline rates for all, even if the payment of VNICs is made after the deadline. Customers who are over State Pension age and who paid VNICs, will receive an increase to their State Pension. For individuals living overseas (who are already over State Pension age), all DWP call-back requests were completed before the end of December 2025. Customers who are over State Pension age and who paid VNICs based on pre-deadline rates, will receive an increase to their State Pension. The pre-deadline contribution rates required to purchase the relevant qualifying years will be honoured.

What plans he has to review the level of the Household Benefit Cap.

There is a statutory obligation to review the levels at least once every five years. They were last reviewed in November 2022 and, as such, a further review is not required until November 2027. This will happen at the appropriate time as determined by the Secretary of State.

What assessment his Department has made of the potential impact of levels of Local Housing Allowance rates on households in the private rented sector following the removal of the two-child limit; and whether he has plans to review LHA levels, in the context of recent trends in the cost of renting.

The Secretary of State reviews LHA rates annually and rates were reviewed in November at Autumn Budget. A decision was made to maintain LHA rates at their current 2024/25 levels for 2026/27. A range of factors were considered, including rent levels across Great Britain, the wider fiscal context and welfare priorities. This included the decision to remove the two child limit, which will lift 450k children out of poverty. Written statements - Written questions, answers and statements - UK Parliament Discretionary Housing Payments are available from local authorities for low-income renters who face a shortfall in meeting their housing costs. From April 2026 DHPs for England will be incorporated into the Crisis and Resilience Fund (CRF).

What assessment he has made of (a) trends in the level of Strategic Lawsuits Against Public Participation and (b) the potential impact of those lawsuits on public-interest advocacy and journalism.

Due to the covert nature of Strategic Litigation Against Public Participation (SLAPPs) cases, with many threats occurring before cases reach the courts, it is difficult to know precise figures. On the available qualitative evidence we recognise that such tactics continue to be used to intimidate and silence journalists and others acting in the public interest. By curtailing free speech, SLAPPs cause a chilling effect on public interest journalism and pose a threat to both our legal system and our democracy. We are considering all options for reform to address this issue.