Written questions by Franklin.

What steps her Department is taking to ensure off-payroll working rules support (a) entrepreneurs and (b) small business growth.

The off-payroll working rules, also known as IR35, are designed to ensure that individuals working like employees, but through their own company, pay broadly the same income tax and National Insurance contributions (NICs) as those who are directly employed. They do not apply to the genuinely self-employed. On 27 February 2025, HMRC published updated analysis on the impacts of the 2021 off-payroll working rules reform in the private and voluntary sectors. It can be found here: Update to the impacts of the 2021 off-payroll working rules reform in the private and voluntary sectors - GOV.UK

What assessment his Department has made of the adequacy of treatment of trans patients in primary care; and whether those patients receive adequate treatment for biological health needs.

It is important that all patients, including transgender patients, feel comfortable and confident in accessing primary care services.The Government is committed to ensuring that transgender patients receive the care and support they need when accessing National Health Services. This includes where care is sex specific, such as the Cervical Screening Management System launched in June 2024, which will allow people to register their sex at birth as well as their gender identity, which should allow for better call/recall for transgender and non-binary people who have a cervix.In line with the recommendations of the Cass Review, NHS England is currently undertaking a review of adult gender services. The review will examine the model of care and operating procedures of each service, with the aim of producing an updated service specification.

Communities and Local Government, what steps his Department is taking to ensure that rental prices remain affordable; and whether she has considered mechanisms to stabilise rents.

Boosting the supply of homes of all tenures must be at the heart of any strategy to improve housing affordability which is why the government’s Plan for Change includes a hugely ambitious milestone of building 1.5 million safe and decent homes in England in this Parliament. The Renters’ Rights Bill will empower private rented sector tenants to challenge unreasonable within-tenancy rent increases. The government has been clear it does not support the introduction of rent controls, including rent stabilisation measures. We believe they could make life more difficult for private renters, both in terms of incentivising landlords to increase rents routinely up to a cap where they might otherwise not have done, and in pushing many landlords out of the market, thereby making it even harder for renters to find a home they can afford.

What steps he is taking to ensure that adults with autism are not placed in accommodation that disrupts access to established support networks.

Under the Care Act 2014, local authorities are tasked with the duty to shape their care markets to meet the diverse needs of all local people. This includes encouraging a wide range of service provision to ensure that people have a choice of appropriate services that put the wellbeing of people who draw on care at the centre of decisions.The Care and Support Statutory Guidance sets out that health, care and support, and housing services should centre on the individual and their family. Housing services should be used to help promote an individual’s wellbeing, so that people in need of care and support and carers can build a full and active life. Suitability of living accommodation is one of the matters local authorities must take into account as part of their duty to promote an individual’s wellbeing.The Department is launching an independent commission into adult social care as part of our critical first steps towards delivering a National Care Service. The commission, led by Baroness Casey, will start a national conversation about what working age adults, older people, and their families expect from adult social care. While the commission carries out its work, the Department is taking immediate action to improve adult social care.

What steps his Department is taking to ensure serving personnel who are posted away on operational duties and have a property in the UK are able to receive council tax discounts; and how his Department ensures personnel are (a) informed and (b) supported in accessing this discount.

The Ministry of Defence (MOD) pays a tax-free allowance called Council Tax Relief for certain Service personnel on specified operations or assignments. In 2011, the MOD doubled the rate from 25 per cent to 50 per cent, under the auspices of the Armed Forces Covenant. The MOD has established structures in place to engage regularly with a wide range of stakeholders including Serving personnel and their families. This routine engagement maintains continued awareness of the support available.

What assessment he has made of the level of availability of non-surgical treatments for Band Keratopathy on the NHS; and if he will consider expanding access to laser treatment as an alternative to more invasive procedures.

No specific assessment has yet been made by the Department on the level of availability of non-surgical treatments for band keratopathy and access to laser treatment. However, the Government is committed to innovation in elective care, so that patients have access to timely and high-quality care, including patients awaiting eyecare treatment.The Elective Reform Plan, published in January 2025, sets out the productivity and reform efforts needed to return to the constitutional standard that 92% of patients are treated within 18 weeks from referral, including ophthalmology patients.In addition, the National Institute for Health and Care Excellence issues authoritative, evidence-based guidance for the National Health Service on best practice that helps people in the NHS make efficient, cost-effective, and consistent decisions about adopting new products.

What discussions her Department has had with police forces on supporting families in relation to criminal cases that have been open for over a decade.

Under the Victims' Code all victims, including a close relative of a person whose death was directly caused by a criminal offence, are entitled to be referred to support services when they report a crime.The Ministry of Justice provides Police and Crime Commissioners (PCCs) with annual grant funding to commission local practical, emotional, and therapeutic support services for victims of all crime types.

Whether she has made an assessment of the potential merits of prioritising active transport schemes.

The Government recognises the merits of prioritising investment in active travel schemes to support its economic growth, health and net zero missions. Active travel can help to revitalise high streets, enable people to live longer, healthier lives and reduce transport emissions. The Department announced the details of almost £300 million of funding for active travel in 2024/25 and 2025/26 on 12 February.

What steps she is taking to support more people with disabilities to (a) enter and (b) remain in the workplace; and what plans she has to improve access to (i) employment opportunities and (ii) workplace adjustments.

Appropriate work is generally good for health and wellbeing, so we want everyone to get work and get on in work, whoever they are and wherever they live. Disabled people and people with health conditions are a diverse group so access to the right work and health support, in the right place, at the right time, is key. We therefore have a range of specialist initiatives to support individuals to stay in work and get back into work, including those that join up employment and health systems. Measures include support from Work Coaches and Disability Employment Advisers in Jobcentres and Access to Work grants, as well as joining up health and employment support around the individual through Employment Advisors in NHS Talking Therapies and Individual Placement and Support in Primary Care and WorkWell. It is also recognised that employers play an important role in addressing health and disability. To build on this, the Joint DWP and DHSC Work & Health Directorate (JWHD) is facilitating “Keep Britain Working”, an independent review of the role of UK employers in reducing health-related inactivity and to promote healthy and inclusive workplaces. The lead reviewer, Sir Charlie Mayfield, is expected to bring forward recommendations in Autumn 2025. Additionally, the JWHD has developed a digital information service for employers, continues to oversee the Disability Confident Scheme, and continues to increase access to Occupational Health. Backed by £240m investment, the Get Britain Working White Paper launched on 26 November will drive forward approaches to tackling economic inactivity and work toward the long-term ambition of an 80% employment rate. As announced in the Green Paper, we are investing £1 billion a year by the end of the decade in new employment, health and skills support – one of the biggest packages of new employment support for sick and disabled people ever - including new tailored support conversations for people on health and disability benefits, and more intensive programmes of support with health and work to break down barriers and unlock work. In addition, consulting on the future of the Access to Work scheme so that it better helps people to start and stay in work through reasonable adjustments, such as aids, appliances and making use of assistive technology The Equality Act 2010 (the Act) provides a legal framework to protect disabled people against unlawful direct or indirect discrimination in employment by placing a duty on employers to make reasonable adjustments to any element of a job, job application or interview process, which may place disabled people at a substantial disadvantage compared to non-disabled people. The failure of an employer to make reasonable adjustments for a disabled employee or job seeker or discounting a job application simply because the applicant is disabled could amount to direct disability discrimination under the Act.

What steps her Department plans to take to improve (a) service quality and (b) fares for passengers once South Western Railway is under public control.

As operators transition to public ownership, improving rail service quality will remain a crucial priority for this government. The Department holds train operators to account for their performance by regularly measuring and monitoring core quality standards such as cleanliness, information and customer service, and setting challenging targets for delivery.Whilst it is our ambition through public ownership to deliver a more affordable railway, any long-term changes or concessions made to rail fares policy require balancing against the potential impacts on passengers, taxpayers and the railway.

What steps his Department is taking to (a) help tackle shortages of epilepsy medication and (b) ensure patients have consistent access to their prescribed treatment.

The Department is working hard with industry to help resolve intermittent supply issues with some epilepsy medications. As a result of ongoing activity and intensive work, including directing suppliers to expedite deliveries, most issues, including with carbamazepine, lamotrigine and oxcarbazepine presentations, have been resolved.We are currently aware of an ongoing supply issue with all strengths of topiramate tablets from one manufacturer. This supply issue is expected to resolve by the end of May 2025. We are also aware of a shortage of phenobarbital 15 milligram tablets from one manufacturer with the resupply date to be confirmed. In both cases, alternative suppliers are in stock with sufficient supply to support patients. These issues have been communicated to the National Health Service.

If she will make an assessment with Cabinet colleagues of the potential merits of introducing a specific offence for the sale of stolen exam board papers.

Ofqual, the independent regulator for qualifications, exams and assessments in England, are clear in their guidance issued to schools, colleges and students about the importance of exam security and the repercussions of committing any form of malpractice.In addition to this, depending on the specific circumstances, individuals could be charged by the police under existing legislation.

For what reason eligibility dates for free childcare provision are set from 1 April rather than aligning with the tax year ending on 5 April; and if she will make an assessment of the potential impact of the eligibility date on families.

The entitlements work on a termly basis, so children become eligible from the term after they reach the relevant age and/or after they or their parents meet the eligibility criteria. Terms begin on 1 September, 1 January or 1 April. Therefore, depending on when a child is born and when the eligibility criteria are met, there will be differing periods to wait until the relevant termly date.Termly deadlines enable local authorities and childcare providers to better plan and ensure sufficient early years places are available for parents each term by delineating when children are likely to enter into a place.

Communities and Local Government, with reference to the debate following her oral statement of 5 February 2025 on English Devolution and Local Government, Official Report, column 780, if she will meet the hon. Members for constituencies in Surrey to discuss the potential impact of council debt in Surrey on her proposals for local government reorganisation before 21 March 2025.

It is for Surrey councils to develop a proposal or proposals in line with the criteria and guidance set out in the invitation. This should include for Surrey, as an area covering a council in Best Value intervention, demonstrating how reorganisation may contribute to putting local government in the area as a whole on a firmer footing and what area-specific arrangements may be necessary to make new structures viable. The invitation is also clear that councils should engage locally and that we also expect and encourage local leaders to engage their Members of Parliament, on any proposals being developed.

Whether she plans to provide support to local businesses potentially impacted by delays to the completion of M25 junction 10 works.

The project has been delayed due to a number of factors. Severe weather, with unexpected heavy rainfall since October 2023 caused poor ground conditions. This postponed planned winter work and required a redesign of embankments and drainage. Additionally, the discovery of unexpected underground utilities along the A3 have further complicated progress, leading to extended relocation and design adjustments. Works on the M25 at junction 10 are expected to complete by late summer 2025, helping to alleviate traffic queues. The scheme is due to complete in Spring 2026. National Highways is working with its supplier to assess the full impact of delays and to minimise costs. Given the project's scale and complexity, the final cost will only be determined upon completion. In terms of the support available for local businesses, National Highways provides compensation as established in legislation across all its projects, ensuring appropriate use of taxpayers’ money. National Highways can only consider compensation in line with legislation, for example where it takes land during scheme delivery, but not for loss of earnings during temporary road works.

For what reason hon. Members representing local constituencies were recently informed of delays to the completion of M25 junction 10 works; and what the cost to the public purse is of those delays.

The project has been delayed due to a number of factors. Severe weather, with unexpected heavy rainfall since October 2023 caused poor ground conditions. This postponed planned winter work and required a redesign of embankments and drainage. Additionally, the discovery of unexpected underground utilities along the A3 have further complicated progress, leading to extended relocation and design adjustments. Works on the M25 at junction 10 are expected to complete by late summer 2025, helping to alleviate traffic queues. The scheme is due to complete in Spring 2026. National Highways is working with its supplier to assess the full impact of delays and to minimise costs. Given the project's scale and complexity, the final cost will only be determined upon completion. In terms of the support available for local businesses, National Highways provides compensation as established in legislation across all its projects, ensuring appropriate use of taxpayers’ money. National Highways can only consider compensation in line with legislation, for example where it takes land during scheme delivery, but not for loss of earnings during temporary road works.

If she will take steps to increase access to audio-based learning resources in schools.

The department respects the autonomy of teachers in terms of what resources they choose to use or recommend to their individual pupils, based on individual need in their own educational context and circumstances.

If her Department will reconsider its decision not to provide compensation to women born in the 1950s and 1960s following the Parliamentary and Health Service Ombudsman’s recommendation that those affected by changes to the state pension age should receive financial compensation.

We carefully considered the Ombudsman’s findings to ensure our decision was fair and based on the evidence. We have accepted the Ombudsman’s finding that there was a 28-month delay in sending out letters and for this we have apologised. However, we do not agree with the Ombudsman’s approach to injustice or remedy. Full details of the Government’s decision are available here Government response to Parliamentary and Health Service Ombudsman’s Investigation into Women’s State Pension age communications and associated issues - GOV.UK

If he will make an assessment of the potential implications for his policies of the difference in waiting times for gender dysphoria treatment between England and Wales.

The NHS Wales Joint Commissioning Committee commissions gender identity services for children and young people from NHS England. There are no plans to assess the difference in waiting times for specialist gender services for adults between England and Wales.NHS England is conducting a review into adult gender services. The review will examine the model of care and operating procedures of each service, and will carefully consider experiences, feedback, and outcomes from clinicians and patients. The review’s findings will inform an updated service specification for adult gender services.

Whether his Department is taking steps to improve access to cardiac screening for people aged 14 to 35 years including (a) at university (b) grassroots sports clubs.

The UK National Screening Committee (UK NSC) last reviewed screening for sudden cardiac death (SCD) in people under the age of 39 in 2019 and concluded that screening should not be offered. The committee’s review is available at the following link:https://view-health-screening-recommendations.service.gov.uk/sudden-cardiac-death/Research showed that current tests are not accurate enough to use in young people without symptoms, and that treatments and interventions were not based on good scientific evidence to prevent SCD.To stop SCDs in young people, the current consensus is to focus on rapid identification and care of people who are likely to be at risk of SCD due to a family link or because they have had symptoms, and to train people to carry out CPR and to use defibrillators.NHS England has published guidance for inherited cardiac conditions which requires services to investigate patients with previously undiagnosed cardiac disease, suggestive symptoms or from families with sudden unexplained deaths. Where a genetic variation is identified, cascade testing is offered to relatives based on risk.We are aware that the UK NSC has received a submission via its annual call process to consider SCD screening in young people aged between 14 and 35 years old engaging in sport. The UK NSC is currently reviewing all annual call proposals. More information on the annual call process is available at the following link:https://www.gov.uk/government/publications/uk-nsc-annual-call-submitting-a-screening-proposal/uk-nsc-annual-call-how-to-submit-a-proposal