Asked by: Baroness Fraser of Craigmaddie (Conservative - Life peer)
Question to the Department of Health and Social Care:
To ask His Majesty's Government what they mean by “enhanced parent–infant relationship support” in the updated Best Start Family Hubs and Healthy Babies guidance; and how equivalent support will be defined, delivered, and funded in local authorities that are not in receipt of that programme funding.
Answered by Baroness Merron - Parliamentary Under-Secretary (Department of Health and Social Care)
Through the Best Start Family Hubs and Healthy Babies guidance, we have a set a series of expectations for local authorities to support them to design their local service offer. The enhanced perinatal mental health and parent-infant relationship support is intended to build on existing provision within the system. Local authorities are empowering the workforce to be able to confidently identify and address need. They are providing high-quality support in a range of ways, such as virtually, one-to-one, and through peer support, and working across the system to strengthen referral pathways.
Through the 10-Year Health Plan, we commitment to rolling out Healthy Babies to match expansion of Best Start Family Hubs. While we do not expect local authorities who are not receiving funding to provide equivalent support to those that are, through the guidance we have set ambitions that we encourage them to work towards, which will lay the foundations for roll out. This includes equipping staff to offer emotional and wellbeing support, promote early attachment and connect families to appropriate services.
Asked by: Baroness Fraser of Craigmaddie (Conservative - Life peer)
Question to the Department of Health and Social Care:
To ask His Majesty's Government whether the proposed national maternity and neonatal action plan will include specific measures to assess and support parent–infant relationships, particularly in the period prior to discharge from maternity and neonatal units.
Answered by Baroness Merron - Parliamentary Under-Secretary (Department of Health and Social Care)
The National Maternity and Neonatal Taskforce, chaired by my Rt Hon. Friend, the Secretary of State for Health and Social Care, will translate the recommendations of Baroness Amos’ independent investigation into National Health Service maternity and neonatal care into a national action plan. The investigation’s final report will be published in June. While its final recommendations cannot be pre-empted, the taskforce’s terms of reference state that all aspects of maternity and neonatal care will be considered when developing its national action plan.
More widely, we are investing £200 million into the Best Start Family Hubs and Healthy Babies programme to strengthen Healthy Babies support in the critical 1,001 days, giving families access to enhanced perinatal mental health, parent-infant relationship, and infant feeding services, to help build the foundations for every baby’s emotional, social, and cognitive development.
On improving neonatal outreach, the NHS England Improving Postnatal Care Toolkit, published in January 2026 and available on the NHS.UK website, helps integrated care boards and local trusts optimise maternal and infant health. It requires commissioners to integrate neonatal and community care, reduce health inequalities, and recommends robust clinical handovers between neonatal units and local general practices and health visiting.
Asked by: Baroness Fraser of Craigmaddie (Conservative - Life peer)
Question to the Department of Health and Social Care:
To ask His Majesty's Government whether the proposed national maternity and neonatal action plan will include provisions to ensure continuity of care between discharge from neonatal units and community services, including health visiting and family hubs.
Answered by Baroness Merron - Parliamentary Under-Secretary (Department of Health and Social Care)
The National Maternity and Neonatal Taskforce, chaired by my Rt Hon. Friend, the Secretary of State for Health and Social Care, will translate the recommendations of Baroness Amos’ independent investigation into National Health Service maternity and neonatal care into a national action plan. The investigation’s final report will be published in June. While its final recommendations cannot be pre-empted, the taskforce’s terms of reference state that all aspects of maternity and neonatal care will be considered when developing its national action plan.
More widely, we are investing £200 million into the Best Start Family Hubs and Healthy Babies programme to strengthen Healthy Babies support in the critical 1,001 days, giving families access to enhanced perinatal mental health, parent-infant relationship, and infant feeding services, to help build the foundations for every baby’s emotional, social, and cognitive development.
On improving neonatal outreach, the NHS England Improving Postnatal Care Toolkit, published in January 2026 and available on the NHS.UK website, helps integrated care boards and local trusts optimise maternal and infant health. It requires commissioners to integrate neonatal and community care, reduce health inequalities, and recommends robust clinical handovers between neonatal units and local general practices and health visiting.
Asked by: Baroness Fraser of Craigmaddie (Conservative - Life peer)
Question to the Department of Health and Social Care:
To ask His Majesty's Government whether their Best Start Family Hubs and Healthy Babies programme will recommend the adoption of holistic family centre frameworks, such as Ei Smart, as part of efforts to support babies and families with the transition from neonatal units to family hubs.
Answered by Baroness Merron - Parliamentary Under-Secretary (Department of Health and Social Care)
In March 2026, we published Best Start Family Hubs and Healthy Babies guidance, setting out a series of expectations to enable local authorities to design their support offer for families tailored to local need. While the guidance is not prescriptive about what provision local authorities should introduce, it sets expectations that targeted support should be provided for families facing health inequalities, including those who have required neonatal care.
Some local authorities are already using programme funding to focus on families with babies who have had a period in neonatal care. For example, in Lincolnshire the Family and Baby project has been introduced which operates from neonatal units and provides early, relationship-based support to improve attachment, infant development, and parental wellbeing.
Asked by: Baroness Fraser of Craigmaddie (Conservative - Life peer)
Question to the Department of Health and Social Care:
To ask His Majesty's Government whether the National Maternity and Neonatal Taskforce will include (1) representatives of families with lived experience of neonatal care, and (2) professionals with expertise in ‘baby voice’ who are able to represent the baby’s perspective in the formation and prioritisation of services.
Answered by Baroness Merron - Parliamentary Under-Secretary (Department of Health and Social Care)
Family voices are key to the work of the National Maternity and Neonatal Taskforce. Families with a wide range of lived experience of maternity and neonatal care are represented on both the taskforce and within the Expert Reference Groups (ERGs) that are supporting the taskforce’s work.
Membership of the taskforce currently includes a representative from the British Association of Perinatal Medicine, providing expertise in neonatal care. There are also currently several professionals with backgrounds in neonatology on the Workforce, Clinical and Academic ERG. These include Dr Adam Smith-Collins, a Consultant Neonatologist of the University Hospitals Bristol and Weston NHS Foundation Trust, Professor James Boardman, a Professor of Neonatal Medicine of the University of Edinburgh, Dr Jideofor Menakaya, a Consultant Neonatologist Paediatrician of the Hillingdon Hospitals NHS Foundation Trust, Dr Jonathan Cusack, a Consultant Neonatologist of the Leicester Neonatal Service, and Shazia Hoodbhoy, a Consultant Neonatologist of the Cambridge University Hospitals NHS Trust.
Asked by: Baroness Fraser of Craigmaddie (Conservative - Life peer)
Question to the Department of Health and Social Care:
To ask His Majesty's Government what discussions they have had with the devolved administrations about the impact of the discontinuation of care worker visas on care provision.
Answered by Baroness Merron - Parliamentary Under-Secretary (Department of Health and Social Care)
Adult social care is a devolved matter. Prior to publication of the Immigration White Paper, devolved administrations were invited to submit their proposals for inclusion and had the opportunity to discuss the paper. Post-publication engagement with the devolved administrations has continued at both ministerial and senior official level to discuss the impacts of reforms.
Asked by: Baroness Fraser of Craigmaddie (Conservative - Life peer)
Question to the Department of Health and Social Care:
To ask His Majesty's Government what assessment they have made of the impact of closing social care visas for carers from overseas on vacancies in the care workforce.
Answered by Baroness Merron - Parliamentary Under-Secretary (Department of Health and Social Care)
As set out in the Immigration White Paper, visa extensions and in-country switching for those already in the country with working rights will be permitted for a transition period until 2028. This will be kept under review.
Care workers are essential to those who draw on care and support, helping them to maintain their quality of life, independence and connection to the things that matter to them. In England, as per the Care Act 2014, it is the responsibility of local government to develop a market that delivers a wide range of sustainable high-quality care and support services, that will be available to their communities. English local authorities have responsibility under the Care Act 2014 to meet social care needs and statutory guidance directs them to ensure there is sufficient workforce in adult social care.
The care worker route has seen unacceptable levels of abuse and exploitation, between July 2022 and December 2024 the Home Office revoked over 470 sponsor licences, impacting around 40,000 workers in the care sector. The Department of Health and Social Care is providing up to £12.5 million to regional partnerships in 2025/26 to respond to unethical international recruitment practices in the adult social care sector. This includes supporting international recruits impacted by sponsor licence revocations to find alternative employment.
In the technical annex published alongside the Immigration White Paper on 12 May 2025, the Home Office has estimated an annual reduction of approximately 7,000 main visa applicants as a result of ending overseas recruitment for care workers and senior care workers. This is based on their internal management information for entry visas granted covering the period March 2024 to February 2025. This estimate reflects that there was a drop in visa grants of more than 90% compared with the 12 months ending in March 2024. This analysis will be refined and included within the relevant Impact Assessments accompanying the rule changes, as appropriate.
The Department of Health and Social Care continues to monitor adult social care workforce capacity, bringing together national data sets from Skills for Care’s monthly tracking data, the Capacity Tracker tool and intelligence from key sector partners. The Department of Health and Social Care primarily uses filled posts as the most accurate measure of adult social care workforce capacity rather than number of vacancies. As vacancies are the total number of posts advertised by the adult social care sector’s independent and competing providers, they don’t necessarily reflect the number of workers required to meet adult social care needs. Vacancies are ultimately impacted by other factors such as providers’ ambitions to grow and are not necessarily a good indicator of capacity pressures as a result.
Asked by: Baroness Fraser of Craigmaddie (Conservative - Life peer)
Question to the Department of Health and Social Care:
To ask His Majesty's Government what assessment they have made of the impact of the discontinuation of care worker visas on care provision.
Answered by Baroness Merron - Parliamentary Under-Secretary (Department of Health and Social Care)
As set out in the Immigration White Paper, visa extensions and in-country switching for those already in the country with working rights will be permitted for a transition period until 2028. This will be kept under review.
Care workers are essential to those who draw on care and support, helping them to maintain their quality of life, independence and connection to the things that matter to them. In England, as per the Care Act 2014, it is the responsibility of local government to develop a market that delivers a wide range of sustainable high-quality care and support services, that will be available to their communities. English local authorities have responsibility under the Care Act 2014 to meet social care needs and statutory guidance directs them to ensure there is sufficient workforce in adult social care.
The care worker route has seen unacceptable levels of abuse and exploitation, between July 2022 and December 2024 the Home Office revoked over 470 sponsor licences, impacting around 40,000 workers in the care sector. The Department of Health and Social Care is providing up to £12.5 million to regional partnerships in 2025/26 to respond to unethical international recruitment practices in the adult social care sector. This includes supporting international recruits impacted by sponsor licence revocations to find alternative employment.
In the technical annex published alongside the Immigration White Paper on 12 May 2025, the Home Office has estimated an annual reduction of approximately 7,000 main visa applicants as a result of ending overseas recruitment for care workers and senior care workers. This is based on their internal management information for entry visas granted covering the period March 2024 to February 2025. This estimate reflects that there was a drop in visa grants of more than 90% compared with the 12 months ending in March 2024. This analysis will be refined and included within the relevant Impact Assessments accompanying the rule changes, as appropriate.
The Department of Health and Social Care continues to monitor adult social care workforce capacity, bringing together national data sets from Skills for Care’s monthly tracking data, the Capacity Tracker tool and intelligence from key sector partners. The Department of Health and Social Care primarily uses filled posts as the most accurate measure of adult social care workforce capacity rather than number of vacancies. As vacancies are the total number of posts advertised by the adult social care sector’s independent and competing providers, they don’t necessarily reflect the number of workers required to meet adult social care needs. Vacancies are ultimately impacted by other factors such as providers’ ambitions to grow and are not necessarily a good indicator of capacity pressures as a result.
Asked by: Baroness Fraser of Craigmaddie (Conservative - Life peer)
Question to the Department of Health and Social Care:
To ask His Majesty's Government what percentage of funding for the NHS is spent on pensions.
Answered by Baroness Merron - Parliamentary Under-Secretary (Department of Health and Social Care)
For 2023/24 we estimate that National Health Service employer contributions are some 7% of total NHS funding. As of 1 April 2024, the NHS employer pension contribution rate rose to 23.7% from 20.68%. In addition, NHS employees pay between 5.2% and 12.5% of their earnings.
Asked by: Baroness Fraser of Craigmaddie (Conservative - Life peer)
Question to the Department of Health and Social Care:
To ask His Majesty's Government what assessment they have made of the case for extending eligibility for medical exemption certificates to patients with cystic fibrosis, given that many cystic fibrosis patients now live well into adulthood.
Answered by Baroness Merron - Parliamentary Under-Secretary (Department of Health and Social Care)
There are no current plans to review the list of medical conditions that entitle someone to apply for a medical exemption certificate. Approximately 89% of prescription items are dispensed free of charge in the community in England, and there are a wide range of exemptions from prescription charges already in place, for which those with cystic fibrosis may be eligible. Eligibility depends on the patient’s age, whether they are in qualifying full-time education, whether they are pregnant or have recently given birth, or whether they are in receipt of certain benefits or a war pension.
People on low incomes can apply for help with their health costs through the NHS Low Income Scheme. Prescription prepayment certificates (PPCs) are also available. PPCs allow people to claim as many prescriptions as they need for a set cost, with three-month and 12-month certificates available. The 12-month PPC can be paid for in instalments.