Asked by: Baroness Manzoor (Conservative - Life peer)
Question to the Department of Health and Social Care:
To ask His Majesty's Government, following analysis by the Royal College of Nursing showing an increase in complaints about racism at work, what steps they are taking to address the increase in racism and discrimination in the health service.
Answered by Baroness Merron - Parliamentary Under-Secretary (Department of Health and Social Care)
Any form of racism or discrimination is unacceptable and has no place in our National Health Service.
Action is being taken to address racism and discrimination in the NHS, including an urgent review of antisemitism, other forms of racism, and the oversight and regulation of healthcare professionals. The NHS is also strengthening mandatory anti-racism training across the NHS.
Additionally, as set out in the 10-Year Health Plan, we will introduce a new set of staff standards for modern employment which will include reducing violence against staff and tackling racism and sexual harassment. They will underpin the NHS Oversight Framework and act as an early warning signal for the Care Quality Commission.
Asked by: Baroness Manzoor (Conservative - Life peer)
Question to the Department of Health and Social Care:
To ask His Majesty's Government what estimate they have made of any direct or indirect costs to the NHS incurred by the provisions in the Terminally Ill Adults (End of Life) Bill.
Answered by Baroness Merron - Parliamentary Under-Secretary (Department of Health and Social Care)
It is not possible, or appropriate at this stage, for the Government to provide a more narrowed consideration of either the policy intents, or the possible total or net costs of implementing the Bill. The Impact Assessment advises the following:
“Where sufficient information and evidence is available, illustrative figures for some impacts have been provided. These quantified elements are for the most part uncertain with wide ranges attached but should allow for some indication of the order of magnitude. The upper bound of these ranges should not be interpreted as maximum values, nor as representative of the full range of potential costs, given there are significant aspects of the Bill that have not been possible to quantify. Adding only the quantified elements of this IA together would not give a comprehensive assessment on the net impact of the Bill because significant unquantified impacts would not be accounted for in that net figure.”
A copy of the Impact Assessment is attached.
Asked by: Baroness Manzoor (Conservative - Life peer)
Question to the Department of Health and Social Care:
To ask His Majesty's Government what plans they have, if any, to update the terms of reference for the independent commission into adult social care to include the level of spending on palliative care within the NHS.
Answered by Baroness Merron - Parliamentary Under-Secretary (Department of Health and Social Care)
The independent commission into adult social care, chaired by Baroness Louise Casey of Blackstock, commenced its work in April. The Terms of Reference have been published and are designed to be sufficiently broad to enable Baroness Casey to independently consider how to build a social care system fit for the future.
The Terms of Reference are clear that recommendations should be considered within the context of the ongoing National Health Service reforms and, in phase 1, should focus on how to get adult social care working more closely with the NHS. Baroness Casey will do this by considering the existing funding for local authority adult social care services together with NHS funding for services at the interface of health and care and whether they are being best used.
Asked by: Baroness Manzoor (Conservative - Life peer)
Question to the Department of Health and Social Care:
To ask His Majesty's Government how much they plan to spend on palliative care in the NHS this year and in each of the next five years.
Answered by Baroness Merron - Parliamentary Under-Secretary (Department of Health and Social Care)
It is difficult to quantify the total provision of, or spend on, palliative and end of life care at either a national or local, integrated care board level, because it is delivered every day by a wide range of specialist and generalist health and care workers providing care for a wide range of needs that include, but are not always exclusive to, palliative care.
Palliative care is provided across multiple settings, including in primary care, community care, in hospitals, hospices, and care homes, and in people’s own homes. Therefore, not all palliative and end of life care will be recorded or coded as such.
We are supporting the hospice sector with a £100 million capital funding boost for eligible adult and children’s hospices in England to ensure they have the best physical environment for care. We are also providing £26 million of revenue funding to support children and young people’s hospices for 2025/26. This is a continuation of the funding which until recently was known as the children and young people’s hospice grant.
Asked by: Baroness Manzoor (Conservative - Life peer)
Question to the Department of Health and Social Care:
To ask His Majesty's Government how many NHS trusts have private finance initiative (PFI) debts; what is the scale of those debts; how many of the 25–30-year PFI contracts have been concluded; and how many PFI contracts are ending in legal dispute over the state of the annuity.
Answered by Baroness Merron - Parliamentary Under-Secretary (Department of Health and Social Care)
The Private Finance Initiative (PFI) programme was first established in 1992, with the final project signed in 2008. There were 126 projects signed by the National Health Service, including through NHS trusts, foundation trusts and primary care trusts, which are now held by NHS Property Services Limited (NHSPS). Some NHS organisations have multiple projects in their estates.
The private sector, through a Special Purpose Vehicle (SPV), entered into a contract with the NHS to design, build, finance and maintain the facilities. There is no debt between the NHS and those SPVs. The annual payment (unitary charge) for these projects includes the cost of facilities management, services such as catering and cleaning in some projects, and the cost of building maintenance and lifecycle replacement in all projects.
The following table shows information from the National Infrastructure and Service Transformation Authority (NISTA)’s 2024 published data on PFIs in the health portfolio and includes PFI projects where NHS trusts or NHSPS are the contracting authority:
Number of NHS trusts with an operational PFI | 96 |
Concluded PFI Contracts | 8 |
Source: NISTA
Notes:
Projects end for a range of reasons, but there are no instances of legal dispute over the level of the unitary charge. The PFI Centre of Best Practice Team at the Department supports NHS trusts with operation projects where needed to ensuring value for money is maintained.
The Government announced in the 10 Year Infrastructure Strategy and in the 10 Year Health Plan that we will explore the feasibility of using new public-private partnership (PPP) models for taxpayer-funded projects in very limited circumstances where they could represent value for money. This includes exploring the potential to use PPPs to deliver certain types of primary and community health infrastructure.
A decision whether to use PPPs in these very limited circumstances will be taken by Autumn Budget 2025, based on co-development of a model and business case between NISTA and the Department. The business case will test value for money. Any new model will be subject to market-testing, will build on lessons learned from past government experience and models currently in use elsewhere in the United Kingdom, and the March 2025 National Audit Office report, ‘Lessons Learned: private finance for infrastructure’, a copy of which is attached.
Asked by: Baroness Manzoor (Conservative - Life peer)
Question to the Department of Health and Social Care:
To ask His Majesty's Government what support they are offering to NHS trusts to ensure that any future private finance initiative contracts are value for money.
Answered by Baroness Merron - Parliamentary Under-Secretary (Department of Health and Social Care)
The Private Finance Initiative (PFI) programme was first established in 1992, with the final project signed in 2008. There were 126 projects signed by the National Health Service, including through NHS trusts, foundation trusts and primary care trusts, which are now held by NHS Property Services Limited (NHSPS). Some NHS organisations have multiple projects in their estates.
The private sector, through a Special Purpose Vehicle (SPV), entered into a contract with the NHS to design, build, finance and maintain the facilities. There is no debt between the NHS and those SPVs. The annual payment (unitary charge) for these projects includes the cost of facilities management, services such as catering and cleaning in some projects, and the cost of building maintenance and lifecycle replacement in all projects.
The following table shows information from the National Infrastructure and Service Transformation Authority (NISTA)’s 2024 published data on PFIs in the health portfolio and includes PFI projects where NHS trusts or NHSPS are the contracting authority:
Number of NHS trusts with an operational PFI | 96 |
Concluded PFI Contracts | 8 |
Source: NISTA
Notes:
Projects end for a range of reasons, but there are no instances of legal dispute over the level of the unitary charge. The PFI Centre of Best Practice Team at the Department supports NHS trusts with operation projects where needed to ensuring value for money is maintained.
The Government announced in the 10 Year Infrastructure Strategy and in the 10 Year Health Plan that we will explore the feasibility of using new public-private partnership (PPP) models for taxpayer-funded projects in very limited circumstances where they could represent value for money. This includes exploring the potential to use PPPs to deliver certain types of primary and community health infrastructure.
A decision whether to use PPPs in these very limited circumstances will be taken by Autumn Budget 2025, based on co-development of a model and business case between NISTA and the Department. The business case will test value for money. Any new model will be subject to market-testing, will build on lessons learned from past government experience and models currently in use elsewhere in the United Kingdom, and the March 2025 National Audit Office report, ‘Lessons Learned: private finance for infrastructure’, a copy of which is attached.
Asked by: Baroness Manzoor (Conservative - Life peer)
Question to the Department of Health and Social Care:
To ask His Majesty's Government how many student midwives are expected to graduate in England and Wales in 2025; and, of these, how many are expected to find employment as midwives following graduation.
Answered by Baroness Merron - Parliamentary Under-Secretary (Department of Health and Social Care)
The Department does not hold an expected figure for midwives graduating in England and Wales for 2025, or for how many of these graduates will find employment as midwives following graduation.
In order to give a sense of scale, data published by the Universities and Colleges Admissions Service shows that there were 3,395 acceptances to undergraduate midwifery courses in England in 2022, and a further 180 in Wales. These students would largely be expected to complete their three-year studies in 2025. The Department does not have a forecast rate of attrition for these students to forecast graduating numbers.
To give a sense of the level of recent midwifery graduates joining the profession, data published by the Nursing and Midwifery Council shows that the number of United Kingdom trained midwives joining the register who had a resident address in England or Wales in the 12 months to March 2024 was 2,503.
Asked by: Baroness Manzoor (Conservative - Life peer)
Question to the Department of Health and Social Care:
To ask His Majesty's Government whether they plan to ban people from going abroad to obtain paid surrogacy in poorer countries.
Answered by Baroness Merron - Parliamentary Under-Secretary (Department of Health and Social Care)
The Government has no plans to restrict international travel for surrogacy. We recognise that surrogacy is a complex and sensitive issue, but we do not support arrangements in which any party may be at risk of exploitation. We have issued guidance for those considering surrogacy overseas, clearly outlining the possible risks for individuals returning to the United Kingdom with a child born through an international arrangement.
Asked by: Baroness Manzoor (Conservative - Life peer)
Question to the Department of Health and Social Care:
To ask His Majesty's Government what action they are taking to ensure that palliative care for seriously ill children is not dependent on where they live.
Answered by Baroness Merron - Parliamentary Under-Secretary (Department of Health and Social Care)
We want a society where every person receives high-quality, compassionate care from diagnosis through to the end of life. We know there are inequalities in access to high-quality palliative and end of life care, and we, alongside NHS England, are looking at how best to reduce these.
NHS England has published statutory guidance and service specifications, which outline areas for consideration when commissioning palliative and end of life care services and, within this, there is reference to improving equity of access and reducing inequity in outcomes and experiences. Additionally, NHS England has developed a palliative and end of life care dashboard, which brings together all relevant local data in one place. The dashboard helps commissioners understand the palliative and end of life care needs of their local population, enabling integrated care boards to put plans in place to address and track the improvement of health inequalities, and ensure that funding is distributed fairly, based on prevalence.
Asked by: Baroness Manzoor (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 findings in the Care Quality Commission's 2024 Maternity Survey; and what plans they have to address those areas where the survey reported an increase in poor maternity experiences.
Answered by Baroness Merron - Parliamentary Under-Secretary (Department of Health and Social Care)
The Care Quality Commission’s 2024 Maternity Survey indicates that women’s experiences of maternity services have mostly either remained similar to 2023, or have shown small levels of decline. Whilst there have been improvements to some areas of maternity and neonatal care provision, such as mental health support during pregnancy, we recognise that the survey shows that women are not always receiving the standard of care they should expect.
NHS England’s three-year delivery plan for maternity and neonatal services continues to make progress in delivering important improvements for services. For example, all women who have given birth now receive a six-to-eight-week postnatal check-up, and Specialist Perinatal Mental Health Services now have full population coverage to support women with, or at risk of, mental health issues, with a range of treatments including support clinics, talking therapies, and pre-conception advice.
The Government recognises the need to go further to ensure that women get the maternity care they deserve, and will use the results of this survey to help inform its next steps on improving maternity and neonatal care.