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 for Science, Innovation & Technology:
To ask His Majesty's Government what action they are taking to ensure that artificial intelligence labs prevent chatbots from discussing suicide with teenagers.
Answered by Lord Vallance of Balham - Minister of State (Department for Energy Security and Net Zero)
Every death by suicide is a tragedy and the government is deeply concerned about the role that online content can play.
Services in scope of the Online Safety Act have duties to protect all users from illegal suicide content and protect children from harmful content that encourages, promotes, or provides instructions for suicide. This includes regulated AI-generated content.
The government keeps all legislation under review and will not hesitate to strengthen the law, where required, to protect children.
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 Foreign, Commonwealth & Development Office:
To ask His Majesty's Government what steps they are taking to prevent the exploitation of women in poorer countries involved in surrogacy.
Answered by Lord Collins of Highbury - Lord in Waiting (HM Household) (Whip)
The UK does not support international surrogacy involving any form of exploitation and is committed to eradicating all forms of modern slavery, forced labour and human trafficking in line with Sustainable Development Goal 8.7. Globally the UK is proud to defend and promote universal and comprehensive sexual and reproductive health and rights. At the multilateral level, and through our diplomatic and Official Development Assistance partnerships, we advocate that all people have the right to make informed decisions about childbearing, including if, whether and when to have children. Family planning interventions, including surrogacy, must always be voluntary and rooted in a human rights-based approach.
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 for Science, Innovation & Technology:
To ask His Majesty's Government what actions they are taking to reduce the use of electronic devices such as tablets and smartphones for preschool children and babies; and how they are alerting new parents of the possible dangers for preschool children and babies overusing these devices.
Answered by Baroness Jones of Whitchurch
Ofcom has duty to promote media literacy to help the public understand the nature and impact of where harmful content and online behaviour affects certain groups.
The Online Safety Act also requires user-to-user and search services likely to be accessed by children to risk assess their service and provide safety measures for child users of all age groups, including early years. In its draft child safety risk assessment guidance, Ofcom has identified age as a risk factor, listing 0-5 years as an age group for which it expects services to consider the age-related risks based on the developmental stage of the children.
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.