Asked by: Lord Hunt of Kings Heath (Labour - Life peer)
Question to the HM Treasury:
To ask His Majesty's Government when they expect to publish the conclusions of the review of VAT for public bodies under Section 41 of the Value Added Tax Act 1994.
Answered by Lord Livermore - Financial Secretary (HM Treasury)
Under Section 41 of the VAT Act 1994 Government departments, NHS Trusts and some wider public bodies can claim VAT refunds on certain outsourced services. Their remaining irrecoverable VAT is funded through Departmental Expenditure Limits. The Government is exploring reforming this system into a ‘Full Refund Model’ which would enable Section 41 bodies to recover VAT on all goods and services incurred during the course of non-business activities.
To ensure the reform is fiscally neutral, the departmental budgets of Section 41 bodies must be adjusted by an amount corresponding to the additional VAT they will be refunded for. HM Treasury is currently analysing data provided by Section 41 bodies on their irrecoverable VAT and will set out the next steps to the reforms in due course.
Asked by: Lord Hunt of Kings Heath (Labour - Life peer)
Question to the Department of Health and Social Care:
To ask His Majesty's Government what action they are taking to recover the reported deficit of the Kent and Medway Integrated Care Board.
Answered by Baroness Merron - Parliamentary Under-Secretary (Department of Health and Social Care)
2025/26 marks a financial reset year for the National Health Service and the majority of NHS systems remain on track to deliver the plans they agreed at the beginning of the year. At the end of December, NHS systems are overspending by £445 million and six systems account for more than half of the total overspend. 17 systems have delivered in line with their plans. At the same point last year systems had overspent by £1,031 million with only four systems delivering their plans to that point.
Where an organisation is assessed to be significantly off track and amongst the most challenged in the country, NHS England will provide a range of national and regional support, including potential enforcement actions, to help organisations develop individual recovery plans and get back on track. More details on NHS England’s oversight and support for challenged organisations are available at the following link:
https://www.england.nhs.uk/long-read/nhs-oversight-framework-2025-26/#performance-assessment
Kent and Medway Integrated Care Board (ICB) has recently updated the forecast for the system and declared a potential overspend of approximately £190 million against the plan it agreed with NHS England at the beginning of the financial year. An external review has been commissioned to understand the drivers behind this recently reported overspend and, working with NHS England’s regional team, the ICB will use the outcomes of that review to develop a sustainable recovery plan.
Asked by: Lord Hunt of Kings Heath (Labour - Life peer)
Question to the Department of Health and Social Care:
To ask His Majesty's Government whether any integrated care boards make exceptional funding requests for liothyronine; and whether the exceptional funding request process is intended to be used for rationed treatments, such as liothyronine.
Answered by Baroness Merron - Parliamentary Under-Secretary (Department of Health and Social Care)
The inclusion of liothyronine in the guidance will be reviewed only if there is a significant change in the evidence, including National Institute for Health and Care Excellence (NICE) guidance on the assessment and management of thyroid disease, which currently aligns with the policy guidance recommendations.
No assessment of integrated care boards’ adherence to guidance has been made. Regions cascaded the ‘items that should not be prescribed in primary care’ policy guidance to systems who are responsible for ensuring prescribing is in line with the available guidance.
The Department and NHS England do not collect or hold this data, as integrated care boards make exceptional funding requests for liothyronine, and therefore the information would be held by individual integrated care boards.
Asked by: Lord Hunt of Kings Heath (Labour - Life peer)
Question to the Department of Health and Social Care:
To ask His Majesty's Government whether they plan to remove liothyronine from the guidance Items which should not routinely be prescribed in primary care, updated on 19 August 2025.
Answered by Baroness Merron - Parliamentary Under-Secretary (Department of Health and Social Care)
The inclusion of liothyronine in the guidance will be reviewed only if there is a significant change in the evidence, including National Institute for Health and Care Excellence (NICE) guidance on the assessment and management of thyroid disease, which currently aligns with the policy guidance recommendations.
No assessment of integrated care boards’ adherence to guidance has been made. Regions cascaded the ‘items that should not be prescribed in primary care’ policy guidance to systems who are responsible for ensuring prescribing is in line with the available guidance.
The Department and NHS England do not collect or hold this data, as integrated care boards make exceptional funding requests for liothyronine, and therefore the information would be held by individual integrated care boards.
Asked by: Lord Hunt of Kings Heath (Labour - Life peer)
Question to the Department of Health and Social Care:
To ask His Majesty's Government what assessment they have made of whether all integrated care boards adhere to NHS England's national guidance on liothyronine.
Answered by Baroness Merron - Parliamentary Under-Secretary (Department of Health and Social Care)
The inclusion of liothyronine in the guidance will be reviewed only if there is a significant change in the evidence, including National Institute for Health and Care Excellence (NICE) guidance on the assessment and management of thyroid disease, which currently aligns with the policy guidance recommendations.
No assessment of integrated care boards’ adherence to guidance has been made. Regions cascaded the ‘items that should not be prescribed in primary care’ policy guidance to systems who are responsible for ensuring prescribing is in line with the available guidance.
The Department and NHS England do not collect or hold this data, as integrated care boards make exceptional funding requests for liothyronine, and therefore the information would be held by individual integrated care boards.
Asked by: Lord Hunt of Kings Heath (Labour - Life peer)
Question to the Department of Health and Social Care:
To ask His Majesty's Government what steps they are taking to ensure an equitable distribution of general medical practitioners in England between regions.
Answered by Baroness Merron - Parliamentary Under-Secretary (Department of Health and Social Care)
Following actions taken by this government, England currently has the highest number of fully qualified general practitioners (GPs) since 2015.
We want to go further than this, and that’s why thousands more GPs are being trained to expand capacity further. The number of GP training places has been expanded by 250, taking the total number of available places to 4250 for 2025/26, and we plan to expand this again for 2026/27. Current and future expansions to post-graduate training, including foundation training and GP specialty training, have been planned on the basis of relative need, balanced with ability of locations to support trainees.
There has long been criticism that the way GP funding is allocated across England (the Carr-Hill formula), is considered outdated. This is why we are reviewing the Carr-Hill formula, to ensure funding for core services is distributed equitably between practices across the country. The first phase of the review is expected to conclude in March 2026.
Following feedback from the 2026/27 GP contract consultation, this Government is introducing a practice-level GP reimbursement scheme using £292 million of repurposed funding from the current Capacity and Access Payment. This funding will be available to practices to hire additional GPs or fund additional sessions with existing GPs to improve access to general practice. The funding is equivalent to 1600 FTE GPs nationally and aims to strengthen capacity, access, and improve patient satisfaction, whilst also addressing GP unemployment and underemployment.
We are also increasing the flexibility of the Additional Roles Reimbursement Scheme (ARRS) by removing the restriction that ARRS funding can only be used for recently qualified GPs, increasing the maximum reimbursement amount for GP roles to reflect experience, and enabling primary care networks to recruit a broader range of ARRS roles, where agreed with the commissioner.
Asked by: Lord Hunt of Kings Heath (Labour - Life peer)
Question to the Department of Health and Social Care:
To ask His Majesty's Government whether they plan to meet representatives of Thyroid UK and The Thyroid Trust to discuss the prescribing of liothyronine in primary care.
Answered by Baroness Merron - Parliamentary Under-Secretary (Department of Health and Social Care)
The Department has no current plans to meet representatives of Thyroid UK and The Thyroid Trust to discuss the prescribing of liothyronine in primary care.
Asked by: Lord Hunt of Kings Heath (Labour - Life peer)
Question to the Department of Health and Social Care:
To ask His Majesty's Government what assessment they have made of whether the Care Quality Commission's 8 January assessment of Orchard Nursing Home, Huyton (1) took into full account of concerns that had been expressed to the Care Quality Commission about the care people received in the home, (2) measured the degree to which care plans were being followed, and (3) sufficiently evaluated the extent to which complaints were properly investigated.
Answered by Baroness Merron - Parliamentary Under-Secretary (Department of Health and Social Care)
As the Care Quality Commission (CQC) is operationally independent, the Government has not made its own assessment of individual CQC assessments.
The CQC has advised that its 8 January 2026 assessment of Orchard Nursing Home, Huyton included consideration of how residents and family members were supported to raise concerns and share their experiences, with inspectors finding a positive culture in which people felt able to speak up and confident that issues would be listened to and addressed. The CQC took into full account concerns raised about the care people received and noted improvements the service had made under new management.
The assessment also found evidence that care plans had improved, with personalised care plans developed before admission, routinely monitored, and reviewed regularly to reflect people’s needs and preferences.
In addition, inspectors considered how complaints were identified, investigated and responded to. A complaints policy was in place, information on how to raise concerns was accessible, and complaints were taken seriously, investigated appropriately, and used to support learning and ongoing improvement.
Asked by: Lord Hunt of Kings Heath (Labour - Life peer)
Question to the Department of Health and Social Care:
To ask His Majesty's Government whether they are satisfied that in the Care Quality Commission's 8 January assessment of Orchard Nursing Home, Huyton, residents, relatives of residents, and relatives of previous residents had an opportunity to discuss their experiences with the Care Quality Commission.
Answered by Baroness Merron - Parliamentary Under-Secretary (Department of Health and Social Care)
As the Care Quality Commission (CQC) is operationally independent, the Government has not made its own assessment of individual CQC assessments.
The CQC has advised that its 8 January 2026 assessment of Orchard Nursing Home, Huyton included consideration of how residents and family members were supported to raise concerns and share their experiences, with inspectors finding a positive culture in which people felt able to speak up and confident that issues would be listened to and addressed. The CQC took into full account concerns raised about the care people received and noted improvements the service had made under new management.
The assessment also found evidence that care plans had improved, with personalised care plans developed before admission, routinely monitored, and reviewed regularly to reflect people’s needs and preferences.
In addition, inspectors considered how complaints were identified, investigated and responded to. A complaints policy was in place, information on how to raise concerns was accessible, and complaints were taken seriously, investigated appropriately, and used to support learning and ongoing improvement.
Asked by: Lord Hunt of Kings Heath (Labour - Life peer)
Question to the Department of Health and Social Care:
To ask His Majesty's Government whether they plan to include primary healthcare chaplaincy as one of the options on which primary care networks can choose to spend additional roles reimbursement scheme funds.
Answered by Baroness Merron - Parliamentary Under-Secretary (Department of Health and Social Care)
The Additional Roles Reimbursement Scheme (ARRS) provides funding for a number of additional roles to help increase capacity in general practice, enabling primary care networks (PCNs) to create bespoke teams.
Following feedback from the 2026/27 GP contract consultation, we are increasing flexibility of the ARRS, enabling PCNs to recruit a broader range of ARRS roles, including primary care chaplains, where agreed with the commissioner.