Question to the Department of Health and Social Care:

To ask the Secretary of State for Health and Social Care, what progress he has made on meeting the 18-week treatment targets in the Elective Reform Plan.

Answered by Karin Smyth - Minister of State (Department of Health and Social Care)

Tackling waiting lists is a key part of our Health Mission. We have exceeded our pledge to deliver an extra two million operations, scans, and appointments, having delivered 5.2 million additional appointments between July 2024 and June 2025. This marks a vital first step to delivering on the commitment that 92% of patients will wait no longer than 18 weeks from referral to consultant-led treatment, in line with the National Health Service constitutional standard, by March 2029.

The Elective Reform Plan, published in January 2025, sets out the productivity and reform efforts needed to return to the constitutional standard. Planning Guidance for 2025/26 sets a target that 65% of patients wait no longer than 18 weeks by March 2026, with every trust expected to deliver a minimum 5% improvement on current performance over that period.

Since April, when the Elective Reform Plan came in to effect, the percentage of patient pathways that involved waits of less than 18 weeks for treatment has improved by 2%, rising from 59.8% to 61.8% as of the end of September. This is the best performance since June 2022. The referral-to-treatment waiting list decreased to 7.39 million in September 2025, a reduction of 231,854 since the start of July 2024. But we know there is still much more to do, and we will continue to support NHS trusts to deliver our targets through innovation, sharing best practice to increase productivity and efficiency, and ensuring the best value is delivered.

Question to the Department of Health and Social Care:

To ask the Secretary of State for Health and Social Care, whether he has made an assessment of the potential merits of removing the use of body mass index thresholds to determine eligibility for joint replacement surgery.

Answered by Karin Smyth - Minister of State (Department of Health and Social Care)

The Department has made no specific assessment of the potential merits of removing the use of body mass index (BMI) thresholds to determine eligibility for joint replacement surgery. It is the responsibility of individual integrated care boards to determine policies for their local area.

As with all surgery, BMI would be considered as part of a holistic, personalised perioperative evaluation of the risks versus clinical need for joint replacement surgery of an individual patient. However, BMI should not be considered in isolation and in and of itself should not act as a barrier to surgery.

As part of the NHS Elective Reform Plan there is a commitment to expand access to the NHS Digital Weight Management Programme for patients waiting for hip and knee surgery.

Question to the Department of Health and Social Care:

To ask the Secretary of State for Health and Social Care, what steps he is taking to help reduce elective care waiting times (a) in general and (b) for joint replacement surgery.

Answered by Karin Smyth - Minister of State (Department of Health and Social Care)

The Government is committed to putting patients first and tackling waiting lists as part of our Health Mission. We exceeded our pledge to deliver an extra two million appointments, tests, and operations in our first year of Government, delivering 5.2 million additional appointments between July 2024 and June 2025. This marks a vital first step to delivering on our commitment to return to the National Health Service constitutional standard that 92% of patients wait no longer than 18 weeks from referral to consultant-led treatment by March 2029.

The Department is taking a range of steps to reduce waiting times for surgery, including joint replacement surgery. There are currently 123 surgical hubs operational across England, and we are committed to expanding the number of hubs over the next three years to increase surgical capacity and deliver faster access to common procedures. Surgical hubs have been shown to deliver approximately 20% increased productivity in the hubs compared to trusts without a dedicated elective hub on site.

The Getting it Right First time (GIRFT) programme published detailed guidance for hip and knee replacements in July 2023 and has been supporting trusts through a multidisciplinary team made up of anaesthetic, surgical, and allied health professional colleagues. Additionally, GIRFT is leading a community musculoskeletal programme, supporting improvements in the early stages of the pathway, to ensure that only those patients who require surgery are referred into secondary care, and that their condition is optimised for surgery as far as possible at the point of referral. Further information on the GIRFT programme is available at the following link:

https://gettingitrightfirsttime.co.uk/

Question to the Department of Health and Social Care:

To ask the Secretary of State for Health and Social Care, what steps he is taking to increase access to weight loss injections for long-term conditions.

Answered by Ashley Dalton - Parliamentary Under-Secretary (Department of Health and Social Care)

Weight loss injections are currently recommended for use on the National Health Service for the treatment of obesity and/or type 2 diabetes. To be routinely used in the NHS in England, a medicine normally needs a marketing authorisation from the Medicines and Healthcare Products Regulatory Agency (MHRA) that shows it is safe and efficacious, and then a positive National Institute for Health and Care Excellence (NICE) appraisal to show if it is a clinically and cost-effective use of NHS resources. NICE is currently developing guidance on the use of semaglutide for the prevention of cardiovascular disease and, subject to licensing, liver fibrosis, without cirrhosis, caused by metabolic dysfunction-associated steatohepatitis.

Most recently, NICE recommended semaglutide, brand name Wegovy, and tirzepatide, brand name Mounjaro, as treatments for obesity, in adults with a high body mass index and at least one weight-related comorbidity such as type 2 diabetes, hypertension, and/or cardiovascular disease.

Until recently, these medicines were only available in specialist weight management services. From 23 June tirzepatide started to become available in primary care. This will help to increase access. Access is being prioritised for those with the highest clinical need first. The NHS will look at different service models including digital and community options and the roll out will be sped up if possible. As set out in the Government’s new 10-Year Health Plan, we are committed to expanding access to these medicines and will work closely with industry and local systems to test new models of care and identify innovative ways to do this.

Question to the Department of Health and Social Care:

To ask the Secretary of State for Health and Social Care, what assessment he has made of the potential merits of increasing funding for the specialist (a) care, (b) advice and (c) assessment provided by hospices.

Answered by Stephen Kinnock - Minister of State (Department of Health and Social Care)

Integrated care boards (ICBs) are responsible for commissioning palliative care services to meet the reasonable needs of their population, which can include hospice services available within the ICB catchment. To support ICBs in this duty, NHS England has published statutory guidance and a service specification.

The Government is developing a Palliative Care and End of Life Care Modern Service Framework for England, due to be published in Spring 2026. I refer the hon. Member to the Written Ministerial Statement HCWS1087 I gave to the House on 24 November 2025.

Additionally, 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.   St Michael’s Hospice in Hereford is receiving £667,020 from this funding. We are also committing £80 million for children’s and young people’s hospices over the next three financial years, giving them stability to plan ahead and focus on what matters most, caring for their patients.

Question to the Department of Health and Social Care:

To ask the Secretary of State for Health and Social Care, what steps he is taking to ensure that hospice contracts reflect the (a) cost of the services they provide and (b) needs of their local populations.

Answered by Stephen Kinnock - Minister of State (Department of Health and Social Care)

Integrated care boards (ICBs) are responsible for commissioning palliative care services to meet the reasonable needs of their population, which can include hospice services available within the ICB catchment. To support ICBs in this duty, NHS England has published statutory guidance and a service specification.

The Government is developing a Palliative Care and End of Life Care Modern Service Framework for England, due to be published in Spring 2026. I refer the hon. Member to the Written Ministerial Statement HCWS1087 I gave to the House on 24 November 2025.

Additionally, 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.   St Michael’s Hospice in Hereford is receiving £667,020 from this funding. We are also committing £80 million for children’s and young people’s hospices over the next three financial years, giving them stability to plan ahead and focus on what matters most, caring for their patients.

Question to the Ministry of Housing, Communities and Local Government:

To ask the Secretary of State for Housing, Communities and Local Government, what assessment his Department has made of the potential merits of changing planning laws to ensure developments with full planning permission are (a) completed on time and (b) not able to exist with minimal work on them.

Answered by Matthew Pennycook - Minister of State (Housing, Communities and Local Government)

Local planning authorities (LPAs) already have a wide range of enforcement powers, with strong penalties for non-compliance, which they can use in instances where development has not taken place in accordance with the relevant planning consent.

These enforcement powers include the power to issue a completion notice which requires a developer to complete their development if it is left uncompleted.

It is for LPAs themselves to decide how and when they use their powers depending on the circumstances of each case.

On 25 May, the government published a Planning Reform Working Paper: Speeding Up Build Out (which can be found on gov.uk here) inviting views on further action the government should take to speed up homes being built.

On the same day, we launched a technical consultation on implementing measures to improve the transparency of build rates from new residential development, which includes proposals to implement provisions in Section 113 of the LURA on the power to decline to determine applications. The consultation can be found on gov.uk here. Subject to the outcome of the consultation, the government intends bring forward the regulations to implement these measures at the earliest practical opportunity with the new build out reporting framework coming into force from 2026.

The consultations closed on 7 July and responses are currently being analysed.

Question to the Department for Transport:

To ask the Secretary of State for Transport, pursuant to the answer of 16 October 2024 to UIN 8287, what the status is of the proposed rural design guide; and when that guide will be completed.

Answered by Lilian Greenwood - Government Whip, Lord Commissioner of HM Treasury

Following consultation with stakeholders, Active Travel England’s Rural Design Guidance is currently in its final development stages and is expected to be published by the end of the year.

Question to the Ministry of Housing, Communities and Local Government:

To ask the Secretary of State for Housing, Communities and Local Government, whether the forthcoming Leasehold and Commonhold Reform Bill will include provisions to (a) regulate the use of estate rentcharges on freehold properties, (b) limit enforcement powers available to estate rentcharge holders under Section 121 of the Law of Property Act 1925 and (c) provide homeowners with a statutory right to vary estate rentcharge deeds to remove disproportionate enforcement mechanisms.

Answered by Matthew Pennycook - Minister of State (Housing, Communities and Local Government)

The use of Sections 121 and 122 of the Law of Property Act 1925 to enforce rent arrears is draconian and wholly inappropriate given alternative means for rentcharge arrears are available.

We will publish an ambitious draft Leasehold and Commonhold reform Bill before the end of the year.

Question to the Ministry of Housing, Communities and Local Government:

To ask the Secretary of State for Housing, Communities and Local Government, what assessment he has made of the potential impact of Section 121 of the Law of Property Act 1925 powers on freehold homeowners' ability to sell properties subject to estate rent charges; and whether he has plans to restrict or remove such powers in relation to estate rent charges.

Answered by Matthew Pennycook - Minister of State (Housing, Communities and Local Government)

The use of Sections 121 and 122 of the Law of Property Act 1925 to enforce rent arrears is draconian and wholly inappropriate given alternative means for rentcharge arrears are available.

We will publish an ambitious draft Leasehold and Commonhold reform Bill before the end of the year.

Question to the Department for Transport:

To ask the Secretary of State for Transport, with reference to Question 8287answered on 16 October 2024, what is the (a) status of the best practice guide to community consultation and engagement and (b) when this guide will be completed.

Answered by Lilian Greenwood - Government Whip, Lord Commissioner of HM Treasury

Following consultation with stakeholders, Active Travel England’s Rural Design Guidance is currently in its final development stages and is expected to be published by the end of the year.

Question to the Department for Education:

To ask the Secretary of State for Education, what assessment her Department has made of the adequacy of funding provided to nurseries to deliver the extended free childcare hours without financial shortfall.

Answered by Olivia Bailey - Parliamentary Under-Secretary of State (Department for Education) (Equalities)

It is the department’s ambition that all families have access to high quality, affordable and flexible early education and care, improving the life chances for every child and the work choices for every parent.

In the 2025/26 financial year alone, the department has provided over £8 billion for the early years entitlements, increasing to over £9 billion in 2026/27.

The department has announced the largest ever increase to early years pupil premium since its introduction and have delivered a significant tranche of supplementary funding of £75 million through the early years expansion grant.

The department wants to ensure the sector is financially sustainable and confident as it continues to deliver the entitlements and high quality early years provision going forward.

Found: Q16 James Naish: When you say “they”, where is the drive coming from?

Found: Q16 James Naish: When you say “they”, where is the drive coming from?