Luke Taylor

The Driver and Vehicle Standards Agency’s (DVSA) main priority is upholding road safety standards while it works hard to reduce car practical driving test waiting times.

Measures in place to reduce waiting times include the recruitment of new driving examiners (DE), conducting tests outside regular hours, including at weekends and on public holidays, and buying back annual leave from DEs. DVSA also continues to deploy DEs from areas with lower waiting times into those where waiting times are longer.

DVSA is largely funded from the fees it charges for the delivery of its operational activities including driving tests.

DVSA keeps the fees it charges for all of its statutory services, including driving tests, under continuous review. Any proposals to change any fees would be subject to HM Treasury approval and public consultation.

Whilst it is our ambition through public ownership to deliver a more affordable railway, any long-term changes or concessions made to rail fares policy require balancing against the potential impacts on passengers, taxpayers and the railway.

Through future legislation, we will set out the role Great British Railways will have in fares, ticketing, and other operational aspects of the Railway. Fares and ticketing will continue to be the responsibility of train operators until Great British Railways is established.

The Secretary of State is committed to improving operational performance across the industry including at South Western Railway. The Government is also committed to bringing Operators into Public Ownership to deliver a better performing railway with South Western Railway announced as the first Operator into Public Ownership from 26th May 2025.

A significant development for South Western Railway will see the current rolling stock on all Suburban routes being replaced by brand new Class 701s which will help to improve the passenger experience.

The costs associated with the transfer of a train operating company into public ownership cannot be determined until engagement with the train operator has commenced.

Each train operator will have their own circumstances that need to be addressed to enable a successful transfer. These are identified during the due diligence phase and then the costs for addressing them can be agreed.

As an example, previously, the Department has paid fees to South Western Railway of £8.2 million between September 2020 to March 2021. These can be found in the following link:

https://www.gov.uk/government/publications/dft-payments-to-passenger-rail-operators-under-emergency-agreements#full-publication-update-history

Overall, transferring service operations to the public sector will result in a saving of fixed and performance-based management fees currently paid to private sector train operators. This saving is estimated to be £110 million to £150 million per annum once all franchised contracts had expired, with a proportion of these savings achieved each year in the interim as individual services transfer. Please see the following link:

https://publications.parliament.uk/pa/bills/cbill/59-01/0133/en/240133en.pdf

Whilst all services will transfer as their existing contracts end, there are costs associated with the transfer from a private sector operator to a public sector company (mobilisation and due diligence costs) estimated at £1 million to £1.5 million per transaction. This is consistent with costs associated with transition following any competed franchise award as shown in the following link:

https://bills.parliament.uk/publications/56108/documents/5037.

When adding or reinstating services, the Department needs to assess business cases and balance demand with value for the taxpayer in its considerations. There are currently no plans to reinstate a later train between Sunday and Thursday. However, a later Friday and Saturday service was reinstated from December 2020 departing from Waterloo at twenty-five minutes past midnight.

Ministers have been clear that rail services have been failing passengers. Bringing train operations into public ownership is the first step in the Government’s plan to improve the railways for passengers and taxpayers. Great British Railways, when established, will take a whole rail system view, ensuring that all parts of the sector are working together, to deliver against Ministers’ priorities and improve reliability for passengers.

The safety of our roads is an absolute priority for this Government.

The Highway Code was updated in 2022 to improve road safety for cyclists and pedestrians, by strengthening pedestrian priority on pavements and at crossings and introducing the Hierarchy of Road Users, which places those road users most at risk in the event of a collision, at the top of the hierarchy.

The Highway Code makes it clear that those in charge of vehicles that can cause the greatest harm in the event of a collision bear the greatest responsibility to reduce the danger they pose to others and highlights the need to take care and be particularly aware of young cyclists and pedestrians.

The Secretary of State has not had discussions with the Mayor of London specifically on levels of noise pollution on the London Underground. Ministers and officials have regular conversations with Transport for London on a variety of issues. However, transport in London is devolved to the Mayor, and TfL is responsible for the operation of London’s transport network.

The government is reviewing the position it has inherited on HS2 and will set out detailed plans in due course.

Public ownership will end the failed franchising system, allowing operators to serve the interests of passengers, not shareholders. The failures of the past three decades cannot be fixed overnight, and bringing train operations into public ownership is only one part of this government’s extensive plans to improve the railways for passengers and taxpayers.

Details on the multi-criteria decision support analysis tool, and how it was applied during the review, can be found in the New Hospital Programme Plan for Implementation, published on 20 January on the GOV.UK website, and available at the following link:

https://www.gov.uk/government/publications/new-hospital-programme-review-outcome/new-hospital-programme-plan-for-implementation

Integrated care boards (ICBs) will collectively receive over £4 billion in annual capital allocations in 2025/26, which will be managed locally, with funds allocated according to local priorities, including maintenance at New Hospital Programme sites. Recently published National Health Service planning guidance sets out the NHS’s operational capital envelopes, national capital programmes, including a £750 million estates safety fund, and allocation processes for 2025/26. I would encourage the Epsom and St Helier NHS Trust to discuss options with the South West London ICB, to allocate operational capital and national capital programme allocations towards repairs at their sites.

Final costs of schemes are subject to the approval of a Full Business Case. Cost estimates produced to enable planning during the business case development process are based on a variety of data which is generated by both the trust and the programme, and includes the capacity, design, and location of the hospital, the enabling works requirements, and the clinical requirements.

Details on the multi-criteria decision support analysis tool, and how it was applied during the review, can be found in the New Hospital Programme Plan for Implementation, published on 20 January on the GOV.UK website, and available at the following link:

https://www.gov.uk/government/publications/new-hospital-programme-review-outcome/new-hospital-programme-plan-for-implementation

Integrated care boards (ICBs) will collectively receive over £4 billion in annual capital allocations in 2025/26, which will be managed locally, with funds allocated according to local priorities, including maintenance at New Hospital Programme sites. Recently published National Health Service planning guidance sets out the NHS’s operational capital envelopes, national capital programmes, including a £750 million estates safety fund, and allocation processes for 2025/26. I would encourage the Epsom and St Helier NHS Trust to discuss options with the South West London ICB, to allocate operational capital and national capital programme allocations towards repairs at their sites.

Final costs of schemes are subject to the approval of a Full Business Case. Cost estimates produced to enable planning during the business case development process are based on a variety of data which is generated by both the trust and the programme, and includes the capacity, design, and location of the hospital, the enabling works requirements, and the clinical requirements.

Treating clinicians use National Institute for Health and Care Excellence guidance, which helps practitioners and commissioners get the best care to patients, when assessing, signposting to, and prescribing pain relief medications.

It is a prescriber’s duty when providing clinical care for conditions, such as urinary tract infections, to prescribe medicines, including pain relief, when they have adequate knowledge of the patient’s health and are satisfied that the medicine is clinically suitable for the patient.

Too many young people are not receiving the mental health care they need, including in London and we know that waits for mental health services are too long. As part of our mission to build a National Health Service that is fit for the future and that is there when people need it, we will recruit an additional 8,500 mental health workers across children and adult mental health services in England to reduce delays and provide faster treatment. We will also provide access to a specialist mental health professional in every school and roll out Young Futures Hubs in every community.

There are currently approximately 65 locally-funded early support hubs in England offering early easy access mental health interventions to thousands of children and young people aged between 11 and 25 years old including those from low-income families.

The Department is running an £8 million Shared Outcomes Fund project throughout 2024/25 to boost and evaluate the impact of 24 of these existing early support hubs, including two in London.

The standard of training for doctors is the responsibility of the General Medical Council (GMC). The GMC sets the outcome standards expected at undergraduate level. The curricula for postgraduate training is set by the Academy of Medical Royal Colleges for foundation training, and by individual Royal Colleges and faculties for specialty training. The GMC approves curricula and assessment systems for each training programme.

Curricula across the specialties where doctors in training might regularly treat patients with urinary tract infections will contain competencies relating to understanding, identifying and treating urinary tract infections and the associated symptoms. The Academy of Medical Royal Colleges Evidenced-based interventions (EBI) programme includes guidance on chronic UTIs, with more information available at the following link:

https://ebi.aomrc.org.uk/interventions/investigation-and-onward-referral-of-women-with-recurrent-uti/

In September 2024, the EBI programme was adopted as standard operating procedure by the National Health Service.

The Royal College of General Practitioners also provide e-learning on UTIs, with more information available at the following link:

https://elearning.rcgp.org.uk/mod/book/tool/print/index.php?id=12652

Diagnostic tests for chronic urinary tract infections (UTIs), such as urinalysis and urine culture, are widely available across all pathology networks in England. Ensuring accurate diagnostic testing not only aids more effective identification of infection but can also reduce unnecessary prescribing and overprescribing of broad-spectrum antimicrobials and directly benefit patients who get the right treatment sooner.

General practitioners can request testing for chronic UTIs via several pathways, including at point-of-care, via community diagnostic centres, or via laboratories. Laboratories across England adhere to stringent quality standards for diagnostic tests, including the UK Accreditation Standard ISO 15189, and implement robust internal and external quality assurance schemes. Together, these measures ensure the accuracy and reliability of diagnostic testing.

The development of new products to diagnose infections more accurately is essential to ensure we can continue to treat infections and protect public health. NHS England is also supporting research into newer, more accurate point-of-care tests for UTIs, such as via the Toucan study. More information on the study is available at the following link:

https://www.phctrials.ox.ac.uk/recruiting-trials/toucan-platform-for-uti-diagnostic-evaluation

Genomic testing in the National Health Service in England is provided through the NHS Genomic Medicine Service (GMS) and delivered by seven NHS Genomic Laboratory Hubs. Genomic testing for genetic haemochromatosis is available through the NHS GMS for all patients in England who show an unexplained iron overload, suggestive of hereditary haemochromatosis, to aid in the diagnosis of the disease. Any healthcare professional who suspects their patient may have haemochromatosis can refer their patient for testing via their local NHS Clinical Genomic Service. Individuals can discuss with their healthcare professional, for instance their general practitioner, whether genomic testing is appropriate for them.

Decisions on whether new medicines should be routinely funded by the National Health Service in England are made on the basis of recommendations from the National Institute for Health and Care Excellence (NICE), following an evaluation of a treatment’s costs and benefits.

The NICE process relies on the company to make an evidence submission. When the company does not make an evidence submission, the NICE is unable to develop recommendations, and the appraisal is terminated. NHS England’s default position is not to routinely commission a treatment where the company has not engaged in the NICE appraisal process. This is to avoid a potential pathway for circumventing the NICE process, that ensures value for the taxpayer.

The Government encourages all companies to engage constructively in the NICE appraisal process. The NICE is able to recommend most medicines for use in the NHS where companies engage in the process, and has recommended 79% of cancer medicines that it has appraised. This includes many medicines for blood cancers, that are now available to NHS patients, including through the Cancer Drugs Fund, which makes promising new medicines available to patients while further evidence is collected to address uncertainties in clinical and cost-effectiveness.

It is a priority for the Government to support the National Health Service to diagnose cancer, including blood cancer, as early and quickly as possible, and to treat it faster, to improve outcomes.

The Department is committing to this by improving waiting times for cancer treatment, starting by delivering an extra 40,000 operations, scans, and appointments each week, to support faster diagnosis and access to treatment.

In addition to improving cancer waiting time performance, the NHS has implemented non-specific symptom pathways for patients who present with vague and non-site-specific symptoms, which do not clearly align to a tumour type. This includes leukaemia, which the national evaluation found was one of the most common cancers diagnosed via these pathways.

We will get the National Health Service diagnosing cancer earlier and treating it faster, including blood cancer. This is supported by NHS England’s key ambition on cancer, to meet the Faster Diagnosis Standard, which sets a target of 28 days from urgent referral by a general practitioner or screening programme to patients being told that they have cancer, or that cancer is ruled out.

NHS England has implemented non symptom specific pathways for patients who present with non-specific symptoms, or combinations thereof, that can indicate several different cancers. This includes leukaemia, which can present non-specific symptoms, such as unexpected weight loss and night sweats. From our national evaluation, blood cancers are one of the most common cancer types diagnosed through these pathways.

Launched in August 2022, the three-year Family Hubs and Start for Life programme provides approximately £300 million to 75 local authorities in England with high levels of deprivation. The joint Department of Health and Social Care and Department for Education programme has created a network of Family Hubs with Start for Life services, which support the period from conception to the age of two years old, providing families with the support they need when they need it.

While the Government does not have plans at this stage to publish a progress report on the Family Hubs and Start for Life programme, two national, independent evaluations are underway to understand implementation and impact.

At the 2024 Autumn Budget, my Rt. Hon. Friend, the Chancellor of the Exchequer announced £69 million to continue delivery of a network of Family Hubs. The Department will confirm Start for Life funding for 2025/26 in due course, including support for perinatal mental health and parent-infant relationship services.