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.

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:

Source: NISTA

Notes:

1. Some NHS trusts contract with NHSPS, not directly with SPVs
2. The number of NHS trusts in the table reflects how many NHS trusts have active PFI projects. Some NHS organisations have multiple projects in their estates.
3. The forecast value is updated annually based on inflation.

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.

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:

Source: NISTA

Notes:

1. Some NHS trusts contract with NHSPS, not directly with SPVs
2. The number of NHS trusts in the table reflects how many NHS trusts have active PFI projects. Some NHS organisations have multiple projects in their estates.
3. The forecast value is updated annually based on inflation.

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.

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.

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.

Found: attendance were Baroness Scott of Needham Market, Baroness Freeman of Steventon, Lord Fuller, Baroness Manzoor