As the noble Baroness knows, debanking and access to banking services is an issue way beyond charities and it is really important. The Government recognise the importance of that, and that is why they have introduced new rules to require banks to give customers 90 days’ notice before closing accounts and to provide a clear explanation. The

Government’s new rules will ensure more transparent and predictable access to banking, while still recognising that it is a commercial decision for a provider as to whom they provide services. But what I would say is that banks are big and rich, most charities are small and poor, and I am on the side of the little guy.

The High-Level Meeting comes at a critical moment for the global HIV response and offers an opportunity to reaffirm international commitments to end AIDS for good. The UK has endorsed the Global AIDS Strategy 2026-2031 and will work to ensure the political declaration upholds its ambitions, particularly on human rights and gender equality, as well as harnessing the opportunity presented by long-acting injectable HIV prevention and treatment.

The High-Level Meeting comes at a critical moment for the global HIV response and offers an opportunity to reaffirm international commitments to end AIDS for good. The UK has endorsed the Global AIDS Strategy 2026-2031 and will work to ensure the political declaration upholds its ambitions, particularly on human rights and gender equality, as well as harnessing the opportunity presented by long-acting injectable HIV prevention and treatment.

The new HIV Action Plan sets out how the Government will enable every level of the healthcare system to work together to engage everyone in prevention, testing, and treatment, tackling stigma, and reaching our ambition to end new HIV transmissions by 2030. This includes a dedicated action to deliver tailored and targeted HIV prevention, treatment, and care services to meet the needs of local populations and address inequalities, including the challenges of HIV prevention and care in prisoners.

Sexual health services in prisons are commissioned by NHS England under the Section 7a Public Health Functions Agreement with the Department. They are required to deliver care and ensure access in accordance with the British Association for Sexual Health and HIV’s prison standards, helping to ensure that all individuals in custody receive equitable healthcare comparable to that available in the community.

Access to HIV pre-exposure prophylaxis in England is via commissioned level three sexual health services. These are commissioned by local authorities for people in the community. NHS England Health and justice commissioners arrange for these providers to enable access for detained people via referral for assessment. The service is accessed by the detained person via in-reach provision, where the sexual health team come on-site, or out-reach provision, where the individual goes out to clinic. The level three sexual health team use the same commissioning policy to provide the service on the same basis to detained people and people in the community.

HIV post exposure prophylaxis is accessed by prisoners in the same way as people in the community. They attend accident and emergency or access a Sexual Assault Referral Centre based on locally commissioned arrangements.

To inform future action, the UK Health Security Agency is working with regional partners to carry out an audit to understand the provision of HIV diagnosis, prevention, and care in English prisons.

The new HIV Action Plan, published on World AIDS Day on 1 December 2025, sets out how the Government will enable every level of the healthcare system to work together to engage everyone in prevention, testing, and treatment, tackling stigma, and reaching our ambition to end new HIV transmissions by 2030. This includes a dedicated action to deliver tailored and targeted HIV prevention, treatment, and care services to meet the needs of local populations and address inequalities, including the challenges of HIV prevention and care in prisoners.

People entering prison receive healthcare assessments on reception which identify current healthcare needs and treatment. This includes identifying people who are receiving treatment for HIV. The healthcare team will use processes for accessing critical medicines to arrange an urgent supply of HIV medicines from the specialist clinic if required. The healthcare team will then ensure a referral to the local HIV specialist team if the patient is in a prison, in a location which lies outside of the area covered by their current specialist. HIV services have clear processes used to promptly transfer care between specialists.

The UK Health Security Agency is working with regional partners to carry out an audit to understand the provision of HIV diagnosis, prevention, and care in English prisons.

The UK Health Security Agency (UKHSA) publishes overall HIV prevalence and HIV testing data annually in the HIV Monitoring and Evaluation Framework and the HIV Official Statistics, which are available on the GOV.UK website. Our recently published 2025 report Understanding HIV testing contains further information on people in prison. The report is also available on the GOV.UK website.

The Chief Medical Officer’s annual report in 2025, The health of people in prison, on probation and in the secure NHS estate in England, also available on the GOV.UK’s website, highlighted the significant health challenges faced by people in prison, including in sexual health and HIV, and we are committed to addressing this.

The UKHSA is working with regional partners to carry out an audit to understand the provision of HIV diagnosis, prevention, and care in English prisons. This will highlight what barriers people are facing and what we need to do to ensure every person gets the care they deserve.

Furthermore, the UKHSA is currently independently reviewing blood borne virus service provision in prisons, including the opt-out testing programme which has been in place since 2014 to update guidance, identify areas to optimise implementation, and ensure prisoners are fully supported.

The new HIV Action Plan sets out how the Government will enable every level of the healthcare system to work together to engage everyone in prevention, testing and treatment, tackling stigma, and reaching our ambition to end new HIV transmissions by 2030. This includes a dedicated action to deliver tailored and targeted HIV prevention, treatment, and care services to meet the needs of local populations and address inequalities, including the challenges of HIV testing in prisons.

HIV testing upon entry into prison is part of a national programme of opt-out blood borne virus (BBV) testing which tests people for hepatitis C, hepatitis B, and HIV. Sexual health services in prisons are commissioned by NHS England under the Section 7a Public Health Functions Agreement with the Department. This sets out targets for this opt-out BBV testing programme, with an efficiency target of 50% testing uptake, and an optimal performance standard of 75% testing uptake.

While uptake of a BBV test has risen from 11% in 2016/17 to 72% overall in 2022/23, this is below the 75% target and there is variation by region and prison. To inform future progress, the UK Health Security Agency is working with regional partners to carry out an audit to understand the provision of HIV diagnosis, prevention and care in English prisons.

All new prison officers complete foundation training which focuses on professional standards, effective communication, and working safely and respectfully with a diverse prison population. This includes training on identifying and supporting vulnerable prisoners, managing sensitive situations, and acting in line with organisational policy and the law.

Training also covers information management and recordkeeping, reinforcing the importance of handling personal and medical information appropriately. HMPPS data protection and information governance requirements apply across the prison estate to safeguard confidentiality.

In addition, HMPPS, working with Skills for Justice, has developed a core capabilities framework for prison and probation staff who work with individuals with health, care and wellbeing needs. The framework sets out the skills, knowledge and behaviours required to support individuals in a person-centred way, including recognising needs, working in partnership with healthcare professionals, and managing sensitive information. It also supports leadership capability and can be used to strengthen existing training provision and identify gaps.

Prison healthcare services in England are commissioned by NHS England. HMPPS works in close partnership with NHS England to ensure people in custody have access to HIV testing and treatment, and that services are delivered safely and confidentially. This collaboration is underpinned by the National Partnership Agreement, which sets out shared priorities and responsibilities to improve health outcomes and reduce health inequalities in custodial settings.

What the noble Baroness describes—people getting the runaround—is, of course, unacceptable, and we have discussed this a number of times. I would be pleased to take back her suggestion to the Minister for Care, Stephen Kinnock.

The new HIV Action Plan, published on World AIDS Day on 1 December 2025, sets out how the Government will enable every level of the healthcare system to work together to engage everyone in prevention, testing and treatment, tackling stigma, and reaching our ambition to end new HIV transmissions by 2030. This includes a dedicated action to deliver tailored and targeted HIV prevention, treatment, and care services to meet the needs of local populations and address inequalities, including the challenges of HIV testing in prisons.

HIV testing on entry into prison is part of a national programme of opt-out blood borne virus (BBV) testing which tests people for hepatitis C, hepatitis B, and HIV. Sexual health services in prisons are commissioned by NHS England under the Section 7a Public Health Functions Agreement with the Department. This sets out targets for this opt-out BBV testing programme, with an efficiency target of 50% testing uptake, and an optimal performance standard of 75% testing uptake.

While uptake of a BBV test has risen from 11% in 2016/17 to 72% overall in 2022/23, this is below the 75% target and there is variation by region and prison. To inform future progress we are supporting regional partners to complete and review the BBV and sexually transmitted infections prisons audit to understand provision of HIV prevention and care in prisons from primary care and sexual health services.

The new HIV Action Plan, published on World AIDS Day on 1 December 2025, sets out how the Government will enable every level of the healthcare system to work together to engage everyone in prevention, testing and treatment, tackling stigma, and reaching our ambition to end new HIV transmissions by 2030. This includes a dedicated action to deliver tailored and targeted HIV prevention, treatment, and care services to meet the needs of local populations and address inequalities, including the challenges of HIV prevention and care in prisoners.

People entering prison receive healthcare assessments on reception which identify current healthcare needs and treatment. This includes identifying people who are receiving treatment for HIV. The healthcare team will use processes for accessing critical medicines to arrange an urgent supply of HIV medicines from the specialist clinic if required. The healthcare team will then ensure a referral to the local HIV specialist team if the patient is in a prison in a location which lies outside of the area coveted by their current specialist. HIV services have clear processes used to promptly transfer care between specialists.

No data is available on HIV treatment attendance for people in prison or on probation. However, engagement work has reported gaps in care, including treatment interruptions. To address this, regional and local partners are being asked to complete and review the blood borne virus and sexually transmitted infections prisons audit to understand provision of HIV prevention and care in prisons from primary care and sexual health services, which will inform future action.

The new HIV Action Plan, published on World AIDS Day on 1 December 2025, sets out how the Government will enable every level of the healthcare system to work together to engage everyone in prevention, testing, and treatment, tackling stigma, and reaching our ambition to end new HIV transmissions by 2030. This includes a dedicated action to deliver tailored and targeted HIV prevention, treatment, and care services to meet the needs of local populations and address inequalities, including the challenges of HIV prevention and care in prisoners.

NHS England Health and Justice commissioned services are required to deliver care and ensure access in accordance with the British Association for Sexual Health and HIV’s prison standards, helping to ensure that all individuals in custody, including women and other vulnerable groups, receive equitable healthcare comparable to that available in the community. Access to HIV PrEP in England is via commissioned level 3 sexual health services. These are commissioned by local authorities for people in the community. NHS England Health and Justice commissioners arrange for these providers to enable access for detained people via referral for assessment. The service is accessed by the detained person via in-reach, where the sexual health team come on-site, or out-reach, where the individual goes out to clinic, provision. The service provided to individuals by the level 3 sexual health team is on the same basis provided to people in the community using the same commissioning policy. HIV post exposure prophylaxis is accessed by prisoners in the same way as people in the community. They attend accident and emergency or access a Sexual Assault Referral Centre based on locally commissioned arrangements.

To inform future action we are supporting regional partners to complete and review the blood borne virus and sexually transmitted infections prisons audit to understand the provision of HIV prevention and care in prisons from primary care and sexual health services.

The UK Health Security Agency (UKHSA) publishes overall HIV prevalence and HIV testing data annually in the HIV Monitoring and Evaluation Framework and the HIV Official Statistics, available on the GOV.UK website.

Our recently published 2025 report Understanding HIV testing contains further information on people in prison. The report is also available on the GOV.UK website.

The new HIV Action Plan, published on World AIDS Day on 1 December 2025, sets out how the Government will enable every level of the healthcare system to work together to engage everyone in prevention, testing and treatment, tackling stigma, and reaching our ambition to end new HIV transmissions by 2030. This includes a dedicated action to deliver tailored and targeted HIV prevention, treatment, and care services to meet the needs of local populations and address inequalities, including the challenges of HIV prevention and care in prisoners.

NHS England Health and Justice commissioned services are required to deliver care and ensure access in accordance with the British Association for Sexual Health and HIV’s prison standards, helping to ensure that individuals in custody receive equitable healthcare comparable to that available in the community. NHS England Health and Justice regional commissioners ensure the level 3 sexual health services for detained people includes the HIV PrEP access pathway, and that prison healthcare teams and prisoners know how to access it. Prisoners with HIV should be seen for HIV care at least once a year. However, no data is available on HIV treatment attendance for people in prison or on probation. To address this, we are supporting regional partners to complete and review the blood borne virus and sexually transmitted infections prisons audit to understand the provision of HIV prevention and care in prisons from primary care and sexual health services, to inform future action.

We absolutely can commit to continuing to fund those organisations. I cannot give numbers at the moment—we are working through the specific allocations at the moment—but the noble Baroness makes a really strong case, which I hear. The fact that we are backing the Global Fund to the extent that we are shows the Government’s intentions on this issue.

Under the Banking Framework Agreement, banks choose which services they wish to offer through the Post Office network. Manual deposit services, where customers can deposit cash using a paying-in slip without a debit card, still exist for those banks under the framework who take up this service and are not being phased out.

The Post Office does not own the customer relationship or the banking products, and therefore neither Government nor the Post Office can mandate how current accounts operate or what arrangements banks put in place for cash deposits without the use of a debit card.

I most certainly can agree with the points the noble Baroness has rightly made. There is a very clear pathway to providing safe care. The provision of telemedicine in this regard came in in 2022, and it has given safe abortions further ballast, so it is nothing other than a safe procedure, as I mentioned earlier.

Perhaps I could assist by clarifying that the spending review, which allows for an increase of over £4 billion of funding available for social care, is by 2028-29; it is not a matter of waiting for that long. That is in comparison with 2025-26. I hope I was helpful to your Lordships’ House in identifying a number of actions we have already taken to professionalise, upskill and allow people to build careers in the social care workforce. That is absolutely crucial. That, aligned with stopping international recruitment in this area—with a period of time for transition of some years—will shift to improve and increase the adult social care workforce in this country.

Your Lordships’ House will be aware of the financial situation that we inherited and seek to put right. The Government have made available up to £3.7 billion in additional funding for social care authorities in 2025-26, and the noble Baroness is right that just last week the spending review allowed for a further increase of over £4 billion to be made available for adult social care in 2028-29. We are taking a whole range of actions. The Employment Rights Bill, which we will come back to later today, seeks, for the first time ever, to bring in fair pay and professionalisation for those in the adult social care workforce. So it is not that nothing is happening in the meantime. We are making progress and ensuring that the funding will be available so that we have not just a decent adult social care workforce but a way of tackling what no Government have managed to tackle before.

Prevention is certainly the best approach. As noble Lords will be aware, one of the three pillars of the published 10-year plan is moving from sickness to prevention, so that will feature very much in the plan. We work closely with industry to ensure that government can benefit from its information and its approach, and that we can bring industry along with us to ensure that, collectively, we are taking the best approach to making healthier foods available. We also have to make sure that people have the resource to have healthier foods, as well as information. It is, again, a many-pronged approach, but that is why it has to be a joined-up approach.