Written questions by Mierlo.

Food and Rural Affairs, whether nutrient pollution will be within the remit of the Independent Water Commission; and how the Commission will interact with the rapid review of the Environmental Improvement Plan.

On 23 October, the Secretary of State, in conjunction with the Welsh Government, launched an Independent Commission on the water sector regulatory system, to fundamentally transform how our water system works and clean up our rivers, lakes and seas for good. The Terms of Reference for the Independent Commission are available at here.

Food and Rural Affairs, what steps he is taking to help ensure high quality water in bathing water designated areas inland.

Designated bathing waters are monitored by the Environment Agency (EA) throughout the bathing season which enables them to assess what action is needed to improve water quality. Sites which receive classifications of poor standard will be subject to an action and improvement plan between the EA, local stakeholders and water companies. Defra also recently launched a consultation on reforms to the Bathing Water Regulations 2013. The three core proposals details in this consultation seek to bring the designation and monitoring process in line with how bathing waters are used today, and ensure it is fit for purpose for inland sites.

Food and Rural Affairs, whether he has made an assessment of the adequacy of the powers of the Environmental Agency to (a) monitor and (b) maintain bathing water (i) status and (ii) quality.

The Environment Agency (EA) is the appropriate agency for monitoring and managing bathing waters in England. Their operational duties ensure the required testing and monitoring of bathing waters, and pollution risk forecasting during the bathing season. On 12 November, Defra also launched a consultation on reforms to the Bathing Water Regulations 2013. This consultation detailed proposals that included moving the fixed dates of the bathing season from Regulations into guidance and considering a sites water quality prior to designation. These proposals would allow the EA greater flexibility when monitoring sites and a more targeted approach to maintaining their status and quality.

If he will review the (a) incentives and (b) funding for physician associates.

There is no current plan to review the funding for Physician Associates’ (PAs) training or pay. The Government has commissioned an independent review on the PA and Anaesthesia Associate professions. This review will consider the safety of the roles, and their contribution to multidisciplinary teams.

What steps he is taking to increase the uptake of (a) digital innovation and (b) patient data systems within the NHS.

NHS England is working closely with National Institute for Health and Care Excellence, the Medicines and Healthcare products Regulatory Agency and the Accelerated Access Collaborative to improve the process for uptake of innovative digital health technologies in the National Health Service. This includes working with healthcare professionals and other key stakeholders to understand what matters to them.The Federated Data Platform (FDP) is being rolled out to all trusts and integrated care systems which wish to use it, to bring together data in different local systems, to allow better co-ordination of care to patients. All trusts and integrated care boards (ICBs) are being asked to provide plans for how they will maximise the benefits of the NHS FDP for their patients in the next two years.The Shared Care Record programme set the target that by the end of September 2021, ICBs across the country would have a basic shared record in place. As of March 2022, all 42 ICBs in England have at least a basic shared care record.My Rt. Hon. Friend, the Secretary of State for Health and Social Care, has announced the intention for there to be a single patient record that both empowers patients by giving them access to their records and gives professionals access to the information they need to make the best-informed decisions when delivering care and treatment. We have begun engaging with the public to help shape our plans, including what information they would want to see included in a single record.

Food and Rural Affairs, whether his Department has (a) held recent discussions with local stakeholders on (i) when bathing water status applications will reopen and (ii) the consultation of bathing water status and (b) taken recent steps to review the cost of applying to the bathing water scheme.

Both Defra Minsters and officials have been engaging with stakeholders before and following the launch of the public consultation. Following this consultation and analysis of responses, we will consider the most appropriate time to reopen applications for new bathing water designations. Defra will publish new application guidance once the Regulations have been reformed and will ensure that there continues to be a clear and easy-to-understand process for applying for bathing water designation.

Whether he has made an assessment of the adequacy of (a) patient knowledge of the training physicians associates receive and (b) information available in general practice for patients on physician associates.

On 20 November 2024, the Government announced that it is establishing an independent review of the physician associate and anaesthesia associate professions. It will consider the safety of the roles, and their contribution to multidisciplinary healthcare teams. The review will report in spring 2025.The introduction of regulation by the General Medical Council (GMC) will provide a standardised framework of governance and assurance for the clinical practice of Physician Associates (PAs) and make it easier for employers, patients, and the public to understand the relationship between these roles and that of doctors.As set out in the National Institute for Health and Care Excellence’s guidelines, all healthcare professionals directly involved in a patient's care should introduce themselves and explain their role to the patient. The GMC has published interim standards for PAs in advance of regulation, which make it clear that professionals should always introduce their role to patients, and set out their responsibilities in the team. In primary care, NHS England has produced patient-facing materials that have been shared widely with general practices to support patient awareness and understanding of the PA role.

Food and Rural Affairs, pursuant to the Answer of 15 October 2024 to Question 8075 on Floods: Government Assistance, for what reason her Department's Property Flood Resilience grant scheme was not activated in response to flooding in September.

The Ministry for Housing, Communities and Local Government (MHCLG) coordinates the Government’s Flood Recovery Framework (FRF). Although Defra’s Property Flood Resilience (PFR) grant scheme is not part of FRF, it has always been activated alongside the FRF. The September flooding was not at the scale where MHCLG, the Department for Business and Trade and Defra would expect to activate the FRF or PFR grant schemes. The PFR grant scheme has been previously activated where more than 2,000 properties have been flooded. The Environment Agency identified that around 1,000 properties were flooded across England in September. Affected householders should ask their insurance provider if they will be eligible for Build Back Better within their claim, which can provide for flood resilient repairs.

When he plans to publish real world evidence on the effectiveness of the respiratory syncytial virus vaccine in the 75-80 cohort; how much such evidence has been collected; and whether such evidence from other countries has been taken into account in consideration of extending eligibility for that vaccine.

The UK Health Security Agency is working on vaccine effectiveness analysis within the 75 to 80-year-old age group for this winter season 2024 to 2025. We are collating data on respitatory syncytial virus (RSV) hospitalisations in England and general practice consultations in a sentinel network.Data is required from across the entire RSV season to give an accurate estimate of effectiveness. Analyses are therefore likely to take place around the end of the winter season 2024-2025. Publication is expected to follow in due course.Evidence of effectiveness in all age groups in all countries where data has been made available is being used to inform eligibility considerations. Emerging real-world evidence will be reviewed by the Joint Committee on Vaccination & Immunisation as part of its considerations for a potential extension to the older adults RSV immunisation programme, currently aimed at people aged between 75 and 80 years old, to include people over 80 years old and risk groups.

If he will make an assessment of the potential merits of testing newborn babies for spinal muscular atrophy.

Work is already underway to assess the potential merits of testing newborn babies for spinal muscular atrophy (SMA).This is following the UK National Screening Committee’s two-fold recommendation in 2023, to simultaneously develop a new cost-effectiveness screening modelling study for the United Kingdom’s screening context, and to start scoping work for an in-service evaluation of newborn screening for SMA in real world National Health Services in the UK.

Whether he plans to take steps to help support people with Coeliac disease with the cost of food; and if he will make an assessment of the potential merits of widening access to gluten free products on prescription.

We recognise the pressures people are facing with the rising cost of living. Our extensive arrangements to help people afford National Health Service prescription charges mean that almost 89% of prescription items in England are already provided free of charge. For those who are not exempt from charges, pre-payment certificates can be used to cap costs at just over £2 a week for regular prescriptions.The national prescribing position in England remains that gluten free bread and mixes can be provided to all coeliac patients on an NHS prescription, and a wide range of these items continue to be listed in part XV of the Drug Tariff. This means that prescribers can issue NHS prescriptions based on the individual preferences of their patients, while also being mindful of which product best suits the patient’s dietary needs.

What assessment he has made of the potential implications for his Department’s policies of the recommendation from the French health authority that the RSV vaccine should be provided to (a) 75-80 and (b) over 80 year olds.

The Joint Committee on Vaccination and Immunisation (JCVI) is the United Kingdom’s expert committee that advises the government on immunisation programmes.In line with JCVI advice, the respiratory syncytial virus (RSV) vaccination programme for adults turning 75 years old began on 1 September 2024 in England alongside a one-off catch-up programme to rapidly vaccinate all those already aged between 75 and 79 years old. The JCVI considered that there was less certainty about how well the vaccine works in people aged 80 years old and older, as there were not enough people of this age in the clinical trials to be able to see if the vaccines are protective in this age band.Whilst the JCVI notes what takes place in other countries, its advice is specific to the UK. The JCVI continues to keep evidence under review, including data from clinical trials and real world evidence emerging from immunisation programmes in different countries.The JCVI recently discussed the RSV programme at their committee meeting on 2nd October 2024. The minutes from this meeting are publicly available at the following link: https://www.gov.uk/government/groups/joint-committee-on-vaccination-and-immunisation

What progress he has made on dementia care in his plans for social care workforce reform; and if he will make an assessment of the potential merits of making dementia training mandatory for adult social care workers as a part of that reform.

Providers must provide sufficient numbers of suitably qualified, competent, skilled, and experienced staff to meet the needs of the people using the service. Staff must receive the support, training, professional development, supervision, and appraisals that are necessary for them to carry out their role.We now have a national career framework for adult social car, the Care Workforce Pathway, which is linked to a number of existing competency frameworks, including the dementia training standards framework.The Department has also launched a new Level 2 Adult Social Care Certificate qualification which links to the outcomes in the Care Workforce Pathway. This contains the baseline knowledge required to provide quality care, and will make sure that those who are starting out their careers have an informed awareness of dementia.

What assessment she has made of the potential impact of proposed business property relief changes on small family businesses.

At Autumn Budget 2024, the Government took a number of difficult but necessary decisions on tax, welfare, and spending to restore economic stability, fix the public finances, and support public services. The Government published information about the reforms to agricultural property relief and business property relief at www.gov.uk/government/publications/agricultural-property-relief-and-business-property-relief-reforms. In accordance with standard practice, a tax information and impact note will be published alongside the draft legislation before the relevant Finance Bill.

What recent assessment she has made of the adequacy of the implementation of restorative justice in the criminal justice system.

This Government supports the use of restorative justice, which is why, under the Code of Practice for Victims of Crime (‘the Victims’ Code’), all adult victims must be told about the option of restorative justice and how to access it. We also provide Police and Crime Commissioners with grant funding for victim support services, including restorative justice services. They are best placed to assess local need and commission services based on the needs of the population in the local area. Restorative justice can also be used as part of out of court resolutions, depending on the circumstances of the case.We know that restorative justice can improve victim satisfaction and reduce reoffending when delivered in the right circumstances. This not only benefits the victims and the offender but also their community.

Communities and Local Government, if she will make an assessment of the potential merits of increasing protections for (a) the Chilterns national landscape and (b) other national landscapes under the national planning policy framework.

The government is committed to ensuring that our most important and cherished landscapes are appropriately protected so they can be enjoyed by future generations.Planning policy is clear that planning policies and decisions should recognise the character and beauty of the countryside, and local authorities are expected to protect heritage assets which can include landscape and setting of listed buildings.Only local authorities, national park authorities, or the Planning Inspectorate (acting on behalf of the Secretary of State), can give permission for development in, or affecting, a National Landscape (previously known as AONB). Relevant authorities must make sure that any proposals seek to further the purpose of conserving and enhancing the natural beauty of the National Landscape.The National Planning Policy Framework states that great weight should be given to conserving and enhancing landscape and scenic beauty in National Landscapes, and that the scale and extent of any development in these areas should be limited.

If she will make an assessment with Cabinet colleagues of the potential merits of increasing the provision of financial support available to kinship carers.

The department recognises the important role that kinship carers play in caring for some of the most vulnerable children and this government is determined to give every child the opportunities they deserve. Kinship carers play a crucial role in delivering this.At Budget, the department recently announced a £40 million package to trial a new kinship allowance in up to ten local authorities to test whether paying an allowance to cover certain costs, such as covering day to day costs, supporting them to settle into a new home with relatives, or affording activities to support their wellbeing, can help increase the number of children taken in by family members and friends. This trial will help the department make decisions about future national rollout.This is the single biggest investment made by government in kinship care to date. This investment could transform the lives of vulnerable children who can no longer live at home.Departmental officials and I will continue to work across government to implement the new kinship allowances trial and to learn from this to inform any future policy.

If she will make an assessment of the potential merits of enabling (a) non-religious belief organisations and (b) Humanists to conduct legally binding weddings as religious organisations.

We are aware that non-religious belief organisations, such as humanists, have long been campaigning to conduct legally binding weddings. Given marriage is such a valued part of our society, I hope you will understand that as a new Government we will need time to properly consider our marriage law, including the Law Commission’s 2022 wedding report, before publicly setting out our position.

If she will make an assessment of the adequacy of services provided by Chiltern Rail from Haddenham and Thame Parkway station.

The Department monitors the adequacy of train services from all train stations, including Haddenham and Thame Parkway. Chiltern Railway provide a frequent service with three trains per hour during peak times and two trains per hour during the off-peak service from Haddenham and Thame Parkway to other stations along the Chiltern Mainline route between London Marylebone and Birmingham Moor Street. When planning the timetable, operators look at several factors including passenger demand and infrastructure constraints, as well as operational considerations, such as, fleet or driver availability. The goal is to provide an efficient and reliable service for all passengers and the Department regularly reviews operational performance across the rail network.

Food and Rural Affairs, whether he has had recent discussions with the trustees of the Royal Botanic Gardens, Kew, on the potential impact of moving the Kew herbarium to Thames Valley Science Park on the study of (a) biodiversity and (b) extinction.

Defra officials are engaged with Royal Botanic Gardens, Kew on development of the New Herbarium Project proposal. Kew’s Herbarium collections are some of the largest and most important in the world, holding over seven million vascular plant specimens, collected globally over the last 170 years. The New Herbarium Project aims to deliver a world-leading scientific research and collections facility, both to preserve those collections in appropriately controlled conditions and to ensure the specimens are accessible to Kew’s researchers and the wider international scientific community. Science is the largest and fastest-growing department at Kew and exploring options for future science research infrastructure is important in anticipation of future changes to global biodiversity. Defra fully recognise the importance of the Herbarium collections, which Kew maintains both for the nation and as a UNESCO World Heritage Site, and is supporting Kew’s Digitisation initiatives, which will ensure that 8.25 million plant and fungi specimens are digitised and made free for the public to access by 2026.