Written questions by Morgan.

Food and Rural Affairs, what steps his Department is taking to protect properties in North Shropshire constituency against surface water flooding.

To ensure we protect the country from the devastating impacts of flooding, we will invest £2.4 billion in 2024/25 and 2025/26 to improve flood resilience, by maintaining, repairing and building flood defences. The Environment Agency has strategic overview for all flood risk in England, however, it is for Lead Local Flood Authorities to develop local interventions to reduce surface water flood risk for communities. The Environment Agency continues to work closely with Shropshire Council, who are the Lead Local Flood Authority on North Shropshire.

Food and Rural Affairs, whether his Department has produced an impact assessment for projects funded by the Frequently Flooded Allowance.

This Government is investing £2.4bn in 2024/25-2025/26 to improve flood resilience. The projects to receive Government funding in 2025/26 will be consented over the coming months in the usual way through Regional Flood and Coastal Committees with local representation. We will consult in the new year on a review of the formula that allocates flood defence funding to ensure the challenges facing businesses and rural and coastal communities are adequately taken into account. The process used to allocate funding to floods projects in the investment programme follows a consistent approach that aims to reduce flood risk and secure benefits. The approach follows Green Book guidance on value for money.

Food and Rural Affairs, whether his Department has made an assessment of the effectiveness of the methodologies used by the Rural Payments Agency for deciding which areas of farmland are eligible for the Farming Recovery Fund.

The Rural Payments Agency uses both the Environment Agency and Met Office data to establish which farm businesses may be eligible for Farming Recovery Payment. The data on river flooding and exceptional rainfall allows the agency to identify affected land.The full methodology can be found in the link below.Our approach to Farming Recovery payments – Farming.

Food and Rural Affairs, what assessment his Department has made of the effectiveness of the methodology used to decide which areas are eligible for funding under the Frequently Flooded Allowance.

This Government is investing £2.4bn in 2024/25-2025/26 to improve flood resilience. The projects to receive Government funding in 2025/26 will be consented over the coming months in the usual way through Regional Flood and Coastal Committees with local representation. We will consult in the new year on a review of the formula that allocates flood defence funding to ensure the challenges facing businesses and rural and coastal communities are adequately taken into account. The process used to allocate funding to floods projects in the investment programme follows a consistent approach that aims to reduce flood risk and secure benefits. The approach follows Green Book guidance on value for money.

Food and Rural Affairs, what methodologies the Rural Payments Agency uses to determine the set proportion of total eligible farm area provided funding.

The Rural Payments Agency uses both the Environment Agency and Met Office data to establish which farm businesses may be eligible for Farming Recovery Payment. The data on river flooding and exceptional rainfall allows the agency to identify affected land.The full methodology can be found in the link below.Our approach to Farming Recovery payments – Farming.

What recent discussions she has had with the Secretary of State for Justice on the potential merits of bringing forward legislative proposals to create domestic abuse-aggravated offences.

I regularly meet with the Lord Chancellor to discuss the Government’s mission to halve VAWG and tackle domestic abuse.I am aware of Private Members Bill tabled by the Honourable Member for Eastbourne.I will carefully consider both the merits and risks of creating domestic abuse-aggravated offences and respond via the usual parliamentary procedure.

What steps his Department is taking to help reduce the risks of (a) uterine prolapse and (b) osteoporosis among women with spinal cord injuries through (i) improved access to preventive care, (ii) diagnosis and (iii) long-term management strategies.

The Government will prioritise women’s health, placing women’s equality at the heart of our agenda, and ensuring that women’s health is never neglected again. Symptoms of uterine prolapse can usually be improved with pelvic floor exercises and lifestyle changes, but sometimes medical treatment is needed. The National Institute for Health and Care Excellence has produced guidance on the management of pelvic organ prolapse in women, which is available at the following link:https://www.nice.org.uk/guidance/ng123For patients who need surgery for uterine prolapse, the NHS England Specialised Commissioning Clinical Reference Group for specialised women’s services has produced a service specification for specialised complex surgery for urinary incontinence and vaginal and uterine prolapse, which is available at the following link:https://www.england.nhs.uk/publication/service-specification-specialised-complex-surgery-for-urinary-incontinence-and-vaginal-and-uterine-prolapse-16-years-and-above/The implications of musculoskeletal (MSK) conditions, such as osteoporosis, for women’s health cannot not be overlooked. MSK conditions disproportionately impact women. One in three women will experience an osteoporotic fracture in their lifetime, compared to one in five men. Women are more at risk of developing osteoporosis due to hormone changes that happen at the menopause, and directly affect bone density.For all people, including those with spinal injuries, regular exercise and healthy eating are important factors in preventing osteoporosis. Weight-bearing exercise and resistance exercise are particularly important for improving bone density and helping to prevent osteoporosis. Eating foods rich in calcium and vitamin D, or taking vitamin D supplements, is also an important way people can maintain their bone health and reduce their risk of osteoporosis.The drug Raloxifene is also recommended by the National Institute for Health and Care Excellence for the primary prevention of osteoporotic fragility fractures in postmenopausal women. In addition, the Government is committed to expanding access to Fracture Liaison Services. Fracture Liaison Services are a globally recognised secondary fracture prevention model for those with osteoporosis, which can reduce the risk of refracture by up to 40%. With NHS England, we are considering a range of options to identify the most effective ways of improving the quality of, and access to, the Fracture Liaison Service model and the interventions it provides.To support early diagnosis of osteoporosis, including in those with spinal cord injuries, the Government is investing £1.5 billion capital funding in 2025/26 for new surgical hubs and diagnostic scanners to build capacity for over 30,000 additional procedures and over 1.25 million diagnostic tests as they come online.

What steps his Department is taking to provide (a) comprehensive healthcare guidance on and (b) access to specialised gynaecological support for (i) the management of menstruation, (ii) contraception options, (iii) safe pregnancy care and (iv) other related matters for people with spinal cord injuries.

The Government will prioritise women’s health, placing women’s equality at the heart of our agenda, and ensuring that women’s health is never neglected again. NHS England Specialised Commissioning has a Clinical Reference Group (CRG) for specialised women’s services that provides clinical advice and leadership for complex obstetrics and maternity, and complex gynaecology and fertility preservation services. Specialist gynaecological services are commissioned in line with the service specification published by the CRG.Furthermore, there is a CRG for rehabilitation, and complex disability and spinal cord injury services. Specialist services for spinal cord injuries are commissioned in line with the service specification published by the CRG. The National Institute for Health and Care Excellence also has guidance on the assessment and early management of spinal cord injuries, which is available at the following link:https://www.nice.org.uk/guidance/ng41Menstrual problems and symptoms, such as heavy or painful periods, are common and can have a significant impact on women and girls’ wellbeing, and their participation in education and the workplace. We also recognise that having a spinal cord injury can create additional challenges for women and girls when it comes to managing their period. A range of treatments are available and can help manage menstrual symptoms and gynaecological conditions. Women and girls should contact their general practice (GP) if menstrual problems are affecting their daily life.In November 2023, NHS England published a decision support tool for managing heavy periods. This tool supports women’s understanding of their symptoms and appropriate treatment options, to support discussion with clinicians.The Royal College of General Practitioners (RCGP) has published a Women’s Health Library which brings together educational resources and guidelines on women’s health from the RCGP, the Royal College of Obstetricians and Gynaecologists, and the Faculty of Sexual and Reproductive Healthcare. This resource is continually updated to ensure GPs and other primary healthcare professionals have the most up-to-date advice, to provide the best care for their patients.We are committed to ensuring that the public receives equitable access to the best possible contraceptive services. Different methods of contraception are available from a range of different settings, including direct from pharmacies, both prescribed and over the counter, from GPs, and from local authority commissioned sexual and reproductive health services.The NHS Pharmacy Contraception Service was launched in April 2023, enabling pharmacists to issue ongoing supplies of contraception initiated in GP surgeries and sexual health services. The service relaunched in December 2023 to enable community pharmacies to also initiate oral contraception. This service offers greater choice in how people can access contraception services. It will also create additional capacity in GP and sexual health clinics to support meeting the demand for more complex assessments.The Government will continue to work with the NHS as it delivers its three-year maternity and neonatal plan to grow our maternity workforce, develop a culture of safety, and ensure women and babies receive safe, compassionate care.

What steps his Department is taking to ensure that women with spinal cord injuries receive adequate postnatal support including (a) breast feeding assistance and (b) tailored rehabilitation services.

The Government will prioritise women’s health, placing women’s equality at the heart of our agenda and ensuring women’s health is never again neglected. According to NHS England’s guidance, all women who have given birth should be offered a check-up with their general practice six to eight weeks after giving birth. The check-up will cover a range of topics such as mental health, physical recovery, breastfeeding, and support with family planning. NHS England is also rolling out perinatal pelvic health services to reduce rates of perineal tears, and maternal mental health services to provide additional mental health support and improve outcomes for women.We know that breastfeeding has significant benefits for both mother and baby. The Government is committed to achieving the healthiest generation of children ever, and central to this is our commitment to give every baby the best start in life. This includes helping families to achieve their breastfeeding goals. It is important that all families are supported to make the right choice for them and have prompt and easy access to high-quality advice and services to help them achieve their infant feeding goals.The Department is working closely with 75 local authorities across England to improve their infant feeding services, including breastfeeding support, through the Family Hubs and Start for Life programme. These services are helping families to access face-to-face and virtual infant feeding support whenever they need it, and in a location that suits them. This could be at home, in their family hub, or in a hospital setting.We want to build on the actions that local areas are already taking through the Family Hubs and Start for Life programme to improve their infant feeding services. At a national level, families across the United Kingdom can access round-the-clock support and advice on breastfeeding through the National Breastfeeding Helpline.The Department recognises the profound impact that spinal injuries can have on an individual and their loved ones, and the importance of early access to high-quality neurorehabilitation. The National Institute for Health and Care Excellence has produced guidance on rehabilitation after traumatic injury, which includes specific recommendations regarding rehabilitation for those with spinal injuries. Further information is available at the following link:https://www.nice.org.uk/guidance/ng211

Food and Rural Affairs, pursuant to the answer of 5 December 2024 to Question 17283 on Milk, how farmers are able to contribute to the engagement process.

We value input from farmers to inform our plans and appreciate their contribution to ongoing dialogue. Individual farmers are encouraged to engage with the process primarily through their representative groups, with whom we conduct regular discussions, and who serve as an effective channel for collective feedback.

What steps his Department is taking to help increase uptake of SGLT2 inhibitor treatments for people with chronic kidney disease.

The National Institute for Health and Care Excellence (NICE) is the independent body responsible for developing authoritative, evidence-based recommendations for the National Health Service on whether new, licensed medicines represent a clinically and cost-effective use of resources.The NICE has been able to recommend two SGLT2 inhibitors, empagliflozin and dapagliflozin, for treating chronic kidney disease, subject to specified clinical criteria. The NHS in England is legally required to fund medicines recommended in a NICE appraisal, usually within three months of final guidance, so these treatments should now be available for healthcare professionals to prescribe to NHS patients in line with the NICE’s recommendations.In September 2024, the NICE added links to the relevant technology appraisal guidance on SGLT-2s, for empagliflozin, which has a NICE reference number of TA942, and for dapagliflozin, which has a NICE reference number of TA775, to the guideline Chronic kidney disease: assessment and management. This is to provide easy access to the relevant appraisal guidance at the right point in the guideline, and to help users find the information more easily. Further information on the guidance for chronic kidney disease, specifically recommendation 1.6.9 on SGLT-2s, is available at the following link:https://www.nice.org.uk/guidance/ng203/chapter/Recommendations#pharmacotherapyThe NICE publishes a range of resources to support services in putting its recommendations into practice. The NICE has also published a general practice indicator on chronic kidney disease and SGLT2 inhibitors. NICE indicators measure outcomes that reflect the quality of care or processes, and can be used in a number of different settings to support high quality care, including the uptake of NICE-recommended treatments, such as SGLT2 inhibitors.The responsibility for implementing NICE guidance rests with the relevant commissioner.

What steps his Department is taking to improve access to SGLT2 inhibitor treatments for people with chronic kidney disease from underserved communities.

The National Institute for Health and Care Excellence (NICE) is the independent body responsible for developing authoritative, evidence-based recommendations for the National Health Service on whether new, licensed medicines represent a clinically and cost-effective use of resources.The NICE has been able to recommend two SGLT2 inhibitors, empagliflozin and dapagliflozin, for treating chronic kidney disease, subject to specified clinical criteria. The NHS in England is legally required to fund medicines recommended in a NICE appraisal, usually within three months of final guidance, so these treatments should now be available for healthcare professionals to prescribe to NHS patients in line with the NICE’s recommendations.In September 2024, the NICE added links to the relevant technology appraisal guidance on SGLT-2s, for empagliflozin, which has a NICE reference number of TA942, and for dapagliflozin, which has a NICE reference number of TA775, to the guideline Chronic kidney disease: assessment and management. This is to provide easy access to the relevant appraisal guidance at the right point in the guideline, and to help users find the information more easily. Further information on the guidance for chronic kidney disease, specifically recommendation 1.6.9 on SGLT-2s, is available at the following link:https://www.nice.org.uk/guidance/ng203/chapter/Recommendations#pharmacotherapyThe NICE publishes a range of resources to support services in putting its recommendations into practice. The NICE has also published a general practice indicator on chronic kidney disease and SGLT2 inhibitors. NICE indicators measure outcomes that reflect the quality of care or processes, and can be used in a number of different settings to support high quality care, including the uptake of NICE-recommended treatments, such as SGLT2 inhibitors.The responsibility for implementing NICE guidance rests with the relevant commissioner.

Pursuant to the Answer of 14 October 2024 to Question Question 8906 on cancer and with reference to the Plan for Change: Milestones for mission-led government, CP 1210, published on 5 December 2024, whether it remains his policy to meet all NHS cancer waiting time targets within five years.

The Government recognises the importance of, and remains committed to meeting, all three National Health Service cancer waiting time standards across England. These are the 28-day faster diagnosis standard, the 31-day decision to treat to treatment standard, and the 62-day referral to treatment standard. Lord Darzi’s report has laid bare the true extent of the challenges facing our health service, which is why we have launched our 10 Year Plan to radically reform the NHS and build a health service that is fit for the future. Following publication of the 10-Year Health Plan, we will publish the new national cancer plan, which will include further details on how we will improve outcomes for cancer patients, including improving performance against the cancer waiting time standards.

What assessment she has made of the adequacy of the level of support available to domestic abuse victims and their children in the Family Court system.

Family courts have various tools available to protect participants. Courts have the power to prohibit the cross-examination of domestic abuse survivors by their abusers. Victims of domestic abuse are automatically considered to be vulnerable when the court is determining whether to make special measures, such as allowing someone to give evidence by video link, or from behind a screen. The Family Procedure Rules and Practice Directions allow for Independent Domestic Violence Advisers and Independent Sexual Violence Advisers to accompany parties in the courtroom.Central to the Department’s commitment to reform the family justice system is the rollout of the Pathfinder pilot. This innovative court model uses a less adversarial approach for private law children proceedings and is operating in Dorset, North Wales, Birmingham and South-East Wales. The pilot courts work closely with local domestic abuse agencies, including Independent Domestic Violence Advisers, to ensure that specialist support and domestic abuse risk assessments are in place. We are committed to expanding the pilot so that more people can benefit from this approach.Evaluation of the pilot is ongoing and involves seeking the views of both parent and child victims of domestic abuse to understand how the support available in the Pathfinder model has impacted their experiences. This evaluation will be published once it is completed.On 27 November, the Government also begun piloting a new Domestic Abuse Protection Order (DAPO) in selected areas. This new order is available across family, civil and criminal courts and brings together the strongest features from current protective orders into a single more comprehensive order. DAPOs can offer more tailored protection to victims and place greater sanctions on a perpetrator.

What steps he is taking to (a) end and (b) prevent strike action by hospital facilities staff.

This is a local issue that is for National Health Service trusts to manage, working in partnership with trade unions.

What assessment he has made of the implications for his policies of the potential impact of hospital facilities staff strikes on patient wellbeing.

No assessment has been made. This is a local issue, managed by National Health Service trusts, who work hard to mitigate the impact of any strike action on patients.In cases where NHS trusts are considering external suppliers to deliver facilities management services, the Government expects that any such outsourced services are delivered by the trust in a way that improves quality, ensures greater stability and longer-term investment in the workforce, and delivers better value for money, as part of the broader commitments on procurement set out in the Government’s Make Work Pay programme.

Food and Rural Affairs, whether he plans to publish a consultation on potential changes to the Fair Dealing Obligations (Milk) Regulations 2024.

Defra is committed to enhancing fairness across supply chains, which will support farmers to boost Britain’s food security. The Fair Dealing Obligations (Milk) Regulations (2024), which were introduced earlier this year, represent an important step forward in ensuring fairness and transparency for dairy farmers. However, some within the sector have raised concerns about potential unintended consequences of the Regulations, which the Government is seeking to address. To ensure that the Regulations meet their original aims, we are undergoing a process of engagement with industry stakeholders and representatives, as well as the Devolved Governments. The Government will make any changes before the Regulations apply to existing contracts, on 9 July 2025.

Food and Rural Affairs, what steps his Department is taking to help ensure (a) transparency and (b) accountability in dairy supply chains.

Defra is committed to delivering this Government’s ambition to support British farmers to boost Britain’s food security. Central to achieving this ambition will be pursuing the right approach to fairness across the supply chain. The Fair Dealing Obligations (Milk) Regulations (2024) came into force for new contracts on 9 July 2024 and will apply to all existing contracts from 9 July 2025. These Regulations will enhance transparency in the dairy supply chain, ensuring that contracts are agreed in writing, are clear on a range of important terms including pricing and termination, and cannot be altered without mutual agreement. The Regulations will be enforced by the Agricultural Supply Chain Adjudicator (ASCA), who can exercise powers to investigate relevant complaints.

What the mean payment to each Government funded hospice was in each year since 2015.

Palliative care services are included in the list of services an integrated care board (ICB) must commission. This promotes a more consistent national approach and supports commissioners in prioritising palliative and end of life care. To support ICBs in this duty, NHS England has published statutory guidance and service specifications.Whilst the majority of palliative and end of life care is provided by National Health Service staff and services, we recognise the vital part that voluntary sector organisations, including hospices, also play in providing support to people at end of life, and their loved ones.The Department does not hold specific data regarding hospice funding for each year. Individual ICBs oversee and maintain records of these transactions.Additionally, the amount of funding each charitable hospice receives varies both within and between ICB areas. This will vary depending on the demand in that ICB area, but will also be dependent on the totality and type of palliative and end of life care provision from both NHS and non-NHS services, including charitable hospices, within each ICB area.

How many hospices there were in England in each year since 2015; and how many of those received Government funding in each of those years.

Palliative care services are included in the list of services an integrated care board (ICB) must commission. This promotes a more consistent national approach and supports commissioners in prioritising palliative and end of life care. To support ICBs in this duty, NHS England has published statutory guidance and service specifications.Whilst the majority of palliative and end of life care is provided by National Health Service staff and services, we recognise the vital part that voluntary sector organisations, including hospices, also play in providing support to people at end of life, and their loved ones.The Department does not hold specific data regarding hospice funding for each year. Individual ICBs oversee and maintain records of these transactions.Additionally, the amount of funding each charitable hospice receives varies both within and between ICB areas. This will vary depending on the demand in that ICB area, but will also be dependent on the totality and type of palliative and end of life care provision from both NHS and non-NHS services, including charitable hospices, within each ICB area.