Written questions by Smart.

What recent discussions she has had with the National Cyber Security Centre on (a) preventing and (b) removing scam or impersonation websites that mimic (a) the DVLA and (b) government services.

The Driver and Vehicle Licensing Agency (DVLA) advises customers to use GOV.UK as the official and only website when seeking information or completing applications. All DVLA literature directs customers to the official GOV.UK website. The DVLA also uses its external communication channels, including social media, to publish advice and to remind motorists that GOV.UK is the only website for government motoring services.The DVLA investigates reports of organisations which act illegally or are actively misleading users about their services. Where appropriate such sites can be and are taken down promptly.DVLA officials have regular discussions and briefings, with the National Cyber Security Centre, to assess and prevent a range of risks. The DVLA is also a longstanding user of the National Cyber Security Centre active cyber defence services and regularly uses the Netcraft takedown service for removing malicious websites.

What steps his Department is taking to prevent third-party websites from misleading members of the public by imitating the DVLA online services.

The Driver and Vehicle Licensing Agency (DVLA) advises customers to use GOV.UK as the official and only website when seeking information or completing applications. All DVLA literature directs customers to the official GOV.UK website. The DVLA also uses its external communication channels, including social media, to publish advice and to remind motorists that GOV.UK is the only website for government motoring services.The DVLA investigates reports of organisations which act illegally or are actively misleading users about their services. Where appropriate such sites can be and are taken down promptly.DVLA officials have regular discussions and briefings, with the National Cyber Security Centre, to assess and prevent a range of risks. The DVLA is also a longstanding user of the National Cyber Security Centre active cyber defence services and regularly uses the Netcraft takedown service for removing malicious websites.

Whether his Department has made an assessment of the adequacy of the (a) current and (b) projected future capacity of the A6 road corridor between Hazel Grove and Whaley Bridge.

This Government is committed to renewing national infrastructure, improving England’s road network and driving growth as part of its Plan for Change. It has been clear that any funding decisions will be part of a long-term infrastructure strategy for this country, as stated within the manifesto. Decisions on funding more generally beyond 2025/26 is a matter for the forthcoming Spending Review. Any assessment of the adequacy of the current or projected future capacity of the A6 road corridor between Hazel Grove and Whaley Bridge is a matter for the local highway authority.

Whether her Department plans to increase the £2.50 fee charged by private parking companies for each V888/3 application to access vehicle keeper data from the DVLA to use in issuing parking charge notices.

The £2.50 fee is set to recover the cost of providing the information and ensures that the cost is borne by the requester, not passed on to the taxpayer. In line with Managing Public Money, the Driver and Vehicle Licensing Agency reviews its fees regularly to ensure that fees are set to recover the costs of providing the service.

Food and Rural Affairs, what steps her Department is taking to ensure that the Extended Producer Responsibility (EPR) fee structure accurately reflects the environmental performance of (a) the brewing sector, (b) the hospitality sector and (c) other sectors which operate closed-loop recycling systems.

The Government has worked closely with industry, including the brewing and hospitality sectors, throughout development of Extended Producer Responsibility for Packaging (pEPR). This is a major reform that will be iterated over several years to incentivise packaging producers to reduce their material footprint and use more sustainable packaging. We are considering further improvements to the scheme, including how to treat businesses which run closed loop recycling systems for packaging that is commonly collected by Local Authorities, and my officials are reviewing options to bring forward an offset for closed loop recycling systems at the earliest opportunity.

Whether she has had recent discussions with UK banks on the provision of (a) bank statements and (b) other financial documents in accessible formats for customers with visual impairments.

The Government works closely with the Financial Conduct Authority (FCA), the independent regulator of the UK’s financial services sector, to ensure that all customers get the right support with their financial products and services. FCA guidance highlights the actions firms should take to understand the needs of customers who may be vulnerable, such as those with visual impairments, and to consider these needs appropriately. The guidance sets out that firms should offer multiple channels of communication where possible and includes examples of how firms can put this into practice, such as by providing large print documents and audio options. Additionally, under the Equality Act 2010, banks must make reasonable adjustments to ensure their services are accessible to all.

Whether his Department has made an assessment of the potential impact of changes in the level of staff overtime pay rates in emergency departments on (a) the quality of patient care and (b) the retention of senior clinical staff.

The Department has not made this specific assessment. Where national rates for overtime are applicable in England, these are set out in the national terms and conditions, and no recent changes have been made to these provisions, nor are there planned to be. Where pay for additional work is set at a local level or where local providers agree overtime rates that are different to those in the national terms and conditions, this would be considered a local matter.

What steps his Department is taking to improve the diagnosis of vitamin B12 deficiency and reduce the number of cases misdiagnosed as (a) dementia, (b) chronic fatigue syndrome and (c) psychiatric conditions.

The National Institute for Health and Care Excellence (NICE) published guidance in March 2024 on the diagnosis and management of vitamin B12 deficiency in over 16 year olds. The guidance is available at the following link:http://nice.org.uk/guidance/ng239It provides guidance to clinicians on recognising the symptoms of vitamin B12 deficiency, outlines the recommended diagnostic tests that should be carried out if vitamin B12 deficiency is suspected, and provides guidance on how to interpret the results from the diagnostic tests. Clinicians adhering to this guidance will help to minimise the number of B12 deficiency cases misdiagnosed as dementia, chronic fatigue syndrome, psychiatric conditions, or any other health condition.The NICE’s guidance is informed by clinical expertise, is evidence-based, and represents best practice. Healthcare professionals are expected to pay due regard to NICE guidance, although NICE guidelines are not mandatory and do not supersede the judgement and clinical discretion of clinicians in determining the most appropriate treatment for their patients.The NICE promotes its guidance via its website, newsletters, and other media. Healthcare professionals are responsible for ensuring that their own clinical knowledge remains up-to-date, and for identifying learning needs as part of their continuing professional development. This should include taking account of new research and developments in guidance, such as that produced by the NICE.

Whether his Department plans to raise the minimum reference range for vitamin B12 serum levels to 500 pmol/L.

The assessment and clinical management of vitamin B12 falls under the remit of the National Institute for Health and Care Excellence (NICE). In March 2024, the NICE published the guidance, Vitamin B12 deficiency in over 16s: diagnosis and management, which is available at the following link:https://www.nice.org.uk/guidance/ng239The guidance provides thresholds in table 1 to guide diagnosis. There are no plans to update this guidance at present.

Whether his Department has made an assessment of the potential merits of expanding standard NHS blood tests to routinely include (a) B12, (b) B6, (c) folate, (d) vitamin C and (e) vitamin D.

The Department has made no assessment of the potential merits of expanding standard National Health Service blood tests to routinely include B12, B6, folate, vitamin C, and vitamin D. The National Institute of Health and Care Excellence (NICE), which provides evidence-base guidance for the health and care system on best practice, makes recommendations on testing for vitamin deficiency based on symptoms and risk factors.NICE guidance makes recommendations on tests where the evidence supports their use in making a diagnosis, ruling out a condition, or for guiding treatment decisions. This is usually condition or symptom specific, and the NICE would not make recommendations on a ‘standard’ blood test or range of blood tests. NICE guidance is not mandatory, and therefore healthcare professionals should use their clinical judgement in deciding what blood tests should be carried out for individual patients, taking into account relevant national or local guidance, including NICE guidelines.

Food and Rural Affairs, if she will make it her policy to (a) exempt and (b) reduce Extended Producer Responsibility (EPR) fees to packaging waste managed through private waste contracts in the hospitality sector.

Since Autumn 2024, the Government has been working with stakeholders, including representatives of the hospitality sector, to consider potential amendments to the definition of household packaging. We are continuing to engage with sectors on a way forward and we are planning next steps as a priority.

If he will take steps to help ensure that carers are (a) involved in patient care decisions and (b) given appropriate access to medical (i) records and (ii) updates during hospital stays in cases where patients have (A) cognitive and (B) neurological conditions.

The Health and Care Act 2022 introduced significant measures for people caring for their family and friends, as well as the people they are caring for. These include:provisions for integrated care boards to promote the involvement of patients and their carers and representatives, if any, in decisions relating to the prevention and diagnosis of illness, and the care and treatment of the person they care for; anda duty for National Health Service trusts and foundations to take any steps they consider necessary to involve patients and carers in discharge planning, where appropriate.Lord Darzi’s independent review of the NHS said that a fresh approach to supporting and involving unpaid carers is required to improve outcomes for carers, people needing care, and the NHS.We will carefully consider these findings as part of our 10-year plan for reforming and modernising the NHS and as we develop plans to reform adult social care, including through the National Care Service.

What steps his Department is taking to ensure that NHS documents are available in (a) large print, (b) braille and (c) other accessible formats for patients with visual impairments.

Under the Equality Act 2010, health and social care organisations must make reasonable adjustments to ensure that disabled people are not disadvantaged.Since 2016, all National Health Service organisations and publicly funded social care providers are expected to meet the Accessible Information Standard (AIS), which details the approach to supporting the information and communication support needs of patients and carers with a disability, impairment, or sensory loss. This includes providing information in alternative formats such as large print and braille.NHS England has been undertaking a review of the AIS to help ensure that the communication needs of people with a disability, impairment, or sensory loss are met in health and care provision. A revised AIS will be published in due course. In the meantime, the current AIS remains in force and therefore there should not be a gap in provision for people using services.

Food and Rural Affairs, if she will review the Extended Producer Responsibility (EPR) cost allocation model for glass packaging.

Defra has engaged with industry and experts to ensure accuracy of the model. This includes consultation with WRAP, the Environmental Services Agency, British Glass and MKD32 on the decision to use volume in the apportionment of kerbside recycling collection costs. Model refinement has continued since the publication of illustrative base fees in December, and Defra will continue working to improve accuracy where possible.

Whether his Department has made an assessment of the potential merits of allowing over-the-counter sales of vitamin B12 injections in the UK.

The Medicine and Healthcare products Regulatory Agency (MHRA) has authorised several medicines for use in different circumstances associated with vitamin B12 deficiency. The legal status assigned to medicines is dependent on an assessment of the product against the criteria for either Prescription Only Medicine status or General Sales List status, and the classification is determined via the marketing authorisation.The criteria for classification are set out in Regulation 62 of the Human Medicines Regulations 2012 [SI 2012/2016 as amended], and Regulation 62(3) is clear that if the medicine is usually prescribed for parenteral administration, that is by injection, then the medicinal product must by law be classified as a prescription only medicine. Other aspects within Regulation 62 also apply in consideration of the most suitable legal status of vitamin B12 injection and its use in deficiency states.Currently, United Kingdom law specifies that all products administered by injection must be subject to a prescription. The MHRA is therefore unable to reclassify the status of injections, including Vitamin B12, to medicines, as this would not be consistent with the legislation.

Whether HMRC plans to improve its (a) telephone and (b) online chat services to ensure that people can receive human assistance when digital systems fail to provide information.

Once they have submitted an A1 certificate renewal or other time-sensitive application, customers can use the “check when you can expect a reply from HMRC” tool which is available on gov.uk to confirm when they are likely to receive a response. Customers can contact HMRC via telephony or web chat for urgent A1 applications. HMRC advisors will then decide if the case needs urgent escalation and will take it forward as appropriate. These cases relate to customers who need a certificate to work in another country. HMRC are always seeking to improve their day to day performance including their telephony and webchat service. HMRC received extra funding last year to recruit more customer service advisers and, under the current Government, are focused on transforming services to better support taxpayers.

What recent assessment she has made of the adequacy of the accessibility of HMRC's communication channels for people seeking urgent updates on (a) A1 certificate renewals and (b) other time-sensitive applications.

Once they have submitted an A1 certificate renewal or other time-sensitive application, customers can use the “check when you can expect a reply from HMRC” tool which is available on gov.uk to confirm when they are likely to receive a response. Customers can contact HMRC via telephony or web chat for urgent A1 applications. HMRC advisors will then decide if the case needs urgent escalation and will take it forward as appropriate. These cases relate to customers who need a certificate to work in another country. HMRC are always seeking to improve their day to day performance including their telephony and webchat service. HMRC received extra funding last year to recruit more customer service advisers and, under the current Government, are focused on transforming services to better support taxpayers.

What recent discussions he has had with the Secretary of State for Environment, Food and Rural Affairs on the economic impact of Extended Producer Responsibility (EPR) implementation on (a) small manufacturers and (b) regional producers.

The Government has listened to feedback from small businesses and introduced support measures to help compliance with EPR, including: exemptions from fee obligations for producers with annual turnover below £2 million and packaging tonnage below 50 tonnes; exemptions from reporting for businesses with turnover below £1 million and packaging tonnage below 25 tonnes; and flexibility for those with obligations to pay in quarterly instalments.Both Secretaries of State will shortly be meeting representatives from across the impacted sectors, from Small and Medium Enterprises to larger companies alike, to discuss the economic impact of EPR in more detail.

Pursuant to the Answer of 26 March 2025 to Question 38407 on Diethylstilbestrol, whether he plans to issue an apology to women who (a) experienced long-term health impacts, (b) were compelled to place their children up adoption and (c) experienced poor maternity care due to being prescribed Diethylstilbestrol between 1950 and 1980.

The government took action regarding Diethylstilbestrol (DES) in the early 1970s. In 1971, it was recognised that DES could cause a distinct type of cancer in the daughters of women who took DES in early pregnancy. Shortly afterwards, its use was contraindicated in pregnancy, pre-menopausal women, children and young adults and the Committee on Safety of Medicines wrote to all doctors in May 1973 to advise against the use of DES in pregnancy and pre-menopausal women.Since 1992, the National Cancer Institute (NCI) at the US National Institutes of Health has been conducting the DES Follow-up Study of more than 21,000 mothers, daughters, and sons, exposed in the womb during the mother’s pregnancy, to better understand the long-term health effects of exposure to DES. The findings of this study have been published in the scientific literature.As such, work has been undertaken to contact historic users of DES. Our sympathies are with anyone harmed by its historic use.The UK Health Security Agency advises that routine cervical screening is appropriate for those who believe they were exposed to DES in utero. Further information is available at the following link:https://www.gov.uk/government/publications/cervical-screening-programme-and-colposcopy-management/5-screening-and-management-of-immunosuppressed-individualsParticipation in the National Breast Screening Programme is also recommended. Pregnant women who know that they were exposed in utero to DES should inform their obstetrician and be aware of the increased risks of ectopic pregnancy and preterm labour.The MHRA continuously assesses the benefit risk balance of all medicines at the time of initial licensing and throughout their use in clinical practice, carefully evaluating any emerging evidence on their benefits and risks.

With reference to the oral answer of the Parliamentary Under-Secretary of State for Justice on 11 March 2025 to Question 903119 on Female Offenders, whether that specialised training is available to all staff.

The Foundation training programme for all new prison officers includes learning in relation to suicide and self-harm.  For officers working in the female estate, there is an additional week of Foundation training which gives officers an understanding of the potential for increased risk factors for women in custody in relation to self-harm and suicide. There is additional Suicide and Self Harm training that deals specifically with suicide prevention across the custodial estate, the target audience of which is all staff across HM Prison & Probation Service.