Written questions by Perteghella.

Commonwealth and Development Affairs, whether she has made an assessment of the potential implications for her policies of the findings of the British Council’s Global Perceptions 2025 report on the likelihood of young people who have participated in British Council programmes to express an intention to do business and trade with the UK; and whether this has implications for future funding for cultural and educational exchange.

We welcome the latest edition of the British Council's Global Perceptions report, and we will take into account its insights across a range of different areas when shaping the substance and communication of the UK's foreign policies over the year ahead.

Commonwealth and Development Affairs, what recent assessment she has made of the potential implications for her policies UK’s trust ratings in France, Germany and Italy as reported in the British Council’s Global Perceptions 2025 study; and what diplomatic steps the Government is taking to help improve the UK's reputation within Europe.

We welcome the latest edition of the British Council's Global Perceptions report, and we will take into account its insights across a range of different areas when shaping the substance and communication of the UK's foreign policies over the year ahead.

Commonwealth and Development Affairs, what assessment she has made of the potential implications for her strategies on trade, inward investment and international partnerships of the finding in the British Council’s Global Perceptions 2025 report on trust in the UK.

We welcome the latest edition of the British Council's Global Perceptions report, and we will take into account its insights across a range of different areas when shaping the substance and communication of the UK's foreign policies over the year ahead.

What steps he is taking to improve support for women’s menopausal health, including (a) training for GPs and (b) training for prescribing nurses.

The Government is committed to prioritising women’s health, including menopause, as we reform the National Health Service, and women’s equality will be at the heart of our health missions.That is why menopause will be added to the NHS Health Checks from 2026 for eligible women aged 40 to 55 years old who attend. This will support up to five million eligible women across England to access high quality information on menopause, including advice on managing symptoms and where to seek support.For new doctors starting their careers in the United Kingdom, the General Medical Council has introduced the Medical Licensing Assessment to encourage a better understanding of common women’s health problems. The content for this assessment includes several topics relating to women’s health, including menopause, and will encourage a better understanding of common women’s health problems.Additionally, for general practitioners and other primary healthcare professionals, 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, including menopause, from the RCGP, the Royal College of Obstetricians and Gynaecologists, and the College of Sexual and Reproductive Healthcare.The National Institute for Health and Care Excellence has also developed a women’s and reproductive health topic suite, and updated guidelines on menopause in November 2024. The guideline recommends more treatment choices for menopause symptoms, and prescribers are encouraged to use these guidelines as best practice when making decisions relating to menopause.

With reference to the planned inclusion of menopause in women’s health checks from 2026, what preparations his Department is making for that change.

We will be working with experts, including general practitioners, over the coming months to design the menopause content for the NHS Health Check.The NHS Health Check Best Practice Guidance will be updated to reflect the addition of menopause, and it will be for local authority commissioners to implement this through their NHS Health Check providers and to ensure that staff have adequate training. This will support eligible women to access high quality information on the menopause including advice on managing symptoms and where to seek support plus treatment options.

What assessment he has made of the potential impact of permanently removing in-patient beds from the Ellen Badger Hospital in Shipston on Stour on acute hospital discharges.

This is a matter for the Coventry and Warwickshire Integrated Care Board (ICB). That is because it is for ICBs to consider, working in partnership with local National Health Service providers and adult social care services, the right configuration of capacity locally to minimise delayed discharges from acute hospitals. In doing so, ICBs must consider the interests of their whole population and value for the taxpayer.

What assessment he has made of burial authorities’ adherence to the guidance that laying memorials flat should be used only where necessary following a risk assessment.

While the Department is responsible for burial law and policy, the Government does not have day-to-day operational responsibility for burial grounds, which lies instead with providers.The Government’s guidance documents Managing the safety of Burial Ground Memorials and Guide for Burial Ground Managers set out best practice for memorial safety inspections, including guidance that laying memorials flat should only occur where necessary and following a risk assessment. The documents also advise burial authorities to make every effort to contact families before taking action, where this does not compromise safety.Burial authorities are expected to follow this guidance when carrying out inspections. Any concerns or complaints about how inspections have been conducted can be raised directly with the relevant burial authority.

What assessment he has made of the adequacy of current NHS (a) guidance and (b) contractual arrangements for ensuring consistent GP prescribing practices for children with ADHD whose treatment has been initiated by a private provider.

It is the responsibility of the integrated care boards in England to make available appropriate provision to meet the health and care needs of their local population, including providing access to attention deficit hyperactivity disorder and autism assessment and support services, in line with relevant National Institute for Health and Care Excellence guidelines.Shared care with the National Health Service refers to an arrangement whereby a specialist doctor formally transfers responsibility for all or some aspects of their patient’s care, such as the prescription of medication, over to the patient’s general practitioner (GP).The General Medical Council (GMC), which regulates and sets standards for doctors in the United Kingdom, has made it clear that GPs cannot be compelled to enter into a shared care agreement. GPs may decline such requests on clinical or capacity grounds.The GMC has issued guidance on prescribing and managing medicines, which helps GPs decide whether to accept shared care responsibilities. In deciding whether to enter into a shared care agreement, a GP will need to consider a number of factors such as whether the proposed activity is within their sphere of competence, and therefore safe and suitable for their patient’s needs. This includes the GP being satisfied that any prescriptions or referrals for treatment are clinically appropriate.If a shared care arrangement cannot be put in place after the treatment has been initiated, the responsibility for continued prescribing falls upon the specialist clinician, and this applies to both NHS and private medical care.

How many NHS GP practices in (a) England, (b) Coventry & Warwickshire, and (c) Stratford-on-Avon have declined to enter into shared care arrangements for ADHD medication prescribed by private providers in each integrated care board area in the most recent 12-month period for which data is available.

The data requested is not held centrally. The Coventry and Warwickshire Integrated Care Board has also confirmed that it does not hold the relevant data. The General Medical Council (GMC), which regulates and sets standards for doctors in the United Kingdom, has issued guidance on prescribing and managing medicines, which helps general practitioners (GPs) decide whether to accept shared care responsibilities. In deciding whether to enter into a shared care agreement, a GP will need to consider a number of factors such as whether the proposed activity is within their sphere of competence, and therefore safe and suitable for their patient’s needs. This includes the GP being satisfied that any prescriptions or referrals for treatment are clinically appropriate.The GMC has made it clear that GPs cannot be compelled to enter into a shared care agreement. GPs may decline such requests on clinical or capacity grounds. If a shared care arrangement cannot be put in place after the treatment has been initiated, the responsibility for continued prescribing falls upon the specialist clinician, which applies to both National Health Service and private medical care.

What steps he is taking to encourage burial authorities to make every effort to contact families before taking action to lay memorials flat where this can be done safely.

While the Department is responsible for burial law and policy, the Government does not have day-to-day operational responsibility for burial grounds, which lies instead with providers.The Government’s guidance documents Managing the safety of Burial Ground Memorials and Guide for Burial Ground Managers set out best practice for memorial safety inspections, including guidance that laying memorials flat should only occur where necessary and following a risk assessment. The documents also advise burial authorities to make every effort to contact families before taking action, where this does not compromise safety.Burial authorities are expected to follow this guidance when carrying out inspections. Any concerns or complaints about how inspections have been conducted can be raised directly with the relevant burial authority.

If he will make an assessment of the potential merits of issuing new guidance to integrated care boards on ensuring that children with Education, Health and Care Plans receive equitable access to ADHD medication regardless of whether their initial assessment was provided (a) privately or (b) through the NHS.

It is the responsibility of the integrated care boards in England to make available appropriate provision to meet the health and care needs of their local population, including providing access to attention deficit hyperactivity disorder and autism assessment and support services, in line with relevant National Institute for Health and Care Excellence guidelines.Shared care with the National Health Service refers to an arrangement whereby a specialist doctor formally transfers responsibility for all or some aspects of their patient’s care, such as the prescription of medication, over to the patient’s general practitioner (GP).The General Medical Council (GMC), which regulates and sets standards for doctors in the United Kingdom, has made it clear that GPs cannot be compelled to enter into a shared care agreement. GPs may decline such requests on clinical or capacity grounds.The GMC has issued guidance on prescribing and managing medicines, which helps GPs decide whether to accept shared care responsibilities. In deciding whether to enter into a shared care agreement, a GP will need to consider a number of factors such as whether the proposed activity is within their sphere of competence, and therefore safe and suitable for their patient’s needs. This includes the GP being satisfied that any prescriptions or referrals for treatment are clinically appropriate.If a shared care arrangement cannot be put in place after the treatment has been initiated, the responsibility for continued prescribing falls upon the specialist clinician, and this applies to both NHS and private medical care.

What steps he is taking to ensure that children with ADHD and autism who are assessed and treated privately as a result of long NHS waiting times are able to access shared care prescribing arrangements through their NHS GP pursuant to section 42 of the Children and Families Act 2014.

It is the responsibility of the integrated care boards in England to make available appropriate provision to meet the health and care needs of their local population, including providing access to attention deficit hyperactivity disorder and autism assessment and support services, in line with relevant National Institute for Health and Care Excellence guidelines.Shared care with the National Health Service refers to an arrangement whereby a specialist doctor formally transfers responsibility for all or some aspects of their patient’s care, such as the prescription of medication, over to the patient’s general practitioner (GP).The General Medical Council (GMC), which regulates and sets standards for doctors in the United Kingdom, has made it clear that GPs cannot be compelled to enter into a shared care agreement. GPs may decline such requests on clinical or capacity grounds.The GMC has issued guidance on prescribing and managing medicines, which helps GPs decide whether to accept shared care responsibilities. In deciding whether to enter into a shared care agreement, a GP will need to consider a number of factors such as whether the proposed activity is within their sphere of competence, and therefore safe and suitable for their patient’s needs. This includes the GP being satisfied that any prescriptions or referrals for treatment are clinically appropriate.If a shared care arrangement cannot be put in place after the treatment has been initiated, the responsibility for continued prescribing falls upon the specialist clinician, and this applies to both NHS and private medical care.

Whether his Department has made an assessment of compliance by GP practices with their obligations under (a) NICE guideline NG87, (b) the Equality Act 2010 and (c) section 42 of the Children and Families Act 2014 in relation to children with ADHD or autism.

The National Institute for Health and Care Excellence (NICE) is an independent body and part of their responsibility is for developing authoritative, evidence-based recommendations for the National Health Service on whether new medicines represent a clinically and cost-effective use of resources.NICE guidelines provide recommendations on best practice in terms of both the effectiveness and cost-effectiveness of interventions and services. Although not mandatory, guidelines describe best practice and NHS organisations are expected to take them fully into account in designing services to meet the needs of their local populations.In terms of the guidance NG87, which is on the diagnosis and management of attention deficit hyperactivity disorder (ADHD), the NICE guideline does not recommend a maximum waiting time for people to receive an assessment for ADHD or a diagnosis, although it does set out best practice on providing a diagnosis. As stated in the Medium Term Planning Framework, all integrated care boards and providers must optimise existing resources to reduce long waits for autism and ADHD assessments and improve the quality of assessments by implementing existing and new guidance, as published, including NICE guidelines. The Medium Term Planning Framework is available at the following link:https://www.england.nhs.uk/wp-content/uploads/2025/10/medium-term-planning-framework-delivering-change-together-2026-27-to-2028-29.pdfUnder the Equality Act 2010, health and social care organisations must make reasonable adjustments to ensure that people with disabilities are not disadvantaged. To make it easier for everyone to use health services, NHS England published guidance for NHS commissioners and providers in July 2025. Further information is available at the following link:https://www.england.nhs.uk/long-read/health-inequalities-equality-legal-duties/NHS England is rolling out the Reasonable Adjustments Digital Flag, which helps healthcare and social care providers identify and implement necessary adjustments for disabled people including autistic people and people with ADHD. This tool support care teams to be aware of individual needs, facilitating appropriate care.On the duty to secure special education provision and health care provision in accordance with education, health and care plans, if the plan specifies health care provision, the responsible commissioning body must arrange the specified health care provision for the child or young person. According to the Children and Families Act 2024 section 42, an education, health and care plan will specify the health care provision, the responsible commissioning body, referred to as the integrated care board, and must arrange the specified health care provision for the child or young person.

How access to fresh food is being incorporated into the NHS Long Term Plan’s approach to tackling preventable diseases linked to diet.

The Government’s Eatwell Guide advises that people should eat plenty of fruit and vegetables, and wholegrain or higher-fibre foods, as well as less processed meat, and food and drink that is high in sugar, calories, saturated fat, and salt. This includes at least five portions of a variety of fruits and vegetables every day. Fresh, frozen, tinned, and dried fruit and vegetables all count. The Eatwell Guide indicates that many foods classified as ‘ultra processed’ such as crisps, biscuits, cakes, confectionery, and ice cream are not part of a healthy, balanced diet.The Department of Health and Social Care (DHSC) and the Department for Environment, Food and Rural Affairs (DEFRA), alongside other Government departments, are funding research on a number of food system trials through the SALIENT programme. The programme prioritises interventions and partners that have the largest reach and the greatest potential to narrow health inequalities, both geographic and socio-economic. These trials include research on food and vegetable pricing in supermarkets and evaluating the effect of food pantries on food insecurity. DEFRA’s 2024 report on food insecurity also considered inequalities in access to a healthy, sustainable diet.DHSC is working closely with DEFRA to develop their cross-Government Food Strategy, which aims to improve affordability and access to healthier food, to help both adults and children live longer, healthier lives. We are committed to making the healthier choice the easier choice.Earlier this year, the Government committed to reviewing the School Food Standards to reflect the most recent Government dietary recommendations. Free school meals will also be extended to all children from households in receipt of Universal Credit from September 2026, including in rural areas. Our free breakfast clubs started with 750 early adopter schools in April 2025, and we have just announced the next wave of 500 schools, with 40% of pupils on free school meals to benefit from the programme from April 2026. The aim of these programmes is to ensure children receive nutritious meals at school and to remove barriers to opportunity.Our Healthy Food Schemes, which comprises of Healthy Start, the School Fruit and Veg Scheme, and the Nursery Milk Scheme, provides support for those who need it the most to eat a healthy, balanced diet. Healthy Start provides funding to pregnant women, babies, and young children under four years old from very low-income households to support a healthier diet. In April 2026, the value of weekly payments will increase by 10%.DHSC is working at pace to develop proposals set out in our 10-Year Health Plan commitments, to introduce mandatory healthier sales reporting for large food businesses and then set new targets to increase the healthiness of sales.We will work closely with business to implement these commitments, and plan to conduct extensive engagement with industry and wider stakeholders throughout policy development. To assist us in the development of the mandatory reporting we will commence our formal engagement with businesses shortly. This will involve a series of workshops with a cross-sector industry working group.

What assessment his Department has made of the potential impact of limited access to affordable fresh food on health inequalities in rural areas.

The Government’s Eatwell Guide advises that people should eat plenty of fruit and vegetables, and wholegrain or higher-fibre foods, as well as less processed meat, and food and drink that is high in sugar, calories, saturated fat, and salt. This includes at least five portions of a variety of fruits and vegetables every day. Fresh, frozen, tinned, and dried fruit and vegetables all count. The Eatwell Guide indicates that many foods classified as ‘ultra processed’ such as crisps, biscuits, cakes, confectionery, and ice cream are not part of a healthy, balanced diet.The Department of Health and Social Care (DHSC) and the Department for Environment, Food and Rural Affairs (DEFRA), alongside other Government departments, are funding research on a number of food system trials through the SALIENT programme. The programme prioritises interventions and partners that have the largest reach and the greatest potential to narrow health inequalities, both geographic and socio-economic. These trials include research on food and vegetable pricing in supermarkets and evaluating the effect of food pantries on food insecurity. DEFRA’s 2024 report on food insecurity also considered inequalities in access to a healthy, sustainable diet.DHSC is working closely with DEFRA to develop their cross-Government Food Strategy, which aims to improve affordability and access to healthier food, to help both adults and children live longer, healthier lives. We are committed to making the healthier choice the easier choice.Earlier this year, the Government committed to reviewing the School Food Standards to reflect the most recent Government dietary recommendations. Free school meals will also be extended to all children from households in receipt of Universal Credit from September 2026, including in rural areas. Our free breakfast clubs started with 750 early adopter schools in April 2025, and we have just announced the next wave of 500 schools, with 40% of pupils on free school meals to benefit from the programme from April 2026. The aim of these programmes is to ensure children receive nutritious meals at school and to remove barriers to opportunity.Our Healthy Food Schemes, which comprises of Healthy Start, the School Fruit and Veg Scheme, and the Nursery Milk Scheme, provides support for those who need it the most to eat a healthy, balanced diet. Healthy Start provides funding to pregnant women, babies, and young children under four years old from very low-income households to support a healthier diet. In April 2026, the value of weekly payments will increase by 10%.DHSC is working at pace to develop proposals set out in our 10-Year Health Plan commitments, to introduce mandatory healthier sales reporting for large food businesses and then set new targets to increase the healthiness of sales.We will work closely with business to implement these commitments, and plan to conduct extensive engagement with industry and wider stakeholders throughout policy development. To assist us in the development of the mandatory reporting we will commence our formal engagement with businesses shortly. This will involve a series of workshops with a cross-sector industry working group.

What discussions he has had with major retailers on improving access to affordable fresh food.

The Government’s Eatwell Guide advises that people should eat plenty of fruit and vegetables, and wholegrain or higher-fibre foods, as well as less processed meat, and food and drink that is high in sugar, calories, saturated fat, and salt. This includes at least five portions of a variety of fruits and vegetables every day. Fresh, frozen, tinned, and dried fruit and vegetables all count. The Eatwell Guide indicates that many foods classified as ‘ultra processed’ such as crisps, biscuits, cakes, confectionery, and ice cream are not part of a healthy, balanced diet.The Department of Health and Social Care (DHSC) and the Department for Environment, Food and Rural Affairs (DEFRA), alongside other Government departments, are funding research on a number of food system trials through the SALIENT programme. The programme prioritises interventions and partners that have the largest reach and the greatest potential to narrow health inequalities, both geographic and socio-economic. These trials include research on food and vegetable pricing in supermarkets and evaluating the effect of food pantries on food insecurity. DEFRA’s 2024 report on food insecurity also considered inequalities in access to a healthy, sustainable diet.DHSC is working closely with DEFRA to develop their cross-Government Food Strategy, which aims to improve affordability and access to healthier food, to help both adults and children live longer, healthier lives. We are committed to making the healthier choice the easier choice.Earlier this year, the Government committed to reviewing the School Food Standards to reflect the most recent Government dietary recommendations. Free school meals will also be extended to all children from households in receipt of Universal Credit from September 2026, including in rural areas. Our free breakfast clubs started with 750 early adopter schools in April 2025, and we have just announced the next wave of 500 schools, with 40% of pupils on free school meals to benefit from the programme from April 2026. The aim of these programmes is to ensure children receive nutritious meals at school and to remove barriers to opportunity.Our Healthy Food Schemes, which comprises of Healthy Start, the School Fruit and Veg Scheme, and the Nursery Milk Scheme, provides support for those who need it the most to eat a healthy, balanced diet. Healthy Start provides funding to pregnant women, babies, and young children under four years old from very low-income households to support a healthier diet. In April 2026, the value of weekly payments will increase by 10%.DHSC is working at pace to develop proposals set out in our 10-Year Health Plan commitments, to introduce mandatory healthier sales reporting for large food businesses and then set new targets to increase the healthiness of sales.We will work closely with business to implement these commitments, and plan to conduct extensive engagement with industry and wider stakeholders throughout policy development. To assist us in the development of the mandatory reporting we will commence our formal engagement with businesses shortly. This will involve a series of workshops with a cross-sector industry working group.

What steps his Department is taking to support burial authorities in carrying out memorial safety inspections that protect public safety while ensuring compliance with the Ministry of Justice guidance Managing the Safety of Burial Ground Memorials (2009).

While the Department is responsible for burial law and policy, the Government does not have day-to-day operational responsibility for burial grounds, which lies instead with providers.The Government’s guidance documents Managing the safety of Burial Ground Memorials and Guide for Burial Ground Managers set out best practice for memorial safety inspections, including guidance that laying memorials flat should only occur where necessary and following a risk assessment. The documents also advise burial authorities to make every effort to contact families before taking action, where this does not compromise safety.Burial authorities are expected to follow this guidance when carrying out inspections. Any concerns or complaints about how inspections have been conducted can be raised directly with the relevant burial authority.

If he will make it his policy to re-introduce postal verification for trustees of (a) companies and (b) charities who are otherwise excluded from these roles due to lack of digital accessibility.

Identity verification at Companies House is a new requirement for company directors. Some charities are incorporated as companies, and some companies limited by guarantee call their directors ‘trustees’. Only trustees who are company directors must verify under the new requirements. Previously no identity verification process existed for these roles. Individuals can verify their identity through Companies House routes or via an Authorised Corporate Service Provider. The process has been designed to be as straightforward and accessible as possible and where identity cannot be verified online, users may be directed to complete the process in person at a participating Post Office.

Food and Rural Affairs, what recent assessment her Department has made of trends in the level of (a) private investment and (b) Government funding for (i) storm overflows, (ii) wastewater treatment and (iii) other water infrastructure.

Ofwat’s final determinations for Price Review 2024 set company expenditure for 2025–2030. This will deliver substantial and enduring improvements for customers and the environment through a £104 billion upgrade for the water sector. The £104 billion funding package is the highest level of investment in the water sector since privatisation and is set to be the second largest private sector investment programme in this parliament. Water companies are investing over £11 billion in PR24, a record amount, to improve nearly 3,000 storm overflows across England and Wales over the next five years. Furthermore, £4.795 billion will be spent over the same period to reduce phosphorus pollution from treated wastewater. This represents an increase when compared to the 2022-2023 equivalent prices for Price Review 19, where overall spending was £61bn, storm overflow investment was £3.6 billion, and wastewater treatment improvements were £3.1 billion.

What discussions he has had with NICE on (a) reviewing and (b) updating (i) clinical guidelines and (ii) guidance on diagnosing Type 1 Diabetes and Eating Disorders.

The National Institute for Health and Care Excellence (NICE) is an independent body and is responsible for determining whether its guidelines should be reviewed or updated in the light of new evidence. NICE takes a proactive approach to surveillance, monitoring for changes in the evidence base that may impact on its recommendations. Topics for new or updated guidance are considered through the NICE prioritisation process. Decisions as to whether NICE will create new, or update existing, guidance are overseen by a prioritisation board, chaired by NICE’s chief medical officer.NICE’s guidelines on the diagnosis and management of type 1 diabetes in adults, with the reference code NG17, diabetes, including both type 1 and type 2, in children and young people, with the reference code NG18, and the recognition and treatment of eating disorders, with the reference code NG69, will be reviewed if there is new evidence that is likely to change the recommendations. NICE currently has no plans to update NG17, NG18, or NG69.