Written questions by Hamilton.

If he will review the November 2025 decrease to the Agenda for Change mileage payments for community staff.

As set out in NHS Terms and Conditions of Service (TCS) Handbook, which is ratified by the NHS Staff Council, mileage reimbursement rates are reviewed twice a year in April and November.The outcome of the November 2025 review resulted in a reduction of reimbursement rates due to sustained decreases in fuel prices for the 12-month period ending in October 2025. Reimbursement rates will drop to 56 pence per mile up to 3,500 miles claimed before dropping to 21 pence per mile thereafter. The revised rates will apply to mileage incurred from 1 January 2026.These changes apply to all staff directly employed under Agenda for Change terms and conditions and Resident Doctors. There are no specific rates for community staff.The NHS Staff Council, which is responsible for maintaining the NHS TCS, is currently negotiating a new mechanism that will determine a fair reimbursement rate for miles incurred by these staff. Further updates on their work will be made in due course.

Commonwealth and Development Affairs, what steps he is taking to organise the next session of the Association Council for the UK-Morocco Association Agreement.

The most recent ministerial meeting of the UK-Morocco Association Council took place in London on 12 November and reaffirmed our commitment to deepening cooperation on trade, investment, education, renewable energy, and security, in line with the step-change in relations following June's bilateral strategic dialogue. The next meeting has not yet been scheduled, but we will confirm the details in the usual way in due course.

What assessment he has made of the potential merits of eliminating tariff rates quotas on Moroccan fresh produce at times of the year when the produce is not in season in the UK.

The UK and Morocco are currently undertaking a review of tariffs on Agriculture goods, of which greater access to the UK market for tomatoes is a priority for Morocco. Tomatoes are amongst a number of products which are being considered as part of the negotiation. Any final agreement will need to benefit UK business and consumers.

What support she is providing to adoptive families when attempting to return a child to care.

Returning a child to care should only ever be a last resort. We recognise the significant emotional and practical strain adoptive parents can face, particularly when managing complex needs and trauma. Our priority is to keep families together wherever possible by providing timely tailored support for parents in crisis.We are investing £50 million into the adoption and special guardianship support fund this year to provide therapeutic services to support children with complex needs to help prevent families reaching crisis. In addition, we have provided Adoption England with £8.8 million so that families can access high quality support provision at all stages of their adoption journey.When a child must return to care, adoption agencies should maintain a non-judgemental approach and remain actively involved to ensure the process is handled with sensitivity and support. This includes working closely with the adoptive parents to understand the circumstances, providing emotional and practical assistance, and facilitating access to therapeutic services when appropriate.

Food and Rural Affairs, pursuant to the answer of 3 July 2025 to UIN 62951, what progress she has made on incorporating method-of-production labelling reform into the development of animal welfare and food strategies; and if she will publish a timetable for implementation.

This Government was elected on a mandate to introduce the most ambitious plans to improve animal welfare in a generation. In the food strategy we identified 10 priority outcomes, including ensuring that food supply is environmentally sustainable with high animal welfare standards. The Prime Minister announced that we will be publishing an animal welfare strategy this year. We have considered key priorities for animal welfare in the development of the strategy and will set these out in the strategy upon publication.

What steps she is taking to support adoptive families from being subject to legal action when attempting to return a child to care.

The department knows that some adoptive families do not get the support they need when in crisis. Rather than being supported, they experience blame and criticism of their parenting approach.Adoption England are working with their local authority partner safeguarding teams to improve the support families receive when they are in crisis. The aim of this work is to develop a national protocol which can be used for all adoption support service teams and local authority front door safeguarding services. This will help ensure that parents are supported when they need it most.We are also investing £50 million into the adoption and special guardianship support fund this year to provide therapeutic services to support children with complex needs to help prevent families reaching crisis, and £8.8 million into Adoption England so that families can access high quality support provision at all stages of their adoption journey.

Commonwealth and Development Affairs, whether British International Investment’s Reporting & Complaints Mechanism is currently engaged regarding Kenya’s Menengai geothermal project; what steps she is taking to ensure access to remedy for affected communities; and what role the High Commission in Nairobi is playing to facilitate dialogue between the parties.

I believe the Hon Member is referring to complaints regarding geothermal exploration activities in specific areas of Nakuru County, Kenya. British International Investment have made clear that they have no investment in any company undertaking geothermal exploration in the relevant areas, and therefore have no basis to consider any complaints.

Food and Rural Affairs, whether her Department has considered mandating the use of compostable fresh produce stickers; and if she will make an assessment of the potential impact of doing so on arable land.

The Department has not considered mandating the use of compostable fresh produce stickers and does not currently have plans to assess the potential impact of such a measure on arable land. However, we remain committed to supporting sustainable packaging solutions and continue to monitor developments in this area.

Food and Rural Affairs, whether her Department plans to incentivise the use of compostable fresh produce stickers through the Extended Producer Responsibility fee structure by using (a) green and (b) amber ratings under the Recyclability Assessment Methodology.

At present, the Recyclability Assessment Methodology (RAM) does not provide a separate incentive for compostable materials; the methodology is designed to support a circular economy by prioritising materials that can be recycled into new products. Therefore, unless compostable stickers meet recyclability criteria under RAM, they would not qualify for a green rating and associated lower fees. PackUK keeps RAM guidance/modulation under review and updates it annually to reflect changes in infrastructure and material performance. Any future consideration of changing ratings for compostable materials within the RAM would require evidence that they can be processed through existing recycling systems without contamination risk.

Innovation and Technology, what steps she is taking to ensure that the Online Safety Act 2023 prevents young people from accessing content that could adversely affect those with eating disorders.

Under the Online Safety Act, social media, chat groups and other user-to-user services are required to use highly-effective age assurance to prevent children of all ages from accessing content that promotes, encourages or provides instructions for eating disorders. Providers must also consider how algorithms can impact children’s exposure to this harmful content and mitigate this risk.All service providers must also take steps to protect children from harmful body stigma content, which is linked to significant harm arising from body or image dissatisfaction.

Food and Rural Affairs, when she will introduce secondary legislation under the Environment Act 2021 for due diligence rules for forest-risk commodities.

The Government recognises the urgency of taking action to ensure that UK consumption of forest risk commodities is not driving deforestation. The Government is actively considering the best regulatory approach to address deforestation in UK supply chains; we will set out this approach in due course.

Whether he plans to review Investor-State Dispute Settlement provisions in UK trade and investment agreements.

Investor State Dispute Settlement (ISDS) provides an independent means for investors to resolve disputes with states where they believe they have experienced arbitrary, discriminatory or unfair treatment or expropriation without compensation. The Government is aware of the interest in this important policy area and, in line with HMG’s Trade Strategy, the UK will continue to work with trading partners multilaterally, such as the OECD and the UN, to pursue opportunities to improve ISDS practice.

What assessment he has made of the merits of opportunities to (a) enable earlier diagnosis of Type 1 diabetes and (b) reduce incidences of diabetic ketoacidosis; and what actions are being taken by (i) his Department and (ii) NHS England to support (A) research and (B) improved clinical practice in these areas.

The early diagnosis of type 1 diabetes is important to reducing incidences of diabetic ketoacidosis. NHS England is working with experts and relevant stakeholder organisations to monitor the outcomes of the current research on the early detection of type 1 diabetes. To support integrated care boards, NHS England has convened experts and stakeholder organisations to consider emerging evidence and articulate what a pathway of care could look like given advancements in this field.

What role mayoral authorities will play in the delivery of Neighbourhood Health Plans.

The wide range of local government responsibilities relevant to health and wellbeing, including social care, public health, and beyond, are central to our vision for Neighbourhood Health. Neighbourhood Health will move care out of hospitals and into communities, with more personalised, proactive, and integrated services starting from where and how people live their lives. This will involve building stronger links to wider local government services such as housing, family hubs, and programmes such as Pride in Place, as well as links with wider civil society including the voluntary, community, and social enterprise (VCSE) sector.We are working closely with the Local Government Association to develop a national framework setting out how the National Health Service, local authorities, and partners should work together under the leadership of health and wellbeing boards to develop and implement local neighbourhood health plans.NHS, local authority, and VCSE services will be co-located in neighbourhood health centres, bringing together a wide range of services to holistically meet the needs of local populations.Neighbourhood teams and services should be designed to reflect the needs of people in their local areas, with licence to tailor the approach to local needs and with an expectation of crossing organisational boundaries.

What recent steps NHS England has taken to help identify (a) children and (b) adults at risk of pre‑symptomatic Type 1 diabetes; and what assessment has been made of (i) the uptake and (ii) effectiveness of those services.

The National Institute for Healthcare Research is funding the EarLy Surveillance for Autoimmune diabetes (ELSA) study into the feasibility of screening for type 1 diabetes in children aged three to 13 years old. The ELSA study has tested over 24,000 people and is being run through schools, general practice surgeries, as well as through online recruitment.The UK National Screening Committee advises the National Health Service on screening programmes and, in 2019, concluded that more research and evidence for the benefits of screening for autoimmune type 1 diabetes was required.

What the role of mayoral authorities will be within Regional Health Innovation Zones.

Collaboration between health systems and local government, including mayoral authorities, is fundamental to the design and delivery of the Regional Health Innovation Zones, as set out in the 10-Year Health Plan and the Life Sciences Sector Plan. The Government is committed to ensuring that local government leaders feel a sense of shared ownership in these plans.The policy is currently in development. It is being designed with flexibility at its core, to ensure it accommodates the diversity of local government structures across the country. The relevant policy teams are already beginning to engage with regional leaders, in health systems and local government, to codesign the approach and to provide more clarity to regions.

When NICE plans to review (a) guideline NG17 for Type 1 diabetes in adults and (b) guideline NG18 for Diabetes (type 1 and type 2) in children and young people; and what the timelines are for the next updates.

The National Institute for Health and Care Excellence (NICE) is the independent body responsible for translating evidence into authoritative evidence-based guidance for the health and care system on best practice, in order to drive improved outcomes for patients.NICE currently has no plans to update guidelines NG17 and NG18. 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 an integrated, cross-organisational prioritisation board, chaired by NICE’s Chief Medical Officer.

What assessment he has made of the potential impact of the 10 Year Health Plan on the roles of mayoral authorities in delivering health and social care services.

As set out in the 10-Year Health Plan, the Government is committed to making mayors, or their representatives, members of integrated care boards (ICBs), harnessing the opportunities of joined-up strategic planning between ICBs and strategic authorities, and supporting delivery of a “health in all policies” approach. Subject to the passage of the English Devolution and Community Empowerment Bill, mayors will be supported by a new health improvement and health inequalities duty, which empowers and supports strategic authorities to exercise their functions in ways that improve health and reduce health inequalities between people living in their area.

How many and what proportion of people initially coded with (a) pre‑diabetes and (b) type 2 diabetes who were later found to have early or established type 1 diabetes in the most recent period for which data is available; and what steps his Department is taking with NHS England to help improve diagnostic accuracy in England.

Data is not collected centrally on the numbers or proportions of people initially coded with pre-diabetes or type 2 diabetes who were later found to have type 1 diabetes. The change of patient diagnosis would be reflected by a change of diagnosis code in clinical systems. However, the way that data extraction works for national audits means that it is not possible to track these types of changes.Published data on diabetes registrations by GP practice can be found in the quarterly National Diabetes Audit (NDA) data release. This also contains data on care process and treatment target attainment as well as the number of new diagnoses by calendar year.The latest quarterly report is available at the following link:https://digital.nhs.uk/data-and-information/publications/statistical/national-diabetes-audit/core-q4-24-25/national-diabetes-audit-nda-2024-25-quarterly-report-for-england-integrated-care-board-icb-primary-care-network-pcn-and-gp-practiceThe NDA supports improvements in diagnosis by assessing whether people with diabetes are receiving the recommended diagnostic checks and to identify variations and shortfalls in care delivery against National Institute for Health and Care Excellence guidelines.

Commonwealth and Development Affairs, what assessment she has made of the potential implications for her policies of reports of attacks on the Indigenous community of Cuahuayula, Mexico on 20 October 2025.

The UK remains committed to promoting and protecting human rights globally, including the rights of Indigenous communities. We are concerned by reports of violence against Indigenous communities in Mexico, including the recent attack in Coahuayula on 20 October. Any violence against Indigenous communities must be fully investigated. We regularly engage with the Mexican authorities and civil society on the issue of protection of civilians, as well as the UN in Mexico on the effective investigation of crimes against human rights defenders.