Written questions by Mierlo.

If she will make an assessment of the potential merits of taking legislative steps to provide VAT relief on the rethatching of listed buildings.

To preserve heritage, restorative work carried out on listed buildings previously benefited from a zero rate of VAT. However, this relief was abolished in 2012, as it was primarily used to carry out extension work unnecessary for heritage purposes. Withdrawing this relief simplified VAT rules and removed the scope for error when categorising construction work as either alteration or repair. VAT is a broad-based tax on consumption and the 20 per cent standard rate applies to most goods and services. VAT is the UK’s second largest tax forecast to raise £171 billion in 2024/25. Taxation is a vital source of revenue that helps to fund vital public services. Evidence suggests that businesses only partially pass on any savings from lower VAT rates. In some cases, reliefs do not represent good value for money, as there is no guarantee that savings will be passed on to consumers. The Government therefore has no current plans to reduce the VAT charged on work to maintain and repair listed properties, but we keep all taxes under review.

What the uptake rate was of the RSV vaccine by pregnant people in each of the last three years; and if he will make an assessment of the potential implications for his policies of trends in the uptake rate of the RSV vaccine by pregnant people in that time.

The respiratory syncytial virus (RSV) antenatal maternal vaccination programme for infant protection began in England on 1 September 2024. The first uptake data will be published on 30 January 2025.The UK Health Security Agency (UKHSA) undertakes evaluations of national immunisation programmes, and will be evaluating the impact and effectiveness of the RSV maternal vaccination programme for infant protection once sufficient data is available. Immunisation programme effectiveness against hospital admissions is typically assessed using the test-negative case-control method.To raise awareness of the potential vaccination benefits and increase awareness of the programmes amongst health professionals, parents, carers, and the wider public, the UKHSA provides a comprehensive suite of public facing resources and assets. This includes information leaflets in multiple languages and accessible formats, like easy read, British Sign Language, and braille. The UKHSA also provides comprehensive clinical guidance, including e-learning programmes and training for healthcare professionals.

Food and Rural Affairs, if he will make an assessment of the potential impact of trends in the level of people (a) accessing national trails and (b) participating in outdoor activities on the cost to the public purse of providing NHS treatment.

The Government recognises that promoting regular outdoor activity is a vital component of preventative health, as it fosters physical activity, reduces the risk of long term conditions, supports mental well-being, and strengthens community health by encouraging active lifestyles and social engagement in natural environments. The 2017 baseline assessment covering the economic and health impacts of walking on English coastal paths found that for the 29 million leisure walking trips taken in 2017, the total benefit to the recreational wellbeing of people using the paths was valued at an estimated £1.8 billion. A 2021 study identified that the physical health benefits of active visitors to National Trails are estimated in the range £186 million to £423 million per year, which represents cost savings to the NHS of between £46 and £107 million per year. Outdoor exercise overall delivers estimated health benefits to adults in England of between £2.0 and £4.7 billion annually. It is clear from this evidence that there are significant benefits through improved access to national trails and engagement in outdoor activities. We will continue to work with other Government departments to embed access to nature as part of community-based preventative care approaches, in support of the Government’s Health Mission.

If he will make an assessment of the potential merits of extending paternity leave.

Paternity Leave supports working people. Access to family-friendly rights means that working people can enjoy a better work-life balance that benefits wellbeing, morale, productivity and retention. The Government has committed to conduct a review of the whole parental leave system. This review will focus on ensuring that parental leave, including Paternity Leave, offers the best possible support to working families. Work is already underway on planning for its delivery.

What assessment he has made of the potential implications for her Department's policies of the length of parental leave in other OECD countries.

Paternity Leave supports working people. Access to family-friendly rights means that working people can enjoy a better work-life balance that benefits wellbeing, morale, productivity and retention. The Government has committed to conduct a review of the whole parental leave system. This review will focus on ensuring that parental leave, including Paternity Leave, offers the best possible support to working families. Work is already underway on planning for its delivery.

What assessment he has made of the impact of the statutory two week paternity leave on the economy.

Paternity Leave supports working people. Access to family-friendly rights means that working people can enjoy a better work-life balance that benefits wellbeing, morale, productivity and retention. The Government has committed to conduct a review of the whole parental leave system. This review will focus on ensuring that parental leave, including Paternity Leave, offers the best possible support to working families. Work is already underway on planning for its delivery.

What assessment she has made of the adequacy of provisions for registration of deaths to ensure that (a) bereaved people are able to meet the requirement to notify a death within five days of the statutory relevant date and (b) the burden on the recently bereaved is minimised as far as possible.

Since the implementation of the death certification reforms in September 2024, the 5-day statutory time period for an informant to register a death commences when the registrar receives a completed Medical Certificate of Cause of Death (MCCD) from a Medical Examiner, or notification from a Coroner.Monitoring by the General Register Office for England and Wales confirms that current appointment availability for the bereaved with registrars in Local Authorities to be available to register deaths is adequate, but the Government is continuing to work towards the electronic registration of deaths to minimise the burden on bereaved family members at a difficult time, as set out by the Secretary of State for Science, Innovation and Technology.

Food and Rural Affairs, what the funding settlement is for National Trails UK for 2025-26.

The Government recognises the value of the Trails and the benefits they bring. We understand the uncertainty around resourcing remains a challenge for National Trails UK. Defra business planning is ongoing, and we will communicate the outcome of the settlements for National Trails UK as soon as possible.

Food and Rural Affairs, If he will make an assessment of the potential merits of introducing a statutory purpose for national trails.

The Government is committed to improving access to nature and is currently considering how best to continue to drive forward our goals in this area. There are no plans to undertake an assessment to consider the merits of introducing a statutory purpose for national trails at this time.

Food and Rural Affairs, what assessment he has made of the contribution of national trails to biodiversity gain.

We are aware of the wider benefits that national trails can bring for nature recovery and biodiversity gain. The Coast to Coast National Trail was the first to include wider benefits in the National Trail proposal. This resulted in funding being allocated to nature recovery projects from the start of the establishment phase. We are mapping biodiversity projects associated with the trails and encouraging Local Nature Recovery Statements to consider the potential of National Trails.

Food and Rural Affairs, if he will make an assessment of the potential (a) merits of increasing funding for National Trails above 2012 levels and (b) impact of not increasing funding for National Trails on those trails.

As part of the Defra business planning process, we assess the requirements, opportunities and impacts of all projects that we fund. These are carefully considered within the wider context of spending review before final decisions are made. Further details will be provided in due course.

What steps he is taking to ensure that pregnant women are informed of their rights to an elective C-section.

NHS England’s three-year delivery plan for maternity and neonatal services recognises the importance of listening to women and families. It aims to ensure that women have clear choices, supported by unbiased information and evidence-based guidelines, and that all women are offered personalised care and support plans.Personalised care and support plans take account of their physical health, mental health, social complexities, and choices. Personalised care includes an open and honest ongoing dialogue between a woman, her midwife, and other clinicians, to understand the care that is wanted.NHS England’s website includes information about asking for a caesarean.

If he will make an assessment of the adequacy of access to (a) ultrasound and (b) other scans during pregnancy in Henley and Thame constituency.

Antenatal care can start as soon as a woman knows she is pregnant. This can be done by contacting a midwife or general practitioner, or by referring herself direct to a maternity service. There will be two ultrasound scans at 11 to 14 weeks and at 18 to 21 weeks, followed by any further scans recommended by the relevant healthcare professionals.Further details can be found on the NHS.UK website, at the following link:https://www.nhs.uk/pregnancy/your-pregnancy-care/your-antenatal-appointments/The Government is continuing to work with NHS England as it delivers its three-year maternity and neonatal plan to ensure that women receive timely care.

If he will make an assessment of the adequacy of (a) the funding provided through and (b) other aspects of general practitioner core contracts.

We have announced a proposed £889 million uplift for general practices (GPs) in 2025/26, and set out the proposed areas of contract reform which will help us to deliver on our commitments. This is the largest uplift to GP funding in years, reversing the recent trend, with a rising share of total National Health Service resources going to GPs.GPs receive funding through a range of income streams in return for providing services specified in the GP Contract. Global sum, which is the funding allocated for providing core services, makes up 50 to 60% of practice income. The global sum allocation formula, also known as the Carr-Hill formula, is designed to ensure that resources are directed to practices based on an estimate of their patient workload and unavoidable practice costs.  The rest of the income is made of the Quality and Outcomes Framework, premises payments, directed enhanced services, and additional services, for instance vaccine and immunisation services.Practices are able to provide additional services by opting in, and will receive payment for these services separately to global sum payments. As commissioners of primary care, integrated care boards are responsible for commissioning additional services locally, which are not agreed nationally and can vary in scope and funding to fit local needs.

If he will make an assessment of the potential merits of Integrated Care Boards taking steps to help general practitioners set up new practices.

Integrated care boards (ICBs) have a delegated responsibility for planning and commissioning healthcare services to meet the reasonable needs of the people for whom they are responsible. ICBs should evaluate the needs of the populations for which they are responsible, including for general practice services, and plan service provision as required.ICBs’ annual commissioning plans for general practice (GP) services will consider requirements for new GP practices, for example, in response to population growth, planned contract expiry and management of unplanned closures, as well as the additional local services they wish to commission. The commissioner must decide on the contracting route for new core general practice services and select providers that will deliver the best quality and outcomes. Commissioners sometimes provide additional funding to new practices while they are growing their list sizes to enable them to recover their fixed costs, as most of the funding GP providers receive is related to the number and type of patients they have on their registered list and growing list size may take time.At the Autumn Budget 2024, we established a dedicated capital fund of £102 million for the next financial year to deliver around 200 upgrades to GP surgeries across England, which will support improved use of existing buildings and space, boosting productivity and enabling delivery of more appointments. This funding represents a first step in delivering the additional capital the primary care sector needs.

Food and Rural Affairs, what assessment he has made of trends in the level of wool prices in the last (a) 6 months, (b) 12 months and (c) 8 years.

British Wool, a public body, is responsible for the collection, sale and marketing of wool from across the UK. Sales are conducted through open auction and will reflect global market developments in price and availability. This Government has made no assessment on the impact of policies on wool prices; however Defra officials meet regularly with British Wool, who share regular reports on auction sales and wool values.

If she will make an assessment of the adequacy of diesel train availability on the Twyford to Henley-on-Thames branch line.

Train operators are responsible for ensuring that they make adequate rolling stock available to meet the needs of their customers. Currently, there are no issues with the diesel fleet availability on this line.

With reference to the Independent review of children's social care: final report, published on 23 May 2022, whether she plans to implement the recommendation on care experience and caring as protected characteristics.

We know care leavers have some of the worst long-term life outcomes in society. We are therefore committed to ensuring children leaving care have stable homes, access to health services, support to build lifelong loving relationships and are engaged in education, employment and training. Through the Children's Wellbeing and Schools Bill we will be driving forward our commitments on children’s social care, including improved support for care leavers. As announced by the Prime Minister on 24 September 2024, care leavers under age 25 will be exempt from rules which require a connection to a local area before accessing social housing. We have also established a care leaver Ministerial Board, which brings together Ministers from key Departments, to improve support for care leavers across Government. On the specific question of protected characteristics, the Government often receives requests for new characteristics such as "carer experience"” to be added to the Equality Act 2010. While many of these carry merit, it would not be practical to legislate because of the public and private sector burdens that this would create. The Equality Act 2010 will already protect many care leavers under the indirect discrimination provisions, because a disproportionately high number are likely to be from an ethnic minority and/ or have a disability. They may also benefit from the age discrimination protections in the Act.

What steps he is taking to help prevent the illegal sale of ADHD medication for recreational use.

The illegal sale and supply of human medicines is recognised as a significant challenge for regulators across the world. Medicines purchased from websites that are illegally trading can be harmful to health, as the products received are generally unlicensed in the United Kingdom. They can contain too little, too much, or incorrect active ingredients. The global trade is substantial, with offences often taking place beyond the geographical reach of UK legislation.The Criminal Enforcement Unit (CEU) within the Medicines and Healthcare products Regulatory Agency (MHRA) works with law enforcement partners and others to tackle the illegal trade, and to prevent products from entering the UK. Where offences are identified in the UK, the CEU can investigate and, where appropriate, bring those involved to justice. In parallel with enforcement action, the MHRA also operates the #FakeMeds campaign, offering safety advice and providing practical tools to help the public stay safe when buying medicines online.

If she will take steps to increase the availability of rolling stock suitable for (a) the Henley branch line and (b) other non-electrified branch lines.

Train operators are responsible for ensuring that they make adequate rolling stock available to meet the needs of their customers. The Government is in the early stages of formulating a rolling stock strategy which will include considerations around the timelines for new build, refurbishments, and potential cascades. Once established, Great British Railways will take the strategy forward providing a long-term approach to future rolling stock needs.