Written questions by Morgan.

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.

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 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.

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.

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.

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.

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 much Government funding has been provided to hospices 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.

If his Department will take steps to discover the full extent of health issues in aircrew exposed to (a) fuel and (b) exhaust fumes from helicopters.

The Ministry of Defence is committed to the health and wellbeing of our people. The Independent Medical Expert Group (IMEG) was previously tasked to review independently the evidence base for causality between Sea King helicopter exhaust fumes and rare cancers. The report by the IMEG concluded that the evidence did not meet internationally adopted criteria for causation of these rare cancers. The Department will continue to monitor medical evidence and respond accordingly.

What the highest individual settlement paid to an aircrew member has been for the impact of helicopter exhaust fume exposure in each of the last five years.

In the last five financial years, damages have been paid in 2019-20, 2020-21 and 2023-24 to former aircrew who have made common law compensation claims alleging adverse impacts of helicopter exhaust fumes. I have concerns that disclosing individual damages awards risks revealing the identity of individual claimants and I am, therefore, withholding the individual settlements under Freedom of Information Act Section 40(2) to protect personal information as governed by the Data Protection Act 2018 and GDPR.

What plans she has to ensure step-free access to Whitchurch Railway Station.

The Government is committed to improving the accessibility of the railway and recognises the social and economic benefits this brings to communities.Given the short time since the general election, I regret I am not yet able to comment on next steps regarding specific stations including Whitchurch station. We are carefully considering the best approach to the Access for All programme and we will provide updates to MPs and other stakeholders in due course.

Whether he has had discussions with his (a) German and (b) Dutch counterpart on longer exhausts in (a) CH-47 Chinook, (b) Puma, (c) Sea King and (d) Westland Wessex helicopters.

We have found no record of any discussions with Dutch or German counterparts regarding longer exhausts on Chinook and Puma aircraft. The German military does not operate Chinook nor Puma helicopters. The Netherlands does not operate Puma helicopters. Due to their out of service dates of 2003 and 2018, no relevant information is held within Ministry of Defence relating to Sea King and Wessex helicopters; however, the Netherlands did not operate Sea King helicopters and neither country operated the Wessex.

What assessment his Department has made of the impact of (a) Sea King (b) Westland Wessex (c) Puma and (d) CH-47 Chinook helicopters on air quality in areas with high helicopter air traffic.

Neither the Sea King nor Westland Wessex remain in service with the Ministry of Defence. They were retired in 2018 and 2003 respectively. We do not believe that there is an increased risk to air quality from Puma and Chinook helicopters. However, we fully recognise the importance of acting on safety concerns. As such, the department has begun work to initiate a programme of engine exhaust emissions substance monitoring for in service helicopters in accordance with Health and Safety Executive approved methods.

What steps his Department is taking to protect aircrew members from exposure to helicopter (a) fuel and (b) exhaust fumes.

Common law claims alleging adverse impact from helicopter fuel and exhaust fumes were first received in 2019. Without any admission of liability, since 23 April 2023 the Ministry of Defence has made five compensation payments, totalling £3,578,566 in relation to common law claims alleging adverse impact from helicopter fuel and exhaust fumes. As of the 14 November 2024 there are six related, continuing common law compensation claims. The department is in the process of testing the exhaust emissions of in-service helicopters, including Chinook and Puma to ensure we are meeting our duty of care for personnel. It is essential that we can assure our people of their safety at work. The Westland Sea king was retired in 2018. The Westland Wessex was retired in 2003.

If her Department will publish the criteria used to decide the bus service improvement plan funding allocations for 2025-26.

The government has confirmed £955 million for the 2025 to 2026 financial year to support and improve bus services in England outside London. This includes £243 million for bus operators and £712 million allocated to local authorities across the country. Shropshire Council has been allocated £4.4 million of this funding.As the Secretary of State noted in her oral statement to the House of Commons on 18 November, funding for local authorities has been allocated based on local needs, including population, the distance that buses travel, and levels of deprivation.