Written questions by Anderson.

What steps his Department is taking to improve diagnosis procedures for Functional Neurological Disorder.

The Government recognises the importance of ensuring that people with neurological symptoms receive an accurate and timely diagnosis. Clearer diagnostic pathways and improved clinical understanding are key to improving earlier recognition and reducing misdiagnosis of conditions like functional neurological disorder (FND).The National Institute for Health and Care Excellence (NICE) guideline, Suspected neurological conditions: recognition and referral, reference code NG127, sets out the symptoms commonly associated with FND and the recommended referral pathways for suspected cases, helping clinicians identify positive diagnostic signs rather than relying on a diagnosis of exclusion.NHS England ensures that integrated care boards (ICBs) follow NICE guidance through a combination of statutory oversight frameworks, annual performance assessments, and local clinical governance requirements.NICE’s Clinical Knowledge Summary on FND offers further practical advice for clinicians in both primary and non‑specialist care on the diagnosis and management of the condition, supporting more consistent recognition across the system.ICBs are responsible for commissioning services that meet the needs of their local populations. This includes ensuring appropriate assessment, referral, and support arrangements are in place for people presenting with symptoms consistent with FND, informed by national guidance.

What steps he is taking to support the recovery of people who have been diagnosed with severe Functional Neurological Disorder in Nottinghamshire.

The majority of services for people with neurological conditions, including functional neurological disorder (FND), are commissioned locally. Integrated care boards (ICBs), including the NHS Nottingham and Nottinghamshire ICB, have a statutory responsibility to commission services that meet the needs of their local population. This includes ensuring appropriate assessment, referral routes, and access to multidisciplinary rehabilitation for people diagnosed with FND. ICBs are expected to work with clinicians, service users, and patient groups to develop pathways that are responsive and convenient for patients.National guidance is also in place to improve the consistency of care. The National Institute for Health and Care Excellence (NICE) provides advice to clinicians on recognising and managing FND through its Suspected neurological conditions: recognition and referral guideline, reference code NG127, and Clinical Knowledge Summary, which support improved identification and care planning across primary and specialist settings.NHS England ensures that ICBs follow NICE guidance through a combination of statutory oversight frameworks, annual performance assessments, and local clinical governance requirements.The National Neurosciences Advisory Group developed an Optimal Clinical Pathway for FND, published in 2023, which sets out what good, person‑centred FND care should look like across the National Health Service. The pathway provides a clear, evidence‑informed framework for commissioners and clinicians, emphasising timely assessment, clear and compassionate communication of the diagnosis, and coordinated multidisciplinary rehabilitation involving neurology, physiotherapy, occupational therapy, and psychological support. It also outlines how services should work together across primary, community, and specialist care to ensure patients receive consistent support, reduce unwarranted variation, and avoid patients being passed between services without a coherent plan.NHS England has also strengthened expectations for FND care through its updated Specialised Neurology Service Specification (Adult), published in August 2025, which, for the first time, includes explicit requirements relating to FND. The specification states that all specialised neurology centres must ensure access to appropriate FND treatment services and adopt a multidisciplinary, networked model of care.

What steps he is taking to ensure people diagnosed with Functional Neurological Disorder can access adequate support services.

The majority of services for people with neurological conditions, including functional neurological disorder (FND), are commissioned locally. Integrated care boards (ICBs), including the NHS Nottingham and Nottinghamshire ICB, have a statutory responsibility to commission services that meet the needs of their local population. This includes ensuring appropriate assessment, referral routes, and access to multidisciplinary rehabilitation for people diagnosed with FND. ICBs are expected to work with clinicians, service users, and patient groups to develop pathways that are responsive and convenient for patients.National guidance is also in place to improve the consistency of care. The National Institute for Health and Care Excellence (NICE) provides advice to clinicians on recognising and managing FND through its Suspected neurological conditions: recognition and referral guideline, reference code NG127, and Clinical Knowledge Summary, which support improved identification and care planning across primary and specialist settings.NHS England ensures that ICBs follow NICE guidance through a combination of statutory oversight frameworks, annual performance assessments, and local clinical governance requirements.The National Neurosciences Advisory Group developed an Optimal Clinical Pathway for FND, published in 2023, which sets out what good, person‑centred FND care should look like across the National Health Service. The pathway provides a clear, evidence‑informed framework for commissioners and clinicians, emphasising timely assessment, clear and compassionate communication of the diagnosis, and coordinated multidisciplinary rehabilitation involving neurology, physiotherapy, occupational therapy, and psychological support. It also outlines how services should work together across primary, community, and specialist care to ensure patients receive consistent support, reduce unwarranted variation, and avoid patients being passed between services without a coherent plan.NHS England has also strengthened expectations for FND care through its updated Specialised Neurology Service Specification (Adult), published in August 2025, which, for the first time, includes explicit requirements relating to FND. The specification states that all specialised neurology centres must ensure access to appropriate FND treatment services and adopt a multidisciplinary, networked model of care.

What steps he is taking to help improve detection processes for Functional Neurological Disorder in children.

The Government recognises that functional neurological disorder (FND) can have a significant impact on the lives of children and their families. Children with FND may experience a wide range of symptoms, and early recognition and access to appropriate support is essential. FND can be difficult to identify in children, as symptoms often overlap with other neurological and developmental conditions. Early and accurate detection is therefore essential to ensure children receive appropriate assessment, clear communication of diagnosis, and timely access to multidisciplinary support.Health professionals are supported by national evidence‑based products which play an important role in strengthening recognition and referral pathways. The National Institute for Health and Care Excellence (NICE) includes FND within its guideline, Suspected neurological conditions: recognition and referral, reference code NG127. It outlines common symptom patterns associated with FND, such as fluctuating limb weakness, sensory disturbances, episodes of altered awareness, and difficulties with memory and concentration, and sets out recommended referral routes for suspected cases.NICE’s Clinical Knowledge Summary on FND also provides practical advice for clinicians on the diagnosis and management of FND, supporting improved recognition in primary and non‑specialist care.In addition, NICE published, in October 2025, new guidance on rehabilitation for chronic neurological disorders, reference code NG252, which will help improve access to consistent, multidisciplinary support for children and young people with neurological conditions, including those with FND.Integrated care boards (ICBs) are responsible for commissioning services that meet the needs of their local populations, including pathways for children with neurological conditions such as FND. ICBs are expected to work with clinicians and specialists, informed by national guidance, to ensure appropriate assessment, referral and support arrangements are in place for children presenting with symptoms consistent with FND.NHS England ensures that ICBs follow NICE guidance through a combination of statutory oversight frameworks, annual performance assessments, and local clinical governance requirements.

Food and Rural Affairs, what assessment her Department has made about the potential impact of high veterinary bills on animal health.

Defra has not made a recent assessment of veterinary bills however it welcomes the Competition and Markets Authority’s (CMA’s) market investigation into veterinary services for household pets. The CMA has made provisional recommendations to make veterinary fees more transparent, helping pet owners to make more informed choices on the type of veterinary care they value. The CMA and Defra have regular discussions on the CMA’s investigation and Defra will formally respond to the CMA’s final report when it is published in the Spring. Additionally, on 28 January, Defra released its consultation on reform of the Veterinary Surgeons Act 1966 which seeks to incorporate the CMA’s provisional recommendations following further assessment. The consultation is also proposing increased ability for veterinary nurse-led care and the regulation of currently unregulated allied veterinary professionals, increasing the choices of animal owners and supporting the cost of living whilst enhancing animal health and welfare.

Food and Rural Affairs, what steps her Department are taking to help support people with veterinary bills.

Defra has not made a recent assessment of veterinary bills however it welcomes the Competition and Markets Authority’s (CMA’s) market investigation into veterinary services for household pets. The CMA has made provisional recommendations to make veterinary fees more transparent, helping pet owners to make more informed choices on the type of veterinary care they value. The CMA and Defra have regular discussions on the CMA’s investigation and Defra will formally respond to the CMA’s final report when it is published in the Spring. Additionally, on 28 January, Defra released its consultation on reform of the Veterinary Surgeons Act 1966 which seeks to incorporate the CMA’s provisional recommendations following further assessment. The consultation is also proposing increased ability for veterinary nurse-led care and the regulation of currently unregulated allied veterinary professionals, increasing the choices of animal owners and supporting the cost of living whilst enhancing animal health and welfare.

Food and Rural Affairs, what steps her Department is taking to increase transparency of the prices of veterinary bills.

Defra has not made a recent assessment of veterinary bills however it welcomes the Competition and Markets Authority’s (CMA’s) market investigation into veterinary services for household pets. The CMA has made provisional recommendations to make veterinary fees more transparent, helping pet owners to make more informed choices on the type of veterinary care they value. The CMA and Defra have regular discussions on the CMA’s investigation and Defra will formally respond to the CMA’s final report when it is published in the Spring. Additionally, on 28 January, Defra released its consultation on reform of the Veterinary Surgeons Act 1966 which seeks to incorporate the CMA’s provisional recommendations following further assessment. The consultation is also proposing increased ability for veterinary nurse-led care and the regulation of currently unregulated allied veterinary professionals, increasing the choices of animal owners and supporting the cost of living whilst enhancing animal health and welfare.

Food and Rural Affairs, what recent conversations her Department has had with the Competition and Market Authority regarding veterinary bill costs.

Defra has not made a recent assessment of veterinary bills however it welcomes the Competition and Markets Authority’s (CMA’s) market investigation into veterinary services for household pets. The CMA has made provisional recommendations to make veterinary fees more transparent, helping pet owners to make more informed choices on the type of veterinary care they value. The CMA and Defra have regular discussions on the CMA’s investigation and Defra will formally respond to the CMA’s final report when it is published in the Spring. Additionally, on 28 January, Defra released its consultation on reform of the Veterinary Surgeons Act 1966 which seeks to incorporate the CMA’s provisional recommendations following further assessment. The consultation is also proposing increased ability for veterinary nurse-led care and the regulation of currently unregulated allied veterinary professionals, increasing the choices of animal owners and supporting the cost of living whilst enhancing animal health and welfare.

Food and Rural Affairs, what recent assessment her Department has made of the (a) economic state and (b) financial viability of independent veterinary businesses.

Defra has not done its own assessment of the economic state and financial viability of veterinary businesses., however, it welcomes the Competition and Markets Authority’s (CMA’s) market investigation into veterinary services for household pets. As part of their market investigation, the CMA carried out an economic assessment of the sector. The CMA released its provisional decision report on 15 October for the veterinary profession to respond. The CMA will review all responses before releasing its final report. Defra will formally respond to the CMA’s final report, and the items within it, when it is published in the Spring. Some of the CMA’s provisional recommendation will require reform of the Veterinary Surgeons Act 1966, on which Defra is currently consulting, and further assessments will be carried out as required.

Food and Rural Affairs, what assessment her Department has made about the potential impact of high veterinary bills in the context of the cost of living pressures.

Defra has not made a recent assessment of veterinary bills however it welcomes the Competition and Markets Authority’s (CMA’s) market investigation into veterinary services for household pets. The CMA has made provisional recommendations to make veterinary fees more transparent, helping pet owners to make more informed choices on the type of veterinary care they value. The CMA and Defra have regular discussions on the CMA’s investigation and Defra will formally respond to the CMA’s final report when it is published in the Spring. Additionally, on 28 January, Defra released its consultation on reform of the Veterinary Surgeons Act 1966 which seeks to incorporate the CMA’s provisional recommendations following further assessment. The consultation is also proposing increased ability for veterinary nurse-led care and the regulation of currently unregulated allied veterinary professionals, increasing the choices of animal owners and supporting the cost of living whilst enhancing animal health and welfare.

Food and Rural Affairs, what recent assessment her Department has made on the affordability of veterinary bills.

Defra has not made a recent assessment of veterinary bills however it welcomes the Competition and Markets Authority’s (CMA’s) market investigation into veterinary services for household pets. The CMA has made provisional recommendations to make veterinary fees more transparent, helping pet owners to make more informed choices on the type of veterinary care they value. The CMA and Defra have regular discussions on the CMA’s investigation and Defra will formally respond to the CMA’s final report when it is published in the Spring. Additionally, on 28 January, Defra released its consultation on reform of the Veterinary Surgeons Act 1966 which seeks to incorporate the CMA’s provisional recommendations following further assessment. The consultation is also proposing increased ability for veterinary nurse-led care and the regulation of currently unregulated allied veterinary professionals, increasing the choices of animal owners and supporting the cost of living whilst enhancing animal health and welfare.

Food and Rural Affairs, what recent conversations her Department has held with animal charities regarding veterinary bills.

Proposed reforms to the VSA support the result of the Competition and Markets Authority’s (CMA’s) market investigation into veterinary services for household pets. The CMA has provisionally recommended making fees more transparent, thus helping owners to make more informed choices on of the type of veterinary care they value. Defra has engaged closely with several sector stakeholders, including representatives from the charity sector, in relation to our consultation on proposed reforms of the Veterinary Surgeons Act 1966. Defra shall continue to involve animal charities in this work. Proposed reforms will allow veterinary nurses to independently carry out a greater range of work within their skillset. Independently, this will aid animal charities by giving them more choice over who can provide treatment.

What steps he is taking to support parents and families who lose a child to Sudden Unexplained Death in Childhood.

We recognise the devastating impact of sudden unexplained death in childhood (SUDC) on affected families and communities. It is important that grieving families and friends who have lost loved ones have access to the support they need, when they need it. Bereavement support, including for parents and families affected by SUDC, is commissioned locally, in accordance with the needs of the local population. Information on SUDC is available on the National Health Service website, which also signposts to the charity SUDC.UK. This is available at the following link:https://www.nhs.uk/conditions/sudden-infant-death-syndrome-sidsThe Department funds research into SUDC through the National Institute for Health and Care Research (NIHR). Recent NIHR‑funded research includes studies focused on the promotion of safer sleeping practices for families at increased risk, the identification and management of genetic and cardiac risk factors, and the improvement of support for bereaved families.The NIHR actively encourages and funds high-quality research into SUDC, ensuring flexibility in both the funding and research type to meet the needs of patients and families.

What steps his Department is taking to increase research into Sudden Unexplained Death in Childhood.

We recognise the devastating impact of sudden unexplained death in childhood (SUDC) on affected families and communities. It is important that grieving families and friends who have lost loved ones have access to the support they need, when they need it. Bereavement support, including for parents and families affected by SUDC, is commissioned locally, in accordance with the needs of the local population. Information on SUDC is available on the National Health Service website, which also signposts to the charity SUDC.UK. This is available at the following link:https://www.nhs.uk/conditions/sudden-infant-death-syndrome-sidsThe Department funds research into SUDC through the National Institute for Health and Care Research (NIHR). Recent NIHR‑funded research includes studies focused on the promotion of safer sleeping practices for families at increased risk, the identification and management of genetic and cardiac risk factors, and the improvement of support for bereaved families.The NIHR actively encourages and funds high-quality research into SUDC, ensuring flexibility in both the funding and research type to meet the needs of patients and families.

Food and Rural Affairs, what recent discussions he has had with UK fishers on (a) challenges and (b) support required.

Defra Ministers meet with representatives of the fishing industry regularly to discuss a wide variety of issues including to understand their perspectives on challenges and support they need.

Food and Rural Affairs, what recent assessment her Department has made of the potential impact of increasing water bills on households.

It is important that customers get value for money from their water bills and that support is available for those who need it. I meet water companies frequently to discuss a range of issues, including customer bills. As the independent economic regulator, it is Ofwat’s responsibility to scrutinise water company business plans and ensure the prices water companies charge their customers are fair and proportionate. It does this through its Price Review, every five years. Ofwat published the results of the 2024 Price Review in December 2024, this sets out company expenditure and customer bills for the next five years, up to 2030. These price controls came into effect on 01 April 2025. Price Review 2024 will deliver substantial improvements for customers and the environment through a £104 billion upgrade for the water sector - the highest level of investment in the water sector since privatisation. The average annual bill rise over the next 5 years will be £31 (or 36%). This will vary across households depending on their circumstances. Information on bills for each water company is available on Ofwat’s website. All water companies have measures in place for customers who struggle to pay for their water and wastewater services, such as WaterSure, social tariffs, payment breaks and holidays, and debt management support. Moreover, Government expects industry to keep the current support schemes under review to ensure that vulnerable customers are supported. The Government has committed to reforming the WaterSure support scheme which supports low-income households with high essential water use due to having a medical condition or three or more children living at home and has consulted on extending the list of qualifying benefits to include non-means tested disability benefits. This proposal is designed to provide better support for low-income households where a medical condition leads to high essential water use. The proposed reforms would also increase support for existing households and update the regulations to reflect best practice adopted across the water sector. The department will publish the response to the consultation in the coming months. Bill increases are necessary to make up for years of under-investment and make sure water companies can deliver a good service to customers and protect the environment. The Government is also bringing forward root and branch reform to secure better outcomes for billpayers and restore trust and accountability. This includes the creation of a powerful new consolidated regulator, which will work to ensure water company bills are fair and affordable for customers. These reforms are detailed in the Government’s Water White Paper.

Food and Rural Affairs, what steps her Department is taking to support people with the cost of water bills.

It is important that customers get value for money from their water bills and that support is available for those who need it. I meet water companies frequently to discuss a range of issues, including customer bills. As the independent economic regulator, it is Ofwat’s responsibility to scrutinise water company business plans and ensure the prices water companies charge their customers are fair and proportionate. It does this through its Price Review, every five years. Ofwat published the results of the 2024 Price Review in December 2024, this sets out company expenditure and customer bills for the next five years, up to 2030. These price controls came into effect on 01 April 2025. Price Review 2024 will deliver substantial improvements for customers and the environment through a £104 billion upgrade for the water sector - the highest level of investment in the water sector since privatisation. The average annual bill rise over the next 5 years will be £31 (or 36%). This will vary across households depending on their circumstances. Information on bills for each water company is available on Ofwat’s website. All water companies have measures in place for customers who struggle to pay for their water and wastewater services, such as WaterSure, social tariffs, payment breaks and holidays, and debt management support. Moreover, Government expects industry to keep the current support schemes under review to ensure that vulnerable customers are supported. The Government has committed to reforming the WaterSure support scheme which supports low-income households with high essential water use due to having a medical condition or three or more children living at home and has consulted on extending the list of qualifying benefits to include non-means tested disability benefits. This proposal is designed to provide better support for low-income households where a medical condition leads to high essential water use. The proposed reforms would also increase support for existing households and update the regulations to reflect best practice adopted across the water sector. The department will publish the response to the consultation in the coming months. Bill increases are necessary to make up for years of under-investment and make sure water companies can deliver a good service to customers and protect the environment. The Government is also bringing forward root and branch reform to secure better outcomes for billpayers and restore trust and accountability. This includes the creation of a powerful new consolidated regulator, which will work to ensure water company bills are fair and affordable for customers. These reforms are detailed in the Government’s Water White Paper.

Food and Rural Affairs, what recent discussions she has had with water companies on the cost of water bills to customers.

It is important that customers get value for money from their water bills and that support is available for those who need it. I meet water companies frequently to discuss a range of issues, including customer bills. As the independent economic regulator, it is Ofwat’s responsibility to scrutinise water company business plans and ensure the prices water companies charge their customers are fair and proportionate. It does this through its Price Review, every five years. Ofwat published the results of the 2024 Price Review in December 2024, this sets out company expenditure and customer bills for the next five years, up to 2030. These price controls came into effect on 01 April 2025. Price Review 2024 will deliver substantial improvements for customers and the environment through a £104 billion upgrade for the water sector - the highest level of investment in the water sector since privatisation. The average annual bill rise over the next 5 years will be £31 (or 36%). This will vary across households depending on their circumstances. Information on bills for each water company is available on Ofwat’s website. All water companies have measures in place for customers who struggle to pay for their water and wastewater services, such as WaterSure, social tariffs, payment breaks and holidays, and debt management support. Moreover, Government expects industry to keep the current support schemes under review to ensure that vulnerable customers are supported. The Government has committed to reforming the WaterSure support scheme which supports low-income households with high essential water use due to having a medical condition or three or more children living at home and has consulted on extending the list of qualifying benefits to include non-means tested disability benefits. This proposal is designed to provide better support for low-income households where a medical condition leads to high essential water use. The proposed reforms would also increase support for existing households and update the regulations to reflect best practice adopted across the water sector. The department will publish the response to the consultation in the coming months. Bill increases are necessary to make up for years of under-investment and make sure water companies can deliver a good service to customers and protect the environment. The Government is also bringing forward root and branch reform to secure better outcomes for billpayers and restore trust and accountability. This includes the creation of a powerful new consolidated regulator, which will work to ensure water company bills are fair and affordable for customers. These reforms are detailed in the Government’s Water White Paper.

What steps she is taking to improve public transport provision in rural areas.

The Government knows how important affordable and reliable public transport services are in keeping communities connected. We introduced the Bus Services Act 2025 to put power over local bus services back into the hands of local leaders, including in rural areas. In addition, the Government has confirmed over £3 billion from 2026/27 to support local leaders and bus operators to improve bus services over the spending review period. This includes multi-year allocations for local authorities under the Local Authority Bus Grant (LABG) totalling nearly £700 million per year. East Midlands Combined Authority will be allocated £65.5 million under the LABG from 2026/27 to 2028/29, in addition to the £21.7 million they are already receiving this year. On 1 January 2025, the Government introduced a new £3 cap on single bus fares in England outside London, and in the Spending Review announced that this would be extended until March 2027. The £3 cap replaced the £2 cap, and without action, the cap would have ended and fares would have returned to their previous levels. Local authorities can also use their LABG funding to introduce local fares initiatives to further reduce travel costs Rail services in East Midlands Combined Authority are supported by requirements on train operators to plan services and design timetables to meet both current and future passenger demand, while also ensuring value for money for the taxpayer. The government commitment to public ownership through Great British Railways will also help to deliver a unified system that focuses on reliable, affordable, high-quality and efficient transport services, whilst also ensuring safety and accessibility. Under public ownership, passenger services can be operated in the interests of passengers, not shareholders.

What steps she is taking to help make public transport more affordable.

The Government knows how important affordable and reliable public transport services are in keeping communities connected. We introduced the Bus Services Act 2025 to put power over local bus services back into the hands of local leaders, including in rural areas. In addition, the Government has confirmed over £3 billion from 2026/27 to support local leaders and bus operators to improve bus services over the spending review period. This includes multi-year allocations for local authorities under the Local Authority Bus Grant (LABG) totalling nearly £700 million per year. East Midlands Combined Authority will be allocated £65.5 million under the LABG from 2026/27 to 2028/29, in addition to the £21.7 million they are already receiving this year. On 1 January 2025, the Government introduced a new £3 cap on single bus fares in England outside London, and in the Spending Review announced that this would be extended until March 2027. The £3 cap replaced the £2 cap, and without action, the cap would have ended and fares would have returned to their previous levels. Local authorities can also use their LABG funding to introduce local fares initiatives to further reduce travel costs Rail services in East Midlands Combined Authority are supported by requirements on train operators to plan services and design timetables to meet both current and future passenger demand, while also ensuring value for money for the taxpayer. The government commitment to public ownership through Great British Railways will also help to deliver a unified system that focuses on reliable, affordable, high-quality and efficient transport services, whilst also ensuring safety and accessibility. Under public ownership, passenger services can be operated in the interests of passengers, not shareholders.