Written questions by Perteghella.

What steps he is taking to improve preparedness for first-time anaphylaxis incidents in rural communities.

In November 2021, the Medicines and Healthcare products Regulatory Agency (MHRA) and the Commission on Human Medicine’s Adrenaline Auto-injector Expert Working Group, with wide-ranging input from patient groups, leading allergy experts and healthcare professionals, published a report which outlined recommendations for the safe and effective use of adrenaline auto-injectors (AAIs), including quicker treatment, to help save lives. MHRA has worked alongside the Department and the wider health system to take forward these recommendations, some of which are already in place.In June 2023, MHRA, with the support of allergy awareness advocates, launched a safety campaign to raise awareness of anaphylaxis and provide advice on the use of AAIs. MHRA produced a toolkit of resources for health and social care professionals to support the safe and effective use of AAIs. Alongside this, MHRA produced guidance, which states that prescribers should prescribe two AAIs to make sure patients always have the second dose and that those who are prescribed AAIs should carry two AAIs at all times.The National Institute for Health and Care Excellence has also produced guidance on assessment and referral for anaphylaxis. It aims to improve the quality of care for people with suspected anaphylaxis by detailing the assessments that are needed and recommending referral to specialist allergy services after emergency treatment.Most community pharmacies offer vaccinations. As part of offering this service, pharmacy contractors are expected to recognise and treat anaphylaxis. They must have immediate access to an anaphylaxis pack, including adrenaline. They are required to undertake training to administer adrenaline from an ampoule using a needle and AAIs in case of anaphylactic reactions.Data regarding all anaphylaxis-related deaths in England and Wales are documented by the Office for National Statistics, and the British Society for Allergy and Clinical Immunology also holds a register to capture and learn fatal cases of anaphylaxis which has been operational since 1992, the UK Fatal Anaphylaxis Register (UKFAR).Regarding the reporting of anaphylaxis in hospitals, NHS England’s National Patient Safety Team is working with the UKFAR to develop a mechanism for sharing relevant patient safety anaphylaxis incidents. The aim will be for the UKFAR to extract and share patient safety incidents reported to the national databases, the National Reporting and Learning System and Learn from Patient Safety Events, relating to severe allergic reactions.

Commonwealth and Development Affairs, what assessment he has made of the potential implications for his policies of violence by armed groups and militias such as M23 armed group in the Eastern Democratic Republic of Congo; and what steps he is taking to help reduce this.

The UK condemns the use of violence by armed groups in the Democratic Republic of Congo (DRC), including M23, and is committed to encouraging continued engagement and delivery on commitments by all parties under the Luanda peace process. In August and September 2024, the Minister for Africa visited Angola, DRC and Rwanda where he met with their respective presidents and urged de-escalation. He has subsequently spoken on a number of occasions with foreign ministers in the region. The UK is delivering a three-year £208 million humanitarian programme in the east of DRC, providing life-saving emergency assistance and increasing the resilience of crisis-affected communities.

Whether her Department will make an assessment of the potential merits of introducing mandatory requirements for nurseries to provide itemised breakdowns of additional service charges.

In December the government published its Plan for Change, which outlines the priority deliverable for the Opportunity Mission is for a record number of children to be starting school ready to learn, measured by attainment against the early learning goals. This is key to breaking the link between young people’s background and their success. The department is hugely ambitious for the early years because we know how important this is for parents and their children.It is important that the funded childcare hours are accessible and affordable for all families that need them. That is why the government is taking action to tackle reported instances of parents facing very high additional charges on top of the funded entitlement hours. These could include extra charges for nappies, lunch or other ‘consumables’, which should not be made a condition of accessing a funded place. It is also important that any additional charges are completely transparent to parents.As part of the department’s regular review of the early years statutory guidance for local authorities, we have engaged with local authorities, providers and groups representing parents to clarify our statutory guidance on charging, including on so-called ‘top up fees’, and are considering how the department can better support local authorities to protect parents from overcharging.The department will publish its updated statutory guidance in due course.

What discussions her Department has had with childcare providers on (a) changes in the level of additional service charges and (b) their potential impact on working families’ ability to access affordable childcare.

In December the government published its Plan for Change, which outlines the priority deliverable for the Opportunity Mission is for a record number of children to be starting school ready to learn, measured by attainment against the early learning goals. This is key to breaking the link between young people’s background and their success. The department is hugely ambitious for the early years because we know how important this is for parents and their children.It is important that the funded childcare hours are accessible and affordable for all families that need them. That is why the government is taking action to tackle reported instances of parents facing very high additional charges on top of the funded entitlement hours. These could include extra charges for nappies, lunch or other ‘consumables’, which should not be made a condition of accessing a funded place. It is also important that any additional charges are completely transparent to parents.As part of the department’s regular review of the early years statutory guidance for local authorities, we have engaged with local authorities, providers and groups representing parents to clarify our statutory guidance on charging, including on so-called ‘top up fees’, and are considering how the department can better support local authorities to protect parents from overcharging.The department will publish its updated statutory guidance in due course.

If she will make an assessment of the potential merits of bringing forward legislative proposals to make care experience a protected characteristic under the Equality Act 2010.

The Government recognises that 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. We have also established a care leaver Ministerial Board, which brings together Ministers from key Departments, to improve support for care leavers across Government.We are determined to tackle stigma and discrimination faced by care-experienced young people. We want to create a culture where all those who play a role in the lives of children in care and care leavers are ambitious for them to reach their full potential. While we do not have plans to make care-experience a protected characteristic in the Equality Act 2010, we are committed to extending corporate parenting responsibilities to government departments and relevant public bodies to ensure that services and support to children in care and care leavers better take account of the challenges they face.

Communities and Local Government, with reference to the English Devolution White Paper, published on 16 December 2024, whether elections to Warwickshire County Council will take place on 1 May 2025.

I will consider any requests I receive to postpone the May 2025 local authority elections in Kent and Warwickshire only where this will help the areas to deliver both reorganisation and devolution to the most ambitious timeframe – either through the Devolution Priority Programme or where reorganisation is necessary to unlock devolution or open up new devolution options. As I set out in my letter of 16 December to those councils, I will need a clear commitment to these aims, including a request from the council(s) whose election is to be postponed, on or before Friday 10 January.

Whether she has made an assessment of the potential impact of interest rates for university student loans on (a) students and (b) their families.

Interest rates on student loans do not affect monthly repayments made by borrowers. Regular repayments are based on a fixed percentage of earnings above the applicable repayment threshold, not on amount borrowed or the rate of interest. The income of the wider household/family is not included. If income is below the relevant repayment threshold, or a borrower is not earning, they do not have to make any repayments. Any outstanding debt, including interest accrued, is written off after the loan term ends, or in case of death or disability, at no detriment to the borrower. The debt does not pass to the borrower’s family. An impact assessment on the current student loan plan type can be accessed at: https://www.gov.uk/government/publications/higher-education-reform-equality-impact-assessment. The government is determined that the higher education funding system should deliver for our economy, universities and students. The department has taken the system under consideration and will continue to engage with stakeholders on this.

If she will have discussions with the Secretary of State for Transport on the potential for data sharing with the DVLA to enable applications for reduced rate vehicle excise duty to be made (a) online and (b) in post offices.

The Secretary of State and I have regular discussions with Ministerial colleagues on a range of issues affecting those receiving social security benefits, including those which may bring with them an entitlement to additional support from other Departments, and how such services can be delivered more effectively.

Communities and Local Government, if she will make an assessment of the potential impact of the introduction of voter ID on specific migrant communities.

As our manifesto made clear, the government will address the inconsistencies in the voter identification policy so that all legitimate electors are able to vote. We are continuing to assess and review the policy and if any further changes are found to be necessary or appropriate, we will bring forward proposals for them in due course.

What steps his Department is taking to tackle fuel poverty in the Stratford-on-Avon constituency in winter 2024-25.

There are multiple targeted schemes to deliver energy efficiency measures to low-income and fuel poor households. The Warm Home Discount schemes also provide a £150 rebate off bills to eligible low-income households across Great Britain. The Government has kickstarted delivery of the Warm Homes Plan, including an initial £1.8 billion to support fuel poverty schemes over the next 3 years, helping around 225,000 households reduce their energy bills by around £200. We will consult shortly on proposals for privately rented homes to achieve Energy Performance Certificate C or equivalent by 2030. We are also reviewing the 2021 fuel poverty strategy.

If she will make it her policy to extend home-to-school transport for SEND students to include those in post-16 education.

I refer the hon. Member for Stratford-on-Avon to the answer of 11 September 2024 to Question 4162.

If she will make it her policy to reduce the VAT (a) rate and (b) threshold for businesses that provide personal care services.

VAT is the UK’s second largest tax, forecast to raise £171 billion in 2024/25. At Autumn Budget 2024, the Government took a number of difficult but necessary decisions on tax, welfare, and spending to fix the public finances, fund public services, and restore economic stability. At £90,000, the UK has a higher VAT registration threshold than any EU country and the joint highest in the OECD. This means the majority of UK businesses are out of the VAT system. Any consideration of changes to the threshold would have to carefully balance the potential benefits to small businesses, the economy as a whole, and tax revenues.

What steps he is taking to increase the number of (a) NHS dentists and (b) NHS dental appointments in Stratford-on-Avon constituency.

The Government plans to tackle the challenges for patients trying to access National Health Service dental care with a rescue plan to provide 700,000 more urgent dental appointments and recruit new dentists to the areas that need them most. To rebuild dentistry in the long term and increase access to NHS dental care, we will reform the dental contract, with a shift to focus on prevention and the retention of NHS dentists.The responsibility for commissioning primary care services, including NHS dentistry, to meet the needs of the local population has been delegated to the integrated care boards (ICBs) across England. For the Stratford-on-Avon constituency, this is the NHS Coventry and Warwickshire ICB.

Whether she has conducted an impact assessment on the potential impact of changes to agricultural property relief on tenant farmers.

The Government published information about the reforms to agricultural property relief and business property relief at www.gov.uk/government/publications/agricultural-property-relief-and-business-property-relief-reforms. It is expected that up to around 520 estates will claim APR (including those that also claim for BPR) and will be impacted by these changes in 2026-27. Almost three-quarters of estates claiming agricultural property relief (or those claiming agricultural property relief and business property relief together) each year are expected to be unaffected by these reforms. In accordance with standard practice, a tax information and impact note will be published alongside the draft legislation before the relevant Finance Bill.

What steps he is taking to ensure the independence of the nuclear deterrent; and if he will take steps to reduce reliance on the US for the (a) testing, (b) maintenance, and (c) replacement of missiles.

I refer the hon. Member to the answer given to her by my hon. Friend the Minister for the Armed Forces (Luke Pollard) on 27 November 2024 to Question 15093.

If she will bring forward legislative proposals to (a) debt collecting companies to wait for decisions of appeal courts before taking action and (b) otherwise require improve the regulation of debt collection practices.

The Government expects fair treatment of individuals in debt and recognises the important role of responsible practices for debt recovery. We likewise recognise the negative impact that aggressive pursuit of debt can have on individuals, particularly where court action is involved.The Government remains committed to improving debt collection practices across sectors and supporting individuals in financial difficulties relating to debt more broadly. While there are already a number of regulations and guidelines in place, we will continue to monitor the sector closely and engage with stakeholders to ensure that regulation keeps pace with changing circumstances.

What steps he is taking to improve waiting times to access dementia treatment in Warwickshire.

Coventry and Warwickshire ICS have a number of initiatives aimed at increasing capacity for dementia assessment and treatment, particularly in South Warwickshire where it is recognised that there are longer delays.An additional consultant and team have been in place in South Warwickshire since September 2024 to run intensive clinics, increasing assessment and treatment capacity and speed.In November 2024, South Warwickshire added additional weekend dementia clinics.The Memory Service in Warwickshire have introduced a range of measures to maximise specialist staff capacity, including employing additional administrative staff to complete tasks not requiring a specialist clinician. October 2024 saw a 40% increase in number of assessments completed by the team compared to the average earlier this year, and a 59% increase in reviews of existing patients.

What steps he is taking to ensure the independence of the nuclear deterrent; and if he will take steps to reduce reliance on the US for the (a) testing, (b) maintenance, and (c) replacement of missiles.

The United Kingdom’s nuclear deterrent is completely operationally independent. Only the Prime Minister can authorise the use of our nuclear weapons, even if they are to be employed as part of a NATO response. We have a close and longstanding relationship with the US on all nuclear issues. One result of this close relationship is that we are able to procure certain non-nuclear components from the US, most notably the Trident II D5 missile, significantly reducing the cost of our nuclear deterrent capability.

Commonwealth and Development Affairs, what steps he is taking to help tackle (a) violation of personal freedoms of female students and (b) other forms of mistreatment of women and girls in Iran.

Iran's human rights record is unacceptable. We condemn the continued repression of women and girls by the Iranian authorities. We maintain 94 human rights sanctions on senior Iranian decision makers, including those responsible for Iran's oppressive hijab law. We continue to support the UN Special Procedures of the Special Rapporteur and Fact-Finding Mission on Iran, mandates which are essential for spotlighting Iran's human rights violations, including against women and girls. We will continue to work alongside international partners to hold the Iranian regime accountable, including at the UN Third Committee this month.

Food and Rural Affairs, what assessment he has made of the (a) costs and (b) impact of the Border Target Operating Model on Environmental Horticulture businesses.

Defra continues to monitor and review the impact of the Border Target Operating Model (BTOM), including the Border Control Post at Sevington. We are working closely with industry, trade partners and enforcement agencies to minimise disruption and costs to trade, while continuing to protect our biosecurity. The effectiveness of the import controls has been demonstrated throughout September and October by the interception at Sevington of 34 consignments of plants infested with Pochazia Shantungensis, a fruit tree pest native to China but now present in mainland Europe. The consignments were destroyed, preventing the potential for a damaging outbreak for UK fruit growers. The BTOM is designed to assure the biosecurity of commercial imports. Illegal imports of products of animal origin are dealt with through intelligence led checks, conducted at the border by Border Force, in Border Force facilities, with the assistance of Port Health Authorities.