Written questions by Perteghella.

What assessment he has made of the adequacy of current NHS (a) guidance and (b) contractual arrangements for ensuring consistent GP prescribing practices for children with ADHD whose treatment has been initiated by a private provider.

It is the responsibility of the integrated care boards in England to make available appropriate provision to meet the health and care needs of their local population, including providing access to attention deficit hyperactivity disorder and autism assessment and support services, in line with relevant National Institute for Health and Care Excellence guidelines.Shared care with the National Health Service refers to an arrangement whereby a specialist doctor formally transfers responsibility for all or some aspects of their patient’s care, such as the prescription of medication, over to the patient’s general practitioner (GP).The General Medical Council (GMC), which regulates and sets standards for doctors in the United Kingdom, has made it clear that GPs cannot be compelled to enter into a shared care agreement. GPs may decline such requests on clinical or capacity grounds.The GMC has issued guidance on prescribing and managing medicines, which helps GPs decide whether to accept shared care responsibilities. In deciding whether to enter into a shared care agreement, a GP will need to consider a number of factors such as whether the proposed activity is within their sphere of competence, and therefore safe and suitable for their patient’s needs. This includes the GP being satisfied that any prescriptions or referrals for treatment are clinically appropriate.If a shared care arrangement cannot be put in place after the treatment has been initiated, the responsibility for continued prescribing falls upon the specialist clinician, and this applies to both NHS and private medical care.

How many NHS GP practices in (a) England, (b) Coventry & Warwickshire, and (c) Stratford-on-Avon have declined to enter into shared care arrangements for ADHD medication prescribed by private providers in each integrated care board area in the most recent 12-month period for which data is available.

The data requested is not held centrally. The Coventry and Warwickshire Integrated Care Board has also confirmed that it does not hold the relevant data. The General Medical Council (GMC), which regulates and sets standards for doctors in the United Kingdom, has issued guidance on prescribing and managing medicines, which helps general practitioners (GPs) decide whether to accept shared care responsibilities. In deciding whether to enter into a shared care agreement, a GP will need to consider a number of factors such as whether the proposed activity is within their sphere of competence, and therefore safe and suitable for their patient’s needs. This includes the GP being satisfied that any prescriptions or referrals for treatment are clinically appropriate.The GMC has made it clear that GPs cannot be compelled to enter into a shared care agreement. GPs may decline such requests on clinical or capacity grounds. If a shared care arrangement cannot be put in place after the treatment has been initiated, the responsibility for continued prescribing falls upon the specialist clinician, which applies to both National Health Service and private medical care.

What steps he is taking to encourage burial authorities to make every effort to contact families before taking action to lay memorials flat where this can be done safely.

While the Department is responsible for burial law and policy, the Government does not have day-to-day operational responsibility for burial grounds, which lies instead with providers.The Government’s guidance documents Managing the safety of Burial Ground Memorials and Guide for Burial Ground Managers set out best practice for memorial safety inspections, including guidance that laying memorials flat should only occur where necessary and following a risk assessment. The documents also advise burial authorities to make every effort to contact families before taking action, where this does not compromise safety.Burial authorities are expected to follow this guidance when carrying out inspections. Any concerns or complaints about how inspections have been conducted can be raised directly with the relevant burial authority.

If he will make an assessment of the potential merits of issuing new guidance to integrated care boards on ensuring that children with Education, Health and Care Plans receive equitable access to ADHD medication regardless of whether their initial assessment was provided (a) privately or (b) through the NHS.

It is the responsibility of the integrated care boards in England to make available appropriate provision to meet the health and care needs of their local population, including providing access to attention deficit hyperactivity disorder and autism assessment and support services, in line with relevant National Institute for Health and Care Excellence guidelines.Shared care with the National Health Service refers to an arrangement whereby a specialist doctor formally transfers responsibility for all or some aspects of their patient’s care, such as the prescription of medication, over to the patient’s general practitioner (GP).The General Medical Council (GMC), which regulates and sets standards for doctors in the United Kingdom, has made it clear that GPs cannot be compelled to enter into a shared care agreement. GPs may decline such requests on clinical or capacity grounds.The GMC has issued guidance on prescribing and managing medicines, which helps GPs decide whether to accept shared care responsibilities. In deciding whether to enter into a shared care agreement, a GP will need to consider a number of factors such as whether the proposed activity is within their sphere of competence, and therefore safe and suitable for their patient’s needs. This includes the GP being satisfied that any prescriptions or referrals for treatment are clinically appropriate.If a shared care arrangement cannot be put in place after the treatment has been initiated, the responsibility for continued prescribing falls upon the specialist clinician, and this applies to both NHS and private medical care.

What steps he is taking to ensure that children with ADHD and autism who are assessed and treated privately as a result of long NHS waiting times are able to access shared care prescribing arrangements through their NHS GP pursuant to section 42 of the Children and Families Act 2014.

It is the responsibility of the integrated care boards in England to make available appropriate provision to meet the health and care needs of their local population, including providing access to attention deficit hyperactivity disorder and autism assessment and support services, in line with relevant National Institute for Health and Care Excellence guidelines.Shared care with the National Health Service refers to an arrangement whereby a specialist doctor formally transfers responsibility for all or some aspects of their patient’s care, such as the prescription of medication, over to the patient’s general practitioner (GP).The General Medical Council (GMC), which regulates and sets standards for doctors in the United Kingdom, has made it clear that GPs cannot be compelled to enter into a shared care agreement. GPs may decline such requests on clinical or capacity grounds.The GMC has issued guidance on prescribing and managing medicines, which helps GPs decide whether to accept shared care responsibilities. In deciding whether to enter into a shared care agreement, a GP will need to consider a number of factors such as whether the proposed activity is within their sphere of competence, and therefore safe and suitable for their patient’s needs. This includes the GP being satisfied that any prescriptions or referrals for treatment are clinically appropriate.If a shared care arrangement cannot be put in place after the treatment has been initiated, the responsibility for continued prescribing falls upon the specialist clinician, and this applies to both NHS and private medical care.

Whether his Department has made an assessment of compliance by GP practices with their obligations under (a) NICE guideline NG87, (b) the Equality Act 2010 and (c) section 42 of the Children and Families Act 2014 in relation to children with ADHD or autism.

The National Institute for Health and Care Excellence (NICE) is an independent body and part of their responsibility is for developing authoritative, evidence-based recommendations for the National Health Service on whether new medicines represent a clinically and cost-effective use of resources.NICE guidelines provide recommendations on best practice in terms of both the effectiveness and cost-effectiveness of interventions and services. Although not mandatory, guidelines describe best practice and NHS organisations are expected to take them fully into account in designing services to meet the needs of their local populations.In terms of the guidance NG87, which is on the diagnosis and management of attention deficit hyperactivity disorder (ADHD), the NICE guideline does not recommend a maximum waiting time for people to receive an assessment for ADHD or a diagnosis, although it does set out best practice on providing a diagnosis. As stated in the Medium Term Planning Framework, all integrated care boards and providers must optimise existing resources to reduce long waits for autism and ADHD assessments and improve the quality of assessments by implementing existing and new guidance, as published, including NICE guidelines. The Medium Term Planning Framework is available at the following link:https://www.england.nhs.uk/wp-content/uploads/2025/10/medium-term-planning-framework-delivering-change-together-2026-27-to-2028-29.pdfUnder the Equality Act 2010, health and social care organisations must make reasonable adjustments to ensure that people with disabilities are not disadvantaged. To make it easier for everyone to use health services, NHS England published guidance for NHS commissioners and providers in July 2025. Further information is available at the following link:https://www.england.nhs.uk/long-read/health-inequalities-equality-legal-duties/NHS England is rolling out the Reasonable Adjustments Digital Flag, which helps healthcare and social care providers identify and implement necessary adjustments for disabled people including autistic people and people with ADHD. This tool support care teams to be aware of individual needs, facilitating appropriate care.On the duty to secure special education provision and health care provision in accordance with education, health and care plans, if the plan specifies health care provision, the responsible commissioning body must arrange the specified health care provision for the child or young person. According to the Children and Families Act 2024 section 42, an education, health and care plan will specify the health care provision, the responsible commissioning body, referred to as the integrated care board, and must arrange the specified health care provision for the child or young person.

How access to fresh food is being incorporated into the NHS Long Term Plan’s approach to tackling preventable diseases linked to diet.

The Government’s Eatwell Guide advises that people should eat plenty of fruit and vegetables, and wholegrain or higher-fibre foods, as well as less processed meat, and food and drink that is high in sugar, calories, saturated fat, and salt. This includes at least five portions of a variety of fruits and vegetables every day. Fresh, frozen, tinned, and dried fruit and vegetables all count. The Eatwell Guide indicates that many foods classified as ‘ultra processed’ such as crisps, biscuits, cakes, confectionery, and ice cream are not part of a healthy, balanced diet.The Department of Health and Social Care (DHSC) and the Department for Environment, Food and Rural Affairs (DEFRA), alongside other Government departments, are funding research on a number of food system trials through the SALIENT programme. The programme prioritises interventions and partners that have the largest reach and the greatest potential to narrow health inequalities, both geographic and socio-economic. These trials include research on food and vegetable pricing in supermarkets and evaluating the effect of food pantries on food insecurity. DEFRA’s 2024 report on food insecurity also considered inequalities in access to a healthy, sustainable diet.DHSC is working closely with DEFRA to develop their cross-Government Food Strategy, which aims to improve affordability and access to healthier food, to help both adults and children live longer, healthier lives. We are committed to making the healthier choice the easier choice.Earlier this year, the Government committed to reviewing the School Food Standards to reflect the most recent Government dietary recommendations. Free school meals will also be extended to all children from households in receipt of Universal Credit from September 2026, including in rural areas. Our free breakfast clubs started with 750 early adopter schools in April 2025, and we have just announced the next wave of 500 schools, with 40% of pupils on free school meals to benefit from the programme from April 2026. The aim of these programmes is to ensure children receive nutritious meals at school and to remove barriers to opportunity.Our Healthy Food Schemes, which comprises of Healthy Start, the School Fruit and Veg Scheme, and the Nursery Milk Scheme, provides support for those who need it the most to eat a healthy, balanced diet. Healthy Start provides funding to pregnant women, babies, and young children under four years old from very low-income households to support a healthier diet. In April 2026, the value of weekly payments will increase by 10%.DHSC is working at pace to develop proposals set out in our 10-Year Health Plan commitments, to introduce mandatory healthier sales reporting for large food businesses and then set new targets to increase the healthiness of sales.We will work closely with business to implement these commitments, and plan to conduct extensive engagement with industry and wider stakeholders throughout policy development. To assist us in the development of the mandatory reporting we will commence our formal engagement with businesses shortly. This will involve a series of workshops with a cross-sector industry working group.

What assessment his Department has made of the potential impact of limited access to affordable fresh food on health inequalities in rural areas.

The Government’s Eatwell Guide advises that people should eat plenty of fruit and vegetables, and wholegrain or higher-fibre foods, as well as less processed meat, and food and drink that is high in sugar, calories, saturated fat, and salt. This includes at least five portions of a variety of fruits and vegetables every day. Fresh, frozen, tinned, and dried fruit and vegetables all count. The Eatwell Guide indicates that many foods classified as ‘ultra processed’ such as crisps, biscuits, cakes, confectionery, and ice cream are not part of a healthy, balanced diet.The Department of Health and Social Care (DHSC) and the Department for Environment, Food and Rural Affairs (DEFRA), alongside other Government departments, are funding research on a number of food system trials through the SALIENT programme. The programme prioritises interventions and partners that have the largest reach and the greatest potential to narrow health inequalities, both geographic and socio-economic. These trials include research on food and vegetable pricing in supermarkets and evaluating the effect of food pantries on food insecurity. DEFRA’s 2024 report on food insecurity also considered inequalities in access to a healthy, sustainable diet.DHSC is working closely with DEFRA to develop their cross-Government Food Strategy, which aims to improve affordability and access to healthier food, to help both adults and children live longer, healthier lives. We are committed to making the healthier choice the easier choice.Earlier this year, the Government committed to reviewing the School Food Standards to reflect the most recent Government dietary recommendations. Free school meals will also be extended to all children from households in receipt of Universal Credit from September 2026, including in rural areas. Our free breakfast clubs started with 750 early adopter schools in April 2025, and we have just announced the next wave of 500 schools, with 40% of pupils on free school meals to benefit from the programme from April 2026. The aim of these programmes is to ensure children receive nutritious meals at school and to remove barriers to opportunity.Our Healthy Food Schemes, which comprises of Healthy Start, the School Fruit and Veg Scheme, and the Nursery Milk Scheme, provides support for those who need it the most to eat a healthy, balanced diet. Healthy Start provides funding to pregnant women, babies, and young children under four years old from very low-income households to support a healthier diet. In April 2026, the value of weekly payments will increase by 10%.DHSC is working at pace to develop proposals set out in our 10-Year Health Plan commitments, to introduce mandatory healthier sales reporting for large food businesses and then set new targets to increase the healthiness of sales.We will work closely with business to implement these commitments, and plan to conduct extensive engagement with industry and wider stakeholders throughout policy development. To assist us in the development of the mandatory reporting we will commence our formal engagement with businesses shortly. This will involve a series of workshops with a cross-sector industry working group.

What discussions he has had with major retailers on improving access to affordable fresh food.

The Government’s Eatwell Guide advises that people should eat plenty of fruit and vegetables, and wholegrain or higher-fibre foods, as well as less processed meat, and food and drink that is high in sugar, calories, saturated fat, and salt. This includes at least five portions of a variety of fruits and vegetables every day. Fresh, frozen, tinned, and dried fruit and vegetables all count. The Eatwell Guide indicates that many foods classified as ‘ultra processed’ such as crisps, biscuits, cakes, confectionery, and ice cream are not part of a healthy, balanced diet.The Department of Health and Social Care (DHSC) and the Department for Environment, Food and Rural Affairs (DEFRA), alongside other Government departments, are funding research on a number of food system trials through the SALIENT programme. The programme prioritises interventions and partners that have the largest reach and the greatest potential to narrow health inequalities, both geographic and socio-economic. These trials include research on food and vegetable pricing in supermarkets and evaluating the effect of food pantries on food insecurity. DEFRA’s 2024 report on food insecurity also considered inequalities in access to a healthy, sustainable diet.DHSC is working closely with DEFRA to develop their cross-Government Food Strategy, which aims to improve affordability and access to healthier food, to help both adults and children live longer, healthier lives. We are committed to making the healthier choice the easier choice.Earlier this year, the Government committed to reviewing the School Food Standards to reflect the most recent Government dietary recommendations. Free school meals will also be extended to all children from households in receipt of Universal Credit from September 2026, including in rural areas. Our free breakfast clubs started with 750 early adopter schools in April 2025, and we have just announced the next wave of 500 schools, with 40% of pupils on free school meals to benefit from the programme from April 2026. The aim of these programmes is to ensure children receive nutritious meals at school and to remove barriers to opportunity.Our Healthy Food Schemes, which comprises of Healthy Start, the School Fruit and Veg Scheme, and the Nursery Milk Scheme, provides support for those who need it the most to eat a healthy, balanced diet. Healthy Start provides funding to pregnant women, babies, and young children under four years old from very low-income households to support a healthier diet. In April 2026, the value of weekly payments will increase by 10%.DHSC is working at pace to develop proposals set out in our 10-Year Health Plan commitments, to introduce mandatory healthier sales reporting for large food businesses and then set new targets to increase the healthiness of sales.We will work closely with business to implement these commitments, and plan to conduct extensive engagement with industry and wider stakeholders throughout policy development. To assist us in the development of the mandatory reporting we will commence our formal engagement with businesses shortly. This will involve a series of workshops with a cross-sector industry working group.

What steps his Department is taking to support burial authorities in carrying out memorial safety inspections that protect public safety while ensuring compliance with the Ministry of Justice guidance Managing the Safety of Burial Ground Memorials (2009).

While the Department is responsible for burial law and policy, the Government does not have day-to-day operational responsibility for burial grounds, which lies instead with providers.The Government’s guidance documents Managing the safety of Burial Ground Memorials and Guide for Burial Ground Managers set out best practice for memorial safety inspections, including guidance that laying memorials flat should only occur where necessary and following a risk assessment. The documents also advise burial authorities to make every effort to contact families before taking action, where this does not compromise safety.Burial authorities are expected to follow this guidance when carrying out inspections. Any concerns or complaints about how inspections have been conducted can be raised directly with the relevant burial authority.

If he will make it his policy to re-introduce postal verification for trustees of (a) companies and (b) charities who are otherwise excluded from these roles due to lack of digital accessibility.

Identity verification at Companies House is a new requirement for company directors. Some charities are incorporated as companies, and some companies limited by guarantee call their directors ‘trustees’. Only trustees who are company directors must verify under the new requirements. Previously no identity verification process existed for these roles. Individuals can verify their identity through Companies House routes or via an Authorised Corporate Service Provider. The process has been designed to be as straightforward and accessible as possible and where identity cannot be verified online, users may be directed to complete the process in person at a participating Post Office.

Food and Rural Affairs, what recent assessment her Department has made of trends in the level of (a) private investment and (b) Government funding for (i) storm overflows, (ii) wastewater treatment and (iii) other water infrastructure.

Ofwat’s final determinations for Price Review 2024 set company expenditure for 2025–2030. This will deliver substantial and enduring improvements for customers and the environment through a £104 billion upgrade for the water sector. The £104 billion funding package is the highest level of investment in the water sector since privatisation and is set to be the second largest private sector investment programme in this parliament. Water companies are investing over £11 billion in PR24, a record amount, to improve nearly 3,000 storm overflows across England and Wales over the next five years. Furthermore, £4.795 billion will be spent over the same period to reduce phosphorus pollution from treated wastewater. This represents an increase when compared to the 2022-2023 equivalent prices for Price Review 19, where overall spending was £61bn, storm overflow investment was £3.6 billion, and wastewater treatment improvements were £3.1 billion.

What discussions he has had with NICE on (a) reviewing and (b) updating (i) clinical guidelines and (ii) guidance on diagnosing Type 1 Diabetes and Eating Disorders.

The National Institute for Health and Care Excellence (NICE) is an independent body and is responsible for determining whether its guidelines should be reviewed or updated in the light of new evidence. NICE takes a proactive approach to surveillance, monitoring for changes in the evidence base that may impact on its recommendations. Topics for new or updated guidance are considered through the NICE prioritisation process. Decisions as to whether NICE will create new, or update existing, guidance are overseen by a prioritisation board, chaired by NICE’s chief medical officer.NICE’s guidelines on the diagnosis and management of type 1 diabetes in adults, with the reference code NG17, diabetes, including both type 1 and type 2, in children and young people, with the reference code NG18, and the recognition and treatment of eating disorders, with the reference code NG69, will be reviewed if there is new evidence that is likely to change the recommendations. NICE currently has no plans to update NG17, NG18, or NG69.

If she will meet with me and my constituents to discuss the introduction of examinations in British Sign Language for deaf children.

Under Ofqual’s regulatory conditions, all students taking GCSE, AS and A level qualifications must be assessed in English, except where another language is permitted, such as in modern foreign language qualifications. Students may be assessed in British Sign Language (BSL) where an awarding organisation offers this as a reasonable adjustment. Guidance is provided by the Joint Council for Qualifications, and adjustments can include the use of BSL interpreters for spoken instructions, readers, scribes and assistive technology.Access arrangements are also available for all national curriculum tests, and guidance is provided by the Standards and Testing Agency. This allows for adjustments such as sign language interpreters for instructions and compensatory marks for pupils with profound hearing impairments.The government is also developing a landmark GCSE in BSL, which will be accessible for both first-time learners and existing BSL users.I would welcome the opportunity to meet the hon. Member and her constituents to discuss this issue.

If he will have discussions with his international counterparts on the potential merits of creating an international symposium of experts on Type 1 Diabetes and Eating Disorders to (a) share best practice and (b) agree consensus guidance on diagnosis and treatment.

There are regular opportunities for ministers to meet with their international colleagues on a range of health issues to discuss best practice and learning. For this reason, there are no current plans to arrange a specific symposium on diabetes.NHS England will continue its type 1 diabetes and disordered eating (T1DE) pilots, which have demonstrated that integrating diabetes and other health services, including mental health services, can significantly enhance the quality of life for people with T1DE and ultimately save lives.

Whether her Department plans to introduce examinations in British Sign Language for deaf children as part of the implementation of the curriculum review.

Under Ofqual’s regulatory conditions, all students taking GCSE, AS and A level qualifications must be assessed in English, except where another language is permitted, such as in modern foreign language qualifications. Students may be assessed in British Sign Language (BSL) where an awarding organisation offers this as a reasonable adjustment. Guidance is provided by the Joint Council for Qualifications, and adjustments can include the use of BSL interpreters for spoken instructions, readers, scribes and assistive technology.Access arrangements are also available for all national curriculum tests, and guidance is provided by the Standards and Testing Agency. This allows for adjustments such as sign language interpreters for instructions and compensatory marks for pupils with profound hearing impairments.The government is also developing a landmark GCSE in BSL, which will be accessible for both first-time learners and existing BSL users.I would welcome the opportunity to meet the hon. Member and her constituents to discuss this issue.

What her planned timetable is for tackling pavement parking.

The Department has been considering all the views expressed in response to the 2020 pavement parking consultation and is currently working through the policy options and the appropriate means of delivering them. We will announce the next steps and publish our formal response as soon as possible.

What assessment she has made of the adequacy of (a) the policy options and (b) delivery mechanisms available to enable local authorities to keep pavements (i) clear and (ii) safe for people.

The English Devolution and Community Empowerment Bill includes measures to empower local leaders to regulate shared on-street cycle rental schemes, such as Lime bikes, and act decisively to address any issues of poor parking and antisocial behaviour. Rental e-scooters are already tightly controlled. The Department’s guidance specifies that there should be sufficient parking in e-scooter trial areas and local authorities should ensure they do not become obstructive to others. Operators are also using geofencing technology, parking incentives and penalties to improve parking compliance.Once the e-scooter trials end, the future framework is designed to be flexible and allows new vehicles like e-scooters, to be included as they are legalised for use on the road.The Department has been considering all the views expressed in response to the 2020 pavement parking consultation and is currently working through the policy options and the appropriate means of delivering them.

Food and Rural Affairs, what steps her Department is taking to ensure that the Environmental Land Management Scheme Landscape Recovery tier continues beyond the current round.

The Government reconfirmed its commitment to Environmental Land Management (ELM) schemes in the Autumn 2024 Spending Review. More than £2.7 billion a year will be invested in sustainable farming and nature recovery from 2026/27 to 2028/29. Landscape Recovery projects that were awarded funding in rounds 1 and 2 are continuing, with the first projects moving into the delivery phase earlier this year. Landscape Recovery is integral to the delivery of Defra’s statutory environmental targets.

Food and Rural Affairs, what her planned timetable is for publication of the rapid review of the Environmental Improvement Plan.

The Government concluded a rapid review of the existing Environmental Improvement Plan (EIP23) and published a statement of the rapid review’s key findings on 30 January 2025. It is our intention to publish a revised EIP in due course, which will be our long-term plan for improving the natural environment and people’s enjoyment of it.