Written questions by Farron.

Whether research is being conducted into the potential association between Gabapentin use and the development of attentional amnestic disorders or other cognitive impairments.

Gabapentin is authorised to treat epilepsy and peripheral neuropathic pain, or nerve pain. The known side effects of gabapentin are outlined in the product information, the Summary of Product Characteristics (SPC) for healthcare professionals, and the Patient Information Leaflet which is provided in each pack of the medicine.The SPC states that in the treatment of peripheral neuropathic pain, such as painful diabetic neuropathy and post-herpetic neuralgia, efficacy and safety have not been examined in clinical studies for treatment periods longer than five months. If a patient requires the medication for longer than five months to treat peripheral neuropathic pain, the treating physician should assess the patient's clinical status and determine the need for additional therapy. Epilepsy normally requires long-term treatment and the SPC states that the dosage for gabapentin should be determined by the treating physician according to the clinical response and side effects experienced by the individual patient.The product information for gabapentin lists amnesia as a common side effect and mental impairment as an uncommon side effect. Dementia is not a known side effect of gabapentin.Gabapentin can cause drug dependence, and the product information includes warnings that patients treated with gabapentin should be monitored for symptoms of misuse, abuse, or dependence. After discontinuation of short- and long-term treatment with gabapentin, withdrawal symptoms have been observed, and gabapentin should be discontinued gradually over a minimum of one week.As with all medicines, the safety of gabapentin is kept under continual review by the Medicines and Healthcare products Regulatory Agency using a number of data sources including reports of suspected side effects through the Yellow Card Scheme, data from marketing authorisation holders, and research published in the scientific literature.

What steps are being taken to inform patients and healthcare professionals about the potential long-term risks of Gabapentin use.

Gabapentin is authorised to treat epilepsy and peripheral neuropathic pain, or nerve pain. The known side effects of gabapentin are outlined in the product information, the Summary of Product Characteristics (SPC) for healthcare professionals, and the Patient Information Leaflet which is provided in each pack of the medicine.The SPC states that in the treatment of peripheral neuropathic pain, such as painful diabetic neuropathy and post-herpetic neuralgia, efficacy and safety have not been examined in clinical studies for treatment periods longer than five months. If a patient requires the medication for longer than five months to treat peripheral neuropathic pain, the treating physician should assess the patient's clinical status and determine the need for additional therapy. Epilepsy normally requires long-term treatment and the SPC states that the dosage for gabapentin should be determined by the treating physician according to the clinical response and side effects experienced by the individual patient.The product information for gabapentin lists amnesia as a common side effect and mental impairment as an uncommon side effect. Dementia is not a known side effect of gabapentin.Gabapentin can cause drug dependence, and the product information includes warnings that patients treated with gabapentin should be monitored for symptoms of misuse, abuse, or dependence. After discontinuation of short- and long-term treatment with gabapentin, withdrawal symptoms have been observed, and gabapentin should be discontinued gradually over a minimum of one week.As with all medicines, the safety of gabapentin is kept under continual review by the Medicines and Healthcare products Regulatory Agency using a number of data sources including reports of suspected side effects through the Yellow Card Scheme, data from marketing authorisation holders, and research published in the scientific literature.

Food and Rural Affairs, what recent assessment she has made of the number of people leaving the agricultural sector.

Defra produces statistical estimates of the number of people working on commercial [see a below] agricultural holdings in England. Defra does not monitor the numbers leaving and entering the sector separately, therefore estimates show the net change in the workforce. Estimates in the table below show a decrease of 1.9% in the agricultural workforce in England between June 2024 and 2025. Agricultural workforce in England at 1 June: 202320242025% change 2025/2024Total people working on commercial agricultural holdings292,401284,797279,493-1.9% Notes(a) Commercial holdings are those registered with the Rural Payments Agency for payments or livestock purposes and with significant levels of farming activity. Full data series for England and the UK are published here:Agricultural workforce in England at 1 June - GOV.UK (www.gov.uk) Agricultural Workforce in the United Kingdom at 1 June - GOV.UK (www.gov.uk)

What measures are in place to monitor patients on Gabapentin for signs of neurological or cognitive decline during treatment.

Gabapentin is authorised to treat epilepsy and peripheral neuropathic pain, or nerve pain. The known side effects of gabapentin are outlined in the product information, the Summary of Product Characteristics (SPC) for healthcare professionals, and the Patient Information Leaflet which is provided in each pack of the medicine.The SPC states that in the treatment of peripheral neuropathic pain, such as painful diabetic neuropathy and post-herpetic neuralgia, efficacy and safety have not been examined in clinical studies for treatment periods longer than five months. If a patient requires the medication for longer than five months to treat peripheral neuropathic pain, the treating physician should assess the patient's clinical status and determine the need for additional therapy. Epilepsy normally requires long-term treatment and the SPC states that the dosage for gabapentin should be determined by the treating physician according to the clinical response and side effects experienced by the individual patient.The product information for gabapentin lists amnesia as a common side effect and mental impairment as an uncommon side effect. Dementia is not a known side effect of gabapentin.Gabapentin can cause drug dependence, and the product information includes warnings that patients treated with gabapentin should be monitored for symptoms of misuse, abuse, or dependence. After discontinuation of short- and long-term treatment with gabapentin, withdrawal symptoms have been observed, and gabapentin should be discontinued gradually over a minimum of one week.As with all medicines, the safety of gabapentin is kept under continual review by the Medicines and Healthcare products Regulatory Agency using a number of data sources including reports of suspected side effects through the Yellow Card Scheme, data from marketing authorisation holders, and research published in the scientific literature.

Food and Rural Affairs, what contingency plans are in place for periods of water shortage and supply outages.

In England and Wales, The Security and Emergency Measures Direction 2022 (SEMD) is the main legislative framework specific to water companies for emergency planning. It requires water companies to ensure continuation of their water distribution functions during an emergency. Separate arrangements apply in Scotland and Northern Ireland. Companies are required under the SEMD framework to plan for a wide range of disruptive scenarios, including continuous monitoring of risks such as severe winter weather. In addition to SEMD requirements, companies are also incentivised under Ofwat’s performance targets regime to minimise supply interruptions and resulting customer impacts. The Drinking Water Inspectorate regulates water company performance on SEMD performance. Water companies are also Category Two Responders under the Civil Contingencies Act (2004) and have duties to plan for emergencies and cooperate with other organisations in their Local Resilience Forums in understanding risk, planning and exercising. Defra maintains regular strategic engagement with water companies on resilience planning. This includes in advance of forecast periods of severe weather. Water companies also engage with their Local Resilience Forums during responses to water outages. Defra undertakes strategic risk assessment, planning and engagement with the water sector and other government departments to regarding water outage risk.

Food and Rural Affairs, what steps the Department is taking to help tackle water scarcity.

The Government recognises the importance of having enough water through the Environment Improvement Plan – ‘Goal 3: Water - We will ensure English waters are clean, resilient and plentiful.’ Within this plan, there are stretching targets to reduce demand for water. The Government is playing its part by introducing a new mandatory water efficiency label and reviewing building standards to help people use a little less water. In addition, water companies are required to publish water resources management plans (WRMP) that set out how the companies will provide secure public water supplies for a 25-year period. The recently published 2024 WRMPs set out how water supplies would be maintained over the coming years through demand management, leakage reduction and enhancing supplies from river and groundwater sources in the time period before new strategic sources of water, such as large reservoirs, come online. The Environment Agency (EA) published the National Framework for Water Resources in June 2025, which sets out the current and future pressures on water resources and the main actions needed across government, regulators, regional groups, water companies and all sectors of use to address the challenge of water scarcity. This includes the need for joined-up planning between different water-using sectors to identify collaborative solutions for water resources. The EA is carrying this work forward, with a programme of resilience workstreams across sectors, including for public water supply, agriculture, energy, and data centres.

Whether prescribing guidelines for Gabapentin include warnings about potential risks associated with extended use.

There are a number of resources available to prescribers to advise them on the potential risks associated with extended use of gabapentin.The British National Formulary (BNF) for adults provides healthcare professionals with a range of information on the selection, prescribing, dispensing, and administration of medicines. The BNF monograph for gabapentin provides information on the cautions and side effects relating to use of the medicine. The BNF also provides important safety information, such as advice from the Medicines and Healthcare products Regulatory Agency on the risks associated with use of gabapentin.In addition, the known side effects of gabapentin are outlined in the product information, the Summary of Product Characteristics for healthcare professionals, and the Patient Information Leaflet which is provided in each pack of the medicine. These provide prescribers with special warnings and precautions regarding the use of gabapentin to inform decision-making.

What assessment has been made of the potential impact of prolonged use of Gabapentin on long-term neurological risks, including dementia and brain damage.

Gabapentin is authorised to treat epilepsy and peripheral neuropathic pain, or nerve pain. The known side effects of gabapentin are outlined in the product information, the Summary of Product Characteristics (SPC) for healthcare professionals, and the Patient Information Leaflet which is provided in each pack of the medicine.The SPC states that in the treatment of peripheral neuropathic pain, such as painful diabetic neuropathy and post-herpetic neuralgia, efficacy and safety have not been examined in clinical studies for treatment periods longer than five months. If a patient requires the medication for longer than five months to treat peripheral neuropathic pain, the treating physician should assess the patient's clinical status and determine the need for additional therapy. Epilepsy normally requires long-term treatment and the SPC states that the dosage for gabapentin should be determined by the treating physician according to the clinical response and side effects experienced by the individual patient.The product information for gabapentin lists amnesia as a common side effect and mental impairment as an uncommon side effect. Dementia is not a known side effect of gabapentin.Gabapentin can cause drug dependence, and the product information includes warnings that patients treated with gabapentin should be monitored for symptoms of misuse, abuse, or dependence. After discontinuation of short- and long-term treatment with gabapentin, withdrawal symptoms have been observed, and gabapentin should be discontinued gradually over a minimum of one week.As with all medicines, the safety of gabapentin is kept under continual review by the Medicines and Healthcare products Regulatory Agency using a number of data sources including reports of suspected side effects through the Yellow Card Scheme, data from marketing authorisation holders, and research published in the scientific literature.

Food and Rural Affairs, what assessment she has made of the flooding risk to farms; and what percentage of farms are at high flood risk.

Our new national flood risk assessment (NaFRA) shows that of the 85,000 square kilometres of agricultural land in England, over 11,000 square kilometres is in areas at risk of flooding from rivers and sea.

Food and Rural Affairs, what assessment the Department has made of the adequacy of water infrastructure investment in each of the last five years.

There has been historic underinvestment in the water industry. Investment has not kept pace with the challenges of an ageing infrastructure system, a rapidly growing population, and climate change. We have already announced that we will create a powerful new regulator – abolishing Ofwat and bringing together the relevant functions from the other existing regulators (the DWI, Environment Agency and Natural England) into one new body. This will ensure better join-up between infrastructure planning, investment, and delivery. These reforms will build on the step change in investment that will be delivered through Price Review 2024, which will see a £104 billion upgrade in the water sector. This investment will accelerate improvements in infrastructure to meet the challenges of the future, secure our water supply, and to meet new environmental requirements.

When she will update guidance titled ‘BB101: Ventilation, thermal comfort and indoor air quality 2018’ for the latest available technical standards.

All new department-delivered schools are designed and constructed to the department’s own school building standards. These standards include ventilation, thermal comfort and air quality and can be found here: https://www.gov.uk/government/publications/employers-requirements-part-b-generic-design-brief.The standards are reviewed regularly and updated when necessary to meet industry best practice and any relevant legislation. An updated set of standards will be published in early 2026.The department’s publication, ‘Building Bulletin 101: Guidelines on ventilation, thermal comfort and indoor air quality in schools’ (BB101), provides non-statutory guidance, and can be found here: https://www.gov.uk/government/publications/building-bulletin-101-ventilation-for-school-buildings.The department reviews non-statutory guidance regularly and publishes updates only when necessary.

How many deaths there were from cardiovascular causes in (a) East Midlands, (b) East of England, (c) Greater London, (d) North East, (e) North West, (f) South East, (g) South West, (h) West Midlands, (i) Yorkshire and the Humber and (j) England in each year since 2021 for which figures are available.

The information requested falls under the remit of the UK Statistics Authority. A response to the Hon gentleman’s Parliamentary Questions of 6th January is attached.

What progress his Department has made in implementing the advice in Table 1 on numbered page 19 of the Climate Change Committee’s report titled ‘Biomass in a low carbon economy’ (November 2018).

The department’s schemes support biomass installations only in rural areas and if additional eligibility criteria are met. New ecodesign standards setting higher minimum efficiency standards for solid fuel space heaters, including wood burning stoves, have been in force since 2022. The government is also consulting on alternative heating solutions, including solid biomass, to gather evidence on the role they could play in ensuring every household has a low-carbon option that is right for them. The consultation runs until 10 February

What discussions his Department has had with ‘Heating, ventilation and air conditioning’ (HVAC) professionals and facilities managers to understand how they reduce air pollution in dwellings and non-domestic buildings while minimising energy use and heat loss.

The Department and the UK Health Security Agency engage with a range of stakeholders on ways to reduce the health impacts of both indoor and outdoor air pollution.This includes engagement by officials with relevant bodies in the United Kingdom and internationally, such as the Chartered Institution of Building Services Engineers and the Air Infiltration and Ventilation Centre, which operates under the International Energy Agency, on issues related to indoor air quality, including ventilation.

How many people died from smoking in England in each year since 2021.

The latest estimates for smoking-attributable mortality in England are for the period 2017 to 2019. The Smoking Profile, produced by the Department, reports 191,903 smoking-attributable deaths of people aged 35 years old and over in the period 2017 to 2019 in England, which is just under 64,000 deaths each year. Further information on the Smoking Profile is available at the following link:https://fingertips.phe.org.uk/profile/tobacco-control/data#page/1/gid/1938132887/pat/159/par/K02000001/ati/15/are/E92000001/yrr/1/cid/4/tbm/1

Food and Rural Affairs, How many people in each of the following regions are expected to be exposed to concentrations of fine particulate matter (PM2.5) exceeding each of (a) 5 micrograms per cubic metre (ug/m3), (b) 6 ug/m3 and (c) 7 ug/m3 or more in 2030: (a) East Midlands, (b) East of England, (c) Greater London, (d) North East, (e) North West, (f) South East, (g) South West, (h) West Midlands, (i) Yorkshire and the Humber and (j) England.

Defra does not publish air quality data in the form requested. The recently published Environmental Improvement Plan set out a target to reduce average exposure to PM2.5 in England by 30% by 2030 compared to the 2018 value. The emphasis of this approach is to continue reducing exposure across the whole of England.

Food and Rural Affairs, what assessment she has made of the effectiveness of the Domestic Solid Fuel Regulations 2020.

In November 2025, we published the Post Implementation Review of the Air Quality (Domestic Solid Fuels Standards) (England) Regulations 2020, which assesses the effectiveness of the Regulations. Data suggest that the Regulations have led to consumers moving from more polluting fuels to less polluting fuels. The review concluded that this has led to a reduction in emissions of PM2.5 and SO2 with environmental and public health benefits.

Food and Rural Affairs, what the largest environmental risks are to public health in the UK.

There are a number of environmental risks to public health in the UK, including air pollution, noise pollution, climate change and extreme weather, emerging chemical and biological risks and water quality.

Food and Rural Affairs, whether any hotspots in zones other than the five zones identified in the Compliance Assessment Summary 2024 exceeded the nitrogen dioxide annual limit value in calendar 2024.

The localised hotspots identified through Defra’s national modelling and monitoring networks are published annually on UK Air (https://uk-air.defra.gov.uk/) as part of the national compliance assessment under the Air Quality Standards Regulations 2010. Localised hotspots that have been identified by local authority-owned monitoring are published in their respective annual status reports.

Which public health factors created the 10 largest direct cost impacts on the NHS in 2024; and how much the NHS spent in 2024 on tackling the health impacts of the following public health factors: (a) air pollution, (b) alcoholism, (c) obesity, (d) excessive salt consumption and (e) smoking.

Global Burden of Disease data considers the top ten public health factors in the United Kingdom in 2023 in order of importance to be: tobacco, high body mass index, dietary risks, high fasting plasma glucose, high blood pressure, high alcohol use, high cholesterol, occupational risks, kidney dysfunction, and drug use. Further information on the Global Burden of Disease data is available at the following link:https://vizhub.healthdata.org/gbd-compare/The following table shows the various estimates of the cost to the National Health Service of the five factors specified:Risk factorEstimated NHS costSource of EstimateAir Pollution£1.6 billion for fine particulate matter and nitrogen dioxide combined between 2017 and 2025.Public Health England Agency, 2018Alcohol£4.9 billion annuallyInstitute of Alcohol Studies, 2021/22Obesity£9.3 billion annuallyFrontier Economics & NESTA, 2025Hypertension (excessive salt consumption is linked to an increased risk of hypertension)£2.1 billion annuallyOptimity Matrix (commissioned by Public Health England), 2014Smoking£1.8 billion annuallyAction on Smoking and Health, 2025 Comparisons of costs should not be made between these estimates because of the different methodologies used in their construction.