Lord Weir of Ballyholme

Small businesses are the backbone of our economy and the Government will ensure the interests of small businesses are embedded into our Industrial and Trade Strategies, as part of a comprehensive approach to delivering on our economic growth mission. The Windsor Framework established a broad set of arrangements to support Great Britain-based businesses to move goods to Northern Ireland, including to small businesses based in Northern Ireland.

The Northern Ireland Retail Movement Scheme reduces checks and administrative burdens on retail agrifood movements. The Northern Ireland Plant Health Label scheme removes unnecessary costs and enables previously prohibited goods to enter Northern Ireland. The first stage of the UK internal market scheme was implemented in 2023, and ensures thousands of businesses can move goods without being subject to customs duties. Businesses can also use the Customs Duty Waiver Scheme to waive any duties entirely, regardless of the destination of the goods, subject to an overall limit. The Government works closely with industry stakeholders and trade associations on the implementation of these arrangements and will continue to do so.

The information requested falls under the remit of the UK Statistics Authority.

Please see the letter attached from the National Statistician and Chief Executive of the UK Statistics Authority.

The Lord Weir of Ballyholme

House of Lords

London

SW1A 0PW

26 March 2025

Dear Lord Weir of Ballyholme,

As National Statistician and Chief Executive of the UK Statistics Authority, I am responding to your Parliamentary Question asking how many deaths of working age people there have been as a result of cardiovascular disease in each of the past three years (HL6089).

The Office for National Statistics (ONS) publish regular statistics on deaths in England and Wales. These statistics are based on information recorded when deaths are certified and registered. They are based on when the death was registered rather than when it occurred. The number of deaths registered in England and Wales over 2021 to 2023 where the underlying cause was cardiovascular disease, and the deceased was aged 16-64, can be found in Table 1.

Table 1: Number of deaths where the underlying cause was cardiovascular disease in England and Wales, aged 16 to 64, deaths registered 2021 to 2023.

Source: Office for National Statistics

Any death assigned an underlying cause of death using the International Classification of Diseases, Tenth Revision codes I00-I99 was included. This will include deaths where the underlying cause was ischaemic heart disease, heart failure and cerebrovascular diseases. Further information on the definition can be found on the World Health Organisation (WHO) website1 .

Yours sincerely,

Professor Sir Ian Diamond

1 https://icd.who.int/browse10/2019/en#/IX

Northern Ireland is a part of the United Kingdom customs territory and internal market. We are looking closely at the retaliatory tariffs announced by the EU and any impact these might have on Northern Ireland businesses.

Under the Windsor Framework, where US imports into NI do not subsequently enter the EU, traders can reclaim any additional duties through the Duty Reimbursement Scheme in full without any limit on total claims.

Northern Ireland is a part of the United Kingdom customs territory and internal market. We are looking closely at the retaliatory tariffs announced by the EU and any impact these might have on Northern Ireland businesses.

Under the Windsor Framework, where US imports into NI do not subsequently enter the EU, traders can reclaim any additional duties through the Duty Reimbursement Scheme in full without any limit on total claims.

Since Storm Éowyn made landfall, His Majesty’s Government’s focus has rightly been on making sure that requests for support in response to its impacts across the UK, were managed quickly and effectively and delivered to whichever part of the UK they were required. It is too early to say what the financial costs of the impacts of the Storm have been.

For goods from the UK to be eligible for tariff-free access upon import into the EU, they must originate from the UK or EU according to the rules of origin of the UK-EU Trade and Cooperation Agreement. We will look closely at the details of the retaliatory tariffs announced by the EU (noting they are currently suspended) and any impact these might have on UK businesses.

The Windsor Framework positions Northern Ireland as a unique gateway for the sale of goods to two of the world’s largest markets, as well as access to global markets through the UK's new trade agreements.

Whilst the Government has not made an assessment of the impact of dual market access on the number of jobs or international companies created, between 2019 and 2023, Northern Ireland’s sales of goods to Great Britain increased by £4.7bn or 69%, and sales to the EU increased by £2.9bn or 54%.

The Windsor Framework is not a barrier to trade deals. The United Kingdom has secured trade agreements with 73 countries and territories, plus the EU, while ensuring compliance with the Windsor Framework. These agreements include free trade agreements with Australia and New Zealand, which entered force on 31 May 2023, and the Comprehensive and Progressive Trans-Pacific Partnership, which the United Kingdom joined on 16 July 2023, and which came into effect on 15 December 2024.

The updated GPSR largely formalises the reality of how many businesses are already operating and the measures are therefore likely to have limited impact in practice. However, we understand that for some businesses, the regulation will require changes, and we take any concerns extremely seriously.

We have issued guidance, will keep this under review and continue to engage businesses directly to ensure we are supporting them to trade freely within the UK and with the EU. We have regular discussions with businesses and consumer representatives from across the UK to hear their concerns.

The updated GPSR largely formalises the reality of how many businesses are already operating and the measures are therefore likely to have limited impact in practice. However, we understand that for some businesses, the regulation will require changes, and we take any concerns extremely seriously.

We have issued guidance, will keep this under review and continue to engage businesses directly to ensure we are supporting them to trade freely within the UK and with the EU. We have regular discussions with businesses and consumer representatives from across the UK to hear their concerns.

We have set out in the Action Plan, which was developed by Matt Clifford, our intention to deliver growth across the UK, working with local stakeholders to devise strategies suited to the UK’s regions. We are committed to working in partnership with regional and local authorities on AI Growth Zones. We are already working with devolved administrations and local authorities across the UK, and will continue to do so, to ensure all parts of the UK benefit from the investment in critical AI infrastructure.

Most AI systems should be regulated at the point of use through our existing expert regulators. In response to the Plan, the government will support regulators evaluate their AI capabilities and understand how these can be strengthened. It will also encourage pro-innovation approaches by regulators, with the new Regulatory Innovation Office playing an important role.

The BBC publishes information about the number of licences in force in its Annual Report and Accounts. For the years 2019/2020, 2020/2021, 2021/2022, 2022/2023, and 2023/2024 there has consistently been approximately 4,000 monochrome licences in force.

This Government, and the previous one, has engaged extensively with a wide range of stakeholders as the policy set out in the Football Governance Bill has developed over the last 3 years. This includes engagement with UEFA.

These discussions have been constructive, and we continue to speak to the relevant football authorities on a regular basis.

Education is a devolved matter, and the response outlines the information for England only.

Milk must be provided free of charge to pupils eligible for free school meals (FSM) who request it. Overall, the department spent over £1.5 billion on FSM and free milk in 2023/24.

To assist with the cost of providing milk, schools can take part in the voluntary National School Milk Subsidy Scheme run by the Department for the Environment, Food and Rural Affairs. In 2023/24, over £2 million was paid out through the National School Milk Subsidy Scheme.

Schools can claim reimbursement from the Nursery Milk Scheme in respect of their pupils aged under five. In 2023/24, the total cost of reimbursements for all settings from the Nursery Milk Scheme was over £54 million.

Education is a devolved matter, and the response outlines the information for England only.

Milk must be provided free of charge to pupils eligible for free school meals (FSM) who request it. Overall, the department spent over £1.5 billion on FSM and free milk in 2023/24.

To assist with the cost of providing milk, schools can take part in the voluntary National School Milk Subsidy Scheme run by the Department for the Environment, Food and Rural Affairs. In 2023/24, over £2 million was paid out through the National School Milk Subsidy Scheme.

Schools can claim reimbursement from the Nursery Milk Scheme in respect of their pupils aged under five. In 2023/24, the total cost of reimbursements for all settings from the Nursery Milk Scheme was over £54 million.

Education is a devolved matter, and the response outlines the information for England only.

Section 512ZB(3) of the Education Act 1996 relates to the provision of free milk. Milk must be provided free of charge to pupils eligible for FSM who request it, we do not hold data on the number of children who make such requests. We expect schools to follow their statutory duty around the provision of free milk.

Education is a devolved matter, and the response outlines the information for England only.

Section 512ZB(3) of the Education Act 1996 relates to the provision of free milk. Milk must be provided free of charge to pupils eligible for FSM who request it, we do not hold data on the number of children who make such requests. We expect schools to follow their statutory duty around the provision of free milk.

Pupils with special educational needs (SEN) and a requirement to attend a private school identified through an education, health and care (EHC) assessment are not impacted by the government’s VAT policy. Where a private school place is necessary to support a child with SEN, the local authority will fund it through an EHC plan. Local authorities can reclaim the cost of VAT added to fees for places that they fund through Section 33 of the VAT Act 1994.

Parents may make a choice that their child should attend a private school, but this is a choice like that made by any parent using the independent sector. Where parents have chosen to send their child to private school rather than a local authority deeming it necessary, VAT will apply to fees.

The Government is seeking to negotiate a SPS agreement to help boost trade and deliver benefits to businesses and consumers in the UK and the EU. As like-minded partners with similarly high standards, the Government has been clear that an SPS agreement that removes barriers and protects our collective biosecurity and public health will benefit both sides.

It is too early to comment on the outcome of discussions linked to the UK/EU Summit that takes place on 19 May.

In line with the commitments we have made, as we move to our new UK internal market system, we will ensure that the only checks when goods move within the UK internal market system are those conducted by UK authorities as part of a risk-based or intelligence-led approach to tackle criminality, abuse of the scheme, smuggling and disease risks. But in order not to undermine that approach, as is the case across the UK we do not disclose the specific number or nature of interventions made by UK authorities.

The UK Government underlines its commitment to ensure the smooth flow of chemical products from Great Britain to Northern Ireland. This includes applying a consistent approach to the regulation of chemical products across the whole of the UK where it is necessary to do so.

The following table shows the tonnage of seed potatoes moved in the past five years broken down by seed classification (data from 2020 for Northern Ireland to Scotland is unavailable due to COVID related disruption):

Northern Ireland has unfettered access to the whole UK internal market, this ensures a smooth flow of goods, including in relation to chemical industries. The UK Government is steadfastly committed to continue protecting Northern Ireland’s unfettered access which has been guaranteed in perpetuity

The government is committed to delivering a transport network which allows disabled people to be able to travel easily and confidently, with dignity and without extra cost. The government expects local authorities and transport operators to make sure this happens, consistent with their legal equalities duties.

On 17th December, the government introduced the Bus Services (No. 2) Bill that will give local leaders in England the freedom to take decisions to deliver their local transport priorities and ensure networks meet the needs of the communities who rely on them, including for disabled people. The Bill includes measures to make the design of bus and coach stations and stops safer and more accessible and sets requirements on training for staff on disability-assistance and disability awareness to ensure bus drivers and staff dealing directly with the travelling public are better informed of the rights and needs of disabled passengers.

The Bill has also been amended so it now provides duties to consult disabled people, to consider the impact of Enhanced Partnership (EP) scheme requirements on accessibility, and to publish Bus Network Accessibility Plans, as well as clarifying that EP scheme requirements can include requirements aiming to improve accessibility.

Disabled people should be able to travel easily, confidently and with dignity. Ministers and officials have regular conversations with Transport for London on a variety of issues including accessibility of their network. Transport in London is devolved to the Mayor and TfL is responsible for managing the London Underground.

£350m is currently allocated to the Access for All programme until 2028/29. A further £75m programme of works to install platform edge tactile strips on at stations that did not already have them is approaching its completion. These investments are in addition to accessibility enhancements delivered as part of other major projects or industry renewal activities.

The recent Pathways to Work Green Paper announced our plans to abolish the Work Capability Assessment (WCA) and instead use the Personal Independence Payment assessment as the single assessment for additional financial support, subject to parliamentary approval. Once the WCA has been abolished the Department for Work and Pensions will no longer classify people as fit or unfit for work.

The Department published “Spring Statement 2025 health and disability benefit reforms – Impacts” alongside the Spring Statement.

This report contains estimated caseloads for the Universal Credit health element from 2026/27 to 2029/30, categorised by whether claimants are receiving the higher rate or the frozen rate from 2025/26.

By 2029/30 an estimated 2.25 million people, the pre-April 2026 current claimants, will still be receiving the higher rate of the UC health element, frozen at its 2025/26 level. A further 730,000 are forecast to be receiving the new lower rate of the health element. All will receive a standard allowance that has been increased by more than CPI inflation.

Table A5: Benefit units affected by UC health element change

Note: Estimates are after behavioural effects and are rounded to the nearest ten thousand. A benefit unit is a single adult or a married or cohabiting couple and any dependent children.

A further programme of analysis to support development of the proposals in the Green Paper will be developed and undertaken in the coming months.

We announced in the Pathways to Work Green Paper that we would establish a new guarantee of support for all disabled people and people with health conditions claiming out of work benefits who want help to get into or return to work. This is backed up by £1 billion of new funding across the United Kingdom, with the share of funding for devolved governments calculated in the usual way.

The UK government will respect settlements with devolved governments.

Within Great Britain, we will work closely with the Scottish and Welsh Governments to ensure all aspects of our new approach to delivering employment support partner effectively with devolved provision, including but not limited to skills, health and careers as well as Scottish and Welsh Government-funded employment support.

In Northern Ireland, health, skills, careers and all aspects of employment support are transferred matters. We will work closely with the Northern Ireland Executive, including sharing best practice with the Northern Ireland Executive’s Department for Communities about how our reforms to reduce economic inactivity and support disabled people and people with a health condition are working.

Improving health and work outcomes for the over 20 million people with musculoskeletal (MSK) conditions in the UK forms a key part of this government's missions to build an NHS fit for the future and kickstart economic growth.

Healthcare professionals play a vital prevention and early intervention role in supporting people to self-manage their musculoskeletal (MSK) condition and enabling them to get in and get on in work.

The 2025 Healthcare Professionals’ Consensus Statement for action on health and work, published 20 January 2025, commits to work over the next five years to support healthcare professionals, including allied health professionals, to engage more proactively with, and to promote ‘good work as a health outcome’ across the health and care sector. This will support patients, including with MSK conditions, to return and remain in good work.

To support people back into work, the Occupational Health Workforce Expansion Funding Scheme (launched July 2023) funded registered health professionals to undertake occupational health training and qualifications. To date, over 200 doctors and nurses have commenced training.

Government recognises the role complementary and alternative medicine treatments such as chiropractic can play in supporting people. NHS England does not currently support or commission chiropractic care in the NHS.

The department estimates that the legislation to means-test Winter Fuel Payments would generate a net saving of £1.3 billion in England and Wales for 2024/25. This reflects an expected increase in Pension Credit take-up, estimated at five percentage points. This assumption reduced the overall saving by £0.3 billion in 2024-25 in England and Wales, but there is significant uncertainty around this element of the costing. For further details, please see Economic and fiscal outlook – CP 1169.

The department estimate that up to 760,000 families who were entitled to receive Pension Credit did not claim the benefit in the financial year ending 2023. Further details can be found at Income-related benefits: estimates of take-up: financial year ending 2023 - GOV.UK.

The National Child Measurement Programme (NCMP) collects data on the weight status of children aged four to five years old, in Reception, and 10 to 11 years old, in Year 6. Findings from the 2023 to 2024 NCMP annual report shows that the prevalence of obesity in children in Reception is not showing signs of decreasing, and remains in line with the stable pre-pandemic level. For Year 6 children, although the prevalence has decreased, it remains higher than pre-pandemic levels and is in line with the increasing pre-pandemic trend. Obesity prevalence also varies across ethnic groups, where a child lives continues to influence their weight status and health, and there remain large and persistent inequalities between the most and least deprived areas of England.

Data from the National Dental Epidemiology Programme oral health survey of five-year-old schoolchildren in England in 2024 showed that 22.4% of five-year-old children surveyed had experienced tooth decay. The most common reason children aged five to nine years old are admitted to hospital is for tooth decay.

Plain milk and water are the safest drinks for teeth. We have published the evidence base in support of this in Delivering Better Oral Health: an evidence-based toolkit for prevention, which states that only plain milk or water should be provided between meals for young children. Young children should not be given drinks sweetened with sugar or sweeteners.

In 2023, the Scientific Advisory Committee on Nutrition (SACN), published its report Feeding young children aged 1 to 5 years, a comprehensive assessment of the scientific basis of recommendations for feeding young children aged up to five years old. The report found no evidence that milk consumption is related to tooth decay and some evidence that there is no link between milk consumption and body fatness. The SACN recommended that plain milk or water, in addition to breast milk, should constitute the majority of drinks given to children aged one to five years old, and that pasteurised whole and semi-skimmed cows’ milk can be given as a main drink from one years old. These recommendations have been accepted by Government.

The Government’s dietary recommendations are based on robust assessments of the scientific evidence by the Scientific Advisory Committee on Nutrition (SACN) and its predecessor, the Committee on Medical Aspects of Nutrition Policy. Government advice on a healthy, balanced diet is encapsulated in the United Kingdom’s national food model, The Eatwell Guide.

In 2023, the SACN published its report Feeding young children aged 1 to 5 years, a comprehensive assessment of the scientific basis of the recommendations for feeding young children aged up to five years old. The SACN found that milk is an important contributor to energy intake and intakes of calcium and other micronutrients in children aged one to five years old. The SACN also found some evidence that there is no link between milk consumption and body fatness. The SACN recommended that:

- plain milk or water, in addition to breast milk, should constitute the majority of drinks given to children aged one to five years old; and

- pasteurised whole and semi-skimmed cows’ milk can be given as a main drink from the age of one years old.

The Nursery Milk Scheme is a statutory scheme which allows early years childcare settings to reclaim the cost of providing one-third of a pint of milk per day to children under the age of five years old who attend a setting for two or more hours per day. Schools can claim reimbursement from the scheme in respect of their pupils aged under five years old.

There are no plans to extend eligibility for the Nursery Milk Scheme to cover children until the end of the academic year, during which they reach their fifth birthday. Separate legislation allows pupils from lower-income families, and who are eligible for free school meals, to continue to receive free milk at school after the age of five years old.

The Government's Elective Reform Plan, published in January 2025 and shared with all National Health Service trusts, exemplifies our dedication to NHS transformation. It sets out a wide-ranging package of reforms, such as increasing patient initiated follow up (PIFU) to 5% of outpatient appointments by March 2029. We are supporting NHS trusts to deliver transformation initiatives like PIFU through innovation, sharing best practice to increase productivity and efficiency, and ensuring the best value is delivered. NHS England has detailed national guidance for trusts with various resources to help implement transformation initiatives.

Shared decision making between patients and clinicians ensures patients are empowered to make informed choices about their care. Investment and development of digital platforms is key to that, including our commitments to go further on the NHS App, the Federated Data Platform and the electronic referral service. These efforts will facilitate shared decision making through improved information for patients on waiting times and better two-way communication between patients and healthcare teams. In addition, our introduction of a new £20 payment per Advice and Guidance (A&G) request for general practitioners, to support stepping up A&G, demonstrates how we are supporting initiatives which transform how primary and secondary care work together to provide seamless patient care.