Andrew Selous

There are global supply issues with glucagon-like peptide-1 receptor agonists (GLP-1 RAs), which are licensed for treating patients with type 2 diabetes, including the branded medicine Ozempic. This appears to be largely driven by off-label prescribing for weight loss, which has led to shortages of these medicines for patients with type 2 diabetes.

We have issued guidance in the form of a Medicine Supply Notification (MSN), addressing all GLP-1 RAs, advising healthcare professionals on how to manage patients requiring these medicines. We are considering whether further communications are required.

The Government expects all providers of healthcare services, whether National Health Service or private, and all those with responsibility for prescribing to take appropriate account of national guidance such as MSNs. The guidance is clear that these medicines should only be prescribed for the treatment of type 2 diabetes, in order to protect supply for diabetes patients. Medicines which are solely licensed to treat type 2 diabetes should not be routinely prescribed for weight loss.

We are working closely with national diabetes specialists, the NHS, wholesalers, all manufacturers of these medicines and the relevant regulatory bodies and agencies to address this problem and to understand how we can help ensure type 2 diabetic patients continue to get access to treatment.

The Government has not conducted an assessment of the adequacy of National Health Service capability and capacity to diagnose Lyme disease or a comparative assessment of best practice in the diagnosis and treatment of this disease in the United Kingdom, the United States and Germany. Diagnosis of Lyme disease in England and Wales is conducted by the Rare and Imported Pathogens Laboratory (RIPL). RIPL provides Lyme polymerase chain reaction PCR testing and a comprehensive serological panel which has been fully validated to UK Accreditation Service standards.

Published research, for example the VICTORY study in Lancet ID, indicates that cellular tests for Lyme borreliosis used by many private laboratories in Europe have a high false positive rate. A copy of the VICTORY study in Lancet ID, is available at the following link: https://doi.org/10.1016/S1473-3099(22)00205-5.)

UK Health Security Agency published accompanying guidance documents on Lyme disease in July 2018, which describe the clinical signs and symptoms and are consistent with the National Institute for Health and Care Excellence guidance. The guidance is available at the following link: https://www.gov.uk/guidance/lyme-disease-management-and-prevention

Services for the treatment of Lyme disease are commissioned locally. These services are the responsibility of integrated care board and general practitioners use their professional judgement in diagnosing and treating this condition.

The Government has not conducted an assessment of the adequacy of National Health Service capability and capacity to diagnose Lyme disease or a comparative assessment of best practice in the diagnosis and treatment of this disease in the United Kingdom, the United States and Germany.

Diagnosis of Lyme disease in England and Wales is conducted by the Rare and Imported Pathogens Laboratory (RIPL). RIPL provides Lyme polymerase chain reaction PCR testing and a comprehensive serological panel which has been fully validated to UK Accreditation Service standards.

Published research, for example the VICTORY study in Lancet ID, indicates that cellular tests for Lyme borreliosis used by many private laboratories in Europe have a high false positive rate. A copy of the VICTORY study in Lancet ID, is available at the following link:

https://doi.org/10.1016/S1473-3099(22)00205-5.)

UK Health Security Agency published accompanying guidance documents on Lyme disease in July 2018, which describe the clinical signs and symptoms and are consistent with the National Institute for Health and Care Excellence guidance. The guidance is available at the following link:

https://www.gov.uk/guidance/lyme-disease-management-and-prevention

Services for the treatment of Lyme disease are commissioned locally. These services are the responsibility of integrated care board and general practitioners use their professional judgement in diagnosing and treating this condition.

The Government has not conducted an assessment of the adequacy of National Health Service capability and capacity to diagnose Lyme disease or a comparative assessment of best practice in the diagnosis and treatment of this disease in the United Kingdom, the United States, and Germany.

Diagnosis of Lyme disease in England and Wales is conducted by the Rare and Imported Pathogens Laboratory (RIPL). RIPL provides Lyme polymerase chain reaction PCR testing and a comprehensive serological panel which has been fully validated to UK Accreditation Service standards.

Services for the treatment of Lyme disease are commissioned locally. These services are the responsibility of integrated care board and general practitioners use their professional judgement in diagnosing and treating this condition.

The information requested is not held centrally.

The UK regularly engages with the Brazilian Government, indigenous leadership, and civil society to understand the drivers and impacts of illegal gold mining and to promote human rights. In late February, His Majesty's Ambassador accompanied Sonia Guajajara, Brazil's Minister for Indigenous Peoples, to the Javari Valley to discuss these issues with the Association for Indigenous Peoples (UNIVAJA). The UK is funding a three-year initiative to reduce environmental crime in the Amazon region and supports the Challenge Fund which investigates the impact of illegal gold mining across northern Brazil.

The UK regularly engages with the Brazilian Government, indigenous leadership, and civil society to understand the drivers and impacts of illegal gold mining and to promote human rights. In late February, His Majesty's Ambassador accompanied Sonia Guajajara, Brazil's Minister for Indigenous Peoples, to the Javari Valley to discuss these issues with the Association for Indigenous Peoples (UNIVAJA). The UK is funding a three-year initiative to reduce environmental crime in the Amazon region and supports the Challenge Fund which investigates the impact of illegal gold mining across northern Brazil.

The UK is committed to working with partners to halt and reverse forest loss globally by 2030. Indonesia, the Democratic Republic of the Congo, and Brazil are home to some of the world's most important forests, which must be protected to meet our goal of keeping within 1.5 degrees of temperature rise. The UK is committed to working with forest countries to ensure that we collectively deliver on the commitment made by 145 governments at COP26 in Glasgow to halt and reverse forest loss while delivering sustainable development and promoting an inclusive rural transformation.

The UK Government is committed to responsible gold extraction, for example, through encouraging compliance with the Organisation for Economic Cooperation and Development (OECD) Due Diligence Guidance for Responsible Mineral Supply Chains from Conflict-Affected and High-Risk Areas. The UK has funded OECD projects in West Africa and Colombia to promote local capacity building and uptake of the OECD guidance. The UK has also funded European Partnership for Responsible Minerals projects in the Great Lakes region in Africa to increase the proportion of responsibly sourced minerals, working across the whole of the supply chain. In April, we are preparing to discuss responsible mining with industry leaders at the Ghana Responsible Gold Mining Summit as part of Ghana's commitment to eradicate illegal mining.

We welcome the steps Qatar has taken on workers' rights. The priority is now full implementation and enforcement of those reforms. The UK Migration and Modern Slavery Envoy visited Doha on 9 October to discuss how the UK can partner with Qatar and the International Labour Organisation to support progress. The Foreign Secretary raised LGBT+ concerns ahead of and during his recent visit to Qatar. We welcome Qatar's establishment of the Doha International Centre for Interfaith Dialogue which hosts an annual interfaith dialogue. We will continue to encourage equal treatment and the respect of individual rights including LGBT+ and the freedom of religion or belief for all.

No assessment has been made of the impact on the economy and public purse on the time taken to conclude inheritance tax assessments.

There are no estates for which IHT400 Accounts (self-assessment of inheritance tax by executors) have been filed for which inheritance tax assessments have not been concluded within two years of death.

Compliance enquiries may be opened within 12 weeks from processing of the IHT Account.

HMRC is currently processing IHT form IHT400 within their agreed service level standards of 80 per cent within 15 working days.

When HMRC have processed the IHT400, if the appropriate amount of tax has been paid, they send the IHT421 to HMCTS. At the same time, a letter is also sent to customers which provides a date by which they will hear from HMRC if a compliance check needs to be undertaken. This date provided will be 12 weeks from the date the tax calculation letter was issued and does not impact the process being undertaken separately by the UK Court Services.

If HMRC has not contacted the customer by the 12 weeks date provided, then HMRC does not have any further questions to ask about the information and values provided in the IHT form and no compliance check will be undertaken.

The Government works closely with the Money and Pensions Service to understand the need for debt advice and monitor financial difficulty through an annual survey and notes the Financial Conduct Authority’s biennial Financial Lives Survey.

The Government recognises that some people are struggling with their finances at this challenging time. To help people in problem debt get their finances back on track, an extra £37.8 million support package has been made available to debt advice providers this financial year, bringing this year's budget for free debt advice in England to over £100 million.

In May 2020, the Government announced the immediate release of £65 million of dormant assets funding to Fair4All Finance, an independent organisation that has been founded to support the financial wellbeing of people in vulnerable circumstances. The funding is used to increase access to fair, affordable and appropriate financial products and services for those in financial difficulties.

From May 2021, the Breathing Space scheme will offer people in problem debt a pause of up to 60 days on most enforcement action, interest, fees and charges, and will encourage them to seek professional debt advice.

The Government has delivered unprecedented support for living standards during this challenging time, protecting livelihoods with the Self-Employment Income Support Scheme (SEISS), the Coronavirus Job Retention Scheme (CJRS), and temporary welfare measures.

The Government has extended the CJRS until 31 March 2021. Eligible employees will continue to receive 80% of their usual salary for hours not worked, up to a maximum of £2,500 per month.

The Government has increased the overall level of the third grant under the SEISS to 80% of average trading profits, meaning that the maximum grant available has now increased to £7,500.

The Government has provided local authorities with £500 million to support people who may struggle to meet their council tax payments this year. The Government expects that this will provide all recipients of working age local council tax support with a further reduction in their annual council tax bill of £150 this financial year.

These measures are in addition to the changes this Government has made to make the welfare system more generous, worth over £7 billion according to recent estimates by the Office for Budget Responsibility.

The Government has worked with mortgage lenders, credit providers and the Financial Conduct Authority to ensure the financial sector provides support for people across the UK to manage their finances by providing payment holidays on mortgages and consumer credit products.

The Government has also delivered protections for renters, including an extension to the ban on bailiff evictions for all but the most egregious cases until at least 21 February 2021, with measures kept under review.

The Charging Infrastructure Investment Fund (CIIF) was announced at Autumn Budget 2017 and aims to catalyse the rollout of electric vehicle charging infrastructure. The CIIF is managed and invested on a commercial basis by private sector partners, and Government will invest up to £200m to be matched by private investors. The location of investments will depend on the business plans of the chargepoint companies the fund invests in. As a result, the Government does not hold the requested information.

Successive years in which record numbers of people have crossed the Channel in small boats has placed our asylum infrastructure under immense strain. In order to meet our statutory obligations to accommodate asylum seekers who would otherwise be destitute, we have been forced to temporarily house asylum seekers in hotels. The use of hotels is a short term solution and we are working hard with Local Authorities and our accommodation providers to find more appropriate accommodation.

Hotel owners are under no obligation to enter into a contract with our providers. However, they recognise a commercial benefit from this arrangement. The decision to cancel any pre booked reservations is the responsibility of the hotel and not the Home Office.

The Government recognises the significant impact that shoplifting can have, not only on businesses but also the wider community and consumers.

We are working closely with retailers, trade organisations, police and enforcement partners across England and Wales via the National Retail Crime Steering Group (NRCSG) to ensure the response to crimes affecting the retail sector, including shoplifting, is as robust as it can be.

We also support the police-led National Business Crime Centre (NBCC) and National Police Chiefs’ Council to help ensure businesses and police are working effectively together to tackle shoplifting. This includes encouraging businesses to report incidents when they occur, gather relevant evidence and work closely with the police to ensure incidents are dealt with appropriately.

The Crime and Policing Minister wrote to PCCs and Chief Constables in September 2020, setting out that the theft of goods valued up to £200 from a shop should be prosecuted as a criminal offence and therefore should not constrain the ability of the police to arrest or prosecute someone in the way they feel is most appropriate.

We expect that all reported crimes, including shoplifting, should be taken seriously and properly investigated.

The Government has committed to reviewing the police funding formula before the next General Election and our intention is to introduce new arrangements at the earliest opportunity.

Reviewing the funding formula will be a complex process that will require close working with the policing sector and relevant experts to develop proposals, and a full public consultation will take place before any new funding arrangements are put in place.

As at 18 May 2021, the IOPC has 29 cases that have been open for longer than 12 months.

For context, in 2020/21 the IOPC started 465 independent investigations.

Of the investigations it completed in 2020/21, it completed 86% within 12 months. When major investigations are excluded, the IOPC completed 91% of investigations in 12 months or less (against a target of 85%).

As at 30^th April 2021, the IOPC workforce totalled 1,004 people.

The Ministry of Defence (MOD) is working with the Department for Transport (DfT) to understand opportunities for Defence to support the UK Jet Zero Strategy. As a baseline, MOD procurement of Sustainable Aviation Fuel (SAF) will be led by the DfT SAF Mandate which intends to introduce a minimum percentage of sustainably derived fuel into aviation fuel sales from 2025, increasing to 10% by 2030, and continuing to increase beyond that point. The MOD is already seeking to procure SAF earlier than 2025, ahead of the mandate, in order to play its part in the migration towards a zero-carbon economy, including the desire to help create a domestic demand.

The Government responded to the 110 recommendations of the comprehensive Living in Our Shoes report in March 2021 and committed to taking this forward through the Armed Forces Families Strategy. Since the publication of the Strategy in January 2022, a great deal of work has taken place to formulate the priorities under the Action Plan, to understand what changes can be delivered in the short, medium and longer term. As the Living in Our Shoes report acknowledged, many of the recommendations are ambitious and will be delivered towards the middle or latter part of the 10-year programme. However, there is much we can do now and indeed many of the recommendations from Living in Our Shoes have in effect already been delivered. An update on progress with the implementation of the Strategy can be found in the 2022 Armed Forces Covenant Annual Report, published on 19 December 2022: https://www.gov.uk/government/publications/armed-forces-covenant-and-veterans-annual-report-2022

As one of the UK's largest landowners the Ministry of Defence (MOD) is committed to contributing to the Government's nature restoration targets and enhancing biodiversity across its estate. Indeed, for 15 years it has funded a programme to improve the condition of Sites of Special Scientific Interest (SSSI) across the Defence estate to support the Governments targets for protected sites.

The MOD is developing a Nature Recovery Plan as required by the Greening Government Commitments. This will include an assessment of the potential future contribution to protected sites and other nature recovery targets. This plan will take account of the Defence imperative, current and future military requirements and where other land use contribute to Defence outputs such as carbon sequestration, renewable energy schemes and tenant farming.

The MOD will continue to engage with Nature Conservation Bodies and Nature Recovery Networks to complement the Department's approach.

The Government responded to the 110 recommendations of the comprehensive Living in Our Shoes report in March 2021. This response, which set the baseline for the new Armed Forces Families Strategy, included input from the Devolved Administrations.

Since the publication of the Strategy in January of this year, a great deal of work has taken place to formulate the priorities under the Action Plan, to understand what changes can be delivered in the short, medium and longer term. As the Living in Our Shoes report acknowledged, many of the recommendations are ambitious and will be delivered towards the middle or latter part of the 10-year programme. However, there is much we can do now and indeed many of the recommendations from Living in Our Shoes have in effect already been delivered. There will be an update on progress with the implementation of the Strategy in the Armed Forces Covenant Annual Report, which is due to be published by the end of the calendar year.

The Armed Forces (AF) Families Plan is derived from both the Defence Plan, and the AF Families Strategy (the latter of which was published on 19 January 2022). Like the AF Families Strategy, the AF Families Plan reflects - but is not exclusively driven by - the commitments in the Government's response to my hon. Friend's comprehensive and insightful report 'Living in our Shoes'. The Plan provides direction to those organisations with policy and/or delivery responsibilities related to Armed Forces families, wherever those families are based across the world. The Plan is dynamic and will be updated routinely to reflect changes in the wider context, and the continuous development and improvement in families-related policy and delivery. Although the Plan will provide essential coherence, it is important to note that many of the key actions within the Plan are already being delivered through existing measures and will now be absorbed within it. We will shortly be publishing a high level version of the plan [on gov.uk] and we will be including implementation updates through the Covenant Annual Report.

I refer my Hon. Friend to the answer given to Question UIN 83564 on 17 November 2022. Preparatory work on a technical consultation on the provision of toilets is underway, with a view to publication later this summer.

In line with the practice of successive administrations, details of internal discussions are not normally disclosed.

The Government is keen to ensure that local planning authorities have the right tools to allow them to take effective enforcement action. Good quality Land Registry data can be an important source of information to support enforcement action.

The Private Parking Code of Practice has been temporarily withdrawn to review the decisions to introduce new levels of private parking charges and to ban additional fees that are currently added on top of the late or unpaid parking charge. While I am not able to confirm when the Code will be reissued, I would like to reassure my honourable friend that my department continues to work with industry and consumer groups to do this as quickly as possible. We are committed to reissuing a Code that provides both the best possible protection for motorists and enables effective management of parking.

The Government’s priority is to ensure that the fire and structural safety risks for all higher-risk buildings are managed effectively by those responsible for building safety. The Building Safety Act 2022 identifies and places legal obligations with regard to building safety on Accountable Persons, irrespective of tenure and ownership. This is to ensure that building safety will be managed on an on-going basis for all higher-risk buildings. Where Accountable Persons do change, provisions in the Act ensure that key information and duties pass to any new Accountable Person.

The Government is committed to creating a fairer and more transparent housing system that works for everyone and to delivering the second phase of our major two-part leasehold reform within this Parliament. Leasehold and commonhold reform supports our mission to level up homeownership and promote true homeownership for all by addressing the power imbalance at the heart of the leasehold system and putting the power into the rightful hands of homeowners.

The Leasehold Reform (Ground Rent) Act 2022 (which comes into force on 30 June 2022) is the first part of leasehold and commonhold reforms in this Parliament. The Act will make homeownership fairer and more transparent for thousands of future leaseholders, by preventing landlords under new residential long leases from requiring a leaseholder to pay a financial ground rent. The impact assessment for the Act was published on 12 May 2021 and can be accessed via the Parliamentary Bills website ( https://bills.parliament.uk/bills/2864).

On 11 January 2022, the Government launched a consultation on a number of recommendations made by the Law Commission aimed at broadening the rights of leaseholders, and reinvigorating commonhold. We are currently analysing the feedback and we will provide a response in due course.

This is a long-term reform programme; it is complex with many interdependencies and will take time to get the detail right. Once it is enacted the effect will be felt for generations and so we are determined this work considers all the implications and impacts with care.

The quarterly HMPPS workforce statistics publication covers staffing information, including the working days lost due to sickness absence. The latest publication covers data for the period up to 30 September 2022.

Therefore, the latest data available to provide a ‘current’ proportion of sick absence is for 30 September 2022.

The ten prisons which had the highest proportion of band 3-5 officers who took time off sick on 30 September 2022 is shown in table 1 below.

Table 1: Snaphot of top 10 prisons with highest proportion of band 3-5 officers1 off sick on 30 September 20222(p)

1. Includes Band 3-4 / Prison Officer (incl specialists), Band 4 / Supervising Officer and Band 5 / Custodial Managers.

2. Includes staff who either had sick end date on or after 30 September 2022 or did not have a sick end date at all, as at time of data being produced for September 2022 HMPP workforce publication

(p) Figures relating to current financial year are provisional

In the 12 months to 30 September 2022, band 3-5 officers lost an average of 17.3 workings days. This is an increase from 16.6 working days compared to the 12 months to 31 March 2022. Trends from 2017 are shown below.

Table 2: Band 3-5 officer sickness, 12 months to 31 March 2017 to 12 months to 30 September 2022

1. Average working days lost per member of staff is calculated as number of working days lost to sickness divided by the average number of full time equivalent staff for a year.

Information about time out of cell for adult prisoners is not held by the Ministry of Justice, as it would require detailed daily monitoring of out-of-cell activity of each prisoner in each establishment. There is no current central instruction prescribing the amount of time prisoners should spend out of their cells. There is a clear commitment, however, to the delivery and performance management of time spent in purposeful activity. Governors have the flexibility to deliver balanced regimes that maintain an appropriate level of time out of cell on a range of activities such as education and employment, which meet the needs of the establishment’s population, with a heavy focus on reducing re-offending. This is alongside basic access to time in the open air and domestic services, such as showers. The Prisons Strategy White Paper (Prisons Strategy White Paper - GOV.UK (www.gov.uk)) sets out the Government’s commitment to prison regime reform. A new Purposeful Activity performance measure has been introduced for the 2022-23 performance period, and additional measures are in place for attendance at work, education, interventions and services.

The quarterly HM Prison and Probation Service workforce statistics publication covers staffing information, including the working days lost due to sickness absence.

The ten prisons which had the highest proportion of band 3-5 officers who had at least one period of sickness absence in the 12 months to 30 September 2022 is shown in table 1 below.

Table 1: Top 10 prisons with highest proportion of band 3-5 officers¹ with at least one period of sickness absence², in the 12 months to 30 September 2022^(p)

1. Includes Band 3-4 / Prison Officer (incl specialists), Band 4 / Supervising Officer and Band 5 / Custodial Managers.

2. Individuals are only counted once, even if they have more than one episode of sickness absence recorded.

(p) Figures relating to current financial year are provisional.

Paragraph 2.23 of Burial Grounds: Guidance for Managers refers to section 214 of the Local Government Act 1972. Subsection 214(6) provides that a local authority burial authority may contribute towards the provision or maintenance of any cemetery in which their inhabitants are buried. For the purposes of section 214(6), the definition of “cemetery” (in subsection 214(8)) is “a burial ground or any other place for the interment of the dead (including any part of any such place set aside for the interment of a dead person’s ashes).” This would include a churchyard if it is used as a burial ground.

I was delighted to have the opportunity to visit the United States over the course of last week. I met the special envoy to Northern Ireland, Joe Kennedy III, where we discussed Northern Ireland’s rich potential for US investors.

I also attended a roundtable with US business leaders in New York and met businesses in Boston. I was greatly encouraged by the enthusiasm shown towards investment in Northern Ireland.

There are huge investment opportunities to deepen UK-US trading links benefiting communities on both sides of the Atlantic, and I look forward to working to strengthen these bonds.

Floating offshore wind will create thousands of high-quality jobs in Wales, drive economic growth and help us reach our net zero and energy security ambitions.

I will continue to work with colleagues across Government and The Crown Estate as they progress plans to bring forward 4 Gigawatts of projects in the Celtic Sea by 2035.