Freddie van Mierlo

The Environment Agency (EA) is the appropriate agency for monitoring and managing bathing waters in England. Their operational duties ensure the required testing and monitoring of bathing waters, and pollution risk forecasting during the bathing season. On 12 November, Defra also launched a consultation on reforms to the Bathing Water Regulations 2013. This consultation detailed proposals that included moving the fixed dates of the bathing season from Regulations into guidance and considering a sites water quality prior to designation. These proposals would allow the EA greater flexibility when monitoring sites and a more targeted approach to maintaining their status and quality.

Designated bathing waters are monitored by the Environment Agency (EA) throughout the bathing season which enables them to assess what action is needed to improve water quality. Sites which receive classifications of poor standard will be subject to an action and improvement plan between the EA, local stakeholders and water companies. Defra also recently launched a consultation on reforms to the Bathing Water Regulations 2013. The three core proposals details in this consultation seek to bring the designation and monitoring process in line with how bathing waters are used today, and ensure it is fit for purpose for inland sites.

Defra officials are engaged with Royal Botanic Gardens, Kew on development of the New Herbarium Project proposal.

Kew’s Herbarium collections are some of the largest and most important in the world, holding over seven million vascular plant specimens, collected globally over the last 170 years. The New Herbarium Project aims to deliver a world-leading scientific research and collections facility, both to preserve those collections in appropriately controlled conditions and to ensure the specimens are accessible to Kew’s researchers and the wider international scientific community.

Science is the largest and fastest-growing department at Kew and exploring options for future science research infrastructure is important in anticipation of future changes to global biodiversity.

Defra fully recognise the importance of the Herbarium collections, which Kew maintains both for the nation and as a UNESCO World Heritage Site, and is supporting Kew’s Digitisation initiatives, which will ensure that 8.25 million plant and fungi specimens are digitised and made free for the public to access by 2026.

The new Government is committed to making Protected Landscapes (National Parks and National Landscapes) greener, wilder, and more accessible. We are currently considering the best way to do this. To support this, Defra is working with Protected Landscapes organisations to improve data on the state of nature in Protected Landscapes.

Policy in this area is a devolved matter.

The UK Government recognises the need to go further on addressing nutrient pollution and supporting nature to recover.

We have already committed to a rapid review of the Environmental Improvement Plan which will set out how the Government will deliver our legally binding targets, including for reducing nutrient pollution.

We are taking action to work with partners to tackle the main sources of pollution. For example, we are taking action to tackle agricultural pollution and deliver the Environment Act target through a suite of proportionate and effective regulations, advice and incentives.

The Government takes biosecurity seriously and has taken steps to mitigate the risk of Brucella canis. Disease risk is monitored carefully and is kept under regular review.

Defra made detection of Brucella canis in dogs reportable in April 2021. The Department has also published information for veterinary professionals and pet owners and has worked with stakeholders to disseminate advice and recommended actions to veterinary surgeons, rescue and rehoming organisations and dog breeding associations. Where necessary Defra have the powers in legislation to introduce preventive health measures to protect animal or public health by controlling diseases or infections that are likely to be spread due to the movement of pet animals into Great Britain.

Defra will continue to monitor and consider any further actions as appropriate.

Ministers continue to consider possible changes to the Bathing water system. In light of this, applications for designations for the 2025 bathing season which were closed by the previous administration, remain closed.

The Government recognises that flooding is devastating for those affected. Protecting communities from flooding is a key priority for this Government.

The Ministry for Housing, Communities and Local Government (MHCLG) co-ordinates the Government's Flood Recovery Framework (FRF). The FRF, which includes support for businesses and households, and Defra's Property Flood Resilience grant scheme (PFR) can be activated in response to large scale and widespread flooding.

Where flooding results in localised impacts, local authorities should provide support as needed.  Affected householders should ask their insurance provider if they are eligible for Build Back Better within their claim, which can provide for flood resilient repairs over and above the cost for like-for-like reinstatement of actual flood damage.

The Government is determined to turbocharge the delivery and repair of flood defences, improve drainage systems and develop natural flood management schemes. That is why the Government set up the Flood Resilience Taskforce to improve coordination of the national and local flood response and strengthen preparedness ahead of the winter flood season. We are investing over £1.25 billion this year to scale up national resilience through building new and improving existing flood defences.

I would be happy to meet with the honourable Member alongside the Environment Agency to discuss this matter.

The Driver and Vehicle Standards Agency’s (DVSA’s) main priority is to reduce car practical driving test waiting times, whilst upholding road safety standards.

As of 21 October 2024, there were 567,344 car practical driving tests booked, and 84,092 driving tests available within the 24-week booking window.

It is not possible to allow approved driving instructors (ADI’s) to temporarily work as driving examiners. The Motor Vehicles (Driving Licences) 1999 regulations require driving test examiners to meet certain criteria and pass an initial qualification and examination and prohibits a person from being an active ADI and an examiner simultaneously.

As part of measures to ensure its booking system is used correctly, DVSA has reduced the number of times a driving test appointment can be changed. Driving test candidates can change their appointment up to six times. If candidates need to make more changes after that, they will need to cancel their test and rebook it. DVSA currently has no plans to reduce this figure further as it is designed to give candidates sufficient flexibility to manage their car practical driving test appointment.

Driving examiners are Civil Servants so their salary is determined by the Civil Service Pay Remit Guidance. The guidance sets out the financial parameters within which Civil Service departments can determine pay awards for their staff. DVSA cannot act independently from this guidance.

The Driver and Vehicle Standards Agency’s (DVSA) main priority is to reduce car practical driving test waiting times, whilst upholding road safety standards.

Measures in place to reduce waiting times for customers at driving test centres include the recruitment of driving examiners, conducting tests outside of regular hours, including at weekends and on public holidays, and buying back annual leave from driving examiners.

As of 7 October 2024, there were 571,047 car practical driving tests booked, and 89,349 driving tests available within the 24-week booking window.

It is not possible to block book car practical driving tests. A driving licence number can only be assigned to one car practical driving test at a time. A survey by DVSA suggests that only 10% of learner drivers use third parties to book their tests. Most either book appointments themselves or through their approved driving instructor (ADI).

To ensure fairness for everyone wanting to book a practical driving test, DVSA continues to work hard to combat the unscrupulous practice of reselling tests. Such apps or bots are not approved by DVSA. They make it harder for candidates to get a test and can also result in people paying more for a test. DVSA will continue to take steps to block cancellation services from accessing the booking system, which are having a positive impact.

DVSA operates an online booking service (OBS) for instructors and trainers so that they can book and manage driving and riding tests for their pupils. DVSA has made changes to the OBS by stopping automatic online registrations to use the service, ensuring each company that registers employs an ADI and removing access for any companies not linked to driving instructors.

In January 2023, DVSA changed the terms and conditions for using the booking service to help prevent anyone from selling tests at profit. Since then, DVSA has issued 313 warnings, 766 suspensions, and closed 705 businesses for misuse of its booking service.

Following these changes, there has been a significant drop in traffic to these services because DVSA is successfully identifying and blocking apps or bots.

On 20 November 2024, the Government announced that it is establishing an independent review of the physician associate and anaesthesia associate professions. It will consider the safety of the roles, and their contribution to multidisciplinary healthcare teams. The review will report in spring 2025.

The introduction of regulation by the General Medical Council (GMC) will provide a standardised framework of governance and assurance for the clinical practice of Physician Associates (PAs) and make it easier for employers, patients, and the public to understand the relationship between these roles and that of doctors.

As set out in the National Institute for Health and Care Excellence’s guidelines, all healthcare professionals directly involved in a patient's care should introduce themselves and explain their role to the patient. The GMC has published interim standards for PAs in advance of regulation, which make it clear that professionals should always introduce their role to patients, and set out their responsibilities in the team. In primary care, NHS England has produced patient-facing materials that have been shared widely with general practices to support patient awareness and understanding of the PA role.

We recognise the pressures people are facing with the rising cost of living. Our extensive arrangements to help people afford National Health Service prescription charges mean that almost 89% of prescription items in England are already provided free of charge. For those who are not exempt from charges, pre-payment certificates can be used to cap costs at just over £2 a week for regular prescriptions.

The national prescribing position in England remains that gluten free bread and mixes can be provided to all coeliac patients on an NHS prescription, and a wide range of these items continue to be listed in part XV of the Drug Tariff. This means that prescribers can issue NHS prescriptions based on the individual preferences of their patients, while also being mindful of which product best suits the patient’s dietary needs.

Work is already underway to assess the potential merits of testing newborn babies for spinal muscular atrophy (SMA).

This is following the UK National Screening Committee’s two-fold recommendation in 2023, to simultaneously develop a new cost-effectiveness screening modelling study for the United Kingdom’s screening context, and to start scoping work for an in-service evaluation of newborn screening for SMA in real world National Health Services in the UK.

The Joint Committee on Vaccination and Immunisation (JCVI) is the United Kingdom’s expert committee that advises the government on immunisation programmes.

In line with JCVI advice, the respiratory syncytial virus (RSV) vaccination programme for adults turning 75 years old began on 1 September 2024 in England alongside a one-off catch-up programme to rapidly vaccinate all those already aged between 75 and 79 years old. The JCVI considered that there was less certainty about how well the vaccine works in people aged 80 years old and older, as there were not enough people of this age in the clinical trials to be able to see if the vaccines are protective in this age band.

Whilst the JCVI notes what takes place in other countries, its advice is specific to the UK. The JCVI continues to keep evidence under review, including data from clinical trials and real world evidence emerging from immunisation programmes in different countries.

The JCVI recently discussed the RSV programme at their committee meeting on 2nd October 2024. The minutes from this meeting are publicly available at the following link: https://www.gov.uk/government/groups/joint-committee-on-vaccination-and-immunisation

The UK Health Security Agency is working on vaccine effectiveness analysis within the 75 to 80-year-old age group for this winter season 2024 to 2025. We are collating data on respitatory syncytial virus (RSV) hospitalisations in England and general practice consultations in a sentinel network.

Data is required from across the entire RSV season to give an accurate estimate of effectiveness. Analyses are therefore likely to take place around the end of the winter season 2024-2025. Publication is expected to follow in due course.

Evidence of effectiveness in all age groups in all countries where data has been made available is being used to inform eligibility considerations. Emerging real-world evidence will be reviewed by the Joint Committee on Vaccination & Immunisation as part of its considerations for a potential extension to the older adults RSV immunisation programme, currently aimed at people aged between 75 and 80 years old, to include people over 80 years old and risk groups.

Providers must provide sufficient numbers of suitably qualified, competent, skilled, and experienced staff to meet the needs of the people using the service. Staff must receive the support, training, professional development, supervision, and appraisals that are necessary for them to carry out their role.

We now have a national career framework for adult social car, the Care Workforce Pathway, which is linked to a number of existing competency frameworks, including the dementia training standards framework.

The Department has also launched a new Level 2 Adult Social Care Certificate qualification which links to the outcomes in the Care Workforce Pathway. This contains the baseline knowledge required to provide quality care, and will make sure that those who are starting out their careers have an informed awareness of dementia.

I received the hon. Member’s letter and replied on 6 November 2024.

As part of our mission to build a National Health Service fit for the future, we are committed to shifting care out of hospitals and into the community, close to people’s homes. NHS England is currently piloting neighbourhood based, open access community mental health centres in six areas to support people experiencing mental ill health.

Whilst there are no current plans to review or amend the list of medical conditions that entitle a patient to receive free prescriptions, extensive arrangements are in place to ensure that prescriptions are affordable for everyone. For example, people who are: in receipt of certain qualifying benefits or tax credits; are pregnant or have recently given birth; or are aged 60 years old and over, all qualify for free prescriptions. Additionally, income-based support is available under the NHS Low Income Scheme, and Pre-Payment Certificates are available to anyone, allowing people to claim as many prescriptions as they need for a set cost.

We have no plans to appoint a statutory mental health commissioner as it would not add significant value within the framework provided by existing bodies.

The Government has not made a recent assessment of the potential merits of introducing legislation on the composition of ‘toddler’ or ‘growing up’ milks. The Scientific Advisory Committee on Nutrition’s (SACN) 2023 report, called Feeding young children aged 1 to 5 years, reported findings from national dietary surveys indicating that free sugars intakes for children aged 18 to 60 months old were above the current recommendations. Furthermore, formula milks, mainly follow-on formula and ‘toddler’ and ‘growing up’ milks, were consumed by 36% of children aged one to one and a half years old, and contributed 50% of free sugars intakes in consumers.

Current recommendations from the SACN are that these products are not required by children aged one to five years old and that milk or water, in addition to breast milk, should constitute the majority of drinks given to children aged one to five years old. National Health Service advice is that there is no evidence to suggest that ‘toddler’ or ‘growing up’ milks provide extra nutritional benefits for young children.

We face a childhood obesity crisis, and the Government is committed to raising the healthiest generation of children ever, which includes considering what action is needed to improve the diets and associated health outcomes for children.

No assessment has been made. To aid ADHD service providers and prescribers further we have widely disseminated our communications and continually update a list of currently available and unavailable ADHD products on the Specialist Pharmacy Service website, helping ensure that those involved in the prescribing and dispensing of ADHD medications can make informed decisions with patients.

The Department has been working hard with industry and NHS England to help resolve supply issues with some attention deficit hyperactivity disorder (ADHD) medicines, which are affecting the United Kingdom and other countries around the world. As a result of intensive work, some issues have been resolved and all strengths of lisdexamfetamine, atomoxetine capsules, and guanfacine prolonged-release tablets are now available.

We are continuing to work to resolve supply issues where they remain for methylphenidate prolonged-release tablets. We are engaging with all suppliers of methylphenidate prolonged-release tablets to assess the challenges faced and their actions to address them. We are also directing suppliers to secure additional stocks, expedite deliveries where possible, and review plans to further build capacity to support continued growth in demand for the short and long-term. We anticipate intermittent regional supply disruptions to continue, and we expect supply to improve in the United Kingdom from October 2024 onwards.

In parallel, the Department has worked with specialist clinicians, including those within the National Health Service, to develop management advice for NHS clinicians to consider prescribing available alternative brands of methylphenidate prolonged release tablets or available alternative ADHD medicines. We would expect ADHD service providers and specialists to follow our guidance, which includes offering rapid response to primary care teams seeking urgent advice or opinion for the management of patients, including those known to be at a higher risk of adverse impact because of these shortages.

A 2019 evidence review showed that babies and young children are exceeding their energy intake requirement and are eating too much sugar and salt. Some commercial baby foods, particularly finger foods, had added sugar or salt, or contained ingredients that are high in sugar or salt.

More recently, the independent Scientific Advisory Committee on Nutrition (SACN) highlighted in their 2023 report, Feeding Young Children aged 1 to 5 years, that free sugar intakes are above recommendations for children at all ages where recommendations have been set. Furthermore, commercial baby food and drinks contributed to approximately 20% of free sugar intake in children aged 12 to 18 months. The SACN also recommended that in diets of children aged one to five years old, foods, including snacks that are high in salt, free sugars, saturated fat, or are energy dense, should be limited. The SACN also recommended that commercially manufactured foods and drinks marketed specifically for infants and young children are not needed to meet nutrition requirements.

We face a childhood obesity crisis, and the Government is committed to raising the healthiest next generation ever. Under our health mission and shift to prevention, we are considering what action is needed to respond to the SACN’s commercial baby food recommendations to establish healthy habits as early as possible.

We face a childhood obesity crisis, and the Government is committed to raising the healthiest generation of children ever. The Department speaks with many stakeholders about its policies to improve the diets and associated public health outcomes for the population.

It is vital that labelling and packaging of infant and baby food products are accurate and honest, to support parents and carers to make the best choices for feeding their young children. This is why infant and baby food products are already subject to robust regulations which set nutrition, composition, and labelling standards.

The Department has been working hard with industry and NHS England to help resolve supply issues with some attention deficit hyperactivity disorder (ADHD) medicines, which are affecting the United Kingdom and other countries around the world. As a result of intensive work, some issues have been resolved and all strengths of lisdexamfetamine, atomoxetine capsules, and guanfacine prolonged-release tablets are now available.

We are continuing to work to resolve supply issues, where they remain, for methylphenidate prolonged-release tablets. We are engaging with all suppliers of methylphenidate prolonged-release tablets to assess the challenges faced and their actions to address them. We are also directing suppliers to secure additional stocks, expedite deliveries where possible, and review plans to further build capacity to support continued growth in demand for the short and long-term. We anticipate intermittent regional supply disruptions to continue, and we expect supply to improve in the UK from October 2024 onwards.

In parallel, the Department has worked with specialist clinicians, including those within the National Health Service, to develop management advice for NHS clinicians to consider prescribing available alternative brands of methylphenidate prolonged release tablets or available alternative ADHD medicines. We would expect ADHD service providers and specialists to follow our guidance, which includes offering rapid response to primary care teams seeking urgent advice or opinions for the management of patients, including those known to be at a higher risk of adverse impact because of these shortages.

To aid ADHD service providers and prescribers further we have widely disseminated our communications and continually update a list of currently available and unavailable ADHD products on the Specialist Pharmacy Service website, helping ensure that those involved in the prescribing and dispensing of ADHD medications can make informed decisions with patients.