Question to the Department of Health and Social Care:

To ask the Secretary of State for Health and Social Care, what assessment his Department has made of the potential impact of the mandatory fortification of non-wholemeal wheat flour with folic acid on people with pernicious anaemia and other medical conditions for whom folic acid supplementation may not be appropriate.

Answered by Sharon Hodgson

Folic acid fortification was recommended by the Committee on Medical Aspects of Food and Nutrition Policy in 2000 and by its successor the Scientific Advisory Committee on Nutrition (SACN) in 2006, after an extensive review of the evidence on folate and health. The SACN has further considered the evidence in its 2009 report to the Chief Medical Officer on folic acid and colorectal cancer risk and its 2017 update on folic acid. The tolerable upper limit was also re-considered by the Committee on Toxicity (COT) in 2018.

In its 2006 report on folate and disease prevention, the SACN considered data from hospital discharge surveys in the United States of America, where mandatory fortification of enriched cereal grain products with folic acid was authorised in 1996 and fully implemented in 1998. The data suggested that the number of cases of pernicious anaemia or subacute combined degeneration of the spinal cord had not increased post-fortification. This suggests that mandatory fortification had not led to a delay in the detection of vitamin B12 deficiency by masking the diagnosis of pernicious anaemia.

In the SACN’s extensive review of the evidence on folate and health it considered other medical conditions for whom folic acid supplementation may not be appropriate including epileptic patients on phenytoin, an epileptic drug, pregnant women in the context of multiple births and embryo selection and anti-folate chemotherapy. For each, the SACN noted that there is no evidence or no substantive evidence to suggest that folic acid fortification would cause adverse health outcomes.

The policy was developed with Government’s public consultations on both the impact assessment and legislation. This issue was considered as part of the consultation and impact assessment process.

The level of folic acid chosen for fortification, 250 micro grams per 100 grams of flour, was based on modelling carried out by Food Standards Scotland. The level of fortification has been chosen in order to minimise the risk of the population exceeding the tolerable upper intake level and therefore the risk of masking the diagnosis of pernicious anaemia. COT concluded in 2018 that “Further work is needed to identify the maximum level of folic acid intake at which masking would not occur. However, it is very unlikely that this would be such that the [upper limit] for intake would be less than 1 mg/day, as at present.”

The Government is planning an evaluation on the impact of the policy to assess the effectiveness of the level of mandatory folic acid fortification for both the prevention of neural tube defect affected pregnancies but also to check that the population are not routinely exceeding a tolerable intake and identify any further unintended consequences.

Question to the Department for Work and Pensions:

To ask the Secretary of State for Work and Pensions, if he will assess the potential merits of introducing an annualised earnings assessment for recipients of Carer's Allowance employed on zero-hours and other irregular contracts to ensure that fluctuations in working hours and holiday pay do not result in the loss of Carer's Allowance and associated National Insurance credits for carers whose overall annual earnings remain below the equivalent annual earnings threshold.

Answered by Stephen Timms - Minister of State (Ministry of Housing Communities and Local Government) (Equalities)

The Government is committed to improving and modernising how earnings are treated in Carer's Allowance. It has increased the weekly earnings limit to match 16 hours at the National Living Wage, improved guidance, and is exploring longer-term changes to the benefit, including automation of earnings and the possibility of an earnings taper. A Call for Evidence to support this work was launched on 7 July 2026 and is open until 18 August 2026: Carer's Allowance: call for evidence - GOV.UK.

Where Carer's Allowance recipients undertake paid work, there is flexibility for Decision Makers to average earnings where these fluctuate in a regular pattern, using a period that best reflects the individual's working pattern.

Found: Watch the meeting Members present: Ruth Jones (Chair); Ann Davies; Gerald Jones; Ben Lake; Andrew Ranger

Found: Andrew Ranger: Thank you very much, Chair, and thank you to members of the Committee.

Found: Watch the meeting Members present: Ruth Jones (Chair); Ann Davies; Gerald Jones; Ben Lake; Andrew Ranger