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12,942 spoken contributions under 12 words (interjections such as “Will the hon. Member give way?”) are hidden. Show them
My hon. Friend has done significant campaigning on this issue in recent months, and we all know why. The Government obviously inherited the student loan system situation, and we have already acted to cap the interest rate on student loans. We look forward to reading her Committee’s report, and, I am sure, to her ongoing campaigning on this issue.
The Conservative Government commissioned the Cass review. In their 2024 manifesto, the Conservatives committed to implement the review in full, which would include a trial. However, as my hon. Friend is saying, they now propose in this motion to stop the trial. Is that not proof that we actually need to have a trial? We need to take the party politics out of this matter, stop politicians from being the lead commentators and put it in the hands of the families and the clinicians.
On amendment 13, the shadow Minister asked why my hon. Friend the Member for Stoke-on-Trent South felt the need to table amendment 13. One can only assume it is because health inequalities have continued to widen for far too long. In a 20 or 30-minute drive across my Wolverhampton North East constituency, life expectancy drops by seven years. I accept that tackling health inequalities is not just about health; it is about a wider web of societal issues, including educational, employment and housing inequalities. That very long list is beyond the responsibility of the Secretary of State for Health and Social Care. Amendment 13 will put the tackling of preventable ill health and health inequalities at the centre of national decision making by ensuring that the Secretary of State must consider not just NHS treatment but wider social and economic factors. Will the Minister assure the Committee that future Secretaries of State will not overlook the wider social and economic factors that drive ill health and unequal life expectancy, and that there will be a responsibility to work across Departments to tackle that wider and growing inequality?
It is a pleasure to serve under your chairmanship, Sir Jeremy. We live in an age in which a handful of technology companies shape how we communicate, shop, work and receive news, and increasingly how the Government deliver public services. There is no question but that technology has brought enormous benefits to us. It has enabled new businesses, accelerated scientific discovery and created opportunities that previous generations could not imagine, but Parliament has a responsibility to ask a fundamental question: who is shaping whom? Is technology serving society or is society being reshaped to serve the interests of technology companies? Today, a small number of global technology corporations possess unprecedented economic power to influence markets. Their algorithms shape public debate and their infrastructure underpins our essential services. That concentration of power raises important questions about sovereignty. The Government are elected by the British people and this Parliament makes laws, yet too often we find ourselves adapting public policy to the priorities of global firms, rather than expecting those firms to adapt to the rules of our society. The rise of artificial intelligence makes those questions even more urgent. AI has extraordinary potential in healthcare, education, public administration and so forth, but it should raise concerns about issues such as transparency and accountability, which affect employment and the concentration of power. That means that there is a need for stronger competition policy when markets become overly concentrated. It means that public data is used in the public interest. It means protecting our citizens from harmful online environments. It also means supporting British innovation so that the next generation of technological advance creates prosperity across our country, rather than a dependence on overseas monopolies. Britain should choose democracy, accountability and innovation in the service of society. That is the task before us. I thank the right hon. Member for The Wrekin (Mark Pritchard) for securing this debate. It is a debate that this House must not shirk.
I would like to start by declaring an interest, because my son Milo, of whom I am extremely proud, is a trans man. I have listened to colleagues very carefully over the course of our proceedings. There have been some truly heartfelt speeches, and this strength of feeling is certainly warranted wherever children are concerned. The Government welcome this scrutiny, and I want to thank Members from all sides of the House for the constructive tone and substance of this debate. I am not the Minister who is responsible for leading on this policy in the Department for Health and Social Care. Nevertheless, I feel a great deal of responsibility for the health and wellbeing of children in our country. As the Minister of State for Care, I am, for example, responsible for making sure children at end of life are receiving the right palliative and end-of-life care. And tooth decay, for example, has an appalling effect on children’s wellbeing. When it comes to gender incongruence, I cannot help but think of those children suffering in great distress, who may even be watching our proceedings this evening, and I want them to know that all of us in this Chamber want what is best for them. We might disagree about how we get there, but I do not doubt the sincerity of anyone who has spoken today. Fundamentally, our approach on this side of the House is to be led by the evidence, and on this I pay tribute to Dr Hilary Cass, who has taken on one of the most sensitive and polarising issues of our times with such courage and professionalism. The shadow Minister, the hon. Member for Sleaford and North Hykeham (Dr Johnson)—I hugely respect her expertise as a paediatrician—has said that our decisions could be motivated by “fear and hostility”, but that is not a charge that anyone could level at Dr Cass, who has shown the utmost courage and professionalism from the moment that she was appointed. It was on the strength of her independence and integrity that the previous Conservative Government, of which the hon. Lady was of course a member, accepted her recommendations. One of those recommendations was for a regulated, robustly safeguarded trial. Yesterday, Dr Cass said that she is “absolutely convinced that more children will be harmed if we don’t do the trial than if we do.”
I know that feelings on these matters are strong and heartfelt. If the Conservative party has changed its position and is putting forward its arguments with sincerity and honour, that is a perfectly acceptable position to take, but I simply remind the House of the journey that the party has been on.
This is a debate about hormones for suppressing puberty, and is related to the matter that the hon. Lady raises, but it is important that we get the sequencing right. Let us look at the trial and the evidence. That is part of the process of understanding the milestones and the forks in the road faced by children who are experiencing gender incongruence. Let us do this one step at a time. We are proceeding carefully, cautiously and under the mantra that the safety and wellbeing of children are non-negotiable, and with clarity that a robustly scrutinised trial with rigorous safeguards is the only way of establishing a robust evidence base for puberty-suppressing hormones. Many hon. Members have asked about safeguards, so let me remind the House what they are. A child can participate only with the consent of a parent or guardian and the child’s own consent or assent, and only if they have had a diagnosis of gender incongruence for at least two years; if they are of stable physical and mental health; if they are not subject to any safeguarding concerns; if they and their parents demonstrate sufficient understanding of the nature of the treatment, including its potential advantages and disadvantages; if they have been deemed clinically appropriate by both their NHS care team and the national multidisciplinary team; and if they are already accessing NHS gender services, including participation in a tailored package of psychosocial care.
A little later, I will go through all the different work that is going on. This is absolutely not happening in isolation; we are taking into account a range of other studies. Some colleagues have raised the work of the MHRA in strengthening the safeguards for young people involved in the trial. The MHRA has been engaged in a scientific dialogue with the trial sponsors, and it was the outcome of that process that led the MHRA, as an independent body, to publish the updated protocol last week. We welcome the changes, because they show that the MHRA is taking its job seriously and that the system is working as intended. We cannot cut corners when it comes to the safety and wellbeing of children, and the safeguards are now in place to guarantee greater monitoring and clinical reassessment, including objective criteria for withdrawing children and young people from the trial entirely. I remind colleagues that the bar to qualify for the trial is extremely high, with only a small number of young people expected to meet the strict criteria. Some other colleagues—I turn now to the point made by the right hon. Member for South Holland and The Deepings (Sir John Hayes)—have queried the need to have a clinical trial when a number of children have already taken puberty blockers and information is already available. However, Dr Cass concluded that there is not enough evidence about the risks and benefits of those medications. That is why she was so clear in recommending a trial to find that clinical evidence, because that is the basis on which we can take those decisions. The information in the data linkage study is much more limited than the detailed information that the research team will be able to collect about the relative benefits and risks of puberty-suppressing hormones. NHS England is, however, committed to delivering the data linkage study and has taken time to ensure that the data is shared by relevant organisations.
As the right hon. Lady will know, a lot of this is about the distress and the tremendous mental health pressure that young people going through gender incongruence feel. Clearly, one of the outcomes that we will look for from the trials is an alleviation and an amelioration of those significant mental health issues and distress. Those are the kind of outcomes we want to see to help some of those young people who often end up in awful situations, leading to self-harm and other terrible situations. Some colleagues have asked about the wider support we are providing for children and young people with gender dysphoria and incongruence. I am pleased that the Pathways study is just one part of the wider work being done to ensure that the support is there. For example, Pathways Horizon is an observational study of all children and young people attending NHS children and young people’s specialist gender services. Pathways Connect is a brain imaging study, Pathways Voices will interview young people, and Horizon Intensive is about ensuring that there is a comparison group of 300 participants who are expressing gender incongruence. Furthermore, NHS England has opened three new children and young people’s gender services in the north-west, London and Bristol, with a fourth planned for the east of England this year. I can confirm that the Government aim to have a service in every region of England in the coming years. These services use a different model with multidisciplinary teams, including mental health support and paediatrics, within specialist children’s hospitals to provide holistic care. The new services will increase clinical capacity and reduce waiting times so patients can be seen sooner and closer to home. I can update the House that waiting lists for children and young people’s gender services have come down since this Government took office. As of April, nearly 3,000 fewer children and young people were on the waiting list compared with September 2024. This Government stand by the principle that we will always be led by clinical advice and clinical evidence, but that does not mean we take these decisions lightly, and it does not mean that we are abdicating our responsibilities either. My right hon. Friend the Secretary of State has requested monthly updates on the progress of the trial, including any emerging risks. Throughout this process, he has immersed himself in the detail, scrutinised the issue and sought the strongest assurances from his most senior clinical advisers. We have received those assurances and are proceeding on the basis of evidence, not ideology. I end with regret that it appears that the cross-party consensus on Dr Cass’s expert review has been lost, but also with hope that colleagues can get behind Dr Cass’s work again. We will move forward on the basis of taking decisions based on the expertise of clinical and medical professionals, and acting within clearly defined safeguards and robust oversight, including in this House, to provide the best quality of healthcare and support for all children and young people to access what they need. On one level, this is a specific debate about a specific issue, but when we zoom out, we see that it goes to the heart of what our NHS is about, which is how best to do the greatest possible good for the greatest possible number of people. When we look at this through that basic ethical prism, there can be no doubt that this Government’s position is the right one. A small cohort of vulnerable children are struggling, and it is our job to help them—it really is as simple as that. I therefore urge colleagues to oppose the Opposition’s motion. Question put.
I rise to support clause 7 and amendment 33, tabled by my hon. Friend the Member for Worthing West. Having worked in the NHS for many years, I have seen that education and training, especially mandatory training, is absolutely necessary. Some may argue that health staff have too much training, particularly mandatory training, but this amendment specifically concerns training “in the wider determinants of health such as housing standards, exposure to air pollution, occupational risk, and use of harmful substances like tobacco.” We may have staff, especially those working in mental health, who have training in some of those areas, but staff in A&E, where patients first present, may not have that training, and may be missing that curiosity. We have heard many incidents involving families living in mouldy houses or people exposed to air pollution. It is important that staff have the curiosity to consider where a patient has come from when they turn up at A&E, or, when planning a discharge, where they are being discharged to. In the last few years, we have seen many internationally trained healthcare workers join our health sector who may not be familiar with the social and housing situation in this country. Whether this is to be a part of their initial training as nurses or doctors, or through mandatory training at work, the amendment is important because it could help to prevent illnesses and identify them earlier through professional curiosity. I support amendment 33.
I strongly support the argument that clinical staff, even if they progress into a senior role, should carry out some sort of clinical practice. Does the hon. Lady agree that that is what went wrong over the past few years, especially when NHS England was created? Many senior clinicians who were moved into management posts had no contact with clinical areas. That is what this Government are trying to fix by abolishing NHS England.
It is a pleasure to serve under your chairship, Sir Jeremy. I am very grateful to my hon. Friend the Member for Bristol East (Kerry McCarthy) for securing this debate. I pay tribute to her long-standing work on climate and environmental issues, and to her generosity in sharing with us her experience of “squelching” in the Indonesian peatlands. Her account, alongside the contributions of other hon. Members who have also recently visited Indonesia, brought to life the richness of the environment in the country, and therefore the importance of our work together on climate and nature. I am also grateful for the thoughtful contributions of hon. Members from across the House in speeches and interventions today, including by the shadow Minister, the hon. Member for Fylde (Mr Snowden); the Liberal Democrat spokesperson, the hon. Member for South Cotswolds (Dr Savage); my right hon. Friend the Member for Oxford East (Anneliese Dodds); my hon. Friend the Member for Leeds Central and Headingley (Alex Sobel); the hon. Member for Strangford (Jim Shannon); and my hon. Friend the Member for Brent West (Barry Gardiner). I recognise that this is a very timely and important debate. It comes just a few months after my first visit to Indonesia. I am very grateful to our climate and nature special envoys who were referred to in this debate, Rachel Kyte and Ruth Davis, for their extremely important work and their contributions to many discussions with Ministers across different Departments. There is a very strong interest in this House in how we tackle climate change and protect nature, and in how we work with partners around the world to do so. With Indonesia, the core of our partnership is focused on climate, nature and energy co-operation. It is also important to say up front that Indonesia is pivotal to global outcomes on climate and nature for the reasons that we have heard today, including the scale of its rainforests and biodiversity. Indeed, its actions on energy, forests and oceans will help to tackle similar challenges across the world. I also pay tribute to the work of my hon. Friend the Member for Bristol East as the UK’s Climate Minister last year, during which time she visited Indonesia. I know that she saw at first hand how our partnership with Indonesia works in practice. In Jakarta, she met Energy Minister Bahlil. She worked to deepen our co-operation on the energy transition—from renewables to carbon capture, carbon markets and critical minerals, all of which were referred to in today’s informed debate—recognising the real economic and political challenges that Indonesia faces as it moves away from coal. I am proud that she launched a UK-supported micro-hydro project in Lombok, demonstrating how we are working alongside Indonesia to support clean, reliable energy at a community level. That combination of high-level policy engagement and practical delivery is central to our approach across climate, energy and nature, and we continue to build on that through our ongoing dialogue with Indonesian partners. Indonesia stands out as one of the most important countries in the world for climate and nature. It is home to the world’s third largest tropical rainforest basin and has rich marine ecosystems that store carbon and support extraordinary biodiversity. It is a major emitter and a major part of the solution. As a G20 economy and a leading voice in the Association of Southeast Asian Nations, Indonesia has influence well beyond its region. Its economy has long depended on sectors such as coal and palm oil, and like many countries it faces difficult choices as it seeks to balance growth with environmental protection. At the same time, Indonesia has committed to reducing emissions and is taking steps on forest protection, clean energy and climate finance. This Government are clear that global challenges such as climate change and biodiversity loss can be tackled only through partnership, because no country can do this alone. I will endeavour to respond to a number of comments raised today. My hon. Friend the Member for Leeds Central and Headingley will be aware of concerns about Mama Yasinta. We take seriously all reports of human rights violations across Papua. We are concerned about the recent increase in violence in Papua, including fatalities. I visited Indonesia in February and underlined the importance that the UK attaches to human rights. I raised the issue of Papua directly with the vice Foreign Minister. I also want to refer to the UK’s approach to supporting orangutans, which is twofold: to decrease the drivers of orangutan habitat loss and to support the mobilisation of finance for habitat conservation. An important example of sustainable commodity production is the multi-stakeholder forestry partnership phase 5, referred to earlier. That programme is helping Indonesia to strengthen the sustainability and legality of its timber production, ensuring that pressure from the forestry industry is managed sustainably. That is relevant for habitats across Indonesia, including the ecosystems of Kalimantan and Sumatra that are home to Indonesia’s orangutans. Threats to Indonesia’s maritime environments include pollution; illegal, unreported and unregulated fishing practices; and warming waters linked to climate change. The UK and Indonesia continue to work closely with each other through the Blue Planet fund country plan. We are proud to partner with Indonesia through that fund and the maritime partnership programme. A number of hon. Members referred to the maritime challenges, and it is important to keep that focus in our debate. In relation to the UK’s action, we have worked closely with Indonesia for more than 20 years, combining diplomacy, technical support and targeted finance to tackle environmental and nature issues. Indeed, what started as co-operation on sustainable timber has grown into a wider partnership. Hon. Members also referred to the important engagement earlier this year when the Prime Minister and President Prabowo Subianto agreed a new strategic partnership. The ambition for climate, energy and nature was clear at the Lancaster House breakfast, which I attended, where President Prabowo and His Majesty the King came together with a vision for Indonesia as a global leader in sustainable nature finance. We are now taking that important ambition forward in practical ways. For example, we are supporting efforts to protect forests and tackle deforestation, including in supply chains such as palm oil. We are backing Indonesia’s energy transition, including through a just energy transition partnership. We are committed to providing a guarantee to unlock $1 billion of additional climate finance from the World Bank to support the energy transition. That is important because we know that Indonesia has to fill a significant climate finance gap to meet its mitigations and adaptation goals.
I am happy for the hon. Lady to write to me to ask about the specifics because there are different funds, some of which are already deployed and some of which will continue in the future. If she would like to know more about specific funds, we can probably answer that. It is also important to recognise that we are supporting efforts to strengthen governance and ensure that communities, including indigenous peoples, are part of that transition. I am grateful to my right hon. Friend the Member for Oxford East for referencing the engagement and the rights of indigenous peoples.
My hon. Friend raises an important point and I am happy to pick that up with colleagues. When we look at sustainability, we should also recognise the role that indigenous peoples play in supporting the environment and climate. As I have referenced, it is important that we raise concerns about deforestation, supply chains and the pace of change. These are complex issues, particularly in countries like Indonesia, where commodities such as palm oil and timber are central to growth and livelihoods. As my hon. Friend the Member for Bristol East referred to, the Government announced today that the UK is introducing a new approach to deforestation regulations to help to ensure that our consumption does not drive global forest loss. That will require businesses to strengthen due diligence and improve traceability in their supply chains. As my right hon. Friend the Member for Oxford East outlined, we are clear on that goal, but we also recognise that it must be done in a way that supports rather than undermines our partners. The UK has worked closely with Indonesia on sustainable forestry and supply chains for many years, and we will continue to engage and work in partnership with Indonesia and other partners as the policy develops to ensure that our approach reflects local contexts, is proportionate and supports sustainable growth, alongside forest protection. Representatives from the Indonesian Government are in the UK this week for London Climate Action Week, to meet representatives from across the UK’s Government, private sector and civil society. This is an important and landmark week, during which we can share the full extent of the UK’s ambitions on climate and energy with partners across the world. I am pleased that on Thursday morning, the Indonesian Minister of Forestry, Raja Juli Antoni, and I will co-host a roundtable at the FCDO to showcase the Peusangan elephant conservation initiative: a flagship model under Indonesia’s new presidential taskforce to develop innovative financing for national parks. That is another initiative that demonstrates how conservation, livelihoods and finance can be brought together in incredible, investable opportunities. To conclude, the UK-Indonesia partnership on environmental sustainability is wide, ambitious and rooted in practical co-operation. It spans forests, wildlife, cleaner energy, ocean protection and support for communities whose lives depend on the natural world. The partnership is backed by strong political commitment on both sides, and is supported by growing engagement between Governments, businesses and civil society. We know that the scale of the challenge is significant, and that progress will take time. Like all countries, Indonesia will need international support to meet its commitments, and the strength of our partnership gives real grounds for confidence. Under Labour’s leadership, the United Kingdom will continue to share investment and practical support with Indonesia, because the choices that we make together will help to shape a safer, more secure and more prosperous future for both of our countries.
It is a pleasure to serve under your chairship, Sir Alec. The shadow Minister asked whether this is really what Members came here to do, and I can say that I genuinely and literally came to this place to do this, so I am delighted that we are doing it. I was one of the people who joined Pregnant Then Screwed in its #Givemesix campaign against maternity discrimination. I spent years practising in employment tribunals, and I saw very large numbers of women with maternity discrimination claims and people with discrimination claims of all types. There is a huge problem: 74,000 women a year are estimated to lose their job while they are pregnant or on maternity leave, over and above what would otherwise be expected for their demographic. This absolutely enormous problem is affecting our national productivity, with so many women falling out of the workplace after they have children. When women have just had a baby and suddenly lose their job, they have very limited money because statutory maternity pay is extremely limited—it is awful—so they cannot afford legal advice. They also have a tiny baby, so bringing legal proceedings is not something they are seeking to do. It often takes them a long time to seek advice about their situation. Women are regularly being ruled out of bringing perfectly legitimate claims for the widespread problem of discrimination. I gently remind the shadow Minister that his Government failed to recruit any employment tribunal judges from 2010 to 2018, and that is how we ended up in this mess. We have no pipeline of people coming through who have seniority. This Government recommenced the recruitment of judges, and, to be fair, at the very back-end of the last Government there was some realisation of the catastrophic mess that had been generated in the employment tribunal system. It is not in employers’ best interests for the system to be run down, and it is not in employers’ best interests for us to assume that the best thing for employees is to insist that they have no rights and are unable to enforce those that they have. None of those things make business better in Britain; what they do is level down so that the worst employers are enabled to get away with misconduct while penalising those who do the right thing. I literally came here to do this. I have campaigned for this for years, and I could not be more pleased to see it happen, because what I think we will see is that good employers have absolutely nothing to fear from these measures. Good employers are the ones who are taking the time to deal with grievances properly, and that takes more than three months. At the moment, we are seeing people being pushed to bring claims to protect their position far too quickly, which pushes them into an adversarial process that is not in their best interests or employers’ best interests, and it is potentially enabling unscrupulous employers to find ways to get people to time-out by unduly elongating the process. I absolutely support these measures, and every Labour Member should be proud of them. I want to say a huge thank you to Pregnant Then Screwed for the campaigning it has done for many years. I am really proud to be here today.
It is a pleasure to follow the hon. Member for Mid Sussex (Alison Bennett). I wholeheartedly agree with her points about the importance of talking therapies. Those are incredibly important tools for children who are in gender distress. We need to see greater access to talking therapies for all children in a timely fashion. May I first say that there is far too much debate about trans people without them? We would not tolerate this in any other debate. Yet somehow, whether in the media or in politics, in debate after debate—online, in the media and in this place—we talk about trans people and people in gender distress without acknowledging that we are lucky to be born into a body we identify with. I will never know the pain of gender distress. There are times when I look in the mirror and I think, “God, I wish I could change this.” Usually, I wish I could not look so tired, but I do not know what it is like to not be in a body that I identify with; I am fortunate and therefore speak from a position of great privilege. I will start with the words of one of my constituents, an 83-year-old trans woman called Teraina. She said, “I was born a male but I have never been a man. I tried but I failed. I always have felt female. Even at school as a boy, I was bullied for being”—in her words—“a ‘sissy’ so I left. I am 83. I have lived my life. This is about the future generations and the others who come next.” Teraina discharged herself from hospital to have that conversation with me because she feels so strongly about future generations: that they should not be bullied for who they are; that they should be able to access treatment; and that they should be able to be who they are. We must get this right for the future generations of people like Teraina, because too many have lost their lives, or have suffered, living a life that was not fully theirs. It is fair to say that there is a varied range of views in the Cass review. However, if future access to treatment for gender dysphoria is dependent on more research, it is vital that the Pathways trial goes ahead with the additional safeguards now put in place. Whatever one’s views on the trial, it is clear that every step has been taken to put the safety of patients at its heart. It has been designed by experienced clinical researchers and checked by independent scientists who advise the National Institute for Health and Care Research, and has included independent academic peer reviewers. As with all clinical trials, this one will be overseen by the data monitoring committee, as the safety and wellbeing of those taking part is vital. All those safeguards should be welcome. After all, those people are the experts when it comes to the medical procedures and the science. The experts when it comes to individual children, however, are the parents. Both today and yesterday, some of the rhetoric around the statement has ignored the important role of parents in the trial.
Absolutely. I thank my hon. Friend for his commitment to the LGBT+ community and for his work, including with his constituents. We have heard a lot today about throwing children into wild experiments, but that is not what we are talking about. We are talking about something done in collaboration with parents—parents who love their children and want the best for them, and with medical professionals who want the same. The rhetoric around the trial really needs to change. No child will be able to take part in the trial without parental consent. That has been confirmed again by the Secretary of State from the Dispatch Box. Of course, there will be some children who will never gain their parents’ consent: a heartbreaking situation for any family. However, there will be many parents who will truly support and know the wishes of their child; they will agree with the suitability of the treatment and want to support them on their journey. Much has been discussed about the child, but parents have huge agency in the process. We are not just talking to the children; we are talking to adults who want the best for their child, and that point should be recognised.
I thank the hon. Member for his intervention and his kind words at the beginning; that is the right tone, which we need to set, and information is key. People need to be able to make informed decisions—whether it is the child or a parent—and there needs to be independent information so that people can make fully informed decisions.
I thank my hon. Friend for his powerful intervention; absolutely, information and scientific evidence are key, and this trial will be conducted by experts with patients’ best interests at heart. We have heard from the Opposition spokesperson, the hon. Member for Sleaford and North Hykeham (Dr Johnson), and I am sure that, as a doctor, she cares about her patients as much as all the doctors and clinical specialists that will be involved in these trials. Last year, the Women and Equalities Committee held a one-off inquiry into the safety and effectiveness of puberty blockers. We stuck to the science. There were different views on our panel of witnesses, but I wanted to demonstrate something that has, sadly, not happened very often around this topic, which was that we could discuss it in a sensitive, respectful way, based on fact, not opinion—not for social media clips or for likes on a particular outlet’s sidebar of shame, but for the good of the people we represent. We also examined the use of puberty blockers for other medical purposes—something that has not been discussed today when talking about the risks, or perceived risks, of puberty blockers. It is commonplace to use puberty blockers for certain cancers, for endometriosis and for children experiencing premature sexual maturity, also known as precocious puberty. When it comes to cancers such as prostate cancer, the professors on the panel described the need to essentially “turn off” testosterone. This is now a commonplace treatment for prostate cancer. Another use of puberty blockers is for endometriosis. We already know the disgraceful delays in diagnosis and treatment for endometriosis and adenomyosis, with women waiting at least 10 to 13 years just for a diagnosis. They are living in pain for far too long, but experts are using puberty blockers, again, to essentially “turn off” menstruation and oestrogen for women with severe endometriosis.
I know that further details will be coming from the Secretary of State as to what a marker of success is, but I think we have to ask ourselves what a marker of success is for the individuals and families. For some, staying in their sex from birth may look like success. For others, that will not be the case. This is very much on the individual.
I will not; I am going to make some progress, as I have been duly told to do. The treatment of premature sexual maturity, or precocious puberty, in children—this is for children—uses puberty blockers now. The professors reported to our Committee that puberty blockers are “recognised as a reversible treatment.” Professor Butler added that we know “from follow-up studies with children who have received it for precocious puberty that there are no ill health effects in the long term nor are there any negative effects on fertility recovery.” Professor Grossman pointed to a “huge amount of evidence” from Harvard University highlighting successful treatment and outcomes for girls prescribed puberty blockers for premature sexual maturity “in terms of fertility and their subsequent life.”
I am not going to take any more interventions, as I have been told that I need to crack on. These puberty blockers are the same drugs, prescribed in the same way, but instead of treating gender distress, they are treating prostate cancer, endometriosis and premature sexual maturity in children. Yet we have heard no call from scientists, campaigners or the medical community to stop the use of puberty blockers for those treatments. Some have been critical of the trial going ahead, but what happens to young people experiencing gender distress if it does not? Dr Hilary Cass believes that without a trial, young people will continue to get drugs from “unregulated and dangerous routes”, and my Select Committee heard evidence to support that. Unfortunately, young people are now self-treating because they see no other option. They are getting hold of medication from abroad, with no assessment, support or medical advice. Dr Hilary Cass was right to say that she is “absolutely convinced that more children will be harmed if we don’t do the trial than if we do.” For me, safety is paramount, but this is an issue of access to healthcare, and there should never be a block to healthcare for anyone. While the trial goes forward, many young people, younger and older, will be scared and frightened about what the future holds. I hope that the Secretary of State can address the hostile environment for young trans people, as well as what support outside of legislation and the medical world needs to be more widely available for people in gender distress and the entire LGBTQ+ community.
T8. My constituency has been extremely lucky in getting £20 million for Glascote Heath and Stonydelph under the Pride in Place programme, which gives local people the ability to choose how the funding is to be spent. Will there be more rounds of this funding or similar schemes so that local people can be put in charge of how their money is spent?
Everyone should have the right of access to high-quality, evidence-based healthcare, whatever their age. At the heart of this debate are young people experiencing profound gender-related distress, and the families who support them. Too often they have found themselves caught in the middle of a political argument while facing long waits, uncertainty, and a lack of clear treatment options. Every young person deserves compassionate, evidence-based care, and that includes transgender young people and children with gender incongruence. The irony of the Opposition motion is that it would stop the very research that many Members have argued is necessary before decisions about treatment can be made. If we are serious about evidence-based medicine, we must also be serious about gathering evidence. The Pathways trial follows a recommendation made by Baroness Cass in her independent review, a recommendation that had enjoyed cross-party support when it was published. Since then the trial has undergone extensive scrutiny by researchers, ethics committees, independent reviewers and regulators. Following further modifications and additional safeguards, it has been approved by both the Medicines and Healthcare products Regulatory Agency and the Health Research Authority. If Members believe that more evidence is needed, surely they should support a process that is designed to produce that evidence. Much has been said about risk, and of course risk must be taken seriously, but the answer to uncertainty cannot simply be to refuse to learn more. The answer is careful, closely monitored research with robust protections. Participants must have experienced gender incongruence for at least two years, must already be receiving NHS gender services, must have undergone psychosocial support, and must be assessed as being physically and mentally stable. Both the young people and their parents must consent, and every participant must be approved by clinicians and a national multidisciplinary team. This is not an uncontrolled experiment; it is a tightly regulated clinical trial operating under some of the highest standards of oversight that are available in modern medicine. The hon. Member for Reigate (Rebecca Paul) made a valid point about the need to ensure that children who realise that they are gay do not decide that they are transgender, and that we do not feel that we should push more gay people back into the closet, as they are feeling very much under threat at present. However, there is another risk that we must discuss, and that is inaction. For two years, puberty blockers have effectively been unavailable outside research settings. Young people and their families have been told repeatedly that more evidence is needed, and now, when a trial designed to generate that evidence is ready to proceed, some seek to stop it. What message does that send? Behind every statistic is a family. Parents of transgender children and children with gender incongruence often speak of the distress of watching their child struggle and feeling powerless to help. They see anxiety, fear and growing distress as their child experiences physical changes that can feel deeply uncomfortable and alienating. These families are not political talking points; they are looking for support, answers and hope. For many transgender young people, puberty itself can be a source of profound distress. We should not pretend that doing nothing is a neutral act, because delays, uncertainty and the absence of treatment options have consequences too. Puberty blockers have generally been understood as a reversible intervention intended to pause puberty and provide time for further assessment and support, and the purpose of this trial is to strengthen our understanding of both the benefits and the risks. If opponents argue that more evidence is needed, blocking the research that would provide that evidence is a contradiction that this House should reject. I also want to address something that often sits beneath debates such as this. If you come to this debate from the position that transgender people do not exist or that it is a fad, you are mistaken. Transgender people have always existed, and they deserve the same dignity, compassion and evidence-based healthcare as anyone else. If, as I believe we all do, we come to the debate motivated by concern for children’s safety and wellbeing, how can we say that we are protecting children while being comfortable with them living in fear of the changes that puberty may bring? How can we say that we are acting in their best interests when some young people are terrified of growing into an adult body that does not align with who they understand themselves to be, while parents watch helplessly from the sideline? If our goal is to truly safeguard children, we should support careful research, rigorous oversight and evidence-based medicine. We should seek answers, not prevent them. We should reduce uncertainty, not prolong it. That is why this trial should proceed.
Does the right hon. Member share my concern that because of the speed at which big tech moves, we in this House as legislators always seem to be five steps behind where the technology is? How are we going to be able to regulate for a world that is faster paced than we are in this building?
On cyber-security, in recent weeks the US Government have decided to block Claude’s new AI software, Fable 5. What are my hon. Friend’s thoughts on new AI software and cyber-security?
I must confess that Opposition days are beginning to feel a little bit like groundhog day. A party that largely sat on its hands during some of the most significant and difficult challenges is now returning to tell us where this Government are going wrong, and doing so with all the fervour of a party that has never held power, let alone governed for 14 years. Just to warn everyone, I will not be taking interventions. This is a deeply emotional issue, and I recognise that it provokes strong and differing views across the House. I am not here to shout down or dismiss any perspective. I have never had to face this decision myself, either as a parent or as a young person. It is a decision that invites intense scrutiny and judgment, often unfairly casting those involved as villains for doing what they believe is right for a child. We would all do well to remember that we can never truly know what it is like to walk in someone else’s shoes. Too often, this debate has been shaped by vilification and misinformation, much of it amplified by opposition voices and anonymous social media accounts, to the detriment of one of our most vulnerable communities. We hear the warped suggestion that people simply wake up one day and decide on a whim to embark on years of hormone treatment, to face discrimination and to fight for legal recognition, or, worse, that clinicians involved are reckless experimenters intent on subjecting vulnerable children to harm. The Conservatives are, of course, entitled to their opposition, but what alternative are they actually proposing? As usual, they have found an apparent problem, but where is their suggested solution? Is it to return to a time when children experiencing gender incongruence were ignored or dismissed as an inconvenience? That approach belongs to the era of section 28, not to 2026. If their answer is an outright ban, they risk driving vulnerable young people into what Dr Hilary Cass has described as “unregulated and dangerous routes.” We are already seeing reports of children presenting at clinics having already accessed irreversible treatments at a very young age. The outrage we hear today about so-called experimentation rings hollow when it is accompanied by no viable alternative, only a return to the same vacuum that previously existed. I do not suggest that this trial will provide all the answers, but it is undeniably better than turning our backs on a complex reality and leaving young people without safe, supported options.
I will not, I am afraid—I did warn you, although I do like the hon. Gentleman very much.
Not enough to give way. If we cannot trust Dr Hilary Cass, the author of a report that the Conservative party itself has endorsed, when she says she is “absolutely convinced that more children will be harmed if we don’t do the trial than if we do,” who exactly are we prepared to trust? Do we follow the evidence, the clinicians and the science, or do we retreat into denial, burying our heads in the sand and pretending that trans people do not exist and have never existed? The process the Government have chosen to follow is not reckless; it is rigorous. The MHRA and King’s College London have undertaken detailed scientific scrutiny, and a revised protocol has been agreed that meets the highest regulatory and ethical standards. That is exactly what responsible, evidence-led policymaking looks like. It is up to us to decide what kind of Parliament we want to be: one that confronts complex and sensitive issues with care, compassion and evidence, or one that turns away, leaving vulnerable young people to navigate these challenges alone and in the shadows. For me, the choice is clear: we owe it to those young people not to look away, not to inflame and not to exploit, but to act, guided by science, led by compassion and grounded in responsibility. I am once again proud to be part of a Government who are doing just that.
The Government recognise that energy costs, inflation and global pressures continue to squeeze household budgets. That is why we have taken careful, targeted action through the great British summer savings package which launches on Thursday, cutting VAT on summer activities so that adventure parks, soft play centres, cinemas and theatres will be cheaper, alongside the work we are doing to maintain the triple lock and to lift children out of poverty.
The measures I took in my Budget last year took £150 off energy bills by getting rid of some levies altogether and moving others to general taxation. If we look at the most recent inflation numbers, inflation in the UK was 2.8% last month, which compares to 3.2% in the eurozone and 4% in the US. Food inflation was at its lowest rate for 17 months.
As my hon. Friend knows, we are investing £3 billion in local bus services to both improve the service for passengers and freeze bus fares until at least March next year. This summer there will be unlimited free travel for children aged between five and 15 in his Cannock Chase constituency and across the country. I also give a special shout-out to my mayor, Tracy Brabin, for the beautiful Weaver Network of electric buses, manufactured in Northern Ireland and Yorkshire, and serving the people of West Yorkshire.
The Government remain dedicated to raising living standards for people in Falkirk and across the UK by driving economic growth and bearing down on inflation, which I know continues to squeeze household budgets. Measures announced in my Budget last year are already taking effect: raising the national living wage and the national minimum wage; maintaining the triple lock on pensions; and extending free school meals to more families. Our great British summer savings package builds on that, reducing VAT on a whole range of summer attractions, including, I believe, Airthrill in my hon. Friend’s constituency.
We timed the great British summer savings so that they start on the first day of the Scottish school holidays and continues to 1 September, when children in England, Wales and Northern Ireland return to school. We hope that the scheme has a big impact on families around the country, alongside the free bus travel in England in August. We did not start the war in the middle east, we did not join it, and I have been clear about my views on it, but the war is clearly having consequences here at home. We will continue to monitor the situation and take every action necessary to support families.
The Treasury published the Green Book supplementary guidance on wellbeing, which helps officials to assess how their policies and projects affect the wellbeing of citizens, in 2021. In February, this Government published an update to the Green Book that reaffirms the importance of considering wellbeing. Most importantly, my new Green Book will support fairer and more balanced decisions on investment in every part of the country, including outside London and the south-east, across urban, rural and coastal communities, so that projects have a better chance of securing Government funding.
I will ensure that the relevant Minister meets my hon. Friend and others to discuss how we can make further enhancements to the Green Book. Something that has held Britain back for too long is that projects outside London and the south-east, including in rural and coastal communities, have missed out on funding because of the way in which the Treasury used to evaluate those projects. I have changed those rules so that we can make investments in all parts of the United Kingdom.
I am pleased to update the House that I met the Secretary of State for Defence and the Chief of the Defence Staff yesterday to talk through the defence investment plan. The Ministry of Defence is producing a defence investment plan that will meet the scale of the challenges and meet the moment with increased readiness. I am confident that the new defence investment plan will be published before the NATO Ankara summit. It will involve more money spent more effectively and will meet the scale of the challenges facing our country.
As I just said, the DIP will be published before the summit. It will involve more money spent more effectively, and it will meet the scale of the challenges we face. Frankly, I will take no lectures from the Conservatives, who left our armed forces, in the words of their former Defence Secretary, “hollowed out”. Our forces hit rock bottom for pay, morale and numbers. The Tories do not like to mention the £12 billion of cuts that they made to defence in their first five years in office. We are turning that around with the biggest uplift in defence spending since the end of the cold war. This Labour Government will continue to invest in defence, with contracts awarded to firms here in Britain to keep our country safe.
I thank my hon. Friend for her question. As Members will know, this Government are working on plans with our NATO allies for a multilateral defence mechanism. We have already signed a treaty agreement with Finland and the Netherlands, and we are working closely with Scandinavian, Baltic and eastern European countries. The multilateral defence mechanism will enable us to procure jointly and stockpile equipment off the balance sheet, ensuring better value for money for taxpayers and enabling innovative forms of finance to fund our defence. We are also working closely with Canada on the multilateral defence mechanism and the Defence, Security and Resilience Bank, which lends to smaller businesses in the supply chain, so that we have one model to help us better fund defence in our country and across Europe.
The hon. Gentleman is literally sitting two places away from the right hon. Member for Central Devon (Sir Mel Stride)—the former welfare Secretary who presided over a record increase in welfare spending. We have commissioned Alan Milburn to do a review—the first part of which was published recently—to address the problem that we inherited of young people not in employment, education or training and get young people back into work. I am proud to be the Chancellor who has overseen the biggest uplift in defence spending since the end of the cold war. We funded that through our difficult decision to reduce overseas development assistance, but that was the right choice. When we set out the defence investment plan ahead of the Ankara NATO summit, the whole House will see the further changes we are making in order to better support defence in an increasingly unstable world.