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Labour Party
Latest entry 11 Nov 2026
Conservative and Unionist Party
Latest entry 11 Nov 2026
Liberal Democrats
Latest entry 11 Nov 2026
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Green Party
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Showing every spoken contribution, including 12,942 under 12 words. Hide short remarks
As detailed in “Post-16 pathways: implementation plan”, we are creating coherent pathways, aligning learning with the skills that employers need and improving progression. New V-levels, the expansion and improvement of T-levels, and clearer level 2 pathways will support young people’s progression to higher study, apprenticeships or employment.
I thank my hon. Friend for drawing the House’s attention to Bucks College Group and the work it does in her constituency. FE colleges have autonomy over staff pay. We have provided an additional £190 million for colleges and 16-to-19 providers for this financial year, which is broadly equivalent to the schools pay award. We have also set out positive new developments on FE teacher training support.
I thank the right hon. Member for the question and the serious spirit in which he asks it. We are providing £9 billion of funding for 16-to-19 programmes in the 2026-27 academic year. We are making a wider range of changes to further education support, qualification routes and apprenticeships to directly respond to the kinds of criticisms from providers and employers that he refers to, and I genuinely believe that the Government have got that right. If there are particular aspects that Alex Miles wants to write to me about, I will be happy to take a look.
We are investing almost £20 billion in the school rebuilding programme to rebuild over 750 schools up to 2034-35. Some 500 of those are already in the programme—we have a further 250 to select, which we will do later this year.
Despite those delays, I can confirm that the school will be considered for the school rebuilding programme, despite those avoidable delays. I thank my hon. Friend for his continued advocacy, both raising it personally with me on a number of occasions and writing to me on multiple occasions.
Yes, I can do that.
The Secretary of State has repeatedly told us that he feels uncomfortable and uneasy. If I am totally honest, I do not think that he believes that this is right at all. I think that in his heart, he knows that this is wrong. Of course it is wrong: stopping an 11-year-old—a primary school child—from going through the natural process that we must all go through to become adults by injecting them with drugs is wrong. We must think about the title of the statement: puberty suppression. People do not need a medical or a science degree to know that the suppression of puberty is wrong. This is a moral question and I am afraid that as it stands the Secretary of State is on the wrong side of it. He says “let them be”—if only they had let Keira Bell be. When she had the treatment, Keira Bell was much older than these children will be when they are given it. She regrets it all and now campaigns to stop this. There is huge public opposition to this—
There is huge opposition to this among people who vote Labour, including many of my constituents, so I implore—
The St Ralph Sherwin Catholic Multi Academy Trust, which runs a number of schools in Derbyshire and Nottinghamshire, is facing extreme financial difficulties despite the considerable extra support that it has received from the Department for Education. We east midlands MPs have written to the Department, but perhaps Ministers could find out whether there is anything else that we can do, and also look at the academy funding model more generally, because the built-in financial risk undermines the education of our children at times.
I thank my right hon. Friend the Secretary of State for her statement. I associate myself with her condolences to the driver’s family and her remarks on those who were injured, and offer my thanks to those who responded from the emergency services, those in the NHS who continue to provide care and treatment and the railway staff. I welcome my right hon. Friend’s saying that she will heed the RAIB’s recommendations and consider them carefully. Many of my constituents use that stretch of railway. I note that there is a recommendation not to travel unless it is essential, but some, including key workers, may have to use the railway and travel on alternative lines. I am conscious that there may be extra pressure on those lines and that, particularly in this hot weather, tempers sometimes fray on the railway. I would be grateful if the Secretary of State could keep the situation on the neighbouring lines under review to ensure that there is capacity and that there is support for the staff working on those other operators, if they need it.
I thank the Secretary of State for the considered way in which he has delivered his statement. In December 2025, The BMJ reported that “the Pathways trial should wait for findings from former patients treated by GIDS between 2009 and 2020” and that “A data linkage study of 9000 patients, now adults, has full HRA approval, and NHS England has encouraged gender clinicians to cooperate, describing it as an opportunity to gather ‘high quality evidence.’” But The BMJ reported that the clinicians “refused to share their data”. Hilary Cass said that was “extraordinary”. Can he tell us whether all the data that is out there is available and whether it is being shared appropriately?
When I was elected nearly two years ago, the very first person to contact me was a BCSSS member. There are about 750 BCSSS members in my constituency, and the campaign has certainly been part of my heart ever since I was elected. I know that many BCSSS members will be watching tonight and listening to the debate, and I am sure that the stories you tell will ensure that they are—
May I take this opportunity to reassure those BCSSS members that, whoever is the next Prime Minister, this issue will continue to be the No. 1 issue for most of my colleagues and the Members here today?
1. What steps her Department is taking to improve the nutritional standards of school food.
Mr Speaker, I know that looking at me you would never guess that my children are now well past school age, but when they were at school—long past Jamie Oliver’s campaign against turkey twizzlers—the school food served was still not as healthy as it should have been, so I am delighted by the Minister’s assurance that the Government have consulted on the first update to school food standards in a decade. I am, however, slightly puzzled by the phased approach to improving the drinks served in secondary schools until September 2028. Will the Government consider speeding up the timetable and moving towards alignment with primary schools, so that we do not miss a crucial opportunity to improve the health of our young people?
T6. In Kent, the county council has adopted a community of schools model for the allocation of high-needs funding, but schools in Dartford are concerned that that has led to a situation in which access to funding is unfair, inconsistent and unpredictable. It has left them unable to plan for the future, because they cannot be confident about how much funding they will receive. Will the Minister look at the model that Kent county council has adopted to ensure that it conforms with the high-needs funding operational guidance and the dedicated schools grant condition?
I join the Secretary of State in sending condolences to the family of Shaun Burton, who died in the accident, in wishing those who are injured a speedy and full recovery, and in thanking the emergency services for their prompt action on Friday. It is important that we have heard from the Secretary of State that a full investigation is ongoing and that all lessons will be learned in order to avoid a repeat. Can the Secretary of State reassure my constituents that the disruption to Thameslink services south of the Thames, arising from the partial line closure, including temporary interruption of services from Rainham through Dartford to Luton, will last no longer than is necessary for the full investigation to take place?
This morning I had the honour of taking part in the flag raising ahead of Armed Forces Day in Thurrock in my home patch. I reflected that while the impact of service is one of pride, there is also a big impact on the families of the men and women who bravely serve our country, and particularly on those with special educational needs and disabilities. What measures is the Secretary of State taking to ensure that when a child with SEND follows their parent due to their military service, they are not adversely impacted?
Will the right hon. Gentleman give way?
It is not, actually, although I can always talk about the Royal Fleet Auxiliary in the context of clause 31, in which it is brilliantly included and which will give the RFA a commissioner at last, which is fantastic. May I ask the Minister to confirm—because I have had some correspondence about this—that clause 2 covers unitary authorities, single foundation strategic authorities and borough councils outside outer London? Some members of the Local Government Association have raised that with me. Will the right hon. Gentleman confirm, just for clarification, that those authorities are covered by the duties in the covenant?
I also echo the Deputy Prime Minister’s remarks about the Prime Minister and his service to our country. Does my right hon. Friend agree that Israel must allow aid into Gaza, stop settlement expansion in the E1 area of East Jerusalem and tackle settlement violence, and that the G7 must use this moment to ensure that Palestinian people have the resources they need to rebuild their country?
A couple of my constituents with direct experience of SMA got in touch with me. The thing that they identified as being most difficult about the current arrangements with the in-service evaluation is the lack of detail about how long it will take. Does the hon. Lady agree that if the Minister could provide a level of clarity about the length of time that the ISE will run, that might give us the sense that there is forward momentum on this issue?
I thank the Deputy Prime Minister for his update on a range of issues from the G7 summit. Could he set out how the Government’s work to de-escalate things in the middle east will help families in Britain and my constituency, specifically when it comes to protecting shipping routes, reducing energy pressures and keeping prices down?
On behalf of my constituents in Rushcliffe in Nottinghamshire, I express my condolences to the family of the deceased driver and to all those involved, and give my thanks to the emergency services. This was particularly poignant, as my officer manager’s 12-year-old nephew, Arthur, was in one of the middle carriages. He sustained injuries, but thankfully he has come out relatively unscathed. May I press the Secretary of State to confirm that those investigating the crash will be resourced appropriately, so they can ensure the investigations are concluded as quickly as possible?
I welcome confirmation that the Pathways clinical trial will continue with the modified protocols in place; it was an important manifesto commitment for the trans community. Does the Secretary of State agree that it might help to reduce the risk in the long term of vulnerable young people seeking to access drugs online, which is currently happening in my constituency?
With your permission, Madam Deputy Speaker, I shall make a statement on the Pathways trial. I know what a sensitive, emotive and difficult issue this is. I myself have wrestled with, and at times struggled with, the profound challenges that this subject raises. In all of my consideration and deliberation over this matter, my bottom line has been to protect the safety and wellbeing of children and young people. The way to do that is to follow expert clinical advice and take an evidence-led approach, which is what this Government are doing. As adults, we all owe a duty of care to every child and young person in the country. It is a responsibility that I—both as a citizen and as Health Secretary—bear with the utmost seriousness and sincerity. I do not believe that children’s safety and wellbeing was being adequately protected just a few years ago. I think it would be helpful to remind Members how we arrived at that point. For several years before the turn of the decade, the number of children and young people being referred for NHS support around their gender identity increased rapidly. Stories subsequently emerged of young people struggling after undergoing radical and permanent transition surgery at a young age, children being rushed into taking medication without adequate therapy beforehand, and clinicians disregarding conditions such as neurodiversity and mental health conditions. As such, there was rightly deep concern about the vulnerability of these children and young people, the care and treatment they were receiving and the surge in referrals. In 2020, NHS England commissioned leading paediatrician Dr Hilary Cass to carry out a review of NHS gender identity services for under-18s. What Dr Cass uncovered was shocking and scandalous, and she made a series of recommendations for how children could be better protected and supported. I remind the House that those recommendations were accepted in full by both the Conservative Government of the time and my party in opposition. It was, in my mind, clearly wrong for children and young people to be routinely prescribed puberty blockers for gender dysphoria without any clear evidence on their benefits or risks. The situation was out of control, and I fully supported the indefinite ban introduced by my predecessor, my right hon. Friend the Member for Ilford North (Wes Streeting), which followed the temporary ban brought in by the previous Government. I do not think there is anyone with more respect as a clinician in this space than Dr Cass, and my predecessors in this role recognised that too. Dr Cass identified treatment for gender incongruence as “an area of remarkably weak evidence”. She found that even clinicians working in the field were divided on the best way to support, treat and care for young people suffering gender dysphoria. Where there is strong divergence of medical opinion on treatment, the two possible responses are to continue with the uncertainty—and, with that, conflicting opinions and advice—or to undertake a trial, not just to resolve a dispute but to make sure that children with gender-related distress get the same standards of care as everyone else in the NHS. As Dr Cass has said, the vast majority of children and young people who question their gender will resolve it without needing any support other than that of their friends and family. For many young people, questioning their identity on many different fronts is a normal part of growing up, and we should simply let them be. For a small number of young people, though, greater support is needed because of the level and longevity of the discomfort that they feel. That can often involve counselling or therapy. For a very, very small number of young people, it is possible—I emphasise the word “possible”—that medical treatment would help to improve their quality of life and mental health, and reduce their gender-related distress. That is why Dr Cass, whose approach until recently commanded cross-party consensus, recommended a trial to establish how best to support children and young people suffering gender incongruence. That is the Pathways study. It has four main parts, one of which is the clinical trial to study the effects of puberty-suppressing hormones on young people’s physical, social and emotional wellbeing. The Pathways trial, which is being led by King’s College London and the South London and Maudsley NHS foundation trust, was initially approved last November. The trial seeks to gain evidence on whether those potential benefits are real, alongside evidence on whether such treatment comes with the risk of harm. It is right that this Government are guided by expert clinical advice and a clinical, evidence-led approach, but as this study involves children, and therefore comes with a particular responsibility, as Health Secretary I have sought the most detailed assurances possible from my clinical advisers about how children taking part in the trial will be protected. There are a number of important safeguards. Children can participate only with the consent of a parent or guardian, and the children themselves must consent or assent. They can participate only if they have had a diagnosis of gender incongruence for at least two years. They can participate only if they have received psychosocial support through the NHS. They can participate only if they are of stable physical and mental health. They can participate only if they are not subject to any safeguarding concerns. They can participate only if they and their parents demonstrate sufficient understanding of the nature of the treatment, including its potential advantages and disadvantages. They can participate only if they have been deemed clinically appropriate by both the NHS care team and the national multidisciplinary team, and they can participate only if they are already accessing NHS gender services. So, when it comes to eligibility, we are talking about a very small subset of a very small group. The number of young people who would expect to quality for the trial will be low, and the safeguards to ensure their safety and wellbeing are rigorous. I have sought and had reassurance that once participants are on the trial, they may be withdrawn at any point. As hon. Members will know, the Medicines and Healthcare products Regulatory Agency raised new concerns at the beginning of this year, and the start of the trial was delayed so that they could be fully scrutinised. On Thursday last week, the regulators approved an updated protocol that significantly strengthened the objective criteria for withdrawing children from the trial. I welcome that change. Signs of greater risk to participants will now trigger increased monitoring, clinical review or automatic withdrawal from the trial. All participants will be monitored before, at the start of, every three months during and after the trial. Before and during the trial, information will be collected about mental health, quality of life, self-harm and suicidality, body image, cognition, puberty stage, physical health and side effects. On bone health, puberty is normally a time of rapid bone gain, so if changes in bone density are identified, that will lead to a reassessment of whether the participant should continue in the trial, with set criteria for automatic withdrawal. On fertility, there is no published scientific evidence of irreversible changes, but that will be proactively addressed, with every participant offered repeated counselling and a range of options to preserve their fertility. On cognition, while there are no established scientific reports proving a cognitive effect, the new protocol sets out strict definitions for investigation and automatic withdrawal of young people from the trial. The new criteria for increased monitoring or withdrawing children from the trial will mean that, at the first sign of negative impacts, action will be taken. These criteria will stop short-term harm, and the view of the National Institute for Health and Care Research is that that means any long-term harm should not occur or go unnoticed. Those reassurances about preventing harm to the children who take part in the trial, and taking clear action if any risks appear to increase, are critical. After considering the matter closely over the past few days, I have requested monthly updates on the progress of the trial, including on any emerging risks. Pathways is rightly one of the most scrutinised UK clinical trials of recent times—we should expect nothing less when we are talking about the health and wellbeing of some of the most vulnerable children in our country. Yet, as Dr Cass has made clear, we have to build the evidence base to show whether the treatments are safe and whether they produce the positive outcomes that young people and their clinicians want from them. My view is that proceeding with the trial is, on balance, the most appropriate way forward. This has not been easy—I am sure many hon. Members are also wrestling with this dilemma—and, as we debate this issue today, I hope that we will keep in mind Dr Cass’s ask to consider the issues sensitively and cautiously. As she said: “Polarisation and stifling of debate do nothing to help the young people caught in the middle of a stormy social discourse, and in the long run will also hamper the research that is essential to finding the best way of supporting them to thrive.” I will not pretend that I do not continue to feel discomfort and unease, but I believe that the only way for us all to come to a fair and settled conclusion on this matter—to move forward as a country on this difficult and sensitive issue—is on the basis of clinical evidence in which we trust. Thanks to the strengthened criteria now in place for monitoring children’s wellbeing and withdrawing them from the trial, there is now intense scrutiny, and there are robust mechanisms to prevent harm from coming to the young people who take part. It is on that basis that I believe we should follow the advice of clinical experts and seek the clinical evidence that will give us the confidence to know that where we settle on this matter in the future is right. I commend this statement to the House.
I agree with the shadow Minister that most children and young people who are questioning their identity and gender are likely to resolve those questions on their own, and I think Dr Cass would agree with that. As I said in my opening remarks, for the majority of children who question their gender, we should let them be; they will resolve the matter through their friends and family and their own development. We are talking here about a small subset within a small group of children who need further support. I also agree with the shadow Minister that the situation before Dr Cass did her review—the situation that had developed in the last few years before the turn of the decade—was totally unacceptable, and we should be clear that that was wrong. The shadow Minister asked about protecting the young people involved in the trial from harm. As I set out, there is intense scrutiny, and there are robust mechanisms to prevent the children involved from being harmed. She mentioned the MHRA recommendation for the lower age limit. Initially, there was no lower age limit, but a scientific dialogue between the MHRA and the trial sponsor led to publication last week of the updated protocol, which recommended the minimum ages of 11 and 12. The gateways to younger people and children becoming involved in the trial are significant. There must be not just consent or assent from the children, and consent from their parents or guardians, but approval from the NHS care team, the national multidisciplinary team and others before anyone can be involved. As I set out, I feel uncomfortable and uneasy when considering this matter, but I think that the right way for us to move forward is to have the clinical evidence on which to base decisions. I have received reassurances about there being the highest possible level of scrutiny and protection from harm for young people involved in the trial, and that is the basis on which, on balance, I think it is right for it to proceed.
As my hon. Friend will know, the recommendations in Dr Hilary Cass’s review set out how to establish better services for young people in the future. The focus of today’s statement, the clinical trial, is just one part of the wider work on how best to support young people who need extra support in this situation. It was welcome that there had been, at least until recently, a cross-party consensus that Dr Cass was finding the right way through this difficult matter.
I welcome the fact that the hon. Lady agrees with the Government that we should base our decisions about whether and how to provide support for children, particularly in the case of the treatment that is at the centre of this clinical trial, on clinical evidence and the expert advice of clinicians. There can be no one in this field more widely respected than Dr Hilary Cass, whose recommendations form the basis of the decision that we have taken as a Government. The hon. Lady asked about the work of the MHRA since early this year to strengthen the safeguards for young people involved in the trial. As I said earlier, I welcome the changes that it has brought forward to strengthen the criteria, which will lead to greater monitoring and clinical reassessment, and to setting objective criteria for withdrawing children and young people from the trial entirely. 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 towards the end of last week. Now that that is in place, we have greater reassurance about the safeguards. The trial is expected to involve around 226 children and young people over five and a half years, with each participant potentially being offered puberty blockers for up to 24 months. As I said, a decision to withdraw is triggered by the participant meeting set objective criteria related to the risk of harm.
I absolutely agree with my hon. Friend about the importance of following clinical evidence and taking a clinically led and evidence-based approach to this decision. As I said, I have felt uncomfortable and uneasy about some of the challenges raised by this matter, but for me, the right way to move forward is to follow the clinical advice, and to base future decisions on clinical evidence, given that I have received the most robust assurances about the safeguards that are in place to protect young people involved in this trial from harm.
I am sure that the hon. Lady will agree that this is now one of the most heavily scrutinised clinical trials in this country in recent history, and rightly so—it is right that it is so heavily scrutinised and that we all seek assurances about the safeguards in place. It is right that, as Health Secretary, I made sure that I got those detailed safeguards before coming to the House to set out the Government’s position today. The hon. Lady asked how usual it is for the MHRA to work with the sponsors of trials. My understanding is that the MHRA routinely works with trial sponsors to iterate the protocols in relation to those trials. Because this trial involves children and young people, for me, the bar should be exceptionally high, to ensure that those safeguards are in place. That is why, although my starting principle is that clinical evidence is the right way to approach such a matter, I wanted that extra reassurance. That is why I asked for the most detailed possible assurances from my clinical advisers, to ensure that those robust safeguards are in place in the way the trial is now designed.
My hon. Friend raises an important point about the relationship between politics and clinical evidence and clinically led decisions. Being led by clinical advice and clinical evidence is a decision that I and this Government stand behind. In this case, it is a matter where in considering some of the issues raised, I have felt uncomfortable and uneasy, but that commitment to clinical evidence, particularly recommended by someone as widely respected as Dr Cass, is the basis on which we can move forward. As I mentioned in response to the Chair of the Health and Social Care Committee, because this involves children and young people, I wanted to receive extra assurances that the clinical advice was robust and that the safeguards would be as robust as possible. That is the assurance I have received, it is what I very much wanted to receive before coming here today.
The hon. Lady refers, apparently with some certainty, to what she considers to be the clinical outcomes of these puberty blockers on young people. I have to say, with all due respect, that I would trust Dr Cass’s conclusion more than the hon. Lady’s, which is that there is not evidence about the risks or benefits of these medications. That is exactly why Dr Cass was so clear in recommending a trial to find that clinical evidence, because that is the basis on which we can take those decisions.
As a result of the work that the MHRA has been doing with these trial sponsors in recent months, there are now objective set criteria against which children and young people involved in the trial would be automatically withdrawn. Those criteria, as I set out earlier, will stop the short-term harm, and the view of the National Institute for Health and Care Research is that this means any long-term harm should not occur or go unnoticed. It is important that we ensure that the appropriate safeguards are in place for this trial. That is why I welcome what the MHRA has done in recent months, because it strengthens those safeguards, which are important in any clinical trial but, in this trial, could not be more important.
The hon. Lady is right to draw attention to some of the gateways that children and young people will have to go through before being accepted on to the trial. That will involve not just the child assenting and the parents giving consent, but the NHS care team and a national multidisciplinary team, which will take into consideration all the different aspects of a child’s life that I set out in my earlier remarks about their health, but also the wider context that the children are coming from. The importance here is to ensure that there is an exceptionally high bar for children and young people taking part in this trial, and that is the process that has now been established.
My hon. Friend asks about the data linkage study, and I apologise to my hon. Friend the Member for North Northumberland (David Smith), who a few seconds ago also asked about that—I did not respond then but can now address both questions together. It is important to understand that the information in the 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 blockers. NHS England is, however, committed to delivering the data linkage study. NHS England, since assuming responsibility for that study, has taken time to ensure that the data is shared by relevant organisations. Let me be absolutely clear, for the avoidance of all doubt, that the Government’s clear expectation is that all relevant organisations will provide the data required to complete the study.
I thank the right hon. Gentleman for his comments, and although he and I come to a different conclusion on this, I do not doubt for a second the sincerity of his motivation in wanting to protect children and young people. I actually agree with him, as I said in my earlier comments, that most young children who are questioning their gender will resolve it on their own—let them be to resolve it. But there is a small subset of children who will need extra support, and within that there is a question about whether for a very small subset of them there might be a benefit to having treatment, and that is what this trial seeks to conclude. I would add that the right hon. Gentleman refers to what happened in the Tavistock clinic and the stories that led to Dr Hilary Cass being commissioned. I think the right hon. Gentleman and I agree on how unacceptable that situation was, and I put on record my thanks to Sir Sajid Javid for commissioning the work by Dr Cass, because it has been such an important piece of work not only to expose what was happening before, but to provide a way forward.
My hon. Friend rightly points out that the clinical trial—the Pathways study, which is the subject of this statement—is just one part of the wider work being done to make sure that the support is there for children and young people who are questioning their gender and who might, or might not, need support in order to feel well about themselves. The 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. Horizon intensive is about making sure that there is a comparison group of 300 participants who are expressing gender incongruence but not receiving puberty-suppressing hormones, as my hon. Friend suggested.
I thank the hon. Lady for her remarks, and for her tone and approach to this sensitive matter. Sadly, we have waiting lists across many different parts of the NHS. This Government are determined to deal with that so that everyone can receive the appropriate treatment. There are wider questions, which we could debate at another time, about the support that children who are questioning their identity might need. The focus of today’s statement is specifically on the clinical trial, and it is right that we let that happen. The trial will last five and a half years and it is right that we do that thoroughly, because I do not want this country to be taking decisions in future that are not based on the most solid evidence.
Dr Cass has raised that point a number of times, particularly when she has spoken in public and been interviewed on her concerns about young people accessing equivalent drugs through an unregulated source—through online sources that are not carefully controlled and where there is no monitoring of the effects on young people. That is part of her motivation for recommending the approach that she proposes. As I said earlier, I and the Government want the decisions about what role, if any, such treatments play in the future to be based on the clinical evidence, with the highest possible safeguards in place for children involved in the trials.