Question to the Department of Health and Social Care:

To ask His Majesty's Government, following the joint statement on contraception by the International Federation of Gynecology and Obstetrics and the International Confederation of Midwives in September, what steps they are taking to integrate person-centred and respectful contraception provision into sexual, reproductive, maternal and adolescent care services, and emergency obstetric and neonatal care.

Answered by Baroness Merron - Parliamentary Under-Secretary (Department of Health and Social Care)

We are committed to ensuring that the public receives the best possible contraceptive services. Contraception advice is delivered in sexual health services, general practice, some pharmacies, abortion and maternity services, and online. NHS England strives to ensure that this is integrated into a range of different health encounters that women are likely to have.

For example, sexual and reproductive health services in England provide a range of services, including contraception provision and advice, particularly for vulnerable groups and teenagers. These services are free, open-access, and confidential, to support people to make informed choices.

Contraception advice is provided during both antenatal consultations and at the time of postnatal discharge. Many maternity services also provide both user-based and longer acting methods of contraception at this opportunity.

The Three year delivery plan for maternity and neonatal services made a commitment to offer all women a personalised care and support plan by 2026, taking into account physical health, mental health, and social complexities, with a risk assessment updated at every contact.

NHS England has published guidance to support general practitioners to provide women with comprehensive mental and physical postnatal check-ups six to eight weeks after they give birth.

The postnatal consultation provides an important opportunity for contraceptive health needs to be assessed and for general practitioners to listen to women in a discrete, supportive environment. As per the guidance, women should be asked about contraception and supported to make planned choices about future pregnancies.

Women’s health hubs pilots are being rolled out across the National Health Service, together with sexual health services. These can provide a wider choice of options for women, including longer acting methods of contraception.

Question to the Department of Health and Social Care:

To ask His Majesty's Government how they will ensure education on, and access to, contraceptives for marginalised and under-served populations.

Answered by Baroness Merron - Parliamentary Under-Secretary (Department of Health and Social Care)

We are committed to ensuring that the public has equal access to the best possible contraceptive services. The women’s health area on the National Health Service website brings together over 100 different women’s health topics, including contraception, as a first port of call for women seeking health information. Education surrounding contraceptives should be delivered to all pupils via the Relationships, Sex, and Health Education (RSHE) curriculum. RSHE became compulsory in all schools in September 2020. The statutory guidance is clear that as part of the topic ‘intimate and sexual relationships’, pupils in secondary schools should know the facts about the full range of contraceptive choices, efficacy, and options available. These subjects should be taught to all pupils in schools, and teachers have the flexibility to deliver the curriculum in a way that meets the needs of their individual pupils.

Contraception is a core service for women’s health hub pilots. Women’s health hubs bring together healthcare professionals and existing services to provide integrated women’s health services in the community, centred on meeting women’s needs across the life course and reducing health inequalities. The Department has invested £25 million over 2023/24 and 2024/25 to support the establishment of at least one pilot women’s health hub in every integrated care system.

To offer greater choice in how women can access contraception services across the country, the NHS Pharmacy Contraception Service was launched in April 2023, enabling pharmacists to issue ongoing supplies of contraception, initiated in general practice surgeries and sexual health services. The service relaunched in December 2023 to enable community pharmacies to also initiate oral contraception.

Survey outputs from the 2023 Women’s Reproductive Health Survey will be used to inform future policy development and support strategy work by improving our ability to monitor changes and inequalities in women and girls’ access to contraceptives.

Question to the Department of Health and Social Care:

To ask His Majesty's Government how they will ensure equitable postpartum and post-abortion contraception provisions.

Answered by Baroness Merron - Parliamentary Under-Secretary (Department of Health and Social Care)

We are committed to ensuring that the public receives equitable access to the best possible contraceptive services. Contraception advice is delivered in sexual health services, general practice, some pharmacies, abortion and maternity services, and online. NHS England strives to ensure that this is integrated into a range of different health encounters that women are likely to have. For example, contraception advice is provided during both antenatal consultations and at the time of postnatal discharge. Many maternity services also provide both user-based and longer acting methods of contraception at this opportunity.

NHS England has published guidance to support general practitioners to provide all women with comprehensive mental and physical postnatal check-ups six to eight weeks after they give birth. The guidance, which was written in collaboration with the Royal College of General Practitioners, provides clear advice to address unwarranted variation for the delivery of safer, more equitable, more personalised care. This includes flexible appointment times tailored to a women’s needs.

The postnatal consultation provides an important opportunity for contraceptive health needs to be assessed. During this, women should be asked about contraception and supported to make planned choices about future pregnancies.

Contraception is commonly offered and provided by abortion services, in line with National Institute for Care and Excellence guidelines on abortion care, that were published in September 2019. The guidelines set out that commissioners and providers should ensure that a full range of contraceptive options is available for women on the same day as their surgical or medical abortion. Providers should also ensure that healthcare professionals have the knowledge and skills to provide all contraceptive options, including the contraceptive implant, injections, and intrauterine methods of contraception.

Question to the Foreign, Commonwealth & Development Office:

To ask His Majesty's Government, following the joint statement on contraception by the International Federation of Gynecology and Obstetrics and the International Confederation of Midwives, when they expect person-centred and respectful contraception provision to be integrated into FCDO-supported sexual, reproductive, maternal and adolescent care services, as well as into emergency obstetric and neonatal care.

Answered by Lord Collins of Highbury - Lord in Waiting (HM Household) (Whip)

The FCDO actively supports women's and girls' right to be able to make their own, informed decisions about modern methods of contraception. We have significantly increased access to voluntary family planning globally. In 2023, the UNFPA Supplies Partnership, which includes the UK, reached 23 million women and girls in the lowest income countries.

Midwives are crucial to ensuring guidance and access to contraception is integrated into maternal health services. The FCDO recently signed an agreement with the International Confederation of Midwives, aiming to strengthen midwifery associations in three countries. Funding will support midwives to implement the midwifery models of care framework.

Question to the Foreign, Commonwealth & Development Office:

To ask His Majesty's Government how they will ensure education and access to contraceptives for marginalised and under-served populations via FCDO-supported sexual and reproductive health and rights programmes.

Answered by Lord Collins of Highbury - Lord in Waiting (HM Household) (Whip)

The UK is proud to defend and promote universal and comprehensive sexual and reproductive health and rights, including access to modern methods of contraception. The UK has a broad range of programming focused on reaching the most vulnerable and marginalised people with education and contraceptive access including through the UNFPA Supplies Partnership; core funding to UNFPA; via our Women's Integrated Sexual Health Programme (WISH) in Africa; and through our support to Global Financing Facility (GFF) for Women Children and Adolescents to strengthen government systems to deliver on reproductive health.

Question to the Foreign, Commonwealth & Development Office:

To ask His Majesty's Government how they will ensure equitable postpartum and post-abortion contraception provisions via FCDO-supported sexual and reproductive health and rights programmes.

Answered by Lord Collins of Highbury - Lord in Waiting (HM Household) (Whip)

The UK has taken action to advance sexual and reproductive health and rights (SRHR) through FCDO-supported programmes to ensure equitable postpartum and post abortion contraception provisions. The UK delivers on this through several programmes including the Reproductive Health Supplies programme and WISH Dividend programme, and through partners including the Safe Abortion Action Fund to deliver on providing access to key sexual and reproductive health services including post-partum and post-abortion contraception options and to support governments to prioritise equitable access to comprehensive SRHR.

Question to the Foreign, Commonwealth & Development Office:

To ask His Majesty's Government to which countries they provide Official Development Assistance for sexual and reproductive rights, and how much each has received.

Answered by Lord Collins of Highbury - Lord in Waiting (HM Household) (Whip)

The Foreign, Commonwealth and Development Office annually reports on Official Development Assistance (ODA) expenditure via the Statistics on International Development publication. Details of UK ODA by sector code and recipient countries from 2017 to 2023 is available here: Statistics on International Development: final UK ODA spend 2023.

In line with the OECD Development Assistance Committee ODA reporting rules, ODA data is categorised using sector (or purpose) codes, which classify ODA activities by the sectors they benefit. Although some codes directly relate to Sexual and Reproductive Health and Rights (SRHR) - such as Family Planning or Reproductive Health - many others are not sufficiently granular to enable tracking of all ODA for SRHR.

While there is no agreed methodology across donors to capture SRHR expenditure, some partners such as the think tank Deutsche Stiftung Weltbevölkerung (DSW) have developed their own methodology for donor SRHR spend (published in their annual report: All Editions - Donors Delivering for SRHR. This methodology was designed to capture donor ODA flow for SRHR, however it does not include an analysis of SRHR ODA flow to specific recipient countries.

Question to the Foreign, Commonwealth & Development Office:

To ask His Majesty's Government which countries have seen the highest reduction in UK Official Development Assistance (ODA) for sexual and reproductive health and rights since ODA cuts in 2020.

Answered by Lord Collins of Highbury - Lord in Waiting (HM Household) (Whip)

The Foreign, Commonwealth and Development Office annually reports on Official Development Assistance (ODA) expenditure via the Statistics on International Development publication. Details of UK ODA by sector code and recipient countries from 2017 to 2023 is available here: Statistics on International Development: final UK ODA spend 2023.

In line with the OECD Development Assistance Committee ODA reporting rules, ODA data is categorised using sector (or purpose) codes, which classify ODA activities by the sectors they benefit. Although some codes directly relate to Sexual and Reproductive Health and Rights (SRHR) - such as Family Planning or Reproductive Health - many others are not sufficiently granular to enable tracking of all ODA for SRHR.

While there is no agreed methodology across donors to capture SRHR expenditure, some partners such as the think tank Deutsche Stiftung Weltbevölkerung (DSW) have developed their own methodology for donor SRHR spend (published in their annual report: All Editions - Donors Delivering for SRHR. This methodology was designed to capture donor ODA flow for SRHR, however it does not include an analysis of SRHR ODA flow to specific recipient countries.

Question to the Department for Science, Innovation & Technology:

To ask His Majesty's Government, further to the Written Answer by Lord Vallance of Balham on 22 October (HL1416), what involvement (1) officials, and (2) Ministers have had in the drafting and content of the review of data, statistics and research on sex and gender, commissioned by the Department for Science, Innovation and Technology, since the general election; and whether they will list the additional stakeholders who have been consulted since the general election.

Answered by Lord Vallance of Balham - Minister of State (Department for Science, Innovation and Technology)

This is an independent review, and Professor Sullivan is fully responsible for the report’s contents and for engaging with relevant stakeholders. Where stakeholders have been engaged since the general election, the decision was made by Professor Sullivan.

As per the Terms of Reference, a draft version of the report was submitted to the Department for Science, Innovation and Technology and to the Cabinet Office ahead of the final version of the report. Ministers have not been involved in the drafting of the report. As per usual practice, officials have provided light-touch, optional feedback on matters of drafting.

Question

To ask His Majesty's Government, further to the Written Answer by Lord Collins of Highbury on 7 November (HL2061), what guidance they are giving to public bodies on whether Gender Recognition Panels should grant a UK Gender Recognition Certificate to a German applicant in the absence of a medical report.

Answered by Lord Collins of Highbury - Lord in Waiting (HM Household) (Whip)

As I stated in the answer to HL2061, at the time of the commencement of The Gender Recognition (Approved Countries and Territories and Saving Provision) Order 2023, the international systems that were on the list were comparable to the UK’s standard route to legal gender recognition.

We continue to work with our counterparts in the Foreign, Commonwealth and Development Office to ensure that any changes internationally are monitored and noted for future updates. The list was last updated in April 2024, and the previous update was 2011. We are committed to more regularly updating the list of approved countries and territories when applying for gender recognition in the UK.

Regarding the Gender Recognition Panel, they have appropriate guidance and training in order to carry out the gender recognition process in alignment with the current law.

Question

To ask His Majesty's Government, further to the Written Answer by Lord Collins of Highbury on 7 November (HL2061), whether they will take steps to assess the appropriateness of Germany remaining an approved country, given Germany’s adoption of a policy of self-identification.

Answered by Lord Collins of Highbury - Lord in Waiting (HM Household) (Whip)

As I stated in the answer to HL2061, at the time of the commencement of The Gender Recognition (Approved Countries and Territories and Saving Provision) Order 2023, the international systems that were on the list were comparable to the UK’s standard route to legal gender recognition.

We continue to work with our counterparts in the Foreign, Commonwealth and Development Office to ensure that any changes internationally are monitored and noted for future updates. The list was last updated in April 2024, and the previous update was 2011. We are committed to more regularly updating the list of approved countries and territories when applying for gender recognition in the UK.

Regarding the Gender Recognition Panel, they have appropriate guidance and training in order to carry out the gender recognition process in alignment with the current law.

Question

To ask His Majesty's Government, further to the Written Answer by Lord Collins of Highbury on 7 November (HL2061), what is the timetable for the Office for Equality and Opportunity’s review of the countries currently listed in the Gender Recognition (Approved Countries and Territories and Saving Provision) Order 2023.

Answered by Lord Collins of Highbury - Lord in Waiting (HM Household) (Whip)

As I stated in the answer to HL2061, at the time of the commencement of The Gender Recognition (Approved Countries and Territories and Saving Provision) Order 2023, the international systems that were on the list were comparable to the UK’s standard route to legal gender recognition.

We continue to work with our counterparts in the Foreign, Commonwealth and Development Office to ensure that any changes internationally are monitored and noted for future updates. The list was last updated in April 2024, and the previous update was 2011. We are committed to more regularly updating the list of approved countries and territories when applying for gender recognition in the UK.

Regarding the Gender Recognition Panel, they have appropriate guidance and training in order to carry out the gender recognition process in alignment with the current law.

Question to the Department of Health and Social Care:

To ask His Majesty's Government, with reference to the Department for Health and Social Care’s publication of the updated Notification of Child Death Form, whether they have adopted self-identification for under-18s; and if so, how this aligns with their response to the Cass Review.

Answered by Baroness Merron - Parliamentary Under-Secretary (Department of Health and Social Care)

The Notification of Child Death Form, part of the National Child Mortality Database, continues to capture the sex of the child for anyone under 18 years old, in line with sex being a protected characteristic under the Equality Act 2010.

Although questions relating to gender identity already existed within one part of the National Child Mortality Database collection, specifically for suicide and self-harm, the change in October expanded these questions to all deaths. This was to capture the language used by young people and their families to improve system learning and to support the prevention of future deaths.