NHS: Single-sex Spaces for Staff

Baroness Ludford Excerpts

Thursday 1st May 2025 Grand Committee

[Baroness Ludford (LD)]

My Lords, I thank the noble Lord, Lord Arbuthnot, for tabling this debate. We all know that provisions to maintain relevant spaces as same-sex are particularly important to women because of concerns around safety, privacy, modesty and dignity.

The first point to note for this debate, which is about NHS staff, is that, for workplaces, statutory health and safety regulations require the provision of separate-sex toilets, changing rooms and washing facilities—and have done for several decades. The second is that the Supreme Court’s judgment on 16 April makes it clear that the Equality Act does not give transgender people the right to use opposite-sex facilities. Hence, thirdly, employers who operate policies allowing individuals to use opposite-sex facilities are doing so unlawfully, in breach of their statutory obligations. Can the Minister tell us what the Health and Safety Executive has been doing to enforce the law?

The mystery is why some employers are breaching that clear law and behaving with disdain towards their female staff if they refuse women-only facilities. This is surely the result of a decade of the NHS misinterpreting and flouting the law, as well as the failure by successive Governments to stop it. Unisex alternative arrangements should be available for those who do not wish to use separate-sex facilities relating to their own sex. As the noble Lord stressed, trans employees must not face discrimination or discomfort, but the Supreme Court judgment is the law on access to facilities. As the court made clear, it always has been the law, so why must we spend so much time on this subject?

More importantly, why are women such as Sandie Peggie in Scotland and the nurses in Darlington being put through hell by their NHS employers for having the temerity to request that the law be obeyed and to expect what was once just taken for granted? When the NHS is strapped for cash, as the noble Lord pointed out, why on earth are some trusts prepared to waste money that should go on patients in risking the expense of employment tribunals and other legal actions?

Maybe a clue comes from the motion passed at the British Medical Association’s resident doctors’ branch conference last Saturday; apparently, junior doctors are now called “resident doctors”. This motion not only condemned the Supreme Court’s judgment but called it “biologically nonsensical” because a

“rigid binary has no basis in science or medicine”.

These people are doctors. This attitude could harm not only women and men being treated by such doctors but trans women and trans men, whose biology it is crucial to know for many, if not most, healthcare procedures. This debate is about staff but, if doctors are prepared to deny the rights of their female colleagues, they will certainly not care about patients.

There is widespread bemusement about why women keep having to justify what was once considered ordinary and banal and was accepted in society. For NHS staff, the regulations are clear cut. For patients, the Government need to cancel the famous Annex B and get on with giving patients the single-sex services that they want, alongside decent and fair treatment for trans patients.