PATHWAYS Study: Puberty Suppression

Baroness Thornhill Excerpts

Wednesday 24th June 2026 Lords Chamber

[Baroness Merron (Lab)]

I agree with the noble Baroness and I thank her for the offer of the briefing, which I mentioned earlier, and for her observations. I associate myself with what she said about the complexity of the matter, which is why I take it so seriously. The fact is that this situation exists. I am exercised about those who are accessing puberty blockers in an unregulated fashion. It is extremely concerning, which is another reason for this trial, as well as the services being set up. That is why we indefinitely banned the sale and supply of puberty blockers via private prescriptions, taking effect from January 2025. If offences are committed then those involved will be brought to justice, and rightly so.

[Baroness Thornhill (LD)]

My Lords, in my pre-political life I was a senior teacher at a very large comprehensive school, and responsible for child protection and what used to be called pastoral care. I dealt with lots of children who were confused about their sexuality, their place in the world and many other issues. I am afraid that I too would have asked the questions that the noble Baroness, Lady Cash, asked, based on that real experience. My question is aligned to my past experience. Studies show that a disproportionate number of children and adolescents with gender distress have neurodivergent conditions, such as autism. These are protected under the Equality Act. Could the Minister explain how neurodivergence was taken into account when designing the PATHWAYS trial, in particular the consent process—that is what troubles me the most, if I am honest—and any equality impact assessment?

[Baroness Merron (Lab)]

The noble Baroness gives me the chance to reiterate that all the questions are valid. We are dealing with a complex, sensitive and difficult issue. What matters is that we get to the right place. As the noble Baroness, Lady Cass, said, I know we are all agreed on protecting children and young people. That is our motivation.

The noble Baroness asked about consent. As I said, children can participate only with the consent of a parent or a guardian, and the children themselves must consent or assent. The individual circumstances and nature of a child will be closely considered as part of the consideration. That is absolutely crucial. Children and young people may participate only if they are not subject to any safeguarding concerns. I am happy to speak in greater detail to the noble Baroness. All of this will be extremely rigorous, and rightly so. When we talk about the trial, we are talking about volunteers—that is crucial. They can participate only if they have been deemed clinically appropriate by both the NHS care team and the national multidisciplinary team. There is, correctly, the opportunity at every level to consider every child or young person as an individual, which is so important.

Safe Housing and Hospital Discharge

Baroness Thornhill Excerpts

Wednesday 19th March 2025 Lords Chamber

Asked by

[Baroness Thornhill]

To ask His Majesty’s Government what steps they are taking to improve collaboration between integrated care boards and housing providers to address barriers to safe housing and support timely hospital discharge.

[The Parliamentary Under-Secretary of State, Department of Health and Social Care (Baroness Merron) (Lab)]

My Lords, the Government recognise that the availability of safe housing contributes to timely and effective hospital discharge. We published a new policy framework for the £9 billion better care fund in January. Integrated care boards and local authorities have to work together, with involvement from local housing authorities, to agree joint plans to deliver joined-up care. The £86 million uplift to the disabled facilities grant this year can provide around 7,800 additional home adaptations.

[Baroness Thornhill (LD)]

I thank the Minister for her Answer and welcome what she has said. It is absolutely clear now that the lack of supported housing is a major factor in delayed discharge from hospital and that integrated care boards are part of the solution. Can the Minister explain why, only last week, the Government made the shock announcement of a 50% cut to the core funding to these very boards? Surely they should be integral to creating solutions to this costly, damaging and seemingly intractable problem.

[Baroness Merron (Lab)]

As the noble Baroness will be aware, this Government want to see provision and decision-making directed by local leaders. She and the House will be aware of the financial situation which we have inherited. I reiterate what I said about the £9 billion committed to the better care fund, which includes £5.6 billion to integrated care boards and around £3.3 billion to local authorities.

Junior Doctors’ Strikes

Baroness Thornhill Excerpts

Thursday 30th March 2023 Lords Chamber

[Lord Markham (Con)]

We have taken the talks incredibly seriously. We have proven in other areas with the Agenda for Change unions that, with good will on all sides, we have managed to reach an agreement. I think most people would agree it is not a reasonable position to go in saying that, unless they get a 35% pay increase, they are not willing to have any further talks. That is not something that I believe many of us could support. We are always open to reasonable negotiation, as we have proved in the other cases, and we remain open to having that reasonable negotiation now.

[Baroness Thornhill (LD)]

My Lords, many hospital trusts are having to bring in more senior doctors in this period to cover the strikes, at what must be considerable expense. Given that quite a few trusts are already going into deficit due to inflationary pressures, will the Government be making provision to cover these additional and unexpected costs? We know that working as a junior doctor is physically intensive, but it is also a mentally exhausting line of work. The decision to strike will have put serious mental stress on junior doctors; they did not train for years to go on strike and cause this. So who is looking after the mental health and well-being of our junior doctors?

[Lord Markham (Con)]

I think we all agree that the mental health and well-being of everyone in society is paramount. At the same time, I would hope that junior doctors did not feel the need to take this action. As I say, in other areas relating to Agenda for Change we have reached a good outcome. We sat down with the BMA junior doctors committee hoping to have the same constructive conversations around settlements that we had already reached, but unfortunately that was not forthcoming. So my main response to concerns in that space is this: please do not strike. Please sit down with us again and engage constructively.

--- Later in debate ---

[Lord Markham (Con)]

Like all noble Lords, I absolutely agree that Parliament has to have every opportunity to fully assess, discuss, debate and scrutinise the plans. As noble Lords know, I cannot say when the report will be released, so I cannot say with all honesty whether it will be over the Recess or afterwards. I can only repeat the words “soon” and “shortly”, and say that there is not a definite plan to announce it over the Recess. What we fundamentally agree on is that these plans are being produced with stakeholders and a lot of consultation, and they will absolutely be subject to a lot of scrutiny, as we would expect. I expect to answer on the plans in this House, as I expect my ministerial colleagues in the other place to have to do as well.

[Baroness Thornhill (LD)]

My Lords, I rather cheekily snuck two questions in, and the Minister did not give me an answer to the first one, which in many ways is very important. Will the Government look at and support those trusts that risk going into deficit because of inflationary pressures?

[Lord Markham (Con)]

I thank the noble Baroness for reminding me of that. I will need to confirm it but my guess is that, although trust are having to pay more for consultants to cover positions, unfortunately a lot of junior doctors will not turn up and so there will not be the same level of pay because there are far fewer consultants than there are positions to cover. I wish there was not that problem, candidly. I think we all wish there were enough consultants to cover the exact number of junior doctors. My hunch is that, because of that, the wage will end up being a bit less. I will check if I am wrong, though, and correct it.