Brain Tumours: Causes and Treatment

Lord Winston Excerpts

Monday 24th November 2025 Lords Chamber

[Baroness Merron (Lab)]

It is an important point, as the noble Lord, Lord Sharpe, raised. As I said, the national cancer plan will give that opportunity to address challenges and needs such as those the noble Lord raised. We are also establishing a brain tumour research consortium through the NIHR, which will bring together researchers from different disciplines. The scientific advancements it will drive will be how to prevent, detect—to the point raised by the noble Lords—manage and treat brain tumours. That will also be of great assistance.

[Lord Winston (Lab)]

My Lords, the Government should be congratulated on trying to improve their work on brain cancer. Talking about treatment, one of the issues is that one of the greatest advances and most important areas is brain imaging using magnetic resonance imaging, PET scanning and even electrical recording in a sophisticated way, but access to these important technologies still seems somewhat deficient. Will the Minister say whether the NHS has plans to increase access to brain imaging? It seems a very important area in treatment.

[Baroness Merron (Lab)]

We certainly want to see services properly available across the country and people not being disadvantaged because of where they live or what the services are. Again, from what I know of it—we will soon see it—the national cancer plan will improve every aspect of cancer care, including outcomes for those with brain tumours and access to the services my noble friend outlines.

Terminally Ill Adults (End of Life) Bill

Lord Winston Excerpts

Committee stage
Friday 21st November 2025 Lords Chamber

[Baroness Hollins (CB)]

I thank the noble Baroness. I thought about that, and it could indeed be brought back in a different way later in the debate, but I feel that the prevention of coercion is really important, so thinking about it at this stage is really helpful.

[Lord Winston (Lab)]

My Lords, I want to ask this question of the noble Baroness, Lady Hollins, but it applies also to the noble Baroness, Lady Berridge: she mentioned various things that are cited as causing pressure, but does she not agree that being in palliative care also causes pressure?

[Baroness Hollins (CB)]

There is no suggestion in anything that I have said of imposing palliative care—none at all. I have listened to the debate, and I was not going to speak personally but I will now, since the noble Lord has challenged me on that. My husband was dying with motor neurone disease last year. He felt under immense pressure from this debate in the House of Commons, the other place. He found it very difficult. It made him ask questions, such as, “Am I still entitled to palliative care? Am I really entitled at a time when the NHS is so short of staff and short of time?” He worried about that, and I had to offer him a lot of reassurance so that he could make his own decision. He was not ready to die. The idea that offering palliative care applies pressure is really not to understand the whole nature of the dying process and the way in which, as we come to realise that our life is coming to an end, we need time to understand, reflect, heal and make sense. The pressure not to be a burden is huge, and the pressure of not having access to services that are in short supply is much worse.

[Lord Winston (Lab)]

I do not wish to extend this conversation but, given what the noble Baroness has said, can she explain why in Australia—I am sorry, in New Zealand—where there is very good palliative care, three-quarters of the people requesting assisted dying, something like 2,000 patients, had been in palliative care at the time of the request?

Terminally Ill Adults (End of Life) Bill

Lord Winston Excerpts

Committee stage
Friday 14th November 2025 Lords Chamber

[Baroness Smith of Newnham (LD)]

I am indeed, which is why I think it needs to be clearly probed. If that is what your Lordships’ House and the other place intend, we should legislate for that, but I am not persuaded that all Members of this House and the other place will have the expertise that the noble Lord, Lord Pannick, has.

I have probably taken enough interventions for the moment. Others may accept being intervened on for a fifth or sixth time.

It was clear at Second Reading that some noble Lords who are in favour of this legislation want to support it and are open to it being amended, but others simply said, “This legislation is about assisted dying. The citizens of the UK want assisted dying. Therefore, we must support this legislation”. That would be a dereliction of our duty. We need to ensure that any legislation that is passed is robust and that, if noble Lords have passed it, they have probed the Mental Capacity Act and questions of capacity and ability, and that the legislation we get is robust and will stand the test of time.

Ability goes beyond capacity. This matters so much because the simple choice between an assisted death and not an assisted death is not so straightforward. The reason I wanted to speak, and I will come back to this in subsequent groups, was to refer to some of the evidence we took. Evidence-giver after evidence-giver said, “If we are going to have assisted dying”—whether or not they were in favour—“we need to have better palliative care than we have at the moment”.

The Bill, if it goes through, will say that people have to be told their choice between the palliative care available to them and other options. There is a gross inequity in palliative care availability in this country. For some people, there might be a genuine choice between getting the care they could have or an assisted death, and they may get to the point of saying, “The care still is not enough”. In many parts of the country, though, people are not being offered that palliative care, and if we do not make it available, we are potentially creating legislation that causes people not to have the choice that some noble Lords are so passionately advocating for but rather to make constrained choices because the health service is not giving them what they need. So a broader discussion about ability has merits. That is not to cut across the debate about the need for capacity, which will come up at various points in Committee.

[Lord Winston (Lab)]

My Lords, as a member of the Select Committee that the noble Baroness has just referred to, I think she ought to refrain from criticising something that the committee either said or thought. We merely took evidence. As we will see in the report, we did not make those observations personally.

[Baroness Browning (Con)]

My Lords, many years ago, in another place, I served on the pre-legislative scrutiny committee and was present taking what became the Mental Capacity Act through the House of Commons. When I came to your Lordships’ House in 2010, I was fortunate enough to secure a House of Lords inquiry to look post-legislatively at how the Mental Capacity Act was working. From the evidence we took at the time, we found that the ability of the medical profession—by which I mean not just doctors but all those across the piece, including social care workers—was not as ideal as it perhaps sounds in today’s Committee. Whatever is built into the Bill to assess either capacity or ability, there will need to be a heck of a lot of training for us all to feel comfortable that the professionals involved know how to go about their task.

I draw the Committee’s attention to the report last month of the National Audit Office, whose press release stated:

“The Department for Health and Social Care (DHSC) and NHS England (NHSE) do not clearly understand what proportion of palliative and end-of-life care is delivered by independent adult hospices, and therefore, how much they are reliant on the sector, or what the real impact of government funding is”.


We have heard that palliative care is patchy. I know from my own recent experience with a close relative that, had I not been somebody capable of organising it myself, it would not have taken place. We are not dealing with finite disciplines in the debate on this group, and I caution the Committee that it is not as perfect out there as it sounds today.

--- Later in debate ---

[Lord Harper (Con)]

My Lords, I have listened carefully to the debate. The noble Baroness, Lady Finlay, has done the Committee a service in tabling this amendment. It has enabled us to think in advance of the debate that we will have when we get to Clause 3 on the existing wording in the Bill about the Mental Capacity Act. Some of those issues came out in the debate that we have just had. It has been helpful to cue that up.

I want to comment on a couple of issues following on from the comments made by the noble Lord, Lord Deben. Two different things are being talked about with capacity and ability. I listened carefully to the comments of the noble Lords, Lord Pannick and Lord Scriven. There is a clear mental capacity test. But as others have said—I will not repeat the quote—experts in assessing capacity from the Royal College of Psychiatrists think that this decision was not thought about when the test was designed and that it is not an adequate test. I will not labour the point now, but we should think about whether we need a new test or, as the noble Lord, Lord Deben, said, an additive process where we take the Mental Capacity Act test and add something to it. There are amendments on both of those—a new test or adding things to it.

That comes to the point that the noble Lord, Lord Scriven, made. Of course, it is true that people make life and death decisions about medical treatment and about whether to refuse medical treatment. But there is a qualitative difference between refusing medical treatment, even if the consequence of refusing that medical treatment will be to hasten the end of your life, and to make a decision for active steps to be taken to administer substances to you which will end your life. They are very different things, and they are treated differently in the law. Perhaps that is the reason why we have had that slight cross-purpose. We need to be very precise about our language when we come to have that debate on capacity. I think that that would be helpful. That is all I will say about that at this point. I suspect that we will have a very extensive debate on Clause 3.

I think that the noble Baroness, Lady Finlay, was getting at something a little wider, which was not just about the capability of the individual to make a decision—that is the capacity piece. It was also about both the information they are furnished with and whether they have all the information at their disposal to be able to exercise their capacity to make a decision. It is not just about whether the information is available but whether the services are available that make that a truly proper, informed decision. Clearly, she has enormous expertise in palliative care.

Whether that palliative care is available in practice is incredibly important. Somebody could have capacity, and we could judge that they do. I listened very carefully to what the noble Baroness, Lady Andrews, said, with her expertise on the Mental Capacity Act, and I listened carefully to my noble friend Lady Browning about the importance of recognising how it works in practice, but it is also about whether those services are available. You could have the capacity and a lot of information provided to you, but if the palliative care services are not available to you, you do not have the ability to make a meaningful choice about whether you wish to end your life. I think that is what the noble Baroness, Lady Finlay, was getting at in that wider use of the word “ability” on top of capacity.

When we get to Clause 3 and the amendments to it, one of the things we should think about is whether we accept that the Mental Capacity Act is a good basis. As people on both sides of the argument have said, it is a tried and tested situation. As we heard earlier, it has been tested in court, up to and including the Supreme Court. We should think about whether we want to replace that with a completely new test or whether we actually stick with the Mental Capacity Act and perhaps have some additions to it, which recognise that it is a qualitatively different decision from whether you are having medical treatment or not. That is the essence of it.

In the place it is in the Bill, just accepting the word “ability” probably is not the right thing to do. We want that wider debate. But the noble Baroness, Lady Finlay, has done us a service in flagging up some of the issues that we can now think about in advance of the debate on Clause 3.

[Lord Winston (Lab)]

Before the noble Lord sits down, perhaps he could just clarify a point. Medical royal colleges are often quoted as having a view, but they are very seldom unanimous. I wonder whether he could tell us not just the percentage of psychiatrists but how many psychiatrists who are members of the royal college specifically had this view and how may did not. That is really important. There were a number of people who just did not respond to a question.

[Lord Harper (Con)]

I am happy to answer. I do not know how many did. My understanding is that the royal college, whatever its decision-making processes are, has publicly said that it does not think this is adequate. As I said, I did not quote it, because it had been quoted at length. I put some weight on that.

As a relatively new Member of your Lordships’ House, I am also very struck that this House is blessed with those who have enormous experience in the law, who have to make some of these decisions in practice, and experienced legislators, such as myself, who have looked carefully at the operation of the legislation, both in taking it and post-legislative scrutiny. Many Members have personal experience, either themselves or through family members, of the exercise of these laws in practice. I will listen very carefully to them.

Therefore, the view of the Royal College of Psychiatrists is clearly an important one that I will put some weight on, but I will also listen very carefully to others in the House, who I think will add enormously to this debate as we weigh up this important piece of legislation. I thank the noble Lord for his question.

--- Later in debate ---

[Baroness Scotland of Asthal (Lab)]

If we look at what Professor Foster and others have said, they say that the Mental Health Act 1983 is the sort of assessment that a psychiatrist should make as to whether they are in a position to make that decision. It is not just the MCA on its own—

[Lord Winston (Lab)]

My Lords—

[Baroness Scotland of Asthal (Lab)]

If I could just be allowed to finish, I would be most grateful, because I have taken only three minutes and 48 seconds, and I do not intend to trouble the Committee for very much longer.

This issue has to be looked at. We have to be serious about looking at the Mental Health Act 1983, looking at the Act on capacity and coming up with something that suits. This is too serious for us not to do it. All of us care deeply about those who suffer, care deeply about those who face a diagnosis about the end of their lives, and we have to get this right. So, I ask the Committee to be kind to each other, to listen, to understand that the pain that is suffered on all sides is real and that we are entrusted to do something quite extraordinary once in a generation and we cannot fail. And I know that the people in this Committee will not fail, because we will take our job seriously.

[Lord Winston (Lab)]

Before my noble and learned friend sits down, will she just recall some evidence that we took in the committee that we sat on together only a week or two ago? My noble and learned friend was very keen to have evidence from New Zealand, where they had a three-year follow-up which showed that three-quarters of the patients who had asked for assisted dying had already been on palliative care. The two things are not exclusive by any means, and it is certainly relevant to consider that. Palliative care, of course, was okay, but some patients finally decided that they did not want it any more—most of them, in fact. It was 2,880 patients.

[Baroness Scotland of Asthal (Lab)]

We were very grateful to receive evidence from New Zealand, and we heard from a practitioner about the challenges and the opportunities that there are. But we also heard that New Zealand had moved from being the third most successful in delivering palliative care to the 12th, and there was a direct correlation, we were told, between the reduction in the investment in palliative care and the existence of the new service. These are the realities, and there are many who have said that if there is to be a real choice—if I can just finish this sentence, I would be grateful—then the choice has to include a fully funded palliative care service to enable people to choose whether that is the course they want to go down, or another. Without that, the choice is not a real one.

Genome Screening: Newborn Infants

Lord Winston Excerpts

Thursday 18th September 2025 Lords Chamber

Tabled by

[Lord Winston]

To ask His Majesty’s Government what plans they have to screen the genomes of newborn infants for different genetic conditions.

[Baroness Thornton (Lab)]

My Lords, I beg leave on behalf of my noble friend Lord Winston to ask the Question standing in his name on the Order Paper.

NHS: Private Equity

Lord Winston Excerpts

Wednesday 25th June 2025 Lords Chamber

[Baroness Merron (Lab)]

I understand the noble Baroness’s concern, but perhaps I could assure her and your Lordships’ House that it was decided this week by the board of Assura to recommend to shareholders an offer from Primary Health Properties, which is another UK real estate investment trust, similar to Assura, which is focused on primary healthcare premises. It is the case—or was the case, depending on how you look at it—that there was another bidder for Assura: KKR. As the noble Baroness said, KKR is an American private equity and investment company, but it seems very unlikely to be successful at this stage. The assurance I can give the noble Baroness is that a change in ownership does not affect the legal status of existing lease arrangements. I would also say that the ownership of the general practice estate is very much a mixed model in which GP practice buildings can be leased from a variety of landlords, including companies such as Assura, which actually constitute quite a small proportion of the overall estate.

[Lord Winston (Lab)]

My Lords, given that there are a vast number of overseas investments in different areas of private medicine in London—for example, in vitro fertilisation, much surgery, and so on—can the Minister tell us whether there is any fundamental difference between this and Assura healthcare? Providing it is under the proper regulation of the NHS—which I believe it is—there is no particular harm that we can identify.

[Baroness Merron (Lab)]

My noble friend is quite right. What matters is the assurances that are in place to enable provision to be made, whether that is on the estate or on services, as my noble friend refers to. I can certainly assure your Lordships’ House that in preparation for this discussion of course I asked the question: are there risks? I am assured there are no risks about which we need to be concerned.

Preterm Birth Committee Report

Lord Winston Excerpts

Friday 6th June 2025 Lords Chamber

[Lord Winston (Lab)]

My Lords, I pay tribute to my noble friend—to misuse the convention—Lord Patel, who, as usual, was an outstanding chairman, as he has so often been for the past inquiries with which I have been associated. I thank him very much indeed.

There is no point in making a treatment unless you can make a diagnosis, and the diagnosis must depend on the understanding of the cause. The problem, frankly, is that various causes have been postulated for over 40 years in this area. I will take a slightly different line, because, otherwise, I will only repeat what the report said and what will be said by others in this debate. I suggest that we need to link much more closely the loss of babies in the uterus well before term, in the early stages of pregnancy—namely, miscarriage—with preterm birth, because the causes are almost certainly related and important. I will discuss this in my short speech.

So many causes have been suggested: chromosome abnormality; changes in the DNA; different genetic predispositions; abnormalities of gene expression; hormone imbalances; metabolic problems; immune changes; molecules that affect implantation; the insufficiency of the placenta or afterbirth; anatomic abnormalities of the genital tract; failure of the eggs to mature properly; blood flow abnormalities; vaginal, oral, uterine and gut bacteria; and infections by either viruses or bacteria and parasitic infections. The fact is that it is very difficult to decipher where we are going with this research. I regret to say that much of the scientific evidence we have received has been rather confusing. The evidence has not been well focused, and we need to consider why that is the case.

There are also associations with the environmental factors that my noble friend Lord Patel mentioned, including pesticides; pollution; smoking; poor diet; alcohol; ingestive toxins; aberrant weight, such as obesity; male and female age; and, obviously, the link with infertility, which is the area in which I am particularly interested. We do not understand why it is more common in some animals than others. We know, for example, that it is not particularly common to lose pregnancies in primates. That seems to be associated with stress in primates and may be related to changes in family circumstances, particularly with the dominant male, which is quite interesting. I am not pretending to suggest that it is relevant here; the point is that it is just another example of why we are very much at a loss.

In 1987, I met a lady called Pamela, who had three preterm babies. They all died. She had one boy who died a few weeks after birth, in addition to the three who died before birth. She also had at least six miscarriages; she thought that she had had more, but she felt that the doctors were not regarding them as miscarriages. She had this constant problem. At one stage, her partner, not surprisingly, left her.

Pamela went on, finally, to deliver James. He was born premature and severely disabled at birth. It became obvious much later, when the medics came to look at him, that there was a genetic disease. The diagnosis of Lesch-Nyhan syndrome, a rare disease which usually affects boys but not girls, was finally diagnosed. Indeed, he was so disabled that he lived strapped in a wheelchair. He was not able to move his arms deliberately, because if he did, he would mutilate himself. Eventually his teeth were extracted because he was biting off his lips and tongue. That is the nature of that disease, which of course causes miscarriage.

After the diagnosis was made, we started to get very concerned about whether we could do some research to understand what was going on. We took three years to identify the diagnosis of Lesch-Nyhan syndrome in embryos. Two embryos were transferred at different stages, but Pamela did not get pregnant. Eventually, she had a normal baby, free of the disease, some four years after we started the research. Her NHS treatments, as noble Lords might imagine, were pretty costly. In fact, the costs of looking after that woman and her children were very considerable. Our research was not funded; in fact, we got our inadequate funding mostly by persuading women to cycle around the world on different bike rides. Those women raised huge sums of money because they felt very compassionately about the cause.

There are at least 23 million miscarriages annually, which means that about 44 pregnancies are lost every minute. The pool of single miscarriages is very high: over 15% of pregnancies are lost in this way. It is a massive medical problem, which is indeed linked to premature birth; sometimes it is a marker for premature birth. That is why we therefore have to consider these things together and why I am focusing on this in my speech today. If you add in premature births, you start to see the colossal consequences in handicap that we have seen, as well as the grave psychological problems that affect people. We need to consider this and ask: why is this happening?

When you look at world figures, it is very puzzling. In the studies of miscarriage, for example, prevalence varies across the world. You might expect it to be much more common in areas with poverty, but let us look at this in detail. Ethiopia is the country with the most serious miscarriage rate that I could find; it is about eight times more common there than it is in the United Kingdom, and the country is certainly very poor. It is also far more common in Guyana and Bolivia. In Eritrea and Zambia, miscarriage is quite prevalent, but in Malawi, which is perhaps the poorest African country of them all, the rate is actually not much dissimilar from that in Britain. That is very interesting, but quite unclear. It is clearly not related to the causes that we imagine are associated with poverty—poor nutrition, smoking and so on. There are a lot of other things going on.

There are many things that we could do which have not been mentioned here. One is this: we have to understand, and have much better recognition of, people who are going through miscarriage, with the proper recording of what is going on and, indeed, with much more investigation at the expense of the health service. I plead with my noble friend Lady Merron that she might see how we could do that. These investigations are not that expensive, but pathology should certainly be part of it. Unfortunately, that is often missed out. We do not look at the products of conception when the miscarriage occurs; they are just ignored. Women come out of hospital without any idea of what has happened, feeling absolutely desperate and bereaved.

It is worth bearing in mind that these women remember the date of the miscarriage years afterwards. They do not have a funeral and they do not have any recognition from other people of what they have gone through; they do not even tell people at work, because of course they cannot. They, along with their partners, have to suffer alone, and sometimes with the very serious problem of continuing infertility, blood loss, and generally feeling really unwell from having had an anaesthetic and an operation, having never been in hospital before for any serious disease. We have to recognise that this is so important.

We have a great opportunity here to do that which we do so well in Britain. We are extremely good at cohort studies. We have, among other things, one of the best examples in Biobank. Biobank is making a massive difference at the moment. If you take the world of ophthalmology, we now begin to understand that Biobank is giving us clues as to the causes of macular degeneration, which has a whole range of causes, just like infertility and other such things. We can now see specific genetic predispositions, which in the next few years is going to lead to much better treatment of this blindness, which prevents people being in work, for example.

I urge the Government to think about this, because this scientific research is much needed. There is a strange paradox here. In the data Bill, we have discussed science, but we have forgotten that science is often due to serendipity; it is not related to careful recognition. Looking at figures in the right way is serendipitous. It is very likely indeed that, if we did that properly, with proper data collection, we would end up with some very useful hypotheses. If we did that then we would be able to focus research on the areas that are most relevant, and we would make real progress in treatment.

This would be so much more than a blanket funding of lots of research. I do not think that that is what is needed. The research councils show that they have been funding up to 35% of grant applications, which is a very high number and much higher than in most other areas of medicine. What we need is much better research, and we need to do it if we are going to change the heartache and suffering, which is so often ignored, with totally healthy women going through this and being ignored. We need to do something about that. It would not mean masses of expense, but it would mean looking at how we do data collection in the NHS a bit better—which we can do—and trying to focus where we are going with better research, which, at the moment, is not in fact present.

Apricity Fertility Closure

Lord Winston Excerpts

Wednesday 12th March 2025 Lords Chamber

[Baroness Merron (Lab)]

As the noble Baroness will be aware, in November 2023 the HFEA published Modernising Fertility Law, in which it made a number of recommendations for urgent change, including around its regulatory powers. I will meet the HFEA chair and CEO tomorrow, and we will further discuss the regulatory challenges that the HFEA faces. I assure the noble Baroness that the Government are currently considering the HFEA’s priorities, including its role with digital clinics such as the one referred to, should an opportunity for legislative reform arise.

[Lord Winston (Lab)]

My Lords, the noble Baroness, Lady Owen, asks a most important Question, and I am grateful to my noble friend the Minister for answering it at least partially. I argue that much more of an answer is needed. Apricity advertised a success rate that was literally impossible; indeed, it was more than double the national success rate. Again and again, patients are being sucked into in vitro fertilisation—which may not always be the best treatment for them, just because they are infertile—because they think they will have a better chance of success than they actually have. It is time to be much more rigorous. As my noble friend the Minister is seeing the HFEA chair tomorrow, will she ask her how well the HFEA feels it is auditing the results it gets from clinics? In my view, many clinics are exaggerating, in all sorts of ways, what the success rate is.

[Baroness Merron (Lab)]

My noble friend raises an extremely important point, which I will of course cover in my meeting tomorrow. It may be of interest to know that the Advertising Standards Authority and the HFEA issued a joint enforcement notice in 2021 to ensure that fertility clinics and others were aware of the advertising rules and were treating consumers fairly. That remains in place. The ASA periodically reviews compliance with its rules. Its recent review in the fertility sector found far fewer absolute claims than it had found previously and that the level of compliance is good. That is not to say that it is good in all cases, and I agree with my noble friend’s point.

National Cancer Plan

Lord Winston Excerpts

Monday 10th February 2025 Lords Chamber

[Baroness Merron (Lab)]

The noble Lord makes an important point about what I would call unnecessary obstacles to innovation and technology—something which the noble Lord, Lord Kamall, also raised. I assure the noble Lord, Lord Kakkar, that engagement with industry is extensive. We seek to identify blocks to improving healthcare provision in this country so that we can take the necessary steps. I agree that there are obstacles. We will continue to identify them—working with industry, which is crucial—and to seek to fix them.

[Lord Winston (Lab)]

My Lords, the Minister mentions the amount of money being spent on cancer research, but it is a small proportion compared with what the life sciences actually earn in Britain through patent and basic research. As UKRI recently pointed out, £3.7 billion has been raised as a result. Does the Minister agree that the Government should perhaps consider reinvesting some more of that money into much-needed basic research, which is currently regarded as being underfunded, with very many projects not being funded as they should be?

[Baroness Merron (Lab)]

As my noble friend is aware, the NIHR very much welcomes funding applications for research into any aspect of human health, including all cancers. As with other government funders of health research, it does not allocate funding for specific disease areas. My noble friend is well aware that applications are subject to peer review and judged in open competition—in other words, to make awards on the basis of the importance of the research to patients and on value for money. I appreciate his observation about investment. It is an area to which we are committed and will continue to be.

First-cousin Marriage

Lord Winston Excerpts

Monday 20th January 2025 Lords Chamber

[Baroness Merron (Lab)]

The noble Baroness is right that consanguineous unions are decreasing. While it had the best data, the NIHR-funded study, Born in Bradford, to which the noble Baroness and I have referred, found that between 2000 and 2010, 39% of British Pakistani couples in Bradford were first cousins. However, that reduced by 27% by 2019, for the reasons suggested. Driving change across whole ranges of areas makes a difference, but it is important that we keep this in perspective and make any communications and support absolutely appropriate.

[Lord Winston (Lab)]

My Lords, surely, this Question is an example of the great value of our genetic science in Britain, and the excellence of the National Health Service in this area. In the Midlands, as the noble Baroness has mentioned, these diseases are common, but the progress we have made in their diagnosis and treatment—and, to some extent, prevention—has been quite remarkable and will continue. I have to add that many of the diseases are extremely rare in such families, and therefore what you could do about cousins in every case would be impossible, but the information being given is exemplary in most cases.

[Baroness Merron (Lab)]

I am grateful to my noble friend for those very informed observations, and I share the assessment that he has made.

Puberty-suppressing Hormones

Lord Winston Excerpts

Monday 16th December 2024 Lords Chamber

[Baroness Merron (Lab)]

I thank the noble Baroness for bringing her expertise directly into the Chamber. We are very glad that she is in the House to do so, and she has actually answered a number of the points better than I ever could.

I will emphasise one point that I am particularly interested in, because I know it has been raised a lot, about why the legislation is being laid in respect of the use of medicines just for gender dysphoria. The noble Baroness, Lady Cass, referred to this. It is really important to emphasise that the medicine might be the same, but the fact is that it is not licensed for gender incongruence or dysphoria—that is the key point. These medicines have not undergone that process, which means that safety and risk implications have not yet been considered. It is true that there are licensed uses of the medicines for much younger children or for older adults, but the issue here is about adolescents, and it is an entirely different situation.

[Lord Winston (Lab)]

My Lords, perhaps I might return to the conventional asking of a question to the Minister—a very quick question. There are a number of practitioners who are considering, if not giving, sex steroids to patients who are requesting gender reassignment; either oestrogen or progesterone, or the equivalent male hormone. Have the Government yet considered how patients will be treated in this situation? There are certain, clear dangers involved.

[Baroness Merron (Lab)]

I understand the point my noble friend rightly raises, and I emphasise again that what matters here are safety considerations—particularly when we are talking about children and young people—but also the evidence in respect of treatments, that there should be the prescription only of medication which is safe and appropriate to the actual patient and situation.