Puberty-suppressing Hormones

Edward Argar Excerpts

Wednesday 11th December 2024 Commons Chamber

[Edward Argar (Melton and Syston) (Con)]

I thank the Secretary of State for advance sight of his statement, and for his courtesy in coming to the House to make an oral statement, which gives hon. Members the opportunity to ask him questions.

When the Secretary of State is wrong, we will challenge him robustly and hold him to account, but when he is right, we will support him. That is responsible opposition. In what he sets out today, he is right, and he has my support for what he is doing. Protecting children is one of the most important priorities that a Health Secretary can have. My predecessor, my right hon. Friend the Member for Louth and Horncastle (Victoria Atkins), worked tirelessly to do just that. She set out that it was her priority to protect children and young people from risks to their safety from the prescription of puberty blockers, given the lack of an evidence base. I welcome the Secretary of State’s continuing the work started under the previous Government, and I welcome his support at the time and all that he has done since, including in his statement on 4 September. I associate myself with the three principles that he enunciated when he opened his statement.

With increasing numbers of young people questioning their gender identity, NHS England, with the support of previous Conservative Health Secretaries Matt Hancock and Sir Sajid Javid, commissioned Dr Hilary Cass to examine the state of services for children questioning their gender. That historic review cut through the noise and ideology to lay bare the clear facts, so that we as policymakers can seek to make decisions based on evidence, safety and biological reality, and create a service that better serves the needs of children, as the Secretary of State set out. In the review, Dr Cass made it clear that not enough is known about the lifelong impacts of using puberty blockers on young minds and bodies to be sure that they are safe, and that the robust evidence base was simply not there. In March, NHS England made the landmark decision to end the routine prescription to children of puberty blockers for gender dysphoria. With the support of the then Government, it announced that it was stopping children under 18 from being seen by adult gender services with immediate effect.

As one of the final acts of the previous Government, my right hon. Friend the Member for Louth and Horncastle used emergency powers under section 62 of the Medicines Act 1968 to extend the ban to private clinics selling puberty blockers to young people questioning their gender. It was the right thing to do, and I agree with and pay tribute to her, as I do to the Secretary of State for what he has subsequently done. The safety and wellbeing of children and young people must come above any other concern. I welcome the fact that the Secretary of State renewed the order; his saying that he will make the ban indefinite, given the absence at present of an evidence base; and his seeking to better understand and build that evidence base.

I have a few questions that I hope the Secretary of State can offer clarifications on in a constructive spirit. I hope—I think he alluded to this—that he will confirm that he intends to implement the Cass review’s recommendations in full. Of course, support must be available to children and young people who are questioning their gender identity, and that support must be holistic, multidisciplinary and evidence-led. The Tavistock clinic closed earlier this year, and as he set out, three new regional NHS children and young people’s gender services have opened to provide better, tailored gender services for children and young people—again, that is based on recommendations in the Cass review. Can the Secretary of State provide more detail on the delivery of the remaining regional centres, and say what order they are due to open in, so that children and families can see what is happening in their region? Again, that is about putting the best interests of young people first.

Can the Secretary of State reassure the House that these measures will be UK-wide and that he is working in tandem with the devolved Administrations? Will he advise on what progress has been made thus far—I appreciate that it is early days—on further research into patient care and increasing that evidence base? Can he update the House on the steps taken to continue the work of his predecessor, my right hon. Friend the Member for Louth and Horncastle, when she announced to the House in May the decision to work to close any online loopholes to the regulations put in place? Finally, will he commit—I suspect I know the answer to this one—to keeping the House updated in the months and years ahead on developments in this space?

Our children and young people deserve healthcare that is compassionate, caring, careful and led by the evidence. I associate myself with the Secretary of State’s concluding remarks on the need for the debate to be conducted in a respectful and sensitive way, with the needs of children and young people at its heart. We will support measures that protect children, and support him in bringing forward such measures; we want to work constructively with the Government to give the next generation access to the right healthcare to meet their needs. I look forward to working with him in the months ahead.

[Wes Streeting]

I thank the shadow Secretary of State for the constructive way in which he has responded to the statement, and for the tone with which he has approached the issue. It is worth everyone bearing in mind that every word of statements in this House, and indeed online, are often hung upon by a particularly vulnerable group of children and young people. Many of them feel afraid about the environment in which they are growing up, as do their families. Establishing an environment in which we can discuss issues with their welfare and wellbeing at its heart is therefore the right way to approach these issues. As I have said many times before—and I am sure the shadow Secretary of State agrees—we need less heat and more light, and we can show leadership together in trying to provide that climate.

I am absolutely committed to the full implementation of the Cass review. The shadow Secretary of State asked about the implementation of new children and young people’s services on gender incongruence. As I said, the north-west London and Bristol services are now open. A fourth service is planned in the east of England for spring next year. We want a specialist gender service in every region by 2026, and of course I will keep him and the House updated on that.

I am working closely with my counterparts in the devolved Governments. I particularly welcome the engagement I have had with my counterpart in Northern Ireland and his predecessor, the hon. Member for South Antrim (Robin Swann), who is within my line of sight. I appreciate the way we have been able to work together on this and many other issues. The shadow Secretary of State asked about loopholes. I will keep the matter under close observation and review.

With regard to sanctions, penalties and enforcement, it is worth pointing out that breach of the order is a criminal offence under the Medicines Act 1968. It is a criminal offence to supply these medicines outside the terms of the order. That means pharmacists who dispense medicines against prescriptions that are not valid may be liable to criminal prosecution. It is a criminal offence to possess the medicines where the individual had responsible cause to know the medicine had been sold or supplied in breach of the terms of the order. There are fines and penalties associated with that, including case-by-case and regulatory enforcement by the General Pharmaceutical Council.

We have approached the matter in an evidence-based and considered way, and with the welfare and interests of children and young people at the heart of our decision making. I urge everyone else involved in the provision of health and care to do the same.