Puberty Suppressants Trial

Julian Lewis Excerpts

Wednesday 17th December 2025 Commons Chamber

[Wes Streeting]

I will try to do that, Madam Deputy Speaker.

We will ensure that young people get good access to wider evidence-led support. I have had to wrestle with the fact that some trans people enter adulthood without ever receiving any sort of healthcare, and I have been heavily criticised by those people in particular for some of the decisions that I have taken. We are working to reduce waiting times, as I have described.

My hon. Friend says that puberty blockers are reversible. We hear contrary views about that from Members across the House, some of whom say that puberty blockers are irreversible. The truth is that the evidence in this area is mixed, which is why we need to build a stronger evidence base.

[Sir Julian Lewis (New Forest East) (Con)]

The Secretary of State deserves our sympathy for having to negotiate such an ethical minefield. Will he tell us whether the data exists from all the people who had puberty blockers under the old regime? He mentioned having met one person for whom they had worked well and one person for whom they were a disaster. Surely it should be possible to do a systematic survey of the dozens, if not hundreds, of people who went through that. Might that be a more constructive and less dangerous way forward?

[Wes Streeting]

The right hon. Member is right that we need that data linkage study. That will happen, but it will not produce the same evidence base as a clinical trial, and that is the distinction between the two. It is frankly a disgrace that people have sought to withhold that kind of data and it is really important that we get this right.

I appreciate the right hon. Member’s sympathy. I have wrestled with this issue probably more than any other ethical decision that I have had to make in this office. I do not seek any pity or sympathy for doing so—it is the job that I signed up to and a job that I love doing. I have taken great care and sensitivity in this area because of the particular vulnerability of this group of children and young people.

NHS: Winter Preparedness

Julian Lewis Excerpts

Monday 15th December 2025 Commons Chamber

[Sir Julian Lewis (New Forest East) (Con)]

I hope that the Secretary of State will give a little more consideration to the rather important point raised by the hon. Member for Walthamstow (Ms Creasy) about 16 and 17-year-olds not being able to be vaccinated.

If any junior doctor—whether or not a member of the BMA, but particularly if a member of the BMA—decides on ethical grounds to go into work during the period of the strike, and then faces sanctions from the BMA, will the Government protect them?

[Wes Streeting]

Two things: first, we will certainly give serious consideration to the point made by my hon. Friend the Member for Walthamstow (Ms Creasy)—the JCVI will do that in the usual way, and we follow its advice —and secondly, resident doctors have been to work in previous rounds of strikes, and I have not been made aware of bullying or intimidation of them. Of course, that should not be happening, and if it does, my priority will be protecting doctors who are doing the right thing. My expectation is that no one will be intimidated for making the moral and ethical judgment that going to work is the right thing to do by patients, by their colleagues and by the NHS this Christmas.

Resident Doctors: Industrial Action

Julian Lewis Excerpts

Wednesday 10th December 2025 Commons Chamber

[Wes Streeting]

My hon. Friend is absolutely right. I do wish the BMA would take yes for an answer sometimes; I would like it even more if the BMA gave yes as an answer to me once a while, but that has not happened in a little while. He is right to talk about the need for workforce planning. The workforce plan, which is in production, is all about making sure we have the right people in the right place at the right time. He mentioned mental health specifically. Our manifesto committed to 8,500 extra mental health workers over the course of this Parliament, and I am happy to report that we have already delivered well over 6,500. There is lots done, but more to do.

[Sir Julian Lewis (New Forest East) (Con)]

I find it rather shocking that when the Secretary of State for Health has offered the BMA leadership an opportunity to strike a few weeks later, they have turned it down, presumably because they prefer to strike at Christmas, when, frankly, lives will be lost as a result. Am I missing something here? Why is it, according to the Secretary of State, that the BMA leaders seem to be so determinedly militant? Does he think that in reality, they simply do not represent the views of their own membership?

[Wes Streeting]

I will say to the right hon. Gentleman that we are doing everything we can to mitigate against harm during the proposed strike dates, but I cannot in all honesty and integrity assure him that no patient will come to harm next week should the strikes go ahead, because the situation is so dire. I really urge the BMA to reflect on that overnight and into tomorrow and to ask themselves—perhaps their members will also ask this of their reps—whether it is really necessary to strike next week, given the offer of an extension to mandate.

To the right hon. Gentleman’s final point, when I was the president of the National Union of Students, I was once asked by a Labour member of a Select Committee that I was appearing before whether I was speaking for my members or for my activists. There is sometimes a difference between the two. I know that lots of people have campaigned hard for pay restoration and that many people are involved in the Doctors Vote campaign in pursuit of that aim. I think there are many doctors, however, who recognise that there has been real progress on pay and that what we are putting forward now is meaningful progress on jobs, too. I say to all members of the BMA: do not let the perfect be the enemy of good, especially when the stakes are so high.

Ageing and End-of-life Care

Julian Lewis Excerpts

Thursday 30th October 2025 Commons Chamber

[Jim Shannon (Strangford) (DUP)]

I beg to move,

That this House has considered the ageing community and end of life care.

I thank the Backbench Business Committee for selecting this subject for debate. I declare an interest as the son of Mona Shannon, who is 94 years young and resides in a nursing home near Killyleagh in my constituency. Along with most other middle-aged sons or daughters—in my case, maybe a wee bit more than middle-aged—I am acutely aware that time is marching on and so are my mum’s needs.

The wee five-foot-nothing lady who kept three six-foot sons under control is no longer to live alone, but she is as sharp as a tack and I am thankful for the wisdom she gives me when I visit her twice weekly. Indeed, I suspect that every Friday and every Sunday I get a wee bit of wisdom—and maybe a wee bit of a telling off. She always likes to know what happens in this House and I am able to tell her that, but she will also give me her opinion, which I never ignore—indeed, I probably keep to it as much as I can.

Those visits to the nursing home, coupled with the focus on assisted dying, have highlighted to me with greater effect the changes that are needed in how we handle our older generation and their needs. I have spoken with representatives of both Sue Ryder and Marie Curie not simply to highlight the difficulties that most of us will be aware of, but to offer some ways that we can improve.

I am pleased to see the Under-Secretary of State for Health and Social Care, the hon. Member for Glasgow South West (Dr Ahmed), in his place. He and I are becoming a bit of a tag team, because on three days this week he has been the Minister responding to the debates that I have been involved in. The shadow Minister, the hon. Member for Hinckley and Bosworth (Dr Evans), has been there as well, so he should not be left out.

According to Marie Curie, in the next 25 years in Northern Ireland—I know it is not the Minister’s responsibility, but I want to give the stats, because they are important— there will be 20,500 people requiring this type of care, which is a rise of 32%. That includes a doubling of need by those aged over 85. It is also projected that the number of deaths in the community in Northern Ireland could rise by 74% during that time. Approximately 60% of the cost of care delivered through the independent hospice sector in Northern Ireland is reliant on charity. That is unsustainable. A new palliative care strategy for Northern Ireland that takes account of demographic changes and associated requirements for service transformation and investment is urgently needed.

That is what is happening in Northern Ireland, and in the mainland, things are very similar. Marie Curie has highlighted that as the population ages, more people will be living with and dying with multiple complex conditions. Every week in my office, when it comes to assisting those of my mum’s generation—and perhaps some of my own—with benefits, I see people with multiple complex needs more than ever. It is not just one thing that people are suffering from, but a multitude of things.

By 2050, the number of people in need of palliative and end-of-life care in the UK will rise by 147,000 to over 745,000 every year, and that increase will be driven by a growth in the number of people dying over the age of 85. These are really important stats, and we cannot ignore them; indeed, I believe the Minister will be focusing on them. Around 90% of the people who die each year need palliative care, but one in four of them is missing out. Older people, and particularly those with a non-cancer diagnosis, are at risk of missing out on the palliative care they need at the end of life. Research indicates that most people want to receive care at the end of their life and die at home. Elderly people tell me that all the time—they want to be at home.

[Sir Julian Lewis]

I am grateful to the hon. Member for giving way; I know he is pressed for time. The charity Together for Short Lives points out that where children’s palliative care is concerned, there is wide variation across different regions in the country. Is he afraid that this applies to the ageing population as well—that there is no consistency in the amount of palliative care available?

[Jim Shannon]

I thank the right hon. Member for his intervention and for the wisdom that he brings to all the debates he participates in. The Minister is listening, and he is a good Minister, so I know he will come back with the response we hope to have.

How often have we listened to family members who are past themselves with exhaustion and guilt about how they are caring for their loved one and who feel unprepared and yet unwilling to let them go into nursing care? With more support, their lives would be easier and their loved one’s life happier. This knowledge is why I was not surprised to learn that almost £12 billion of public funds was spent on healthcare for people in their last year of life, 81% of which was spent in hospital, with only 11% spent on primary and community care.

Access to a 24/7 palliative care advice and support telephone line has been recommended as a minimum service requirement for nearly two decades, but research shows that very little has happened, which underlines the issue that the right hon. Member for New Forest East (Sir Julian Lewis) raised. Only seven of the 42 integrated care boards in England said they have a dedicated 24/7 single point of access to palliative and end-of-life care advice, guidance and onward referral to other services, when needed—those are all important factors.

Despite the introduction of a new legal duty for ICBs to commission palliative care services in the Health and Care Act 2022, the urgency and importance of ensuring that everyone has the best possible care and support at the end of life has yet to be recognised as a national priority. I hope the Minister will be able to provide assurance on this, because that is what Marie Curie wants, it is what Sue Ryder wants, and it is what every mum, dad and family member wants as well.

NHS 10-Year Plan

Julian Lewis Excerpts

Thursday 3rd July 2025 Commons Chamber

[Sir Julian Lewis (New Forest East) (Con)]

Does the NHS 10-year plan include an assisted dying scheme? If the present private Member’s Bill runs out of time at the end of this parliamentary Session, and thus falls, will the Secretary of State reintroduce the legislation as a Government Bill in the next parliamentary Session?

[Wes Streeting]

I am grateful to the right hon. Gentleman for that question—[Laughter.] Given that the Bill is still passing through Parliament, assisted dying is not referred to in this 10-year-plan, but I assure both this House and the other place that regardless of different views among Ministers and across the House, we will abide by the law of the land. We will abide by the will of this House and the other place. If the Bill times out in the other place, I have no doubt that someone else will bring it back. I suspect it will not be a Government Bill.

It is important that we have the debate and that we scrutinise the legislation well. I am proud of the way the House has conducted the debate. My hon. Friend the Minister for Care, who is not in his place now, along with the Minister of State, Ministry of Justice, my hon. and learned Friend the Member for Finchley and Golders Green (Sarah Sackman), have done an exemplary job in supporting people on both sides of the debate to give the Bill the detailed scrutiny that it had here and that it will no doubt have in the other place. That is a credit to this House.

Spending Review: Health and Social Care

Julian Lewis Excerpts

Thursday 12th June 2025 Commons Chamber

[Karin Smyth]

I thank my hon. Friend for the excellent role she plays as a clinician. Her expertise is really welcome; we want to hear from a wide variety of experts in this House—that is very valuable. She understands from her professional background, as well as from her constituency, how important it is to look at the entire pathway of care for patients, and to ensure that they have the best possible care as close to home as possible. We think that is better not just for patients, but for clinical outcomes, and it is more efficient and better use of taxpayers’ money. The move from hospitals to communities is front and centre of our 10-year plan, as is delivering neighbourhood health services.

[Sir Julian Lewis (New Forest East) (Con)]

The Minister will be well aware of Sir Andrew Dilnot’s ambitious plan to put a cap of £86,000 on the cost of the social care that any family would ever have to pay. It was never going to be easy to implement that. Previous Governments postponed the plan, and the Chancellor effectively scrapped it completely. May I appeal to the Minister to work across party lines, and to focus on the crippling debt that hits hard-working families when they come to the end of their working lives and need the support of the state?

[Karin Smyth]

I agree that this issue absolutely needs to be resolved. There was agreement previously, under the coalition, and it is so disappointing that it was so unceremoniously dumped when I came to this place in 2015; that was one of the first things that the subsequent Tory Government did. It was a great disappointment to many people across the country, particularly those who were responsible for supporting an older person or a disabled person. We have ensured that we will address this issue, and have appointed Louise Casey to lead the interim report. I know that she will continue to work with everybody, and that all hon. Members will take an active interest in that work.

Access to NHS Dentistry

Julian Lewis Excerpts

Thursday 22nd May 2025 Commons Chamber

[Sir Julian Lewis (New Forest East) (Con)]

Thank you, Madam Deputy Speaker, for that no-pressure introduction. I congratulate the hon. Member for Great Grimsby and Cleethorpes (Melanie Onn) on her speech and I agree with every part of it. I was hoping to quote from individual cases raised by constituents and from the local Women’s Institute, but all that will have to go by the board.

I have a wonderful briefing from the British Dental Association and, in the remaining two and a half minutes, I would like to make one pertinent observation, from which everything else flows. Dentistry is a highly skilled profession in which practitioners can charge colossal sums of money in private practice, which gives them a financial incentive to steer clear of working for the NHS. That is the root of the problem.

On 13 March, I put a question to the Secretary of State for Health and Social Care about a point made by the Darzi report, last September, which says:

“There are enough dentists in England, just not enough dentists willing to do enough NHS work, which impacts provision for the poorest in society.”

I was pleasantly surprised when his reply was:

“NHS dentistry is in a terrible state and, in fact, in many parts of the country it barely exists. There are lots of reasons for that, and it is a source of constant astonishment to me that the dentistry budget was underspent year after year despite that situation.”—[Official Report, 13 March 2025; Vol. 763, c. 1298.]

In reality, as the BDA points out, the reason why that budget is underspent is not because of the lack of demand, but because NHS practices cannot fill vacancies and are unable to meet contractual commitments. Therefore, those who do work with and for the NHS are having to deliver dental care at a loss. There is a fundamental requirement for a rewritten constitution and contract by which it becomes worthwhile for people to practice dentistry in the NHS, because otherwise we will see a two-tier society, in which only the rich can get the dental care that people so desperately need.

Hughes Report: First Anniversary

Julian Lewis Excerpts

Thursday 27th March 2025 Westminster Hall

[Sir Julian Lewis (New Forest East) (Con)]

I must say, the hon. Member for Leeds South West and Morley (Mark Sewards) has done us all a service by outlining in detail one case out of what are understood to be a minimum of 10,000; some estimates put the number of people damaged by mesh as high as 40,000. We should bear that statistic in mind when we think about the limited redress that people have had so far through the courts.

In the time available, I wish to touch briefly on the topics of research, legal cases, waiting lists and financial support. I make no apology for coming back to the question of research, because as we have heard, the victims of the mesh implant scandal are still suffering today, and there is no definitive gold standard of how to remediate their suffering.

I did table a question in February that drew attention to a particular world-leading expert called Dr Dionysios Veronikis, who, I gather, has developed extremely effective mesh-removal methods in Missouri. I believe that he has, in the past, offered to give the benefits of his research and successful practice to members of the NHS. I would hope that the Minister would take this away and consider whether an effort should be made to reach out to the best practitioners worldwide on mesh removal and take advantage of their expertise.

[Tony Vaughan (Folkestone and Hythe) (Lab)]

On the question of treatment, one of my constituents, who I will call Louise, endured years of pain and suffering due to the complications from mesh implants. After facing delays caused by local hospitals, she had no choice but to pay for private healthcare that would remediate the issue in one operation. That would not have been available on the NHS. She would have had to go through three separate, painful and lengthy procedures. Does the hon. Member agree that her experience underscores the urgent need for investment in urogynaecology services, as well as the justice that everybody is rightly calling for?

[Sir Julian Lewis]

That is exactly right. The problem is that people are going back for partial remediation time and time again, and it is not achieving the desired outcome.

When we move on to the question of how someone can get financial redress other than by virtue of a Government scheme, we find that of the 1,252 legal cases initiated between 2014 and 2024, only 356 were settled in or out of court with damages, but 678 were concluded without any such damages being awarded. I understand that many of those rejected were rejected because they were out of time, which leads me back to a point that I highlighted during the previous debate we had on this, in December 2024, in which it was pointed out that the 10-year limit on initiating action arising out of medical devices needs to be extended because, in this particular case, the limit has often long passed before it can be established that the victim was damaged by mesh in the first place.

I said we should remember that minimum figure of at least 10,000 mesh-damaged women and bear in mind that out of that pretty large figure—and the real figure is probably much larger still—only 1,200 legal actions were initiated. That is hardly surprising because of the extra burden placed on someone initiating a legal action.

I would also like to look at the question of removal centres. There are nine of these specialist centres, and we have established that people who are justifiably extremely worried about going back to one of them that might be run by the very person who inserted the mesh, do have the option of visiting other centres. However, when it comes to waiting times there is a huge variation. The waiting time for Bristol, which has a particularly high reputation, is much longer than for some of the other centres.

Finally, on the question of financial support, we know that the Government have had to take moves to deal with the question of personal independence payments. We hope that will not affect these victims adversely.

--- Later in debate ---

[The Parliamentary Under-Secretary of State for Health and Social Care (Ashley Dalton)]

It is a pleasure to serve under your chairship, Ms Furniss. I congratulate my hon. Friend the Member for Washington and Gateshead South (Mrs Hodgson) on securing this important debate, and I thank all hon. Members for their powerful words on this emotive topic.

I know that my hon. Friend met with the Minister for Patient Safety, Baroness Merron, last November to discuss the transparency of industry payments to healthcare practitioners, one of the nine recommendations that the independent medicines and medical devices safety review put to the then Government in 2018. This is something that the Government take extremely seriously. We must ensure that lessons are learned, and that is why we are putting patient safety at the heart of improving our health and social care system. I will continue to build a system that listens, hears and acts with speed, compassion and proportionality.

I want to repeat the apology that the previous Government made, which was echoed by my predecessor, the hon. Member for Gorton and Denton (Andrew Gwynne), and by Baroness Merron. I say to all of those mentioned today—to Samantha and her family; to my hon. Friend the Member for Washington and Gateshead South’s mam; to the constituents of my hon. Friends the Members for Leeds South West and Morley (Mark Sewards) and Stoke-on-Trent North (David Williams), my hon. and learned Friend the Member for Folkestone and Hythe (Tony Vaughan) and the hon. Member for Chichester (Jess Brown-Fuller); to Karen from Harrow East; to Bev from Bury North; to Colleen, Andy and Byron from North West Norfolk; to Paula and Gillian from Bexleyheath and Crayford; to Paula Goss; and to all those affected in the Gallery and across the country—we are sorry. We are sorry for the time the system took to listen to you and to your families. Everyone who has suffered complications from sodium valproate and pelvic mesh implants has our deepest sympathies and our assurance that we have listened and will continue to listen to those affected.

I am grateful to the Patient Safety Commissioner, Dr Henrietta Hughes, and her team for the Hughes report, which was published just over a year ago. It built on the important work started by Baroness Cumberlege in 2020. We will continue to work closely with Dr Hughes on how best to support affected patients and prevent future harm, on both this issue and a number of others.

The independent medicines and medical devices safety review was among the first of its kind, shining a searing spotlight on the harmful side effects of certain medicines and medical devices, including sodium valproate and pelvic mesh. The Cumberlege review revealed grave systemic issues in our health system that needed to be addressed with urgency. They covered areas ranging from the healthcare system’s lack of engagement with patients to the lack of safety monitoring for devices once they are on the market. That is why we are working to improve how the system listens and responds to concerns raised by patients; to strengthen the evidence base on which decisions are made; and to improve the safety of medicines and medical devices.

Recommendation 8b of the IMMDS review stated that there should be mandatory reporting for industry payments made to the health sector, akin to the Physician Payments Sunshine Act in the US. The previous Government accepted that in principle and held a six-week consultation. I recognise the importance of transparency and trust in the health system, and the Department is considering options regarding payment reporting, with an aim to publish a response later this year.

I absolutely understand why colleagues are pushing for clarity on our response to the Hughes report. I am acutely aware that this is a difficult and sensitive topic, and I appreciate frustrations about timescales, but this should not be rushed. The Government will need to consider carefully all the options and the associated costs before responding to the report’s recommendations. I assure Members that we will continue to progress this work across Government, ensuring that lessons are learned, and I will commit to writing to Baroness Merron on the timescales, as requested by so many Members today.

[Sir Julian Lewis]

I think it is true to say that the author of the Hughes report anticipated that the Government would want to take their time over these matters, but that is why Dr Hughes—and Baroness Cumberlege, I believe, as well—recommended an interim payment. If at least that interim payment could be made, people might be more patient about the bells and whistles that have to be added to the response later.

[Ashley Dalton]

I do appreciate the frustrations. Since we came into government last July, patient safety has been, and I can confirm that it remains, a top priority for this Government. Although it has been a year since the publication of the Hughes report, this is a complex issue involving several Departments, and it is important that we get the response right. As I have said, I will commit to writing to Baroness Merron on timescales, as requested, to get further clarification on that, and we are committed to learning from other instances in which patient safety has been impacted. The infected blood inquiry was mentioned by the right hon. Member for Salisbury (John Glen).

NHS England Update

Julian Lewis Excerpts

Thursday 13th March 2025 Commons Chamber

[Wes Streeting]

My hon. Friend is absolutely right: if we just replicate NHS England as it is with all the challenges in its set-up in ICBs across the land, we will have failed. Frankly, if we replicate NHS England and the Department as they are today just in one organisation, we will have failed to meet the challenge of change. It needs to feel and act like a completely new organisation, culture and way of working to modernise the state, so that if Disraeli, Gladstone, Churchill or Attlee walked into Whitehall at the end of this Government, it would not look so much like the Government they worked in during the 19th and 20th centuries. That is the reality of Whitehall today; it is not a reflection on the people who work in it, but it shows why it needs to change, and that is also true of the NHS. I look forward to working with ICB leaders to reform their ways of working, clarify their priorities, give them clearer marching orders and ensure that they can deliver.

Finally, my hon. Friend mentions the staff of NHS England—indeed, this affects staff in my Department, too—and I thank her for the care she has shown. Change is always disruptive and it can be scary, and of course that is particularly the case when job losses are involved. I want to acknowledge that on the Floor of the House, as I have to staff across both organisations this morning. I know that the Permanent Secretary and the chief executive of NHS England have done so in recent days, and I will be holding a town hall with staff next week. This really is not a reflection on them. In fact, I think they will recognise in my description of our ways of working the many things that frustrate them. None the less, they are dedicated and talented people, and some of the best people I have ever worked with in any walk of life or career work in this system. I look forward to working with them in the coming weeks and months with the same dedication and professionalism they have always shown, so that we can all look back on this time with pride, knowing that we were part of the team that took the NHS from the worst crisis in its history to getting it back on its feet and making it fit for the future.

[Sir Julian Lewis (New Forest East) (Con)]

Does the Secretary of State agree that one of the worst and most intractable problems that the founders of the NHS had to deal with was the involvement of medical practitioners and consultants who were used to receiving a private income in a national service where they would not receive anything like the same remuneration? If he agrees, would he accept that there is a similar situation with NHS dentistry today? The Darzi report said:

“There are enough dentists in England, just not enough dentists willing to do enough NHS work, which impacts provision for the poorest in society.”

How does he think his reforms will help address that particular crisis, on which Members like myself and my right hon. Friend the Member for New Forest West (Sir Desmond Swayne) are being consistently and rightly lobbied by such formidable organisations as the New Forest branch of the women’s institute?

[Wes Streeting]

NHS dentistry is in a terrible state and, in fact, in many parts of the country it barely exists. There are lots of reasons for that, and it is a source of constant astonishment to me that the dentistry budget was underspent year after year despite that situation. The Minister for Care is working with the British Dental Association to reform the contract. I know that Members are frustrated at the pace, and so am I. We are trying to clear an enormous challenge; it is not going to be easy, but we are committed to working with the profession. We are rolling out the 700,000 urgent dentist appointments and supervised toothbrushing, as we promised and as the BDA has welcomed, but we have a lot more to do. That requires working with the profession—not simply tinkering with the system as it is, but fundamentally rethinking it and how we rebuild it into an NHS dentistry service that we can be proud of.

Puberty-suppressing Hormones

Julian Lewis Excerpts

Wednesday 11th December 2024 Commons Chamber

[Wes Streeting]

Very heavy consideration—of all the considerations, it is the one that has weighed most heavily. As I said in my statement, trans people too often find themselves at the wrong end of the statistics on mental ill health, self-harm and suicide. I take those issues very seriously indeed.

What I would say to my hon. Friend, Members of this House, and campaigners—particularly online actors—is that a number of claims have been made about the data that are not borne out by the facts. In fact, I asked Professor Louis Appleby, the Government’s suicide prevention adviser, to examine the evidence for some of the claims made that there has been a large rise in suicide. His paper, published on 19 July, concluded as follows:

“The data do not support the claim that there has been a large rise in suicide in young gender dysphoria patients at the Tavistock.

The way that this issue has been discussed on social media has been insensitive, distressing and dangerous, and goes against guidance on safe reporting of suicide.

The claims that have been placed in the public domain do not meet basic standards for statistical evidence.

There is a need to move away from the perception that puberty-blocking drugs are the main marker of non-judgemental acceptance in this area of health care.

We need to ensure high quality data in which everyone has confidence, as the basis of improved safety”.

I would add that it is important that we make sure that these children and young people have access to good-quality mental health support, and I am working with NHS England to make sure that this is the case. This area is one in which all Members should tread carefully when engaging in debate.

[Sir Julian Lewis (New Forest East) (Con)]

I do not think anyone who has listened to the Secretary of State today could be in the slightest doubt about the responsibility that he has borne and the personal empathy that he has injected into his handling of this very difficult question. I personally thank him for it.

I was told a long time ago that one should never ask a question in the House to which one does not already know the answer, but I think I will break the rule this time. What about surgical procedures? One hears about irrevocable steps such as so-called top surgery—the removal of healthy breast tissue from young females. Where does the law stand on that issue at the current time?

[Wes Streeting]

The only thing worse than a Member not knowing the answer to their own question is the Minister not knowing the answer. Happily, in this case, I can say that surgical intervention for trans people does not apply to children and young people.