Oral Answers to Questions

Karin Smyth Excerpts

Tuesday 13th January 2026 Commons Chamber

[Rosie Duffield (Canterbury) (Ind)]

3. What discussions he has had with King’s College London on the compliance of the PATHWAYS puberty blocker trial with the Medicines for Human Use (Clinical Trials) Regulations 2004.

[The Minister for Secondary Care (Karin Smyth)]

The PATHWAYS trial has undergone a thorough independent review and has received all the regulatory and ethical approvals. The sponsors of the study, King’s College London and South London and Maudsley NHS foundation trust, are working to ensure that it is conducted in compliance with the relevant regulations.

[Rosie Duffield]

The United States Department of Health and Human Services’ peer-reviewed report found that harms from paediatric medical transition are significant, long term and too often ignored and inadequately tracked, as testified by Keira Bell, who is here in Parliament today. What is the Government’s rationale behind medicalising yet more vulnerable children, given that we have no evidence of any benefit to this approach and, in fact, plenty of evidence of harm?

[Karin Smyth]

As the hon. Lady knows, the Government are acting on the recommendations of the excellent report from Hilary Cass, which I think she would agree is world-leading evidence, and moving the model away from medical intervention towards a more holistic approach to care. The Government will continue to be guided by that evidence, as the whole House will appreciate. The hon. Lady referenced Keira Bell, and I know that my hon. Friend the Member for Birmingham Edgbaston (Preet Kaur Gill) has asked the Secretary of State to meet clinicians and others who disagree with the trial. That meeting is being arranged, and we will continue to work under the guidelines for clinical evidence.

[Nadia Whittome (Nottingham East) (Lab)]

I remind the House that puberty blockers are still prescribed to young people who are not trans; I do not see some of my colleagues who are so exercised when puberty blockers are given to young trans people expressing the same concerns for their cisgender peers. Even Dr Cass herself acknowledged that puberty blockers are effective for some young trans people and recommended against a blanket ban. While the trial is ongoing, can the Minister outline what steps the Department is taking to increase funding and capacity for children and young people’s gender services to address the unacceptably long waiting times, which continue to cause enormous harm?

[Karin Smyth]

We need to be very careful about our language, in line with Dr Cass’s report. We are talking about children who are presenting with gender dysphoria and in gender distress. The Government support moving away from the medical intervention model towards a holistic approach to care based on the evidence, and that has cross-party support more generally, although I am not entirely sure of the position of the Liberal Democrats on supporting it. That is the model with which we are progressing. On the wider issues with regard to support for children and young people, particularly as they present across the board, this Government are investing much more than anyone else has indicated that they would in support for all services.

[Gregory Stafford (Farnham and Bordon) (Con)]

Part of the trial is to ask the child participants the Avon longitudinal study of parents and carers romantic relationships questionnaire. Is the Minister as concerned as I am that children under the age of 13 will be asked sexually explicit questions?

[Karin Smyth]

I think all Members across the House are concerned about the distress with which young people are coming forward for all of these services, and the need to support them and their families. Again, it is important that all parts of this trial follow clear ethical and clinical guidelines.

[Jonathan Hinder (Pendle and Clitheroe) (Lab)]

The Government were right to bring in the indefinite ban on puberty blockers due to concerns over the past 15 years about the gender services treatment that was being given. Over that time, 2,000 children who were questioning their gender identity have been given puberty blockers, so could the Minister explain why we are not following up on their long-term outcomes before we administer these powerful drugs to 200 more children?

[Karin Smyth]

I thank my hon. Friend for his question and his constructive work in this area on behalf of young people. I think there is a further question on this topic on the Order Paper. The Government are looking at how we can best use the data linkage study from that previous work. As I think hon. Members understand, that data was collected for different purposes—it is not of the quality that might be needed for this review—but we will continue to use all the evidence that is available, both in this country and in others, in line with the best clinical practice and under the guidance that Dr Hilary Cass prescribed in her review.

[Dr Caroline Johnson (Sleaford and North Hykeham) (Con)]

The Secretary of State has previously said that he accepts all the recommendations in the Cass review. One such recommendation is that the Secretary of State mandate the release of data for the data linkage study. Can the Minister tell us what specific steps have been taken to mandate the release of that data?

[Karin Smyth]

We absolutely stand by that work, and we are working with NHS England to make sure it is mandated to do exactly that.

[Edward Morello (West Dorset) (LD)]

4. What steps his Department is taking to ensure the accessibility of regular NHS dental check-up appointments in West Dorset constituency.

--- Later in debate ---

[Aphra Brandreth (Chester South and Eddisbury) (Con)]

8. When he plans to publish the NHS 10-year workforce plan.

[The Minister for Secondary Care (Karin Smyth)]

The Government will publish the 10-year workforce plan in the spring. This plan will ensure that the NHS has the right people in the right places with the right skills for patients when they need them, and we are engaging extensively with partners to ensure that this plan delivers for staff and patients.

[Aphra Brandreth]

I have been contacted by concerned doctors in Chester South and Eddisbury who, after five or six years at medical school and a further two years of foundation training, are now struggling to secure specialty posts and are being forced to consider leaving the NHS altogether. While I will reserve judgment on the medical training Bill to be presented later today until I have seen it in full, I welcome the fact that the Government are finally treating this issue with the urgency it deserves. Can the Minister set out how this legislation will be accompanied by a credible plan to expand training numbers, so that the number of places is sufficient to meet the NHS’s short, medium and long-term workforce needs?

[Karin Smyth]

I thank the hon. Member for her almost support for the Bill that we will present later to address much of this problem. Again, we are clearing up the mess we were left by her party, which, by changing the rules in delivering a workforce plan in 2023, essentially ramped up the supply of staff by extrapolating existing trends without any reference to the constraints or needs of the service. Our workforce plan will be different. We do hope for support for the Bill to remove some of the problem with foundation and specialty training places, and we look forward to rigorous debate on that subject.

[Jen Craft (Thurrock) (Lab)]

Unfortunately, my constituency is not unique in seeing long waits for diagnosis of neurodiversity. From 18 to 24 months is the expected waiting time in Thurrock, and some have to wait much longer. Given that, for a child, a wait of 18 to 24 months can sometimes be their whole lifespan or half their lifespan, will the upcoming workforce plan make sure that there is a plan for paediatric care, particularly for allied health professionals such as occupational therapists, speech and language therapists, and clinical physicians?

[Karin Smyth]

The services my hon. Friend outlines cover a number of different areas in different locations, and I think it is very important that the workforce plan we are bringing forward reflects a different model of care. We have seen more services going into secondary care and particularly hospitals, at the expense of community care and particularly primary care. That needs to change across the age spectrum, and the new workforce plan will be designed in lockstep with a new service design, more staff in neighbourhoods and more digital support, as well as to address the issues she outlines.

[Joe Robertson (Isle of Wight East) (Con)]

A study by the Health Foundation has found that the cost to the NHS of staff sickness and staff turnover is of the order of £12 billion a year. Will the Government’s new workforce plan cover the issue of excessive cost through the entirely avoidable turnover of staff?

[Karin Smyth]

Yes, because those issues are a result of the shocking staff morale as a result of the policies of the hon. Gentleman’s Government. As highlighted by Lord Darzi, staff morale, and issues around staff sickness and the huge increase in agency spending on their watch, are all signs of a system that is not functioning for patients or staff. We absolutely will bring forward measures to address those issues.

[Josh Fenton-Glynn (Calder Valley) (Lab)]

When the Secretary of State was in front of the Health and Social Care Committee, he recognised that we will not solve the workforce problems in the NHS without solving the workforce problems in social care as well. There are 150,000 unfilled posts in social care—three times greater than in the wider economy. What are we going to do to help solve this problem?

[Karin Smyth]

My hon. Friend and the Secretary of State are right to address the fact that we need to look across the whole span, and at people moving between those workforces. As he will know, the fair pay agreement, with the £500 million increase to support it, is part of our work to ensure those issues are addressed across the piece.

[Jo Platt (Leigh and Atherton) (Lab/Co-op)]

10. What steps his Department is taking to improve ADHD services.

--- Later in debate ---

[John Whitby (Derbyshire Dales) (Lab)]

T9. Until covid, Hulland Ward had a local NHS clinic serving the community. However, it was closed, first temporarily and then permanently, leaving many vulnerable and elderly residents without healthcare and putting immense pressure on services in Brailsford. Will the Minister consider reopening that health centre? What steps is the Department taking to ensure that more people in Hulland Ward can access healthcare close to where they live?

[The Minister for Secondary Care (Karin Smyth)]

I know that this is of great concern to my hon. Friend and his constituents. It is a matter for the commissioning officer at his local ICB. I recommend that he keeps talking with them about the best provision for his constituents.

[Dame Caroline Dinenage (Gosport) (Con)]

I was fascinated by the Minister’s earlier answer about the closure of pharmacies, because there has been fantastic news in Lee-on-the-Solent in my constituency: a new pharmacy wants to open there. Local people are desperate for a second pharmacy in Lee-on-the-Solent and the local GP practice supports it. The problem is that the Hampshire ICB has rejected it. Does the Minister share my disappointment that local people are not going to be served in the correct way by pharmacy provision, and will he meet me to discuss this?

--- Later in debate ---

[Tracy Gilbert (Edinburgh North and Leith) (Lab)]

I and a number of colleagues have concerns about the upcoming PATHWAYS trial. The Secretary of State has powers to use existing medical records for research purposes. Will he therefore consider using those powers to increase the evidence base and prevent the PATHWAYS trial from proceeding?

[Karin Smyth]

I thank my hon. Friend for her constructive approach to this difficult issue. She is right to challenge; we must have open and transparent debate. To be very clear—and to refer to my previous answer—the Secretary of State will use that power. We will have a retrospective data linkage study to identify the associations informing patient experience and outcomes, through the analysis of available digital information in health records and other nationally held databases. It will not establish causation but will be an important contribution to the evidence base.

[Ben Obese-Jecty (Huntingdon) (Con)]

Mr Speaker, I am not ashamed to say that I have had a finger up my bum—not like that! In all seriousness, as a black man in the target age range, and with a family history, I am a keen advocate for prostate cancer screening. One of my constituents has been told by his GP surgery that, as there is no national screening programme for opportunistic testing, they follow national guidance and patients cannot request a screening without GP authorisation. What advice does the Secretary of State have for those of my constituents who are struggling to get screening for prostate cancer? I say a big thank you to the team at Kingston hospital for their swift action in moving my dad from active surveillance to treatment—he raves about them.