Puberty Blockers Clinical Trial

Tonia Antoniazzi Excerpts

Monday 23rd March 2026 Westminster Hall

[Jamie Stone (Caithness, Sutherland and Easter Ross) (LD)]

I beg to move,

That this House has considered e-petition 751839 relating to the clinical trial into puberty blockers.

It is always a pleasure to speak under your chairmanship, Mr Mundell. I sincerely thank everyone I met in preparation for this debate: the legal and medical professionals who shared their expertise and the individuals with deeply personal, lived experience on both sides of this discussion. It goes without saying that this is a complex topic. I am grateful for the time and care that people have taken to help inform this debate.

I also thank the petition’s creator, James Esses, and petition supporter and campaigner Keira Bell. I had the pleasure of meeting them ahead of this debate, and they are watching today. Their petition asks that the clinical trial for the use of puberty blockers be cancelled. They believe that medical intervention in this area is dangerous, poorly evidenced and ethically questionable. They have asked Parliament to ensure that children are protected from potential harm.

I want to make it crystal clear that this debate is not about trans rights or whether people who identify as transgender have the right to exist and live free from discrimination. This discussion focuses on a clinical and ethical issue: whether puberty blockers should be prescribed to children experiencing gender dysphoria, and specifically whether a new NHS-backed clinical trial into their use should proceed.

Puberty blockers are medicines that suppress the production of sex hormones. They press pause on puberty, delaying changes like periods, breast development, voice changes and facial hair growth. Historically, they have been prescribed to children who enter puberty unusually early and, in some cases, for the treatment of cancers or endometriosis. Importantly, they are distinct from gender affirmation or cross-sex hormones. Blockers temporarily pause development, while cross-sex hormones actively induce the physical changes of the opposite sex and are generally irreversible.

The petition raises two main areas of concern: the possible long-term medical side effects of puberty blockers, and whether meaningful consent can ever be obtained from a child or adolescent.

[Tonia Antoniazzi (Gower) (Lab)]

The hon. Gentleman is making a very good start to his speech. I appreciate that this is very contentious, but I am concerned about the manner in which young people—children—are asked questions. The KIDSCREEN-10 index is a primary outcome measure for the PATHWAYS trial, and when I look at the questions, I wonder how my son would have answered them aged 11. One of them asks:

“Have your parent(s) treated you fairly?”

The truth is that any child at that age would probably say, “No.” Does the hon. Gentleman share my concern that these questions are not fit for purpose?

[Jamie Stone]

I thank the hon. Member for her intervention, but she will understand that it is my job as Chairman of the Petitions Committee to present a fair description of both sides of the discussion, which is what I hope to do.

James Esses, who started the petition, is a psychotherapist, and he impressed on me the benefit that good psychiatric intervention could have, without medicalisation. Puberty, he argued, is rarely a picnic for anyone—it can be confusing, uncomfortable, and sometimes miserable—but it is an essential developmental stage, and suppressing it pharmacologically could alter physical and cognitive development in ways we do not yet fully grasp. His argument is not to remove care for children experiencing gender incongruence, but to focus efforts on careful psychological support.

Others question the trial’s purpose, noting that puberty blockers have already been paused for new NHS patients with gender incongruence, following concerns about safety. They fear that authorising a new trial implies a level of confidence that the evidence base does not yet justify, arguing that enough data exists to recognise the potential harms, from reduced bone density to uncertain impact on brain development. Continuing could erode the safeguards that protect young people.

--- Later in debate ---

[Josh Newbury (Cannock Chase) (Lab)]

It is a pleasure to see you in the Chair, Mr Mundell. At the outset, I want to acknowledge the strength of feeling on all sides of this debate, and our responsibility in this House to provide clarity that is grounded in evidence and centred on the wellbeing of the young people we are talking about.

The petition calls for the cancellation of the planned clinical trial of puberty-suppressing hormones, describing them as unsafe and inconsistent with safeguarding. However, the reality is that Dr Cass was clear in her review that we are lacking evidence, and that one of the scenarios where she believed that puberty blockers should be prescribed for gender incongruence is a clinical trial. A trial is a response to uncertainty, focused on ensuring that clinical decisions are made on a foundation of robust evidence.

I find it a little more than ironic that, when the Cass review was published, many of the voices now telling us that a trial should not go ahead were saying that the Cass review should be accepted and implemented in full. They have gone from saying, “We need the evidence,” to, “This trial should be stopped.” If someone can show me another way of properly gathering clinical evidence other than a full clinical trial, then I am all ears, but, in reality, we are talking about shutting down options for trans people. With waiting times for a first appointment for a gender identity service currently standing, in many cases, at more than five years, it is not as if there are copious alternatives out there for this group of young people. Many are waiting the entirety of their adolescence just to start treatment. Would we tolerate that for any other group of patients? I doubt it.

[Tonia Antoniazzi]

Will my hon. Friend give way?

[Josh Newbury]

In the interest of time, I will not.

Although I respect the concerns that have led many to sign the petition, I urge colleagues to reflect on the consequences of the course of action it proposes. Cancelling research does not resolve uncertainty, but entrenches it. In doing so, it risks leaving vulnerable young people without the evidence base needed to support safe, informed and compassionate care. As someone who is proud to be an ally of the trans community, I believe that we have a duty to ensure that trans young people hear a clear message from this House: they are supported, respected, cared for and never alone.

--- Later in debate ---

[Tom Tugendhat (Tonbridge) (Con)]

It is a pleasure to serve under your chairship, Mr Mundell. We should start off by recognising that the life choices that adults make, in whatever way they make them, are to be respected and not criticised. This matter is not in any way a criticism of anybody who chooses a trans identity or who identifies as trans, or who chooses any other identify or identifies in any other way. It is simply about the experimentation on children.

Let us be clear: we would not tolerate any form of medical experimentation on children in such an uncertain category with any other treatment. We would, quite rightly, put forward the Hippocratic oath to do no harm. To change that, particularly for a group of children who are often already suffering from some other element of potential harm, including autism, as the hon. Member for Canterbury (Rosie Duffield) mentioned, would be to re-victimise children who are already vulnerable. This issue must be treated delicately and carefully, but the truth is that it is getting wrapped up in identity politics and being played with politically by those who wish to advertise their progressive credentials but who are forgetting that it is fundamentally about one thing: the protection of children.

[Tonia Antoniazzi]

Will the right hon. Gentleman give way?

[Tom Tugendhat]

I will not. Whatever the views of people in this room, there is a second element that this Government must consider. We are already seeing honourable individuals like Keira Bell who have raised the problem of detransitioning, and we are seeing the legal costs of their actions against the state. What money has the Government set aside for legal action for those who are too young to consent because they are not 18 years old and who will therefore able to bring legal action against the state for any experimentation that was done on them, as would have happened in this circumstance?

[Emily Darlington (Milton Keynes Central) (Lab)]

It is a pleasure to serve under your chairmanship, Mr Mundell. I want to start with the expression, “Do no harm.” To be clear for the people who have come to speak to me—parents and young people themselves—we are doing them harm by not giving them the treatment they need, with the wait times of six years, and potentially in respect of puberty blockers, where that is agreed with their healthcare professionals.

My overarching concern is that the clinical trial was suggested in the Cass review. It was proposed and designed in conjunction with the MHRA, but then the MHRA changed its mind. Why was that? Dr Hilary Cass said:

“There are no new research findings and the MHRA hasn’t presented any new evidence. It feels to me like they are responding to political pressure rather than to science.”

That is what she said; I was quoting her verbatim. It was her review that the people around this Chamber wanted us to listen to and to make changes in response to, so we have to listen to her in this instance as well.

The MHRA should operate without any political interference or fear of legal action, yet the MHRA itself referenced potential legal action in relation to the trial as one of the reasons why it changed its mind. That is a problem. The MHRA is there to make sure that anything from clinical trials to medical technologies and new drugs are dealt with on the basis of science and science alone.

[Tonia Antoniazzi]

The problem is that the MHRA lead, Professor George, is being hounded and scapegoated after recusing himself. It is really sad to see a professional in such a situation. I urge my hon. Friend to use words with caution, because he recused himself. He is a great man who is being hounded.

[Emily Darlington]

I am not for hounding any particular individual. The only person I have referred to by name is Hilary Cass and she has been on the public record. I have been hounded for my views as well—

[Tonia Antoniazzi]

We all have.

[Emily Darlington]

Exactly, and that is completely inappropriate. A leader of a political party shouted “Traitor” at me when I said we should watch our language around this issue. I do not know who they think I am a traitor to, but I am certainly not one to the human race. The hon. Member for Canterbury (Rosie Duffield) has said she has received death threats; I get death threats too. This is not unique to the hon. Member.

The MHRA should not be in an environment where it has any fear of any legal action; it should only look at the science. Many in the community feel that the trial has now become too political for anybody to touch and that we have forgotten about those children who, quite frankly, if we do not do anything for them, we are doing harm.

--- Later in debate ---

[Rachel Taylor]

For the sake of time, I will not.

The need to be guided by evidence is precisely why the current situation is so troubling. It is concerning that the MHRA initially raised no objections to the trial when it was approved but has since changed that position. As Dr Cass made clear, no new evidence has been presented to justify that shift. That raises serious questions about the basis of the decision, and whether an independent regulator has buckled to pressure from a well-funded lobbying campaign. As a consequence, vital research is now at risk, and that matters. The trials are not an optional extra; they are the mechanism through which we build the evidence base that critics say is lacking.

[Tonia Antoniazzi]

Will my hon. Friend give way?

[Rachel Taylor]

No, I am not giving way.

We cannot afford to sacrifice the future of vulnerable young people on the altar of ideology. The trials received ethical approval and were recommended by one of the country’s foremost experts in child health. It is vital that they go ahead so that we can build the evidence we need to support safe, effective healthcare for young trans people.

Oral Answers to Questions

Tonia Antoniazzi Excerpts

Tuesday 11th February 2025 Commons Chamber

[Wes Streeting]

The hon. Member is absolutely right to put the spotlight on paediatric health. Mental health is important for children and young people, but physical health is too. This Government are committed to dramatically reducing waiting lists and returning to the 18-week standard by the end of this Parliament, but we should aim to go even harder after those childhood waiting lists, because many children waiting in pain and agony are losing valuable years of their childhood that they will never get back.

[Tonia Antoniazzi (Gower) (Lab)]

The Government know how hard I have worked as co-chair of the all-party parliamentary group for medical cannabis on or under prescription. I am pleased to hear that there is a trial, but I urge the Minister and her team to make sure that it actually goes ahead, as others have not because of Brexit, covid and elections. Can she please meet me to ensure that the APPG and I are kept up to date on the work of the NHS?

[Karin Smyth]

My hon. Friend has been a strong campaigner on this issue on behalf of her constituents, and I congratulate her on that work. We are confident that the randomised trial will go forward, and we have invested over £8.5 million in it. I am very happy to meet her, and I urge people to come forward and support the trial. That is the way forward on this issue.

Puberty-suppressing Hormones

Tonia Antoniazzi Excerpts

Wednesday 11th December 2024 Commons Chamber

[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.

[Tonia Antoniazzi (Gower) (Lab)]

I thank the Health Secretary for his statement and for the manner in which he continues to handle this important issue. I welcome the fact that the Government are following clinical evidence, particularly in relation to children and young people, whose wellbeing and protection are paramount—that is the right approach. Given that the Cass review found insufficient evidence on whether puberty blockers are safe, and highlighted their potential harms, there are understandably concerns about the risks of trialling them. Can the Secretary of State reassure me that the upcoming trial will have robust safeguards, and will he continue to be led by the wellbeing and safety of children?

[Wes Streeting]

I can certainly give my hon. Friend that assurance. Better-quality evidence is critical if the NHS is to provide reliable and transparent information and advice to support children and young people, and their parents and carers, in making potentially life-changing decisions. That is why we support the setting up of the study into the potential benefits and harms of puberty-supressing hormones as a treatment option. The study team’s application for funding is going through all the usual review and approval stages ahead of set-up—including peer review, consideration by the National Institute for Health and Care Research funding committee, and ethical approval processes. We want the trial to begin recruiting participants in spring 2025. I am confident in the robust, appropriate and ethical way in which the trial is being established.

Cass Review

Tonia Antoniazzi Excerpts

Monday 15th April 2024 Commons Chamber

[Tonia Antoniazzi (Gower) (Lab)]

The starting point of all modern medicine must be robust and reliable—in fact, rigorous—evidence. Back in 2017, I tabled a written question at the request of a trans constituent who was concerned that many adults and young people were putting themselves through a process that was not the right one for them. That was in 2017, and we still do not have much better data, but the data is the most important thing; it informs everything.

There has been a chilling effect in this Chamber, and on social media, on people who have spoken out, and who have asked questions like that—questions that we ask for reasons to do with everyday healthcare, which we have denied, and the Government have denied, to the children in our care. My hon. Friend the Member for Ilford North (Wes Streeting) has been fantastic; he has shown great maturity and reflection in his comments in the Chamber and in the media, and so has the Secretary of State, but as someone who has been at the other end of this, I say: please, Secretary of State, let us get the tone of this debate right, and move forward. The Cass report is a great thing, and we have to work with it to deliver the best outcomes for the children in our care.

[Victoria Atkins]

Again, I approach the Dispatch Box with humility because I know about the journey that the hon. Lady has been on, and about the debates and questions that she has brought forward, not just on behalf of the constituent that she mentions, but on the wider issue of the treatment of women in healthcare and in other parts of public life. I very much want us to view the future as a clean sheet, so that we can build services around children, rather than expecting them to slot into services for the convenience of arguments that were put forward in the past.

However, we have to acknowledge that this has been such a long and toxic debate that there will be people who want answers. I appreciate the fact that the hon. Member for Ilford North (Wes Streeting) has walked back some of his comments, but it is important that we acknowledge the toxicity, so that we can move on and achieve exactly what the hon. Lady and I, and others around the Chamber, seek. [Interruption.] Interestingly, Opposition Members are chuntering from sedentary positions. I think that we can make a real change, but a little less sniping from the sidelines and a little more constructive work is needed.

Under-age Vaping

Tonia Antoniazzi Excerpts

Wednesday 12th July 2023 Commons Chamber

[Andrew Gwynne]

I am grateful to my hon. Friend for succinctly stating the reason for this debate. That study is very clear: for adults, the appearance of the packaging makes no difference, but children and young people are attracted to the bright colours and cartoon characters and so on. The same arguments were made about smoking and led to us moving several years ago to standardised cigarette packaging. The evidence on children vaping is now so overwhelming that Parliament must take the lead. Industry will not act without a nudge from us. We must make sure that vapes are not packaged and advertised in a way that attracts children.

In a recent article penned for The Independent, a teacher in Oxfordshire described having been:

“rostered on to control numbers of students in the toilet block in an attempt to prevent the constant vaping that goes on in there.”

She went on to describe discovering

“a stash of over 50 vapes stored above a ceiling panel in the toilets—a tactic learnt and shared on TikTok.”

Worryingly, ASH estimates that most children who vape make the purchases themselves, despite it being illegal to sell vapes to those under the age of 18.

[Tonia Antoniazzi (Gower) (Lab)]

My hon. Friend is making an excellent speech. Only yesterday, I had a call from a head of year in Gowerton School in my constituency who wanted to know why the police and social services were not acting on his reports of sales of vapes in a barber’s shop in Swansea city centre. Does my hon. Friend agree that it is up to the police, social services and trading standards to take a stand and stop the face-to-face sale of vapes to under-age children?

[Andrew Gwynne]

Absolutely. There has to be a strategy that is not just about restricting packaging and advertising. There has to be more enforcement at the local level. I have some sympathy with local government, which has had to endure massive cuts over the past 13 years, so that things such as trading standards have been cut right back to the bone, but there can be no excuse whatsoever for shops selling these products to children. Every action should be taken to prevent that and to enforce the law.

Prescription Charges: People Aged 60 or Over

Tonia Antoniazzi Excerpts

Monday 6th March 2023 Westminster Hall

[Tonia Antoniazzi (Gower) (Lab)]

I beg to move,

That this House has considered e-petition 594390, relating to prescription charges for people aged 60 or over.

It is an honour to serve under your chairship, Sir Edward. The petition I am presenting touches on a number of incredibly important issues in healthcare from access to treatment to public health and preventative care, all within the context of how the NHS adapts to an ageing population. Although the petition focuses on prescription charges, it must be considered in the broader economic context of the cost of living crisis, with months of rising prices and inflation where even the most basic necessities are becoming luxury items for many.

The steady rise of pensioner poverty since 2015 shows no sign of stopping, continuing a trajectory that will see millions of us face a retirement dominated by debt and hardship. That context means we are duty-bound to look beyond figures on spreadsheets and examine what the proposed scrapping of free prescriptions for that age group would mean for those who would be impacted by it. It is those impacts that the petition creator Peter had in mind when he set it up.

When I spoke to Peter about why he started the petition, he shared his concern about the impact these changes would have not on him, but on his local community—the men and women who are already struggling with costs and are making difficult choices about what to prioritise. It is people like him who have spent a lifetime working in industry and those who, because of that work, now suffer from a variety of medical conditions, each needing different medications. It is those women, including his wife, who had their lives upended by the callous way the Government implemented the equalising of the state pension age. WASPI—Women Against State Pension Inequality Campaign—women, who were born in the 1950s and live in England, have further issues to deal with compared with those in devolved countries.

[Margaret Ferrier (Rutherglen and Hamilton West) (Ind)]

Uprating the age when prescriptions become free in England to be in line with the state pension age, as the Government consulted on, would be harmful given the cost of living crisis, as the hon. Lady said, and the growing economic activity in those over 50 for various reasons, including their health. Does she share my concern about what this could mean for ease of access to medical treatment for the older generation?

[Tonia Antoniazzi]

I thank the hon. Lady for her contribution. It is, indeed, a huge concern that people with multiple health problems are facing extra difficulties in accessing prescriptions and are having to make those difficult choices about how they spend their money.

For Peter, it seems that something has gone incredibly wrong to get us to this point—something broader than this planned introduction of charges, but something encapsulated by it. It is the breaking of a promise—the promise between citizen and state and the promise that a lifetime of contribution, whether financial through tax and national insurance or through the unpaid labour of care that enables our economy to function, means support in retirement. Peter kept his part of the bargain. It was great to have a conversation with him. He could not believe that his petition was being debated in this place, and it is so important that his voice and the voices of others are heard in this place. He kept his part of the bargain, first in the shipyards on the Tyne and then working on aircraft. He paid in and did what was expected, as did hundreds of thousands of others, but the Government have not held up their end of the bargain. They have changed the rules, and it looks like they will do so again. That unfairness is the reason why we are discussing the matter today.

The plan to introduce charges seems particularly unfair when Peter does not even have to look that far from home to see a better way. England is the only nation in the United Kingdom without free prescriptions and, as colleagues may have guessed from my accent, I am Welsh. I have the great pleasure of representing Gower, one of the three Swansea constituencies, which is beautiful. If anyone ever wants to visit, please do.

Swansea and Newcastle have a lot in common: both are port cities with a proud industrial heritage; both are famous for an excellent night out. It seems the height of unfairness to many in Newcastle and across England that they alone in the United Kingdom pay for prescriptions. I am sure that the Government will tell us that several conditions are exempt and that pre-payment certificates cut costs, but, as I said earlier, we must look beyond the briefings to the reality of the system actually. The exemptions list is not only woefully out of date but, apart from the addition of cancer in 2009, it has not been reviewed since 1968. It also does not cover several life-changing conditions, such as Parkinson’s, arthritis, asthma, Crohn’s disease, cystic fibrosis, lupus or motor neurone disease.

That is the tip of the iceberg. People with those conditions, and other complex, lifelong conditions, still pay for their prescriptions. For those with multiple, co-existing conditions, the cost is even higher. Evidence from the Prescription Charges Coalition, a group of 50 organisations calling on the Government to scrap prescription charges for people with long-term conditions in England, shows that people with long-term conditions struggle to pay for their medication. A third of respondents in England with long-term conditions reported that they had not collected a prescription item due to the cost. Nearly a third admitted that they are skipping or reducing medication doses, with cost concerns a key factor for more than four out of 10. As a direct result of reducing or skipping medications, nearly three in five—59%—became more ill, and 34% needed to visit their GP or hospital. In fact, the Government’s own impact assessment on the introduction of charges highlighted that issue and noted the potential effect on people’s health.

In 2018, thousands of over-the-counter medicines were taken off the list of those that GPs are able to prescribe, leaving those with long-term conditions facing additional costs for their conditions and to stay well. Those worrying health outcomes come with a cost to the NHS. Several member organisations of the PCC conducted research last year. They found that, of those surveyed, one in six of those with asthma and lung disease had cut back on using their potentially life-saving inhalers, as they were worried about the cost; 29% of respondents with cystic fibrosis reported that they had skipped their medication due to prescription charges; and one in five people with multiple sclerosis say that they do not have enough money to pay for the medication or treatment they need.

One lady who lives with kidney disease was hospitalised twice because she had to wait until payday to collect a prescription. In hospital, she had to have a lumbar puncture and an MRI scan, which cost the NHS thousands of pounds more than the prescription would have. As colleagues can see, the impact is vast and, when meeting campaigners prior to this debate, I heard far too many stories like that one. The lived reality of those impacted by this proposed change and the issues caused by the current dysfunctional exemptions system are best understood through that lens.

I work closely with Parkinson’s UK, which is one of the many organisations deeply concerned by this proposal. Medication is the only way to control the symptoms of Parkinson’s disease; most have to take a cocktail of medications to stay well. Research shows that Parkinson’s cost households over £19,000 a year in 2021, due to loss of work; and additional health and social care costs. As Parkinson’s progresses, it becomes more complex. Among people eligible to pay for prescriptions who are aged 60, in any year 5.5% will die within five years and 23.8% will need support to live independently—that is within only five years of being diagnosed. However, they would still have to pay for their essential medications for Parkinson’s.

I want to tell the Chamber a little about Denise. She is 59 and was diagnosed with Parkinson’s in April 2019. She has had to reduce her working hours from 37.5 to only 12 per week, due to her symptoms. She uses a prepayment certificate for her prescriptions, because it is cheaper than purchasing them individually. If the exemption age rises to 66, however, she will have to continue paying for them.

Denise told Parkinson’s UK about the impact that that would have on her:

“I always thought I would work until I was 67, because I would be able to. However, as my Parkinson’s advances I worry about whether I physically will be able to. My employer is really understanding, allowing flexibility to start later in the mornings until my medication has kicked in, but I have already had to reduce my hours by 60% and I’m already noticing the impact of this reduced earning capacity on our household.

I have to pay for my prescriptions, and this is eating into the diminishing amount I can contribute towards the household bills. If they were to increase the age at which I become exempt, it would be really tough because we haven’t allowed for more years of these additional charges.

It feels like the Government is once again penalising those living with a long-term condition like Parkinson’s that anyone could get and for which currently there is no cure.”

Denise’s story is not an isolated one. Parkinson’s is not the only condition whose sufferers will be further disadvantaged by the change, but this is not a problem that will be solved by changing the exemption list. An exemption list has winners and losers baked into its design, and the complexities of managing chronic conditions mean that any approach that is not universal is not fit for purpose.

Furthermore, the Government need to answer why the change is being prioritised now. What evidence is there that it will have any kind of positive impact? We cannot see one. Even if the Government make savings in the short term, the long-term impacts could be catastrophic, leading to greater illness and to more GP and hospital visits.

A poll published in Pulse found that 40% of GPs linked prescription charges to adverse patient outcomes, also indicating that those could lead to far greater costs and more adverse outcomes down the line. Initial results of the 2023 survey by the Prescription Charges Coalition showed that nearly 10% of respondents had not collected medicine due to cost. Of that group—I have more data —30.74% said that they now have other physical health problems, in addition to their original health condition; 30.33% said that they had to go to their GP; 17.32% said that they had to go into hospital for treatment; and 8.32% said that they had to go to A&E.

Research published in 2018 by York Health Economics Consortium highlighted how ending prescription charges for long-term conditions could save money and reduce pressure on the NHS. That comes from preventing avoidable health complications that occur when people do not take their medication. The research identified net savings of more than £20 million per year if the NHS scrapped prescription charges for people with Parkinson’s and inflammatory bowel disease alone. Instead, the Government are discussing introducing additional charges. That flies in the face of common sense.

We know that the NHS is under pressure, but that is the case across the United Kingdom, and the devolved nations are not even discussing removing universal free prescriptions. I urge the Government to follow that lead, to look to the future and not to engage in short-termist, quick fixes that will not be a fix for all, and not for the petition creator.

--- Later in debate ---

[Tonia Antoniazzi]

I thank Members for participating in the debate and the Minister for his response. I am sure that the people I have met will not be reassured by that response, but it is difficult, with no decision having been made about the reduction in prescription charges. That needs to be done, and the Minister needs to confirm it.

I feel for the many unpaid carers—mostly women—who look after children or partners, given of the impact of this situation on them. People see that as unfair, and the system is not perfect, so we hope that change will come.

Question put and agreed to.

Resolved,

That this House has considered e-petition 594390, relating to prescription charges for people aged 60 or over.

Health and Care Bill

Tonia Antoniazzi Excerpts

Consideration of Lords amendments
Wednesday 30th March 2022 Commons Chamber

[Edward Argar]

I will not now, but I may during my wind-up speech, if I have time. I want to conclude my remarks so that colleagues can make their contributions on the matters that I have referred to, but if there is time, I commit to taking an intervention from the hon. Lady at the end of our consideration of this set of Lords amendments.

We come, finally, to Lords amendment 92 and the amendment offered in lieu relating to abortion. I am aware of strong and sincerely and genuinely held views from Members on all sides of this debate and this issue, and I respect the integrity of their views. Although I will set out why the Government took the action that they did and the procedure that is in place, I emphasise at the outset that, given that this matter is before the House because of an amendment by their lordships, it is right that this is properly considered and that this will be—in line with how we normally treat these matters—a free vote, in which how individual Members vote will be a matter of conscience.

In response to the covid pandemic, an approval was issued in accordance with the Abortion Act 1967 that allowed women to take both pills for early medical abortion at home. That temporary measure addressed a specific and acute medical need, reducing the risk of covid-19 transmission and ensuring continued access to abortion services. My right hon. Friend the Secretary of State announced last month that the approval will end at midnight on 29 August 2022.

[Tonia Antoniazzi (Gower) (Lab)]

Does the Minister acknowledge that, in Wales—[Interruption.]—and in Scotland, telemedical abortion will continue to be available to all women after the covid-19 pandemic has finished? To be honest with the Minister, that needs to follow suit in England.

[Edward Argar]

I would not suggest for a moment that Wales or Scotland should follow England or that England should follow Scotland and Wales. They are devolved competences. Each devolved Administration will rightly form their own view of the balance of benefits, the pros and cons, and that is right. That is what our devolution settlement is for. This House is considering the amendment that was brought here from the Lords and this is an opportunity for Members to express their view on what should happen in this country.

The Government remain of the view that the provision of early medical abortion should return to pre-covid arrangements, and face-to-face services should resume, given that the temporary change was based on a specific set of emergency circumstances. However, we recognise that their lordships have made an amendment in that respect and it is therefore right that this House considers it.

In normal times, we prefer and believe that decisions about the provision of health services are more appropriately dealt with through the usual processes, rather than through primary legislation. We have a number of concerns about the approach taken in the amendment. Parliament has already given the Secretary of State a power to issue approvals under the Abortion Act. That allows the Secretary of State flexibility to make decisions about how healthcare in this area is provided, which can be adapted quickly and easily to respond to changes in service provision or other external circumstances, as was the case with the temporary approval in response to concern about the risk to services from covid-19.

From a process perspective, it is not appropriate, in our view, to insert into primary legislation the intended detail regarding home use of both pills. That would mean that should any issues arise, there would no longer be scope to react quickly, as the Secretary of State did during the pandemic. However, we recognise that that is now a matter for debate and decision by this House.

In addition, Lords amendment 92, as drafted by my noble Friend Baroness Sugg, would not have the intended effect. If agreed to, it would create legal uncertainty for women and medical professionals by including wording on the statute book that does not, in fact, change the law in the way it appears to. On a procedural point, we therefore urge all right hon. and hon. Members to disagree with the Lords in their amendment.

All Members have the opportunity, however, to vote on our amendment (a) in lieu, which we have drafted to ensure, irrespective of colleagues’ views, that the provision does the job it was intended to do. We all agree that it is crucial that the law is clear in this area and does not create any uncertainty for those who rely on it. That is why we have tabled our legally robust amendment in lieu, which stands in my name and which would achieve the intended purpose of Baroness Sugg’s amendment.

It is for right hon. and hon. Members, in a free vote, to judge how they wish to vote on the amendment in lieu. I encourage them to reflect and make their decision when the amendment is pressed to a Division.

Abortion Services Commissioning: Northern Ireland

Tonia Antoniazzi Excerpts

Tuesday 14th December 2021 Westminster Hall

[Tonia Antoniazzi (Gower) (Lab)]

It is a pleasure to serve under your chairship, Mr Pritchard. I congratulate my hon. Friend the Member for Pontypridd (Alex Davies-Jones) on securing this timely debate on the commissioning of abortion services in Northern Ireland. I am proud of her work, as my predecessor, for women and girls in Northern Ireland. I will endeavour to do all that I can to support them.

At the beginning of my parliamentary career, I worked as Parliamentary Private Secretary to the shadow Northern Ireland team and was a member of the Women and Equalities Committee. This afforded me the opportunities to work with colleagues in Northern Ireland and to have a greater insight into the inequality of women in Northern Ireland compared with the rest of the UK. I had the opportunity to meet the hon. Member for Belfast South (Claire Hanna) before she was in this place. I remember the conversation well. She spoke today about compassion and learning and that this issue is a journey. I think we all understand what a journey it is for women in Northern Ireland.

Being part of the Women and Equalities Committee when it did the report on abortion law in Northern Ireland gave me an in-depth view of the change that was needed to move forward. I pay tribute to all the organisations and politicians who spoke to us. Moreover, I pay tribute to the women who shared their deeply personal experiences with us as well.

The standpoint of the Labour Front Bench is that these women should have the right to make an informed choice. Any woman who suffers a loss or makes a decision to end a pregnancy should have support services available to them. I was very dismayed to hear that there is an 80% increase in need, and limited funding means that women have got up to a six month waiting list for support. How can this be acceptable in 2021?

I have listened to all of the speakers in today’s debate. It is important that we all understand and are respectful of each other’s views. I was brought up a Roman Catholic and my father was the deputy head of a Roman Catholic school. I had that one-sided view of the right to life. However, as a woman and having been in education for 20 years, I have seen at first hand the pain that girls and women have had to go through. That is why those services are so important. As my hon. Friend the Member for Pontypridd outlined at the start, this is not a debate about the mechanics of devolution; it is a debate about the rights and the duty of this Parliament to uphold the rights of citizens across the United Kingdom. The law is clear: we need to get on with delivering those services.

The hon. Member for North Antrim (Ian Paisley) and the hon. Member for Strangford (Jim Shannon) talked about the views of the people in Northern Ireland. I want to draw their attention to an Amnesty International poll, done by an independent research company in 2020, which

“demonstrates an overwhelming demand for change to Northern Ireland’s draconian abortion laws.”

It is important that we are fair, just and transparent about the data that is out there on the views of people in Northern Ireland.

As my hon. Friend the Member for Pontypridd explained in her excellent speech, the changes to abortion laws extended abortion rights to the women of Northern Ireland. They were made in line with the recommendations of the UN Committee on the Elimination of Discrimination against Women and affording women in Northern Ireland those rights was about aligning abortion policy across the United Kingdom. It was a key moment for us, but little has changed since March 2020 for women in Northern Ireland. This is the title of the debate, and the lack of the commissioning of abortion services in Northern Ireland is having a direct impact on women.

The debate is about the rights of women in Northern Ireland and their right to access basic reproductive healthcare without needless barriers. It is about their right to clear, accurate and impartial advice and guidance about their healthcare choices. There is a worrying lack of impartial guidance, if any guidance at all, on a woman’s right to choice when she finds out she is pregnant. The GP should be women’s first port of call and they do not always get the advice they need there. When women turn to the internet and google abortion services in Northern Ireland, they are led to services that put in delaying tactics, making it impossible for them to terminate their pregnancy if they wish to. It also forces more and more women to purchase abortion pills online. We should not be in that situation. Fortunately, those women are not living in fear of prosecution now when they use that service.

[Ian Paisley]

Will the hon. Lady give way?

[Tonia Antoniazzi]

Unfortunately, I need the time.

The lack of commissioning means that Informing Choices NI has had to withdraw its central access point and BPAS has had to come in to support it as well. Women have a right to have high-quality access services as early as possible and as late as necessary and those rights are currently denied to women because of the inaction of the Northern Ireland Executive, the Department of Health in Northern Ireland and the Secretary of State. It has been nearly two years since those essential services should have been made routinely available in Northern Ireland, but as colleagues have said, the reality for many women is that the change in legislation might as well not have happened.

The lack of funding or a commissioning framework has led to piecemeal service provision, with women’s access dictated by their postcode. Women in the Western Health and Social Care Trust area have had not access to services in nine months and they cannot go to another trust to access services, having to pay nearly €500 privately to go to Ireland or to England and access pills online if it is not too late. What should be a service for all becomes a service for a lucky few: those who can take a hit to their income, take a day off work or travel the hours to access healthcare. That is not fair. The impact of covid has also been felt in service provision and in the travel restrictions.

The reality for women in Northern Ireland is that access to basic healthcare rights is in no way guaranteed. Will the Minister and the Secretary of State for Northern Ireland meet me to discuss an immediate way in which the Government can address the current crisis for women in Northern Ireland? What additional measures will the Executive put in place, especially in light of the new covid variant omicron, to ensure that the provision will be extended and maintained into the new year?

I look forward to hearing what the Minister has to say, because this is a very important issue for women and girls in Northern Ireland.

Health and Care Bill

Tonia Antoniazzi Excerpts

Report stage
Tuesday 23rd November 2021 Commons Chamber

[Caroline Nokes]

I thank the hon. Lady for using exactly that term because she is right: it is about the NHS picking up the pieces and spending taxpayers’ money trying to correct something that should not have been done in the first place. If it is to be done to somebody, it should be done only by the qualified, trained and, as my new clause argues, licensed. I call today for some form of licensing or regulation. I absolutely accept that the Minister may view my new clause as deficient and not doing what he would want it to do. I appreciate the fact that he took the time to meet me and other Members last week to discuss the issue, because there are concerns throughout the House.

I pay particular tribute to my hon. Friend the Member for Sevenoaks (Laura Trott), who has done so much work on injectables in respect of under-18s and deserves absolute credit for getting her private Member’s Bill on to the statute book. That is amazing work and I really appreciate the fact that she has done it. Nevertheless, we need to do more and to go further.

I pay tribute to a number of my constituents who, following the work I did last year on the beauty industry, approached me on this issue. In particular, I pay tribute to Dr Chris Rennie of Romsey Medical Aesthetics, and to Dr Mitra Najafi, who has developed an incredible process by which plasma-rich platelets are extracted from a patient’s blood and injected back into them. It is a highly medicalised procedure and her big worry is that if it falls into the hands of somebody who is unregulated and unlicensed, it could be extremely dangerous indeed. Those with medical qualifications absolutely understand how they have to treat blood products; the stark reality is that those without do not.

I pay tribute to aestheticians—I struggle to say that word—such as Naomi O’Hara who came to me, as someone who practises, to call for regulation and licensing.

I pay tribute to a lady who is not my constituent but travelled to Romsey to see me: Tania Gough, who publishes the Image Directory. Her concern was that it is perfectly possible for someone to set themselves up in practice with next to no training whatsoever. She spoke to me of some of the horror stories that she herself had seen and some of the training courses she had gone on that she said were quite simply not worth the money she paid for them or the waste of her time. She said that certificates were issued at the end of such courses that gave the impression that people were qualified and trained when in fact they had had no more than a couple of hours—in one case it was 90 minutes—of training.

I also pay tribute to the Chartered Institute of Environmental Health and the Joint Council for Cosmetic Practitioners; they have been incredibly supportive and helpful in the drafting of new clause 1. The Joint Council for Cosmetic Practitioners says:

“The creation of a national licensing scheme for practitioners of aesthetic non-surgical cosmetic procedures would ensure that all those who practise are competent and safe for members of the public.”

To my mind, that is the abiding word: safe. We want those who receive these sorts of treatments not to be putting themselves in harm’s way.

I look forward to the Minister’s response; I know he is listening on this issue. He can expect me not to push my new clause to a vote, but I very much hope he can show us a constructive way forward that may take us to the regime that we want to see.

[Tonia Antoniazzi (Gower) (Lab)]

I could speak about so many aspects of the Bill—such as the U-turn on the social care cap, the lack of action to include health inequalities, allowing private healthcare providers to access our NHS and, frankly, whether a reorganisation of the NHS at this time of crisis is what we need to support all our healthcare workers—but I am sure that colleagues will more eloquently cover a lot of those points in their contributions. As the chair of the all-party parliamentary group on cancer, I will restrict my comments to the amendment on the NHS workforce tabled by the right hon. Member for South West Surrey (Jeremy Hunt).

Staffing is the biggest challenge facing the NHS. The Prime Minister claims to be building 40 new hospitals; if that ever happens, they will be of no use to anyone if there are not the doctors, nurses, radiotherapists, pharmacists, porters, cleaners and other staff to look after patients. As we have already heard, the NHS had 100,000 vacancies before the pandemic started. That, coupled with the intense strain and burnout that staff have suffered over the past 18 months, is causing a crisis in staffing that needs bold action now.

The Budget was a missed opportunity to invest in the people who make the NHS great, but amendment 10 would go some way to rectifying that. According to research from Macmillan, it is estimated that we need an extra 3,371 cancer nurse specialists by 2030—that is a doubling of the number of cancer nurses in just over eight years if we are to have any chance of providing the care and support that patients deserve. Macmillan has worked out that it would cost £174 million to train and develop specialist cancer nurses to plug the gap. Any increase in funding would be passed on to devolved Governments through Barnett consequentials. In the grand scheme of things, £124 million in England, £31 million in Scotland, £12 million in Wales and £7 million in Northern Ireland is not too much to ask of the Government—it is probably in the region of the amount of money spent on security for the Prime Minister’s trip to Peppa Pig World at the weekend.

World Menopause Month

Tonia Antoniazzi Excerpts

Thursday 21st October 2021 Commons Chamber

[Tonia Antoniazzi (Gower) (Lab)]

I would like to commend the hon. Lady for her speech and to commend my hon. Friend the Member for Swansea East (Carolyn Harris) for the excellent work that she has been doing. I also commend everybody in the Chamber this afternoon. I had a very similar experience to that of the hon. Lady at the age of 48 or 49. On the point about prescriptions, we are fortunate in Wales and I did not have to pay for my HRT prescriptions. I would like to give a shout-out to the Welsh Labour Government for looking after women in that way.

[Nickie Aiken]

I thank the hon. Lady for her intervention.

I had a discussion with the Secretary of State for Health and Social Care this week about the costs of HRT and the stresses and strains on the NHS budget following covid, which I understand. With this in mind, will the Minister reiterate to the House the current NICE guidelines and ask NICE to reach out to GPs and encourage them to tell their patients about all the options available to them, as well as any associated costs? I understand that there is a system in place where women can get an annual prescription for their HRT, but there is a lot of confusion about that, so I would appreciate it if the Minister could address that in her summing up.

As has already been said, and I completely agree, the menopause is not just a women’s issue. This is a people’s issue, and men have to be part of the discussion, too. I thank my hon. Friends the Members for Totnes (Anthony Mangnall), for Eastleigh (Paul Holmes) and for Heywood and Middleton (Chris Clarkson) for sitting down with me last week to ask about the menopause—my hon. Friend the Member for Totnes asked, “Will you please talk me through the menopause?” because he knows how important it is—and I gave them a complete and utter description. They were quite horrified, to be honest.

It goes back to what my hon. Friend the Member for Hazel Grove (Mr Wragg) said: men have to understand what their mothers, sisters, partners and work colleagues are going through if we are ever to break down the barriers and make the menopause less of a taboo. I reiterated that to the Secretary of State for Health and Social Care this week, and he agreed with me that men have a huge part to play in breaking down the barriers.

It is important that we consider the workplace. I take my hat off to the likes of Timpson and PwC for their brilliant work. Women, and particularly menopausal women, make up so much of the workforce. I am a woman in the prime of my life and hopefully just beginning my political career in this place. I believe I have so much to offer, and knowing that I have the HRT and the support will help me. We need to ensure that companies focus on developing strategies to help their women, and to help their colleagues to help women through this.

I am proud to support the Government’s ambitious project to set women’s health as a huge priority. We are making women’s voices heard and putting them at the centre of their own care, to make sure that our national health system truly works for the whole nation. I believe the Minister is listening and I look forward to her response.