Wes Streeting
MP for Ilford North · Labour · United Kingdom
“We hope for the best and plan for the worst in terms of the continuation of this war, but we are also actively working to prepare for conditions in which a ceasefire has been agreed by Ukraine, with Ukraine and, from our perspective, for Ukraine.”
“The threats we face are not only evolving; they are getting closer to home. Every day, the UK and our allies encounter espionage, cyber-attacks and military posturing by hostile states.”
“One discipline I have to bring to the Ministry of Defence, drawing on my experience at the Department of Health and Social Care and the NHS, is to ensure there is no culture of routine overspending, that we are improving productivity, that we deliver value for money and that we recognise that the money we are investing in defence comes wi…”
“With permission, I will make my first statement to the House as Secretary of State for Defence on Ukraine, the ongoing threat from Russia and the Government’s approach. It is not yet clear whether freedom or tyranny will define the 21st century. What is clear is that the United Kingdom will not be a bystander in that struggle.”
“I am grateful to my hon. Friend for raising that very serious and important issue. She will understand that, as a matter of policy, I will not comment on intelligence, but I will address the reports she has raised.”
“We know that this Prime Minister and this Chancellor are both fully committed to funding our nation’s defence, including meeting our NATO commitment of 3.5% by 2035 and setting out an earlier 3% commitment at the next spending review.”
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“We will certainly write to the hon. Member with further information about Hereford CDC. On capital investment, I say to her and to other right hon. and hon. Members that we were very pleased with what the Chancellor was able to deliver in the Budget. We recognise that the stop-start we saw on a number of capital programmes under our predecessors was frustrating and we are determined not to repeat that. That is why we are setting out clear and consistent proposals for capital investment in the NHS.”
“I warmly congratulate Professor Richard Field on his clinical leadership, which has made a difference to countless lives, not only in my hon. Friend’s part of London but because of the national example that he set, which many others followed. That confirms my strong conviction that the best innovations will come from great clinicians. It is our determination to make sure that senior leadership in the NHS and in government back great clinical leadership and innovation, and take the best of the NHS to the rest of the NHS.”
“Once again, the arsonist is complaining that the fire brigade is not doing a quick enough job. We are a bit sick of it on the Government Benches, but we are at least rolling up our sleeves, getting on with the job and making improvements, and we will continue to do that. I heard the same complaints about Darzi: “What can Darzi tell us that we did not already know?” Quite a lot, actually. The Conservatives should hang their heads in shame for it.”
“I thank my hon. Friend for that question. I am a proud member of Unison, and I am proud of its work to stand up for its workforce in the social care sector. She and Unison are absolutely right to argue that fair pay is essential to recruitment and retention. That is why I am delighted that the Deputy Prime Minister included fair pay agreements in the Employment Rights Bill in the first 100 days. I am looking forward to working with Unison, GMB and others to negotiate the first ever fair pay agreements for care professionals in this country.”
“It does. I was talking about the fact that working class people are often left behind in a two-tier system where those who can afford it pay to go private, and those who cannot are left behind. It is the determination of this Government to bring back to life the essential Bevanite principle of an NHS that is there for everyone when they need it: healthcare available to all on the basis of need, not on ability to pay.”
“I am grateful to my hon. Friend for his question. That is why in the Budget the Chancellor delivered a big uplift in the spending power of local authorities, with £880 million ringfenced specifically for social care. We are also delivering through measures such as the disabled facilities grant to deal immediately with the pressures— [ Interruption. ] It is no good the right hon. Member for Beverley and Holderness (Graham Stuart) complaining. He voted against the investment, so he cannot very well complain about it.”
“Clinical academics have an important role to play in the national health service and in innovation in medicine. My right hon. Friend the Secretary of State for Education is focused on university finances, and I think universities should ensure that they prioritise efficiently and effectively, making best use of the resources available to them. I would gently say that universities have not struggled as much as other parts of the public sector over the past 14 years.”
“By definition, an elective recovery plan for England does not include Wales. However, I can assure the hon. Lady that we have a great working relationship with Jeremy Miles, the Health Minister in the Welsh Government, and with the First Minister herself. Not only are we providing support to the Welsh Government on elective reform to help them to cut waiting lists and waiting times, but we are receiving advice from the Welsh Government on areas where health and social care services are doing better than in England. Together, we will create a rising tide that lifts all ships across the UK.”
“I am so grateful to my hon. Friend for her question and for championing that issue since she arrived in the House six months ago. The disabled facilities grant is not just about new handrails, new ramps, new accessible kitchens and bathrooms and home adaptations; it is about freedom, independence, dignity and happiness. It is really good investment in preventing demand on other health and care services by giving people back their own independence and happiness.”
“Before Christmas—I appreciate that it was just before, but I wanted to get out the certainty to general practitioners before we all went off for Christmas—we announced the biggest uplift in funding for general practice in a considerable number of years, and we will now negotiate the contract in the usual way. That should give general practitioners the stability and certainty to know that this Government are determined to fix the front door to the NHS. The other thing I would say to the Opposition is that they cannot continue to welcome the investment while opposing the means of raising it, unless they spell out which services they would cut or which other taxes they would increase. They do not have an answer; they do not have a leg to stand on.”
“Of the many great possibilities and opportunities facing this country are our strengths in life sciences and medical technology. If we can combine the strength of our scientific and technological base with the ingenuity and care of our NHS staff and our ability to deliver at scale with the model that was designed in 1948, which is well served to take us well into the 21st century, the sky is the limit for what we can achieve. We will have to support staff through that revolution. I appreciate that for many staff working in the NHS today they would be grateful if the machine simply turned on when they turned up for work.”
“I am very grateful for that question for two reasons. First, it gives me the chance once again to say that the first part of the Casey commission will be reporting next year, so we can set out a whole range of further actions that will be needed throughout this Parliament. We have taken a great number of actions already in the first six months and I dare say there will be more to follow in the next 12 months. I must say it is very encouraging that one thing we are hearing from across the House on the Casey commission overall is to go faster. I think that shows genuine cross-party appetite on this issue and that is a really good place to start.”
“I am grateful for that question. I am not sure that the level of exploitation in either independent healthcare or adult social care mirrors what we have seen, disgracefully, in children’s social care, but we keep a sharp eye on that. I remind my hon. Friend of the commitments we made in opposition around tackling the excesses and the worst kind of behaviour of some private equity-owned care homes that are leeching money out of the system. We will not tolerate that. We will act to regulate further. I hope that provides Members across the House with the assurance that we are taking both a principled and a pragmatic approach to the constructive and positive relationship we want to build with the independent sector, as we rebuild our national health service and build a national care service we can be proud of.”
“My second responsibility, in addition to ensuring that patients are treated at the right time, in the right place and in the right way, is ensuring that we have a sustainable healthcare system in which there is reduced demand. That means doing more on the prevention side, so that we can keep people out of hospital and not needing to knock on the door of their GP surgery, so that they do not achieve the frequent flier status in the NHS that so many people do achieve—the one frequent flier status to which they do not aspire. We can deal with this only through both health service reform and public health reform, and I want very much to build cross-party consensus on the latter.”
“I am grateful for that thoughtful question. Let me say two things to the right hon. Gentleman. The first relates to the wider fiscal pressures on the Chancellor. I find it difficult enough to manage the different choices and trade-offs to be made between different parts of health and social care and the competing challenges that I hear from Members in all parts of the House, so I am always thankful that I am not the Chancellor of the Exchequer, who has to balance demands from the NHS alongside the demands of education, a rising welfare bill, rising child poverty and the threats to our nation. These are enormous challenges, which is why I am determined to ensure that every penny that goes into the health service is well spent.”
“I wholeheartedly agree with my hon. Friend, who has done much to bang the drum on this issue during the six months in which she has been a Member of this House. That is why we are taking a systematic approach to health and social care reform.”
“We had a referendum and two subsequent general elections on the issue of Brexit, and I can tell the hon. Gentleman that none of those three democratic events went the way that I wanted. As we said to people at the time, the country chose a path that would have consequences and implications. However, we have a constructive working relationship with our friends and allies in the European Union, and while we cannot change the past, we can build a new partnership and a brighter future for our country.”
“My hon. Friend is right, and that is why the vaccination campaign has been so important this winter. He is also right about the importance of community-based teams. One of the Darzi conclusions was that since 2019, we have significantly increased staffing in our hospitals, but because we had the wrong people in the wrong place, we ended up with falling productivity in hospitals. We need a shift out of hospital into the community, which is what our 10-year plan will deliver.”
“Thanks to the decisions taken by the Chancellor in the Budget, we are boosting the spending power of local authorities significantly, and £880 million has been ringfenced specifically for social care. I appreciate that a single Budget cannot undo 14 years of Conservative failure, but this is an important start, and of course we want year-on-year improvement in the delivery of social care. Baroness Casey will consider all these issues, and also how we can improve ease of access and care quality across the public and private sectors.”
“My hon. Friend is absolutely right about that. If we improve the service at Whipps Cross hospital for his constituents, it will have the added benefit of improving the service at Whipps Cross Hospital for my constituents, too.”
“I was grateful to staff at Derriford hospital for showing me at first hand the emergency department pressures when I visited just before Christmas. I have also visited Derriford at the height of summer, when it experiences high pressures. There are year-round difficulties at Derriford, and I thank the staff and leadership of the hospital for what they are doing in difficult circumstances. We will come forward shortly with the timetable for the new hospitals programme. I expect that it will be published sooner than the Conservatives apologise for their appalling record.”
“Some of the new capacity announced in today’s elective reform plan will come through the independent sector, and some of that new capacity will be in the NHS. It is our ambition to rebuild the NHS so that it is available for everyone where and when they need it, and we will work with the independent sector. We are publishing full details of our independent sector agreement, so that people can see the deal that we have reached, and the sensible and effective partnership, including safeguards and protections, that we have come to. I look forward to working with the sector to make sure that everyone, whatever their income and background, can get faster access to care.”
“I can definitely reassure the right hon. Gentleman that the Deputy Prime Minister and I are working very closely on this issue, which is close to her heart; she has a huge amount of experience in this area. We will follow her progress as she embarks on her local government reforms. Baroness Casey will take those reforms into account when she considers what the long-term future for social care will look like. Once again, I note the exhortation to go faster.”
“We got to work on that issue within weeks of taking office, and we will do more over the next 12 months.”
“That is an excellent question. Having put in place funding to ensure that there are 1,000 more GPs on the frontline before April, and having announced just before Christmas a significant uplift for general practice, I hope that in the first six months of this Government, we have sent the strong message to people who aspire to long careers in medicine that general practice has a huge role to play in the NHS in the 21st century. It is an exciting place to be, but I recognise that we have to fix the front door to the NHS to make it more attractive. The situation is even worse than my hon. Friend has described, because when the Conservatives left government, there were qualified GPs unable to find jobs, at a time when patients were unable to find GPs.”
“The ministerial team and I have enjoyed working with counterparts in the devolved Governments over the last six months, and we will continue to do that. Thanks to the decisions that the Chancellor took in the Budget, we see significant investment in health and care services here in England, and the Barnett consequentials will create a rising tide that will lift all ships across England, Wales and Scotland. I might even say that all roads lead to Westminster. I say this to Scottish National party colleagues: down the road to Westminster lie the resources for the SNP Government, so they do not have an excuse not to act.”
“I know it will not feel like it, based on the decisions that I am taking today, but I really do care about this, and so does this Government. I am determined to improve the quality of care and access to healthcare for all trans people. I am convinced that the full implementation of the Cass review will deliver material improvements in the wellbeing, safety and dignity of trans people of all ages, and the Government will work with them to help them live freely, equally and with the dignity that everyone in our country deserves. I commend this statement to the House.”
“This has not been helped by some highly irresponsible public statements, which threatened to put vulnerable young people at risk. In the past few months, I have met young trans people, who either have been, may be, or will be affected by the decisions that I and my predecessor have taken. I have listened to their concerns, fears and anxieties, and I want to talk directly to them. I know it is not easy being a trans kid in our country today. The trans community is at the wrong end of all the statistics for mental ill health, self-harm and suicide. I cannot pretend to know what that is like, but I do know what it is like to feel that you have to bury a secret about yourself, to be afraid of who you are, to be bullied for it, and then to have the liberating experience of coming out.”
“We do not yet know the risks of stopping pubertal hormones at this critical life stage. That is the basis on which I am making decisions. I am treading cautiously in this area because the safety of children must come first. There are some who have called on the Government not to go ahead with the clinical trial recommended by Dr Cass. Others on the opposite side of the debate want the Government to ignore the recommendations of the independent expert Commission on Human Medicines. We are taking a different approach. The decisions that we take will always be based on the evidence and the advice of clinicians, not on politics or political pressure. Finally, there are many young people in this country who are desperately worried and frightened by the toxicity of this debate.”
“At first, the new services were prioritising patients registered with the old Gender Identity Development Service, but I am delighted to report that the north-west and Bristol services are now taking patients off the general waiting list. On the waiting list, Dr Cass’s review painted a picture of a service unable to cope with demand. Children and young people face unacceptably long waits for care, with some children passing into adulthood before their first appointment, leaving them facing a dangerous cliff edge. I am pleased to tell the House that NHS England is working with potential partner organisations to explore establishing a much-needed follow through service for 17 to 25-year-olds, as Dr Cass recommended. Young people’s distress or needs do not vanish when they turn 18, and neither should their healthcare.”
“It has also published a new services specification, to ensure that children and young people experiencing gender incongruence have an appointment with a paediatrician or mental health professional before being referred to specialist services. Dr Cass was clear on the need for the model of care to change and take account of children and young people’s holistic needs. Since April, NHS England has opened three new gender identity services—in the north-west, in London and in Bristol—with a fourth expected in the east of England by the spring. That puts us on track to open services in every region by 2026. These services offer a fundamentally different clinical model. They bring together clinical experts in paediatrics, neurodiversity and mental health, so that care can be tailored to patients’ needs.”
“The National Institute for Health and Care Research is working closely with NHS England to establish a clinical trial on puberty-supressing hormones. The NIHR is now contracting the team that will deliver the study and is working tirelessly towards recruiting the first patients by spring. The trial is the first of its kind the world over. It will help us better understand the effects of puberty-suppressing hormones on young people, providing the robust evidence required. The Cass review also made clear recommendations to the Government and NHS England on improving healthcare services for children with gender dysphoria. I will now provide an update on the progress made. NHS England has published its implementation plan, which will transform its services.”
“On the basis of those findings, I am acting on the commission’s advice and putting in place an indefinite order to restrict the sale or supply of puberty blockers to under-18s through a prescription issued by either a private UK prescriber, or a prescriber registered outside the UK. This is on the advice of expert clinicians, the independent Commission on Human Medicines—advice based on the best available evidence—and follows the cautionary and careful approach recommended by Dr Cass. The legislation will be updated today, and will be reviewed in 2027, when there will be an updated assessment of the safety of the prescribing environment for these medicines. We are working to grow a thorough evidence base for puberty blockers.”
“After thoroughly examining all the available evidence, it has concluded that prescribing puberty blockers to children for the purposes of treating gender dysphoria, in the current prescribing environment, represents “an unacceptable safety risk”. Of particular concern to the commission was whether these children and their families were provided with enough time and information to give their full and informed consent. The commission found that children had received prescriptions after filling out online questionnaires and having one brief Zoom call with prescribers from outside the UK. Consequently, the commission has recommended that the Government extend the banning order indefinitely, until a safe prescribing environment can be established for these medicines.”
“In Opposition, my party and I, as shadow Health and Social Care Secretary, supported those decisions. Since coming into office, I have renewed this order twice, continuing restrictions until the end of this year. That was done jointly with the Health Minister in Northern Ireland, and I updated the House via a written statement. While the temporary ban was in place, I asked the Commission on Human Medicines to look at the current environment for prescribing puberty blockers, and we launched a targeted consultation. The commission is an independent body, made up of leading clinicians and epidemiologists, that advises on medicine safety. It took evidence directly from clinical experts, consultant paediatric endocrinologists and patient representatives, including representatives of trans people, young people and their families.”
“This Government are determined to change that. The Cass review made it clear that there is not enough evidence about the long-term effects of using puberty blockers to treat gender incongruence to know whether they are safe or beneficial. That evidence should have been established before they were ever prescribed for that purpose. It is a scandal that medicine was given to vulnerable young children, without proof that it was safe or effective, or that it had gone through the rigorous safeguards of a clinical trial. Following the Cass review, the NHS ceased the routine use of puberty blockers to treat gender incongruence in children. In May, the previous Government issued an emergency order to extend these restrictions to the private sector.”
“With permission, Madam Deputy Speaker, I shall make a statement on puberty blockers. At the outset, I wish to make clear the principles that drive the Government’s approach to this issue. First, children’s healthcare must always be led by evidence. Medicines prescribed to young people should always be proven to be safe and effective. Secondly, evidence-led, effective and safe healthcare must be provided to all who need it, when they need it. Thirdly, this Government believe in the dignity, worth and equality of every citizen, and recognise that trans people too often feel unsafe, unrecognised and unheard, and that must change. None of these simple ambitions has been achieved in recent years. Medicine has been provided with insufficient evidence, and young people have been left to go without the support and care that they need.”
“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.”
“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.”
“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.”
“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 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.”
“I think there is a danger that the focus on that treatment—because of an inevitable but necessary political process—means that it is held up as the gold standard, so some children and young people and their families feel that if they miss out on it, they are missing out on all treatment. That is not the case. Indeed, for many trans people of all ages in our country, puberty blockers have never been considered an appropriate intervention. We must see all the treatment options in the round, which is why I support the holistic approach to supporting children and young people with gender incongruence, as Dr Cass outlined in her excellent report.”
“I know that for that group of children and young people, time really does feel of the essence, so we owe it to them to get the waiting lists down faster. We are also working to implement the recommendation on the follow-through service for 17 to 25-year-olds. I know that there is some anxiety about that issue—some people have interpreted it as an extension of children’s services up to the age of 25, but that is not what we intend. It is about a transitional service from children’s to adult services, which I think will lead to better care. Finally, in the context of a statement that focuses on puberty-suppressing hormones, it is worth pointing out that they are not the only treatment for children and young people in this area.”
“I thank the Liberal Democrat spokesperson for her approach to this matter. I can certainly respond to her questions. We want all those regional centres to be up and running by 2026, and we are working with NHS England to achieve that outcome. The hon. Lady mentioned the waiting lists. To give people a sense of the challenge, the latest figures show that 6,237 children and young people are on waiting lists for gender services, so we have seen growth in the waiting list in the time that she mentioned. As with all NHS waiting lists, I want to see those numbers fall. It is particularly important to note, in the context of children and young people’s services—be they gender identity or other paediatric services—that a wait of many years can represent a school lifetime.”
“The order relates to the use of puberty blockers by that particular group of patients for that particular purpose, where the evidence base is not sound and for which the Commission on Human Medicines has described the current prescribing environment as representing an “unacceptable safety risk.” Puberty blockers are safe and proven for use among children and young people for other conditions, including precocious puberty. Where we lack a sound evidence base and a safe prescribing environment, and where that medicine represents an unacceptable safety risk, is in relation to its use for that particular purpose for that particular group of patients.”
“It is important, particularly with this group of children and young people, that clinicians ask a range of questions to identify the nature of a child’s needs, and respond appropriately by providing holistic and evidence-based healthcare. That is the best way of turning around the horrendous statistics on the effects of gender dysphoria on children and young people, and it is how we will achieve better, healthier and happier outcomes for that cohort of patients.”
“Thinking about some of the young people I have met in recent weeks and months, I have taken to heart what they have said, and I know this will be deeply upsetting to them. I do not take that lightly, but to anyone challenging me to do something else, I ask them quite sincerely whether if they were standing in my shoes as the Secretary of State for Health and Social Care, looking at recommendations from clinicians in our country—including the Commission on Human Medicines—saying that there is insufficient evidence for the use of medication in children and young people for this purpose and an unacceptable safety risk arising from the current prescribing environment, they would really take a different position.”
“I am certainly happy to continue meeting my hon. Friend on this issue. With great respect to the Council of Europe and the authors of the report that she mentions, I have to take decisions about the welfare, wellbeing and safety of children in this country based on clinical evidence. When our own Commission on Human Medicines says that there is an “unacceptable safety risk” and an unsafe prescribing environment, I have to take that seriously. When one of our country’s leading paediatricians says that there is insufficient evidence about the long-term effects of the use of this particular drug for this particular purpose for this particular cohort of children and young people, I have to take that seriously. I know there are people who will be deeply disappointed by this decision, including many trans people and their families.”
“I do not agree with the hon. Member’s characterisation. A whole range of medicines are prescribed for a whole range of uses among a whole range of patient cohorts that may well be unsafe, inappropriate or ineffective for use by other patients with other conditions. That is a basic fact of medicine and, if I may say so, the hon. Member’s intervention is why we should listen to clinicians, not politicians.”