James Murray
MP for Ealing North · Labour (Co-op) · United Kingdom
“Travellers will not need to do anything differently when using the allowances, but the revised categories change the combinations of products that can be brought into the UK duty-free. The changes were announced at the 2025 Budget and follow a review of travellers’ allowances after our exit from the European Union.”
House of Commons19 October 2026Contains Parliamentary information licensed under the Open Parliament Licence v3.0Source ↗
“The overall volume of alcohol that individual travellers are allowed to bring back remains the same; it is the categories that different alcohol products fall into that is changing. Where people have previously maximised allowances across separate categories, they may be able to bring back less of those products in total.”
House of Commons19 October 2026Contains Parliamentary information licensed under the Open Parliament Licence v3.0Source ↗
“Secondly, the existing still wine category is replaced by a single wine category covering both still and sparkling wine. Sparkling wine now forms part of the 18-litre wine allowance rather than the separate nine-litre category for drinks of up 22% alcohol by volume.”
House of Commons19 October 2026Contains Parliamentary information licensed under the Open Parliament Licence v3.0Source ↗
“I thank hon. Members for their contributions. I welcome the support of the official Opposition for this measure, and acknowledge the long-standing conversations that the hon. Member for Grantham and Bourne and I have had on different sides of the aisle along Committee corridor.”
House of Commons19 October 2026Contains Parliamentary information licensed under the Open Parliament Licence v3.0Source ↗
“Although individual travellers will not need to do anything differently when using the allowance, the revised categories will have changed the combinations that can be brought into the UK duty-free. The existing 42-litre beer allowance remains unchanged, but cider is now included in that allowance.”
House of Commons19 October 2026Contains Parliamentary information licensed under the Open Parliament Licence v3.0Source ↗
“Some travellers are now able to bring back more of certain products duty-free, while those who previously maximised allowances across separate categories may be able to bring back less of those products in total. However, the overall duty-free allowance remains the same.”
House of Commons19 October 2026Contains Parliamentary information licensed under the Open Parliament Licence v3.0Source ↗
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“My hon. Friend asks about the immediate actions that the Government are taking in response to Donna Ockenden’s review. For me, above all else—above all the shocking, harrowing detail—the review highlights the fact that women simply were not listened to. That comes up time and again. I know that it comes up in other aspects of healthcare as well, but it came up so strongly in this report and underlined so many of the shocking failures that have occurred. As a first step, extending Martha’s rule to all maternity services across the country means that when women or their family members are concerned that they are not getting the treatment or care they need, they can get a second opinion—an urgent, independent review.”
House of Commons24 June 2026Contains Parliamentary information licensed under the Open Parliament Licence v3.0Source ↗
“The hon. Lady makes an important point about the fatigue, weariness and exhaustion of families at so many recommendations being made and accepted but not put into action. To pick up on the point made earlier by the Liberal Democrat spokesperson, the hon. Member for North Shropshire (Helen Morgan), we must now break that cycle to ensure that the recommendations do not simply get accepted and sit on a shelf gathering dust, but that they feed into the plan of action, which will then produce the change that we need to see. As the hon. Member for Canterbury (Rosie Duffield) said, the change must be nationwide. Although we are today rightly talking about what happened in Nottingham, we know that it is far from the only place where such failures in maternity and neonatal services have been seen.”
House of Commons24 June 2026Contains Parliamentary information licensed under the Open Parliament Licence v3.0Source ↗
“This is a problem that goes very deep; it is systemic, cultural and deeply embedded, and a comprehensive plan will be required to change that.”
House of Commons24 June 2026Contains Parliamentary information licensed under the Open Parliament Licence v3.0Source ↗
“I thank my hon. Friend for her comments, and for talking about the shocking situation with her daughter’s baby that she managed to avert. She spoke about the inequalities, the racism and the fact of women being silenced, all of which come through very strongly in Donna Ockenden’s report. As I have explained, the taskforce I chair will now consider the full set of recommendations from that report, as well as the recommendations from Baroness Amos’s national review and other reviews and inquiries into what has happened in maternity services. That taskforce will produce a comprehensive plan of action that will cover the whole range of actions that need to be taken, because we know it will take more than one action, or even a small handful of actions, to transform maternity services and make them as they should be.”
House of Commons24 June 2026Contains Parliamentary information licensed under the Open Parliament Licence v3.0Source ↗
“While the conversation we are having today is of course about the failures in Nottingham, we know that most women will receive high-quality care, and the majority of the NHS workforce do an important job supporting them. We should make sure that is acknowledged in this difficult conversation. However, one of the changes we want to make immediately is extending Martha’s rule to maternity services right across the country, because we know it is something we can do now. Martha’s rule is a mechanism that has worked well in other parts of the NHS, and it will mean that when women and their families feel they are not being listened to, they will have a way to get an urgent, independent review of the care they are receiving.”
House of Commons24 June 2026Contains Parliamentary information licensed under the Open Parliament Licence v3.0Source ↗
“I thank the hon. Gentleman for his remarks, and for his tone and approach in encouraging cross-party working—he is absolutely right that that will be essential for making progress on this most important issue. I will consider the important point he has made about the Ministry of Justice and its remit in relation to what we have seen in mortuary services. As I said earlier, in a report full of shocking revelations, that inhumanity and lack of dignity left me truly aghast; it is almost unbelievable that it could have happened. The hon. Gentleman also raises an important point about women and their families across the country using maternity services.”
House of Commons24 June 2026Contains Parliamentary information licensed under the Open Parliament Licence v3.0Source ↗
“I thank my hon. Friend for his question. I was personally inspired by meeting Ryan’s mum Sarah when I visited Nottingham last week—she told me about Ryan, and showed such incredible strength and courage in advocating for the forgotten children in Nottingham. I can reassure my hon. Friend and the whole House that I will do everything in my power to support children with acquired brain injuries. We are working on an acquired brain injury plan at the moment, and I am also working with the Department for Education and NHS England on ambitious reforms to the special educational needs and disabilities system, including on the future direction of EHCPs.”
House of Commons24 June 2026Contains Parliamentary information licensed under the Open Parliament Licence v3.0Source ↗
“I thank the hon. Gentleman for drawing my attention to that report. We will certainly ensure that any reports containing relevant recommendations are considered as part of the taskforce’s work, because one of the changes that I want to make sure we achieve is to not have so many different reports with hundreds of recommendations that then do not become a plan of action. That is a cycle we are seeking to break through the taskforce’s work by producing a plan of action by the end of the year.”
House of Commons24 June 2026Contains Parliamentary information licensed under the Open Parliament Licence v3.0Source ↗
“My hon. Friend is absolutely right to point to regulatory failure, which has been drawn out very strongly by Donna Ockenden’s report. For me, what is completely unacceptable is that in their response to what has happened in Nottingham, they have sought to protect their own. That is something we must change, because it is only through effective regulation that we can have true accountability, and it is only through true accountability that we can get action and change.”
House of Commons24 June 2026Contains Parliamentary information licensed under the Open Parliament Licence v3.0Source ↗
“I thank the hon. Lady for welcoming our decision about applying the duty of candour to future maternity reviews and inquiries, including those in Sussex and Leeds. We have always been clear that the Public Office (Accountability) Bill—the Hillsborough law—is an important priority for this Government. As soon as it is in law, we will ensure that the duty of candour is applied. Our commitment today is to ensure that NHS staff, current or past, cannot refuse to take part in what the lead investigator wants in future inquiries.”
House of Commons24 June 2026Contains Parliamentary information licensed under the Open Parliament Licence v3.0Source ↗
“I commend my hon. Friend on mentioning his constituent, Louise Thompson, who is campaigning on this important issue. He mentioned the impact of racism, discrimination and inequality in maternity services and their failures—all raised powerfully by Donna Ockenden’s report today. As I said earlier, the action plan, which the taskforce will be producing, will be published by the end of this year. We are determined to break that cycle where recommendations get accepted and then get left on the shelf to gather dust. We want an action plan that can be implemented. We want to make sure that delivery is set out and is progressed by the Secretary of State and the Department. That is a key part of the accountability in making sure that the delivery plan is put into action.”
House of Commons24 June 2026Contains Parliamentary information licensed under the Open Parliament Licence v3.0Source ↗
“I thank the hon. Lady for expressing how she feels angry and upset. I think that that feeling is shared by all of us in the House today. The publication of Donna Ockenden’s report today has exposed the lifelong suffering of those families. The details of the action plan will be published by the end of the year, because we want to make sure that recommendations are not simply accepted and then not implemented. The recommendations must go into the taskforce, and the taskforce must produce that clear action plan, which we can then implement, and people can see us doing so. That is the way to break the cycle of recommendations that do not get implemented and to make progress towards the justice, accountability and change that I understand from families is so important to them.”
House of Commons24 June 2026Contains Parliamentary information licensed under the Open Parliament Licence v3.0Source ↗
“I thank my hon. Friend for raising the important issues that she referred to in her remarks. I am happy to make sure that either me or a member of my ministerial team will meet her to discuss them in further detail.”
House of Commons24 June 2026Contains Parliamentary information licensed under the Open Parliament Licence v3.0Source ↗
“One of those learnings that I am conscious of is how unacceptable it is that senior leaders refused to take part, for which I can see no justification whatever. I am pleased that, through the duty of candour that have we spoken about today, that will no longer be possible.”
House of Commons24 June 2026Contains Parliamentary information licensed under the Open Parliament Licence v3.0Source ↗
“My hon. Friend speaks about his constituents whose experience might be relevant to some of the findings around mortuary services and their failings. I would be happy to ensure a meeting with either me or a member of my ministerial team. As I said earlier, the details of what happened in mortuaries leave me struggling for words, because of how dehumanising, disrespectful and abhorrent that was. I would be happy to make sure that his constituents’ points are picked up as part of that. On learning the lessons from the review in Nottingham and applying that to Leeds and Sussex, we are fortunate that Donna Ockenden will be leading those reviews, having just completed the review in Nottingham. She will be in a strong position to ensure that she goes into that with the learnings she has made from the current review.”
House of Commons24 June 2026Contains Parliamentary information licensed under the Open Parliament Licence v3.0Source ↗
“Friend has said, this is not just a case of individual cases going wrong or individual members of staff making the wrong decision. It is endemic, and shows the incuriosity of leaders in maternity services about what is going on and what is going wrong in their services. It is a failure of regulators, it is systemic, and the response to it must step up accordingly.”
House of Commons24 June 2026Contains Parliamentary information licensed under the Open Parliament Licence v3.0Source ↗
“I thank my hon. Friend for his comments, and for telling us what happened to his constituent. He asked about some of the wider changes that we are making in the NHS modernisation Bill. The aim is to bring the patient experience across the NHS into the heart of the new organisation that will arise from the merging of NHS England into the Department of Health and Social Care to ensure that the patient experience drives the decisions being taken about how NHS care is delivered, and is at the heart of what we do as a Department and a national health service. However, as the report makes clear, the level of failure in maternity and neonatal services is truly devastating. It demands a specific response, which is why the work of the taskforce will begin and it will report by the end of the year. As my hon.”
House of Commons24 June 2026Contains Parliamentary information licensed under the Open Parliament Licence v3.0Source ↗
“My hon. Friend is right to emphasise quite how shocking it is that people in senior leadership positions refused to take part in Donna Ockenden’s review. I cannot understand how they could make that decision and think it acceptable. That is exactly why the law needs to change. It shows why the Hillsborough law is so important and why it was important to put it on the statute book, and also why it was important for us to decide now to apply that duty of candour to future reviews of the failures of maternity services so that never again can NHS staff, current or past, decide not to take part in the search for justice and accountability that it is so crucial for us to deliver.”
House of Commons24 June 2026Contains Parliamentary information licensed under the Open Parliament Licence v3.0Source ↗
“I thank my hon. Friend for sharing with us his experience of brain injury in his own family, and for reminding us how some of the issues that we are discussing today touch the lives of many people in the House and across the country. We all have a responsibility to act on the basis of the recommendations of today’s report, and I assure my hon. Friend that those recommendations, along with those in Baroness Amos’s report, will enable the taskforce to produce a comprehensive action plan. A key element of that work—this concerns his direct point—will be ensuring that when people are at greater risk of harm, greater risk of being ignored, greater risk of being discriminated against, lied to or not being given the care that they need, that inequality will be addressed.”
House of Commons24 June 2026Contains Parliamentary information licensed under the Open Parliament Licence v3.0Source ↗
“That is why it is so important that we develop our plan, which will have a nationwide impact, in order to finally tackle this challenge head-on and ensure that we deliver the maternity and neonatal services that women across the country need and deserve.”
House of Commons24 June 2026Contains Parliamentary information licensed under the Open Parliament Licence v3.0Source ↗
“Although the report that we are discussing today deals with what has happened in Nottingham over the past 13 years, my hon. Friend is right to point out that it has not just happened in Nottingham and it has not just happened over the past 13 years. When I have spoken to people about this report, even today, so many have shared their own stories from many years ago in all different parts of the country. That reminds us that although the focus of the report is what has happened to the families in Nottingham, this issue affects families throughout the country, which is why, as my hon. Friend says, it is “all too familiar” to so many people when they hear what has happened.”
House of Commons24 June 2026Contains Parliamentary information licensed under the Open Parliament Licence v3.0Source ↗
“She found that even clinicians working in the field were divided on the best way to support, treat and care for young people suffering from gender dysphoria. Where there is strong divergence of medical opinion on treatment, the two possible responses are either to continue with uncertainty—and with that, conflicting opinions and advice—or to undertake a trial. It is only by doing that that we can ensure that children with gender-related distress get the same access to and standards of care as everyone in the NHS.”
House of Commons23 June 2026Contains Parliamentary information licensed under the Open Parliament Licence v3.0Source ↗
“What Dr Cass uncovered was shocking and scandalous, and she made a series of recommendations for how children can be better protected and supported. It was, in my mind, unquestionably wrong for children and young people to be routinely prescribed puberty blockers for gender dysphoria without any clear evidence on their benefits or risks. The situation then was out of control and so I fully supported the indefinite ban introduced by my predecessor, my right hon. Friend the Member for Ilford North (Wes Streeting), which followed the temporary ban brought in by the previous Government. In considering what to do next, Dr Cass identified that treatment for gender incongruence was “an area of remarkably weak evidence”.”
House of Commons23 June 2026Contains Parliamentary information licensed under the Open Parliament Licence v3.0Source ↗
“From around 2009, the number of children and young people being referred for NHS support around their gender identity increased rapidly. Stories subsequently emerged of young people struggling after undergoing radical and permanent transition surgery at an early age, of children rushed into taking medication without adequate therapy beforehand, and of clinicians disregarding conditions such as neurodiversity and mental health issues. As such, there was rightly deep concern about the vulnerability of these children and young people, the care and treatments they were receiving, and the surge in referrals. And so, in 2020, NHS England commissioned the leading paediatrician, Dr Hilary Cass, to carry out a review into NHS gender identity services for under-18s.”
House of Commons23 June 2026Contains Parliamentary information licensed under the Open Parliament Licence v3.0Source ↗
“I remind the shadow Minister that it was her party that commissioned the Cass review and accepted its findings, which included the Pathways trial. I have been clear to the House that this is a challenging area. I accept and welcome the scrutiny of Members, but I encourage us to keep in mind Dr Cass’s request to consider the issues sensitively and cautiously. She says: “Polarisation and stifling of debate do nothing to help the young people caught in the middle of a stormy social discourse, and in the long run will also hamper the research that is essential to finding the best way of supporting them to thrive.” I do not think that there is any question that a few years ago, children’s safety and wellbeing was not being protected when it came to gender incongruence.”
House of Commons23 June 2026Contains Parliamentary information licensed under the Open Parliament Licence v3.0Source ↗
“I know what a sensitive, emotive and difficult issue this is. As I said in the House yesterday, I have myself struggled with the profound challenges this subject raises. We all, as adults, owe a duty of care to every child and young person in this country. That is a responsibility I bear, both as a citizen and as Health Secretary, with the utmost seriousness and sincerity. It is why, in all my deliberations on this matter, my consideration is to protect the safety and wellbeing of children and young people. Children’s healthcare must always be evidence-led, safe and effective. The way to ensure that is to follow expert clinical advice, which is what the Government are doing. Dr Hilary Cass, the clinician who I think has more respect in this space than any other, has spoken about the importance of this trial in recent days.”
House of Commons23 June 2026Contains Parliamentary information licensed under the Open Parliament Licence v3.0Source ↗
“The hon. Gentleman’s question allows me to address that matter directly. The data-linkage study will not provide clear evidence of the risks and benefits of puberty-suppressing hormones, which is needed to guide future clinical practice for this cohort. The type of information that would be available in a linkage study is much more limited than the detailed information that the research team will collect about the relative benefits and harms of puberty-suppressing hormones when accessed alongside a holistic model of care.”
House of Commons23 June 2026Contains Parliamentary information licensed under the Open Parliament Licence v3.0Source ↗
“I have responsibility for NHS England as Secretary of State for Health and Social Care, and I am setting out the protocol agreed in relation to this trial, as it is a subject that is arousing a lot of questions in the Chamber, which is fair. [ Interruption. ] I will come back to that point, if the hon. Member for Gordon and Buchan (Harriet Cross) allows me to make a little progress.”
House of Commons23 June 2026Contains Parliamentary information licensed under the Open Parliament Licence v3.0Source ↗
“That is why Dr Cass recommended a trial to study the effects of puberty-suppressing hormones on young people’s physical, social and emotional wellbeing, and to establish how best to support children and young people suffering gender incongruence.”
House of Commons23 June 2026Contains Parliamentary information licensed under the Open Parliament Licence v3.0Source ↗
“I will make a little progress, and then I will be open to more interventions. We need to be clear about who we are talking about. As Dr Cass said, the vast majority of children and young people who question their gender will resolve it without needing any support other than their friends and family. For many young people, questioning their identity, on many different fronts, is a normal part of growing up, and we should simply let them be. A small number of those young people, however, need greater support because of the level and longevity of discomfort that they feel, and that can often involve counselling or therapy. For a very small number of young people, it is possible—and I emphasise the word possible—that medical treatment would help improve their quality of life and mental health and reduce their gender-related distress.”
House of Commons23 June 2026Contains Parliamentary information licensed under the Open Parliament Licence v3.0Source ↗
“What is important, however, and what I hope will set this Pathways trial in a wider context, is all the other work that is being done to study the incidence of gender incongruence and the responses to that among young people, which will go beyond the trial we are talking about to look at children and young people questioning their gender through talking to them, understanding their mental health and their approach to that. All that will happen alongside this trial, which is one part of a much wider study to understand how best to support young people who are facing these gender-related issues.”
House of Commons23 June 2026Contains Parliamentary information licensed under the Open Parliament Licence v3.0Source ↗
“The hon. Gentleman raises an important question around how the clinical trial is designed. In this case, the young people involved in the trial, of whom there will be around 226, will be split into two groups; one half will have the puberty blockers from the start, the other half will receive them after a year. My understanding of this matter, having interrogated the detail carefully, is that a placebo would not be appropriate for this trial because the subject will be able to know the impacts of having the puberty blockers; they will be aware of whether they are having the medication.”
House of Commons23 June 2026Contains Parliamentary information licensed under the Open Parliament Licence v3.0Source ↗
“I thank the right hon. Gentleman for the tone he took in asking an important question, which I am pleased to be able to respond to. The bar for getting on to this trial is set extremely high, with strict eligibility criteria: parental consent, alongside the young person themselves consenting or assenting; a diagnosis of gender incongruence for at least two years; and consent from both the NHS care team and a national multidisciplinary team, including a wide range of disciplines, to understand all aspects of a young person’s health, context and situation. The level of approvals and scrutiny that young people will have to go through to participate in the trial will, therefore, set the bar extremely high.”
House of Commons23 June 2026Contains Parliamentary information licensed under the Open Parliament Licence v3.0Source ↗
“The Opposition’s motion would prevent us from following expert clinical advice, when proceeding with the trial is the most appropriate way forward. I say that not because I am suggesting that we should feel instinctively comfortable in doing so but because I have arrived at that conclusion after considering the clinical evidence and receiving robust assurances on the safeguards that are in place.”
House of Commons23 June 2026Contains Parliamentary information licensed under the Open Parliament Licence v3.0Source ↗
“Before and during the trial, information will be collected about mental health, quality of life, self-harm and suicidality, body image, cognition, puberty stage, physical health and side effects. I have been determined to ensure that the oversight of this trial is as rigorous and robust as it possibly can be, so I have requested monthly updates on its progress. That will include my being notified of any emerging risks. This trial is rightly one of the most scrutinised UK clinical trials of recent times. We should expect nothing less when we are talking about the health and wellbeing of some of the most vulnerable children in our country. Yet, as Dr Cass has made clear, we have to build the evidence base to show whether the treatments are safe and whether they produce the positive outcomes that young people and clinicians want from them.”
House of Commons23 June 2026Contains Parliamentary information licensed under the Open Parliament Licence v3.0Source ↗
“I have sought and had an assurance that, once they are involved in the trial, participants may be withdrawn at any point. We are not proceeding with the previous, now decommissioned, model of care overseen by the Conservatives when they were in government. We are proceeding cautiously, with rigorous safeguards in pursuit of the evidence, as Dr Cass recommended. Last Thursday, the independent MHRA approved an updated protocol that significantly strengthened the objective criteria for withdrawing children from the trial, which is a change that I welcome. Signs of greater risk to participants will now trigger increased monitoring, clinical review or their automatic withdrawal from the trial. All participants will be monitored before, at the start of, every three months during, and after the trial.”
House of Commons23 June 2026Contains Parliamentary information licensed under the Open Parliament Licence v3.0Source ↗
“They can participate only if they have had a diagnosis of gender incongruence for at least two years, have received psychosocial support through the NHS and are of stable physical and mental health. They can participate only if they are not subject to any safeguarding concerns and if they and their parents demonstrate sufficient understanding of the nature of the treatment, including its possible advantages and disadvantages. They can participate only if the treatment has been deemed clinically appropriate by both the NHS care team and the national multidisciplinary team and if they are already accessing NHS gender services. On eligibility, the bar is extremely high. The number of young people who would expect to qualify for the trial will be low and the safeguards to ensure their safety and wellbeing will be rigorous.”
House of Commons23 June 2026Contains Parliamentary information licensed under the Open Parliament Licence v3.0Source ↗
“If a child is looked after under a care order, the local authority has parental responsibility, so it would need to be part of the consent process as the corporate parent. I turn to the points raised by the right hon. Member for Salisbury (John Glen) about young people becoming involved in the trial and the checks that are in place to enable that to happen. As I set out earlier, as the trial involves children, it comes with a responsibility to interrogate and understand its design. As Health Secretary, I have sought the most detailed assurances possible from my clinical advisers as to how children taking part in the trial will be protected. There are a number of important safeguards. As I have said, children can participate only with the consent of a parent or guardian, and the child themselves must consent or assent.”
House of Commons23 June 2026Contains Parliamentary information licensed under the Open Parliament Licence v3.0Source ↗
“That is the assurance that I have sought in interrogating this matter carefully in recent days, and that is the basis on which I am talking to the right hon. Gentleman and others in the House today. We must come to a fair and settled conclusion on this matter to move forward as a country, and I believe that we should follow clinical advice and establish the clinical evidence gathered in a highly scrutinised trial with all the safeguards in place that I have described. Only that approach will give us the confidence about where we settle on this matter in the future. On that basis, the Government oppose this motion.”
House of Commons23 June 2026Contains Parliamentary information licensed under the Open Parliament Licence v3.0Source ↗
“The MHRA has introduced additional safeguards. As a result of its dialogue with the trial sponsors, the amended protocol published last week increases the level of safeguards. That means that if the regular monitoring, which will happen at least every three months—it can be more regular during the trial—shows any sign of increased risk of harm, that will lead to increased monitoring, clinical review and, when considered against objective criteria, automatic withdrawal from the trial. It is a question of monitoring this trial, possibly more closely than any trial before—the level of scrutiny is very great indeed—to ensure that at the first sign of any increased risk of harm, action will be taken.”
House of Commons23 June 2026Contains Parliamentary information licensed under the Open Parliament Licence v3.0Source ↗
“That is the assurance I have received, it is what I very much wanted to receive before coming here today.”
House of Commons22 June 2026Contains Parliamentary information licensed under the Open Parliament Licence v3.0Source ↗
“Thanks to the strengthened criteria now in place for monitoring children’s wellbeing and withdrawing them from the trial, there is now intense scrutiny, and there are robust mechanisms to prevent harm from coming to the young people who take part. It is on that basis that I believe we should follow the advice of clinical experts and seek the clinical evidence that will give us the confidence to know that where we settle on this matter in the future is right. I commend this statement to the House.”
House of Commons22 June 2026Contains Parliamentary information licensed under the Open Parliament Licence v3.0Source ↗
“Members are also wrestling with this dilemma—and, as we debate this issue today, I hope that we will keep in mind Dr Cass’s ask to consider the issues sensitively and cautiously. As she said: “Polarisation and stifling of debate do nothing to help the young people caught in the middle of a stormy social discourse, and in the long run will also hamper the research that is essential to finding the best way of supporting them to thrive.” I will not pretend that I do not continue to feel discomfort and unease, but I believe that the only way for us all to come to a fair and settled conclusion on this matter—to move forward as a country on this difficult and sensitive issue—is on the basis of clinical evidence in which we trust.”
House of Commons22 June 2026Contains Parliamentary information licensed under the Open Parliament Licence v3.0Source ↗
“After considering the matter closely over the past few days, I have requested monthly updates on the progress of the trial, including on any emerging risks. Pathways is rightly one of the most scrutinised UK clinical trials of recent times—we should expect nothing less when we are talking about the health and wellbeing of some of the most vulnerable children in our country. Yet, as Dr Cass has made clear, we have to build the evidence base to show whether the treatments are safe and whether they produce the positive outcomes that young people and their clinicians want from them. My view is that proceeding with the trial is, on balance, the most appropriate way forward. This has not been easy—I am sure many hon.”
House of Commons22 June 2026Contains Parliamentary information licensed under the Open Parliament Licence v3.0Source ↗
“On cognition, while there are no established scientific reports proving a cognitive effect, the new protocol sets out strict definitions for investigation and automatic withdrawal of young people from the trial. The new criteria for increased monitoring or withdrawing children from the trial will mean that, at the first sign of negative impacts, action will be taken. These criteria will stop short-term harm, and the view of the National Institute for Health and Care Research is that that means any long-term harm should not occur or go unnoticed. Those reassurances about preventing harm to the children who take part in the trial, and taking clear action if any risks appear to increase, are critical.”
House of Commons22 June 2026Contains Parliamentary information licensed under the Open Parliament Licence v3.0Source ↗
“All participants will be monitored before, at the start of, every three months during and after the trial. Before and during the trial, information will be collected about mental health, quality of life, self-harm and suicidality, body image, cognition, puberty stage, physical health and side effects. On bone health, puberty is normally a time of rapid bone gain, so if changes in bone density are identified, that will lead to a reassessment of whether the participant should continue in the trial, with set criteria for automatic withdrawal. On fertility, there is no published scientific evidence of irreversible changes, but that will be proactively addressed, with every participant offered repeated counselling and a range of options to preserve their fertility.”
House of Commons22 June 2026Contains Parliamentary information licensed under the Open Parliament Licence v3.0Source ↗
“The number of young people who would expect to quality for the trial will be low, and the safeguards to ensure their safety and wellbeing are rigorous. I have sought and had reassurance that once participants are on the trial, they may be withdrawn at any point. As hon. Members will know, the Medicines and Healthcare products Regulatory Agency raised new concerns at the beginning of this year, and the start of the trial was delayed so that they could be fully scrutinised. On Thursday last week, the regulators approved an updated protocol that significantly strengthened the objective criteria for withdrawing children from the trial. I welcome that change. Signs of greater risk to participants will now trigger increased monitoring, clinical review or automatic withdrawal from the trial.”
House of Commons22 June 2026Contains Parliamentary information licensed under the Open Parliament Licence v3.0Source ↗
“They can participate only if they have received psychosocial support through the NHS. They can participate only if they are of stable physical and mental health. They can participate only if they are not subject to any safeguarding concerns. They can participate only if they and their parents demonstrate sufficient understanding of the nature of the treatment, including its potential advantages and disadvantages. They can participate only if they have been deemed clinically appropriate by both the NHS care team and the national multidisciplinary team, and they can participate only if they are already accessing NHS gender services. So, when it comes to eligibility, we are talking about a very small subset of a very small group.”
House of Commons22 June 2026Contains Parliamentary information licensed under the Open Parliament Licence v3.0Source ↗
“The trial seeks to gain evidence on whether those potential benefits are real, alongside evidence on whether such treatment comes with the risk of harm. It is right that this Government are guided by expert clinical advice and a clinical, evidence-led approach, but as this study involves children, and therefore comes with a particular responsibility, as Health Secretary I have sought the most detailed assurances possible from my clinical advisers about how children taking part in the trial will be protected. There are a number of important safeguards. Children can participate only with the consent of a parent or guardian, and the children themselves must consent or assent. They can participate only if they have had a diagnosis of gender incongruence for at least two years.”
House of Commons22 June 2026Contains Parliamentary information licensed under the Open Parliament Licence v3.0Source ↗
“That can often involve counselling or therapy. For a very, very small number of young people, it is possible—I emphasise the word “possible”—that medical treatment would help to improve their quality of life and mental health, and reduce their gender-related distress. That is why Dr Cass, whose approach until recently commanded cross-party consensus, recommended a trial to establish how best to support children and young people suffering gender incongruence. That is the Pathways study. It has four main parts, one of which is the clinical trial to study the effects of puberty-suppressing hormones on young people’s physical, social and emotional wellbeing. The Pathways trial, which is being led by King’s College London and the South London and Maudsley NHS foundation trust, was initially approved last November.”
House of Commons22 June 2026Contains Parliamentary information licensed under the Open Parliament Licence v3.0Source ↗