YouSaid · the spoken record
Victoria Atkins
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On the record 2015–2026
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“I thank my hon. Friend for his powerful question. I am going to deal, if I may, with his point about a public inquiry, because I know that there are some who are asking whether that would be appropriate. Will my hon. Friend take it from me that, at the moment—bearing in mind that the report landed less than a week ago—I am determined to drive forward the actions that are needed on the ground to help children and young people? We have had a four-year review into this—Dr Cass has gathered a great deal of evidence and it is a very thorough review—and so, for the moment, I want to concentrate on implementing the recommendations and on ensuring that the services are brought up to the standards that my hon. Friend rightly understands. On my hon. Friend’s second point, of course I will liaise with my colleagues in the Department for Education.”
House of Commons15 April 2024Contains Parliamentary information licensed under the Open Parliament Licence v3.0Source ↗
“I am conscious that I have just answered that, but may I put on the record my thanks and respect for everything that the hon. and learned Lady has done in this field? She has at times had to walk a very, very lonely path, and I find it extraordinary that parliamentarians—who are elected to represent the best interests of our constituents, and indeed of our countries—would find themselves under that sort of pressure for simply stating biological fact. I hope that the hon. and learned Lady will be working with me to ensure that the recommendations in the Cass review are applied not just in England but in Scotland, in Wales and in Northern Ireland.”
House of Commons15 April 2024Contains Parliamentary information licensed under the Open Parliament Licence v3.0Source ↗
“This report sets out the evidence, which was not there before. It has taken four long years of very hard work to gather that evidence, and I hope and expect that the health sector will implement these recommendations. I also hope we can have a conversation about our wider public space, and I was very pleased to read the article by my right hon. Friend the Minister for Women and Equalities over the weekend. We have to de-politicise the public space and ensure that this evidence is applied across the board for the health of all our constituents and our country.”
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“I hope he will never again behave as he did in the Chamber that day, because that is how we sort out the toxicity of this debate.”
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“I am sorry, but I think there is a certain amount of disbelief in the Chamber. I cannot be the only one who remembers the debate on the Gender Recognition Reform (Scotland) Bill in January 2023 when the hon. Gentleman not only tried to shout down female Opposition colleagues but felt so exercised that he crossed the Floor of the House to sit next to my hon. Friend the Member for Penistone and Stocksbridge (Miriam Cates). I remember how Conservative Members were genuinely surprised that a Member of Parliament would think it appropriate to behave in that way when debating a subject that we are entitled to, and should feel free to, debate. I am sorry to hear that the hon. Gentleman suffered the abuse that he describes, but setting a good example starts at home.”
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“I thank my hon. Friend for his careful and considered question. I very much hope that the Scottish National party Government will look at the evidence very carefully and find the recommendations to their liking. It is to NHS England’s credit that it has acted so promptly, and I would hope and expect that the devolved nations, let by the Scottish National party and the Welsh Labour party, will follow with similar speed. As I have had to say, because it is in line with the atmosphere in which clinicians are having to operate, the Hate Crime and Public Order (Scotland) Act 2021, brought forward by the Scottish National party Government and supported by Scottish Labour, cannot help the considered debate that we wish to have about this very complex subject, and I encourage them to look at that as part of their overall approach.”
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“This Government, including me and many of my predecessors as Prisons Minister, set clear rules to ensure that situations such as the Karen White case are not repeated, so it was very troubling that Opposition Members did not appear to have the same concerns when it came to the placing of a trans double rapist, Isla Bryson, in Scotland. [ Interruption. ] I am being told that it is not true but, if Opposition Members want to factcheck, apparently it was the deputy leader of the Labour party who said that it does not matter.”
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“True leadership is not just about being careful with the words we use. I will not recite the many words that other Labour Members have used about trans issues. They say, for example, that it is factually inaccurate to say that only women have a cervix— [ Interruption. ] I am not naming them, but that seems an extraordinary things for a Labour Member to say. [ Interruption. ] They do not like to hear their words repeated back to them, but I will resist that temptation and instead focus on the application of policy. Trans prisoners, including those who are fully intact and have been convicted of serious sexual offences, are demanding to be held in prisons that match their chosen gender.”
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“The brevity of my answer demonstrates my respect for the observations and experience of my hon. Friend the Member for Stone (Sir William Cash). I completely agree with him, and I will enjoy working with him on this.”
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“I thank the hon. Gentleman for his advocacy on this issue. I very much hope that all Members will be able to use the evidence produced in this review and report in future debates about legislation so that we can all make informed and correct decisions.”
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“I thank my hon. Friend and near neighbour for that. She is right, as is my hon. Friend the Member for Stone (Sir William Cash), to emphasise that this is about not just the debate within the NHS, but what happens online. I know that parents of children affected by this are very aware of the online “grooming”, as they describe it, of children on social media. I do not want to trespass for the time being on the regulators—we have already had some constructive conversations with them—but the will of the House is clear that we expect the report to be followed and clinicians to act on the basis of that evidence.”
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“I thank the hon. Lady for her thoughtful question, because she rightly lists some of the mental health conditions that both Dr Cass and professionals in this area have realised can be part of the complex needs of children and young people who are asking questions of their identity and about their path in life. On funding, the financial value of the contract last year with the Tavistock was £9.3 million, but for this financial year NHS England has committed some £17.1 million for the two new hubs for gender services. Of course, they will keep this under review as we build up the services across the country in the ways envisaged in the report.”
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“I completely understand my hon. Friend’s desire for accountability. I just remind us all that some clinicians have acted in a morally exemplary way, trying to blow the whistle on practices they observe. He and I, and, I hope, others, want to ensure that clinicians who have not acted in accordance with their professional duties are held to account. As I say, ongoing conversations are taking place with the independent regulators, but I suspect that they have very much understood the way in which the House is viewing this and the seriousness with which we view clinicians who have not abided by their professional duties in this regard.”
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“I hope the hon. Lady will forgive me if I have misunderstood her question, but I think she is referring to the decision that NHS England will prevent under-18s from accessing adult gender services. A consultation has just closed and we are looking at the results of that, but I am very sensitive to the needs of young people within that 17-to-25 cohort for whom the “cliff edge”, as it has been described to me, of moving from children’s services to adult services may not be in their best interests. I promise that that is very much the focus of my work on this in the weeks ahead.”
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“I thank my hon. Friend sincerely for that. Again, she articulates the concerns of many families where a teenager or young person may be suffering complex needs and are asking questions of themselves and their place in society. We must treat not just the child or young person, but the family with care and respect, trying to support them to get to the right place for the child.”
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“It is about the healthcare and emotional care and support that we give to young people and their families, and the professional confidence we give to clinicians to ensure that we get to the right place for each and every individual child.”
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“I thank the hon. Lady for giving me the opportunity to make it clear again that this report is about gathering the evidence to help support our children and young people to the best care they can have. For a very small number that may well be a medical pathway, but for the overwhelming majority we know from Dr Cass’s report that there may be other ways in which they can be best supported and looked after. I do not want anyone to walk away from this debate thinking that this is somehow a report about those adults who have made that decision of their own free will and are living their lives as freely as we all want them to—it is not.”
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“My hon. Friend’s observations about Members from other parts of the Chamber and their response to this are well made, frankly. [ Interruption. ] Gosh, I am being told they are not true. Crikey, Opposition Members may have just opened up a Pandora’s box. On my hon. Friend’s point about supporting people who have gone through the process and are trying to detransition, she is absolutely right that they need particular care. I am actively looking into what NHS England needs to provide to look after the very complex needs that such people have.”
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“I genuinely thank the right hon. Gentleman for giving me the chance to re-emphasise that. When I have talked about ideology, it is the ideology influencing or making assumptions about the provision of services for any child or young person who is questioning their place, sexuality, identity or future path in life. The ideology is the one that influenced the services that Dr Cass has set out so very well. Of course, if an adult chooses to live their life as a transgender adult then they must do so freely, and, I would hope, with compassion and understanding from all of us. By the way, I have been talking about this for many years; when I was Minister for Women, I talked about this subject. We must deal with this issue in a caring and careful way, and that is what Dr Cass emphasises in her report.”
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“I very much agree with my hon. Friend. He is always very good at exposing the differences in treatment that patients in Wales receive compared with those in England. Given that the leader of the Labour party has said that Wales is the “blueprint” for how it plans to run the NHS in England, I hope and expect that the Labour party will be true to its word and the Labour-run NHS in Wales will be announcing its immediate adoption of these recommendations, as well as the transformation to services that we in England are already undertaking.”
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“I refer the hon. Lady to the answer I gave earlier about funding. In relation to the waiting list, we have already removed the Tavistock as the single provider of these services. We have now set up two sets of services in highly respected—world-respected—children’s hospitals, and we will add more. Again, the issue goes back to giving GPs and other practitioners the confidence to look after these children as they would if they were presenting solely with, for example, ADHD symptoms or concerns about mental health. This is about saying that this issue is one part of the patient they must treat, not isolating and siloing it in the way that has happened historically.”
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“Friend’s point about campaigning organisations, part of our collective frustration is that our public spaces have become politicised. I would say there is no space for that sort of campaign activity in any of our public institutions. I appreciate that a range of views must be represented. Young people must be helped to discover their path in life, their sexuality and all of the things that are such a wonderful part of growing up, but we have to do so in a way that is fair and rigorous, and does not give way against the evidence into the realms of ideology, which sadly we have seen in some instances.”
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“I thank my hon. Friend, and I will set out the practical and important steps NHS England has already taken, which I hope other parts of the United Kingdom will follow. NHS England has banned the prescription of puberty blockers for gender dysphoria to children under the age of 18. On the advice of Dr Cass, cross-sex hormones can be prescribed only with extreme caution for those aged 16 and older. No cross-sex hormones may be prescribed to those under 16 for gender dysphoria. There are medical caveats to that for other medical conditions, and we need to be very careful about unintended consequences, which is why this is such a complicated piece of work. We want to ensure that these drugs are prescribed to the right people, if they should be prescribed at all. On my hon.”
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“If the hon. Gentleman wants to work constructively with me on ensuring that we deal with this report and the evidence in a caring and careful way, for the benefit not just of children and young people but of the wider trans community, I would welcome his support in so doing.”
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“Not only have I tried to espouse those principles in every ministerial role that I have held, but it is the guiding light of this Government to try to ensure that we get the right healthcare and support to patients as quickly as possible. We also want to ensure that we are treating not just the condition, but the patient as a whole. As some of the complexity of the debates that we had this afternoon shows, young people are at the very heart of this. I think this is the final question, Madam Deputy Speaker, so I will end with the young people that we are concerned about. [Interruption.] I am so sorry; I have one more question from the hon. Member for Strangford (Jim Shannon). The children and young people who are the focus of this report have to be, and will be, the focus of our work going forward.”
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“It shows the complexity of the matter and the real need for a very clear, detailed and principled approach to help reform our NHS so that we make it faster, simpler and fairer.”
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“Let me offer the hon. Gentleman my sincere apologies; I am out of practice and should have known that his would be the last question. I genuinely look forward to working with my Northern Irish counterparts on this, as we have already worked together on other matters. The hon. Gentleman makes a point about private practices. That is one area that I am working on at pace. What we do not want is to have any idea forming that somehow people can get round the strict rules that the NHS is setting the system to get these drugs to young people and children. I promise to come back and update the House when I have more news on that, but the hon. Gentleman is right to identify that issue.”
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“The Government’s 2021 fuel poverty strategy recognised that warm homes can help to reduce health inequalities and pressure on the NHS. That is a key reason why we are delivering a package of cost support worth £3,700 per household on average from 2022 to 2025 and investing heavily in fuel efficiency.”
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“The hon. Gentleman is right to say that a number of local warm homes prescription schemes have offered additional support to help people with health vulnerabilities to stay warm and well. Such schemes are excellent examples of local collaboration between the NHS, local government and other partners—tailored, of course, to the local needs of their areas—and I would be interested to see whether other parts of the NHS choose to take up these sorts of ideas in the future.”
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“We have met our manifesto commitment to deliver a record extra 50 million GP appointments annually. Our primary care recovery plan addresses increased GP access and expands community pharmacy services nationwide with Pharmacy First. Our NHS dentist reform plan also allocates resources for 2.5 million appointments, targeting rural and coastal communities.”
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“I congratulate my hon. Friend on the enormous amount of work she has done in her constituency to secure that community diagnostic centre. We have rolled out some 160 or so of those centres across England —we want to do more—and they are supplying some 6 million tests and scans for patients across England. On the important issue that my hon. Friend raised, my officials and Levelling Up officials are already considering how primary care infrastructure can be better supported in the planning process to ease the pressure on primary care estates, particularly in areas of housing growth. I know that she will continue to be as conscientious in her campaigning on that as she is on other matters.”
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“Again, I very much admire the effort and determination that my hon. Friend is showing to stand up for his constituents. He will know that sadly I am constrained from commenting on individual cases, but what I do know is that the innovation he is showing alongside his parish council—and, indeed, I would hope, his local integrated care board—is the approach we want to adopt across our rural and coastal communities to ensure that they, too, have the access to primary care that we all expect.”
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“I understand the concerns—we have seen them in the media—but, please, we in this House have a responsibility to our constituents and to professionals working in healthcare, including our clinicians and physician associates. In fact, physician associates have been working in the NHS for some two decades. They are there to work with doctors to assist them, freeing up doctors’ time to focus on the tasks that only they are qualified to do. We have been very careful to listen to the concerns raised, which is why we recently announced intentions to regulate them. But, please, we must all take that responsibility for ensuring that we are not spreading concern. Actually, these roles can have a very positive effect on healthcare system.”
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“Again, it is for integrated care boards to assess the needs of their area. If there are concerns about access to primary care, we are keen to give them the autonomy to make decisions about how they spend their budget. We have set expectations of integrated care boards in a couple of respects—in particular, we expect them to use the money that we have provided for dental care and we have set clear expectations that integrated care boards will introduce at least one women’s health hub in their area this year.”
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“We are determined to bring not just primary care but the whole NHS up to speed with technology. We are firm advocates of the idea that technology can help free clinicians’ time and ensure that they are spending time looking at their patients rather than at computer screens. In primary care, we are working to ensure the digital telephony services that have played such a critical role in providing those 50 million additional appointments, as I described. I will take away my hon. Friend’s points, and look into them carefully.”
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“It has been a very long time since Labour were in government, but even the hon. Gentleman knows that Ministers will never comment on fiscal events the day before they occur. Let me introduce some facts into his analysis. We have now delivered on our manifesto commitment for 50 million more general practice appointments per year, with 363.8 million booked in the last 12 months. That compares with 312 million deliveredin the 12 months to December 2019. [ Interruption. ] If the hon. Gentleman stopped shouting, perhaps he would be able to hear me. About 62,000 more appointments were delivered per working day last December, excluding covid vaccinations. We have our primary care recovery plan, and it is working. Of course there is more to do, but even the hon. Gentleman would not be so churlish as to deny those extra 50 million appointments.”
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“Women’s health is one of my top priorities. As we approach International Women’s Day, we have already improved access to contraception and the treatment of urinary tract infections through Pharmacy First, announced £50 million of funding for research on maternity disparities and other health conditions affecting women, and set the expectation that each integrated care board area will have at least one women’s health hub operating this year.”
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“I thank the hon. Lady for her work in this regard, and I absolutely acknowledge the issues that women are experiencing with this highly invasive procedure at what is often an extremely distressing time in their lives. We are waiting for the Royal College of Obstetricians and Gynaecologists to update its guidelines on best practice in hysteroscopies. Following consultation last year that is under peer review, and is due to published soon. However, as the hon. Lady knows, I am clear that it should not be the responsibility of women in those very distressing circumstances to ask for pain relief. Clinicians must assume that a woman wants it, and discuss that with her before the procedure.”
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“Let me put on record my admiration for my hon. Friend’s action in sharing her own experiences in order to improve healthcare for women across the country. She will know of yesterday’s important announcement about suicide prevention, elements of which addressed exactly the concerns that she has rightly raised. Thanks to her hard work, we have also announced that within eight weeks or so of giving birth mums will be asked by GPs whether they are okay, and we hope very much that that will open up the conversation with women who may be struggling.”
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“The hon. Lady describes a very interesting piece of work. I will ask my ministerial colleague to meet the charity, as we want to support women. Indeed, part of our work across the women’s health strategy is ensuring that maternity services are not just safe, but trusted by mums-to-be.”
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“I sincerely thank my right hon. and learned Friend for raising this issue. As the Prime Minister set out on the steps of Downing Street last week, there are people whose ideology and dogma are in direct conflict with our country’s shared values. Just as we will not stand for that across the country, nor will I stand for it in our NHS. I have already written to NHS England and regulators, setting out their responsibilities and our expectations of them, and I can assure my right hon. and learned Friend that I will be looking into this issue with great urgency and great care.”
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“The vast majority of this group of women will already have been receiving screening on a three-yearly basis, but NHS England wants to ensure that they receive annual tests, in line with the clinical guidance. I wanted to alert hon. Members to that because, with the letters having been sent out yesterday, it is perfectly possible—indeed, probable—that they will start to receive queries from their constituents. I will of course keep the House updated. I emphasise, however, that what I have given is a summary, and I would encourage hon. Members to look at the very detailed letter from NHS England in order to reassure their constituents that we are scooping up everybody we can to look after them at this very troubling time.”
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“Martha’s rule not only recognises this powerful instinct, but allows anyone concerned to act on it and to make sure that the NHS listens. With your permission, Mr Speaker, for which I am very grateful, I would like to alert the House to a written ministerial statement and a detailed letter from NHS England that has been laid this morning. It addresses a historical issue whereby women who received radiotherapy above the waist to treat Hodgkin lymphoma, and who were therefore at a higher risk of breast cancer, were not given annual checks. Yesterday, the NHS wrote to the 1,487 women affected in order to inform them. We expect all women to be offered a scan within the next three months, and NHS England has established a helpline and briefed GPs and relevant charities.”
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“I am committed to making our NHS faster, simpler and fairer for all, including families, which is why the Government have recently introduced baby loss certificates. Nothing can diminish the pain of losing a baby, but we hope that this formal recognition of a life lost can help families to live alongside their grief. Indeed, since we announced the launch some two weeks ago, more than 37,000 certificates have been requested by parents. That same commitment to families is why we are rolling out Martha’s rule across England, giving patients and their families the automatic right to a rapid review of their case—24 hours a day, seven days a week. Families and carers know when something is not right or their loved one’s condition is deteriorating.”
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“I thank my hon. Friend for supporting our dental recovery plan. Indeed, he is one of many colleagues who campaigned hard for it. I am pleased to inform him that dental activity, as measured by courses of treatment, has increased by 15% on the previous year in his local integrated care board area, and our plan will support further increases to dental access through some 2.5 million additional appointments across the country, including in his constituency. The first measure, namely new patient premiums, went live on Friday, and we hope to have the results very soon.”
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“One of the joys of being at the Government Dispatch Box is that not only do we have to deal with very serious matters, such as I have just set out, but we get to have a knockabout on the Labour party’s electioneering. The hon. Gentleman will know the Conservatives’ proud record on funding our NHS since 2010. I invite him to wait for tomorrow’s Budget to see what more this Conservative Government are doing to support our constituents, and to help our economy grow for a bright future.”
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“The Leader of the Opposition is a former barrister, and barristers like to rely on evidence, so let me give some evidence on what the Labour-run NHS in Wales looks like. People are almost twice as likely to be waiting for treatment under the Labour-run Welsh NHS—21.3% of people in Wales are waiting for hospital treatment after a consultant referral, compared with 12.8% in England. Patients in Labour-run Wales are, on average, waiting five weeks longer for NHS treatment than patients in England, and the number of patients in Wales who are escaping to seek treatment in England has increased by 40% in two years. But don’t worry, folks, according to the Leader of the Opposition this is the blueprint—”
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“Again, I thank the hon. Lady for sharing her experience, and of course we are doing all we can. I know that the SNP Scottish Government share our determination to ensure that cancer treatment continues to improve. England is diagnosing earlier and treating more. We have seen cancer survival rates improve by almost 10 percentage points since 2005, but we also know that four in 10 cancers could be prevented, which is exactly why we are bringing forward the smoke-free generation work. Of course, if the Scottish Government would like us to help with some of their waiting lists, we genuinely stand ready to do so.”
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“One of the many ways we have tackled access to dental care is to ensure that those dentists who have a contract to conduct NHS work are using them to the top of their licence. We are encouraging dentists to do that through the new patient premium and a higher rate paid for units of dental activity. There is so much more to the plan. Labour keeps trying to claim credit for our plan, but the truth is that our plan promises 2.5 million appointments while its plan promises a miserly 700,000.”
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“I thank the hon. Lady for her question. In fairness, colleagues from across the House have been raising this issue with me because it affects a large population of London and the surrounding areas. I must leave it to NHS England to finish its consultation process, but I would be very happy to visit not just the Evelina but our other wonderful hospitals that look after children.”
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