Wes Streeting MP: speeches

Speeches

• 17 Dec 2025 · Puberty Suppressants Trial · Hansard source

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  I absolutely agree with my hon. Friend that we need a strong evidence base, that we need to conduct these conversations with great care, consideration and compassion, and that we need to recognise the vulnerability of this particular group of children and young people, and the fear that so many trans people in our country feel about whether this is a country that accepts and respects them. The political climate has changed since we made all the progress we have made on LGBT equality over the last 20 or 30 years, but do I think the character of this country has changed? Do I think we are less inclusive, less respectful, less loving or less caring? Absolutely not—those are the hallmarks of this country and of the British people. We might be having a debate about the efficacy of this trial, but I think the overwhelming majority of people in this House are doing so in the spirit of wanting trans people to live healthy, happy lives in which they feel safe, included and respected in our country.

• 17 Dec 2025 · Puberty Suppressants Trial · Hansard source

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  I can certainly give my hon. Friend that assurance.

• 17 Dec 2025 · Puberty Suppressants Trial · Hansard source

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  Let me just start by acknowledging the sensitivities around this issue and the strong beliefs held around this House. For all the division and divided opinion, I believe that there is a determination shared by everyone in this House to do the right thing by a vulnerable group of children and young people. It is for those reasons that I am taking the course of action that I am. Put simply, that is to follow expert clinical advice and take an evidence-led approach. The Cass review found shocking levels of unprofessionalism, a lack of clinical oversight and puberty blockers prescribed to children without sufficient evidence that doing so was safe or beneficial to those children and young people. What Dr Hilary Cass uncovered was a scandal. That is why, on coming to office, I made the temporary ban brought in by my predecessor, the right hon. Member for Louth and Horncastle (Victoria Atkins), a permanent one. Dr Cass also recommended a thorough study to establish how best to support children and young people who suffer gender incongruence. That is the pathways study. The study 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 other aspects of the pathways study will track the physical, social and emotional wellbeing of all young people attending UK NHS gender services. It will look at young people’s thinking and brain development, following both those who are and are not taking puberty-suppressing hormones, and it will gather evidence directly from young people, parents and staff about their experiences of living with gender incongruence. The bar for the trial to be approved was extremely high and oversight will be rigorous. Children cannot consent to being on the trial, so places will require parental consent, as well as the assent of young people. It is because protecting and promoting the health and wellbeing of affected young people is our primary concern that there are also strict eligibility criteria in place to join the pathways clinical trial. As such, the number of young people who would expect to qualify for the trial will also be low. Participants must undergo thorough mental and physical assessments and will be followed over a number of years with regular wellbeing checks. Puberty blockers have also been used to delay puberty in children and young people who start puberty much too early. Use in those cases has been extensively tested and has met strict safety requirements for that use. The study is led by King’s College London and the South London and Maudsley NHS foundation trust. It has been carefully checked by independent scientists who advise the National Institute for Health and Care Research and by the Medicines and Healthcare products Regulatory Agency, and received approval from a research ethics committee. I am treading cautiously in this area because the safety of children must come first.

• 17 Dec 2025 · Puberty Suppressants Trial · Hansard source

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  I am grateful to the hon. Member for the way that she asks her question, as a critic of some of the decisions that I have taken in this space. The reassurance that I can offer is that the study will look at the holistic care that this group of children and young people receives, and ensure that wider evidence-led therapeutic support, including mental health support, is available, so that regardless of whether a young person receives puberty blockers, they will certainly receive that wider range of support.

• 17 Dec 2025 · Puberty Suppressants Trial · Hansard source

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  I am grateful to my hon. Friend for that question. I recognise that the decision I took, within days of coming into this office, was received by trans people in particular, and the wider LGBT+ community, as a negative decision that detrimentally impacted their rights and identity. That is why it was an uncomfortable decision for me to take; I knew how it would be received and had to balance up the risk. I believed—and still believe, by the way—that it was the right thing to do, for the right reasons: a clinically led decision. When it comes to the care and health of children and young people in particular, I make no apology for exercising extreme caution. I do want trans people in our country to know that this Government respect them and their identity, and want them to live with dignity, safety and inclusion. That is the approach that the Government are taking. I realise that decisions that I have personally taken have not been received in that way. That has not been comfortable for me, but I do believe it has been the right thing to do.

• 17 Dec 2025 · Puberty Suppressants Trial · Hansard source

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  The shadow Minister asks, “Why?” There is a simple answer. It is because this was recommended by Dr Cass in the Cass review, which was commissioned by my predecessor, Sir Sajid Javid. I think that was the right thing to do, and it is why, when my predecessor brought forward the Cass review, I supported it in opposition. I certainly did not try to play politics with an extremely vulnerable group of children and young people. I will tell the hon. Lady why. It is because, under the previous Government, those puberty-suppressing hormones were prescribed without proper oversight, supervision or safety, yet we did not hear a peep about that fact for years until Dr Cass, commissioned by Sir Sajid Javid—who deserves enormous credit—did the study, which was published and widely supported and which contained this recommendation. The Conservatives may have changed their tune in opposition, but I remember what they said in government when they published the Cass review and supported its recommendations, so I think their response now is a real shame. The shadow Minister accuses me of inconsistency, so let me be clear. Am I comfortable that this clinical trial has undergone the proper process and ethical approval to ensure the highest standards and supervision? Yes, I am comfortable about that. Am I uncomfortable about puberty-suppressing hormones for this group of young people for this particular condition? Yes, I am—because of risks. It is why I was also uncomfortable when I upheld the temporary ban by my predecessor and then put in place a permanent ban. The reason I was uncomfortable with that, too, is because I had to look children and young people, and their parents, in the eye when they told me in no uncertain terms that that decision was harmful to them, as have many other clinicians who have opposed that decision. Whatever my discomfort in this extremely sensitive area, the reason that I have made this decision is that I am following clinical advice and, as Health Secretary, it is my responsibility to follow expert advice. Had the Tavistock clinic faced such challenge and scrutiny a decade ago, we would not be in this mess. The Conservatives were right to commission the Cass review and they were right to accept its recommendations. I accept that there is now a difference on this particular recommendation, but I would urge Members not to walk away from the cross-party consensus we built behind that approach but to build on the work that Dr Cass has done. Let me turn to the important questions raised by shadow Minister. There will be two groups within the trial, as well as a further control group of children and young people with gender incongruence who do not receive puberty-suppressing hormones. At least 226 participants are required in order to detect a statistically significant difference between the two treatment groups. However, this is not a target and no young person will find themselves on this trial because there is a drive to make sure that a certain number of young people are participating. In order for anyone to participate in this trial, it has to have the most robust clinical oversight from clinicians within the service, as well as national oversight and the consent of parents. It is only where young people will be deemed to benefit that they will be on this programme. The shadow Minister asks about the data linkage study. That is important. The data linkage study will be undertaken, but when it is completed it will not provide us with the same evidence as this clinical trial. That is why Dr Cass made a distinction between this trial and the data linkage study. The hon. Lady also asks about the motivations of those who withheld data. That is an extremely important question. It is utterly appalling that anyone in a position of responsibility in the NHS withheld data on a very vulnerable group of children and young people. I accept that there were many well-meaning people involved in these services at the Tavistock clinic, but the fact that Dr Cass found such a lack of rigour, such a lack of standards and such a lack of proper oversight is disgraceful. It is the clinicians who are well meaning and ideologically driven who have given me the most cause for concern in this whole debacle and who have done more harm to children, young people and the trans community than most other people who have taken part in this debate. I appreciate the work that Dr Cass has done, and I am glad that she is in the other place, bringing welcome scrutiny. Were she not supportive of this approach, I might think again, but she has made her recommendation and given her support. I am following clinical advice. It is not comfortable, but I do believe it is the right thing to do, on balance.

• 17 Dec 2025 · Puberty Suppressants Trial · Hansard source

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  I am grateful to my hon. Friend for his question. The reassurance that we can provide trans people in our country is that we are committed to making sure that they have access to the highest quality, evidence-based healthcare. That does not just apply in the case of children and young people; I also hope to report to the House before the Christmas recess the work undertaken in the Levy review into adult services. We are committed to making sure that we provide high-quality care to a particular vulnerable group of children and young people.

• 17 Dec 2025 · Puberty Suppressants Trial · Hansard source

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  I am very happy to receive further clinical representations on this issue and to hear from experts on it. I hope the public will understand why, on this particular issue, I am not simply led by opinion polling. I have to follow the clinical advice and evidence, particularly given the enormous risks that surround these children and young people, including the risks that weighed on my shoulders and conscience when I denied access to puberty blockers by upholding the temporary ban and then making it permanent.

• 17 Dec 2025 · Puberty Suppressants Trial · Hansard source

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  I can absolutely assure the hon. Member that we are doing that wider research and that of course we will take into account high-quality international evidence, as well as the research we are undertaking domestically. It is so important that we recognise that, for many young people with gender incongruence, even if approved, puberty blockers will never be the right medication. One of the things I have been most saddened by in the discourse among adults in this debate, many of whom should know better, is the elevation of puberty blockers to the status they have received in public discourse and debate; many young people out there think not only is this the gold standard of care, but that it is the only care available, and, of course, that is not true. NHS England has opened three new children and young people’s gender services in the north-west, London and Bristol, with a fourth planned for the east of England in 2026. We aim to have a service in every region of England in the coming years. These services use a different model with multidisciplinary teams, including mental health support and paediatrics, within specialist children’s hospitals to provide good clinical care. The new services will increase capacity and reduce waiting times so that patients can be seen sooner and closer to home. We have also commissioned additional support for young people waiting to be seen through local children and young people’s mental health services.

• 17 Dec 2025 · Puberty Suppressants Trial · Hansard source

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  I do not doubt the hon. Member’s sincerity and integrity on this issue, but I say to her respectfully that when she talks about barriers to entry, those “barriers” are safety and clinical oversight, as well as parental consent and the assent of the young person. I do not believe that those are barriers; I believe that those are necessary bars for participation in this trial.

• 15 Dec 2025 · NHS: Winter Preparedness · Hansard source

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  People can check their eligibility for a vaccine online or via the NHS app. They can and should seek to protect themselves. If people need healthcare, they should seek to access it. I do not want people to be deterred unnecessarily by strike action. It is important that people get the right care in the right place. Unless it is an accident or an emergency, the best thing to do is to call 111; from there, patients will be directed to the most appropriate service. My hon. Friend is right about the progress that we are making with the NHS since coming into office. That is one of the many reasons I am so disappointed by the BMA’s action. This is lose-lose: it is bad for the NHS, and therefore for patients, and it leaves doctors working in poorer conditions for longer than I, they and the country would want.

• 15 Dec 2025 · NHS: Winter Preparedness · Hansard source

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  I thank the hon. Member for being helpful in two ways. First, it is always good to hear voices from the right making the case for vaccine uptake. That contrasts the Conservative party starkly with Reform UK, which we hear peddle anti-science nonsense. Secondly, I thank him for reminding resident doctors and the BMA of what they used to have when the Conservative party was in government. Maybe I do not look so unreasonable after all.

• 15 Dec 2025 · NHS: Winter Preparedness · Hansard source

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  I have lost count of the number of times I have met the BMA personally, or spoken on the telephone, including as recently as this afternoon, with the chair of the resident doctors committee and his predecessors. Of course, we are always willing to consider bringing in people who can help to close the gap between those on either side of the table. In the past, the BMA has not been too fond of ACAS. We will let this round of strikes pass. Our first priority now has to be managing our way through this period and recovering the NHS into the new year. There will then, by my reckoning, be at least six weeks without strikes, and of course we will do our best to resolve the situation with the BMA. I would just say to my hon. Friend, to the House and to the BMA that there really is not much further for the Government to go. We have given a 28.9% pay rise already. The BMA wants to talk about future years’ pay, but we have not even had a recommendation from the Doctors and Dentists Review Body. I think it is extraordinary that BMA members are out on strike on pay after the 28.9% pay rise. On jobs, the BMA peddles to its members the idea that there were just 4,000 extra specialty training places up for grabs; it seems to completely sideline the point about emergency legislation to deal with UK graduate prioritisation, which is exactly what it asked from us, in all the meetings that I had with it. Since it has rejected that offer, it should not expect to see the legislation. If BMA members want to see the Government move forward constructively with them, they really need to stop striking, stop harming the NHS and maybe start thinking about patients while they are at it.

• 15 Dec 2025 · NHS: Winter Preparedness · Hansard source

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  My hon. Friend can rest assured that he has my support as he keeps his eye on the temporary nature of this closure. I share his desire for it to be temporary. I would make this point, too. There is a view among some in the BMA that somehow these strikes are consequence-free for patients and the NHS on the basis that we can just cancel some operations and it is okay because consultants will be covering. That is quite a cavalier attitude to take to fellow frontline staff who will be having their annual leave cancelled and finding themselves recalled right now. It also really minimises how patients feel when they cannot access a walk-in service, such as my hon. Friend’s, or indeed have waited, often for far too long, for a diagnostic test, scan or operation. They will have psyched themselves up and be ready for that appointment, but then find it cancelled because of strikes. The BMA might try to kid everyone else that the strikes are consequence-free for patients, but BMA members really ought not to kid themselves.

• 15 Dec 2025 · NHS: Winter Preparedness · Hansard source

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  Regardless of the result today, I think that the BMA is finding that I am not a soft touch and that we will not accede to a completely unreasonable and unaffordable demand. The reason we made that pay award within weeks of coming into government was that we did not think that the BMA’s treatment at the hands of our predecessors had been fair, and we recognised the issues that it was raising on pay. Indeed, the irony of this round of strikes, and previous rounds of strikes under this Government, is that I recognise that whether it is about pay, jobs or working conditions, resident doctors make a whole series of fair and reasonable points, and we are doing our best to address those. I think that 28.9% is a meaningful step in the right direction on pay. Our offer of emergency legislation, which is unusual in this House, would make a real difference, reducing competition for jobs from 4:1 to less than 2:1—but the BMA has rejected that course of action. In the end, I think that people will judge the BMA’s actions to be unreasonable. Of course the issues that it raises are serious and substantial, but we see similar issues raised not just across the NHS but across the entire public sector. We cannot fix everything for everyone everywhere all at once. Most reasonable people accept that; for reasons I cannot understand, the BMA does not.

• 15 Dec 2025 · NHS: Winter Preparedness · Hansard source

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  Thanks to the decisions taken by this Labour Government, we have increased funding for general practice by £1.1 billion, we deployed not just 1,000 more GPs to the frontline in our first year as promised but 2,500 and, through reforms to the Carr-Hill formula, we are restoring the deprivation link to health funding. As a result, the poorest communities with the greatest needs are receiving greater care, support and investment. All this is undoing the damage left by 14 years of Conservative government and it is only possible because people chose to elect Labour MPs.

• 15 Dec 2025 · NHS: Winter Preparedness · Hansard source

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  My hon. Friend is right to raise the issue of disruption. Although we have carefully laid plans to manage industrial action this week, the thing I am really worried about as we look towards the end of this week is the long tail that takes us into next week, the following week and the new year. That is for a few reasons. First, in our experience, there is always a need to recover the service following such disruption; ironically, sometimes the worst disruption is seen in the weeks that follow and not just during strike days. Secondly, this is normally the busiest time of the year, and we normally get through it because we have experienced consultants who are willing to put in extra shifts over the Christmas and new year period, recognising those pressures. Those same people are now going to be absolutely knackered because of the toil of covering for their resident doctor colleagues over the five-day period. I really think that, in choosing the timing of these strikes, the BMA has been highly inconsiderate of colleagues, and I do not think it has even thought about patients.

• 15 Dec 2025 · NHS: Winter Preparedness · Hansard source

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  There is no shortage of the vaccine, which makes things even more frustrating for our constituents, and for the hon. Member; they know that there are flu vaccines available, but they are not in the right place at the right time. I am extremely sorry that her constituent has suffered that inconvenience and setback three times. She has placed her concerns on record, and we will look at what has happened in her constituency. We will look at the supplies, and I will make sure that my Department works with her to resolve that situation. More generally, where we have seen reports of shortages, or of suppliers being caught short, we have acted rapidly to remedy the situation.

• 15 Dec 2025 · NHS: Winter Preparedness · Hansard source

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  It is as if the ghost of Christmas past has come to visit: one of my predecessors is here to remind the BMA of what it used to have to deal with. Perhaps the BMA will be a bit more content with the ghost of Christmas present—and that is before we are threatened by the ghost of Christmas future— [ Laughter. ] I am being slightly tongue in check, but the right hon. Gentleman asks a serious question, and I will treat it seriously. We put in evidence to the pay review body process. The pay review body will make its recommendation, which we will consider. We are in active discussions with Agenda for Change unions about whether we can reach an agreement on future years, including exploration of the prospect of a multi-year offer. I have made the same approach to all health unions, including the BMA and resident doctors. The challenge with resident doctors is that their expectations are some way from affordability. They are asking for a 24% pay rise on top of the 28.9% they have already had. That is not acceptable. As the right hon. Gentleman’s question implies, I have a responsibility to the entire NHS workforce, particularly the Agenda for Change staff, who have not done as well as doctors. Addressing that is not only a practical issue for me, but a moral one.

• 15 Dec 2025 · NHS: Winter Preparedness · Hansard source

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  The hon. Gentleman is absolutely right to raise the interests not just of our cities and towns but of rural communities. I was proud of the emphasis that we placed on rural services and coastal communities in our 10-year plan for health, and we take that into account with our urgent and emergency care plan. I have been encouraged by the way that some of our ambulance services that are dealing with remote and rural constituencies are responding this year compared with last year, but there is still much more for us to do, particularly across the midlands. We want consistent year-on-year improvement so that whoever someone is and wherever they live, the NHS is always there when they need it.

• 15 Dec 2025 · NHS: Winter Preparedness · Hansard source

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  The right hon. Gentleman is right to call for an evidence-based approach. That is why the Government are not mandating mask use across the NHS or social care. We are supporting leaders in providers to make their own judgments based on the situations in their trusts as to whether wearing of masks by patients and visitors is necessary, given the pressures they are under. Even in those cases, there is an understanding that people may not wish to comply, but I hope that, if asked to do so, they would comply.

• 15 Dec 2025 · NHS: Winter Preparedness · Hansard source

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  There are many examples of great community-based vaccination initiatives. Many of those initiatives are supported by faith-based organisations, which is really important given the vaccine hesitancy in some of those groups. I do not believe that people are hard to reach; I believe that public services often do not try hard enough, and our approach is to do so. We will reflect on our success this year and seek to build on it for future years.

• 15 Dec 2025 · NHS: Winter Preparedness · Hansard source

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  Yes. The JCVI makes evidence-based recommendations, and we follow its evidence. With the best will in the world, we of course give out practical, common-sense advice, but we should not infantilise our constituents. They are perfectly capable of working out who can get together this Christmas. They really do not need Government Ministers to start issuing directions about who can get round the table for Christmas dinner and who can get together in the days after. In the exchanges we have in this House there is sometimes a degree of patronising of the British people. They really, really do not need us. They really do not need our advice on the seating plan at Christmas dinner; what they need is for NHS services to be there when they need them, and that is what the Government are focused on.

• 15 Dec 2025 · NHS: Winter Preparedness · Hansard source

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  This Labour Government are investing more in the NHS—£26 billion, rising to £29 billion over the spending review period. Urgent and emergency care is improving. Ambulance response times are improving year on year. I recognise that there are particular challenges with the West Midlands ambulance service. We are going as hard and fast as we can to repair the damage done by 14 years of Conservative Government. We are able to do that only because people chose to vote Labour at the last general election.

• 15 Dec 2025 · NHS: Winter Preparedness · Hansard source

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  I am not a clinician or a scientist, but the JCVI is full of them and we follow its expert advice. It will, in the normal way, review how this winter has gone and look ahead to future pressures, but it is important that we are guided by the evidence, whatever the political pressure.