Peers begin line-by-line scrutiny of Health Bill as puberty blocker fight returns

The House of Lords begins its committee stage on the Government’s Health Bill today, Wednesday 28 October. It is the first chance for peers to amend the bill line by line, and further committee days are set for 3, 9, 11, 17, 23 and 25 November.

The bill, sponsored by Health Secretary Wes Streeting, has already passed the Commons. At report stage on 8 September MPs rejected two new clauses that campaigners had backed. New Clause 142, on puberty blockers for under-18s, was defeated by 357 votes to 108. New Clause 143, on single-sex NHS facilities, was defeated by 302 votes to 106.

Amendments on the same ground can be tabled again in the Lords, where the arguments have already been rehearsed.

Peers clash over the PATHWAYS trial

Several peers attacked the PATHWAYS clinical trial in a Lords debate on puberty blockers and cross-sex hormones last Thursday, 22 October. Opening it, crossbencher Baroness Deech said: “I suggest that a child does not have the legal competence to give effective consent to life-changing medical interventions.”

Conservative peer Baroness Cash said the debate drew attention to “an ongoing medical scandal of our times, which is the consent to drugs around which we have no evidence of safety”. Her Conservative colleague Baroness Meyer asked how “an 11 year-old child” could “understand the consequences of interrupting their puberty”. Lord Frost, who sits as a non-affiliated peer, said “I support what the Government have done so far on this general issue”, but added: “I do not see how we can, in conscience, proceed with such a trial involving 11 year-olds.”

Liberal Democrat Baroness Barker said the debate was “happening in the context of two very well-funded campaigns”, which she said were aimed at trans people, and asked the minister to set out “all the safeguards that are in this research and why they are there and needed”. Replying for the Government, health minister Baroness Merron said: “We are implementing the Cass review and transforming children and young people’s gender services.”

PATHWAYS is run by King’s College London and is open to children with gender incongruence from age 11 for girls and 12 for boys. Set-up was paused in February, before any child was recruited, after the medicines regulator, the MHRA, raised concerns about children’s wellbeing. A revised protocol, which added the minimum ages, was approved in June. On 31 July the High Court refused permission for a judicial review of the trial brought by Bayswater Support Group, Keira Bell and James Esses.

What comes next

In a written answer on 22 October, the Government said: “A period of consultation on the proposed clinical commissioning policies is expected to begin in the coming months, with a final decision expected in spring 2027.” In a separate answer the same day, ministers said that data on referrals for gender surgery “was not collected nationally until 2023/24”.