Asked by: Baroness Wolf of Dulwich (Crossbench - Life peer)
Question to the Department of Health and Social Care:
To ask His Majesty's Government how much was paid out to NHS pension scheme members in (1) 2023, and (2) 2024.
Answered by Baroness Merron - Parliamentary Under-Secretary (Department of Health and Social Care)
The following table shows the value of pension benefits paid to NHS Pension Scheme members in financial years 2023/24 and 2024/25:
Financial year | 2024/25 | 2023/24 |
Pensions | £13,760,850,000 | £12,577,538,000 |
Commutations and lump sum benefit on retirement | £4,050,330,000 | £3,095,639,000 |
These figures comprise the value of annual pensions and lump sums paid. It does not include other payments made by the scheme such as contribution refunds or pension tax payments to HM Revenue and Customs.
Annual accounts for the scheme are published for each financial year and record the total value of all payments made. The annual accounts are available on the GOV.UK website and on the NHS Business Service Authority’s website.
Asked by: Lord Shinkwin (Conservative - Life peer)
Question to the Department of Health and Social Care:
To ask His Majesty's Government what oversight they exercise over the commissioning of prosthetic and orthotic services to ensure that they are appropriately funded and that investment is linked to measurable patient outcomes.
Answered by Baroness Merron - Parliamentary Under-Secretary (Department of Health and Social Care)
Prosthetics is a specialised service, with commissioning transferring to integrated care boards on 1 April 2025, ensuring service providers must adhere to the national service specification and national clinical commissioning policies. Orthotic services are locally commissioned by integrated care boards or National Health Service trusts. It is the responsibility of local employers to ensure they have the right people with the right skills to meet local population needs. The Department remains committed to working with stakeholders, including the British Association of Prosthetics and Orthotics, to support service improvements and meet patient demand.
Asked by: Lord Shinkwin (Conservative - Life peer)
Question to the Department of Health and Social Care:
To ask His Majesty's Government what steps they are taking to protect the workforce pipeline for small and vulnerable allied health professions from the risk of university programme closures or reductions.
Answered by Baroness Merron - Parliamentary Under-Secretary (Department of Health and Social Care)
The Department of Health and Social Care works closely with the Department for Education to support the availability of a diverse range of training routes into health and care careers. While the Government is committed to ensuring sustainable training pathways for small and vulnerable healthcare professions, higher education institutions are independent providers and are responsible for making their own decisions about course delivery and viability.
NHS England has a focussed programme for small and vulnerable professions, including Allied Health Professions. This programme helps maintain and strengthen training and education pathways for pre‑registration learners, including apprenticeship routes, to support a national strategic approach to placement capacity and to build awareness of healthcare careers.
Asked by: Lord Shinkwin (Conservative - Life peer)
Question to the Department of Health and Social Care:
To ask His Majesty's Government what assessment they have made of the risk that university programme closures or reductions could pose to the future supply of prosthetists and orthotists; and what contingency plans are in place to sustain education and training provision for these professions.
Answered by Baroness Merron - Parliamentary Under-Secretary (Department of Health and Social Care)
As a small and vulnerable profession, course closures or reductions pose a considerable risk to the future supply of prosthetists and orthotists.
The Department of Health and Social Care works closely with the Department for Education to support the availability of a diverse range of training routes into health and care careers. While the Government is committed to ensuring sustainable training pathways for the future supply of prosthetics and orthotists, higher education institutions are independent providers and are responsible for making their own decisions about course delivery and viability.
NHS England has a focussed programme for small and vulnerable professions, including prosthetics and orthotics, and has recently commissioned the British Association of Prosthetists and Orthotists to help maintain and strengthen training and education pathways for pre‑registration learners.
Asked by: Lord Jackson of Peterborough (Conservative - Life peer)
Question to the Department of Health and Social Care:
To ask His Majesty's Government what estimate they have made of the percentage of abortions in which women (1) deliberately, and (2) accidentally, misreport the date of their last menstrual period; and how they have incorporated that estimate into the implementation of allowing the prescription of abortion pills by telemedicine.
Answered by Baroness Merron - Parliamentary Under-Secretary (Department of Health and Social Care)
The Department collects information on abortions via the HSA4 abortion notification form, which does not hold this information.
The prescription of mifepristone and misoprostol for abortions is controlled by the Abortion Act 1967 and Human Medicines Regulations 2012. During the consultation, women are informed that their abortion medication has been prescribed for their use only and that it cannot be given to anyone else. In line with the Department’s required standard operating procedures for the approval of independent sector places for termination of pregnancy in England, all providers must ensure women are given information about how to dispose of, or return, the abortion pills if they are not used.
Before an early medical abortion can be undertaken at home, women are given the choice to have either an in-person consultation or a virtual consultation. However, if there is any uncertainty about the gestation of the pregnancy, the medical practitioner would ask the woman to attend an in-person appointment to enable them to form an opinion that the pregnancy will not have exceeded ten weeks at the time the first abortion pill is taken.
Asked by: Baroness Maclean of Redditch (Conservative - Life peer)
Question to the Department of Health and Social Care:
To ask His Majesty's Government what steps they are taking to ensure that NHS adult gender clinics maintain comprehensive patient data and outcomes records.
Answered by Baroness Merron - Parliamentary Under-Secretary (Department of Health and Social Care)
On 18 December 2025, NHS England published the Review into the operation and delivery of NHS Adult Gender Dysphoria Clinics, which was chaired by Dr David Levy. This review provides a strong basis for action to improve adult gender services.
Recommendation 13 of the review states that NHS England should work with adult gender dysphoria clinics (GDCs) to establish a national minimum dataset so medium and long-term patient outcomes can be understood following treatment by the adult GDCs, and to develop a national research strategy for adult gender dysphoria services.
NHS England, in full partnership with the Department, will now take forward the implementation of the review’s recommendations.
Asked by: Baroness Maclean of Redditch (Conservative - Life peer)
Question to the Department of Health and Social Care:
To ask His Majesty's Government what guidance they have issued to NHS adult gender clinics about the assessment and management of patients with mental health comorbidities; and what proportion of patients prescribed cross-sex hormones have comorbidities.
Answered by Baroness Merron - Parliamentary Under-Secretary (Department of Health and Social Care)
The approach for assessment, diagnosis, and care planning, including patients with other presentations, are described in NHS England's published service specification for National Health Service adult gender clinics, which was adopted in April 2020 following a comprehensive public consultation, respondents to which included medical bodies, professional associations, and regulatory bodies. There is currently no specific data field that records the number of patients who are prescribed cross-sex hormones and who have comorbidities.
Asked by: Baroness Maclean of Redditch (Conservative - Life peer)
Question to the Department of Health and Social Care:
To ask His Majesty's Government whether they plan to increase the minimum age for access to adult gender clinics.
Answered by Baroness Merron - Parliamentary Under-Secretary (Department of Health and Social Care)
On 18 December, NHS England published the Review into the operation and delivery of NHS Adult Gender Dysphoria Clinics, which was chaired by Dr David Levy. The review provides a strong basis for action to improve adult gender services.
As set out in the Written Ministerial Statement published alongside the Review, NHS England and the Department are taking forward a set of immediate priorities. This includes raising the referral threshold to 18 years old, aligning it with the age of discharge from the NHS Children and Young People’s Service.
Asked by: Baroness Maclean of Redditch (Conservative - Life peer)
Question to the Department of Health and Social Care:
To ask His Majesty's Government what assessment they have made of the reasons why annual referrals to adult gender clinics have doubled since 2022–23; and whether they have made an assessment of the impact of social media and educational settings on referral patterns of young people.
Answered by Baroness Merron - Parliamentary Under-Secretary (Department of Health and Social Care)
The review into the operation and delivery of NHS Adult Gender Dysphoria Clinics (GDCs), led by Dr Levy, was published on 18 December 2025 and undertook a comprehensive examination of all nine National Health Service-commissioned adult GDCs in England. The review specifically considered issues of access to clinics, reviewing both the volume of referrals and the length of waiting times for initial assessment and treatment. Dr Levy identified that waiting times for first appointments remain lengthy, with a significant increase in the number of people awaiting assessment, as annual referrals have doubled since 2022/23. The review attributed these extended waits to several factors, including improved reporting as more clinics have joined the national system, as well as a backlog from referrals deferred during the COVID-19 pandemic.
The review also set out that surgery waiting times also contribute to the problem, as some masculinising procedures have waits of approximately eight to nine years. As a result, many patients require extra GDC appointments because the current service specification mandates follow-up reviews every six months for those waiting for surgery.
NHS England has established a National Portfolio Board, in line with Dr Levy’s recommendation, to build and develop a full implementation plan. This will address each of the review’s recommendations in turn and be aligned with the ambitions of the Government’s 10-Year Health Plan for England.
Baroness Cass’s Independent Cass Review of Gender Identity Services for children and young people published in 2024 and observed social factors, including social media and links with children and young people experiencing gender dysphoria.
Asked by: Baroness Maclean of Redditch (Conservative - Life peer)
Question to the Department of Health and Social Care:
To ask His Majesty's Government what research they have commissioned, if any, to assess whether peer-group clustering occurs in gender clinics, in particular among adolescent girls; and what clinical protocols are in place to assess the influence of social factors in referrals to gender services.
Answered by Baroness Merron - Parliamentary Under-Secretary (Department of Health and Social Care)
The new, regional children and young people (CYP) services provide holistic care, centred on psychosocial support. This will include thorough mental health support that takes account of the child and young person's individual circumstances, including social factors.
More widely, the Independent Cass Review published in 2024, of which the new National Health Service CYP Gender Services are based, sets out the role social factors, including the role of social media and family mental health problems have in CYP experiencing gender dysphoria.