Question to the Department of Health and Social Care:

To ask His Majesty's Government, further to the Written Answer by Baroness Merron on 29 April (HL16569), when they expect the information explaining to patients how care in the independent sector differs from NHS care to be published; and what has caused the delay in fulfilling this recommendation of the Paterson Inquiry report Report of the Independent Inquiry into the Issues raised by Paterson, published on 4 February 2020.

Answered by Baroness Merron - Parliamentary Under-Secretary (Department of Health and Social Care)

The Department recognises the importance of ensuring that patients have clear information about their care in the National Health Service, whether delivered by NHS providers or independent sector providers. We have recently published a set of patient experience minimum standards setting out our expectations of providers of NHS funded elective care while patients are on the waiting list.

We will provide an update on this commitment in due course.

Question to the Department of Health and Social Care:

To ask His Majesty's Government whether they plan to revise the guidance in the NHS service specification on gender identity services for adults that psychological interventions "will not be offered routinely or considered mandatory" in the light of the findings of the Cass Review, published in April 2024, and the Operational and delivery review of NHS adult gender dysphoria clinics in England, published in December 2025, that patients may have complex needs and co-occurring conditions.

Answered by Baroness Merron - Parliamentary Under-Secretary (Department of Health and Social Care)

NHS England plans to publish new service specifications for adult gender services, for the purpose of public consultation, later this year. As part of its work to build new service specifications, Dr David Levy, who chaired the Operational and Delivery Review of Adult Gender Services, is overseeing work to define 'clinical complexity' in the context of the adult gender pathway, and for the new service specification to describe the clinical approach for responding to complexity.

Question to the Department of Health and Social Care:

To ask His Majesty's Government whether they have commissioned research to establish the rate at which patients treated at adult Gender Dysphoria Clinics subsequently detransition, express regret about their transition, or discontinue treatment.

Answered by Baroness Merron - Parliamentary Under-Secretary (Department of Health and Social Care)

The Cass Review concluded that the percentage of people who subsequently detransition following medical intervention remains unknown due to the lack of long-term follow-up studies.

In response to the recommendations of the Cass Review and the Operational and Delivery Review of Adult Gender Services, NHS England plans to consult on a service specification for a detransition pathway later this year, an element of which will be proposals for building the evidence through data collection, formal research and clinical audit.

Question to the Department of Health and Social Care:

To ask His Majesty's Government when NHS England's evidence review of hormone treatment for adults with gender dysphoria will be published; and whether the NHS service specification on gender identity services for adults will be revised in the light of the findings of the review before any new services are commissioned.

Answered by Baroness Merron - Parliamentary Under-Secretary (Department of Health and Social Care)

NHS England plans to publish proposed clinical commissioning policies for the use of masculinising and feminising hormones in adult gender services later in the summer, for the purpose of public consultation. Separately, NHS England plans to publish new service specifications for adult gender services, for the purpose of public consultation, later this year.

Question to the Department of Health and Social Care:

To ask His Majesty's Government, further to the Written Answer by Baroness Merron on 29 April (HL16567), whether the National Consultant Information Programme (1) is publicly accessible to patients, (2) includes data on consultants practising in the independent sector, and (3) records the practising privileges held by consultants; and what assessment they have made of that Programme's compliance with the Paterson Inquiry's recommendation for a single repository of information about consultants across England.

Answered by Baroness Merron - Parliamentary Under-Secretary (Department of Health and Social Care)

The National Consultant Information Programme (NCIP) is publicly accessible to patients on the Getting It Right First Time website.

The NCIP portal is a free data platform containing consultant and provider-level activity and outcomes data for over 500 procedures in 13 surgical specialties. It covers National Health Service practices, NHS funded work in the independent sector, and privately funded work carried out in the NHS. Over time, the ambition is to add independent sector data, to provide a single repository of whole practice. Currently, patients are not able to access this data.

NCIP allows consultants in 13 surgical specialties to access their individual outcomes data, for personal learning, clinical governance, and appraisals. NCIP does not record practising privileges in the independent sector.

NCIP is a critical part of the response to the Paterson Inquiry, which recommended that there should be a single repository of the whole practice of consultants across England. By sharing high-quality outcome data, consultants, their appraisers, and responsible officers can compare outcomes for their practice or use peer review to improve their performance in a way that is measurable and objective, leading to better safety and efficiency across the NHS.

Question to the Department of Health and Social Care:

To ask His Majesty's Government how many patients of adult gender dysphoria clinics are simultaneously receiving prescriptions from private or overseas online providers; and what mechanisms exist to identify such patients.

Answered by Baroness Merron - Parliamentary Under-Secretary (Department of Health and Social Care)

Neither the Department nor NHS England hold this information.

Question to the Department of Health and Social Care:

To ask His Majesty's Government whether breast reconstruction surgery is routinely available on the NHS to women who detransition following a mastectomy carried out as treatment for gender dysphoria; and if not, why mastectomy is routinely commissioned but reconstruction is not.

Answered by Baroness Merron - Parliamentary Under-Secretary (Department of Health and Social Care)

NHS England has a published service specification that covers the provision of surgical interventions for individuals on the National Health Service pathway of care for the treatment of gender dysphoria. Providers are expected to follow this service specification.

Question to the Ministry of Justice:

To ask His Majesty's Government what assessment they have made of the appropriateness of current sentences for sexual offences.

Answered by Lord Lemos - Parliamentary Under-Secretary (Ministry of Justice)

Sentencing in individual cases is a matter for the independent judiciary. They must sentence within the legislative framework set by Parliament, and in line with the relevant Sentencing Council guidelines, unless not in the interest of justice to do so.

The Sexual Offences Act 2003 establishes a comprehensive framework of serious offences with robust maximum penalties. These penalties reflect the gravity with which such offending is treated.

The Government keeps criminal offences and the associated penalties under review to ensure that the legislative framework remains effective, proportionate and responsive to the seriousness of offending. The legislation has recently been further strengthened through the creation of specific sexual offences against children under 16, which carry a maximum penalty of life imprisonment. This demonstrates the Government’s commitment to ensuring that the law provides the highest level of protection for children and reflects the seriousness of these crimes.

Question to the Ministry of Justice:

To ask His Majesty's Government what assessment they have made of the effectiveness of custodial sentences under 12 months.

Answered by Lord Lemos - Parliamentary Under-Secretary (Ministry of Justice)

The evidence shows that those given a community order or suspended sentence reoffend less than similar offenders given a short prison sentence. Short prison sentences can exacerbate issues with employment, housing, and maintaining family ties, without allowing sufficient time to provide effective rehabilitative services.

In line with this evidence, and recommendations made by the Independent Sentencing Review, the Sentencing Act 2026 introduced a presumption for the courts to suspend sentences of immediate custody, of 12 months or less. The courts will always have the power to send offenders to prison where they have breached a court order, an individual is at significant risk of physical or psychological harm, or in exceptional circumstances.

Limiting the use of short sentences will help offenders to break the cycle of re-offending, reduce crime and lead to fewer victims and safer communities.

Question to the Ministry of Justice:

To ask His Majesty's Government what assessment they have made of the risks to public safety arising from the early release of prisoners, including registered sex offenders, under the current early release scheme.

Answered by Lord Lemos - Parliamentary Under-Secretary (Ministry of Justice)

This Government inherited prisons days from collapse. We had no choice but to take decisive action to stop our prisons overflowing and keep the public safe. Without the changes this Government made, courts would have had to halt trials and the police cancel arrests, undermining public safety.

Whilst measures like the SDS40 change provided the intended medium-term relief to the system, this was only ever a temporary change as a bridge to a more sustainable solution. That is why the Sentencing Act has been passed, to deliver a more sustainable solution to the prison capacity crisis we inherited.

Following a review, the Prime Minister and Lord Chanceller have decided that rape and certain child sex offences will be excluded from the progression model and these sentences will retain their current release points. This is in addition to the 18,000 offenders who are already ineligible for earlier release under the model given they have either been found by a court to be the most dangerous or are serving a life sentence.

Question to the Ministry of Justice:

To ask His Majesty's Government when they intend to make further progress with the Courts and Tribunals Bill.

Answered by Lord Lemos - Parliamentary Under-Secretary (Ministry of Justice)

This Government understands the pressure that is currently on the court system. The Crown Court backlog currently stands at over 80,000 cases and over 22,000 of those cases have been open for over a year. Behind each of those cases is someone awaiting justice – defendants seeking to clear their name and victims putting their lives on hold. The Crown Court caseload means that thousands of victims and witnesses are waiting years for their day in court. This cannot be acceptable. The justice system exists to serve the public, and this Government is committed to building a stronger justice system in which the public can have confidence.

The Courts and Tribunals Bill is currently progressing through Parliament and will have report stage in the House of Commons when parliamentary time allows.

Question to the Ministry of Justice:

To ask His Majesty's Government whether they intend to set out a policy on the suitability of accommodating biological males in the women’s prison estate.

Answered by Lord Lemos - Parliamentary Under-Secretary (Ministry of Justice)

The policy inherited by this Government is that no transgender woman charged with or convicted of a sexual or violent offence, or who retains birth genitalia, can be held in the general women’s estate, other than in exceptional circumstances and where granted an exemption by a minister. No such exemptions have been granted under this Government.

We are currently reviewing transgender prisoner allocation policy in light of the recently updated EHRC Code of Practice for Services, Public Functions and Associations, and will be able to say more on this shortly.

Question to the Home Office:

To ask His Majesty's Government what assessment they have made of making refugee protections temporary subject to review every 30 months.

Answered by Lord Hanson of Flint - Minister of State (Home Office)

The 30-month review period for those granted protection reflects the Government’s view that protection should be provided for as long as it is needed. As conditions in countries of origin can change over time, it is appropriate to review whether an individual continues to require international protection before further permission is granted.

Individuals with an ongoing protection need will have their status renewed, while those who no longer require protection will be expected to leave the UK unless they qualify for leave on another basis. Safe return reviews have long been a feature of the UK's protection system. Protection needs can change over time, and it is therefore right that an individual's circumstances are reviewed before further leave or settlement is granted. The Government remains committed to providing protection to those who need it, in line with the UK's international obligations.

Settlement for those granted protection has never been automatic. Individuals have always needed to meet the requirements in place at the point they become eligible to apply, including demonstrating that they continue to require protection where relevant. The principle that protection should be provided for as long as it is needed, and reviewed where circumstances change, is a longstanding feature of the UK's protection system.

In addition, in future those on core protection will be able to switch to the protection work and study route, which will provide greater certainty about their future in the UK. This will also allow them to earn down the time it takes to obtain settlement and open up refugee family reunion rights. Individuals who switch to this route will no longer be subject to safe return reviews, recognising their contribution through work or study.

Question to the Department of Health and Social Care:

To ask His Majesty's Government what regulatory action has been taken following the closure of the WellBN practice in Brighton; and what assessment they have made of whether other primary care providers are prescribing gender-related medication outside national clinical policy.

Answered by Baroness Merron - Parliamentary Under-Secretary (Department of Health and Social Care)

As an outcome of an Independent Patient Safety Investigation by the National Health Service, the WellBN Practice in Brighton has stopped prescribing hormone medications to children under 18 years old for gender dysphoria, outside of NHS clinical commissioning policy.

The Care Quality Commission (CQC) suspended WellBN’s ‘Good’ rating while concerns with the practice were investigated further. Suspension of ratings does not mean closure of the practice or suspension of the service’s registration with the CQC.

As part of their ongoing inspection, the CQC is also reviewing historical information relating to prescribing practices at the service. This may involve the use of the CQC’s legal powers to investigate incidents where individuals may have experienced harm or been put at risk of harm within health and social care services in England.

Additionally, a number of former and current clinicians at WellBN have been referred for the purpose of further professional investigation, both through their independent professional regulator and/or through the NHS professional standards mechanism.

The NHS has analysed prescribing data relating to hormone treatments given to children under 18 years old among general practices across England and it found that the WellBN Practice was a clear outlier.

Question to the Department of Health and Social Care:

To ask His Majesty's Government what safeguarding requirements apply to adult gender dysphoria clinics when patients present with a history of childhood trauma, abuse or serious mental illness.

Answered by Baroness Merron - Parliamentary Under-Secretary (Department of Health and Social Care)

Safeguarding is firmly embedded within the core duties and statutory responsibilities of all organisations that provide National Health Services. The organisations that manage adult gender dysphoria clinics will have reference to NHS England's Safeguarding Accountability and Assurance Framework, 5th edition, published 2026, that sets out the safeguarding roles and responsibilities for NHS-commissioned providers and sets out the legal framework for safeguarding adults.

Question to the Department of Health and Social Care:

To ask His Majesty's Government what guidance has been issued to safeguarding leads in local authorities regarding parental disagreement with a child's or young adult's wish to undergo social or medical transition.

Answered by Baroness Merron - Parliamentary Under-Secretary (Department of Health and Social Care)

No such guidance has been issued.