NHS Corridor Care

Iqbal Mohamed Excerpts

Wednesday 8th July 2026 Commons Chamber

[Dr Allin-Khan]

My hon. Friend is absolutely right, and I am so sorry to hear of the situation in her community in Scotland. It is regrettable, and patients and their families deserve better. Absolutely, if we cannot accurately assess the issue in full, it is impossible to deal with, and I hope the Minister will talk today about how she will commit to revising this definition to make it more robust.

[Iqbal Mohamed (Dewsbury and Batley) (Ind)]

I thank the hon. Member for securing this debate and for allowing me to intervene. The Mid Yorkshire Teaching NHS trust published data about patients in corridors for the first time only in May, and in that month it recorded 121 patients per day being treated outside clinical rooms and areas. A constituent of mine, Catherine, wrote to me to describe seeing at first hand elderly people waiting in corridors for hours with no family members to support them. Does the hon. Member agree that corridor care has moved from being an exceptional problem to an everyday issue in many NHS trusts, and that the Government must act to address the root cause of this issue?

[Dr Allin-Khan]

The hon. Member is right, but I know that the Government care deeply about this. This is not something on which I am in tension with the Government in any way. I have spoken to the Ministers and the Secretary of State, and I know that they are committed to acting and ensuring that every single patient across our country gets the best possible care. Let us be really clear: the NHS should not be a political football. Safe and dignified healthcare should not be a political football. I hope that we are all in agreement on this issue today. I would have hoped to see more Members on the Opposition Benches today, and I hope that their absence is not a reflection of how much they care about the issue, because, quite frankly, we owe it to all our communities to get this right.

I know from my own experience, as will other hon. Friends in the Chamber, that when someone comes to A&E, it is often the worst day of their life. It could be the worst day of their life because of their experience as a patient, or it could be the worst day of their life because someone they love—their child, their partner, their mother or their father—is dying or has died. When we think about the dignity and care that we give, we have to look at it holistically—not simply as a set of symptoms that we are treating but as a family and the experience that they take away with them of what has happened on that day. People are in tears, people are in pain, and we owe it to them to get this right.

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[Iqbal Mohamed (Dewsbury and Batley) (Ind)]

I congratulate the hon. Member for Tooting (Dr Allin-Khan) on securing this debate. Some very important points have been made. I am going to skip through some of those important points to reinforce the message, and bring forward issues raised directly with me by my constituents.

What we have heard is that what was once regarded as an exceptional state of affairs in the NHS has become so commonplace that Parliament is now debating it as a national issue in its own right. We have heard about the lack of investment and the redirection of resources, and about the issue being compounded over the many years of the previous Government. I acknowledge and recognise the efforts made by the current Government to try to address this, as well as many other challenges in the NHS. I congratulate them on their efforts to bring down waiting lists by many, many thousands; my constituents appreciate that.

We heard that more and more that patients are being treated away from clinical and sterile places: in corridors, cupboards and other places not designed for treatment. They are being denied their privacy, dignity and adequate support. One doctor described patients dying because they could not access appropriate clinical areas in time. That is not what we would class as a jewel-in-the-crown public service—but that is what the NHS is, and all of us across the House want to restore it back to being the world-class, free-at-the-point-of-need care service for every single person in our country.

For many years, hospitals under pressure often managed overcrowding by keeping patients and ambulances outside emergency departments while they waited to be handed over and moved into clinical areas. That resulted in ambulance waiting times going through the roof and many patients not receiving the emergency paramedic assistance they clearly required. Under the previous Government, that issue was displaced: from holding patients inside ambulances to moving them into the hospital building, freeing up ambulances to go and serve other patients.

I am not a medical doctor, but I am a scientist and an engineer, and what is obvious is that the 40 hospitals under the previous Government did not get delivered—not all of them were new, but that is also true of the ones that were to be refurbished and expanded. As with prison spaces, we lack the number of beds in our country that the NHS needs to provide safe and dignified care for every patient who seeks treatment.

Catherine, one of my constituents, wrote to me to say that she went into hospital with her husband. She waited in a corridor for five hours, but she saw many elderly patients with no relatives or friends with them, who had been waiting there for many hours before she arrived, and nobody was able to look after them or offer them water. They had to keep asking for water from other patients. That experience will exacerbate somebody’s medical condition and increase demand on the NHS. We have heard—

[Madam Deputy Speaker (Ms Nusrat Ghani)]

Order. I call Sarah Hall.

Department of Health and Social Care

Iqbal Mohamed Excerpts

Tuesday 30th June 2026 Commons Chamber

[Iqbal Mohamed (Dewsbury and Batley) (Ind)]

An estimated 229,000 excess deaths by 2036—that is the eye-watering figure that BMJ analysis identifies as the upshot of diverting NHS funding to pay more for pharmaceuticals in response to Trump’s threats.

Estimates day debates exist to scrutinise how public money will be spent before that spending has happened, not least when the decisions could have such damaging consequences for the health of our nation. This estimates day debate does not include the full budgetary consequences of the UK-US pharmaceutical deal agreed on 1 December. When we look at the cost, the Government’s figures simply do not stack up. Instead, we see a structural weakening of NHS safeguards on drug pricing, higher thresholds, weaker rebate mechanisms and a commitment to dramatically increase spending, which will prove devastating for patient health.

Ministers claim that the arrangement will cost about £1 billion over the current spending review period, but independent analysis tells a different story. Using the projections of the Office for Budget Responsibility, the House of Commons Library suggests that increasing spending on medicines in line with the Government’s commitments would require about £1.7 billion extra by 2028, and potentially as much as £14 billion a year by 2036.

The Government have been clear on one point, and one point only: they say that those increased costs will come from existing NHS budgets. No new funding has been guaranteed. Every extra billion spent on higher-priced medicines is a billion not spent elsewhere in a system that is already under immense strain. This is money not spent on tackling waiting lists, not spent on primary care, and not spent on saving lives. As we have heard, the Nuffield Trust has made that point starkly, estimating that the NHS will be able to save 340,000 fewer years of quality-adjusted life in 2035 if the promised spending goes ahead.

Despite the magnitude of these changes, the Government have refused to publish the full impact assessment of the deal that they hold. Why? This worrying development can be seen in the way in which the UK-US pharma deal was forced through, with no vote and scant parliamentary oversight. Let me summarise what I wrote on PoliticsHome back in March. This deal will increase the cost-effectiveness threshold set by the National Institute for Health and Care Excellence, curtail the overall cost cap on patented medicines, double the amount spent on such medicines, and increase the share of the NHS budget allocated to medicines. That should worry every Member of this House, because once those safeguards have been eroded, they are very difficult to restore.

[Sadik Al-Hassan (North Somerset) (Lab)]

I must declare an interest as a registered pharmacist for nearly two decades and an expert on pharmacy procurement.

Let be begin by saying that I welcome the UK-US pharmaceutical trade agreement, and also by saying something quite controversial: President Donald Trump is right. We do underpay for drugs—not just our expensive, lifesaving rare cancer drugs, but the everyday drugs that we purchase.

[Iqbal Mohamed]

Will the hon. Gentleman to comment on the fact that the NHS pays 10 times the manufacturing costs for over 80% of the licensed medicines that we buy? How is that underpaying?

[Sadik Al-Hassan]

I am not sure where the hon. Gentleman’s figures come from. When we look at the drug tariff reimbursement, which is the system that we use to pay, and compare it with the arrangements in other countries, it is clear that we underpay significantly. Perhaps he is referring to something of which I am unaware; I should be happy to chat to him outside.

We in this country are addicted to low-cost drugs for our health service, and what does that addiction mean? It means that we have the lowest costs and we always go for the cheapest drugs, and that favours foreign manufacturers. It destroys UK supply chains, as we have seen over the last 25 years, and it endangers our resilience as a country. We are already seeing the side effects of that, with drugs being out of stock. We have a system for payment called the drug tariff, which establishes how much pharmacies will buy drugs for and how much they will be reimbursed for. There are currently 254 price concessions. Price concessions happen when a drug is out of stock, and we must make an emergency increase to the price in the drug tariff to try to bring it back into the country. Given that there are 3,500 drugs in that section of the drug tariff, 254 does not sound a lot, but it is the highest level that I remember seeing in my entire professional career. Last month’s highest level of 230 has just been exceeded.

Cheap drugs often mean that we overvalue the benefit of medicines in our system and use a “drug first” approach in the NHS, and that has continued for decades. When we increase the price that we pay for drugs, it allows us to start considering the benefits of other types of treatment, such as social prescribing. Social prescribing becomes a great deal cheaper by comparison in a system in which drugs are valued at the correct level. The all-party parliamentary group on pharmacy, which I chair, published a report in June 2025 that laid out some of the problems with drug pricing and availability. I absolutely support the idea of paying more for drugs, because at the moment we are building a system that is creaking and breaking. By trying to pursue every penny of savings, we have destroyed UK manufacturing and offshored our problems. The only way to bring that back is to rebuild the drug tariff, with the idea of paying to procure more in the UK.

Puberty Blockers

Iqbal Mohamed Excerpts

Tuesday 23rd June 2026 Commons Chamber

[Dr Johnson]

I am sorry, but I just do not support that. We would not give children cocaine on the basis that they wanted it and would get it illegally otherwise. These are not sweeties; they are powerful drugs and need to be treated with respect.

Even if we accept the premise that a very small number of people might benefit from treatment, how could clinicians decide which children to treat? On what ethical or moral code would we want to inject powerful drugs into children who are likely to have a self-limiting illness and therefore do not need it? That is what the Government have chosen to do, and it is not necessary.

Following on from the point made by my hon. Friend the Member for Farnham and Bordon, they have this data already. The Tavistock was a travesty, but it means that the Government could analyse the data from the outcomes of those children. They could establish the outcomes as children went into adulthood, and Baroness Cass tried to do this using the data linkage study. Shockingly, six out of seven adult gender clinics refused to provide the Government with the data. Even when a specific piece of legislation was passed by the previous Government to clarify that it was legal to provide the information to this trial, the gender clinics still did not provide it.

I understand that NHS England is working on the data linkage study, but I ask the Secretary of State why it is taking so long. Is the abolition of NHS England causing delay? Why is he letting this trial, which he has expressed reservations about, go ahead in the knowledge that it is unnecessarily broad and in advance of the data linkage study?

[Iqbal Mohamed (Dewsbury and Batley) (Ind)]

Does the hon. Lady agree that unblocking the reasons why the data is not being made available should be the top priority, and that analysis of that data should be done before any further experiments on children are done?

[Dr Johnson]

The hon. Gentleman is exactly right, and he expresses my point succinctly. Why is the Secretary of State going ahead with a trial—experimenting on more children unnecessarily—when he has the data to analyse already? Why has he chosen to fund this trial? Is he worried about the children who will be put on a medical pathway that may lead to cross-sex hormones and a lifetime of medicalisation when they would have got better by themselves anyway?

I want to talk about the age of these young people. The Medicines and Healthcare products Regulatory Agency warned in February that the youngest patients are at the greatest risk, and may end up on puberty blockers for a much longer period. They have a higher risk to fertility because sperm and eggs have not yet fully developed at Tanner stage 2, but this Government have chosen to include children of 11 or 12. Some will wonder why it is 11 for girls and 12 for boys—indeed, I was asked that question yesterday—but as a paediatrician I am aware that puberty starts earlier in girls than in boys. It is somewhat ironic that a trial based on the premise that girls could be boys recognises this biology, but I am glad that in this respect it does. However, that means some of the participants will be primary school-aged children with the merest form of puberty. How can they possibly meet the eligibility criteria, which includes

“sufficient understanding of the treatment advantages and disadvantages, including discussion of fertility preservation”?

How can a child of 11 understand what it means to lose sexual function, to be unable to have children when they are older, to have difficulties in thinking and to have weak bones? Remember that this Government think that 14-year-olds are not old enough to watch social media, but they think 11-year-olds are capable of understanding this.

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[James Murray]

I have responsibility for NHS England as Secretary of State for Health and Social Care, and I am setting out the protocol agreed in relation to this trial, as it is a subject that is arousing a lot of questions in the Chamber, which is fair. [Interruption.] I will come back to that point, if the hon. Member for Gordon and Buchan (Harriet Cross) allows me to make a little progress.

[Iqbal Mohamed]

Will the Secretary of State give way?

[James Murray]

I will make a little progress, and then I will be open to more interventions. We need to be clear about who we are talking about. As Dr Cass said, the vast majority of children and young people who question their gender will resolve it without needing any support other than their friends and family. For many young people, questioning their identity, on many different fronts, is a normal part of growing up, and we should simply let them be. A small number of those young people, however, need greater support because of the level and longevity of discomfort that they feel, and that can often involve counselling or therapy.

For a very small number of young people, it is possible—and I emphasise the word possible—that medical treatment would help improve their quality of life and mental health and reduce their gender-related distress. That is why Dr Cass recommended a trial to study the effects of puberty-suppressing hormones on young people’s physical, social and emotional wellbeing, and to establish how best to support children and young people suffering gender incongruence.

[Iqbal Mohamed]

On that point, in normal clinical trials, the active substance and a placebo would be used, and the impact, changes or benefits that each cohort experienced would be checked. If children have a psychological leaning and are emotionally feeling that they are in the wrong body, is there not value in having a cohort that takes a placebo and seeing if that improves their mental health?

[James Murray]

The hon. Gentleman raises an important question around how the clinical trial is designed. In this case, the young people involved in the trial, of whom there will be around 226, will be split into two groups; one half will have the puberty blockers from the start, the other half will receive them after a year.

My understanding of this matter, having interrogated the detail carefully, is that a placebo would not be appropriate for this trial because the subject will be able to know the impacts of having the puberty blockers; they will be aware of whether they are having the medication. What is important, however, and what I hope will set this Pathways trial in a wider context, is all the other work that is being done to study the incidence of gender incongruence and the responses to that among young people, which will go beyond the trial we are talking about to look at children and young people questioning their gender through talking to them, understanding their mental health and their approach to that. All that will happen alongside this trial, which is one part of a much wider study to understand how best to support young people who are facing these gender-related issues.

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[Alison Bennett (Mid Sussex) (LD)]

This debate is on a subject that, it goes without saying, is emotive and complex. We must therefore as always endeavour to have this conversation with compassion and empathy. The Liberal Democrats’ position is clear and simple, as reflected in our amendment to the motion: any medical treatment and the approval of any clinical trial, including the one we are discussing, must be led by expert medical advice. It should not be led by personal belief, no matter how sincerely and passionately that belief is held. Politics has a place, but not in questions of medical trials and clinical consensus—those are better left to experts.

The Cass review, originally commissioned by the Conservatives, was clear that there was a need to gather more evidence. The safety of young people is paramount, and the experts involved in this space know that better than anybody; they work with these children day in, day out and understand the risks of both action and inaction. That is why we supported the previous decision to pause the trial after the MHRA raised concerns, and why we now support the decision to start it again.

We will listen to the experts and the clinicians, but to build trust in expert advice we need transparency and clarity, and throughout the process, we have pushed for exactly that. We want the expert opinions on the public record, as that allows us as politicians, as well as the wider public, to approach this issue with clarity and facts, not ideology or misunderstanding. That is why we called for the Government to publish how the MHRA arrived at its decision when concerns were first raised, and yesterday we called for the Secretary of State to confirm that the MHRA had confirmed that its concerns had been substantially addressed. Transparency is needed so that people can be confident that clinical advice is being followed.

[Iqbal Mohamed]

Will the hon. Member give way?

[Alison Bennett]

I am afraid that I will not.

Liberal Democrats have been arguing for many years that improved access to better specialist healthcare services for children and young people struggling with their gender identity is extremely important. Those young people have been badly let down by low care standards and extremely long waiting lists. The closure of the Gender Identity Development Service made it clear beyond doubt that change was needed. We have consistently campaigned for real action to tackle the shocking waiting times across the NHS, including for gender identity services.

Liberal Democrats welcome the move to create new regional centres to offer this care to the young people who need it. There is a need for multiple geographically dispersed clinics so that care is closer to those who need it, but roll-out has been slow, and more needs to be done to tackle the waiting lists—quite simply, a three-year average wait is not acceptable. For the centres to run effectively, we must support the specialists who provide children and young people with high-quality, compassionate and clinically appropriate care.

Treatment, first and foremost, should be based on talking therapies. Space and time to talk through feelings is vital for young people struggling with their gender identity. It is a deeply complex set of feelings, and questioning and understanding one’s identity is never an easy thing, especially for a child, but for talking therapies to be an effective first step, children must be able to access them when they need them, not after years on a waiting list.

The debate is about access to a form of healthcare—one that is led by doctors and clinicians—and, as for any other form of healthcare, we must listen to the experts: the people who have spent years training and years delivering care.

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[Sarah Owen]

Absolutely. I thank my hon. Friend for his commitment to the LGBT+ community and for his work, including with his constituents. We have heard a lot today about throwing children into wild experiments, but that is not what we are talking about. We are talking about something done in collaboration with parents—parents who love their children and want the best for them, and with medical professionals who want the same. The rhetoric around the trial really needs to change.

No child will be able to take part in the trial without parental consent. That has been confirmed again by the Secretary of State from the Dispatch Box. Of course, there will be some children who will never gain their parents’ consent: a heartbreaking situation for any family. However, there will be many parents who will truly support and know the wishes of their child; they will agree with the suitability of the treatment and want to support them on their journey.

Much has been discussed about the child, but parents have huge agency in the process. We are not just talking to the children; we are talking to adults who want the best for their child, and that point should be recognised.

[Iqbal Mohamed]

My hon. Friend is making a powerful speech. I have huge respect for her and I completely agree that nobody here or outside should be looking to disrespect or harm any individual, whatever their age. Would she agree that parents should also be given all the information available around this condition, its treatments and the paths that children follow? Over 93% of children who experience gender dysphoria grow out of it and then are happy in their natural body. Does she agree that that and other information should be made available to the parents?

[Sarah Owen]

I thank the hon. Member for his intervention and his kind words at the beginning; that is the right tone, which we need to set, and information is key. People need to be able to make informed decisions—whether it is the child or a parent—and there needs to be independent information so that people can make fully informed decisions.

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[Joy Morrissey]

My doubts come from why, for example, we are not allowing the data linkage study to be fully completed before proceeding with the new trial. That study would find out what has happened to all the children who have already taken puberty blockers. I wanted to ask the Liberal Democrat spokesperson, the hon. Member for Mid Sussex (Alison Bennett), that question, but I was not able to make that intervention; I do not know whether that had anything to do with the £1.5 million donation from Ferring Pharmaceuticals that the Lib Dems took before the 2019 election. I do not know whether that had anything to do with it, but there has to be some level of declaration if a political party has taken donations from a pharmaceutical company that is promoting this drug. That is relevant to how one represents oneself in the Chamber.

There is no justification for proceeding with the Pathways trial before the data linkage study is complete. Puberty is how a child transitions from childhood to adulthood, and anything that affects that process is going to have long-term effects. Those effects are going to be felt, not in one or two years, but in 10 years. The brains we have as adults, at the age of 24, are very different from the brains we have as 11-year-olds—our frontal cortexes are not fully developed. This is not just about the effect on these children’s psychology; what effects do these drugs have on humans over the long term? We do not know that, so why not look at the data linkage study? It does not have to be perfect, but it will allow us to protect the children going into this trial, so that the trial is as well-run as possible.

[Iqbal Mohamed]

I thank my hon. Friend for giving way, and for making such a passionate speech. I think we all agree, across the House, that we are here not to politicise or to demonise, but to try to make the right decisions for the safety of children. I think that all Members here share that intention. It was said earlier that these drugs are already used to treat different conditions, such as prostate cancer, endometriosis and precocious puberty. For the first two conditions they are taken by adults for a very short time, and for the third they are taken for a limited period until the child reaches the age of puberty. Such misinformation—or comparison—is not really valid, and should be avoided.

[Joy Morrissey]

That is an excellent point. When I heard about those other uses for the drug, I thought that I would be interested to see more clinical trials for conditions such as endometriosis and cancer to establish its long-term effects. However, that is for adults. When it comes to protecting children, I want to ensure that this trial involves as much safeguarding as possible.

We do not fully understand the long-term risk. We come to the House again and again to discuss what constitutes a child and what constitutes protecting a child. We need to be clear about the fact that we must protect people under the age of 16, or 18—I do not care which age it is, but it should be an age on which we all agree—and that they must be subject to extra protection and safeguarding until they reach adulthood. That is why we are asking for so many safeguards—we need to ensure that the unintended consequence of trying to help a few young people does not lead to greater harm to many—and it is why we are here today.

I do not feel that asking the Government to include the data linkage study is too much to ask. This trial is a trade-off: long-term health is being exchanged for short-term happiness. This trial, in my opinion, is not safe, and this trial will not protect children from harm.

NHS Federated Data Platform

Iqbal Mohamed Excerpts

Thursday 16th April 2026 Westminster Hall

[Iqbal Mohamed (Dewsbury and Batley) (Ind)]

It is a pleasure to serve under your chairship, Dame Siobhain.

In a briefing for investors, Palantir chief executive officer Alex Karp said:

“we are super proud of the role we play, especially in places we can’t talk about…Palantir is here to disrupt…and when it’s necessary, to scare our enemies and on occasion kill them.”

If it looks evil, if it smells evil and if it behaves evil, then it is evil. I thank the hon. Member for Newton Abbot (Martin Wrigley) for securing this debate. Given my lack of speaking time, I am going to have to cut my speech short.

We must examine Palantir’s record elsewhere in the world in our assessment of its suitability as a supplier to the NHS. Palantir has long-standing contracts with United States Immigration and Customs Enforcement, and the tools to track and target migrants that it has provided to ICE have facilitated racial profiling, family separation and violations of due process. In January 2024, Palantir entered into a strategic partnership with the Israeli Ministry of Defence to support war-related missions, meaning that its advanced data systems are used to perpetuate a genocide against the Palestinian people. Reports from Novara Media and the Financial Times state that NHS staff have been warned that they could be fired for criticising the NHS contract with Palantir, that NHS organisations are under pressure to sign up voluntarily to the Palantir data system, and that technicians have been told to stop working on alternate systems.

The Swiss Government have previously rejected engagement with Palantir, raising national security concerns; in the US, hospital systems in New York have moved away from Palantir arrangements, citing data governance and control issues; and here at home, uptake of the FDP remains uneven, with many NHS professionals reluctant—in some cases refusing—to engage with it. Perhaps most concerning of all are the reports that patient data opt-outs do not apply to the federated data platform due to a legal direction issued under section 254 of the Health and Social Care Act 2012, yet that direction has not been published or named or been subject to scrutiny. This debate is not about technology; it is about who we trust to sit at the heart of our NHS, and on that question, the Government must think again.

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[Navendu Mishra (Stockport) (Lab)]

It is a pleasure to serve under your chairship, Dame Siobhain. I thank the hon. Member for Newton Abbot (Martin Wrigley) for securing the debate.

From links to serious human rights abuses to an ongoing lack of clarity around the security of sensitive patient data, a large number of my constituents have raised concerns about the ethical implications of using Palantir technology in our NHS. The hon. Member mentioned that a newspaper report in The Times on 9 April told us that the data chief of the NHS remains committed to the use of Palantir’s technology across the health service despite the company’s ties with ICE and the US military. I have written to the chief executive of Stockport NHS foundation trust as well as the Greater Manchester ICB on that issue.

Amnesty International and Medact, an organisation that brings together health workers in the UK, have been vocal in urging hospitals not to use Palantir software and have highlighted the link to some very concerning instances of human rights abuses.

[Iqbal Mohamed]

Will the hon. Member give way?

[Navendu Mishra]

I am limited for time and the hon. Member has already contributed, so I ask him to accept my apologies.

Patients must feel confident that their data is handled transparently, securely and in a way that reflects British values. That is why we should be investing in and developing our own sovereign technological capabilities here in Britain. I want to see Britain at the forefront of science and technology, and that starts with backing our own institutions. The UK has a proud heritage of education, with some of the finest universities and institutions in the world. We should be investing in them instead of relying heavily on foreign companies.

France has set a good example here. The French Government are moving all their desktops from Windows to Linux as part of a nationwide strategy to reduce reliance on US tech giants. We should take similar action in the UK. Retendering the federated data platform could benefit the country, addressing ethical and security concerns while also delivering long-term economic and technological benefits. I know the Minister is an NHS worker—a transplant surgeon—and on behalf of the people of Stockport, I thank him for the work that he does for the NHS. I know he will take seriously the point that it is not just the cost of the £330 million to the British taxpayer that cross-party Members here are concerned about; they are also concerned about their private, personal health data and the ethical behaviour of Palantir. I hope he will take the concerns raised today urgently back to the Government.

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[Dr Danny Chambers (Winchester) (LD)]

It is an honour to serve under your chairpersonship, Dame Siobhain. I thank my hon. Friend the Member for Newton Abbot (Martin Wrigley) for his tenacity and expertise in this subject. He has done a huge amount of research, and made an absolutely excellent speech.

At a moment of rising global instability, it is extraordinary that we are prepared to trust the health of our citizens and the functioning of our NHS to a US corporation that does not share our values or interests. Outsourcing the storage, handling and analysis of NHS data to a foreign company, rather than securing the national and economic benefits of this work being done by a British or UK-led organisation, is yet another example of our unnecessary reliance on others to keep our vital infrastructure running. Doctors and the public have made it clear that they do not trust this company. Fewer than half of NHS trusts have begun using this technology, in large part because of the concern from patients and clinicians. If, as the Health Secretary says, the federated data platform is

“absolutely critical to the future of the NHS”,

placing it in the hands of a company that staff and patients do not trust risks undermining that future from the outset.

This is the central issue: we hold doctors and nurses to the highest ethical standards, and rightly so. We expect them to protect confidentiality, to act with integrity and to put patients first. So why are we asking them to use a system they do not trust and stake their professional reputations on it?

Palantir is not a neutral contractor. It is a company that is deeply embedded within the political ecosystem of Donald Trump, a convicted felon whose Administration has repeatedly undermined the international rule of law. It is a company that has worked hand in glove with US Immigration and Customs Enforcement, whose behaviour is morally and legally outrageous and whose agents have operated like masked vigilantes in the deportation of individuals. We are all aware of the tragedies that that rogue Trump organisation has left in its wake. Why are we allowing a Trump-aligned company to sit at the heart of Britain’s most precious public service? Why are we comfortable placing NHS data in the hands of a company whose values are so clearly at odds with those of the British public?

This is not a technical decision—this is a political choice. The NHS is not only one of our most important public services but one of the largest areas of public spending. Therefore, it is deeply concerning that Palantir’s contract for the federated data platform is so heavily redacted that it makes scrutiny almost impossible.

[Iqbal Mohamed]

Health inequality in the NHS for people of ethnic minorities is a challenge that we need to address. The New Orleans police department and the Los Angeles police department both terminated Palantir-powered predictive policing due to the system’s reinforcing racial bias and creating feedback loops to overpoliced communities that were affected. Does the hon. Member agree not only that the company and its leaders are unethical but that the systems it supplies are unethical and racist?

[Dr Chambers]

That is an important point. Amnesty International, whose representatives I believe are present, and others including voices within the NHS have been raising serious concerns about the potential misuse or inappropriate sharing of sensitive data. The Government must come clean about how the contract was awarded in the first place and what steps they will be taking to bring it to an end.

We should be building NHS data processing capacity here in the United Kingdom, strengthening our resilience, backing our own expertise and building sovereignty in a more dangerous world. Instead, we are exporting control of one of our most valuable national assets. I ask the Government today to use the break clause, stand with NHS staff, protect patient trust and keep Donald Trump and his allies out of our NHS.

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[The Parliamentary Under-Secretary of State for Health and Social Care (Dr Zubir Ahmed)]

It is always a pleasure to serve under your chairmanship, Dame Siobhain. I am grateful to the hon. Member for Newton Abbot (Martin Wrigley) for securing this important debate and for his and other hon. Members’ contributions to it. Of course, we should also welcome the hon. Member for Solihull West and Shirley (Dr Shastri-Hurst) to his place in his first debate on the Front Bench.

We have heard a lot about concerns and insights and interpretations about the NHS’s technological architecture. Some would have us think that the FDP is synonymous with just one company. It is not. The FDP is fundamentally an NHS construct. It consists of multiple contracts awarded to a number of consortia, including Palantir, Accenture, PwC, Carnall Farrar and the North of England Care System Support. Each of those have different responsibilities to make sure that there is training, health expertise and security in the FDP.

Ultimately, the FDP is a federation of local trusts and ICBs within NHS England, each with their own version of the FDP and their own abilities to decide which information they put there on the basis of their own service needs and governance arrangements. Although there should be scrutiny of Palantir and of any contract, we should also provide clarity about what the FDP is delivering for the NHS. It is my duty to make sure that the FDP is improving patient and clinical experience and improving patient outcomes.

Making the best use of data generated by the NHS and social care is essential to transforming services, improving outcomes for patients and making sure that we use resources in the best manner possible. Lord Darzi’s independent investigation into the NHS found that, despite huge volumes of data, fundamentally:

“The last decade was a missed opportunity to prepare the NHS”

to use the latest technologies.

The FDP is part of an infrastructure—it is not the infrastructure or the only infrastructure—resolve that gap. It is improving efficiency and generating savings across the health service worth up to £2.4 billion, according to independent estimates. Those independent estimates are being further bolstered by a commissioned study by Imperial College that will look at the economic impact of the FDP. It is an important tool for us being able to make the NHS fit for the future on clinical efficiency, transparency of data and outcomes for patients up and down the country.

Before I go into more detail about what the FDP does, it is important that I say what it does not do. For instance, it is not synonymous with the single patient record, the NHS app or—necessarily—with linking primary care data with secondary care data.

[Iqbal Mohamed]

Will the Minister give way?

[Dr Ahmed]

I am going to carry on for a bit longer.

The hon. Member for Aberdeenshire North and Moray East (Seamus Logan) tempts me with his speech, and he knows that I cannot resist his temptation. He spoke about Scotland and he will know that I am an NHS surgeon in Scotland. I hope he thinks that I can speak with some authority about the NHS in Scotland, so let me tell him a few things about the digital architecture in the NHS there.

The NHS app has been running successfully in England for over eight years. Three out of four people in the NHS in England have that app. To clarify, the app is not Palantir; it has been devised organically on the ground by NHS England—by clinicians and by technologists. It now serves millions of patients to book test results, screenings and appointments—including GP appointments —to end the 8 am rush.

The hon. Member for Aberdeenshire North and Moray East spoke about the MyCare app in Scotland. That remains a far-fetched dream rather than a reality. The limit of the ambition of that app seems to be, as I understand it, a dermatology service in one part of Scotland called Lanarkshire, for those who are not familiar with Scotland. It is a million miles away from what has been developed down here in England.

[Dr Ahmed]

I will not; I am going to carry on—and I will tell the hon. Gentleman something further. The NHS in England was quite happy to use the expertise of technologists up and down the country, including in Scotland—including, in my own constituency of Glasgow South West, a company called Cohesion Medical. His Government in Scotland, who have been in government for over 20 years, refused that offer. That is why my patients and constituents in Scotland are unable to access simple digital services. It is why my patients and my constituents under NHS Scotland are 30 times more likely to wait over two years for treatment. It is why my patients and my constituents in Scotland are unable to access optimal stroke therapy and lung cancer screening.

The NHS federated data platform in England connects health information held in different systems, helping to manage activity to improve productivity and outcomes. By connecting critical data streams, it can accelerate diagnosis pathways, streamline discharge processes and ensure faster, more co-ordinated care that reduces waiting times for all patients.

I will briefly describe a couple of examples. North Tees and Hartlepool NHS foundation trust uses an FDP product called OPTICA to map the patient’s journey from being admitted to going home. It used to be done with spreadsheets, which were not always updated. Because of that, discharges were delayed, medicines were not sorted on time—in some cases time-critical medicines, causing real patient harm—and patients were therefore impacted. OPTICA lets the trust see all that information in one place in real time. It has reduced the number of long stays by a third, and despite a 7% increase in admissions over that time, we are improving services overall.

[Iqbal Mohamed]

Will the Minister give way?

[Dame Siobhain McDonagh (in the Chair)]

Order. May I just say that the hon. Member had very generous time allocated to him during this debate? If the Minister does not want to take an intervention, he does not need to.

NHS Continuing Healthcare

Iqbal Mohamed Excerpts

Wednesday 25th March 2026 Westminster Hall

[Ayoub Khan]

I absolutely agree. There is an unnecessary burden on families to start off with, and when the appeal process can take months and it is difficult for families to secure representation—they may end up representing themselves—that causes them further anxiety. I agree that there needs to be a review of the whole system, because it is a further bottleneck in an already very stressful situation for families. I will come to an example of a family I am trying to assist in that regard.

In many cases, decisions are overturned and the status quo is restored. We must be honest about what is driving this. It is the same culture of cuts and austerity, sweeping across this Government and the previous one, that is to blame for the crisis. Independent analysis shows that CHC spending decreased by 42% in 2024 compared with previous years, even as need continued to grow. That is not because people are suddenly less ill, but because access is being constrained.

Investigations have also revealed that private companies are being contracted to review CHC eligibility and, in some cases, to reduce care packages, raising serious ethical concerns about profit being tied to cuts in vital care provision. A system where decisions are not always driven by clinical need but by cost containment will inevitably fail to protect and care for some of our most vulnerable individuals.

My constituent Daniel has experienced the injustice of the CHC process at first hand. He suffers from severe learning difficulties, autism, anxiety and behaviour of distress, and is cared for by his elderly parents, Linda and Dave. In order to receive the proper care, Daniel is supported every day by six personal assistants, all of whom are being paid thanks to CHC funding. After an annual review in January last year, it was confirmed that his condition had not changed and therefore his funding ought to continue, and yet, since a spontaneous and unwarranted review of the decision, Daniel’s eligibility has been under excessive and unreasonable scrutiny. The reassessment directly contravened the national framework for CHC, which states that a full reassessment must be arranged only if there is

“clear evidence of a change in needs to such an extent that it may impact on the individual’s eligibility”.

The saga was concluded two weeks ago when, despite providing no clinical rationale for the “significant change” in Daniel’s medical needs, the care board revoked his funding, leaving his parents to foot the bill for his care. For more than a year, Linda and Dave have carried on their fight against the care board’s impropriety, which has understandably come at a great financial, emotional and personal toll, all while continuing to care for Daniel. Unfortunately, Daniel’s story is neither exceptional nor surprising. It shows how many of those reliant on Government support are being stripped of it in the blink of an eye.

The stories of Daniel and so many others show exactly what is wrong with the system. Since 2017, despite an ageing population and increasing complexity of need, the number of people eligible for CHC has fallen by more than 9%. Over the same period, the proportion of people found eligible after a full assessment has dropped dramatically, from around 31% to just 18.6%. That means that more people are being assessed, but fewer are receiving support.

For families, that often means a gruelling process, characterised by a mire of lengthy assessments, appeals, delays and uncertainty, at the most difficult time of their lives. Confusion, exhaustion and distress are mainstays of that process. Even for those who are fortunate enough to be granted CHC funding, it can be withdrawn upon review, leaving families in a state of permanent anxiety that they could be plunged back into crisis at any moment.

Behind every statistic is a family caring for a loved one with dementia, a neurological condition or even a severe disability—a family forced to give up work, drain their savings or even sell their home, all while navigating a system that is rigged against them from the start.

[Iqbal Mohamed (Dewsbury and Batley) (Ind)]

I congratulate my hon. Friend on securing this important debate. I wholeheartedly agree with him, in particular about his constituents who had the support that their child needed for many years, had an annual review that reconfirmed that that support was necessary, and then suddenly, out of the blue, faced a challenge by some new body or process. Does he agree that there should be a clear, transparent process that is easy to understand by families who go through it, that there should be clear checks and balances to ensure that families receive a fair hearing, and that, when support is agreed and secured, it should be maintained until the next formal review is required and the criteria and conditions have changed?

[Ayoub Khan]

I wholeheartedly agree. One of the difficulties in Daniel’s case was that an assessment found that there was no material change in the level of support that he required, but a reassessment was conducted subsequently, and the funding was then withdrawn. I met Daniel, and I felt so sorry for his parents, who are now struggling because of the withdrawal of the funding. It is shocking that someone can sit somewhere and make a desk-based reassessment of someone’s condition and then strip them of funding. I am confident that the family will ultimately secure funding, but the stress that they are going through is simply unacceptable.

I urge the Minister to review Daniel’s case. I recall writing to him on this very matter in July last year. He replied that the operational delivery of CHC is the responsibility of integrated care boards. Care boards do indeed have delegated autonomy to make funding decisions, but they must follow national guidance, and the Government have the power to act when those duties are breached. I would welcome the Minister’s reflecting on his stance on this matter. At the very least, will he meet me, Linda and Dave so that he can gain insight into how the system is failing people like Daniel? Caring for our loved ones should not be subject to a cliff edge or an all-or-nothing gamble. If we want to build an NHS fit for the future—one that delivers care closer to home and puts patients first—then fixing CHC must be a core part of that mission.

--- Later in debate ---

[Iqbal Mohamed]

It is the responsibility of ICBs to administer and provide this support, but does the Minister share my concern and that of my hon. Friend the Member for Birmingham Perry Barr (Ayoub Khan) that the involvement of private contractors in eligibility reviews may not be appropriate? The ICB may feel that responsibility lies with the private contractor to guide it, rather than owning its decisions.

[Stephen Kinnock]

Of course, we want to see consistency and quality right across the board, regardless of who is actually delivering the work. If there are specific issues around private contractors that the hon. Gentleman can flag to me, perhaps he could write to me; we would be very happy to look into them.

We have committed to reduce the running costs of integrated care boards and to redirect that funding to frontline services. To deliver that, our 10-year health plan sets out that integrated care boards must focus on their role as strategic commissioners, ensuring the best possible value in securing local services that improve population health and reduce inequalities. However, NHS England has been clear that, although transformation is required, it must be carried out with clear safeguards in place to protect frontline responsibilities. Legal duties in relation to NHS continuing healthcare must continue to be met. This means that running-cost reductions should aim to make administrative and corporate functions more efficient. They are not there to change funding for direct care or statutory duties.

I acknowledge that integrated care boards have worked intensively to strengthen their plans for 2025-26, focusing on areas where efficiencies and savings can be made. I thank NHS England for working with integrated care boards to monitor spend against these plans. The Department is working closely with NHS England on how responsibilities will be delivered from April 2027 onwards, when—subject to the will of Parliament—NHS England will be abolished. Until those changes are made, the Department and NHS England will continue to carry out their respective statutory functions. In the interim, teams are increasingly working together closely under an interim joint leadership team, including on NHS continuing healthcare.

Fundamentally, addressing some of the issues that hon. Members have discussed today will require wider reform of the social care system. That is why Baroness Casey is chairing an independent commission into adult social care. The commission has a clear mandate to undertake the most comprehensive review of adult social care in a generation. With Baroness Casey as its chair, it will cut through the political stalemate, identify what the country needs and wants from adult social care, and support the Government in establishing a system that works.

Baroness Casey has made it clear that she will not wait until the end of the commission to recommend action where she sees fit to do so. Hon. Members may have seen her speech at the Nuffield Trust summit on 5 March. I thank her for setting out recommendations for immediate action on adult social care, which focused on three key areas: safeguarding, dementia and motor neurone disease. We will not waste time in taking those recommendations forward. We look forward to reviewing Baroness Casey’s phase 1 report, which is due later this year and will set out further recommendations to address immediate priorities for adult social care in this Parliament, laying the groundwork for long-term reform and setting us on the path to delivering a national care service.

In her recent speech, Baroness Casey rightly raised challenges with NHS continuing healthcare. We are carefully considering her reflections. I acknowledge existing tensions between integrated care boards and local authorities regarding NHS continuing healthcare eligibility decisions. Those decisions hinge on whether the support required by an individual is above the limits of what the local authority can provide. Integrated care boards must consult with the relevant local authority before making any decision about an individual’s eligibility for NHS continuing healthcare, putting individuals at the heart of the decision-making process.

However, I acknowledge that, in practice, it is not always straightforward to determine clearly who is responsible for meeting an individual’s needs, so we are working with NHS England to better join up support between the NHS and local authorities, exploring areas where good joint working is helping to improve outcomes for people accessing NHS continuing healthcare. Through the development of our neighbourhood health services, local authorities and integrated care boards are encouraged to consider how services can be reconfigured to focus more on prevention and early intervention, embedding new ways of working to set the direction of travel for future years.

I want all individuals who are eligible for NHS continuing healthcare to receive support in a timely manner, and I want the assessment process to be as smooth, clear and transparent as it possibly can be. We know that eligibility rates can vary from year to year, and across regions and integrated care boards. That variation often exists for good reasons, including differences or changes in the health needs of local populations or individuals over time. To check that the variation is warranted and justified, NHS England continues to monitor eligibility rates by undertaking detailed work to compare eligibility and referral rates between integrated care boards. When it identifies unwarranted variation between integrated care boards with similar demographics, it follows up and seeks to ensure coherence and consistency.

My Department is also engaging with local areas to explore current work on eligibility disputes, and how they address those challenges. There are no quick fixes, but we remain committed to supporting the sector to improve outcomes for individuals. I want to stress that while disputes between organisations are being resolved, individuals must never be left without the appropriate care and support.

There is a robust dispute resolution process in place for when a full assessment for NHS continuing healthcare has been undertaken and the person or people concerned disagree with the outcome. First, an individual or their representative can ask for a local review from the relevant integrated care board. All integrated care boards should have developed a local resolution process that is fair, transparent and includes timescales. Where it has not been possible to resolve the matter locally, an individual may apply to NHS England for an independent review panel to review the decision. Finally, if the original decision is upheld and there is still a challenge, the individual can make a complaint to the Parliamentary and Health Service Ombudsman.

I was very sorry to hear from the hon. Member for Birmingham Perry Barr of the difficulties that his constituents are experiencing, and I thank him for sharing the details of Daniel’s case. I would of course be happy to receive further representations from the hon. Member. Perhaps he could start by setting out in a letter what the issues are, and then we can make sure that appropriate action is taken.

I also know that concerns have been raised about the relatively low number of individuals who are ultimately found eligible for NHS continuing healthcare after they have been referred for full assessment. The threshold for initial referral by GPs, social workers and others is deliberately set low to ensure that anyone who may be eligible is fully assessed. For that reason, many individuals will not go on to receive NHS continuing healthcare. However, an assessment is also a gateway to other forms of NHS-funded support, such as NHS-funded nursing care and joint packages of care between local authorities and integrated care boards. My Department and NHS England continue to work with partners, including the CHC Alliance, Dementia UK, the Nuffield Trust and other sector bodies. We want to support integrated care boards in delivering national policy and guidance, including on how we can achieve better join-up between the NHS and local authorities.

I congratulate the hon. Member for Birmingham Perry Barr again on securing this important debate—and I thank all those who intervened in it—so that we can continue to focus on improving services for the people who need them most. I know that this is a very challenging and emotive topic for many families who are going through extremely difficult times, and I absolutely accept that sometimes controversial decisions are made. We need to ensure that in every one of those controversial cases there is transparency, clarity and coherence. I look forward to working with the hon. Gentleman and with Members across the House to ensure that, collectively, we achieve that goal.

Question put and agreed to.

Puberty Blockers Clinical Trial

Iqbal Mohamed Excerpts

Monday 23rd March 2026 Westminster Hall

[Iqbal Mohamed (Dewsbury and Batley) (Ind)]

It is a pleasure to serve under your chairship, Mr Mundell. This is a Government who have shown that they care for the safety and welfare of children. They supported the Online Safety Act 2023 to counteract harmful digital content and removed, albeit eventually, the punitive two-child benefit cap to reduce poverty. The Government have committed to halving violence against women and girls, and have banned the pre-watershed advertising of junk food on TV.

However, the trial flies in the face of the Government’s explicit mission to protect children from harm. It would expose children to severe and irreversible harm when viable, less harmful alternatives are available. Despite that, the Government are happy to permit a clinical trial that would give puberty blockers to 226 children. Research has shown that over 95% of children who start out on puberty blockers continue on to cross-sex hormones, while other research has shown that between 60% and 98% of children with gender dysphoria will outgrow that feeling and go on to live a normal, natural, healthy life in their born body.

[Rachel Taylor]

Will the hon. Gentleman give way?

[Iqbal Mohamed]

I am going to continue, given the lack of time.

The numbers are important. They mean that the Government are choosing to prioritise the interests of between five and 90 of the 226 children involved in the clinical trial at the expense of deliberately harming between 135 and 203 children, who will eventually come to terms with their birth sex. I ask the Minister, will the Government now confirm that the current pause—which I welcome and am grateful to the Government for—will remain in place unless and until all safety, ethical and scientific concerns are fully and transparently resolved?

--- Later in debate ---

[Dr Caroline Johnson (Sleaford and North Hykeham) (Con)]

It is a pleasure to serve under your chairmanship this afternoon, Mr Mundell. I must first declare an interest as an NHS consultant paediatrician. I thank James Esses for the petition and the thousands of people who have signed it, including many of my constituents, for enabling today’s important debate. I also thank the hon. Member for Caithness, Sutherland and Easter Ross (Jamie Stone) for leading the debate so well.

The petition asks the Government to cancel the puberty blockers trial and to safeguard vulnerable children. Perhaps it is worth considering whether clinical trials in children are a good idea in principle. The answer, of course, is yes. Children are not just small adults; they have different illnesses from adults, they present with different symptoms and respond differently to medication, and they require different doses at different ages. Properly designed clinical trials ensure that children’s medicines are safe and effective for them.

However, today we are discussing one particular trial: a proposal to give puberty blockers—gonadotrophin-releasing hormone analogues—to children, specifically for gender incongruence. Perhaps at this point it is worth considering why doctors and others prescribe medication; we do it to treat or cure disease, to treat or lessen symptoms and to aid in diagnosis.

What does this trial seek to do? On the face of it, it seeks to establish whether puberty blockers are a safe and effective treatment for gender incongruence. ICD-11 defines gender incongruence as:

“A marked and persistent incongruence between an individual’s experienced gender and the assigned sex”.

To suggest persistent incongruence with gender stereotypes is wrong could undo years or decades of rolling back gender norms. If it is not causing the person any distress, why would we want to treat it, especially when we know that most children, even those with gender dysphoria who do have distress, will get better without any puberty blockers?

Currently, there is no way to identify which children will persist with a trans identity as adults and which will not. The much-delayed data linkage study could help with that. It could enable more targeted interventions and may also provide information on the long-term outcomes for people who have taken puberty blockers in the past. However, the Government insist on pushing on with the puberty blockers trial anyway, before the data linkage study is complete. Why? In written parliamentary questions, Ministers have said that they expect the data linkage study to be finished by April 2027, so what is the rush?

What is the point of the treatment? It has been suggested that it helps transgender adults pass more easily as the opposite sex and potentially avoids surgical operations in adulthood, but how on earth can it be ethically, morally or medically right to treat a large group of children with risky medication to give cosmetic benefits to a much smaller number of adults?

There are also cosmetic risks to the treatment. The penis grows very little between the ages of three and 10 years. The use of puberty blockers restricts growth, meaning those with a persistent trans identity may struggle with having enough tissue for a vaginoplasty surgery, and those who do not have a persistent trans identity may struggle with normal intimate relationships.

As mentioned earlier, the Secretary of State has said that he has confidence in this trial. Now it has been paused, we can presume that he is not quite so sure. But can we, patients and the general public have confidence in this trial? There are certainly causes for concern. In fact, there are so many that I cannot speak of them all today, but I would like to speak of a few in the time I have available.

First, on the selection of patients, we have had a dramatic change in the demographic. There has always been a small number of children uncomfortable in their own bodies, but there has been a rapid increase, which is not fully understood, particularly among girls. Many of them are in care, some have autism spectrum disorders and many are same-sex attracted. We need to understand this before prescribing irreversible treatments.

We do prescribe—and I have prescribed—drugs that are high risk or potentially harmful to children. An easy example would be chemotherapy, but that is being given to save a child’s life; it is not used to pause a perfectly normal physiological process in a physically healthy child. The risks of these treatments have been listed today, but I will list just a few: fertility problems; idiopathic intracranial hypertension; demineralisation of bone density, leading to fractures; in some studies, an increase in depression and anxiety; and the long-term loss of sexual function in some patients. We have discussed consent. How do you get consent from a parent of a child—a boy or a girl at Tanner stage 2—about long-term sexual function and fertility?

On the design of the trial, it is said to be a randomised controlled trial. Well, it is, but that is a bit of a fudge, because instead of an actual randomised controlled trial where some patients receive puberty blockers and some do not, it has given some now and some slightly later, with a very short difference in the timing. The comparison group that does not have any puberty blockers at all is taken from a slightly different population, which introduces an unnecessary bias. The trial’s organisers have said that they are doing that because they think the children would get the drugs from elsewhere or from abroad, but that is not how we do medical trials. When I have raised this issue, Ministers have responded that it cannot be blinded, but blinding and randomisation are not the same thing. The trial is also far too short to provide data on long-term outcomes.

On the process of the trial, the hon. Member for Gower (Tonia Antoniazzi) raised questions about what children are being asked as part of this trial. Why is the trial proposing to ask children about their sexual experiences? Why is this helpful to the trial?

[Iqbal Mohamed]

Will the hon. Member give way?

[Dr Johnson]

I will not because I am aware of the time.

The Commission on Human Medicines’ report heard that, because trials of puberty blockers have been blocked, some clinicians are trying to use other drugs to limit puberty, such as spironolactone and cyproterone acetate. There have been reports that the number of prescriptions for spironolactone in 10 to 17-year-olds is going up. Could the Minister confirm whether that is the case and what the Government are doing to look into it?

The MHRA was happy with the process; now it is not. What has changed? None of the issues raised seem to have not been raised before. The Government are being secretive about it: in February, Ministers brought forward a written statement referencing an MHRA letter in November, but the Minister is refusing to publish it. I have asked Ministers whether they talked to MHRA officials about the trial before February 2026, and they will not answer the question. There was a letter between the MHRA and KCL; I asked when it was received, when the Department became aware of it and when Ministers became aware of its contents. They will not tell me.

What about the people controlling the trial? As has also been mentioned during this debate, Professor Jacob George has been recused from further involvement. According to the MHRA’s statement, this is “a precaution”, because of social media posts made before his involvement. Why have those who have made the opposite type of comment not been recused too? This will inevitably make members of the public think there is bias involved.

There is an oversight board. What has the Minister done to ensure that the clinicians and scientists on that board are impartial, and that it is balanced between both perspectives? The Tavistock trial was supposed to report to the MHRA, but it did not, seemingly with no consequence. There will be lay members on the board with lived experience; will one of those be a detransitioner, or will they all be people on one side? That would increase the perception of bias in this trial.

In summary, this is a trial of risky medication on healthy children, most of whose features of gender incongruence will resolve in time, given normal puberty. What is particularly worrying is that, at the end of this treatment, the trial has so many flaws that it is bound to be disputed, whatever the result.

To give this treatment, the lead clinician will need to think that there is a reasonable prospect of a patient benefiting from puberty blockers. Given all that has been said, how can any clinician believe that that is the case? I hope we can all agree that we do not need a clinical trial to know that helping a child to be at peace with themselves and their body is infinitely preferable to a lifetime of harmful medical intervention.

--- Later in debate ---

[Karin Smyth]

I am not going to give way; I am going to get through these points.

The safety and wellbeing of children and young people have always been the driving consideration in every decision we have made regarding this trial, and always will be. That is why the trial sponsor has paused recruiting until these issues can be resolved. There have been calls today to cancel the pause, to continue with the pause and to cancel the trial, but the position is that the trial is paused until the issues are resolved, because we will not compromise an inch on safety. The trial will proceed only if the regulatory approval is reconfirmed. We will provide an update on the outcome of those discussions as soon as we can.

[Iqbal Mohamed]

Will the Minister give way?

[David Mundell (in the Chair)]

Order. I think the Minister has made it clear that she is not taking interventions.

GP Contract

Iqbal Mohamed Excerpts

Monday 16th March 2026 Commons Chamber

[Stephen Kinnock]

My hon. Friend is right that it is vital that ICBs have a clear understanding of their population health needs and their demographics. It is important that the ICB is ahead of that curve and taking decisions well in advance of a practice closing down so that a commensurate service is provided; that is a really important part of the ICB’s responsibilities. If he has specific examples where he feels that his ICB has not been delivering on that basis, he is welcome to share those with me.

[Iqbal Mohamed (Dewsbury and Batley) (Ind)]

I pay tribute to the GPs in Dewsbury and Batley and the surrounding villages. The Minister mentioned preventive health. What steps are the Government taking to support GPs in their treatment of patients with preventable or avoidable diseases through the prescription of exercise and healthy foods? Secondly, we talk about online access, which is welcome—my constituents welcome surgeries that offer appointments throughout the day—but how will the Minister support the digitally excluded who cannot get through at 8 am and do not have access to online applications?

[Stephen Kinnock]

On prevention, there are some really important measures in the contract: in essence, we are recalibrating the quality outcomes framework, which is the basis for payments to incentivise the actions that GPs take. By changing the QOF, as it is called, we can shift that in one direction or the other, and we have changed it to incentivise boosting childhood vaccination rates, particularly in those areas of the country where vaccination rates are worryingly low, and better care for patients living with obesity. That is about exactly the things the hon. Member just mentioned: prescribing, if you like, exercise regimes and advising on better nutrition. We are also changing the QOF to require GPs to share data with the lung cancer screening programme. Those are just three examples of what we are doing within the contract.

On online access, it is clear that there must always be three channels of access to a GP—walk-in, telephone and online—and that for an urgent matter it would be a walk-in or a telephone call. What has really worked is that online access has taken pressure off the telephone lines as people who do not have urgent requirements have been migrating online and using the NHS app—take-up of the app is also excellent—so we are moving in the right direction.

Type 1 Diabetes: Infant Testing

Iqbal Mohamed Excerpts

Monday 9th March 2026 Westminster Hall

[Iqbal Mohamed (Dewsbury and Batley) (Ind)]

It is a pleasure to serve under your chairship, Sir Alec. I join Members across the Chamber in paying tribute to Lyla Story, and I extend my deepest condolences to her family. No parent should ever have to endure the loss of a child. The courage and determination shown by Lyla’s parents, Emma and John Story, in relentlessly campaigning to prevent other families from experiencing similar tragedy is nothing short of extraordinary.

With more than 120,000 signatures nationally, including 165 from my own constituents in Dewsbury and Batley, the petition reflects a deep and urgent concern among the general public that no parent should go through what Lyla’s parents did. We have heard about the symptoms and the consequences. Diabetes UK estimates that about 35,000 young people and children have diabetes, 96% of whom have type 1 diabetes. We have heard that one in four cases are not detected until it is too late.

I will jump to my request of the Government, which, supporting John and Emma’s campaign, is to have a national public awareness campaign explaining the four Ts across TV, radio, social media, schools, nurseries, surgeries, pharmacies and health visitor packs. Countries that have run sustained awareness campaigns, such as Italy, reduced DKA at diagnosis from approximately 40% to under 10%.

My final request—I do not have much time—is to mandate the rule that children presenting to a GP with any symptoms of diabetes should receive at finger-prick blood glucose test. Although that is in the NICE guidance, it is not enforced.

ADHD Diagnosis

Iqbal Mohamed Excerpts

Tuesday 20th January 2026 Westminster Hall

[Iqbal Mohamed (Dewsbury and Batley) (Ind)]

It is a pleasure to serve under your chairship, Ms Vaz. I thank the hon. Member for Sefton Central (Bill Esterson) for securing this important debate.

Delays and problems relating to ADHD diagnosis are not just a marginal administrative issue, but a profound failure of our system to meet medical needs early, effectively and equitably. For too many children and adults, long waits for diagnosis can negatively shape their entire life trajectory, harming their educational attainment, mental health, employment prospects and personal relationships.

NHS estimates suggest that 2.5 million people in England have ADHD, including nearly half a million children and young people, yet demand continues to vastly outstrip capacity. In September 2025, over 60% of both adults and children had been waiting more than a year for an ADHD assessment.

In my constituency of Dewsbury and Batley, Rachel reached out to me rightly outraged at an 18-month wait for ADHD assessment, with Kirklees council working through a backlog from November 2022. Another constituent, Laura, has spoken about her difficulty accessing medication even after diagnosis. The pressure on councils has been increasing on all fronts, with funding decreasing at the same time over the 14 years of the previous Government. I am not blaming the councils, but they do need support.

[Adrian Ramsay (Waveney Valley) (Green)]

I thank the hon. Member for giving way. He makes the point very strongly that long waiting times mean that children are being left behind. As we have heard, it was revealed last week that many integrated care boards are capping the number of assessments without telling GPs or patients. Does the hon. Member agree that a child’s access to diagnosis and support should not depend on where they live or whether their parents can afford to go private?

[Iqbal Mohamed]

I completely agree. We hear the phrase “postcode lottery” a lot, and we should not have a postcode lottery in our country for access to essential healthcare and educational services. Everybody should have equal access to the support that is available to other people, without having to go private.

The consequences of these delayed assessments are stark. Families are pushed towards private assessments they cannot afford, entrenching a two-tier system that makes a mockery of the NHS’s spirit of free care at the point of use by rendering access contingent upon income.

The Justice Gap also reports that around 25% of prisoners have ADHD, with many entering the system having not been diagnosed. They are more prone to reoffending.

I will conclude to give time for other colleagues to speak. I urge the Government to look at this issue holistically, as mentioned by the hon. Member for York Central (Rachael Maskell), and provide support for children, adults and offenders. I believe that investment would render a greater return.

--- Later in debate ---

[Dr Ahmed]

I thank my hon. Friend for her very valid point. It is important to mention that we expect that the prevalence review will align with the review that the Department for Work and Pensions is carrying out on employability and other issues affecting disability.

NHS England is working with ICBs that are trialling innovative ways of delivering ADHD services and is using this information to support systems to tackle ADHD waiting lists and provide support to address people’s needs. I understand that it is increasingly clear to patients and staff that the current highly specialist ADHD assessment model needs to evolve quickly. Moving to a more generalist service model could improve care and reduce waiting lists. That was one of the taskforce’s key recommendations.

[Iqbal Mohamed]

Approximately a quarter of the prison population—22,000, give or take—have ADHD. Will the Government commit to an impact assessment of what savings the Government could make, and how many people’s lives could be improved, by assessing people either before they commit a crime or after?

[Valerie Vaz (in the Chair)]

Order. The Minister knows that he has two minutes.

Puberty Suppressants Trial

Iqbal Mohamed Excerpts

Wednesday 17th December 2025 Commons Chamber

[Wes Streeting]

My hon. Friend is absolutely right. Given that I work for a former Crown prosecutor, I could not possibly disagree with her on evidence.

[Iqbal Mohamed (Dewsbury and Batley) (Ind)]

I thank the Secretary of State for his response to the urgent question. One thing we should all agree on is that the human rights of all, including trans people, must be protected and delivered by the Government and supported by us all. The reason we are here today is to discuss the risks and potential adverse consequences of the proposed pathways trial. The trial compares the timing of treatment initiation, rather than using a placebo. There is no arm that provides psychotherapy as a treatment option without puberty blockers, and there is no arm to assess children who do not receive any of those options. Will the Secretary of State consider ensuring that all the various arms and channels are tested as part of this trial to get a complete picture, rather than a partial picture, which may be misleading?

[Wes Streeting]

May I thank the hon. Member for the way in which he put his question? It is so important to emphasise that right across this House, there are many people who oppose this trial, but who do want to see trans people well supported and protected and to respect their identities. That is important for everyone to bear in mind.

The hon. Member talks about placebo. For obvious reasons in this case, a placebo would not be appropriate, because it would be very obvious whether a young person was receiving the real medication or the placebo, but the trial design has included a control group. The way in which the trial is established will help us to distinguish between the benefits of receiving or not receiving this particular medication, and there will be really close oversight of the impact on development, but he is right that we need to judge these things on the question of risk. That is what led Dr Cass to make her recommendation, and that is why I support it.