Asked by: Tom Morrison (Liberal Democrat - Cheadle)
Question to the Department for Work and Pensions:
To ask the Secretary of State for Work and Pensions, what steps he is taking to support young people pursuing apprenticeships who are unable to obtain English and Maths GCSEs; and what assessment he has made of the potential impact of the requirement to obtain English and Maths GCSEs when irrelevant to their chosen vocation on young people's confidence and self belief.
Answered by Andrew Western - Parliamentary Under-Secretary (Department for Work and Pensions)
Young people are not required to hold GCSE qualifications in English and/or maths before starting an apprenticeship.
Apprentices under the age of 19 are funded to achieve up to a level 2 qualification in English and/or maths (where they do not already hold one) before the end of their apprenticeship, putting them in the best position to progress in their life and career. This can be a GCSE or functional skills qualification.
Further flexibility is in place for apprentices with a learning difficulty and/or disability, where there is evidence this is likely to be a barrier to them completing their apprenticeship. In these cases, they are able to achieve an entry level 3 functional skills qualification to complete. Since August 2024, this flexibility has been available to apprentices with a learning difficulty and/or disability but without an Education Health and Care Plan.
Asked by: Baroness Deech (Crossbench - Life peer)
Question to the Department of Health and Social Care:
To ask His Majesty's Government what assessment they have made of the long-term physical, mental and legal consequences of the Puberty Suppression and Transitional Healthcare with Adaptive Youth Services study of children with gender dysphoria.
Answered by Baroness Merron - Parliamentary Under-Secretary (Department of Health and Social Care)
The Government is following expert, independent advice from the Cass Review to implement a programme of research to support high quality National Health Service care for children and young people with gender incongruence. Responding to the specific recommendations of the review, the programme includes the PATHWAYS trial, a carefully designed clinical trial to assess the relative benefits and harms of puberty-suppressing hormones as a treatment option for children and young people with gender incongruence when provided alongside an updated model of NHS care incorporating holistic assessment and a tailored package of psychosocial support.
The trial is now in the set-up phase following comprehensive independent scientific, ethical, and regulatory review and approvals. It was designed by an independent research team, in conjunction with patient and public involvement as well as independent ethics, clinical, and legal experts. The team responsible for the protocol design have given considerable thought to the most appropriate eligibility criteria for entry into the trial, and to the physical and mental outcome measures to be monitored, to properly assess and protect young people's wellbeing.
Asked by: Luke Akehurst (Labour - North Durham)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health and Social Care, what steps he is taking to ensure that the views and lived experience of teenagers and young adults with cancer are being incorporated into his forthcoming national cancer plan; and how their involvement will be reflected in the plan’s publication and launch.
Answered by Ashley Dalton - Parliamentary Under-Secretary (Department of Health and Social Care)
The Department is committed to improving outcomes for teenagers and young adults with cancer. The Children and Young People Cancer Taskforce was relaunched on 4 February 2025 to identify tangible ways to improve outcomes and experiences for young cancer patients. The taskforce will explore opportunities for improvement in England, including detection and diagnosis, genomic testing and treatment, research and innovation, and patient experience. The taskforce will ensure that the unique needs of children and young people, including teenagers and young adults with cancer, are carefully considered as part of the forthcoming National Cancer Plan.
The Government is committed to including the views and lived experience of teenagers and young adults in the National Cancer Plan. That is why the Department has worked with the Children and Young People Cancer taskforce members to assemble a Patient Experience Panel of people with lived experience of cancer. The panel is made up of a diverse group, including parents of children with cancer, young adults who were diagnosed with cancer as teenagers, and those who were diagnosed as children.
As part of the Department’s engagement to inform the development of the forthcoming National Cancer Plan, officials from the Department’s cancer team have worked closely with patient organisations, clinicians, and cancer partners, and has considered over 11,000 responses to the call for evidence. These included submissions from Teenage Cancer Trust, Ellen MacArthur Cancer Trust, Young Lives vs Cancer, CCLG: The Children and Young People's Cancer Association, and so on.
Asked by: Liz Jarvis (Liberal Democrat - Eastleigh)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health and Social Care, what progress his Department has made on achieving the Access and Waiting Time Standard for children and young people with an Eating Disorder.
Answered by Zubir Ahmed - Parliamentary Under-Secretary (Department of Health and Social Care)
The number of children and young people starting treatment for eating disorders has increased since the pandemic, rising from 8,034 in 2019/20 to 11,174 in 2024/25, an increase of almost 40%. This increase in demand has affected performance against the Access and Waiting Time standard, which states that 95% of routine referrals should begin treatment within four weeks and 95% of urgent referrals should begin treatment within one week.
In the rolling quarter from September to November 2025, the Mental Health Services Data Set shows improved performance against the standard. During this period, 78.4% of, or 384 out of 490, urgent referrals and 81.7% of, or 2,145 out of 2,625, routine referrals started treatment within one and four weeks respectively.
To support systems to meet the Access and Waiting Time Standard, NHS England has published updated guidance on children and young people's eating disorders. The new guidance focuses on whole pathway approaches to early intervention, whilst ensuring swift access to specialist support as soon as an eating disorder is suspected.
Asked by: Sarah Pochin (Reform UK - Runcorn and Helsby)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health and Social Care, what assessment he has made of the potential merits of completing the Data Linkage Study to help inform safe PATHWAYS trial design.
Answered by Zubir Ahmed - Parliamentary Under-Secretary (Department of Health and Social Care)
Children’s healthcare must always be evidence-led. That’s why we are following expert, independent advice from the Cass Review to implement a programme of research to support the National Health Service to provide the best support to children and young people with gender incongruence.
The programme includes a data linkage study which will provide valuable information about the needs, experiences, and outcomes of former Gender Identity Development Service patients. However, the study will not provide high-quality or ‘causal’ data about the relative benefits and harms of puberty supressing hormones, when administered to current National Health Service patients alongside an improved model of care. Only a high-quality prospective clinical trial can provide that data.
Therefore, the Government has commissioned the PATHWAYS study, which will provide new evidence directly relevant to the current cohort of children and young people accessing newly designed NHS gender services which reflect the Holistic Assessment Framework proposed by the Cass Review. The study includes the PATHWAYS trial, which is a carefully designed clinical trial to assess the relative benefits and harms of puberty-suppressing hormones as a treatment option for children and young people with gender incongruence. The trial protocol is publicly available on the National Institute for Health and Care Research website at the following link:
https://fundingawards.nihr.ac.uk/award/NIHR167530
It includes details on eligibility criteria, control group design, and follow up. It includes details of HORIZON INTENSIVE, which will provide a non-randomised control group of young people with gender incongruence not receiving puberty-suppressing hormones.
The trial has been subject to independent scientific, ethical, and regulatory scrutiny and peer review and has received the necessary research approvals. The study design, including inclusion criteria and safety protocols, has been thoroughly scrutinised to protect young people's wellbeing. Acceptance into the trial is subject to robust procedures including consent from a parent/carer and informed assent from the young person, a diagnosis of gender incongruence for at least two years, receipt of tailored psychosocial support, and the puberty suppression being deemed clinically appropriate, within the context of a study, by both their NHS care team and the national multi-disciplinary team. The research sponsor is responsible for organising insurance for the trial.
After the first two years, all participants will be included in annual follow-up throughout the study period. Follow-up into adult life is important and participants will also be asked to consent to long-term follow-up through ongoing involvement with the PATHWAYS team, with a national health registry for gender care and linkage to health information routinely collected by NHS Digital.
Asked by: Sarah Pochin (Reform UK - Runcorn and Helsby)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health and Social Care, what criteria will be used to decide whether PATHWAYS trial participants are offered cross sex hormones at the end of the study.
Answered by Zubir Ahmed - Parliamentary Under-Secretary (Department of Health and Social Care)
Children’s healthcare must always be evidence-led. That’s why we are following expert, independent advice from the Cass Review to implement a programme of research to support the National Health Service to provide the best support to children and young people with gender incongruence.
The programme includes a data linkage study which will provide valuable information about the needs, experiences, and outcomes of former Gender Identity Development Service patients. However, the study will not provide high-quality or ‘causal’ data about the relative benefits and harms of puberty supressing hormones, when administered to current National Health Service patients alongside an improved model of care. Only a high-quality prospective clinical trial can provide that data.
Therefore, the Government has commissioned the PATHWAYS study, which will provide new evidence directly relevant to the current cohort of children and young people accessing newly designed NHS gender services which reflect the Holistic Assessment Framework proposed by the Cass Review. The study includes the PATHWAYS trial, which is a carefully designed clinical trial to assess the relative benefits and harms of puberty-suppressing hormones as a treatment option for children and young people with gender incongruence. The trial protocol is publicly available on the National Institute for Health and Care Research website at the following link:
https://fundingawards.nihr.ac.uk/award/NIHR167530
It includes details on eligibility criteria, control group design, and follow up. It includes details of HORIZON INTENSIVE, which will provide a non-randomised control group of young people with gender incongruence not receiving puberty-suppressing hormones.
The trial has been subject to independent scientific, ethical, and regulatory scrutiny and peer review and has received the necessary research approvals. The study design, including inclusion criteria and safety protocols, has been thoroughly scrutinised to protect young people's wellbeing. Acceptance into the trial is subject to robust procedures including consent from a parent/carer and informed assent from the young person, a diagnosis of gender incongruence for at least two years, receipt of tailored psychosocial support, and the puberty suppression being deemed clinically appropriate, within the context of a study, by both their NHS care team and the national multi-disciplinary team. The research sponsor is responsible for organising insurance for the trial.
After the first two years, all participants will be included in annual follow-up throughout the study period. Follow-up into adult life is important and participants will also be asked to consent to long-term follow-up through ongoing involvement with the PATHWAYS team, with a national health registry for gender care and linkage to health information routinely collected by NHS Digital.
Asked by: Sarah Pochin (Reform UK - Runcorn and Helsby)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health and Social Care, whether (a) detransitioners and (b) whistleblowers were consulted in the design of the PATHWAYS trial.
Answered by Zubir Ahmed - Parliamentary Under-Secretary (Department of Health and Social Care)
Children’s healthcare must always be evidence-led. That’s why we are following expert, independent advice from the Cass Review to implement a programme of research to support the National Health Service to provide the best support to children and young people with gender incongruence.
The programme includes a data linkage study which will provide valuable information about the needs, experiences, and outcomes of former Gender Identity Development Service patients. However, the study will not provide high-quality or ‘causal’ data about the relative benefits and harms of puberty supressing hormones, when administered to current National Health Service patients alongside an improved model of care. Only a high-quality prospective clinical trial can provide that data.
Therefore, the Government has commissioned the PATHWAYS study, which will provide new evidence directly relevant to the current cohort of children and young people accessing newly designed NHS gender services which reflect the Holistic Assessment Framework proposed by the Cass Review. The study includes the PATHWAYS trial, which is a carefully designed clinical trial to assess the relative benefits and harms of puberty-suppressing hormones as a treatment option for children and young people with gender incongruence. The trial protocol is publicly available on the National Institute for Health and Care Research website at the following link:
https://fundingawards.nihr.ac.uk/award/NIHR167530
It includes details on eligibility criteria, control group design, and follow up. It includes details of HORIZON INTENSIVE, which will provide a non-randomised control group of young people with gender incongruence not receiving puberty-suppressing hormones.
The trial has been subject to independent scientific, ethical, and regulatory scrutiny and peer review and has received the necessary research approvals. The study design, including inclusion criteria and safety protocols, has been thoroughly scrutinised to protect young people's wellbeing. Acceptance into the trial is subject to robust procedures including consent from a parent/carer and informed assent from the young person, a diagnosis of gender incongruence for at least two years, receipt of tailored psychosocial support, and the puberty suppression being deemed clinically appropriate, within the context of a study, by both their NHS care team and the national multi-disciplinary team. The research sponsor is responsible for organising insurance for the trial.
After the first two years, all participants will be included in annual follow-up throughout the study period. Follow-up into adult life is important and participants will also be asked to consent to long-term follow-up through ongoing involvement with the PATHWAYS team, with a national health registry for gender care and linkage to health information routinely collected by NHS Digital.
Asked by: Sarah Pochin (Reform UK - Runcorn and Helsby)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health and Social Care, what safeguarding measures are in place to ensure that families do not feel pressured into the PATHWAYS trial.
Answered by Zubir Ahmed - Parliamentary Under-Secretary (Department of Health and Social Care)
Children’s healthcare must always be evidence-led. That’s why we are following expert, independent advice from the Cass Review to implement a programme of research to support the National Health Service to provide the best support to children and young people with gender incongruence.
The programme includes a data linkage study which will provide valuable information about the needs, experiences, and outcomes of former Gender Identity Development Service patients. However, the study will not provide high-quality or ‘causal’ data about the relative benefits and harms of puberty supressing hormones, when administered to current National Health Service patients alongside an improved model of care. Only a high-quality prospective clinical trial can provide that data.
Therefore, the Government has commissioned the PATHWAYS study, which will provide new evidence directly relevant to the current cohort of children and young people accessing newly designed NHS gender services which reflect the Holistic Assessment Framework proposed by the Cass Review. The study includes the PATHWAYS trial, which is a carefully designed clinical trial to assess the relative benefits and harms of puberty-suppressing hormones as a treatment option for children and young people with gender incongruence. The trial protocol is publicly available on the National Institute for Health and Care Research website at the following link:
https://fundingawards.nihr.ac.uk/award/NIHR167530
It includes details on eligibility criteria, control group design, and follow up. It includes details of HORIZON INTENSIVE, which will provide a non-randomised control group of young people with gender incongruence not receiving puberty-suppressing hormones.
The trial has been subject to independent scientific, ethical, and regulatory scrutiny and peer review and has received the necessary research approvals. The study design, including inclusion criteria and safety protocols, has been thoroughly scrutinised to protect young people's wellbeing. Acceptance into the trial is subject to robust procedures including consent from a parent/carer and informed assent from the young person, a diagnosis of gender incongruence for at least two years, receipt of tailored psychosocial support, and the puberty suppression being deemed clinically appropriate, within the context of a study, by both their NHS care team and the national multi-disciplinary team. The research sponsor is responsible for organising insurance for the trial.
After the first two years, all participants will be included in annual follow-up throughout the study period. Follow-up into adult life is important and participants will also be asked to consent to long-term follow-up through ongoing involvement with the PATHWAYS team, with a national health registry for gender care and linkage to health information routinely collected by NHS Digital.
Asked by: Sarah Pochin (Reform UK - Runcorn and Helsby)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health and Social Care, what assessment he made of the potential merits of (a) a feasibility study and (b) external peer review of the PATHWAYS trial.
Answered by Zubir Ahmed - Parliamentary Under-Secretary (Department of Health and Social Care)
Children’s healthcare must always be evidence-led. That’s why we are following expert, independent advice from the Cass Review to implement a programme of research to support the National Health Service to provide the best support to children and young people with gender incongruence.
The programme includes a data linkage study which will provide valuable information about the needs, experiences, and outcomes of former Gender Identity Development Service patients. However, the study will not provide high-quality or ‘causal’ data about the relative benefits and harms of puberty supressing hormones, when administered to current National Health Service patients alongside an improved model of care. Only a high-quality prospective clinical trial can provide that data.
Therefore, the Government has commissioned the PATHWAYS study, which will provide new evidence directly relevant to the current cohort of children and young people accessing newly designed NHS gender services which reflect the Holistic Assessment Framework proposed by the Cass Review. The study includes the PATHWAYS trial, which is a carefully designed clinical trial to assess the relative benefits and harms of puberty-suppressing hormones as a treatment option for children and young people with gender incongruence. The trial protocol is publicly available on the National Institute for Health and Care Research website at the following link:
https://fundingawards.nihr.ac.uk/award/NIHR167530
It includes details on eligibility criteria, control group design, and follow up. It includes details of HORIZON INTENSIVE, which will provide a non-randomised control group of young people with gender incongruence not receiving puberty-suppressing hormones.
The trial has been subject to independent scientific, ethical, and regulatory scrutiny and peer review and has received the necessary research approvals. The study design, including inclusion criteria and safety protocols, has been thoroughly scrutinised to protect young people's wellbeing. Acceptance into the trial is subject to robust procedures including consent from a parent/carer and informed assent from the young person, a diagnosis of gender incongruence for at least two years, receipt of tailored psychosocial support, and the puberty suppression being deemed clinically appropriate, within the context of a study, by both their NHS care team and the national multi-disciplinary team. The research sponsor is responsible for organising insurance for the trial.
After the first two years, all participants will be included in annual follow-up throughout the study period. Follow-up into adult life is important and participants will also be asked to consent to long-term follow-up through ongoing involvement with the PATHWAYS team, with a national health registry for gender care and linkage to health information routinely collected by NHS Digital.
Asked by: Sarah Pochin (Reform UK - Runcorn and Helsby)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health and Social Care, what assessment he has made of the potential merits of including a control group of children who receive no puberty suppression in the PATHWAYS trial.
Answered by Zubir Ahmed - Parliamentary Under-Secretary (Department of Health and Social Care)
Children’s healthcare must always be evidence-led. That’s why we are following expert, independent advice from the Cass Review to implement a programme of research to support the National Health Service to provide the best support to children and young people with gender incongruence.
The programme includes a data linkage study which will provide valuable information about the needs, experiences, and outcomes of former Gender Identity Development Service patients. However, the study will not provide high-quality or ‘causal’ data about the relative benefits and harms of puberty supressing hormones, when administered to current National Health Service patients alongside an improved model of care. Only a high-quality prospective clinical trial can provide that data.
Therefore, the Government has commissioned the PATHWAYS study, which will provide new evidence directly relevant to the current cohort of children and young people accessing newly designed NHS gender services which reflect the Holistic Assessment Framework proposed by the Cass Review. The study includes the PATHWAYS trial, which is a carefully designed clinical trial to assess the relative benefits and harms of puberty-suppressing hormones as a treatment option for children and young people with gender incongruence. The trial protocol is publicly available on the National Institute for Health and Care Research website at the following link:
https://fundingawards.nihr.ac.uk/award/NIHR167530
It includes details on eligibility criteria, control group design, and follow up. It includes details of HORIZON INTENSIVE, which will provide a non-randomised control group of young people with gender incongruence not receiving puberty-suppressing hormones.
The trial has been subject to independent scientific, ethical, and regulatory scrutiny and peer review and has received the necessary research approvals. The study design, including inclusion criteria and safety protocols, has been thoroughly scrutinised to protect young people's wellbeing. Acceptance into the trial is subject to robust procedures including consent from a parent/carer and informed assent from the young person, a diagnosis of gender incongruence for at least two years, receipt of tailored psychosocial support, and the puberty suppression being deemed clinically appropriate, within the context of a study, by both their NHS care team and the national multi-disciplinary team. The research sponsor is responsible for organising insurance for the trial.
After the first two years, all participants will be included in annual follow-up throughout the study period. Follow-up into adult life is important and participants will also be asked to consent to long-term follow-up through ongoing involvement with the PATHWAYS team, with a national health registry for gender care and linkage to health information routinely collected by NHS Digital.