Written questions by Smith.

Commonwealth and Development Affairs, what steps he plans to take to use the UK's position as penholder for Sudan at the UN Security C Council to press for (a) a ceasefire before peace talks in August, (b) adherence to international humanitarian law and (c) the free flow of humanitarian aid.

On 13 June, the UK successfully led a UNSC resolution calling for an immediate de-escalation in El Fasher and full, unimpeded humanitarian access, including the reopening of the Adre border crossing. It also requested that the Secretary-General provide recommendations on the protection of civilians. On 6 August, the UK called a UNSC session to urgently discuss the Famine Review Committee's findings and the need for the obstruction of aid by the warring parties to stop. The UK intervention re-iterated our support for UN efforts in Sudan, including through the recommendations set out by the UN Secretary White Note, released on 15 March 2024 under UNSC Resolution 2417. We continue to put pressure on the parties to ensure the recent move to re-open Adre is honoured in full and without excessive restrictions. The Foreign Secretary publicly welcomed the ceasefire talks co-hosted by the US, Saudi Arabia, and Switzerland in August and urged the warring parties to participate.

Commonwealth and Development Affairs, what steps his Department is taking with humanitarian groups and partners in Sudan to provide (a) humanitarian aid and (b) support for (i) food systems and (ii) local agriculture in Sudan; and if he will take steps to increase the level of aid for refugees from Sudan.

The UK is working with international partners, including UN agencies, other donors and NGOs, to improve and increase the delivery of aid into Sudan. UK ODA to Sudan nearly doubled this year to £97m, with the vast majority of this funding going to humanitarian assistance. This aid will also provide additional support for food systems and local agriculture. As part of this, I recently announced an additional £15m to increase support for Sudan refugees fleeing to Chad and South Sudan. We will also continue to push for the best data and evidence to inform our policy and programming.

Commonwealth and Development Office, pursuant to the Answer of 22 July 2024 to Question 210, whether he has had discussions with the Chancellor of the Exchequer on the fiscal circumstances within which the level of the Official Development Assistance budget will be raised to 0.7% of gross national income.

The Foreign Secretary and Chancellor regularly discuss a wide range of issues. This Government is committed to restoring ODA spending at the level of 0.7 per cent of GNI as soon as fiscal circumstances allow and will set out its approach to the House in due course.

When she plans to publish her Department's response to the consultation entitled Modernising support for independent living: the health and disability green paper, published in April 2024.

The consultation on the Modernising Support Green Paper closed on Monday 22 July. Over 16,000 responses have been received and we will review these responses. The proposals in this Green Paper were developed by the previous government. We will be considering our own approach to social security in due course.

Food and Rural Affairs, whether his Department plans to launch a consultation on which activities should be banned from being (a) advertised and (b) offered for sale under the Animals (Low-Welfare Activities Abroad) Act 2023.

The Animals (Low Welfare Activities Abroad) Act 2023 provides a framework for the introduction of a future bans on the advertising and offering for sale, in England and Northern Ireland, of low-welfare animal activities abroad. Future decisions on the next steps will be evidence-based and subject to Parliamentary scrutiny. The Government will introduce the most ambitious programme for animal welfare in a generation. We are considering the most effective ways to deliver these commitments and will be setting out next steps in due course.

Whether his Department is taking steps to ensure that those proscribed puberty blockers for the treatment of gender incongruence will continue to receive them.

The emergency banning order limiting the sale or supply of puberty blockers against private or non-United Kingdom prescriptions allows a child under 18 years old, who was already on a course of treatment with Gonadotrophin-Releasing Hormone Analogues before 3 June 2024 from a UK based private or National Health Service provider, to continue to have them supplied. Those who were already on a course of treatment prescribed by an EEA or Switzerland registered prescriber can legally switch to a UK based prescriber to continue their treatment.This government has committed to implementing the expert recommendations of the Cass Review to ensure that young people presenting to the NHS with gender dysphoria are receiving appropriate and high-quality care. That is why NHS England and the National Institue of Health and Care Research – the research arm of the department – are working together to commission a study into the potential benefits and harms of puberty suppressing hormones as a treatment option for children and young people with gender incongruence. The study team is now in place and are finalising their application for funding which will be assessed by an independent scientific review study ahead of the commencement of wider approvals, including ethics, and set up.Children and young people unable to access puberty blockers are strongly advised to meet with their clinician. We expect clinicians to be working with impacted patients to consider what the best care for them is going forward. Some children and young people may be concerned by these changes. If they are already under the care of a Children and Young People’s mental health provider or the Child and Adolescent Mental Health Services, they can contact their team for advice. If they are not, their general practice team will be able to assess whether further referrals for mental health support are required. Patients can also be signposted to the advice on getting mental health support available on the NHS.UK website. Anyone in need of urgent support can contact NHS 111 and choose the mental health option, option two. Further details are available at the following link:https://www.nhs.uk/nhs-services/mental-health-services/where-to-get-urgent-help-for-mental-health/

Whether his Department has made a comparative assessment of the UK’s position on the prescription of puberty blockers for the treatment of gender incongruence with that of other European countries.

The Cass Review is one of the most comprehensive reviews of gender identity services for children and young people to date worldwide.The Cass review included an assessment of evidence from other countries and concluded that there was a lack of evidenced-based guidelines and, therefore, limitations for adopting these for National Health Service gender services. Informed by the Cass review, we are now reforming transgender care for young people in this country, based on the best possible evidence. That means a holistic approach, with puberty suppressing hormones only considered within a much broader needs assessment, and only then in the context of a clinical trial. We are committed to implementing the recommendations of the Cass Review, as that is the care model we believe to be the best approach in the interests of patient safety.It is simply not possible for pharmacists to check whether prescriptions issued from overseas registered prescribers have been issued in a similarly safe and effective way, and we know that some overseas providers who advertise their services do not follow this approach.

What his timetable is for the clinical trial being conducted on the use of puberty blockers for the treatment of gender incongruence.

The expert Cass Review, which is one of the most comprehensive reviews of gender identity services for children and young people to date, states that the rationale for early puberty suppressing hormones to treat gender dysphoria is unclear and the effects on cognitive and psychosexual development are unknown. This is why NHS England and the National Institute of Health and Care Research, the research arm of the department, are working together to commission a study into the potential benefits and harms of puberty suppressing hormones as a treatment option for children and young people with gender incongruence. The study team is now in place and are finalising their application for funding which will be assessed by an independent scientific review study ahead of the commencement of wider approvals, including ethics, and set up.

What assessment his Department has made of the potential risks of harm being caused by restrictions on puberty blockers for treatments of gender incongruence.

The emergency banning Order, restricting the sale or supply of puberty blockers, was introduced by the previous Government. The Order enables those who were already on a course of treatment with Gonadotrophin-Releasing Hormone Analogues, before 3 June 2024 from a UK based private or National Health Service provider, to continue to have them supplied. Those who were already on a course of treatment prescribed by an EEA or Switzerland registered prescriber can legally switch to a UK based prescriber to continue their treatment.The expert Cass Review, which is one of the most comprehensive reviews of gender identity services for children and young people to date, states that the rationale for early puberty suppressing hormones to treat gender dysphoria is unclear and the effects on cognitive and psychosexual development are unknown. This Government will always act in the interests of patient safety, which is why the Secretary of State signalled his intention to renew the Order and consult on a permanent ban (subject to the outcome of the ongoing judicial review).We are committed to implementing the recommendations of the Cass Review to ensure that young people presenting to the NHS with gender dysphoria are receiving appropriate and high-quality care. That is why NHS England and the National Institute of Health and Care Research, the research arm of the Department, are working together to commission a study into the potential benefits and harms of puberty suppressing hormones as a treatment option for children and young people with gender incongruence. The study team is now in place and are finalising their application for funding which will be assessed by an independent scientific review study ahead of the commencement of wider approvals, including ethics, and set up.We will continue to monitor the impacts of the Order, including on mental health. Professor Louis Appleby, Chair of the National Suicide Prevention Strategy Advisory Group, has examined evidence for a large rise in suicides claimed by campaigners. His paper, which was published on 19 July 2024, concluded that the data do not support the claim that there has been a large rise in suicide in young gender dysphoria patients at the Tavistock clinic.Some children and young people may be concerned by these changes. If they are already under the care of a Children and Young People’s mental health provider or the Child and Adolescent Mental Health Services, they can contact their team for advice. If they are not, their general practice team will be able to assess whether further referrals for mental health support are required. Patients can also be signposted to the advice on getting mental health support available on the NHS.UK website. Anyone in need of urgent support can contact NHS 111 and choose the mental health option, option two. Further details are available at the following link:https://www.nhs.uk/nhs-services/mental-health-services/where-to-get-urgent-help-for-mental-health/Professor Appleby’s paper is available at the following link:https://www.gov.uk/government/publications/review-of-suicides-and-gender-dysphoria-at-the-tavistock-and-portman-nhs-foundation-trust/review-of-suicides-and-gender-dysphoria-at-the-tavistock-and-portman-nhs-foundation-trust-independent-report

If he will meet with (a) young trans young people and (b) their families to discuss the prescription of puberty blockers for the treatment of gender incongruence.

The emergency banning order limiting the sale or supply of puberty blockers against private or non-United Kingdom prescriptions allows a child under 18 years old, who was already on a course of treatment with Gonadotrophin-Releasing Hormone Analogues before 3 June 2024 from a UK based private or National Health Service provider, to continue to have them supplied. Those who were already on a course of treatment prescribed by an EEA or Switzerland registered prescriber can legally switch to a UK based prescriber to continue their treatment.This government has committed to implementing the expert recommendations of the Cass Review to ensure that young people presenting to the NHS with gender dysphoria are receiving appropriate and high-quality care. That is why NHS England and the National Institue of Health and Care Research – the research arm of the department – are working together to commission a study into the potential benefits and harms of puberty suppressing hormones as a treatment option for children and young people with gender incongruence. The study team is now in place and are finalising their application for funding which will be assessed by an independent scientific review study ahead of the commencement of wider approvals, including ethics, and set up.We recognise the value of engaging with representative groups and want to reset the relationship the department has with LGBT+ groups. My rt. Hon. Friend, the Secretary of State for Health and Social Care, will be meeting with LGBT+ stakeholders as soon as possible to hear directly about the health and care issues that are most important to them.

What assessment his Department has made of the potential impact of restricting puberty blockers for the treatment of gender incongruence on the (a) physical and (b) mental health of young trans people.

The emergency banning Order, restricting the sale or supply of puberty blockers, was introduced by the previous Government. The Order enables those who were already on a course of treatment with Gonadotrophin-Releasing Hormone Analogues, before 3 June 2024 from a UK based private or National Health Service provider, to continue to have them supplied. Those who were already on a course of treatment prescribed by an EEA or Switzerland registered prescriber can legally switch to a UK based prescriber to continue their treatment.The expert Cass Review, which is one of the most comprehensive reviews of gender identity services for children and young people to date, states that the rationale for early puberty suppressing hormones to treat gender dysphoria is unclear and the effects on cognitive and psychosexual development are unknown. This Government will always act in the interests of patient safety, which is why the Secretary of State signalled his intention to renew the Order and consult on a permanent ban (subject to the outcome of the ongoing judicial review).We are committed to implementing the recommendations of the Cass Review to ensure that young people presenting to the NHS with gender dysphoria are receiving appropriate and high-quality care. That is why NHS England and the National Institute of Health and Care Research, the research arm of the Department, are working together to commission a study into the potential benefits and harms of puberty suppressing hormones as a treatment option for children and young people with gender incongruence. The study team is now in place and are finalising their application for funding which will be assessed by an independent scientific review study ahead of the commencement of wider approvals, including ethics, and set up.We will continue to monitor the impacts of the Order, including on mental health. Professor Louis Appleby, Chair of the National Suicide Prevention Strategy Advisory Group, has examined evidence for a large rise in suicides claimed by campaigners. His paper, which was published on 19 July 2024, concluded that the data do not support the claim that there has been a large rise in suicide in young gender dysphoria patients at the Tavistock clinic.Some children and young people may be concerned by these changes. If they are already under the care of a Children and Young People’s mental health provider or the Child and Adolescent Mental Health Services, they can contact their team for advice. If they are not, their general practice team will be able to assess whether further referrals for mental health support are required. Patients can also be signposted to the advice on getting mental health support available on the NHS.UK website. Anyone in need of urgent support can contact NHS 111 and choose the mental health option, option two. Further details are available at the following link:https://www.nhs.uk/nhs-services/mental-health-services/where-to-get-urgent-help-for-mental-health/Professor Appleby’s paper is available at the following link:https://www.gov.uk/government/publications/review-of-suicides-and-gender-dysphoria-at-the-tavistock-and-portman-nhs-foundation-trust/review-of-suicides-and-gender-dysphoria-at-the-tavistock-and-portman-nhs-foundation-trust-independent-report