Written questions by Pochin.

What steps he is taking to reduce the supply of illegal drugs into prisons, including through improved searching, staff screening and security technology.

Prisons in England and Wales have a range of specialist staff and equipment to tackle the smuggling of contraband into prisons, including drugs. This includes X-ray body scanners, airport-style Enhanced Gate Security, X-ray baggage scanners, detection dogs, and other specialist equipment. In addition, local security strategies allow for routine and random rub-down searches of prison officers and other staff upon entry to, or within, prisons. This year we are investing over £40 million in physical security measures across 34 prisons, including £10 million on anti-drone measures, such as window replacements, external window grilles and specialist netting across 15 priority prisons. All HMPPS prison staff are subject to rigorous pre-employment security vetting checks. These checks enable the organisation to assess whether candidates pose a risk to the safety and security of HMPPS information, assets, staff, and offenders, and whether they demonstrate the standards and core values expected of everyone working within HMPPS. While the vast majority of prison staff act with integrity, HMPPS recognises the risk of corruption and is committed to tackling it at all levels. HMPPS’s Counter Corruption Unit works proactively with prisons and police to deter and disrupt staff wrongdoing. Prison security must be dynamic and be able to respond to shifting risks as they manifest. We regularly review our security countermeasures capabilities and will not hesitate to adjust our approach as needed and use all the tools at our disposal.

What steps he is taking to improve the (a) accuracy and (b) oversight of prison release date calculations.

On 11 November, the Deputy Prime Minister announced a five-point action plan setting out initial steps to address issues including release in error and unlawful detention. This includes the establishment of an Urgent Warrant Query Unit supported by court experts so prisons can escalate queries to reduce the risk of release in error. We have also stood up a digital rapid response unit to reduce human error with cutting-edge technology. We will provide up to £10 million over the next 6 months to deliver AI and technology-based solutions to support frontline staff, helping to avoid mistakes and calculate sentence accurately. We are also simplifying release policy; one of the aims of the Sentencing Bill is to standardise how cases are treated.

What the average sum of compensation paid per day is to prisoners who have been held in custody beyond their lawful release dates.

Release inaccuracy is yet another symptom of the prison system crisis inherited by this Government. While the overwhelming majority of offenders are released correctly, we are clamping down on those errors that do occur, and this includes unlawful detentions.On 11 November, the Deputy Prime Minister announced a five-point action plan setting out initial steps which includes an independent inquiry which will report its recommendations to prevent further inaccuracies. The Government is determined to fix release inaccuracies and ensure the public is properly protected.The data requested comes from internal management information and is not centrally collected. It is not quality assured and does not meet the standard required for publication.

What steps he is taking to reduce the number of prisoners who are held in custody beyond their lawful release dates.

Release inaccuracy is yet another symptom of the prison system crisis inherited by this Government. While the overwhelming majority of offenders are released correctly, we are clamping down on those errors that do occur, and this includes unlawful detentions.On 11 November, the Deputy Prime Minister announced a five-point action plan setting out initial steps which includes an independent inquiry which will report its recommendations to prevent further inaccuracies. The Government is determined to fix release inaccuracies and ensure the public is properly protected.The data requested comes from internal management information and is not centrally collected. It is not quality assured and does not meet the standard required for publication.

What estimate he has made of the number of prisoners who were held beyond their lawful release dates but did not submit claims for compensation.

Release inaccuracy is yet another symptom of the prison system crisis inherited by this Government. While the overwhelming majority of offenders are released correctly, we are clamping down on those errors that do occur, and this includes unlawful detentions.On 11 November, the Deputy Prime Minister announced a five-point action plan setting out initial steps which includes an independent inquiry which will report its recommendations to prevent further inaccuracies. The Government is determined to fix release inaccuracies and ensure the public is properly protected.The data requested comes from internal management information and is not centrally collected. It is not quality assured and does not meet the standard required for publication.

What assessment the Department has made of the potential impact of puberty suppression on levels of likelihood of progression to cross sex hormones.

The Cass Review recommended that there is a need to build a more robust evidence base for the use of puberty suppressing hormones as a response to gender dysphoria in childhood, through a carefully considered research programme. The PATHWAYS Trial Study has been established for that purpose, in which puberty suppression will be offered solely within the context of the comprehensive assessment and psychosocial support now offered by the National Health Service.Kings College London University, which is leading the research, has advised that it is not possible to know before starting puberty suppressing hormones what the treatment plan for any single young person will be at the end of the trial. This will depend on several factors, including their experience of puberty suppressing hormones, their mental and physical health, and their preferences for future care.

What therapeutic or psychosocial interventions must be provided before a child is considered for the PATHWAYS trial.

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.

What safeguarding measures are in place to ensure that families do not feel pressured into the PATHWAYS trial.

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.

How the PATHWAYS trial will distinguish true clinical effects from placebo or expectation effects in an open label design.

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.

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.

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.

What assessment he has made of the compatibility of the PATHWAYS trial with the requirement that clinical trials minimise foreseeable risks to child development.

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.

Whether the PATHWAYS trial is insured against potential (a) loss of fertility, (b) impaired bone or cognitive development and (c) other long-term harms.

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.

What assessment he has made of the potential merits of completing the Data Linkage Study to help inform safe PATHWAYS trial design.

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.

What assessment he made of the potential merits of (a) a feasibility study and (b) external peer review of the PATHWAYS trial.

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.

Whether (a) detransitioners and (b) whistleblowers were consulted in the design of the PATHWAYS trial.

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.

What criteria will be used to decide whether PATHWAYS trial participants are offered cross sex hormones at the end of the study.

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.

For what reason the PATHWAYS trial follow up period is limited to two years.

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.

What long term monitoring will be in place to track adult reproductive, sexual and psychological outcomes of PATHWAYS trial participants.

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.

If she will publish a list of businesses that have committed furlough fraud but have not yet repaid the money.

HMRC has a “Publishing Details of Deliberate Tax Defaulters” programme which publishes details of deliberate tax defaulters on Gov.uk for a period of 12 months. Since HMRC began compliance on the COVID-19 support schemes, details of 195 people have been published for deliberately overclaiming CJRS and/or Eat Out to Help Out. The latest publication was in November 2025: Details of deliberate tax defaulters - GOV.UK

Of the firms reported to HM Revenue and Customs for furlough fraud, how many (a) have been investigated and (b) remain to be investigated.

HMRC’s Fraud Reporting Gateway receives Human Intelligence reports on a variety of topics, including COVID-19 error and fraud, that are of interest to HMRC. This Fraud Reporting Gateway has resulted in 23,000 intelligence reports relating to the COVID schemes to assess, and a further 900 reports received from the Public Sector Fraud Authority. Due to firewalls in place to protect human sources of information, the recipients of the intelligence do not know its origin. Therefore, once the intelligence is circulated, we are unable to directly identify and attribute yield generated from the Fraud Reporting Gateway contacts, or why an investigation was or was not started.