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Official Report: search what was said in Parliament

The Official Report is a written record of public meetings of the Parliament and committees.  

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Dates of parliamentary sessions
  1. Session 1: 12 May 1999 to 31 March 2003
  2. Session 2: 7 May 2003 to 2 April 2007
  3. Session 3: 9 May 2007 to 22 March 2011
  4. Session 4: 11 May 2011 to 23 March 2016
  5. Session 5: 12 May 2016 to 5 May 2021
  6. Current session: 12 May 2021 to 21 April 2025
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Displaying 1135 contributions

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Health, Social Care and Sport Committee

Assisted Dying for Terminally Ill Adults (Scotland) Bill: Stage 1

Meeting date: 5 November 2024

Dr Sandesh Gulhane

With my final question, I want to focus on workload. Obviously, your system is very different from ours. Here in the United Kingdom, we do not charge. How many people per capita would you say go through the assisted dying process? I do not mean how many complete the process; how many at least start the process? If we had that information, that would help us to work out what that would mean for the workload over here.

Health, Social Care and Sport Committee

Assisted Dying for Terminally Ill Adults (Scotland) Bill: Stage 1

Meeting date: 5 November 2024

Dr Sandesh Gulhane

Is a different amount of training required for the different parts of what happens? For example, is there a bespoke version of the training for your care co-ordinator or the doctor who would administer the medications?

Health, Social Care and Sport Committee

Assisted Dying for Terminally Ill Adults (Scotland) Bill: Stage 1

Meeting date: 5 November 2024

Dr Sandesh Gulhane

I have a question about workload. In Australia, is assisted dying something that is provided by independent practitioners who perform that role in particular, or is it added on to the role that, for example, a general practitioner would perform here?

Health, Social Care and Sport Committee

Gender Identity Services for Children and Young People (Independent Review)

Meeting date: 29 October 2024

Dr Sandesh Gulhane

Good morning. I remind the committee of my entry in the register of members’ interests, which states that I am a practising NHS general practitioner.

Professor Smith, you have said today that we need more evidence in this area. You have also said:

“The Cass Review highlighted that the evidence for prescribing gonadotrophin releasing hormone (GnRH) analogue to suppress puberty is inadequate and the risk of short- or long-term harm remains uncertain.”

My question to you, therefore, is this. Why were we allowed to get in a position in which such medication was given to children, even though, according to your own words, the knowledge about it is uncertain and inadequate?

Health, Social Care and Sport Committee

Gender Identity Services for Children and Young People (Independent Review)

Meeting date: 29 October 2024

Dr Sandesh Gulhane

I want to ask two questions, if I may.

Building on Emma Harper’s questions, I note that Professor Ellis said that the MDT would include a psychiatrist. We know from comparative studies that transgender young people are about four times more likely to think about attempting suicide, and the latest stats show that, in 2023, more than 7,000 children and young people had their referrals rejected by CAMHS, which is an average of 26 children a day. How are you going to get psychiatry involved in this particular MDT if we cannot provide basic services to children around our country at the moment?

Health, Social Care and Sport Committee

Gender Identity Services for Children and Young People (Independent Review)

Meeting date: 29 October 2024

Dr Sandesh Gulhane

In the devolved health service, we are watching, but we did not do anything to start it off.

My final question is for Professor Strath. Will you please give us an update on where we are with current research and current indications on what is happening? I appreciate that it is always difficult to tell with trials, but roughly when will we get an update?

Health, Social Care and Sport Committee

Gender Identity Services for Children and Young People (Independent Review)

Meeting date: 29 October 2024

Dr Sandesh Gulhane

Professor Smith, hospitals are pushing more and more things to GPs—and I say that as a GP. The standards, as written, make it clear that gender services are able to push prescribing to GPs, too. Having spoken to many GPs, I know that they are very concerned, and a lot of them are not comfortable with prescribing puberty blockers, because, for example, they feel that such activity is off licence, they are awaiting robust evidence or they see that there is no formal protocol. Moreover, the Royal College of General Practitioners supports GPs not taking on shared care, there is the potential for litigation if patients decide that puberty blockers are harming them, one in two patients have, as Professor Ellis has told us, underlying mental health issues, and the General Medical Council has told us that prescribing must be appropriate.

If those issues are not addressed, are we following GMC competence? Can you reassure me that the prescribing of puberty blockers will not be pushed to primary care without GPs having the credentials—and, indeed, wanting—to take that work on, and that all GPs will be able to opt out?

Health, Social Care and Sport Committee

Gender Identity Services for Children and Young People (Independent Review)

Meeting date: 29 October 2024

Dr Sandesh Gulhane

Absolutely, and that is where we are right now, but my question goes back to when the services were set up, when things were beginning and money was being spent on creating a service. Explain to me what randomised controlled trial—for “quality” and “safety”, in your own words—said that the prescribing of GnRH to children was acceptable and safe in this case.

Health, Social Care and Sport Committee

Gender Identity Services for Children and Young People (Independent Review)

Meeting date: 29 October 2024

Dr Sandesh Gulhane

Yes.

Health, Social Care and Sport Committee

Gender Identity Services for Children and Young People (Independent Review)

Meeting date: 29 October 2024

Dr Sandesh Gulhane

It is not really, because it was England that decided to do the Cass review, not us. The emerging evidence did not push us into asking whether we should pause, or have a think about where we are and launch such work. England did that and we have followed on the back of it. I do not necessarily think that what you say is exactly the case.