NHS ‘taking time to transform’ gender services amid accusation of foot-dragging

NHS England is taking time to “transform” gender services for children and young people, the Health Secretary has said as the Government was accused of dragging its feet on the issue.

It emerged in October that the opening of new regional gender identity clinics in England had been delayed as the “complex” set-up of the new service continues.

After an initial aim for clinics to be up and running by spring 2023, this was changed to autumn earlier this year and has now been pushed to April 2024.

Dr Caroline Johnson, Conservative MP and member of the Health and Social Care Committee, asked about the development of new services.

She said: “The Government seems to be really dragging its feet on managing and dealing with this, why is that?”

Appearing before the committee on Wednesday afternoon, Health Secretary Victoria Atkins said there is a need to “get this right”.

She said: “I appreciate there is a great deal of pressure for speed on this but it is important we get this right.

“NHS England are taking time to transform the services available to children and young people and I’m very, very grateful to all of the clinicians and other professionals involved in this because it is difficult, I fully accept that.”

She said NHS England is “very much looking to launch this (service) to help ensure that those children who need these services are getting them and getting them from the right experts in the right environment to help them with some of the issues that they’re facing”.

Sir Chris Wormald, permanent secretary at the Department of Health, rejected the accusation of foot-dragging, saying the NHS is establishing a “completely new service”, which is a “very technically difficult thing to do”.

He said: “We are updated regularly by the NHS on their progress. This is a very technically difficult thing to do. It is establishing a new service, completely new service in a whole set of new institutions for this service.

“And they are pressing ahead but they are very conscious that the consequences of getting it wrong are very high indeed. So I don’t think it’s foot-dragging. I think they are properly assessing the complexity and the risk while pushing forward on the new service in the way that you describe.”

The regional clinics will replace the current London-based Gender Identity Development Service (Gids) clinic, which is now slated for closure by the end of March next year.

An independent review, led by Dr Hilary Cass, was commissioned in September 2020 amid the rise in demand, long waiting times for assessments and “significant external scrutiny” around the approach and capacity of the capital’s clinic and it was announced in July 2022 that it would be shutting down.

NHS England previously stated the new regional services must be ready to take on patients before the Gids service at the Tavistock and Portman Trust is closed, in order to ensure there is no gap in the provision of care.

The new service will be made up of the southern hub – a partnership between Great Ormond Street Hospital, Evelina London Children’s Hospital and South London and Maudsley NHS Foundation Trust – and the northern hub – a partnership between Alder Hey Children’s NHS Foundation Trust and the Royal Manchester Children’s Hospital.

A spokesperson for the southern hub previously said they hoped to be fully open by the start of April and that they are working with colleagues on the safe handover of current patients.

Meanwhile, at a separate committee, equalities minister Kemi Badenoch suggested some medics were reluctant to work in the gender field because of the “hassle” they get.

The senior Conservative, speaking at a session of the Women and Equalities Select Committee, made the comments as she responded to questions about the delays trans children faced in getting specialist care.

Ms Badenoch said there was a “general pressure” on the NHS that was not specific to gender identity services, even though the Government was spending more than ever.

But she said she had been told by whistleblowers that “many clinicians … do not want to work in this space, because it has become so contentious”.

“We are now seeing a lot of paediatricians saying they do not want to be in this space because of the hassle,” she told MPs.

“They don’t always believe that gender-affirming care is right. And yet there is a lot of pressure to start with gender-affirming care as the default. They don’t think that that is right – I agree with them.

“Gender-affirming care as a way to treat gender dysphoria should be a last resort, not a first resort.”

She added there was also increased demand for services from those who may not need them.

“If many children who don’t have gender dysphoria are being told that they are trans, they are going to block the queue for those children who do actually need that care,” she said.