Thread by @JolyonMaugham

I have some questions for @wesstreeting. 🧵

https://twitter.com/wesstreeting/status/1812435914473295927

First, have you investigated the explosion of deaths amongst those on the NHS waiting list since NHS England introduced a softer version of the ban?

https://x.com/JolyonMaugham/status/1803729360731406489

Second, given that the structure of the ban recognises the risks to of cutting off puberty blockers for those already prescribed them by the NHS, what steps have you taken to ensure those prescribed puberty blockers privately can continue to access them?

Third, as there are no private prescribers or NHS prescribers in the UK, and you plan to criminalise the use of prescriptions written in eg Germany and Switzerland, do you acknowledge that we now have the most restrictive regime in the Western world?

Fourth, where does Hilary Cass' report recommend the ban on puberty blockers that you are implementing?

Fifth, you once said it was important to listen to trans people. Why are you now pressing forward with a ban that followed from your predecessor instructing civil servants not to consult any trans families or organisations representing them?

Sixth, have you read the repeated submissions from civil servants to Victoria Atkins warning of the risks to vulnerable young people of the ban and urging her not to introduce it? Why are you also ignoring those risks?

Seventh, what assessment have *you* made of the risks to young trans people of continuing with the emergency ban? Or have you made none?

Eighth, what investigation have you made of whether key NHS and Cass Review appointments were political? Badenoch has said the ban was possible only because her Government placed people with a particular ideological position into the positions that mattered most in health.

Ninth, you say the NHS is establishing a clinical trial.

Do you accept that Hilary Cass recommended this two years ago - but no trial has yet started?

Tenth, as to that clinical trial, the ban was introduced by a Secretary of State who did not want such a clinical trial (despite the fact Cass had recommended it).

Do you accept this raises questions about the judgment of the previous Secretary of State? If so why are you endorsing her ban?

Eleventh, did you read the High Court evidence of parents worrying about their children taking their own lives in consequence of the ban? Are you aware of the suicide attempts in its immediate aftermath? Did you read the evidence from parents of the positive effects of PBs?

Twelfth, shortly before introducing the ban, your predecessor as Secretary of State was warned by senior civil servants of a "high risk of unanticipated consequences. This may include harm to patients".

How have you engaged with those risks?

Thirteenth, the advice given by the NHS was that the measures concerned an "extremely vulnerable group, liable to self-harm" and "it would cause a larger patient safety issue to force them to stop treatment... than it would to allow them to continue."

Why are you ignoring it?

Fourteenth, indeed civil servants continued repeatedly to warn your predecessor that they were very concerned about these measures and asked her again to take those risks into account.

She ignored them. Why are you also ignoring them?

Fifteenth, when (and the evidence I have cited strongly suggests it is a 'when' rather than an 'if') one or more young trans people take their own lives in consequence of your shoddy attempt to ignore professional advice but appease billionaires and the press, will you resign?

Sixteenth, can you name even one reputable international health body that agrees with the position taken by the NHS under those Kemi Badenoch has said were selected for their political views?

How convinced are you that their views justifies us being an international outlier?

Seventeenth, by banning regulated prescribers in eg Germany, France, Spain, Switzerland, all of whom are subject to professional regulation in their home states, you are saying all those health systems are wrong.

How did you reach that confidence level?

Eighteenth, PBs are only prescribed to under 18s where a doctor, the patient and (in practice) the parent agrees.

Why should they not balance the risks? Why, alone for trans healthcare, should you make that decision? On what basis can you claim to know better than them?

Nineteenth, the evidence is that (as your predecessor was warned) the ban is causing suicide attempts. And even your lawyers concede that Cass did not conclude in terms that puberty blockers cause a serious danger to health.

How do you justify the risk they pose?

Twentieth, there is evidence that the ban was introduced in response to coverage of the issue in the right wing press.

On what basis do you justify the right wing press making healthcare policy?

Twenty-first, a whole scope of serious risks arising from these regulations were pointed out to your predecessor as Secretary of State.

Did you assess them before deciding to continue with the banning order - or ignore them?

Twenty-second, senior civil servants spoke about the basis of the Order not being a “patient safety basis” but the intent being a “slightly different interpretation”.

Does this not give you any pause for thought?

Twenty third, do you accept that your predecessor at no stage received clinical or other scientific advice on whether any of the possible impacts of GnRHAs created a serious danger to health despite her being told, and recognising, that such was necessary?

Twenty-fourth, you seem to accept that new patients can be provided with PBs inside a clinical trial whilst contending that they are so dangerous as to trump all other risks outside a clinical trial.

How do you justify that?

Twenty-fifth, and I also ask this of @AngelaRayner and @Keir_Starmer, how do you justify your Government's offer to meet JK Rowling but, in a world in which your predecessor told civil servants not to consult with trans people or their organisations, not to meet them?