Health Bill 2026–27
Puberty blockers, PATHWAYS and single-sex NHS provision
Tracking the Health Bill through the House of Lords, with particular attention to safeguarding children, the PATHWAYS puberty-suppression trial, and single-sex NHS facilities for patients and staff.
The Health Bill completed its Commons stages on 8 September 2026 and received its First Reading in the House of Lords on 9 September 2026.
The Bill is currently before the Lords as HL Bill 52 (as brought from the Commons).
At a glance
Puberty blockers / PATHWAYS
Commons New Clause 142 concerned puberty blockers for under-18s experiencing gender dysphoria or gender incongruence and proposed parliamentary approval for clinical trials involving their use.
Ayes 108 | Noes 357
Single-sex NHS provision
Commons New Clause 143 concerned single-sex changing, washing and toilet facilities for NHS staff and single-sex wards, toilets and washing facilities for patients, subject to specified exceptions.
Ayes 106 | Noes 302
Neither NC142 nor NC143 forms part of the Bill now before the House of Lords. If peers wish to revisit either issue legislatively, a member of the Lords would need to table a new amendment.
Parliamentary progress
Issue Watch 1 — Puberty blockers and PATHWAYS
New Clause 142
NC142 would have required the Secretary of State, within three months of Royal Assent, to make regulations preventing puberty blockers from being prescribed, dispensed or supplied to under-18s for treatment related to gender dysphoria or gender incongruence.
It would also have prevented those drugs being used in clinical trials for those purposes unless the particular trial had been approved by resolutions of both Houses of Parliament.
Ayes 108 | Noes 357
NC142 rejected
What happens now?
NC142 itself fell in the Commons. Protect & Teach will monitor the Lords stages for any new amendment concerning puberty suppression, PATHWAYS or parliamentary oversight of clinical trials involving children.
PATHWAYS trial watch
King’s College London’s public PATHWAYS page currently describes the project as “Starting”.
The modified trial protocol has received the necessary regulatory and research-ethics approvals. Protect & Teach has not recorded recruitment as having commenced unless and until that is publicly confirmed.
Bayswater Support Group & Ors v Health Research Authority & Anor
In R (Bayswater Support Group & Ors) v Health Research Authority & Anor [2026] EWHC 2043 (Admin), Mr Justice Chamberlain refused permission to apply for judicial review and refused interim relief. The claimants were Bayswater Support Group, Keira Bell and James Esses.
The challenge concerned decisions of the Health Research Authority and Medicines and Healthcare products Regulatory Agency relating to PATHWAYS. The Court concluded that none of the five grounds advanced was arguable with a realistic prospect of success.
The judgment concerned the lawfulness of the regulators’ decisions and the public-law grounds on which they were challenged. It did not amount to the Court substituting its own clinical or ethical assessment of the trial for that of the specialist regulators. Read the press summary or full judgment.
Protect & Teach opposes the PATHWAYS puberty-suppression trial on ethical and safeguarding grounds.
Our concern is whether exposing children to the known physiological effects, identified safety concerns and unresolved uncertainties of puberty suppression for the purpose of obtaining further evidence is compatible with safeguarding them from avoidable harm.
Our position is that it is not.
If significant uncertainty about an intervention is the reason further evidence is required, who carries the risk while that evidence is generated?
In PATHWAYS, it is the participating child.
We are tracking
- PATHWAYS recruitment status
- regulatory, research-ethics and relevant legal developments
- safety information and protocol changes
- parliamentary questions and ministerial statements
- Lords debate
- any new Lords amendments
Issue Watch 2 — Single-sex NHS provision
New Clause 143
NC143 would have required the Secretary of State to ensure the availability of single-sex:
- changing rooms for NHS staff;
- toilets and washing facilities for NHS staff;
- wards for NHS patients; and
- toilets and washing facilities for NHS patients.
The proposed clause also allowed specified exceptions concerning patient wards and facilities where necessary for children, intensive care, critical care and specialist high-observation areas including A&E resuscitation and initial theatre recovery.
Ayes 106 | Noes 302
NC143 rejected
Protect & Teach will monitor the Lords stages for any new amendment concerning single-sex NHS accommodation or facilities for patients or staff.
Same-sex accommodation guidance
NHS England’s Delivering same-sex accommodation guidance remains under review following the Supreme Court judgment in For Women Scotland Ltd v The Scottish Ministers.
NHS England currently says providers should continue to meet patients’ clinical needs, safeguard them from harm and protect their privacy and dignity while continuing to record breaches of the NHS Constitution pledge concerning same-sex accommodation.
Revised guidance is expected to be published following the review.
Clear single-sex provision is an important safeguard for privacy, dignity and safety, while appropriate additional arrangements can and should be made for individuals requiring them.
We are tracking
- revised NHS England same-sex accommodation guidance
- patient accommodation and facilities
- NHS staff changing, washing and toilet facilities
- Government statements
- Lords debate
- any new Lords amendments
Lords scrutiny watch
Lord Rooker — proposed amendment to the committal motion
Lord Rooker has tabled an amendment seeking a ministerial statement identifying clauses, schedules and amendments which the Commons did not have time to consider on the floor of the House before Committee stage begins in the Lords.
Protect & Teach will record the outcome following Second Reading.
What we are watching next
13 October 2026 — Lords Second Reading
Protect & Teach will check the official parliamentary record for:
- references to puberty blockers and PATHWAYS;
- scrutiny of the ethics and safeguarding of the trial;
- references to single-sex NHS provision;
- Government commitments or new information;
- the outcome of Lord Rooker’s proposed amendment;
- the timetable for Committee stage; and
- any subsequent Lords amendments relevant to these issues.
Read the evidence and take part
Protect & Teach has published a detailed analysis of the two issues and prepared a template letter for members of the public who wish to contact a member of the House of Lords.
Official sources
- UK Parliament — Health Bill 2026–27
- UK Parliament — Parliamentary stages
- UK Parliament — New Clause 142: Puberty blockers
- Commons Division — NC142
- UK Parliament — New Clause 143: Single-sex NHS facilities
- Commons Division — NC143
- House of Lords — Business for 13 October 2026
- Courts and Tribunals Judiciary — PATHWAYS judgment press summary (31 July 2026)
- High Court — Approved judgment: [2026] EWHC 2043 (Admin)
- King’s College London — PATHWAYS Trial
- MHRA / Government — PATHWAYS clinical trial update
- NHS England — Delivering same-sex accommodation
- UK Supreme Court — For Women Scotland Ltd v The Scottish Ministers
Last checked: 6 October 2026.