NHS: Single-sex Provision for Staff and Patients

Question

15:07:00

Asked by

To ask His Majesty’s Government whether they plan to issue guidance relating to single-sex provision for NHS staff as well as patients.

My Lords, all employers, including the NHS, are required to comply with existing law on single-sex facilities. In these cases, a common-sense and empathetic approach is needed. It is important that service providers have clear guidance about the Equality Act. We will consider whether further guidance is needed, including on how lawfully to apply its single-sex exemptions.

I thank the Minister for that reply. I know that the Government value front-line health workers and I am sure that they are concerned to hear that NHS trusts are allowing ideology to deny nurses safety, privacy and respect at work. I am disappointed, however, that action is not more immediate. The Secretary of State, Wes Streeting, said that he was horrified by the case of the Darlington nurses being forced to share their changing facilities with a male colleague who identifies as female. Does the Minister agree that trusts need urgent guidance on this issue? I know that the Darlington nurses have submitted draft guidance to the department—

Question.

Okay, the question is: can that guidance be brought forward, because nurses are being bullied and harassed at work around this issue?

I am not sure that I can agree with the noble Baroness about trusts being driven by NHS ideology. All staff should be and must be treated with dignity, with their safety and privacy respected. Much of this is about practicalities and working with staff in the same way that other policies are worked with, and I would expect a common-sense and sensitive approach to prevail. The Secretary of State did indeed meet with the five nurses from Darlington regarding their concerns about single-sex spaces. We have indeed received a draft version of the guidance that they have produced and will reply to them at the earliest opportunity. However, the guidance that I would focus on is from the Government. We are looking at how we can assist all employers in complying with legislative requirements.

My Lords, would the Minister agree—

My Lords, NHS England wrote to me on the—

I think we will hear from the noble Baroness, Lady Thornton, first.

My Lords, would the Minister agree that once again we must reinforce the need to treat everyone with compassion, dignity and respect, especially in media reports that discuss protected characteristics and cases of alleged discrimination?

I would indeed agree with the comments of my noble friend.

My Lords, is the Minister considering any possible unintended consequences of this guidance? As a lesbian who is frequently told she is in the wrong toilets and who is addressed as “my Lord” and “sir” frequently around this place—which is always cute—does the Minister think there might be some unintended consequences for those who are not trans but perhaps do not fit the immediate, on-first-glance version of what a woman might look like? Perhaps we should let women determine their own sense of identity in these situations.

I am sorry to hear of the noble Baroness’s experience, which I have heard her speak of before. To me, as I said earlier, it points to the need to treat people with respect, with dignity and without making assumptions. I cannot emphasise enough the need for sensitivity and respect, which applies to everybody. While we are talking about changing facilities, we should think about the huge difference in shops over the years. There used to be communal changing rooms, but you would be hard pushed to find them now. People have private spaces for changing and this again applies to everybody. I recognise the challenge of the NHS estate, of course, but I am talking about creative solutions and working with staff to get to where we need to be.

My Lords, the noble Baroness is absolutely right to talk about dealing with this issue very sensitively, by respecting people’s dignity and acting with compassion. However, some NHS staff and patients—the noble Baroness, Lady Fox, referred to this—have asked for single-sex provisions to protect their privacy and dignity. If the Government are planning further guidance, how do they intend to achieve that difficult trade-off and balance in potential conflicts between single-sex provisions for NHS staff and patients and the rights of individuals under the Equality Act 2010, while respecting their dignity and acting with compassion?

The noble Lord raises an interesting point. In all cases with guidance, that is always the balance we seek to reach. I am also interested in the history of this, and I am sure the noble Lord will remember that the 2019 guidance on trans patients in single-sex spaces proved somewhat controversial, if I might put it that way. The guidance was meant to be updated under the last Government, but this did not happen. I am advised that it was delayed by a dispute between the previous Government and NHS England, which also delayed proposed updates to the NHS constitution. These again were consulted on under the last Government—which was a good thing—but nothing actually happened. So all these come to us as a new Government and will be given full consideration to get us into the right place.

In the last few weeks alone, we have heard about the range of challenges facing our NHS: physically collapsing hospitals, extensive waiting lists and a social care review, to name but a few. More guidance in areas of uncertainty is to be encouraged. However, given that only 0.55% of the English population is trans, where does the Minister think that this should come in the order of priorities?

I know that everybody in your Lordships’ House will take the view that the NHS is there both as an employer—as all employers are; this is not specific to the NHS—and in its service to patients. It is there to treat all with the right dignity and respect. We have a legislative framework to which reference can always be made. We will see what further guidance is needed—and that may be to all employers, not just the NHS. Again, I cannot emphasise enough the need for careful consideration and the involvement of all staff, on what has to be a trust-wide basis, because everybody is different in terms of their estate and what their challenges may be. It is not as simple as numbers: it is about fairness and dignity for all.

My Lords—

My Lords—

We will hear from the noble Baroness, Lady Hayter.

NHS England wrote to me to confirm that any patient can choose the sex of a chaperone. Will the new guidance define what is meant by “sex” in that case?

There is, of course, already a definition in legislation of what that means. I know my noble friend will understand that I cannot predict what the guidance will be, but I will certainly pick up the point she has made.

My Lords, I remind your Lordships that I sit as a non-affiliated Member of this House. I encourage the Minister and the department to proceed with the utmost caution. Trans women and trans men pose a threat to no one. In relation to single- sex space, this House has debated the issue frequently. Therefore, does the Minister agree that the Equality Act works, with any measures for exclusion being on a case-by-case basis, proportionate and evidence-based? Will the Minister give the House an assurance that the Government will continue that sensible and humane approach?

I agree with the noble Lord that the legislation provides a clear framework to all employers, but I also accept that some employers may wish to have further guidance on the existing legislation to enable them to make the right local decisions as employers, and it is that that we will consider.