Debate contribution: Gender Identity Services: Cass Review of Provision in Northern Ireland

Debate contribution by Mr Mike Nesbitt on 8 September 2025.

MLA

Mr Mike Nesbitt

Party at the time

Ulster Unionist Party

Date

8 September 2025

Type

Debate contribution (made as a minister)

Business

Question for Urgent Oral Answer

Heading

Gender Identity Services: Cass Review of Provision in Northern Ireland

Assembly identifier

Official Report component 5068543

Read the official Assembly record

Text

Just before I respond to Mrs Dillon, I want to address something that I have not addressed, which is the idea that the plan was in the public domain before I briefed the Executive. I can confirm that that was the case because we did not make the announcement; it came via the Rainbow Project. To Mrs Dillon, the beauty of the National Health Service — the glorious, glorious concept — is that it does not matter who you are. If you need health and social care, you get it for free. Yes, all of those groups — those vulnerable groups that were let down by people like us, people in authority, be they politicians or people who were running institutions or whatever — have been hurt and let down, and they all deserve our attention. If anybody is trying to say that we should deliver health and social care only for the people whom we approve of, then, once again, count me out.

It will not be gender-affirming. If you mean that somebody is going to come in and say, "I believe I am a girl, not a boy", we will not simply say, "Right, we are going to make that happen for you".

Stakeholders were involved in the discussions that have led to this lifespan gender identity service. My officials have assured me that that has happened and that stakeholders are as happy as possible with what we propose. They also believe, as I do, that what we are doing is compliant with the Cass recommendations. When Dr Cass comes, she will do that short, sharp quality assurance that that is the case. There is no need for stakeholders to be involved in that, because the four people will be talking to the clinicians and the team who will deliver the service to make sure that everything is as we believe it should be. That is the nature of an independent review.

I will run through some of the costs. The Member's opening remarks take me back to this point: we do not decide who does and does not deserve to have access to medical health and social care services for what they need or believe that they need. We will not cherry-pick on that. A lot of the money will go on staffing and the workforce for the new service. There will be a psychologist, which comes in at over £100,000, and there will be a service manager, a practitioner, another lower-band psychologist, administrative support, a medical secretary, a nurse, a pharmacy technician — that sort of thing. The figures all add up.

I am afraid that I am at a loss to remember when I said "we" rather than "I", but, as a general rule, if I say "we", you can take it that I mean "I", because I am the Minister, and the buck stops with me. Regarding the advice that you get, I am sure that your daughter's is first class. My advice has come from, for example, officials, CAMHS and the Knowing Our Identity service — people who are professional, expert and experienced in such things — and we have taken those ideas and consulted on them, as we should do. Maybe not in every debate or every day in the House, but that is a staple of how we deliver government services. We talk about co-design and co-production. That is how we have got to where we are today, and it is not the first time in this role and certainly not the first time in life that I have been given advice and thought, "I would like to bring in a little independent expert advice for some quality assurance". For example, I am reluctant to raise it, but, regarding the water issues at the maternity hospital, the Member will know that options were put to me with a recommendation for a specific option, and I refused to accept it. I said, "No, I want to bring in an independent expert to review and quality-assure what I'm being told, and then we will move forward". As with this, it does not delay moving to delivery, because I said to the trust, "You can go on with the design and continue to talk to consultants and experts about delivering your preferred option, and let us hope that that is where we end up". In the same way, the recruitment for the other posts that I have mentioned today and for those that I have not mentioned will continue, so bringing in Dr Cass and colleagues for a couple of days will not delay anything.

Obviously, there will be recurrent costs. It is not a service that will last until the end of the financial year or for a single financial year. With no disrespect to the Member, I think that making that point is redundant. As to the other costs that he mentions, I am not aware of any costs for primary care or for general practitioners. They will refer into CAMHS as they do for a lot of other issues. If the Member has fact on that that I do not have, I am more than happy to look at it.

869 words. Text as published by the Northern Ireland Assembly.

Assessment

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Assessed 21 October 2026 at 13:02 UTC by jev-1.13.0 (requested as typesafe/jev) under rubric 2026.10-r9, methodology 1.9.

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