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Critics say that sounds less like prevention and more like accommodation.
Fluency in Urdu was listed as desirable. That detail raised eyebrows because first cousin marriage rates are especially high in parts of Britain’s Pakistani community, with some studies placing the rate between 55 and 60 percent. The practice remains legal in the UK and is concentrated in cities such as Bradford, Birmingham, and Manchester.
Medical research has repeatedly shown increased risk to children born from first cousin unions. A peer reviewed BMC Medical Genetics study found that such children face a 2 to 4 percent higher risk of congenital and genetic disorders compared to the general population.
The landmark Born in Bradford study, which tracked more than 13,500 families, found a 6 percent congenital anomaly rate among children of first cousins, compared to 3 percent for children of unrelated parents. A 2013 Lancet study revealed that 31 percent of all congenital anomalies in babies of Pakistani origin could be attributed to consanguinity.
In Bradford alone, cousin marriages account for 30 percent of all autosomal recessive disease cases, despite Pakistanis making up only a small share of total UK births nationwide.
The financial toll is staggering.
Birmingham Women’s and Children’s NHS Foundation Trust reportedly spent £3.6 million between 2020 and 2025 treating 1,559 patients diagnosed with “family history of consanguinity.” That is one trust, over five years, spending nearly four million pounds on conditions widely understood to be preventable.
Research has also suggested that 20 percent of infant deaths in Birmingham are linked to genetic complications that are significantly more likely when parents are related. When cousin marriage continues across multiple generations, the genetic overlap increases well beyond the 12.5 percent typical of a single first cousin union. In those cases, researchers warn the risk of death or severe disability can climb to 10 percent.
The NHS is not unaware of these numbers.
Last September, NHS England briefly posted guidance that claimed cousin marriage carried “benefits” before removing it within 48 hours following backlash. Health Secretary Wes Streeting publicly called the material “wrong” and demanded to know how it was approved.
The guidance had appeared on a training platform used by midwives, GPs, and genetic counselors. Some NHS materials still advise healthcare workers to build cultural competence and to understand consanguinity from an Islamic perspective.
Emma Schubart of the Henry Jackson Society has warned that creating specialized roles could normalize close relative relationships and place “undue strain on an already overburdened NHS.”
She also pointed to additional public health concerns, noting that among British Pakistanis, individuals face 3 to 6 times the average UK risk of type 2 diabetes, with 5 to 18 percent of cases directly attributable to cousin marriage.
In December 2025, Conservative MP Richard Holden introduced the Marriage (Prohibited Degrees of Relationship) Bill, arguing cousin marriage poses “risks to health, freedom and the cohesion of our society.” The Labour government has rejected calls for a ban, instead pledging to expand genetic counseling services.
Recent data from February 2025 out of the Born in Bradford project showed that children of first cousins were more likely to experience speech and language delays, require additional hospital appointments, and struggle to meet typical developmental milestones.
The science is clear about the mechanism. When two cousins who share the same grandparents both inherit a defective gene, their child faces a significantly higher chance of receiving two copies of that gene and developing serious illness. Genetic testing can identify risk. It cannot eliminate the biological reality once conception occurs.
Britain built a healthcare system meant to protect its citizens. Now, critics argue, it is hiring specialists to manage — rather than confront — a practice that is costing millions and raising profound questions about policy, culture, and public responsibility.
For taxpayers watching the bills rise and hospitals strain under pressure, the question is no longer academic. It is urgent.
