Women’s Health Strategy for England

Eleanor Laing Excerpts

Wednesday 20th July 2022 Commons Chamber

[Wes Streeting (Ilford North) (Lab)]

Let me begin by thanking the Secretary of State for advance sight of his statement and adding my thanks to the Minister of State, to his predecessor as Secretary of State, the right hon. Member for Bromsgrove (Sajid Javid), who is sat opposite, and to officials in the Department for the work they have done. I am genuinely glad that this work is out of the door when so much else has been in hiatus because of the wider political change afoot in the Government. I join the Secretary of State in recognising the campaigning efforts of his constituent Kath Sansom, as well as the efforts of my hon. Friend the Member for Swansea East (Carolyn Harris), who has campaigned tirelessly to raise awareness of the menopause and has been a driving force for change on behalf of women everywhere.

For too long, women's health has been an afterthought, and the voices of women have been at best ignored and at worst silenced. Four out of five women who responded to the Government’s survey could remember a time where they did not feel listened to by a healthcare professional, and that has simply got to change. In recent years, we have seen a string of healthcare scandals primarily affecting women: nearly 2,000 reported cases of avoidable harm and death in maternity services at Shrewsbury and Telford; more than 1,000 women operated on unnecessarily by the rogue breast surgeon Ian Paterson; thousands given faulty PIP— Poly Implant Prothèse—breast implants; and many left with traumatic complications after vaginal mesh surgery. Meanwhile, every woman who needs to use the NHS today faces record high waiting times. The NHS is losing midwives faster than it can recruit them. Gynaecology waiting lists have grown faster than those for any other medical specialty. The number of women having cervical screening is falling. And black women are 40% more likely to experience a miscarriage than white women. That is the cost for women of 12 years of Conservatives mismanagement, so I want to address each part of the strategy in turn.

The strategy promises new research, which is of course important. Studies suggest that gender biases in clinical trials are contributing to worse health outcomes for women. There is evidence that the impact of women-specific health conditions such as heavy menstrual bleeding, endometriosis, pregnancy-related issues and the menopause is overlooked. So of course what the Secretary of State has said today about improving data is so important, but will he also set out how exactly the Government intend to make use of this new data to improve outcomes for women?

Improving the education and training of health professionals is essential, because when we do not do that, there are consequences. Almost one in 10 women has to see their GP 10 times before they get proper help and advice about the menopause, and half of medical schools do not teach doctors about the menopause, even though it affects every woman. I challenge the Secretary of State to go further than the proposal he outlined to train incoming medical students and incoming doctors. What plans do the Government have for clinicians who are already practising? We need to upskill the existing workforce, not just the incoming workforce. However, let us be clear: informing clinicians is no good if we do not also improve access to hormone replacement therapy, so where is the action in the strategy to end the postcode lottery for treatment?

Breast cancer is the most common cancer in the UK, and the NHS offers regular breast cancer screening to women aged between 50 and 70. That can prevent avoidable deaths by identifying cancer early, when it is more treatable and survival is more likely. Yet, fewer women in the most deprived areas than in the most affluent areas receive regular breast screening. Even before the pandemic too many women with suspected breast cancer were waiting more than the recommended two weeks to see a specialist. How will the programme announced today make a difference to outcomes for patients if, once diagnosed, they just end up on a waiting list that is far too long and they cannot access the treatment they need?

I welcome what the Secretary of State said about removing barriers to in vitro fertilisation for women in same-sex couples. For far too long they have faced unnecessary obstacles to accessing IVF, for no other reason than that they love another woman. It is high time that we put that right.

I also want to mention endometriosis. Tens of thousands of women provided testimony to the Government about the issues they face with diagnosis and treatment. Will the Secretary of State give the House an assurance that every woman who is treated for this disease will have equal access to specialist services from day one? Will he make sure that they do not have to fight to get the diagnosis in the first place?

On polycystic ovary syndrome, what will the Secretary of State do to make sure that we equalise access to a range of treatments, not least for women for whom the pill is simply inappropriate? We must make sure we end the division between those who receive a prescription on the NHS and those who go private, receiving better treatment.

I also want to raise some points about what has not been mentioned today. In addition to the appalling figures on black maternity deaths, a quarter of black women surveyed by Five X More felt that they received a poor or very poor standard of care during pregnancy, labour and post-natal care. Women who live in deprived areas are more likely to suffer a stillbirth than their richer counterparts. My hon. Friend the Member for Oxford East (Anneliese Dodds), the shadow Secretary of State for Women and Equalities, has pledged a new race equality Act to tackle the structural inequalities in our society, including in healthcare. However, the Government are more interested in stoking culture wars than in acknowledging that these inequalities even exist. Surely that has to change when there is a new leadership of the Conservative party.

In conclusion, the reality that faces women in this country is this: breast cancer waiting times are through the floor, half a million women are waiting for gynaecology treatment, black women are four times more likely to die in pregnancy and childbirth, and too many women still cannot get HRT when they need it. This strategy simply will not solve the depth of the crisis in women’s healthcare after 12 years of Conservative mismanagement. Every day this Conservative Government remain in office is another day when women will have to wait far too long for the care they desperately need.

[Madam Deputy Speaker (Dame Eleanor Laing)]

I call Sajid Javid.

[Steve Barclay]

rose—

[Madam Deputy Speaker]

Oh, I beg your pardon! It is probably a good idea if I allow the Secretary of State to answer the shadow Secretary of State. I am too many steps ahead.

[Steve Barclay]

I do not want those on the Opposition Front Bench thinking that their points have not been addressed.

I think there is much common ground on both sides of the House on the importance of this strategy and the need for a culture and system change in the NHS to address many of the concerns raised in past debates in the House on issues such as mesh, Paterson and Ockenden. I also think there are a lot of areas where colleagues on both sides of the House will work together to encourage commissioners in our constituencies to reshape services in a way that better reflects the needs set out in this strategy.

The hon. Member for Ilford North (Wes Streeting) is right to highlight the fact that many respondents felt they had not been heard in the past. That is why we have taken the first step of appointing a women’s health ambassador—Professor Dame Lesley Regan, who is an extremely respected figure in women’s health—to better champion women. It is also why I signalled in my statement the importance of data and of breaking it down by sex by default to better target our research on conditions that impact women differently from men or that affect only women and that are often not as well researched as they should be. Again, I think there is common ground on both sides of the House on the issue of research.

I agree with the hon. Gentleman about the need to improve training for existing clinicians as well as for those new to the profession. That is why I signalled in my statement our desire to work with the royal colleges and others to make sure that that continuing professional development is there.

The hon. Gentleman raised the issue of access to HRT. He will be aware that we have put prepayment certificates in place from April next year so that someone will pay only the equivalent of two prescription charges for their HRT supply. Officials in the Department have done considerable work on supply chain issues to tackle some of the difficulties that were there in the past.

On the hon. Gentleman’s point about how we address outcomes for patients, I saw a good illustration this morning at Homerton. Redesigning services avoids the need for invasive and more expensive theatre treatment, and the use of new equipment allows a better service to the patient. In the strategy, Professor Dame Lesley Regan makes the point that the irony is that we could deliver services that are far better for the patient but also cheaper for the taxpayer if we embraced a women’s hub model of the sort we see in Homerton. I very much look forward to taking the data we have forward in conversations with other commissioners around the country.

I am pleased that the hon. Gentleman recognised and welcomed the removal of barriers to IVF, as will Members on both sides of the House who have seen the challenges that that issue presents in constituency cases.

On speed of service, community diagnostic centres have an important role to play. The hon. Gentleman also raised the issue of ethnic minorities. We have put in place a maternity disparities taskforce, and ministerial colleagues have already met three times as part of that taskforce, so the characterisation that Ministers are not engaging on the issue is, I am afraid, wide of the mark.

The hon. Gentleman mentioned breast cancer. He will have noted from my statement that an additional £10 million has been targeted specifically at that issue, with a further 25 mobile units. Again, that is about addressing the disparity in women’s health data in different parts of the country.

Overall this is an important strategy. We have listened to the very large number of responses to the consultation, and that is reflected in the strategy. I think this is an area on which there is much common ground on both sides of the House.

[Madam Deputy Speaker (Dame Eleanor Laing)]

And now I call Sajid Javid.

[Sajid Javid (Bromsgrove) (Con)]

There was a time when I would follow right after the shadow Secretary of State, but not any more. However, I am very pleased to follow my right hon. Friend the Secretary of State, and I welcome him to his new role. He has the privilege of running a fantastic Department that is so important to the British people. He has excelled in every role he has held in Government so far, and I know he will do so again.

I strongly welcome the women’s health strategy—as we heard, it is the first published by any Government. I congratulate everyone involved, including all the officials and especially the excellent Minister of State, Department for Health and Social Care, my hon. Friend the Member for Lewes (Maria Caulfield), who is sitting on the Treasury Bench, and the previous Minister of State, my right hon. Friend the Member for Mid Bedfordshire (Ms Dorries).

Does the Secretary of State agree that, when it comes to women’s health, early diagnosis is essential? I absolutely welcome the commitment in the strategy on mandatory training in women’s health issues for new doctors, but will my right hon. Friend say a little more about what can be done on training for existing doctors and clinicians?

--- Later in debate ---

[Steve Barclay]

Part of the reason this is a 10-year strategy is that we do need a change of culture as well as a change of systems, and that is what the strategy maps out. A key component of that is how we empower patients through areas such as the NHS website, working with trusted partners who provide health information. The hon. Lady is also right about training, not just for new entrants into the medical profession but for existing clinicians. We will be working with the royal colleges and others to drive that forward.

[Madam Deputy Speaker (Dame Eleanor Laing)]

And finally, Jim Shannon.

[Jim Shannon (Strangford) (DUP)]

Thank you, Madam Deputy Speaker. I have the strongest legs in the Chamber.

I very much welcome the Secretary of State’s announcement of additional moneys for women’s health training. He referred to one-stop clinics. I coincidentally spoke to a medical student who graduated in Cardiff today, who feels that more is needed for the specialty of women’s health, and specifically the menopause, which the hon. Member for Swansea East (Carolyn Harris) mentioned. What training will be extended to GPs, in the context of one-stop clinics, to ensure that each surgery has a trained GP available to advise and to help?

[Steve Barclay]

One of the key issues highlighted in the response to the call for evidence was how areas such as the menopause were being dealt with by the NHS. That is why we have a menopause taskforce looking at specific recommendations, one of which concerns the training of clinicians.

[Madam Deputy Speaker]

I thank the Secretary of State and everyone who took part in the statement.