Women’s Health Strategy

Baroness Merron Excerpts

Thursday 23rd April 2026 Lords Chamber

[Baroness Walmsley (LD)]

My Lords, I thank the Minister and I, too, welcome the women’s health strategy, as it includes many important objectives. In communities up and down the country, we have seen the devastating toll of sustained failures to invest in and deliver better women’s health. Women’s lives, families and economic productivity are damaged when they do not receive treatment in a timely way. Indeed, this also happens when menopause difficulties are ignored. This is because vital services remain understaffed and underfunded, while women and girls go without the care they need.

In 2022, we had the previous women’s health strategy, which had similar important goals to this one with similar delivery mechanisms and the same reliance on local systems to make it happen. Yet four years on, the problems remain stubbornly in place, with half a million women suffering long waits for gynaecology, patchy access to services, women reporting that they are not listened to, women not being given pain relief when they need it and serious conditions diagnosed too late. These facts must give the Government pause for thought that perhaps things need to be done differently this time.

Medical misogyny is still a perverse and unacceptable norm in the health service and that requires a culture change, which is notoriously difficult to achieve. How does the Minister’s department plan to go about it?

This strategy is being implemented when the NHS is already stretched and ICBs are facing cuts while, at the same time, taking on some of the responsibilities of the disappearing NHS England. Now we also have soaring inflation, due to Trump’s war in Iran. In this climate, can we reasonably expect the strategy to deliver meaningful change? I really hope so.

Although the issues affecting women’s health generally are numerous, the NHS failures in maternity services are the most widely reported and deeply shocking. Review after review has uncovered the same failures across the country: a failure to listen to women, a lack of time for training, inadequate staffing levels leading to staff burnout, a lack of proper assessment, poor management of risk and a failure to learn lessons when things go wrong. All this is leading to a rise in perinatal mortality, with the figures showing inequality between different groups, such as those on lower incomes and some ethnic minority groups. How will that be tackled by the strategy?

That is why the Liberal Democrats recently launched our maternity secure package to make Britain the safest place in the world to give birth. We want every maternity unit in the country brought up to a good or outstanding level of safety. That could be done by guaranteeing one-to-one midwifery and specialist doctors on every unit. Will the Minister consider incorporating these proposals into the new strategy?

On medical misinformation, many people now get their health advice online, particularly via social media. Long waits for NHS services and GP appointments are pushing people into getting their so-called information this way, but advice on those platforms does not adhere to clinical standards or guidelines, which is leading to rampant medical disinformation, with sometimes disastrous results. There is some evidence that this is a particular issue in women’s health, where gaps in scientific knowledge and public awareness are being exploited. Does the Minister have any plans to tackle that?

It is possible to fight back. In order to be helpful, we are calling for the following for the Minister’s consideration. The first is a new kitemark for health apps and digital tools that are clinically proven to help people to lead healthier lives, regulated by the GMC. The second is a big effort by the NHS, with a ring-fenced budget, to dominate the health advice social media ecosystem and algorithms, with clinically approved information in plain English. That could improve patient care and save staff time and costs. The third is a new verification requirement for any social media account claiming to be written by a medical professional.

I have a few more questions before I finish. In line with the 10-year health plan’s objective to make care more local, is the Minister confident that women in every area will benefit from a family health hub, as promised, without the threat of closure or cuts, especially in this time of reduced resources for ICBs?

How will the new system linking feedback from patients to provider funding work? Will the results for each unit be made public? Will improved staffing be funded to achieve the promise that women no longer face long waits for diagnosis for conditions such as endometriosis? Will we be able to hear from the Minister in the education department about the promised menstrual education programme to ensure that girls are better equipped to recognise the difference between healthy and unhealthy periods, and will the programme be evaluated by the girls receiving it? Finally and most importantly, will women themselves be involved in developing the implementation plans for the new measures in the strategy and coproduction of their communication with other women?

[The Parliamentary Under-Secretary of State, Department of Health and Social Care (Baroness Merron) (Lab)]

I thank the noble Lord and the noble Baroness on the Front Benches for their warm welcome for this renewed women’s health strategy. It represents a major shift in this country and, as the noble Lord, Lord Kamall, said, it recognises the fact that women’s voices have not been heard. It is shocking, although sadly not surprising, to know that some eight out of 10 women report not having been listened to. The noble Baroness, Lady Walmsley, talks about a culture change. The biggest culture change that we can make is to embed women’s voices into women’s healthcare, and that is exactly what we will do.

This strategy gives women and girls voice, choice and power over how they receive their healthcare. When we say that we are transforming care as part of the 10-year health plan, we mean it. I absolutely agree with the noble Lord that strategy is one thing, but delivery is another.

I was asked why this is different from the 2022 strategy. Let me first acknowledge the importance of the 2022 strategy: it was the first time we had a women’s health strategy. I spoke to the women’s health ambassador, Dame Lesley Regan, about this, and she told me that, with this renewal, we have embedded women’s healthcare in the NHS in a way that has never happened before. I have been moved and struck by the responses I have had from stakeholders, women, parliamentarians—the list goes on—because their voices were heard.

I will pick up some of the points; I am sure that a number of the points raised will come up. The matter of waiting times is key. They have improved, as the noble Lord, Lord Kamall, said—the number of patients on gynaecology waiting lists is down by over 25,000 in the same period—but there is much more to do. If I had to make just one point about this women’s health strategy, it would be that this is not the end of it but the start of the continuum of work we have been doing. How will we drive down waiting lists? I am very excited to say that, when we launch the NHS online hospital next year, we will prioritise gynaecology pathways. It is one of the limited number of pathways that there will be.

We are prioritising gynaecology for treatment in surgical hubs. We are piloting gynaecology pathways in clinical diagnostic centres, which are now in place up and down the country. We are increasing relative funding to incentivise more gynaecology procedures, as and when they are clinically appropriate. Those things are very practical and, alongside shorter waits and more convenient gynaecological care for patients, they will make that shift not only in practice but in culture.

One way in which this strategy is different from the 2022 strategy is in its considerable emphasis on measuring impact, which noble Lords have asked for. If we cannot measure something, we do not know what it is. There are three overarching measures of success: reversing the decline in healthy life expectancy, which was seen to decline in the 2010s; improving healthy life expectancy in the poorest regions to at least 61 years of age; and reducing the time that women spend in poor health, particularly for women experiencing the greatest health inequalities. That will be measured in the short, medium and longer terms. I would be happy to provide further information if required.

Women’s voices are a key focus, again in both practice and culture. We are establishing a women’s voices partnership, which means that women’s organisations, particularly those representing the more marginalised, will be able to influence national decision-making. We have described it as a direct line to Whitehall; in other words, this is not the end of the conversation. We have consulted very widely and will build on what was done with the 10-year health plan—that will continue. This has been welcomed.

In particular, we are introducing patient power payments as a trial. We will see how this goes, and I look forward to monitoring it. It will link provider funding to women’s experiences, particularly in gynaecology services, and whether a service is found wanting. The noble Lord asked about including those who are often excluded, and I absolutely agree with him. Again, culturally—to the noble Baroness’s point—women will not just have to come forward with a complaint. They will be asked, “What is your experience of care?” That is crucial. It may be that the care was excellent but the experience was terrible, and I think many of us will know about that. If that is the case, the provider will have money withheld. As I said to a former Health Minister, how do you make real change? You do it through finance, funding and systems. The money will be withheld, but it will come back into the improvement of those services. So women will not lose out, but that provider will have its feet held to the financial fire.

On the important matter of redress, we are carefully considering the work done by the Patient Safety Commissioner, and I am glad that she welcomed the women’s health strategy. I re-emphasise my deep sympathy with those who have been harmed, and I recognise the harm to those individuals and the families. We continue to look at the recommendations for redress and, as soon as we are able to make a comment, we will of course do that. In view of the time, I will just say that reducing inequalities is hard-wired throughout the women’s health strategy.

[Baroness Verma (Con)]

My Lords, on osteoporosis and post-menopause in particular, we could save a lot of money in the health service if interventions came in earlier. I am very concerned that we do not talk enough about this, and we certainly are not looking particularly at lower-income households and women, especially from minority communities, who do not always have diets that enable their bone health to be good. Will the Minister tell us what she is doing there?

[Baroness Merron (Lab)]

I would be pleased to. This is an important point because MSK conditions disproportionately affect women. We are investing in diagnosis, and this financial year we are funding 21 new DEXA scanners in priority locations. That will mean some 60,000 scans per year, so we will be upping the game in that respect. On the noble Baroness’s important point, we aim to use polygenic risk scores to identify those at higher risk. It is about being proactive, not reactive. A study by Our Future Health, which is currently focused on cardiovascular disease, will be expanded to osteoporosis and dementia in the future. As your Lordships’ House knows, we will roll out fracture liaison services in every part of the country, and we have set an expectation for ICBs to roll out community service models in line with the 10-year plan.

[Baroness Blackstone (Lab)]

My Lords, I declare an interest as the chair of the Royal College of Obstetricians and Gynaecologists trust board, which greatly welcomes this strategy. But will the Minister agree that a well-resourced workforce is vital if we are to deliver it? In this context, is she aware that an RCOG survey finds that one in five obstetricians and gynaecologists is considering leaving the profession, citing burnout, poor working conditions and, above all, staff shortages. It would be helpful if she could tell the House, in this context, exactly when the workforce plan that I know she intends to publish will actually be completed and come out. I am sure she will agree that this plan is absolutely central to delivering the new strategy that we all welcome so much.

[Baroness Merron (Lab)]

I thank my noble friend for echoing the warm response we have had from the Royal College of Obstetricians and Gynaecologists and from a number of the other royal colleges. I put on record my thanks to the royal colleges, including RCOG, for their engagement throughout to help us get to where we are. That is another reason I have confidence in this renewed strategy.

I absolutely agree with my noble friend about the centrality of the workforce and the need for a comprehensive workforce plan. The trajectory, which I looked into, is on the way up for consultants in obs and gynae: we have 3.8% more than we had in 2025 and—I was rather shocked by this figure—81.5% more than we had in 2018. That is not to say the matter is over. The workforce plan will be published in the spring—we are currently in that season, so that gives some idea to noble Lords. We have discussed in this House many times how long spring goes, but we are definitely still there.

I have just one other point. I do not wish to speak for my noble friend Lady Amos, who is conducting an independent inquiry into maternity, which the noble Lord, Lord Kamall, also referred to, but I am sure she will have a number of things to say, including about workforce.

[Lord Patel (CB)]

My Lords, my interests are well known in regard to women’s health. I congratulate the Minister on this report, which I think is a good one. The gaps are in how, in some places, it will be delivered on. But I also recognise her personal commitment to improving women’s health, and I applaud that.

I hope she will forgive me, but I observe that the strategy is called The Renewed Women’s Health Strategy for England, so there is a suggestion that there was one before. And the Command Paper number is 1558. That was the year Queen Elizabeth I came to the throne, so I presume the strategy had not been renewed since then—but I joke.

The important point I want to make is related to research. Many of the issues recognised in the report are because of failure of research, conducted over a long period of time, in better understanding the biology and molecular basis of these diseases. They are treated empirically, and when they are treated empirically, the treatment cannot always be right. We need a strategy in research that focuses over a longer period on better understanding the biology of some of these diseases and finding treatments for them. One way to do this is not by project grants in areas of research, as this report suggests, but by promoting long-term research through what are known as programme research grants. These are given over a longer period of time and competitively allocated into academic institutions to address the issue of understanding the biology of diseases in women’s health and find treatments.

Polygenic risk scores sound sexy, but they will not be the answer. They are exactly what they say they are: they are based on scores. Some of them are evidence-based, and some are not. What we need is better evidence. My suggestion and question to the Minister is this: would the Government look at the possibility of investigating, with their research institution, developing programme grant funding for a longer period for research in women’s health? If she would like a more detailed conversation, I would be delighted.

[Baroness Merron (Lab)]

I am very grateful, as ever, for that offer and the engagement of the noble Lord. To his point about Command Paper 1558, I do not think that is the year the first one or this one were published. I understand there have been that many Command Papers, but this is a cracking one, and I am glad that the noble Lord has welcomed it.

Research is extremely important, as the noble Lord identified. Through the strategy, our approach will be to research and development that actually works for, but also empowers, women. That is why I am glad we will be launching a femtech challenge fund. We want to accelerate the adoption of innovations and make sure they transform women’s healthcare. There is also an accelerator for female founders, and that is also key. I can confirm that the NIHR will be applying its new sex and gender policy. That will make sure that research is inclusive—as it has not always been in the past, as the noble Lord says—and is representative of women, and I welcome that.

On the point about the long-term research and programme grant, as we develop this work I will ensure that my colleague, Minister Ahmed, builds this in. I also offer the noble Lord a discussion, because this is an important point.

[Baroness Sugg (Con)]

My Lords, I welcome the commitment in the strategy to women’s health hubs:

“Where high quality women’s health hubs exist, they will continue to lead service delivery. In other areas we anticipate there will be a dedicated space within broader neighbourhood health centres”.


However, the guidance for neighbourhood health centres states that gynaecology is a minimum requirement, which is welcome given the waiting lists, but the women’s health hubs are not. Will the Minister explain the Government’s plan for women’s health hubs? How are they supporting and expanding the ones that are open, and how are they ensuring that women across the country do not face a postcode lottery for care?

[Baroness Merron (Lab)]

The whole point about the strategy is to ensure that the last point about a postcode lottery does not apply. Access to NHS Online will help hugely with that because it will not matter where you are. If you are referred to the NHS online hospital, you will be able to access the best without initial travel. That will help hugely.

On women’s health hubs, we are building on the pilots that were established. We are now asking integrated care boards to integrate women’s healthcare properly into neighbourhood health centres. It is a big push in the 10-year health plan and, obviously, because this is aligned with it in the women’s health strategy, it is about neighbourhood health, which I know the noble Baroness is a strong voice for. We will also develop more guidance for integrated care boards about how they provide quality and the right amount of speedy and appropriate healthcare for women in neighbourhood settings, which may well be through women’s health hubs. They have taught us a lot. I think we can probably move even further than women’s health hubs, so in that respect the pilot has been extremely helpful.

[Baroness Bennett of Manor Castle (GP)]

My Lords, in responding to the Front-Bench questions, the Minister referred to holding providers’ feet to the financial fire. I believe that she was referring to the part of the strategy that says it will empower women to have a stronger say by asking them to say whether, based on their experience, money should be withheld from providers or where it should be invested. This is returning to the idea of competition, which has done such damage to our health and education systems. Surely if a service is struggling, it needs support; taking money away from it is going to be a real problem. We know that services very often struggle in the most economically deprived areas. Does the Minister agree that reducing funding has never improved a medical system or made it safer, more accessible or better?

[Baroness Merron (Lab)]

That is an interesting invitation to consider. It would probably be helpful if I reiterate or explain better the points about the patient power payments. As I said in response to the Front Benches, its strength—by the way, I emphasise that it is a pilot—is that women’s voices are the voices that are least heard, and we know that creates the biggest problem in women’s healthcare. We know that just asking women what they think—we will be doing that, and we will be transparent in publishing the results, which will drive improvement—will not be enough. The reason for the financial point is that if the provider—it could be a private or a public provider—is not providing the right service then why can women not be heard on that? What will happen is not a cut in funding but the direction of an amount to go into the improvement of the service. In other words, at present there are no consequences for giving poor service. I do not see why women should have to put up with that.

[Baroness Nargund (Lab)]

My Lords, having served as a front-line doctor in women’s health for more than 40 years, 30 of them as a consultant gynaecologist in the NHS, I warmly welcome the new women’s health strategy and congratulate my noble friend the Minister on her efforts in making it happen. I also applaud the Government for the commitment to address the gender health gap and to tackle health inequalities in our country. Will the community hubs function as genuine one-stop clinics, with ultrasound and other facilities, to give women the diagnosis that they need without any delay, and will they take into account the needs of the local population so that women from lower socioeconomic backgrounds and ethnic minorities are not left behind?

[Baroness Merron (Lab)]

I am glad that my noble friend, with her professional experience, welcomes the women’s health strategy. I assure her that community diagnostic centres are absolutely key, as I mentioned earlier, to the ambition and intent to shift care closer to home and improve women’s experience. By their very design, they are streamlined and more convenient; they offer a wide range of tests, often in a single visit and, increasingly, same-day testing and consultation, where that is clinically appropriate. There are about 170 CDCs operating across the country; many have extended hours to fit around people’s lives—and, on the point about inequalities, we are working with local systems to make sure that they are located and developed according to the needs of the population.

[Baroness Altmann (Non-Afl)]

My Lords, I, too, welcome the Government’s women’s health strategy. I know that the Minister is passionate about it.

I want to return to the first question, on osteoporosis. In her answer, the Minister talked about the rollout of fracture liaison clinics across the country—Scotland and Northern Ireland already have 100% coverage. She mentioned the 10-year plan but did not mention that by 2030 the Government still intend to have rolled out FLCs across the country. Can she confirm that that date still exists and is still a commitment? I welcome the DEXA scanners, too—but could she comment on the comments made by some radiographers that there are staff shortages in operating those and say whether there is anything that the Government can do about it?

--- Later in debate ---

[Baroness Merron (Lab)]

I am pleased to confirm to the noble Baroness the date of 2030, which she rightly gave. I thank her for her welcome for the strategy and kind comments.

On the matter of the workforce, I again refer to the workforce plan, which we will see shortly; it will take account of the very point that she makes. I also refer to the use of technology, because this is not about standing still—it is about enhancing what technology we use, which will drive productivity improvements. With the kind of improvements that we have been talking about, we estimate an up to 21% increase in productivity, which will make a big change and take pressure off the workforce.

[Baroness Hyde of Bemerton (Lab)]

My Lords, I, too, warmly welcome this strategy and thank my noble friend the Minister for all her hard work and persistence with it. It touches on many aspects of my experience but, in the interests of brevity, I shall focus my questions and comments today on endometriosis, having waited eight years myself for diagnosis. I am delighted that the strategy includes a new programme to help young girls to grow up understanding menstrual health and when to seek help. Knowing when to seek help would have saved me many years of monthly agony, vomiting and fever, convulsed on a cold bathroom floor. I note the commitment that women with fibroids and endometriosis will be listened to at first presentation. I have had many bad experiences of clinicians over the years, so I ask my noble friend how we ensure that primary care practitioners listen at first presentation and how we embed that so that future generations of primary care practitioners continue to do so, to save many women the kinds of experiences that I and other people I know have had.

[Baroness Merron (Lab)]

I am sorry to hear of the experience my noble friend has had, and I am sure continues to have in some way. Her experience is reflective of so many women. The education programme for girls about their menstrual health, in which we are investing an additional £1 million, will be delivered through schools and community settings and is absolutely important. If I had to say one thing about the strategy, I would say to women—to us—that we do not need to put up with this. In saying that, you do not always know what is normal, and that is where education comes in and why this is so crucial. Heavy periods are potentially a sign of a number of conditions, including endometriosis, fibroids and others. We will also be working with GPs to improve diagnosis, and we have already introduced “Jess’s Rule”, where, if somebody presents three times with the same or an exaggerated condition, the GP will be required to review it.

[Baroness Shawcross-Wolfson (Con)]

I would like to add my thanks to the Government and the Minister personally for the commitment and work done to renew the women’s health strategy. Other noble Lords have mentioned maternity services. Could the Minister tell us a bit more about the timetable for the conclusion of the review from the noble Baroness, Lady Amos, and how the new maternity and neonatal taskforce will then translate her recommendations into action and fully integrate maternity and neonatal services into this women’s health strategy, as the Royal College of Midwives has called for?

[Baroness Merron (Lab)]

I thank the noble Baroness. The noble Baroness, Lady Amos, has recently published an interim report. She has been meeting hundreds of families and the national call for evidence is still going on. In the next few months, she will give her final report. The Secretary of State has already chaired a new maternity and neonatal taskforce to develop a new action plan.

We have also not waited to take action on maternity and neonatal care. We have recruited 800 more midwives. We have invested over £140 million to address critical safety risks in terms of the estate, and we are also rolling out guidance to tackle the leading causes of maternal death. This is absolutely crucial and that is why it is taking such a high priority.