Endometriosis Workplace Support

Alec Shelbrooke Excerpts

Tuesday 29th October 2019 Westminster Hall

[Alec Shelbrooke (Elmet and Rothwell) (Con)]

I beg to move,

That this House has considered endometriosis workplace support.

It is a pleasure to serve under your chairmanship, Mr Pritchard. This issue affects not just the Minister’s Department, but the Department of Health and Social Care, the Department of Business, Energy and Industrial Strategy, the Department for Education and the Department for Work and Pensions.

I thank Dr Larisa Corda, who is an obstetrician, gynaecologist and fertility expert—she is in the Public Gallery—the many hundreds of women who have contacted me, and the very brave women who have made the journey to London today to support this debate. I will not reveal the names of the people who have written to me even if they are happy for me to do so, because I want to maintain their confidentiality and ensure that it remains their choice. In opening the debate, I will cover the following areas: the disease itself; the poor diagnosis and medical expertise in dealing with this debilitating condition; its impact on women’s lives; its impact on workplace activity; and the protections that many women feel are not honoured, despite strong workplace health assessment laws.

The disease is often described as cells from the womb growing in other places, but that is a gross underestimation. I believe that that simplistic description is among the reasons why women find it hard to get employers to understand the terrible condition that they are suffering from. According to Dr Corda, since the start of this year more than 100 women have taken their lives as a direct result of this disease.

Endometriosis comes with many symptoms, which occur not just at the time of a woman’s period. The most common are abdominal cramps, back pain, severe menstrual cramps, abnormal or heavy bleeding, painful bowel movements, pain urinating, painful sex, difficulty becoming pregnant, and nausea or sickness. According to endometriosis.org, people with endometriosis are more at risk of several diseases. The risk of ovarian cancer is 37% higher than for the general public; the risk of endocrine tumours is 38% higher than for the general public; the risk of kidney cancer is 26% higher than for the general public; the risk of thyroid cancer is 33% higher than for the general public; the risk of brain tumours is 27% higher than for the general public; the risk of malignant melanoma is 23% higher than for the general public; and, according to cardiosmart.org, a heart attack is 62% more likely. That series of statistics does not describe the impact of the symptoms; I will give some real-life examples later, but the stark truth is that 30% to 50% of women become infertile from the disease.

[Tracey Crouch (Chatham and Aylesford) (Con)]

I congratulate my right hon. Friend on securing this incredibly important debate. I am sure millions of women around the country will be enormously grateful that he is raising this issue at the highest level. Does he agree that one of the challenges that many people face is that there is a significant lack of understanding of the condition? That leads to all sorts of things, including dreadful delays in diagnosis and a lack of understanding in workplaces of what the chronic pain really means to those women.

[Alec Shelbrooke]

My hon. Friend summarises the biggest issues that those women face. I will talk about the real-life experiences of the women who have contacted me, but one of the most important things—I hope other Members will expand on this—is that there are support networks out there, because women often suffer in silence. As I said, this subject goes beyond the DWP: certainly, the Department for Education and the Department of Health and Social Care have a role to play.

In June 2015, the BBC carried out a study on 15,000 women in Scotland. It found that women with the condition had a 76% chance of miscarriage, which is unbelievably high. The article reported that women with endometriosis had a trebled risk of ectopic pregnancy. The chance of premature birth was 26% and the chance of having a caesarean was 40%.

Later, I will talk about the impact on women of abnormal and heavy bleeding and bowel movement impacts, which can be distressing in the workplace. I am aware that the issue I am about to talk about falls under the authority of the Department of Health and Social Care, but it is vital to add context and explain why this disease has a knock-on effect in the workplace. I ask the Minister to ensure that this debate is fed into the relevant Ministers in the Department of Health and Social Care.

The House of Commons digital engagement team put out a survey only last Thursday, and there have been 2,610 responses, 1,083 reactions, comments and shares on Facebook, and 215 retweets. I want to cite some of the quotes from it. Again, I will not put the names out there; I will just set out the reports.

“At 18 I am currently being put through medically induced menopause to try and fight back against my endo, it’s horrific, it’s debilitating and it’s exhausting. The pain I have I cannot even describe, and two operations later I am no further to being pain free or living a normal life. My next step is a hysterectomy, I haven’t even had children yet and this is what is being recommended to me. My life has been overtaken by operations, drugs, injections, sickness, anxiety, depression and a whole load of awful nights with no sleep and no rest. I am currently finishing my A Levels and I am absolutely terrified of what life will be like after. My dream is to become a primary school teacher, but I think that dream is unachievable. How will I find an employer who will understand that I often have to lay in bed because as soon as I move I will throw up, or that I have had to have time off work because I’ve got to have my ovaries removed? It’s about time that endometriosis is taken seriously, and people understand that life is so challenging and excruciating, but we carry on, smiling through the pain, simply because we have no alternative.”

[Paula Sherriff (Dewsbury) (Lab)]

I thank the right hon. Gentleman for securing this very important debate. Like the woman whose case he is discussing, I had a chemical menopause at the age of 37, but many women have to go to the GP at least 10 times in order to be referred to a specialist. Does he agree that we should include this issue in statutory sex and relationships education, so that when young girls and women experience gynaecological problems or even heavy periods, which may be a sign of endometriosis, they seek help at the earliest opportunity?

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[Alec Shelbrooke]

I am most grateful to the hon. Lady, who speaks with a great deal of personal experience. We have been friends for a long time—since we came to this place. We are two West Yorkshire MPs, despite being on different sides of the aisle. I am grateful to her for making those points. As I said, it is important that the Department for Education and the Department of Health and Social Care take this forward. Other Members may wish to try to secure debates that are responded to by those Departments. I know that my hon. Friend the Minister will certainly feed those issues in.

I apologise for citing a lot of stories, Mr Pritchard, but it is important to set out the context. Another lady said:

“I had stage 4 (severe) endometriosis. I had a 7 year wait for diagnosis. From my referral to the hospital, I had a year and a half wait for surgery. My surgery was lifesaving as my bowel was 50% blocked with a mass of adhesions that had grown through the bowel. I was in constant pain, slept for 3 or 4 hours a day and was unable to care for my son properly, I considered putting him into care. If it wasn’t for him, I would have given up on everything. Despite being told in 2010 I ‘probably had endometriosis’ I was still given pain killers and mefenamic acid for years to manage the pain and symptoms. Throughout this time the endo was worsening, it is progressive. Had I been diagnosed earlier I may not have needed the bowel resection I needed and will have bowel issues for life. I was on the pill for 15 years, which is still considered a ‘treatment’. It is not. The same year I came off it (2010) I was at the GP with SEVERE bowel pain during my period (It was fused to my womb). The pill masked the symptoms, but it was quietly progressing. Please ban the use or presentation of the pill as ‘treatment’.”

[Stephanie Peacock (Barnsley East) (Lab)]

I congratulate the right hon. Gentleman on securing this incredibly important debate. One in five women will suffer from this disease, and it has been shown that, as that story shows, it can take up to seven years to convince a doctor. That is completely unacceptable. We have an issue in this country with what has been called the gender pain gap. We need to put more money into research and funding to look at proper cures and support for women when they need it most.

[Alec Shelbrooke]

I entirely agree with those sentiments. As I said, I hope this debate will go beyond the Department for Work and Pensions. I thank the hon. Lady for that contribution; it is spot on.

Endometriosis affects 1.5 million women in the UK. It takes an average of eight years to diagnose and there is not really a cure.

I will share a few examples from women who have spoken out through the digital platform. One said:

“I have suffered with endometriosis since the age of 15 and I was diagnosed aged 22. The worst thing about endometriosis is the lack of awareness. Even some doctors haven’t even heard of it which is very frustrating! I’ve had 4 surgeries to try to alleviate the symptoms. Unfortunately, this hasn’t worked. I want to try to basically create more awareness of endometriosis, especially online, as much as I can.”

Another woman said:

“I was diagnosed with endometriosis in May 2016. I would say 2 years was spent actively pursuing a diagnosis. But the previous 9 years I often went to the doctors, complained of pain and heavy flow and I was told ‘it’s just a bad period, it’s normal’. The hardest part of endometriosis for me would be the mental health side of things, coming to terms with the fact my body has limits and my life probably isn’t going to take the direction I thought it would.”

Someone else said:

“I was 17 when I was diagnosed with endometriosis. I’ve had 6 surgeries since. The thing I hate most about endometriosis is not being able to plan ahead because you don’t know how your pain is going to be that day. You could be absolutely fine, or you could be crippled.”

A young woman said:

“I was diagnosed with endometriosis on the 14 February last year, I was only 15. It took me 3 years to get diagnosed. For those 3 years, I was told I had unexplainable abdominal pain.”

Another story comes from a woman who said:

“I was diagnosed when I was 25 when I had a miscarriage. I had been struggling since I was a teenager with all the common signs of endometriosis. It just wasn’t picked up until I had my first surgery. What I hate most about endometriosis is that it takes time away from my children. Especially when I have to just go and rest in bed. I would love to be able to make it more aware for children, especially young girls and in schools, to be able to support them through this and see the early signs and educate GPs on the signs and symptoms.”

[Hannah Bardell (Livingston) (SNP)]

I thank the right. hon Gentleman for giving way and congratulate him on securing this hugely important debate. Does he agree that local groups, such as Endo Warriors in my constituency, which do such important work to educate young people in schools and to ensure that early signs of endometriosis can be picked up by doctors and health professionals, are absolutely vital and have such an important place in our communities and constituencies?

[Alec Shelbrooke]

I am grateful to the hon. Lady, who raises a very important point; there are many support groups out there. I will come to the workplace impact, for which the Minister is responsible, but one of the things that I want this debate to achieve is to highlight to women far and wide that there are lots of support groups in different areas of the country. More importantly, I hope that the debate will be heard by the Department for Education. To strengthen our point, we may have to come back to debate the issue with each separate Department, and we should ensure that we do so.

Another sufferer said to me:

“I have suffered with endometriosis since being 19. I had always had heavy periods and then my symptoms escalated to constant bleeding, pain on intercourse, really bad pain in the lower tummy and lower back. I was backwards and forwards from anywhere between 6 months plus, who constantly checked me for STDs. They’d do swabs, send me on my way and they’d come back clear, and I was in that cycle. I was in work one day when I was given an awareness form for endometriosis. Every symptom listed, I ticked. I’m now 36 and I’ve had 22 laparoscopies. At 29, I had a hysterectomy. When they removed my cervix, they found the endometriosis in there.”

A young woman who has given me a huge amount of help in preparing for this debate told me:

“My journey with endometriosis began when I was 11 years old, when I had my first period. From a young age I was going back and forth to the doctors for leaking through my clothes at school, just after being to the toilet. I have always been active in football and dancing but found myself struggling with the disease due to the pain, lack of energy and continued leaking through my clothes.”

We are talking about an 11-year-old girl. She continued:

“Initially I was told they thought I had endometriosis but was too young for the surgery required for diagnosis. I ended up going through surgery for a womb polyp and ovarian cysts. To date, I have now had 10 surgeries, all with general gynaecologists. Finally, I have been able to see an endometriosis specialist after 10 years of suffering. I had surgery on the 8th of April 2019 which was the diagnostic surgery I had been waiting for. The specialist surgeon found years of missed endometriosis due to untrained surgeons. Unfortunately, a shortage of worldwide endometriosis specialists means this is not uncommon for women suffering.

This disease has had a huge impact on my mental health. Alongside other personal family issues, the daily pain I have been going through has made tackling day to day life harder. Whilst I have had friends and family support me, I have also lost friends because they don’t understand this disease. I have tried to take my life multiple times because of it. The problems have also extended to my fertility. I have had miscarriages and a medically advised abortion. Not only was this a devastating and horrific experience for me but had a dramatic impact on my work life as well as personal.”

Another lady said to me:

“As soon as my periods started when I was just 12 years old, the problems began. I suffered extreme pain and heavy bleeding, to the point where I passed out several times. On speaking to my GP, I was told ‘every girl has this, it’s normal’. The doctor prescribed me oral morphine for the pain, but most of the time it barely touched it. Finally, I was offered a laparoscopy in February 2016. The surgeon told me I had endometriosis, but that they had treated it and I wouldn’t have any further problems. I was so happy and relieved, little did I know the fight was far from over. By October the symptoms had returned. On speaking to my doctor, I was told it couldn’t have come back after surgery, it was part of being a woman and I simply needed to be more positive. Eventually, I got referred to an endometriosis specialist hospital where an MRI scan showed my left ovary and bowel were stuck to my cervix and I had 100% got endometriosis back. This means more surgery.”

I am so grateful to the members of the public who engaged with the digital engagement platform. A woman from Newcastle shared her workplace experience. She said:

“I have been disciplined for being off sick. I am terrified to go off sick again, so I have to force myself to work even when the pain makes me vomit. If I go off sick again, I know they will sack me, this has been made very clear. I work for HMRC and I know this is a massive issue for other members of staff as well.”

Another lady said:

“I have been fired from all my jobs, my last workplace bullied me and mocked my illness, nothing was done via HR and I was made to leave instead. I have never had support from any workplace.”

[Gill Furniss (Sheffield, Brightside and Hillsborough) (Lab)]

I thank the right hon. Gentleman for securing this extremely important debate. As a member of the all-party parliamentary group on endometriosis, which is ably chaired by the hon. Member for Southend West (Sir David Amess), I have been privy to many of these stories. Does the right hon. Gentleman agree that a major barrier to support in the workplace is the taboo around menstrual health? Surely, we have to get people talking about that. One idea may be to encourage employers to become endometriosis-friendly, so that people get support and HR departments understand that it is a real illness and not something that someone should have to endure.

[Alec Shelbrooke]

I am grateful to the hon. Lady for that important point. That goes back to the earlier example of the lady who suffered for so many years and who got a diagnosis only when she had ticked every single box of a workplace survey. That is why we need a debate with the Department for Business, Energy and Industrial Strategy—we need to work across so many areas of Government. The hon. Lady is right: any issue of women’s health, but especially menstrual health, is still taboo. Someone asked me why I secured this debate. The primary reason is that I have worked very closely on this with a previous constituent of mine, but I also think it important that a man stands here and says that women’s health is not a taboo subject. We are all human beings and we all have health issues. We should all stick together and help everybody, regardless of how embarrassing we might find the subject. There is nothing embarrassing about health and we need to look after people.

The stories that I have given all share the same underlying theme: “I was told by doctors that it was all part of being a woman.” Given the backdrop of the personal trauma that women with endometriosis suffer—years without a diagnosis, personal relationships breaking down and strain on personal finances—they should at least be able to expect the law to protect them in the workplace, like anyone else who suffers with a disability. The truth, however, is that a whole host of employers are completely unsympathetic to the disease, and often dismiss employees because of a “poor sick record”.

[Dr Dan Poulter (Central Suffolk and North Ipswich) (Con)]

My right hon. Friend makes a very good case and highlights the challenges faced by many women with endometriosis. He will recognise that many people have other chronic health conditions, such as inflammatory bowel disease, Crohn’s disease, ulcerative colitis or rheumatoid arthritis, which can also be life-limiting in the ways that he has outlined. For clarity, is he saying that endometriosis is a special case, or do the principles that he is outlining actually apply to many other chronic health conditions, the sufferers of which often find that they are also discriminated against at work?

[Alec Shelbrooke]

Of course, all employers should support people in the workplace who have any of the whole host of chronic illnesses that my hon. Friend mentioned, but quite a few of those illnesses get diagnosed relatively easily, or in a shorter time than endometriosis. One of the problems is that there is such a long diagnosis time—I will refer to that later. The hon. Member for Sheffield, Brightside and Hillsborough (Gill Furniss) made a point about better education in the workplace. I absolutely agree with my hon. Friend the Member for Central Suffolk and North Ipswich (Dr Poulter) that this is not about singling out one disease—the whole range of workplace diseases must be covered—but it creates many issues when women cannot even get diagnosed, and cannot tell an employer, “This is what is going on.”

I was given a copy of this text message, which a lady received:

“Hey Karen,

I hope you are doing a bit better, i am sorry to hear you have so much going on physically.

We have had to pause your email access due to confidentiality as you are signed off sick. I am aware you may be off for a few months, so we will end your contact at this point as you are off for a prolonged period of time.

Should you wish to reapply when things work out for you please get in touch through the usual route.

I hope this all makes sense for you, and you can take the time you need to recover and get things back to normal.

Many thanks for all your input, and maybe hear from you again in the future.”

That last sentence perfectly encapsulates an utter lack of understanding and support that is far too commonplace.

I quote from an email I received this morning from the Open University, highlighting the work of PhD student Victoria Williams. She has given the following statistics, based on her doctoral research on the workplace:

“In a study of 7,000 women across 52 countries, over 40% had given up or lost their job because of endometriosis…Others are being pushed into part-time roles or becoming self-employed whether the motivation or support is present or not…Women lose an average of 10.8 hours per week due to pain…Women lose an average of £5,757.72 per year due to lost work days…Many suffer in silence in the workplace in a bid to protect their jobs, careers, credibility and reputation. Women live with the daily predicament of disclosing symptoms which may drive accommodations or negatively fuel workplace discrimination…Endometriosis is a condition that is closely connected to menstruation alongside a history of shame, secrecy and lack of knowledge, it is classed as a taboo topic that constrains requesting and/or receiving organisational accommodations and support. Currently there is no advice for working with endometriosis from government bodies, occupational health specialists or the CIPD.”

One woman told me,

“I have had to have extended probations, sickness meetings, ‘what are you going to do to make this better’ and you have to sit there knowing you can’t do anything as there’s no cure.”

Going back to the lady in my previous story, when she had to have the medically advised abortion, a manager said, “Should’ve worn a condom.” The lady said it was hard to describe how disgusted she was, as the manager knew what she was going through.

A catalogue of women starting jobs only to fail the probation period due to sick leave is, I am afraid, an all too common reality. However, it would be remiss of me not to name an employer that women have told me has tried very hard to help sufferers. NPower allowed one severe sufferer to work from home, on flexible working, and was understanding of hospital appointments and surgeries. Let me take this opportunity to highlight an employer that shows that it is not impossible to support women in the workplace with this terrible disease.

My ambition for today’s debate is to raise awareness, especially of support groups, such as the one that the hon. Member for Livingston (Hannah Bardell) mentioned, and others such as the Northern Endometriosis Sisters Support and Period Powerful Hub, to mention just two. I want better education in schools for young girls, as we can easily overlook the problem that a young woman with a single-parent father may have in understanding these issues. As I said, I hope that this debate will be recognised by several Departments, but I ask the Minister to ask the Department for Work and Pensions to do a full assessment of how the Department recognises endometriosis as a disability.

For too long, women with this disease have been dismissed as lazy, unreliable, dishonest and a nuisance. It surely must be illegal for a manager who is told of a sufferer’s condition to dismiss it out of hand by saying, “Should’ve worn a condom.” Women have described having to cope with blood seepage through their clothes, but another common factor can be a complete loss of bowel control, and having to dash to the bathroom unexpectedly. To have such an embarrassing and distressing situation used against them, and sometimes to be mocked in the workplace, must surely be illegal. The Equality Act 2010 is a piece of legislation we should all be proud of, but as with all law, it should evolve and change, especially when previously unrecognised situations come to the fore.

I want an assurance from the Minister that he will instruct his Department to do an assessment of how the blatant breaches of law on workplace humiliation, employment protection and, quite frankly, workplace bullying can be addressed, since this silent disease, which often has no physical appearance, can be so easily ignored by employers.

[Dr Poulter]

One of the challenges that the Minister will face when responding to the debate is that while there are medical guidelines from the Royal College of Obstetricians and Gynaecologists, and I think there are some National Institute for Health and Care Excellence guidelines on how to diagnoses and support women with endometriosis, those guidelines are not particularly well known among all the medical community. I wonder whether more should be done by the Department of Health and Social Care to improve diagnostic rates. If more women had a confirmed diagnosis, it would strengthen this Minister’s hand in taking action in the workplace.

[Alec Shelbrooke]

I was just about to say that I need the Minister to work with the Department of Health and Social Care, because without a proper medical sign-off, this situation will keep arising, and by the time a diagnosis is finally made, many women have already seen their life destroyed. The Minister will have heard my hon. Friend’s intervention.

I close with some rhetorical questions. Why is a disease that affects 1.5 million women in this country so unrecognised, and so easily dismissed? Why is there not women’s health education in schools, to help young women through their life journey and illnesses they may be suffering from? Why do we have such poor medical diagnosis? How have we been able to go so long without in-depth training for gynaecological surgeons who can help tackle this disease? Fundamentally, and pertinent to this debate, why, despite decades of work on the protection of employee rights in the workplace, do employers try to not only ignore this disease, but shuffle sufferers out of the door?

More than 1.5 million women in this country have been desperately crying out for far too long. Let today be the day that we stop failing so many women in our society.

[Several hon. Members rose—]

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[Justin Tomlinson]

I will come to that in my speech, so I ask hon. Members to be a little patient. I will cover most of the points raised.

When, of the four Departments, my Department and I were selected to respond to the debate—one of four Ministers could have been selected to respond—my initial reaction was: do I know much about this? I was contacted by a former employee, Kamya Gopal—she is happy for me to name her—who had this condition. When I employed her, we had had a conversation and made some relatively easy changes that involved being sympathetic: she had to go for short-notice GP appointments; we took into account a need for urgent toilet breaks when doing visits, making sure we were not too far away; and we took things on a day-to-day basis. For a reasonable length of time, no changes were needed. Sometimes they were, and we just accepted that, and it worked. The key thing is that it was easy for me to make those changes, and I as an employer benefited, for four years, from a really valuable member of my team. It was a win-win from having the confidence to have that conversation. She made it clear to me—this has come across clearly in hon. Members’ speeches—that it affects everyone differently. For her, it is a family trait, but they all have different symptoms and challenges to overcome. It all comes down to having that conversation.

Linked to that, another impact is the need to use disabled toilets. Kamya has a RADAR key—it is a hidden disability—and recently someone challenged her for using the disabled toilet. She had to explain, which was embarrassing for her and for the lady who challenged her. That is why I pay tribute to the hon. Member for East Lothian (Martin Whitfield), who has been championing Grace’s sign, which is fully supported by my Department, to raise awareness of hidden disabilities and hidden health conditions and avoid those confrontational, embarrassing situations.

It is important that people with health conditions get the support that enables them to stay in work, and productive in work. Such support is wide-ranging and relies on employers being open to discussing health matters with their employees in a respectful and constructive way.

I am on my fifth Secretary of State as a Minister in the DWP, and I have many roundtables with different stakeholders. We were talking about disability employment yesterday, and it was interesting how there has been a shift in focus to ensuring that people do not drop out of work due to disability or a health condition. Collectively we must do much more in that area. I am encouraged that there is increasing awareness and recognition of hidden disabilities, and hidden health conditions in particular. There is still a huge way to go, but there is a willingness in society to do better.

Endometriosis is a serious condition; we have heard about the ways that it can be debilitating. For the estimated one in 10 women in the UK who suffer, the condition can have a huge effect on their daily lives, including their ability to work to their full ability. As the examples quoted by various Members today show, diagnosis is not always straightforward. Problems arise because symptoms can vary significantly, and because diagnosis tends to require invasive procedures. I do not profess to be a health expert, but it is clear that because endometriosis is seen as a taboo, that will impact on the ability to diagnose and provide support. Members have spoken powerfully about how we have to do much more in that area.

The challenging nature of the condition is recognised within the health system, which now has specialist training. NHS England has developed a service specification for severe endometriosis under the specialised commissioning area of complex gynaecology. That is a good step. It is the beginning of the journey and we will have to see what difference it makes, but I am encouraged that it is starting to happen.

Through these measures diagnosis and treatment should improve, but we must also consider the effect on the ability to work. A survey by investment firm Standard Life found that one in six women with endometriosis report having to give up work because of the severity of their symptoms, with almost all—some 87%—reporting that the condition affected their financial position in some way.

Individual women feel the harmful effects, but employers and the economy as a whole lose out. The leading charity, Endometriosis UK, has estimated that the total cost to the economy of the condition is £8.2 billion; the cost from loss of work is a key contributor to that figure. As outlined in the Work Foundation report, such an impact means that the days of dismissing topics such as these as “women’s issues” are long gone. We know that both the health and work landscapes must be more aware of the condition and its symptoms, for the sake of the women who suffer from it and in order to build a healthier and more productive society for all.

One way that people in work are protected is through the Equality Act 2010, which is the principal means through which disabled people are protected from discrimination in Great Britain. Other than for a very few exceptions, the Act recognises a disability by the impact on the person’s life rather than by the condition itself. Importantly, that means that women with endometriosis are protected by the Act if their condition has a substantial and long-term adverse effect on their ability to carry out normal day-to-day activities. I recognise the points that have been highlighted about how we need to improve the awareness and the enforcement of the Act, and about wider support. I will come on to some of the work in that area.

Individuals are also protected in law against unfair dismissal. While those legal protections exist, sufferers continue to face barriers to work and barriers in the workplace, as we have heard. More must be done to raise awareness of hidden conditions. Workplace cultures must adapt to spread understanding of the importance of supporting individuals with health conditions and the value of open discussions about health in the workplace.

[Alec Shelbrooke]

Can my hon. Friend pick up on the specific point that was raised about HMRC by myself and the hon. Member for Livingston (Hannah Bardell)? I absolutely agree with what he is saying, but it seems like an easy starting point to address that point with a Government Department.

[Justin Tomlinson]

Yes, absolutely. HMRC has been named and shamed in this debate; we will make sure it is made aware of that. I hope and expect that it will act to improve on that.

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[Alec Shelbrooke]

I thank every single right hon. and hon. Member who has contributed today. Given the times we are going through, it goes to show the strength of parliamentarians from across parties that we have come together to deliver a clear message about where we want to get to as we move forward.

My main aim today was to raise the issue further into the public perspective. I welcome the Minister’s words; I know the APPG will be feeding into that. I am excited by the fact that the issue is now with the Cabinet Office, so that it can look at it across Departments. We have made it clear—all coming at the subject from different angles—that we need different Departments to get a handle on the issue if we are to sort it out.

I pay personal tribute to the hon. Members for Sheffield, Heeley (Louise Haigh) and for Dewsbury (Paula Sherriff). Many of us in this Chamber suffer from health issues, but not many of us are brave enough to stand up and say what they are. People who inspire other people make change possible. Being able to look at someone who is in the position of being a Member of Parliament and say, “That person has the same thing I am suffering from,” hopefully lets the word spread. Fundamentally, we have to break down the taboos. We have to educate better in the workplace and use the education system we have, but we have to break down the taboos. We have made a good start today.

Motion lapsed (Standing Order No. 10(6)).