Women’s Health Outcomes

Baroness Fraser of Craigmaddie Excerpts
Thursday 8th July 2021

(3 months, 1 week ago)

Lords Chamber

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Department of Health and Social Care
Lord Sikka Portrait Lord Sikka (Lab) [V]
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My Lords, I thank the noble Baroness, Lady Jenkin, for this debate.

The key to reversing poor health for women is ensuring that the Government provide a range of public services related to women’s health, child and family care, domestic violence and reproductive and sexual health, as well as a just redistribution of wealth and income. Fiscal and welfare policies have major consequences for women but government announcements are rarely accompanied by any gender impact assessment.

Wage freezes for public sector workers have hit women the hardest, as many occupy low-paid jobs, but there has been no gender impact assessment even though poverty levels are higher for female-headed households. By freezing personal allowances, the 2021 Budget will force poorly paid women to pay more in tax. The 107 pages of the Budget document uses to the word “women” just three times. Childcare was not even mentioned. Some 46% of mothers being made redundant say that lack of childcare is a major factor in their redundancy.

The Government are cutting universal credit by £1,040 a year. That is not accompanied by any assessment of the impact on women. Janet Mackay from Oxfordshire wrote to me. She stated:

“My disabled daughter can’t just get a job and this cut will lower her quality of life. It’s monstrous to do this to the disabled.”

Despite gender inequalities, the Government raised the state pension age to 66 and deprived millions of 1950s-born women of their state pension for six years. The impact assessment said little about the quality of life for women. It does not get any easier after retirement either. As a fraction of average earnings, the UK state pension is one of the lowest in the industrialised world. The charity Independent Age has reported that 2.1 million pensioners are living in poverty and 1.1 million in severe hardship. People aged over 85 are most affected, and women are worse affected than men.

I therefore ask the Minister to give a public undertaking that all fiscal and welfare policies will be accompanied by an impact assessment from women’s perspective.

Baroness Fraser of Craigmaddie Portrait Baroness Fraser of Craigmaddie (Con)
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My Lords, I, too, thank my noble friend Lady Jenkin of Kennington for this important debate and for her awesome—as the noble Lord, Lord Rooker, described it—opening speech. Given the time constraints, I simply want to make two points.

First, women’s health is not only important for all the reasons noble Lords have already outlined. Women’s health issues have far-reaching implications beyond just the health of women. When looking at positive outcomes for families and children, particularly disabled children, the burden of care still, in 2021, falls disproportionately on mothers. Therefore, ensuring continued good health for women has consequential effects on the well-being and good health of the rest of the population, as well as on women themselves.

Secondly, I want to address the importance of data, including what data we are collecting, how we are collecting it and what we might do with it to improve women’s health outcomes. Good data can ensure that women’s issues are addressed in research and lead to practical improvements in service delivery. NHS Greater Glasgow is currently undertaking a project funded by the Scottish Government to develop an epilepsy register for Scotland so that appropriate continuous care can be successfully delivered. I declare an interest as, in my capacity as chair of the National Advisory Committee for Neurological Conditions in Scotland, I have been able to monitor the progress of this work. The project team has started by focusing on women with epilepsy because, as was previously noted by the noble Baroness, Lady Walmsley, there are risks associated with pregnancy. In particular, taking epilepsy medicines containing sodium valproate can cause serious harm to an unborn baby. The project has identified who holds what data: GP, consultant, midwife or pharmacist. These data sources may not even talk to each other but, once the data has been gathered, consultants can cross-reference to see who is taking what medication, whether medication is being missed and whether appointments are being missed so that the highest-risk women can be identified and their care actively managed. Early results are showing that the development of a register is leading to significant improvements in outcomes for women with epilepsy and their babies.

This is just one project in one area covering one condition. I hope that this work will find a way to be scaled up to cover more conditions in more areas. Think what could be achieved if we were able to ensure that the information gathered and stored regarding women’s health could be co-ordinated in such a positive way, for it remains the case that if you are not counted, you do not count. I believe that the Covid pandemic has illustrated the importance of robust health data and has given us the impetus to ensure that such data is co-ordinated across services. I ask that the Government’s first women’s health strategy for England ensures that women’s health data is identified, collected and used to inform service improvements so that we can see actions and results to improve women’s health outcomes.

Lord Young of Norwood Green Portrait Lord Young of Norwood Green (Lab) [V]
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My Lords, I, too, thank the noble Baroness, Lady Jenkin, for this debate and for her thoughtful and informative intro. She pulled no punches—rightly so—in her description of the often painful lifelong journey of women and girls. I welcome the statement by Nadine Dorries, the Minister for Patient Safety, on the government-led women’s health strategy—the first one.

In May 2020, in response to a Written Question on whether hospitals were required to provide single-sex services, including spaces for patients, the noble Lord, Lord Bethell, said that the revised guidance on delivering same-sex accommodation published by NHS England and NHS Improvement stated that

“providers of National Health Service-funded care are expected to have a zero-tolerance approach to mixed-sex accommodation, except where it is in the overall best interest of all patients”.

Many NHS trusts interpret that in a number of ways that are not always conducive to the health and treatment of women and girls as patients. As many noble Lords have said, we should be listening to patients and seeking examples of best practice. Women often favour single-sex wards for good reason. Rates of sexual assault are far higher in mixed-sex wards. In 2009, Channel 4 discovered that almost two-thirds of sexual assaults by patients occurred in mixed-sex wards.

The Minister stated that there were

“no plans to withdraw the guidance.”

Can I suggest to the Minister that he reconsider this whole issue? He also stated:

“NHS trusts have not been asked to provide the information required to make an assessment of the impact of allowing patients to self-identify their gender and there are no plans to ask them to do so.”

There are many examples of assaults on women in mental hospitals and other areas. Surely we recognise that, when women enter hospital, they do so to experience a calm, safe and non-threatening environment. I ask the Minister to meet Peers concerned about this issue.