Women’s Health Outcomes

Baroness Greengross Excerpts
Thursday 8th July 2021

(3 months, 1 week ago)

Lords Chamber

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Department of Health and Social Care
Lord Rooker Portrait Lord Rooker (Lab) [V]
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My Lords, as the first male Member of your Lordships’ House to speak in the debate, I welcome very much what the noble Baroness, Lady Jenkin, had to say. Her opening speech was, frankly, awesome—that is how I would describe it.

I do not apologise for returning to the Marmot review, which the Minister has heard me speak about before. Inequalities in life expectancy have increased since 2010, especially for women. Female life expectancy declined in the most deprived 10% of neighbourhoods between 2010-12 and 2016-18. Female life expectancy decreased in every region save for London, the West Midlands and the north-west. Life expectancy in England has stalled since 2010, which has not happened since 1900. When health has stopped improving, it is a sign that society has stopped improving. That is all from the Marmot Review 10 Years On, published in February 2020.

Of course, health is linked to all the other conditions in which people are born, grow, live and work, together with inequalities in power, money and resources. Frankly, the Government have not prioritised health inequalities, despite the concerning trends, and there has been no national health inequality strategy since 2010. This is a national UK issue and cannot be shoved off as a devolved matter.

I have not mentioned Northern Ireland. It has suffered the same as the other three nations but one figure, set out on page 12 of Build Back Fairer: The COVID-19 Marmot Review, is unique in respect of female health. The table is titled: “Relative cumulative age-standardised all cause mortality rates by sex, selected European countries, week ending 3 January to week ending 12 June 2020”. Of the eight countries where the situation got worse—as opposed to the 11 where it got better—the UK’s four nations were in the eight, and in only one of all the countries where it got worse, it got worse for females compared to males. That was Northern Ireland. There is quite clearly something badly wrong in health inequalities between men and women in Northern Ireland for it to stick out like that among all those countries. The recommendations for change are all well known. They are listed in both the Marmot reports I have used.

I note the BMA has highlighted more targeted issues, such as those relating to domestic abuse, pregnancy and maternity services, which male Secretaries of State keep ignoring. However, the first move has to be an acceptance that things have gone really badly since 2010, when the coalition Government imposed swingeing cuts to public expenditure without any analysis of the consequences. One consequence is the stalling of life expectancy, where women have been affected worse than men.

Baroness Greengross Portrait Baroness Greengross (CB) [V]
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My Lords, I welcome today’s debate on women’s health outcomes and thank the noble Baroness, Lady Jenkin of Kennington, for bringing this Motion to the House today in an extraordinarily moving way.

We know that there are many conditions where women are overrepresented—for example in mental health, where 26% of young women have experienced anxiety, depression or eating disorders. We know that with gynaecological conditions it often takes seven to eight years to receive a diagnosis of endometriosis, with 40% of women needing 10 or more GP appointments before being referred to a specialist.

In one area of women’s health, I became aware late last year that there was a national shortage of widely used contraceptive preparations and hormone replacement therapy products. In response to my Written Question, the Minister, the noble Lord, Lord Bethell, responded that this shortage was due to

“Issues such as regulatory or manufacturing problems, problems accessing supplies of pharmaceutical raw ingredients and commercial decisions to divest certain products”,

which

“can affect the supply of medicines.”

Throughout 2020, thousands of women were not able to access their normal oral contraceptive or hormone replacement therapy products. This is one recent example of women not having access to the pharmaceutical products they regularly used, though this also happens, as we know, with various medicines that both men and women take.

I declare my interest in the register as co-chair of the All-Party Parliamentary Group on Bladder and Bowel Continence Care. Women are five times more likely to develop urinary incontinence than men. This is something many women feel uncomfortable talking about or raising with their GP. For many women, bladder continence issues can result in a loss of independence, as they feel unable to leave their homes unless they know there are accessible public toilets near to where they are going. Much like gynaecological conditions, issues with continence care can take time to diagnose and cannot always be treated. Much greater awareness is needed of these conditions and, in particular, how they impact on women’s lives.

My final point is to draw attention to some depressing findings from the 2020 Marmot report, about which the noble Lord, Lord Rooker, spoke so movingly just now. According to Sir Michael’s 2020 report on health disparities, women living in the most deprived 10%—

Baroness Penn Portrait Baroness Penn (Con)
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My Lords, I am afraid I am going to have to remind the noble Baroness of the time limit for Back-Bench contributions, given the number of speakers we have in this very important debate.

Baroness Greengross Portrait Baroness Greengross (CB) [V]
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Can I finish or not?

Baroness Penn Portrait Baroness Penn (Con)
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My Lords, I suggest to the noble Baroness that perhaps she is already over the time limit and that we move on to the next speaker.

Baroness Chakrabarti Portrait Baroness Chakrabarti (Lab) [V]
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My Lords, I thank the noble Baroness, Lady Jenkin, for leading this debate, an initiative wholly consistent, if I may say so, with her long record of campaigning on behalf of women.

Even in these days of deliberately stoked and exaggerated culture wars, there can be few who do not agree that millennia of structural inequalities have undermined women’s health worldwide. Further, it is obvious that the current devastating pandemic has magnified every such inequality on the planet. This includes the shocking, yet predictable, rise in domestic violence during necessary lockdowns, reduced access to sexual and reproductive healthcare and other vital women’s health and social services internationally.

Women are more likely to be involved in childcare, social care and cleansing, whether in the home or outside it, placing millions of them on the front line of infection. While older men seem more likely to die of Covid-19, it seems that women who survive it may be more likely to suffer from the chronic symptoms associated with long Covid. That means that every current decision in the debate about how best to either combat or live with the virus is likely to have a gendered impact.

The extent to which casting off the mask has become associated with one’s love of freedom is unfortunate indeed. I worry about the way in which some in government have become so wedded to irreversible “business as usual” from a particular date that they are risking more than necessary and perhaps forgetting that, for many, business as usual, even before the pandemic, was far from free, fair, safe or healthy.

If the Government want to honour their promise to vaccinate the planet and an earlier pledge for a new era of global Britain, they must stop siding with Germany in blocking the TRIPS waiver at the WTO and join the United States, India, South Africa and most of the Commonwealth—celebrated here earlier this afternoon—in demanding that industry shares know- how around vaccines, tests and treatment manufacture so these can be decentralised and scaled up to meet global demand.

19 July is not “freedom day”, but it could yet be solidarity day in a global race against vaccine-resistant variants and even more deaths.