Women’s Health Strategy

Baroness Thornton Excerpts

Tuesday 9th March 2021 Lords Chamber

[Baroness Thornton (Lab)]

My Lords, we welcome this Statement, made yesterday on International Women’s Day. We believe that the six pillars it outlines are important signals of the need to take women’s health very seriously. It is welcome that the Government want to understand the plight of women throughout the country. However, although the Statement says that this strategy is the first of its kind, that is not the case. For example, when the Government launched the women’s mental health task force in 2017, the Minister responsible for mental health at the time, the honourable Member for Thurrock, Jackie Doyle-Price, said:

“This report is a call to action for all providers, commissioners and practitioners across the health care system to drive forward the ethos of trauma- and gender-informed mental health care.”


That is absolutely right, but we have to ask: why are the Government asking exactly the same questions four years later? The three matters that I want to raise with the Minister are: the questions that arise out of the effect of Covid on women’s health and well-being; the troubling matter of breast cancer and sexual health; and the implementation of the recommendations of the Cumberlege report.

Analysis of Covid-19 data from around the world suggests that men make up a higher share than women of reported hospitalisations, intensive care admissions and deaths, but the impacts of the pandemic extend far beyond health outcomes for people who have been infected with the Covid virus. There have also been significant economic impacts from measures adopted to control the spread of the virus, and those have affected women in specific ways. For example, what support can be offered to a woman who experiences baby loss without her partner by her side?

The Statement is right to highlight the fact that black women are four times more likely to die in pregnancy or childbirth. I welcome the launch of the forum but the Government have known about these inequalities for many years. Now we need to see some actual investment and action.

Covid-19 has worsened the mental health crisis among young women in the UK. Before the pandemic, young women aged 16 to 30 had the worst mental health of any age and gender group in the population. In the last 12 months those in this same group have experienced a bigger fall in their mental health than any other. The mental health of teenage girls and young women is now a very serious health issue. This will need some investment and attention in the call for evidence launched yesterday.

I turn to the issue of working mothers and the increase in the burden of care. The Government were quite rightly criticised for their sexist “Stay at home” advert depicting women doing schooling and housework. I am very glad it was withdrawn at short order. But this is the reality of the lockdown in many households with young children. The pandemic has revealed stubbornly persistent gender stereotyping in the division of domestic labour. It has shown that men and women are not equal when it comes to unpaid childcare and housework.

Before the pandemic, women did more than 60% of home childcare. When schools and childcare closed during the first lockdown, they took on roughly the same share of the massively increased burden of additional care. Evidence from the ONS indicates that women have taken on even more of the burden of home-schooling during the 2021 lockdown. Two-thirds of mothers, compared with half of fathers, report that they have personally home-schooled their children. Half of those who have done home-schooling report that this has negatively affected their mental health and well-being.

Looking at older women, before the pandemic, those aged 70 and above enjoyed a relatively high level of mental health compared to the population as a whole. But they have experienced one of the biggest falls, far greater than that of older men. An important factor is of course that older women are likely to experience a higher level of bereavement, since older men have a higher risk of death from Covid-19. We have seen a higher level of grief following deaths, with the inability to say goodbye to loved ones. The cost of grief has received relatively little attention from economists, with some notable exceptions, but it is a very important factor in the mental health of older women in our society. The cost of grief needs to be factored into this inquiry.

Women are still being misdiagnosed in 2021, with male bodies being seen as the default body. There is a huge historical data gap in understanding women’s health needs. It is shocking that women are 50% more likely to be misdiagnosed following a heart attack, simply because their symptoms differ from those of men. The research of the government commission needs to bridge that divide.

I turn to breast cancer specifically. Almost 11,000 women in the UK could be living with undiagnosed breast cancer because of the Covid-19 pandemic, according to new analysis by Breast Cancer Now. It says that 10,700 fewer people were diagnosed with breast cancer between March and December than one would have expected. That data has to be factored into this commission of inquiry.

I turn now to women’s sexual health. Jo’s Cervical Cancer Trust said that

“600,000 tests failed to go ahead in the UK last April and May … in addition to a backlog of 1.5 million appointments missed annually.”

Thousands of IVF cycles were cancelled or postponed in the early stages of the pandemic, with many clinics then facing a backlog of patients. Again, this needs to be factored into this research.

One of the most potent symbols of how the health service fails women is that identified in the report of the noble Baroness, Lady Cumberlege, First Do No Harm. It shows decades of women being ignored and dismissed by the medical profession and all of those in it. The report talked of the

“disjointed, siloed, unresponsive and defensive”

health service not adequately recognising the needs of women over decades. Surely the best way to mark International Women’s Day would be to commit to implementing all the recommendations in that report, would it not?

[Baroness Brinton (LD) [V]]

My Lords, the warm words in this Statement regarding women’s health inequalities are certainly a start, but there is so much to do. Many of us in your Lordships’ House have been working on the Domestic Abuse Bill, where looking at access to health and mental health support for victims—the vast majority of whom are women—has exposed that there is a major problem.

Mental health has been brought into sharp relief, as the noble Baroness, Lady Thornton, has already said. But we know that it has been underfunded, and services pre- pandemic were already at breaking point. The pandemic has really exposed these shortcomings. What are the Government going to do to provide that parity of mental health services they committed to in 2015, which women in particular are finding difficult to access?

The Statement talks about women’s experiences of specific services. For pregnancy and maternity support, the pandemic exposed that, for far too long, pregnant women have been isolated and their partners not permitted to be with them. My own niece had a baby during lockdown and was not particularly well. When she went in for her weekly tests, not knowing whether she would have to stay in until the birth, her husband was not allowed into the hospital with her until she was actually in the delivery suite. That caused tension for far too long.

We have also seen that the vital role of health visitors and community nurses, which has been curtailed somewhat, is absolutely evident when they are not there. Community services for young mothers are really important, and I hope the Government will look at that.

The Statement talks a lot about endometriosis. I was diagnosed with endometriosis well over 40 years ago. I am pleased to say that treatment in hospitals has advanced considerably since those days. But what seems not to have changed is diagnosis and referral. I ask the Minister this: what support is there to train all GPs, primary care nurses and employers to recognise when women have these problems? They should not be dismissed as “a bit of a bother” because all women have a problem at that time of the month. It is not just an information issue for women themselves to recognise it. We need the professionals and the business community to understand that endometriosis is a very serious illness.

The Statement notes that

“77% of the NHS workforce and 82% of the social care workforce are women”.

They are absolutely on the front line but too often have been let down. Despite that enormous ratio of women in the workforce, there are still pay gaps—certainly at a higher level. It would be interesting to see the publication of the percentage of male and female staff at each level and for all trusts and CCGs to publish their pay gaps on an annual basis, as we ask large companies to.

We also know that a higher percentage of BAME women were at risk of serious Covid and death. This was particularly amplified for our front-line NHS and social care staff.

I echo the points raised by the noble Baroness, Lady Thornton, about caring responsibilities. It is not just about care for children who are home from school. The pandemic has brought into sharp relief the unpaid carers of adult family members. I would like to make a call out, and I hope the Minister will support me: when it is time for every one of us to fill in our census form in 10 days’ time, please will unpaid carers tick the box saying that they are carers? We need to know how many people out there are doing this. We know that the majority of them are women.

The Statement talks about issues facing women with disabilities. Yesterday, it was wonderful to see a series of tweets from disabled women about their lived experiences in our society. Some of it, especially on access to health services, was pretty depressing too.

Women with learning difficulties are also often at the end of the queue for health treatments. Ciara Lawrence, who is a Mencap ambassador, is an absolute shining example of how women with learning difficulties can get access to those services. She went for her cervical smear test a year ago. Since then, she has not only been promoting it among other young women with learning difficulties but is teaching the NHS how to work with women with learning difficulties to encourage and support them to have their tests. Women with learning difficulties also say that access to family planning services can often be harder too. Will the Government make sure that these issues for this group of disabled women are addressed?

The paper refers briefly to LBGT women, who also face particular difficulties in accessing services throughout their adult lives. What will the Government do to reach both these groups? I note that, towards its end, the Statement talks formally about working with women’s organisations, but so much will be missed if women who also have other protected characteristics—and their organisations—are not specifically asked.