Women’s Health Outcomes

Baroness Uddin Excerpts
Thursday 8th July 2021

(3 months, 2 weeks ago)

Lords Chamber

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Department of Health and Social Care
Baroness Bryan of Partick Portrait Baroness Bryan of Partick (Lab) [V]
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My Lords, I too thank the noble Baroness, Lady Jenkin, for enabling this important debate. Unlike other health comparisons, the gap between men’s and women’s health is wider in some developed countries than in some less-developed ones. The UK ranks 87th in the world for men’s health, while it ranks 125th for women’s health—38 places lower. This gap puts it 12th in the international list of women’s health inequality. How can this be?

One of the reasons appears to be the misdiagnosis of women’s symptoms, which I will come to later. A second reason is that women are more likely to live in poverty than men. Whether as single parents, unemployed, on low pay, disabled or as pensioners, women are likely to be poorer than their male counterparts.

Not all inequalities in health relate to gender. Better-off women can expect 20 additional years of healthy life than those who are worse off. Even before the pandemic, progress on healthy life expectancy had stalled and begun to go backwards. The latest figures show that less than a third of women are still in work by the time they reach retirement age. For many, this is not through choice but because they cannot find work or are actually too ill to work. We are condemning many of these women to spend the remainder of their lives in poverty.

As we have heard from several speakers, women have to shout louder to get their concerns listened to. Some of the women who have had to shout the loudest are those affected by mesh implants. The independent review chaired by the noble Baroness, Lady Cumberlege, produced its report First Do No Harm one year ago today. It found that women describing their excruciating chronic pain were dismissed as imagining it or told it was their “time of life”. The report argued that anything and everything that women suffer is perceived as a natural precursor to, part of or a post-symptomatic phase of the menopause. What do the Government intend to do to prevent so many women spending their later years in ill health and poverty? When can we expect the establishment of a redress agency, as proposed in First Do No Harm?

Baroness Uddin Portrait Baroness Uddin (Non-Afl) [V]
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My Lords, it is nearly 40 years since a group of us women set up our country’s first women’s health advocacy group, with the aim of improving both equality of access for women’s health and prenatal mortality rates for women and babies, in addition to unlocking women’s voices and choices of maternity care. According to the same project, to this day women’s experiences remain poor and unequal.

While we continue to frame minority women, particularly Muslim women, within the parameters of numerous health and social problems, including domestic violence and cultural disadvantages, Muslim women’s presence in the public square remains negligible and they are mostly absent from NHS management and decision-making boards. Some minority women, when they are in such positions, feel so constrained in their advocacy on racism, prejudice and Islamophobia that in order to avoid political rejection they feel unable to effect any meaningful changes for women, who continue to have no voice and to experience generations of poor health and inequalities, as my noble friend Lord Boateng so ably pointed out.

The experience of Islamophobia is deep-rooted, affecting every sinew of politics, policies and, therefore, services. In maternity and care services, Islamophobia has continued to impact the quality of care, attitudes and behaviours for the last five decades. It is so regrettable that women continue to experience these painful inequalities. I do hope the new strategies that the noble Baroness, Lady Jenkin, so powerfully highlighted will speak to all women in all communities.

Baroness Eaton Portrait Baroness Eaton (Con) [V]
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My Lords, I add my congratulations to my noble friend Lady Jenkin on her excellent introduction to this very important debate.

As we have heard, one of the biggest health issues for women is mental health, which has been exacerbated by the Covid pandemic. Evidence suggests, and the front-line experience of GPs I have spoken to shows, that women are more prone than men to experiencing anxiety, depression and somatic complaints. Depression is the most common mental health problem for women and suicide is a leading cause of death in women under 60. Linked to this, there has been an increase in physical and psychological problems and sexual abuse, with increasing domestic violence towards women.

During the pandemic, the resulting reduction in sexual health and pregnancy services has caused serious problems. Women’s health is incredibly important because women are frequently the cornerstone of a family’s overall health and well-being. They are carers of children, providers of home schooling and often carers of elderly, sick and/or disabled family members. There is clearly a major impact on the family when there is a deterioration in women’s health.

It is estimated that 28% of women over 65 have diagnosable depression but only 15% will receive treatment from the NHS. Ensuring that women have access to quality and appropriate care directly leads to improved health for children and families. Future service provision should mean co-producing collaborative care models that encourage service users and clinicians to engage in a shared understanding of care needs, treatment and support preferences. This agenda should prompt greater public mental health and preventive self-management. I am impressed by the work being done by Dynamic Health Systems, a company about to launch an evidence-based, artificial intelligence-enabled platform for the self-management of mental health conditions by individuals and populations. An appropriate and effective mental health service needs a gender-informed approach, with services diagnosed to take account of the differential needs of women and men. There must be recognition of the need to collect gender-informed health and social care data. If women’s mental health services are to improve, successful implementation requires a workforce trained in gender differences in mental health.

Can my noble friend the Minister clarify in his response the approach that the Government will take to wider mental health support, particularly in suicide prevention work? What support are the Government giving to the self-management of mental health through digital services such as those to which I have referred?