Endometriosis Services

Debate between Luke Evans and Mims Davies

Tuesday 24th March 2026 Westminster Hall

[Dr Luke Evans (Hinckley and Bosworth) (Con)]

It is a pleasure to serve under your chairmanship, Mr Dowd. Hon. Members have share powerful and distressing stories and experiences from their constituents. They are typified by Monica and I pay tribute to her for coming here to explain her story.

We must recognise the reality faced by many women and girls living with endometriosis. For too many, it means years of pain and possibly being dismissed, and it definitely means lives put on hold. From a GP’s perspective, the diagnosis is frequently delayed because symptoms overlap with other conditions such as fibroids, adenomyosis, irritable bowel syndrome, PCOS or pelvic inflammatory disease.

However, this debate is really about access, and there is a risk that current changes will make access worse, not better. The hon. Member for Ipswich (Jack Abbott) is a stalwart for raising that point as a central issue. The last Government drastically increased testing. They rolled out 161 community diagnostic centres across the country, which carried out ultrasounds, MRI and CT scans, and blood tests. That has helped with diagnosis by ruling in endometriosis and, equally importantly, ruling it out. That is not to mention the elective surgical hubs, 48 of which were delivering gynaecological procedures by March 2024. Those were important steps, but capacity remains constrained.

The first women’s health strategy, which committed to reducing diagnostic times for endometriosis, was also published in 2022. That strategy is now due to be renewed. In March 2026, the Women and Equalities Committee published a report from its inquiry into the menstrual health of girls and young women, which states that women’s health has not been “sufficiently prioritised” in recent proposed reforms to the healthcare system. The Government’s plan to renew the women’s health strategy is an opportunity to do so. Will the Minster confirm that those recommendations will be considered, and confirm when the renewed women’s health strategy will be published?

[Mims Davies (East Grinstead and Uckfield) (Con)]

The points my hon. Friend makes, as a clinician and an MP, are very important. Eleanor, my constituent from East Grinstead, has faced dismissal and delay. She has multiple issues, including pelvic congestion, which she says have ripped her life apart. Will my hon. Friend talk about the impact on A&E if that health strategy does not work? Far too many women see their symptoms as normal and extreme pain is dismissed too easily, which can lead to A&E trips.

[Dr Evans]

I am grateful to my hon. Friend for raising her constituent’s case; Eleanor must be suffering, and the aim is to try to get more people into primary care so they can get the support that they need. That view is shared by both sides of this House and that leftward shift into primary prevention would be helpful. Access will be crucial, which is why some of the Government’s changes to that access—which I will touch on later—are concerning.

Women’s health hubs were intended to improve access to care for menstrual problems. They were rolled out by the last Government with £25 million of investment and 39 out of 42 were in place. However, after Labour came in, it removed the national targets in January 2025, leading to an article from the Health Service Journal in April 2025 that stated:

“Most integrated care systems lack a women’s health hub offering full services—contrary to government claims—according to research seen by HSJ.”

It is not clear whether those numbers have improved and what the situation now looks like. I ask the Minister to provide any updates she has on those women’s health hubs, how they are functioning and whether they are fully operational; if she does not have that information—I know she is a new Minister—I would be happy to receive a letter on that.

That leads on to Endometriosis UK pointing out that there have been shortages in trained clinicians and diagnostic specialists. We know that as we expand community diagnostic centres, that will be really important. Under the last Government, there was a workforce plan. We have heard talk of a workforce plan, but it has been delayed multiple times by the Government. I wonder whether there is a date for when that will be finalised, because it is really important.

Finally, the heart of this debate is access to primary care. In a debate on endometriosis at the start of this month, the Minister for Secondary Care said:

“We have introduced Jess’s rule, which requires GPs to rethink diagnoses for their patients.”—[Official Report, 5 March 2026; Vol. 781, c. 1068WH.]

That rightly encourages GPs to rethink the diagnosis and refer when needed, but at the same time, every referral will now have to be routed through advice and guidance. In effect, it is moving to a single point of access, with a system explicitly aimed at diverting a significant proportion of referrals back to GPs. The new advice and guidance are aiming for about 25% of GP referrals to be diverted back to GPs for “10 high volume specialities”—of which gynaecology will be one—meaning one in four referrals will be bounced back under the neighbourhood health framework released 17 March.

On the one hand, GPs are told to refer; on the other hand, the system is designed to send those patients back, which risks patients being kept on waiting lists and away from secondary and specialist care. That really matters for endometriosis. It is a perfect test case, and the new NICE guideline is crystal clear. Recommendation 1.1.3 states:

“Gynaecology services for women with suspected or confirmed endometriosis should have access to: a gynaecologist with expertise in diagnosing and managing endometriosis, including training and skills in laparoscopic surgery; a gynaecology specialist nurse with expertise in endometriosis; a multidisciplinary pain management service; a healthcare professional with an interest in gynaecological imaging and fertility services.”

All those services are gatekept as secondary care. Someone might have a normal scan in primary care, primary care treatments might fail and a GP might know that they will need to be referred to a specialist—yet they will not be able to get access. Women’s waits could become longer, not shorter. I have tabled multiple parliamentary questions on advice and guidance and have received only holding answers, despite the changes coming in on 1 April.

I ask the Minister three questions. First, does she accept that mandating advice and guidance risks delaying referral? Secondly, how will this system avoid conflicting with Jess’s rule? Thirdly, will GPs retain the ability to refer directly into secondary care when clinically necessary?

Endometriosis is already hard enough to diagnose and treat; for patients, it is harder still. If access is to improve, the Government must set out clearly how this new system will work. If they cannot do that, they risk making access worse, rather than better—and that is something none of us wants to see.