Menopausal Symptoms: Support

Rosie Duffield Excerpts

Wednesday 9th June 2021 Westminster Hall

[Rosie Duffield (Canterbury) (Lab) [V]]

It is a pleasure to serve under your chairship for the first time, Ms Ghani. I thank my hon. Friend the Member for Swansea East (Carolyn Harris), the deputy leader of the Welsh Labour party, for securing the debate today and for all that she is doing to raise awareness of this and many other women’s health issues.

Menopause will affect the vast majority of women, with some experiencing menopause earlier as a result of cancer or other health conditions. I have friends who have gone through it who then have the added stress of having to explain to others why they are unable to have children, or to share their medical histories. There seems to be such a lack of awareness and understanding of issues around the menopause. It can still feel like a bit of a taboo subject.

The menopause is, of course, a women’s health issue, so quite why the House of Commons titled today’s debate

“support for people experiencing menopausal symptoms”

is a bit of a mystery, particularly when the House of Commons Library report uses the word “women” throughout. Like all mostly women’s health issues, there is often difficulty with our being able to access the right help or support, or even the most basic information. Like many women in Parliament, I am in the age group most likely to be experiencing menopause and, like most women I know of my age, we rely on personal and professional friendship groups for sharing information and our own experiences. We talk to each other and usually find that every one of us will have had some similar, but also some very different, symptoms. It is often hearsay, rumour, second-hand or third-hand stories, shared articles or scraps of advice that are our main source of information about this major life change and huge change to our bodies.

My constituent, Elizabeth Ellis, started her campaign group 50Sense and the campaign “Know Your Menopause” to inform women after she could not get any help and support when she was first going through the menopause herself. How many times do politicians meet people like Elizabeth, who have used their own life experiences to become an expert and a champion in order to help others?

50Sense’s Pausitivity campaign produces a variety of really useful information, as well as posters that people can print out and put up in their workplaces and ask GPs to display. I encourage anyone who wants to know more to find the pausivity.co.uk website and download the great resources, including questions to ask GPs. Of course, that includes men. As husbands, partners, friends, colleagues and responsible employers, they ought to find out as much as they can, too, about this big event in the life of almost every woman they know. I hope hon. Members will note that I left sons out of that list, as, if I am being honest, I know that mine really do not want me to discuss my menopause with them, as lovely as that might sound.

Elizabeth, my constituent, and so many other women like her, should not have had to go back and forth to the GP for almost four years, with symptoms that she now knows were quite obviously the menopause. She was sent to A&E with heart palpitations and was even asked more than once if she was a cocaine user. If she had seen one of the Pausitivity posters she has now produced, it would surely have saved her a huge amount of distress, not to mention the NHS a lot of money. Another constituent, Michelle, had a surgical menopause and, because of the horrendous symptoms and lack of NHS treatment, was forced to go to a private consultant and spend a lot of money because the support she needed was not there. These women are not alone. Menopause cafés such as those mentioned by the Under-Secretary of State for Transport, the hon. Member for Redditch (Rachel Maclean), in the last menopause debate are popular places for women to support each other and share stories. It is extremely common for many women to become almost suicidal with the lack of understanding or help available.

We need to end the postcode lottery or luck element of menopause support. All GP surgeries should have someone available to advise or support women, or should display a poster, so that they know what they are going through is perfectly normal. GPs and healthcare professionals can inform women about local support groups and menopause cafés. We need easy access to fully funded HRT treatment. Men too should also familiarise themselves with some of the facts. After all, most people in the UK are female and at some point will go through the menopause. I urge everyone to log onto pausitivity.co.uk or watch the excellent documentary produced by Davina McCall for Channel 4 recently.

[Ms Nusrat Ghani (in the Chair)]

To ensure that all the speakers get in, we must impose a time limit of four and a half minutes.

Coronavirus

Rosie Duffield Excerpts

Tuesday 15th September 2020 Commons Chamber

[Matt Hancock]

I understand my right hon. Friend’s point. We do understand the impact of the rules that we have to put in place. It is the same around the world: the rules that need to be put in place to deal with a pandemic are not pleasant ones or ones that anybody would want to have in force, but unfortunately they are necessary to save lives. Sadly, we are seeing the consequences, including in some of our closest neighbours, of what happens if we do not take the action that is needed.

[Rosie Duffield (Canterbury) (Lab)]

Although I am sure that many ordinary people were thrilled to learn that the Government’s rule of six does not apply to so-called sports such as grouse shooting, for which up to 29 people can mingle, expectant mothers in my constituency and throughout the country are unable to take their partners to crucial checks during pregnancy. Currently, individual health trusts are left to make decisions on this issue, leading to a postcode lottery. Is it not time that the Government stopped passing the buck, as they did to school leaders, and instead provided national leadership across the country on matters as vital as maternity care?

[Matt Hancock]

I have a huge amount of sympathy with the case that the hon. Lady makes. In fact, last week we changed the guidance on this issue to allow partners to go with pregnant women to these sorts of tests and, of course, to the whole of the birth. The Minister for Patient Safety, Mental Health and Suicide Prevention, my hon. Friend the Member for Mid Bedfordshire (Ms Dorries), is responsible for this issue and leading on it, and we have made some significant progress in the past week. I commend the campaigners who are pushing so hard to make sure that each hospital follows the new guidance so that people can have a loving partner with them during these very special moments.

Covid-19

Rosie Duffield Excerpts

Monday 16th March 2020 Commons Chamber

[Matt Hancock]

As the hon. Gentleman knows from my previous answers, that is not the way we are addressing this question. The way we are addressing it is that we will buy as many ventilators as are made. It is not a question of putting a target on it. We are just going after as many as we possibly can.

[Rosie Duffield (Canterbury) (Lab)]

Gaps in NHS capacity, particularly in mental health services, have been filled in recent years by excellent local charities in my constituency such as Home-Start, which supports isolated, disabled and terminally ill parents in their own home. However, it has now almost completely run out of money. How does the Secretary of State suggest that I support such charities to continue, now that we need their services more than ever?

[Matt Hancock]

To the extent that the charity, to which I pay tribute, can support the local effort, the hon. Lady’s local CCG will be best placed to make that judgment.

Maternity Services: East Kent

Rosie Duffield Excerpts

Thursday 13th February 2020 Commons Chamber

[Ms Dorries]

My right hon. Friend is absolutely right. One of the issues in dealing with the ongoing problem—this is a bit like the airline industry—is that we need to generate a culture in which NHS staff feel able to speak up without fear of blame or litigation and we can take learning forward. Another issue is that when we have inquiries, we should take the recommendations and ensure that they are implemented. That piece of work is also going forward, along with HSIB and inquiries. We should look at implementing absolutely everything that we can to make sure that the safest possible environment exists.

[Rosie Duffield (Canterbury) (Lab)]

I am extremely grateful to the Minister for addressing these urgent issues and to the right hon. Member for North Thanet (Sir Roger Gale) for securing the urgent question, as well as to the former Health Secretary, the right hon. Member for South West Surrey (Jeremy Hunt), who has shown a real interest in this case—especially now that he is Chair of the Health and Social Care Committee. I thank them very much.

I am grateful that we are talking about these inquiries and investigations. So many things have been brought up in the reports, and there are many questions from my constituents, dozens of whom are now really terrified about their future pregnancies and having babies in the area. Will the Minister think about committing to safe staffing levels, because there are so many issues in our trust, and that would be one way to reassure staff and patients?

[Ms Dorries]

I thank the hon. Lady for her commitment to working with her constituents, which is shared by my right hon. Friend the Member for North Thanet (Sir Roger Gale) and my hon. Friend the Member for Dover (Mrs Elphicke). I think that we should refrain from using words such as “terrified” because, as I said, the trust is a safe place for any woman to give birth. We have the best midwives, obstetricians and neonatologists from outstanding trusts working there now. She will know, as I do, that the trust’s location is slightly remote. Recruitment outside the major cities is a difficult issue, and we have to look at that for maternity services in trusts that are outlying in geographical terms. She is absolutely right to raise that issue, but I reiterate that it is very important that she lets her constituents know that the trust is a safe and welcoming place for women to go and give birth, because some of the very best staff in the country are working there right now and making sure that that is the case.

Oral Answers to Questions

Rosie Duffield Excerpts

Tuesday 28th January 2020 Commons Chamber

[Jo Churchill]

I am delighted to join my right hon. Friend in congratulating Jo’s Cervical Cancer Trust on the work it does. I had the pleasure of meeting its team only last week, who do fantastic work to raise awareness of vital cervical screening. He is right about Mike Richards’s review. We must ensure that we screen all the available population in order to see cervical cancer eliminated for good, which would be brilliant. I am delighted to support this year’s “Smear for smear” campaign. There is nothing shameful about human papillomavirus, and we must bust the myths, because being tested can save someone’s life.

[Rosie Duffield (Canterbury) (Lab)]

Following the desperately upsetting news headlines last week about preventable baby deaths at East Kent, including that of Harry Richford, aged just seven days old, whose death was described by the coroner as “wholly avoidable”, will the Secretary of State join me and Harry’s family in calling for a full, transparent public inquiry?

[The Parliamentary Under-Secretary of State for Health and Social Care (Ms Nadine Dorries)]

I thank the hon. Lady for raising this issue, and also my hon. Friend the Member for Dover (Mrs Elphicke), who made an excellent speech last night about this very issue at East Kent. I would like to reassure the hon. Lady that the Care Quality Commission conducted a further investigation of the whole trust last week and will take enforcement action if necessary. On Monday, I asked it to provide a summary report within 14 days. The Healthcare Safety Investigation Branch has examined 26 individual maternity cases at the trust, and it has already reported on 15. It was also asked on Monday to complete its work within 14 days and to send in a summary report to give us further information.

The National Health Service

Rosie Duffield Excerpts

Wednesday 23rd October 2019 Commons Chamber

[Jonathan Ashworth]

I will give way in a few moments. Let me just finish this point.

When the Secretary of State announces new hospitals in press releases from Conservative campaign headquarters, he should also announce where he is downgrading hospitals. He should go to Telford and explain why the accident and emergency department there is closing and being replaced by an “A&E local”, which is presumably something like a Tesco Express. We would save that A&E department. The Secretary of State went to Chorley recently. The A&E department there is not open overnight. We would provide a rescue package for Chorley. I wonder whether the Secretary of State will also be visiting Canterbury to apologise, because the Prime Minister promised—

[Rosie Duffield (Canterbury) (Lab)]

rose—

[Jonathan Ashworth]

My hon. Friend represents Canterbury, so I will give way to her.

[Rosie Duffield]

Does my hon. Friend agree that the Prime Minister’s recent false promise of a brand-new hospital in Canterbury was extremely irresponsible? It turned out to be fake news, which left my desperate constituents confused and bitterly disappointed.

[Jonathan Ashworth]

The Prime Minister promised that new hospital at the Tory party conference, only for the Department to confirm later that Canterbury was not actually on the list.

Oral Answers to Questions

Rosie Duffield Excerpts

Tuesday 23rd July 2019 Commons Chamber

[Stephen Hammond]

I know that my hon. Friend has worked with the National Centre for Rural Health and Care and chairs the all-party group on rural health and social care. She is right to mention the fact that there are particular challenges in the delivery of the best-quality healthcare that we want to see in rural areas. I would be delighted to work with her and the all-party group on the matter.

[Rosie Duffield (Canterbury) (Lab)]

It has now been almost 18 months since health commissioners proposed that the two options for acute medical care in east Kent be put forward for public consultation. My constituents, particularly those in rural areas, are simply fed up with waiting for a new hospital. Will the Minister please confirm for me today just when a full public consultation on the future provision of acute services in east Kent will finally take place?

[Stephen Hammond]

The hon. Lady asks a good question on behalf of her constituents. I cannot confirm today when that will happen, but I will look into the matter and write to her to make sure that she gets the answer.

Oral Answers to Questions

Rosie Duffield Excerpts

Tuesday 24th July 2018 Commons Chamber

[Jackie Doyle-Price]

The hon. Lady’s starting point was “since 2009”. It is certainly true that there was a decline then, for a number of reasons, not least the fact that we are improving treatment in community settings rather than acute in-patient beds. Our Five Year Forward View began in 2014, and we have been delivering improvements in the number of beds and staff since that date.

[Rosie Duffield (Canterbury) (Lab)]

8. What recent assessment he has made of the effect on the health and social care sector of the UK leaving the EU.

[The Minister for Health (Stephen Barclay)]

The Government are undertaking a wide range of analysis in support of our EU exit negotiations and preparations. Our overall programme of work is comprehensive, thorough and continuously updated.

[Rosie Duffield]

Brexit poses major challenges for the NHS and, in particular, the beleaguered and neglected hospitals of East Kent. Can the Minister reassure me—and the Royal College of Midwives and other bodies—that we will be able to recruit much needed migrant worker staff to the health and social care sector and will encourage them to stay after March 2019?

Perinatal Mental Illness

Rosie Duffield Excerpts

Thursday 19th July 2018 Westminster Hall

[Rosie Duffield (Canterbury) (Lab)]

It is a pleasure to serve under your chairship, Mr Davies, and I congratulate my hon. Friend the Member for Stockton South (Dr Williams) and the hon. Member for South West Bedfordshire (Andrew Selous) on securing this debate.

We should judge the success of our society by how we treat our new mothers—it really is that simple. I am here today to speak up for better-quality, more consistent and well-funded services for perinatal women.

I am not a new mother. In fact, my youngest teenage son is sitting just over there in the Public Gallery and Members may be able to tell from his towering 6-foot frame just how long it has been since I was recovering from giving birth to him, the second of my two gigantic children. Even so, I remember those special early days for all the many wonderful, and some horrible, reasons that all mothers will know.

We do not discuss post-natal truths enough in the UK. Women will sometimes share with their friends the gory details of their experience of giving birth, but we rarely ever see in the print media, on TV, or in films what happens after a baby is born. If the fairy tale does not end when Cinderella weds her prince, as most fairy tales do, it most certainly has ended by the time Cinderella has entered her third trimester and is waddling around the palace. Nobody wants to hear about Cinderella’s third-degree tear, the fact that her boobs leak, the possibility that she may experience incontinence, or the fact that, even though she has a wonderful, healthy baby in her arms, she just cannot stop crying. But fairy tales are out of date and so is the fact that we do not talk about perinatal experiences—both external and internal experiences—with the honesty we need.

Things are changing, however. After all, we are here today saying that what is on offer to post-partum women in the UK just is not good enough. It is outrageous that women in one quarter of the UK are still without access to specialist perinatal mental health services. How can the mental healthcare of new mothers still be a postcode lottery? It is not as if mental health changes are uncommon after a woman has given birth. In fact, 81% of women say they have experienced at least one perinatal mental health condition either during or after their pregnancy.

I know from talking to friends, family and, indeed, constituents how imperative perinatal mental health support is. We must remember that three quarters of women who say they have experienced a perinatal mental health condition had no previous history of mental health problems. For those who have experienced mental health problems before giving birth, changes to the brain’s chemistry post-birth, combined with post-partum isolation, can trigger the return of symptoms that they had previously experienced, often in their teenage years.

Speedy referrals and access to early treatment is vital for those who experience mental health issues during or after pregnancy. What is so worrying is that it takes more than four weeks for 38% of women in the UK who are referred to be seen. In fact, there are cases of women suffering post-partum who have the courage to seek help from their doctors and health visiting teams but who still have to wait beyond a year for help after referral. That is a whole year that these women are waiting for help in what is often one of the most turbulent, joyous, change-filled and complicated times in any mother’s life. Any service that keeps people waiting for more weeks that I can count on the fingers of one hand is completely unfit for purpose.

We must close the funding gaps that cause huge waits—it is reassuring to hear that the Government intend to do that—and end omissions in service provision. We must also ensure that maternity services do not remain overstretched and understaffed. We must bring back full bursaries for midwives and related healthcare qualifications, which will allow staffing gaps to be filled with the much-needed new caring talent that will have the capacity to offer continuity of care to high-risk women in pre and post-natal moments of vulnerability. The erosion of higher education bursaries, especially for nurses, midwives and other healthcare students, was yet another example of this Government knowing the cost of everything but the value of nothing.

There is another reason why we must act and act soon. A study by the department of anthropology at the University of Kent, which is in my constituency, shows that post-partum depression discourages mothers from having more than two children. The decision to have children, or the decision to have more children, is a woman’s choice alone. However, that choice must be made without the pressures and limitations that come with poor funding of post-natal care. A choice made through fear is no free choice at all.

I completely echo colleagues’ calls for there to be much greater depth in the maternal six-week check. The baby’s check by the doctor and the mother’s check by her doctor must be separate. A woman’s six-week check cannot be limited, as I so often hear it is, to a few rushed questions. I have been told of women being asked only about the contraception they plan to use, with no questions at all about their physical or mental wellbeing. I have heard from friends that their doctors simply asked them, “Are you feeling okay?” That is not a proper question. As any mother will say, the moment their new new-born is in their arms, the definition of what was previously considered “okay” is thrown of out the window. Time must be put aside for proper, in-depth questions and for real insight.

After all, as we have already heard, according to the Royal College of Midwives 42% of women with post-natal depression never even mention it to a healthcare professional, and three quarters of those women stay quiet because they feel guilty about having such thoughts. Moreover, many women are led to believe that serious mental health issues are merely a bout of the baby blues. We urgently need proper training and proper conversations to create an environment where mothers feel safe, well-informed and able to talk about any difficult experiences.

I acknowledge that even the most thorough six-week check for women would not always pick up on everything. Post-natal depression can sometimes manifest slowly. One study suggested that the majority of women experiencing symptoms did not report them until six months post-partum or later. To tackle that, I urge that the maternal mental health check by health visitors at three to four months is reinstated. Even taking more time at that early point when a woman is sat with her GP at the six-week check will save lives. A couple of weeks ago, I attended the NCT’s #HiddenHalf event, where several brave women attested to just that.

[Andrew Selous]

Has the hon. Lady had a chance to look at the clinical evidence base for the effectiveness of the three to four-month check? Is she aware of a good base of evidence from clinicians that it is a sensible use of money at that point?

[Rosie Duffield]

I thank the hon. Gentleman for that intervention. I have not looked at the issue in that kind of depth. I have been working on it with local women and local groups who suggest that it would be good to reinstate it. I will look into it further.

The women at the #HiddenHalf campaign event said that their lives had been saved by a fortuitous visit to the right GP at the right time, but they know they were the lucky ones. The mother’s six-week check must also allow time for a full physical health check to prevent long-term and often totally avoidable health complications resulting from difficult deliveries. Furthermore, it is my belief that a course of pelvic floor physio should be provided for every single woman who has experienced a vaginal birth, as happens in France. I am working with a group of women on health policy for post-partum women. This debate focuses on the perinatal health symptoms of the hidden half, but many of the mental health conditions that health visitors report are triggered by the physical trauma of a difficult birth and women having to reconcile themselves to a completely new sort of body.

Those of us here today will not stop campaigning and raising the issue until the situation changes for new mothers and new families who need our help. We should get the full truth of post-natal motherhood out there and become a country that can rightly say, “There’s lots of help here for you. We will assist you and your families for as long as it takes. We are here to champion and celebrate you in being the happy, healthy, supported mother that you ought to be able to be.”

NHS Outsourcing and Privatisation

Rosie Duffield Excerpts

Wednesday 23rd May 2018 Commons Chamber

[Rosie Duffield (Canterbury) (Lab)]

A few weeks ago, my local NHS trust in east Kent announced that more than 1,000 employees—more than 800 Serco employees and more than 200 NHS employees—working in cleaning, catering, estates and facilities will now be employed by an arm’s length management organisation.

Most of us in this House will be familiar with ALMOs, but for those watching, listening and reading about them for the first time, although ALMOs may sound a bit like that well-known cuddly Muppets character, they are nowhere near as fun. This is not “Toy Story” but Tory story, a story of endless austerity and endless cuts to our vital and much-loved health and public services.

ALMOs have become a mechanism by which primarily local authorities, but now it seems NHS trusts too, can avoid responsibility by keeping things such as housing departments and cleaning facilities at arm’s length—away from too much scrutiny, and away from the managers and councillors whose jobs might depend on keeping themselves as far away as possible from that scrutiny.

[Judith Cummins (Bradford South) (Lab)]

My hon. Friend is making an excellent speech. Staff in Bradford have real concern about the plans to create a wholly owned company that could see 300 members of staff at Bradford Teaching Hospitals NHS Foundation Trust transferred out of the NHS, creating a two-tier workforce. Does she agree that we need to keep our health service, in the words of Unison’s campaign, 100% NHS?

[Rosie Duffield]

Absolutely. I was just about to speak about Unison, which is my union.

Leading unions have called the move in my local NHS trust—the East Kent Hospitals University NHS Foundation Trust—a “wolf in sheep’s clothing” and fear, with good reason, that workers’ conditions, including pay, will be eroded. I know many of those workers personally and they include some of my friends. The unions are right: workers’ conditions will be eroded, and it is already happening in other public services across Kent.

The Conservative-run Kent County Council, for instance, has introduced another ALMO called the Education People. Educational psychologists currently working directly for the council are being transferred to be employed by the Education People. The terms and conditions being offered by the ALMO to new educational psychologists are significantly worse than existing terms and conditions for those employed by the county, so no new educational psychologists have been recruited for Kent. We already have a serious shortage.

Of course, Kent County Council is doing that because central Government have starved it of funds and, perhaps because it is the same shade of blue, it is too timid to make that big a noise about things, so I will do it instead: Conservative central Government cuts are reducing our ability to care for people properly. In my constituency, the local NHS is potentially doing the same by setting up an ALMO to make yet more cuts by stealth. More money, less responsibility.

My union, Unison, represents nearly half a million healthcare staff employed in the NHS. That is one in every 60 or so working adults in one sector in the UK represented by one union standing up with one voice against injustice.

In Canterbury, rooms at the once thriving city hospital can now be found stacked with old equipment, and staff tell me that whole wings of old, neglected hospitals, such as the Buckland in Dover, lie abandoned, underused and under-occupied while waiting rooms in our not-so-local accident and emergency departments remain rammed. In Canterbury, services that were removed “temporarily” in 2017 look likely never to return to those old buildings. Proposals are afoot for a new hospital, but it simply will not be built if the central Government funding is not there to fill it. I am the only Labour MP in Kent and, as such, I am proud to make a loud noise about and stand up against the Conservative cuts that have caused vital hospital services to disappear in my county in recent years.

Things need to change drastically, and the new university medical school in Canterbury will be part of that much-needed change. If someone in my constituency is sick, they currently have to travel a long way to Ashford or Margate to get the emergency care they need.

Combine an underfunded NHS with a South East Coast Ambulance Service in special measures, and we have the ingredients for chaos. Chaos and a lot of sadness are apparent in all the letters I receive from constituents about the NHS week in, week out. Members will get the idea. The funding is not there, so the services have gone.

[Helen Whately]

I have a question about what the hon. Lady said regarding the loss of services at Canterbury Hospital. She and I both oppose that. Does she acknowledge that services were lost under a Labour Government?

[Rosie Duffield]

I agree that services started to be cut under a Labour Government, but they have got so much worse that our hospital is now underused, unusable and unrecognisable.

Madam Deputy Speaker, you will hear the same thing repeatedly from my concerned Labour colleagues this afternoon. The impact of austerity on our health service has been truly dreadful. Trusts are beginning to look to PFIs to keep walls from crumbling, and the desire for a short-term fix has meant that private companies, such as Virgin, Serco and Spire, have stepped in, especially near me in Kent, to profit from sickness, which is fundamentally abhorrent.

So much must change. The privatisation of the NHS and supporting services must be stopped and funding must be fully restored to the levels it was at under the last Labour Government. If Conservative Members continue to erode our health service and encourage private companies to step in to fill in the gaps, there will be little left when they finally realise what they have done. With so many pieces given away, the NHS jigsaw will certainly never look the same again.

Labour Members are constantly accused of running down, criticising and putting down our health service. The fact is that we are telling the truth about the urgent state of our broken NHS, which is staffed by amazing, dedicated and selfless people who deserve so much better from this Government.