PARLIAMENTARY DEBATE
Menopause - 9 June 2022 (Commons/Westminster Hall)

I beg to move,

That this House has considered the menopause.

It is a pleasure to serve under your chairmanship, Mr Robertson. It has been four years since I first spoke in a debate in this place on the menopause. Each year that followed, I duly put my name down to speak in the annual debate on or around World Menopause Day, but it was not enough. While it might have gone some way towards breaking down barriers and lifting the taboo on this great unspoken issue, speaking about the menopause was not doing anything for the millions of women across the country who were suffering the symptoms and in desperate need of help. This issue was something I had a burning desire to champion as I learned more and more about how support and services are failing women across the country, and my opportunity came when I was successful in the private Member’s ballot last year.

The twenty-ninth of October 2021 felt like a momentous day. As we gathered in Parliament Square, there were cheers of joy and tears of relief; the Minister herself was there, so she will know what I mean when I say that you could feel the utter delight in the atmosphere as women celebrated what they perceived as a victory. It is no exaggeration to say that, since that day, I have been bombarded with messages asking when the annual prescription charge for hormone replacement therapy in England will be introduced. We now know—I am sure the Minister will explain the technical reasons for this—that the answer is April 2023: 18 months after the commitment was made, 18 months after the cheers and the tears, and 18 months after that delightful taste of victory, which is so rapidly turning sour.

Naturally, I am frustrated. I have been angry, and I have been very vocal. All the explanations for how and why this has happened mean nothing. They do not help the women who are struggling through a cost of living crisis and can barely afford food and heating, let alone “luxuries” like their medication.

As a woman of a certain age, I put on record my personal thanks to my hon. Friend for her tireless campaigning on this important issue and thank her on behalf of many of my family and friends who have repeatedly shared with me their praise and admiration for her work. Does she agree that the menopause is not a minor condition, but can severely impact every part of a woman’s life, and that the only way we can properly support menopausal women is by taking a holistic approach, looking at everything from employment to medicines and mental and physical health, and of course—as my hon. Friend is rightly doing—by keeping this important issue firmly on the agenda?

I totally agree with my hon. Friend. As she knows, my passion for this subject means that I will champion every one of the issues she has brought to my attention.

Women such as Brioni say:

“We live in deprived communities where HRT is considered a luxury item. The women I support work part time for minimum wage and on temporary contracts. We simply can’t afford the resources, products, private consultations that other women from more privileged backgrounds can.”

I can testify to the truth of that. I discovered quite early on that my own menopause was menopause, not depression, and when I spoke publicly about it, my friends said to me, “You’re posh having a menopause, Carolyn”—posh, because all the symptoms they were experiencing were things they just put up with and shut up with. I put it under the label of menopause, and the fact that I was able to have HRT—because I went private—made me posh. That was the only time in my life I have ever been called posh.

Brioni is from Doncaster, but what she says is relevant in working-class communities right across the country. Women will always put the needs of their families first, and as long as they have to choose between feeding their kids and paying for their prescriptions, we know where they are going to put their money. To all the Brionis out there struggling, I send my personal apologies that their hopes were prematurely raised. It is not what I expected or wanted, and it is certainly not what I am prepared to accept.

Outside this place, the menopause is a priority, and credit for that must go to all those who are campaigning for change at a grassroots level. Thanks to the willingness of so many of them to work together for the greater good, we now have the menopause mandate in place. We are joining women’s voices into a chorus whose mantra is menopause, menopause, menopause, amplifying the individual voices of grassroots campaigners so that all those individuals and their cases, with all their passions, are brought together in one collective.

My hon. Friend is making an incredibly powerful speech, and we are all very grateful. One of my constituents, who wrote to me recently, wants to be one of the voices joining my hon. Friend in calling for change. She says:

“I’m tired of worrying about my next prescription. Will I be able to talk to the GP? Can I persuade the receptionist to talk to the GP on my behalf and get them to issue a repeat? Will the prescribed HRT be available? Will the pharmacy leave me guessing and calling daily for updates? Will they eventually admit they can’t get hold of it? I don’t want to feel helpless, anxious, potentially suicidal again. Not when this is easily and cheaply treatable.”

She is right, isn’t she? Those are precisely the problems that we need to sort out.

My sympathy goes to my hon. Friend’s constituent, because the story that she tells is a story that I and other colleagues hear day in, day out from women who are troubled, anxious and scared that they are not getting the treatment or that, if they have the treatment, they cannot get their medication.

I am so proud to work with everyone involved in the menopause mandate, and I am heartened by the work that each and every one of them is doing—whether they are on a national television programme addressing millions of people and spreading the message, or helping a handful of women in their local community. Every one of them is making a difference. We have people such as Davina McCall, Lisa Snowdon, Patsy Kensit, Mariella Frostrup and Gabby Logan. These are strong women with loud voices, who are prepared to share their stories to help support women right across this country to get justice. The right hon. Member for Romsey and Southampton North (Caroline Nokes) and I contribute the political platform for the mandate. We have both made it our mission to mention the menopause in every single policy area right across Whitehall, because it deserves a place at every one of those tables.

Obviously, the Department of Health and Social Care has the biggest role to play when it comes to support and treatment for the physical and psychological impact of the symptoms. It is not just about the prescription charges or the availability of products, because I have grave concerns about the suicide rates among women of menopausal age. There is a 16% increase in risk for this cohort, and there have been some devastating stories in the press recently about women who failed to get a diagnosis and treatment, and who consequently ended their lives. Just a fortnight ago, Penny Lancaster sent me a clip from her local paper about a local solicitor who had taken her life after spending 18 months trying to convince her GP to diagnose her and prescribe her HRT.

However, other Departments have a huge role to play in this endeavour, including the Department for Business, Energy and Industrial Strategy. We have seen women in their 40s and 50s leaving the workplace in growing numbers due to the lack of support. The Department for Work and Pensions deals with the fallout from this, with women suddenly claiming benefits—possibly for the first time in their lives. The Home Office needs to consider the impact that the menopause is having on victims of domestic abuse. We know from research by AVA—Against Violence & Abuse—that domestic abuse escalates when a woman is experiencing menopausal symptoms, and that the symptoms are worse for those who are victims of violent relationships. Education is key if we are to ensure not only that medical professionals are sufficiently trained to diagnose and treat the menopause, but that the next generation are more prepared than any of us were.

Something that really concerns me is the disparity in HRT products currently available in the country. We only have to look at the local formularies to realise that levelling up appears to have overlooked menopausal women. Oxfordshire is recommending the use of newer products, while Manchester’s first-line treatment recommendation is cheap oral medication with synthetic progestogens, with patches reserved for more complex cases, such as those with underlying health conditions. That treatment postcode lottery must be taken seriously. I will continue to campaign for a national formulary, so that all women have fair access to all treatment, regardless of where they live.

Something that came to my attention today, which I am now looking into, is the disparity in the advertising of medications on social media. It is my understanding that on Instagram, medication for erectile dysfunction has free rein to be advertised, but lubricants for vaginal dryness and menopause medications are blocked because they relate to the female genitalia and are therefore assumed to be of a sexual nature. I will be writing to Instagram, and indeed other platforms, to clarify the situation. If that is the case, why are male sexual wellness products given the green light, yet medications for women with menopause are categorised as pornographic? If that is the case, the Department for Digital, Culture, Media and Sport can also expect to hear from me.

At Women and Equalities questions on Wednesday, I raised the issue of menopausal support for women on the prison estate. With 39% of women prisoners aged 40 or over, and 38% aged 30 to 39, I would have assumed that it was vital for a menopause strategy to be in place to provide for those women while they serve their sentences. That is primarily because we know that menopause and perimenopause symptoms affect our physical and mental health, as well as our behaviours.

Next Monday is Menopause Monday, and we are bringing Menopause Mandate to Parliament. All Members will have received invites, but will anyone who has not please let my office know? I encourage everyone to come along to the Jubilee Room and meet the fantastic group of women guests and speakers that we have lined up. I am delighted that, in the afternoon, the Fawcett Society will join us to present its recent report on menopause in the workplace. It is a fantastic piece of work, and many of the areas highlighted as concerns are exactly the same as those that colleagues have mentioned today and that are in the menopause mandate. We will also have clinicians, experts and academics explaining why getting the right treatment and support is so important for both physical and mental health. Finally, we will have women telling their own stories about the barriers they have faced in accessing support and treatment for their symptoms.

When Menopause Mandate was first launched, we invited women to not just sign our petition on the implementation of the single prescription charge, but share their own experiences if they felt able to, and it has been humbling to see how many have done that. I urge colleagues, especially those on the Front Benches, to read the submissions on the website, because they really paint a picture of what some women experience every single day.

Take Lucinda from Kent, who told us about her difficulties in being diagnosed and about the impact of her experience:

“My symptoms started at 41. Three and half years and nine GP appointments later, it was the dentist who first said the word perimenopause to me. By this time my confidence was non-existent, I was unemployable, I was being a terrible parent, a vile and unreasonable housemate, and didn’t think anything would ever improve. I thought about removing myself far too often”—

it was that bad. Lauren told us about the impact on her work:

“I was a senior leader in financial services…but in my early forties I left my job, thinking I had early-onset dementia. I went from being an uber-confident competent leader and the only female in a peer group of 18 men to losing all my self-confidence.”

We also heard from Catherine, who told us about the “painful hell” she descended into after being dismissed by her GP and prescribed anti-anxiety medication:

“I was in so much distress, but I was labelled as a ‘challenging patient’. I felt every subsequent doctor was influenced by this label and that prevented them from doing proper investigations.”

Thankfully, all three women eventually got put on to treatment paths that worked for them. In fact, Lauren says that when her doctor finally diagnosed her, she was the happiest menopausal woman in Bristol. Despite the heartbreaking circumstances those women originally faced, it is encouraging to read their stories and to know that they are now content and able to cope, but there are plenty more out there still living the nightmare that Lucinda, Lauren and Catherine previously experienced.

Women have been denied HRT because their doctors are not properly educated in diagnosing the menopause or in the benefits of the treatment. Women have been prescribed HRT, but struggle with the cost of their prescriptions as they wait for the annual prescription charge. Women who have been given a new lease of life since taking HRT, but who have vivid memories of hot flushes, sleepless nights, brain fog and extreme anxiety, are now terrified of the very real prospect of the symptoms returning due to shortages of the product that literally changed their lives. There are women who cannot take HRT, who need more support, and who feel broken, lost and helpless. We want all those women to be like Lucinda, Lauren and Catherine and to find what works for them. We want them to get the support they need and to be the happiest menopausal women in every town and city up and down this country. That is why we will keep fighting.

One good thing that came out of my private Member’s Bill was the establishment of the menopause taskforce, which I co-chair with the Minister. It brings together decision makers, policy advisers and experts in the field from across the four nations. We can share what works, and what does not, and make joint decisions that will help us all to provide the best possible care and resource for women in future.

I am sure the Minister, the civil servants in the Department of Health and Social Care and the Health Secretary himself have had quite enough of me going on and on about the menopause and the Government’s failure to prioritise this area of women’s health. I know I sound like a broken record—I very often get on my own nerves—but I will not stop, because everyone experiencing symptoms of the menopause deserves more. They deserve fair and equal access to affordable treatment and to be listened to, supported and prioritised. They deserve to be able to carry on their lives once menopause hits.

I wish I could put my arms around every one of those broken and desperate women who have reached out on our website, and even more so around the ones who have not had the chance or the courage to do so. I wish I could tell them that everything will be okay, that the prescription charges and the stock crisis will be sorted and that life will get better. I care passionately about this issue, and I know that there are MPs of all parties right across the House who care passionately too, whether or not they are in this room today.

Mr Speaker himself has pledged his support, and I am delighted to say that on Monday evening he will be signing the Wellbeing of Women menopause workplace pledge, which signals the House of Commons position as a progressive and supportive employer. Employers showing that they understand and support their staff is such a positive step, and I am thrilled that Mr Speaker has embraced that and is leading by example.

We are making progress, albeit slowly, and it would appear that globally the UK is seen as a leader in the field. Since last October, I have heard, as has the Chair of the Women and Equalities Committee, the right hon. Member for Romsey and Southampton North, from the press, politicians and experts from across the world. People expressed a desire to learn from what we are doing—from Australia, Canada, Japan, and across mainland Europe. But if we are going to be the world leaders, we need to get it right ourselves. What is so frustrating is that what is needed to completely change women’s lives is so simple. We need to improve support services and access to treatment and give women’s health the priority it deserves. I know the women’s health strategy is on its way, but it is 2022. Why has it taken until now for women’s health to be prioritised? Some 51% of the population are reliant on this, and they have been left out.

No more delays or false hopes. The time for warm words and gestures has well and truly passed. We cannot let menopausal women today suffer any longer, and we must ensure that future generations do not suffer the same experiences as those who came before them. We need a commitment that this will be a priority, and a promise that it will be taken seriously. We need action, and we need it now.

It is a pleasure to serve under your chairmanship, Mr Robertson, and, dare I say—I do not wish to be rude—an even greater pleasure to follow the hon. Member for Swansea East (Carolyn Harris), who has been such a champion on this issue.

As I said at an event earlier this week, having got to the grand old age of nearly 50, I am now a woman in a hurry. I do not feel as if I have an awful lot of time left to effect real change and I have got to the point with the menopause where I am determined that we see change, and we see change quickly. I think it is an age thing, but I have turned into a woman in a hurry. I want there to be change, support and help for women.

Over the last 12 years in this place, one thing I have learned—apologies, Mr Robertson—is that women do things differently in Parliament. We have become very pragmatic. We look at the solutions and the answers, not at the problems and the ideologies. There is no political ideology around the menopause; we just want it sorted, and as quickly as possible. That is why it has always been a huge privilege to work in tandem with the hon. Member for Swansea East. She and I come from different parts of the country and different political persuasions, but we have both recognised a problem that just needs solving.

Women across the country do things pragmatically. We heard from the hon. Member for Swansea East about different support groups, and it really struck me that women, usually of a certain age, come together to provide each other with support, advice, hints and tips about how to get through the menopause. We have all done it in this place, and turned to someone who may be a little bit older or wiser than us to ask them for advice. Last October, I gave up a weekend away. Fridays tend to be precious to Members of Parliament, and none of us likes being in here for private Members’ Bills on a Friday, but occasionally a private Member’s Bill comes along and one thinks, “That is worth it. That is where I will be this Friday. Instead of going away for a nice weekend, I will be in Parliament to make sure that we effect real change.”

On that day, I sat and I listened to a speaker from the other side of the House who cannot be here today because, absolutely fabulously, she is on maternity leave; that speaker was the hon. Member for Leicester West (Liz Kendall), who spoke about her own menopause symptoms. It took real bravery and courage for her to stand up in a packed Chamber of the House of Commons and start listing off all the weird and wonderful symptoms she was suffering. She identified anxiety, sleeplessness and night sweats, and I sat there thinking, “I get that. Yes, I get that. Yes, I get that too.”

I then trotted downstairs and found Dr Louise Newson sitting in Portcullis House and said, “The speech by the hon. Member for Leicester West was absolutely fascinating and it made me think that I am suffering from some of those things.” Dr Louise Newson turned to me and said, “Will you please go and get yourself a prescription for HRT?” For me, it was a lightbulb moment that showed that in this place, and indeed outside, people can learn so much from their peers.

I take my hat off to my constituent Jo Ibbott, who runs the naughtily entitled What the Fog? group, which is specifically designed for menopausal women in the Romsey area. Jo is a menopause guru and a fount of advice. She wanted to come and talk to me about the debate initiated by the hon. Member for Leicester West and about the menopause, and instead she found herself sat in Costa Coffee in Romsey giving me advice about what I needed, the importance of body identical HRT and not allowing myself to be fobbed off with anything that was a lesser product. She managed to persuade the Chamber of Commerce in Romsey to bring together a group of employers, and she has held a number of seminars, in the evening, talking to employers in the town about what they can do to support menopausal women.

That brings me to the whole raison d’être of the Women and Equalities Committee over the course of the last year. It feels as if we have been talking about the menopause forever, and I am not going to stand here and trail the recommendations of our report, because it is not yet public but is coming very soon indeed. We have taken evidence from some brilliant and interesting men and women about what we can do to help menopausal women in the workplace. It is not good enough to have policies that sit in filing cabinets gathering dust. They have to be real, living documents that both employers and employees can talk about, so that people can highlight the challenges of their symptoms and be open about them and the flexibilities and changes that might help.

I have spent the last two years trying to find some positives from the pandemic. One of the positives we have learned is that, while flexible working can be a benefit to everyone, it can particularly work for women. I get terribly cross when male employers say that it has been great for women in the workforce. It has been great for everyone—men as well—and particularly for people suffering from hot flushes, anxiety or sleeplessness. We all know how debilitating insomnia can be. Flexible working could be something that helps menopausal women stay in the workplace.

Standard Chartered and the Fawcett Society have done research on this. They learned that 50% of women do not take on additional responsibilities at work if they are going through menopausal symptoms. I scratched my head and thought, “What does that mean?” It means that they do not take promotions, which means they have less income, which means that they make smaller pension contributions. The menopause does not just affect women physically; it affects them financially, because those promotions are gone.

We know that 25% of women consider leaving work altogether. That is not just an additional income forgone. It is their whole income and whole pension contribution forgone. Is it any wonder that we suffer from a gender pensions gap when over a million women have left the workplace because of the menopause and many more have been forced to take career breaks? That brings me on to some of the wider governmental issues.

I am not going to copy the speech of the hon. Member for Swansea East. Members will have noticed me tearing up pages of my speech, because she covered the issues I wanted to speak about. There is a whole Government challenge around the menopause. I desperately want to see the Department for Work and Pensions and the Department for Business, Energy and Industrial Strategy working hand in hand. It is crucial that if somebody is lost from the workplace, there are routes back into it. It is important that work coaches are given support and training so that they understand what the challenges may be for women in their late 40s and early 50s returning to work.

The menopause can give people anxiety, so it is about restoring confidence and giving people the belief in themselves to be able to take on new challenges. Perhaps we need to be looking at retraining programmes that are gendered. I get terribly cross from time to time with the employment Minister, my hon. Friend the Member for Mid Sussex (Mims Davies), who tells me that she must look at employment policies in the round. We have lost a million women going through the menopause from the jobs market. How can we get them back? What additional training and programmes might be put in place in order to achieve that?

We heard yesterday from the Minister for Children and Families, my hon. Friend the Member for Colchester (Will Quince), about the work being done in schools and the statutory nature of what I refer to as PSHE and what he refers to as RSHE. It is crucial that we focus not just on building resilient young people and teaching them how not to get pregnant, how to respect each other and about their own bodies; we do have to have to those conversations, but there will come a time in every girl’s life when they will not be able to get pregnant any more. How will it impact them?

I got to the age of 49 without knowing the slightest thing about the menopause. I have managed to turn myself over the course of the last year into something of an expert. We do not educate children and young women enough about the changes that the menopause will bring to their body and how important it is that they have knowledge and the ability and confidence to talk about it, whether it be with their employer, family or friends.

We heard moving evidence during the course of the Select Committee’s inquiry. It would be unfair to stand here and reel off a great long list; Members would get bored by me, but I do want to highlight some particular challenges. No two women will experience the menopause in the same way. Yes, of course, there will be many similarities, but it is different for each woman. I would particularly like to highlight these challenges for the sake of younger women, for those who might be going through a surgical menopause and for those who go through very early menopause. It can suddenly be very debilitating and feel completely out of kilter with their age and the experience of their peer group. We have to realise that those women need particular assistance.

There are other groups. We heard evidence from a fantastic woman called Karen Arthur, who set up the organisation Menopause Whilst Black. I was being very bad that day and did not take part in a Division that was happening in the House. Instead, I snuck out into the corridor to talk to her about her personal experience. My goodness—she was the most incredibly inspirational and motivating woman. It is true not only that different ethnicities experience the menopause differently but that there are different cultural expectations. It may well be harder for those people to talk to their friends and family about it, and we have to keep breaking down those stigmas.

We heard from representatives from the police service and the ambulance service. I personally picked up the phone to one of the Justice Ministers and begged them to allow the Davina documentary into a prison to talk about the work that was being done not only with inmates but with staff going through the menopause. Every organisation, large or small, has menopausal women in its workforce.

I have been bowled over by the constituents who email or phone me to thank me for doing this, including Simon Parkes, who runs a tiny company in Romsey. Sometimes people say to me, “Will you please stop banging on about the menopause?”, but he rang me up to say, “Will you please keep talking about the menopause?” He has very few female employees, but he said that suddenly the penny dropped about what was going on with his wife and what the challenge was with staff members. We have to be able to talk about this and give women in the workforce the support they need.

There were some shocking, sad, awful stories too. I was stunned by how many people wanted their evidence kept confidential. I was struck by an email from the female human resources director of a major blue chip company, who emailed me with her personal story of the menopause and finished by saying, “Please keep this confidential, because I would never want my employers to know what I am going through.” That is the HR director of an organisation who did not want her employers to know what she was going through, so we have a long way to go in beating down the taboo.

I am conscious that I have probably spoken for far too long, but I want to make a final plea to the Minister. These are my asks for the Government. The hon. Member for Swansea East rightly focused on prescriptions and the shortages of some HRT products. The DHSC is working hard to resolve that matter, and I very much welcome the establishment of the taskforce and the appointment of Maddy McTernan. I think we are beginning to see progress on that front, and that gives me hope. It would be wrong of me not to reiterate that we were promised last October that there would be the £18.70 charge for 12 months-worth of prescriptions. I know there are IT challenges and that it is difficult, but please can that be expedited?

I implore BEIS and the DWP to work hand in hand. Why do we still not have an employment Bill that promises flexible working from day one? Why do we not have programmes targeted at retraining women over 45? Why are work coaches not easily able to identify the additional challenges of menopausal women who want to get back into the workforce? I have pointed out the challenges with personal, social, health and economic education and the importance of the Department for Education in ensuring girls are educated about the challenges they will face later in life.

It is really important that we have a women’s health ambassador to champion these issues. I raised that with the Minister just yesterday, and it would be remiss of me not to remind her of it. We need to see that appointment. I want to see somebody in place who is experienced, dedicated and committed, and will be a real champion for women up and down the country on a wide range of issues, but please can menopause be front and centre in that?

It is a pleasure to serve under your chairmanship, Mr Robertson, I believe for the first time. I congratulate my hon. Friend the Member for Swansea East (Carolyn Harris) on securing this important debate and on all the campaigning she has done to raise awareness about the barriers women face when accessing HRT prescriptions. There is certainly a lot more work to be done, including on the interaction between black and Asian women and healthcare professionals.

For the last 10 years, I have experienced a multitude of symptoms, including hot flushes, memory loss, fatigue and poor sleep, but I just thought it was this job—boo hoo—so I used the lockdown to press the reset button. I thought, “If I do my bloods, maybe I can find out what is wrong with me.” My doctor did not advise me to do my bloods, but I thought I would use my own agency, so I turned up and said to my doctor, “This is what I want to do,” and my doctor said, “Okay, go and do your bloods. Let’s see what’s wrong with you.” Bear in mind that for the last 10 years, I have been experiencing different symptoms intermittently, but my doctor did not join the dots for me, and did not explain or say, “Possibly, Kate, this is what you’re going through.” What came back from the bloods was that I was pre-diabetic—another menopause symptom, but my doctor looked at my results and said, “You are pre-diabetic. You need to change the way you are eating and possibly you will be okay and will not become diabetic.”

This was not what I was expecting to find out. I was trying to find out why I was having all the other symptoms, but the bloods showed up different symptoms. I used lockdown and the time I had to reset the button and turn my food habits around and, fortunately, I was able to take my body back to where it should be. I am no longer pre-diabetic and I did not become diabetic— I was really happy about that—but my GP did not explain to me that the persistent symptoms were related. If I am honest, it was not until I watched Davina McCall’s recent TV show on menopause that I connected the dots.

I grew up, as many of us in this room did, watching Davina on “Big Brother” and all her other shows. She is relatable, she is fun—she is like a friend I have never met. She is a trusted voice. Her view and her vulnerability made me look at the symptoms she was presenting and made me think, “Okay, that could be me.” I was not alone. So many women I have spoken to watched the same show and said that Davina turned on the light for them. I thank her for that.

I then had to go on to speak to my GP. Now I had the information I needed, which I had not been given before, and I had the agency to tell my GP, “This is what I want.” We had a long discussion and my GP offered me antidepressants. Many women may have taken that option, but I know, from watching Davina’s show, that it is an option that a lot of women were being offered. I could have taken the antidepressants, not knowing that it was almost like a barrier put up to stop women getting HRT. I listened, we had a little discussion and my GP agreed to give me HRT. I should not have had to have that conversation and I feel really sorry for those women who do not get past that barrier, accept the antidepressants and just carry on existing, taking the antidepressants but not dealing with the symptoms.

Many black women experience menopause disproportion- ately. Many black women I speak to say that there is no point going to the GP. It is not something we discuss in our community; it is not something that is passed down to us. We are encouraged to be strong, as black women. We are encouraged to carry the family and to sort out our problems privately. That is not a slight on the community—it is about how we hold ourselves together—but as individuals in the community, at times we need the support when we do go to the doctor. That could be to have antidepressants, but in this instance it is to talk about HRT. That is something we do not do.

I am standing up in Parliament to say, “Let’s talk about it. Let’s have that discussion. Let’s help each other and let’s think about the next generation, who will be able to say, there is the blueprint and these are the things that we should be looking for, and when they come up we will go to our doctor and have agency and have strength.” We should do that, rather than being quiet and thinking, “My mother never spoke to me about this and my aunties never spoke to me about it, so it must be something to do with my job or my partner or my friends or whatever”. It is something that is part of every woman, whether they are black, white or Asian.

I also want to say that black women’s voices are less likely to be heard or shared in the media. Black women are less likely to appear in media campaigns. In the menopause landscape, we do not exist. We need to be heard. Our experiences are really important. The next generation need a reference point.

As I said, in our community we are taught to be strong. Slogans like “Black Girl Magic” are associated with strength and glamour, against all odds, which is fantastic, but trying to live up to that all the time puts a lot of pressure on us. We need a wider discussion as a community, but we also need the media and health professionals to get involved, to reach out to us and to explain, “These symptoms appear at a certain age and if they do, this is what you should do.” The media and companies should be looking for black women to front their campaigns to ensure that women feel that there are relatable faces and voices. Yes, here we all know Davina McCall, but not everyone knows Davina—I should not say that; Davina might not be happy. On a serious note, when someone is young and looking up to people, they want to see faces that look like theirs—that is really important. If the Black Lives Matter movement showed us anything, it showed the globe that all lives matter. We should work together.

Do not get me wrong, there are some fantastic black and Asian British women who are raising menopause awareness. There is Karen Arthur, who runs the Menopause Whilst Black Instagram account; she also has a podcast where she shares black women’s stories of menopause. There is Dr Arif, the family GP who specialises in women’s health—she is a bit of a celebrity now. Dr Arif says:

“NHS practitioners are not trained in menopause. They often don’t realise you can have menopausal symptoms during perimenopause, or have symptoms and still have your period. And that there’s no blood test that can reliably tell you if you’re perimenopausal as hormones fluctuate. That’s a barrier to all women.”

Today I want to take this opportunity to look forward, based on my own experience, to how we can be better and more productive in the relationships between black women, GPs and advertising. All women need to be included in the menopause debate. Let’s be honest: if any other issue had been found to cause one million people to leave the labour market, cause problems with sleeplessness, anxiety, brain fog and countless other overlooked symptoms, and impose an unacceptable and unappreciated burden, then the tabloids would be in overdrive. It is a basic issue of equality in the workplace, and should be treated as such. There should be endless debates and significant Government legislation needs to be passed.

A study earlier this year by Koru Kids found that a quarter of women going through the menopause feel unhappy at the lack of support on offer. Many are likely to be the next workers to drop out of the labour market. While employees can claim some protection through existing legislation, such as the Equality Act 2010, clearly it is falling short. There remains no legislation which expressly puts obligations on employers to ensure they provide necessary adjustments for women going through the menopause. Therefore, I would like to make a few recommendations to the Government.

First, legislation should be passed ensuring women going through the menopause are protected in the workplace in the same way that other protected characteristics are, such as those that exist around pregnancy and maternity discrimination. Workplace menopause policies should be made mandatory. Many employers already recognise the importance of bringing in a menopause policy, but need a little nudge. The Mayor of London announced City Hall’s policy on International Women’s Day this year, which Unison helped develop. That policy includes tackling discrimination and stigma around menopausal symptoms, as well as introducing temperature-controlled rooms and flexible adjustments to the workday to accommodate symptoms. Leading examples should be admired, yet progress remains too slow across the board and the best way to enforce minimum standards is by statutory change.

Secondly, the Government should take a proactive approach to promoting best practice on workplace policies. The Government should work alongside the TUC, which has produced a series of recommendations for employers. Those include: awareness training for all staff; risk assessments; and a confidential point of contact for women in their workplace for problems arising due to the menopause.

Lastly, flexible working should be made the default for all workers, unless there are reasons why it is not possible. Sadly, the employment Bill was not included in the Queen’s Speech, which is a great shame for all workers —especially those who are going through menopause. Without that right, many workplaces will continue to fall short on making reasonable adjustments, and women will continue to feel their health suffer as they are forced to work hours that do not meet their health needs. These changes are a necessity if we aspire to have a truly equal workplace.

It is a pleasure to serve under your chairmanship, Mr Robertson, and to follow the hon. Member for Edmonton (Kate Osamor). I congratulate the hon. Member for Swansea East (Carolyn Harris) on securing the debate, on her brilliant private Member’s Bill that went through last year, and on setting up the incredibly important menopause taskforce with the Minister. I am looking forward to Menopause Monday next week, and I shall look for the invitation in my inbox. I have just checked my diary and shall try to clear it so that I can come along. The work that the hon. Lady is doing is incredibly important, because she is shining a light on something that has been swept under the carpet for a long time.

I feel lucky that I had a mother who was open and who answered the incredible number of curious questions that I had as a teenager. She is 30 years older than me, so I was 18 when she was 48, and I am nearly 48. I remember her going off to the doctor and being diagnosed with depression. This is such a perennial story, and I cannot believe that, 30 years later, we still have women being diagnosed with depression instead of perimenopause, which is what she was going through. She did not get on with the antidepressants, so she stopped taking them and went back to her old doctor—she had moved area—who prescribed her HRT. She did not get on with that either, but that was probably due to my mother’s sensitivity to changes. Throughout my life, I have not been able to cope with hormones from certain forms of birth control and such things. I have never really wanted to use them or got on with them, and I think a lot of people are sensitive to them. Because my mother did not have a very good experience with HRT, I thought, “When I get to that time of my life, I’m just going to be tough and see it through,” like we all have to do.

I loved the hon. Lady’s comment about HRT being a posh woman’s thing. It probably is, to some extent. She is absolutely right to talk about the postcode lotteries. However, the majority of women—they are busy and getting on with their lives, because they are working or have children at various different ages—put themselves last. We do not put ourselves first, and it often takes something quite significant for us to seek the medical help that we need, as we all lead busy lives.

I first experienced menopausal symptoms last summer —it was a bit before my right hon. Friend the Member for Romsey and Southampton North (Caroline Nokes), and before the debate last October. During the summer I thought, “Have I got long covid again?” I had had covid in March 2020 and had nine months of long covid, which involved complete and utter exhaustion. I got over it and got my lung function back again, and I thought, “Why am I so tired? Why am I exhausted all the time?” Like the hon. Member for Edmonton, I thought, “Is it just this job?”

I was curious to hear my right hon. Friend talk about the HR director saying, “I don’t want anybody to know I’ve got this.” I can promise Members that, as an MP, I rely on the fact that people realise that I work hard for my constituents seven days a week. Why would I want to tell them that I am absolutely exhausted, that I am struggling to sleep at night, that I am having hot flushes, and that it takes me about five attempts to get up in the morning? That is what it was like with long covid.

The point I want to make to the Minister is that about 2 million people in the country are currently suffering from long covid. It is really important for women who are over the age of 40 and who are suffering from long covid to double-check and make sure that they are not also having to deal with perimenopause or the menopause. There could be an easy solution for them, such as taking HRT. The symptoms include brain fog and not being able to find the right words, which is a serious problem in a job like this. When your brain stops working and you are in the middle of a speech, you think, “I know what the answer is. Why can’t I find it? What’s going on?” It is due to perimenopause, and there is a good solution for it.

I decided in August last year—thankfully, we were on recess—that I could not wait any longer. I needed to go and see a doctor, and I did the research. I am lucky: I am able to spend time googling. I am looking up things all the time, and I found Dr Alex Standring at the Surrey Park Clinic, who had put together a whole load of informative videos about symptoms and what women were going through. I got in touch with her and managed to get myself a prescription, and the change was immediate. Almost within two weeks, I felt like a different person.

I came into this place thinking, “I don’t want to be boxed in talking about women’s issues. I’ve got to talk about the economy, defence, justice and big meaty things”, but we have to speak our truth and talk about what we are going through. As women, we have powerful voices in this place. We ask women to stand for Parliament, and it is quite often at this time in their life that they are ready to make that sort of contribution, yet they might come in and find themselves suffering with perimenopausal symptoms, and then probably from impostor syndrome—“What am I doing here? I don’t belong here. I can’t do this job.” We absolutely can do this job, and we need more women to come into this place. We have hit the prime of our life. Quite often, women have had their children—or they may not have had children, but they are at a point in their career when they should absolutely be humming. It is such a shame to see so many women step back from what they can potentially be in the workplace and in everything they are doing because these awful symptoms of perimenopause and menopause come along. Many role models have been mentioned, and I just wanted to say that Sophie, Countess of Wessex, is also doing a brilliant job in raising awareness.

My colleagues have already mentioned asks of Government in their speeches, so I will not repeat them, but it is important that we keep talking about this issue and raising awareness. I am pleased that steps seem to be being taken on a more regular basis, due to the one- woman campaign machine that is the hon. Member for Swansea East, as well as the Chair of the Women and Equalities Committee, my right hon. Friend the Member for Romsey and Southampton North, keeping these things at the forefront of everyone’s mind. I thank all Members present for their indulgence, because it is important that we are able to tell our stories and talk about what we have experienced. I also thank the Minister for her tireless work behind the scenes; it is not always easy.

It is a pleasure to serve under your chairmanship, Mr Robertson, and I offer my warmest commendations and congratulations to the hon. Member for Swansea East (Carolyn Harris), who has done such a magnificent job of raising awareness and understanding of the menopause. She has ensured that many women feel heard and understood, but crucially has also galvanised change—information, services, policy, and a strategy—to normalise and support something that half of the population are going to go through at some point. Many of us share her righteous frustration about the delay in implementing many of these changes, but the conversations and actions of the hon. Member and others now constitute a real movement for change and progress in this area, so that fewer women will suffer in silence or experience anxiety and ill health.

I also commend the Chair of the Women and Equalities Committee, the right hon. Member for Romsey and Southampton North (Caroline Nokes), whose Committee is on the frontline of so many of the issues facing women, and the all-party parliamentary group on menopause that is capturing and organising all of the actions and ideas that are now flowing.

I particularly want to speak up for women in Northern Ireland, who feel that this—like other issues that affect women, women’s health and women’s lives—is an area in which we are lagging behind other parts of these islands. Over the past couple of years, primarily through the entry point of HRT supply issues, which Members have referenced, I have been engaging with constituents and others about the need for a co-ordinated approach to menopause support, one that is funded and joined up between the many Departments and areas of responsibility that have been identified today, and hopefully will be ultimately underpinned by legislation. That approach, of course, starts with awareness and understanding, which thankfully is improving as a result of many of the people in this room and others pushing the issue.

Last night, I posted on social media that I would be taking part in today’s debate. I was amazed by the number of replies from people who are experiencing challenges with the menopause and those who are just delighted by this fresh climate of support and action. Many had very developed and constructive ideas for how to improve the situation.

I am grateful to all the people who got in touch, particularly Siobhan Kearney of At One Wellbeing and Anne McGale at Menopause Wellbeing NI for sharing with me the benefit of their research and experience as practitioners. I also pay tribute to Marie-Louise Connolly, BBC Northern Ireland’s redoubtable health correspondent, who has been brilliant at forcing this issue on to the agenda in Northern Ireland and keeping it there; Members will appreciate that the policy agenda in Northern Ireland is fairly cluttered at the best of times.

Although many will experience few or manageable menopause symptoms, for some women the menopause is intense and bleak, and women often enter into it without having the right information or the right access to decisions. One woman—a robust and well-regarded professional at home—told me:

“I’m going through it. It’s something I find difficult to discuss. I’m surprised at myself but just can’t. Rotten symptoms, making life miserable. Open to HRT but due to personal and family medical history, it might be difficult. GP says I need to see specialist at the clinic in Belfast but the waiting list is 4 years...It feels like a death sentence, bringing back trauma about family and my own medical conditions, and my physical symptoms make me feel like a stranger in my own body which is attacking me. It feels like a death sentence, there is no escape.”

I found that really difficult to hear from somebody I regard as strong and confident and able to articulate herself well. I feel so much for others who may be unnecessarily going through this situation in the dark, without knowing that there is a definable cause and without knowing that there are things that can be done to help them. I also heard from other women who had been in a very difficult place but who now, having received the right support, are on the other side and desperate to ensure that other women need not fight the same battle that they have.

The dearth of appropriate services is a core problem. Although many GPs have been brilliant, and able to guide and advise their patients, we know that primary care is overwhelmed and under-resourced. Many people cannot get access to their GP, or there is inadequate continuing professional development and education for GPs on this issue, and insufficient time for them to explore and pinpoint some of the issues, so that they can holistically address them. Then, of course, there are few or no specialists to refer to. Enhanced specialist clinics now available in the south of Ireland. There are two in Northern Ireland, but the majority of NHS trusts do not have one, and I have already referred to the long waiting lists.

We know that many doctors are either not sold on HRT or are cautious about complicating factors, and people often tell me about the pushback that they have experienced. I am not sure whether other Members are watching “Borgen”; if they are not, I warmly recommend it, as it is an excellent series. I was struck, while watching the new episodes on Sunday night, that the brilliant character of Birgitte Nyborg, a former Prime Minister and former Foreign Minister, had a scene in which she explained her menopause symptoms and the impact they were having on her work. I was struck by her being, I suppose, brushed off. I mean, medical reasons were discussed, but I thought it was telling that a woman with all of that character’s powers of communication also felt unable to access the services that we need.

Numerous constituents report feeling brushed off or—of course—being offered inappropriate antidepressants. Members have addressed the acute problems caused by shortages of HRT drugs and I ask the Minister when the HRT tsar is expected to be able to report. That issue is causing real concern for people who are worried that, having finally found this solution to their problem, it will suddenly drop. I am hearing of people sharing medication, which obviously brings its own complications.

Menopause is also very much a workforce issue. Currently, about 9 million women in the UK are experiencing or will experience the menopause, and around 3.5 million of them are in the workplace. Policy is not in place to support and protect those women, who might be experiencing some of the symptoms that have been referred to here today, including tiredness, anxiety, brain fog, mood swings, headaches, joint pain and the spill-over effects from things such as insomnia and relationship challenges that the menopause can exacerbate.

There is no policy in place to protect and retain the huge skills and experience bank that these women offer. Other Members have referred to the point in people’s lives and careers when they are particularly valuable for the workplace, so the menopause is also an economic issue. If more women have to leave the workforce, that will exacerbate existing issues such as the gender pay gap. We are all increasingly aware of the benefits for public policy, decision making and economic activity when women are at the table. We know that childbearing and caring responsibilities mean that many women are deleted from that area of their lives and face marginalisation and exclusion later in their careers or soon after.

A growing number of employers are taking the issue very seriously and putting policy and guidance in place, but that is far from universal, perhaps due to lack of awareness, embarrassment, or not understanding the relevance. Workplaces need guidance and, in time, legislation to ensure that that guidance is in place. They also need support. Some practitioners have developed a really good skillset and go into workplaces big and small.

Menopause is an economic issue and an equality and public health issue. We need to normalise all aspects of women’s health so that they can be addressed like every other health and wellbeing issue, so that people do not feel alone, inadequate, confused or unprepared, and so that they feel empowered to make choices, whether about their lifestyle or medical support, to help them walk this path.

In her excellent speech, the right hon. Member for Romsey and Southampton North was right to say that this is not an ideological issue, but there is no doubt in my mind that if men experienced a similar, universal change, it would be a massive part of political discourse and culture. I can imagine all the movies and books that would be made and written about this time in life. Given that issues such as menstruation, women’s reproductive health, low-paid care work, the pension changes experienced by WASPI women, and childcare primarily affect women, they do not reach the top of the policy agenda. We need to address that.

We also have an opportunity to establish menopause as a rite of passage—hopefully, a rite of passage to a stage in a woman’s life when they are valued for the benefits, talents and wisdom that come with having lived decades of life. I commend the motion, the work and all the policy suggestions that have been made here today.

It is a pleasure to serve under your chairmanship, Mr Robertson. I want to start by congratulating my dear friend, the hon. Member for Swansea East (Carolyn Harris), on securing this debate and on all her brilliant work highlighting the importance of speaking about the menopause. I am very proud to be a vice chair of the APPG on menopause, which she chairs. We have done some brilliant work together and will continue to do so. We have finally lifted the lid off the menopause jar—the genie is out of the bottle. I could refer to other sayings, but it is important that finally we are ensuring this is no longer a taboo subject where we whisper, “the change”.

The issue crosses over every demographic—from royalty, including the Countess of Wessex, all the way through. I was fascinated to hear the hon. Member for Swansea East refer to it as a “posh” issue. That is so depressing, but she is absolutely right that some women feel that HRT products and help and support are available only if they are posh and can demand them. She is right that in the cost of living challenge we are now living through, too many women will be putting food on the table for their children rather than spending £18 on the vital HRT products that they need.

I welcomed the Minister and the Secretary of State for Health’s support for the private Member’s Bill promoted by the hon. Member for Swansea East. They agreed to her proposals, but it is disappointing that we have to wait until April 2023, given that there are women in England who are desperately waiting for an annual prescription.

It was interesting to listen to the hon. Member for Belfast South (Claire Hanna). The issue applies to all four nations, and it is a shame that England is still the poor relation of the four. She reminded me of a close friend of mine who lives in Northern Ireland and is a constituent of the hon. Member for Strangford (Jim Shannon). She was telling me a few weeks ago of all the symptoms she had. She had been to her GP in Northern Ireland and he was suggesting antidepressants. I begged her and said, “Please, you are 51. You are going through the menopause. Go back to that GP and demand.” She did, and now she is on HRT. She is an educated woman who has been to university and has a high-profile job, but she still has to beg her GP to take her seriously. That is unacceptable. There is more to do to ensure that GPs across the four nations have the right advice and training.

I want to highlight Pausitivity, an organisation I know very well and whose posters I have previously mentioned in the Chamber. I wrote to the Minister recently and I hope she will respond positively. We need to support Pausitivity’s Know Your Menopause campaign. Its leaflets are a signpost for women and highlight symptoms, so that they can go back to their GPs and demand support and help.

My hon. Friend makes an important point about Pausitivity. Claire Hattrick from Hampshire has published a whole book about self-help. There is a brilliant case for the Department of Health and Social Care to consider making small funding streams available to ensure that the work of all those smaller, regional self-help and campaign groups can be disseminated much more widely. All of us have friends, like my hon. Friend’s friend in Northern Ireland, who have not had the confidence, knowledge or expertise to go to their GP and say, “This is what I have got. Please can I have?” We need to spread the information. Perhaps DHSC should look at how it can fund that.

My right hon. Friend is absolutely right. I wrote in my letter to the Minister that we need to support organisations such as Pausitivity so that women can use them as a signpost. Its posters are brilliant. They are in Urdu, Punjabi, French, Dutch, German, English and also, as the hon. Member for Swansea East will be delighted to know, Cymraeg. Let us support women from all walks of life, and let us also support families.

This morning I went to talk to a group of year 10 pupils at Pimlico Academy. They asked me what I was doing this afternoon and I said that I would be speaking in the menopause debate. I said, “It is really important that you guys, aged 15—boys and girls—are aware.” I said to the girls, “PMT and periods are tough enough, but you wait: the menopause is something to really know about. You have to know for your mums who are going through it, or are about to go through it, and for your grandmothers and your aunties. It is really important that you know about the menopause so that you can support them and so that you know that when they are screaming at you, there is probably a reason for it. It is not because of you, but because they are probably having a really tough time because they haven’t slept for five days, they feel like they are having an out-of-body experience, they do not feel themselves and then they take that out on their families.” It is really important that husbands, partners, brothers and fathers also understand what women are going through.

We have come a long way. The Government have been listening. I know that the Minister takes a lead on this issue and I absolutely welcome the Government’s real emphasis on it, but we still have issues with a shortage of HRT products. When I went to get my prescription a few months ago, I was told that I could not have my Oestrogel because it is not in supply at the moment. I was really worried. I have one bottle left and am squeezing every single ounce of it. I hope to God that it will be back in when I go back to the GP next week. I urge the Minister to do all she can to make sure that the products get back on the shelves. I fear for my Chief Whip and my Whip if I do not get my HRT product. I am just putting that out there to the Minister—you have been warned.

More seriously, there is so much more that we have to do on education and for businesses. I am extremely proud that this week the Cabinet Office—the Minister was also at this event—became the largest organisation to sign the menopause workplace pledge. More than 1,000 organisations have now done so. That is a start, and it is amazing. The Government are actually taking the lead, but as many have said here today, including my right hon. Friend the Member for Romsey and Southampton North, there is much more that each Government Department can do—like not working in silos. We know that when Governments work in silos, nothing gets done. There has to be a holistic approach. Let us get this done.

It is very important to ensure that women are aware of the symptoms of menopause, but also that they can be symptoms of other conditions. I have recently been diagnosed with hypothyroidism and Hashimoto’s, and the symptoms are very much related to the menopause. Although I may have been going through the menopause, I wonder whether the vast majority of my issues over the past two or three years were because of my thyroid problem. I am now on thyroxine, and it is changing my life, but women need to understand that their symptoms might not just be from the menopause. GPs have to understand that, too. Again, I would like there to be more information and for GPs to have a better understanding of those issues.

To conclude, being in politics can be very difficult. We have so many arguments, and there is so much that can divide us, but women’s health—particularly issues such as the menopause—unites us. We can see Northern Irish, Scottish, Welsh and English MPs here today in support of getting more help for the menopause. That is what makes it great to be a Member of Parliament—we can come together and join forces to ensure that we support women and men in all walks of life. The menopause revolution has only just begun. It is only the start, but I am sure that, working together, we will ensure that women have the products and support they need to carry on with their lives. The menopause is a change. It is the midpoint in our lives. It should never be the end of women’s lives. I feel that I am just beginning my life.

As always, I am thankful to be able to speak on behalf of my constituents. I want to start by congratulating the hon. Member for Swansea East (Carolyn Harris). I have been fortunate in my life to have always been surrounded by powerful women. It was my mother to start with, then my wife, and in the political sphere the hon. Member for Swansea East, who is a really powerful lady. Whenever she asks me to be involved with debates, she is pushing on an open door. She knows I will be more than happy to support her—I always have been.

When the hon. Member for Swansea East started this campaign some time ago, she and I talked about it, and she was very keen to have a man on board. I am very happy to give my support, for a number of reasons. I do it because the request is right: it is about raising awareness. As a man, I do not find these subject matters particularly easy to discuss—it is probably my old-fashioned, traditional nature—but I know that these things happen. It happened to my wife, Sandra. We have been married 35 years. She is an extremely powerful lady. She is very understanding and has stuck with me for 35 years, so I think that tells you all about that lady.

I remember that when we married she had period problems. The doctor she went to see was very good and he said, “Sandra, when you have children, everything will change.” Well, it did not. We had three children fairly quickly in a period of five to six years. We both wanted children. I was very fortunate to get three boys. I think Sandra would have liked a wee girl, but it did not work out that way. Throughout her life, she always had problems with her periods—they were always very heavy—but then she came to the menopause.

I am pleased to speak in this debate and give a man’s point of view. I am giving a husband’s point of view, too, because I understood from the very beginning what the problems were for my wife. It was all the things that the hon. Members for Belfast South (Claire Hanna) and for Guildford (Angela Richardson) referred to: the night sweats, the brain fog, the pain, the agony. She just could not get settled and was always restless. I understood why that change was coming in Sandra’s life. I was not there all the time—perhaps that was better for her, actually—but whenever I was, on those three and a half days a week, I understood that she was having terrible difficulties. We are lucky that the boys have left the house, but the two cats and the dog absolutely dote on her. They do not understand what is happening, but they trot alongside her.

I tell that story because I want the ladies here—the right hon. and hon. Members—to know that I do understand, although I have not experienced it personally. The hon. Member for Belfast South asked what would happen if men could live through this. I tell you what—we would have a different attitude. I have lived through it with my wife, and I think I understand it—I hopefully understand it well.

I have been very pleased to see more businesses and people seeing the benefit of bringing menopause into the light. The civil service has launched a menopause strategy, citing that females account for 50% of the 24,000 Northern Ireland civil service workforce, and that more than 55% of the female employees are over the age of 45, so a significant number of employees are likely to be affected by the menopause. The aim of the policy is to raise awareness and understanding of menopause and outline the support available.

The hon. Member for Belfast South and I, as Northern Ireland MPs, understand this debate from a Northern Ireland perspective, but also because we are active constituency MPs. We understand the importance of having a good workforce who are able to do the work and understand when things are not right.

The hon. Member for Cities of London and Westminster (Nickie Aiken) referred to GPs. I have seen a change—I just whispered this to the hon. Member for Belfast South—in GPs and doctors in my constituency. The hon. Member for Cities of London and Westminster inadvertently, or maybe purposely, referred to her friend from Killinchy. Men have retired and ladies have taken their place, so I hope that means that there will be better understanding. Giving depression and anxiety mediation is the wrong thing to do; HRT should be given. I hope to see those changes. I see them in my doctor’s surgery and in the surgeries and clinics in Newtownards. That seems to be replicated across the whole of the constituency, and I suspect it is happening in other parts of Northern Ireland. The hon. Member for Belfast South, in conversations we have had, has said that women GPs and doctors have to take time out to look after their families. That happens at times, but I see a change coming, with a better understanding, so that in the future we will hopefully not have the problems that we once had in the past.

I referred to the strategy for the 24,000 members of the Northern Ireland civil service workforce, and that comes on the back of the first meeting of the UK-wide menopause taskforce, which has been established to strengthen co-ordination across Government and raise awareness of the impact of menopause, improving care and support for women and ending the taboos and stigmas what still surround a natural part of ageing.

I echo the request that every other Member has made. I am very pleased to see the Minister in her place. I have seen more of her this week than I have seen of my wife—she has been in this Chamber on three or four occasions to respond to debates. She said to me, “You’re back again,” to which I said, “Well, I never leave here.” I am so pleased to see her in her place. I know that she has understanding of the issue and compassion. When the hon. Member for Swansea East was introducing the debate, the Minister was cheering as much the hon. Lady was—that’s the Minister. I look forward to her response.

I am pleased that the taskforce is attempting to lead the way. While I am thankful to all the big businesses that are stepping in to acknowledge this medical issue, my mind turns to those smaller businesses that do not have a human resources department to guide them. I ask the Minister—I do not know whether this is under her control; responsibility might lie with another Minister —what support are the Government offering smaller businesses to help them understand the issues that their workforce are facing, and to support their workforce throughout their journey?

I am very fortunate to have always had powerful women in my life. I have six ladies in my office—apart from me, it is a purely female staff. That sometimes gives me an understanding of what happens in the office among ladies. One of the lovely ladies in my office had a hysterectomy and went through her menopause in her mid-50s. The hon. Member for Cities of London and Westminster referred to the age of 51 in relation to the menopause. I do not miss too much in the office; I usually have a fairly good idea of what is cooking. One of the other girls in the office did a small thing that I think made a big difference. She bought her a wee pink fan—I use the word “wee” all the time; it is a Northern Ireland thing—that sat on her desk and made a psychological difference for her. The girls were telling her, “We know what you are going through.”

The hon. Gentleman makes a brilliant point about the small pink fan. Some of the interventions, changes and support measures that employers can put in place are small, cheap, unobtrusive and not difficult.

The right hon. Lady is absolutely right. As with constituents, the small things that we do are big things in their lives.

At the same time that my staff member had her hysterectomy, one of the younger girls in the office—I have two girls in their early 20s in my office—was going through endometriosis treatment, and her medication pushed her into menopause. It was drastic for a such a young girl, and one who is keen to have children someday— I very often feel for her.

The issue of menopause and perimenopause affects a large amount of the working population. It is great that work has begun to recognise that, but that support should be in every avenue of work, not simply the big companies. Can the Minister therefore give us some indication of what is happening for smaller companies in that regard?

The hon. Members for Cities of London and Westminster and for Belfast South asked about HRT. We would really appreciate an update on the supply of HRT medication. When ladies present themselves to GPs, there needs to be a better understanding of how to respond. In this House we need to ask ourselves how we can come alongside the small business owner to ensure that they are aware of how the small things—as the right hon. Member for Romsey and Southampton North (Caroline Nokes) said—can make a huge difference to the quality of life of their employees, as well as to the environment and productivity in the workplace. It has been said for many years that a contented workforce is a productive workforce, and which of us does not want to understand how to get the best work out of our employees and allow them a decent quality of life?

The hon. Member for Cities of London and Westminster and I must have been speaking to the same script writer. I remember the days when people muttered under their breath, in hushed tones, that someone “must be going through the change.” People almost whispered it—“don’t say it too loudly.” Today’s debate is about saying it loudly, because it is important. That is what the hon. Member for Swansea East has done, right down the line. I admire her courage and determination to make things happen, which is infectious—I come to all her debates and support her in everything she does. I do it because I want to, but also because it is right. This is a debate that is right.

It is time for us not to be ashamed of the menopause or to try to hide it; we should accept that it is a part of life with medical implications. We need appropriate responses in the workplace and appropriate responses from the general public—from men and all those out there who do not understand it. That may be because they do not want to, or because they have a wee bit of trepidation about it. We should give those businesses the opportunity to learn more, and put in place effective policies. That is up to the Departments for Work and Pensions and for Health and Social Care, working in partnership and, respectfully, what I believe we must see.

Again, I am thankful for the opportunity to represent my constituents, and to represent my wife, obviously, since I have first-hand knowledge of how this has affected her. I have always tried very hard to be supportive and understanding. I hope that this will not be another lost opportunity, where words are spoken but no action is taken. To be fair, today’s debate is about actions, and there are people here who drive actions.

I said this in the last debate, and I will say it again:

“Eighty per cent. of women suffer from menopausal symptoms; 100% of women deserve support.”—[Official Report, 21 October 2021; Vol. 701, c. 1023.]

For me, this debate is about every one of those 80% of the ladies, and giving them my 100% support, as everyone else here today does. I look forward to hearing the Minister’s response shortly, and to the participation of my male colleague, the hon. Member for Coatbridge, Chryston and Bellshill (Steven Bonnar).

It is a pleasure to see you serve in the Chair, Mr Robertson. I commend my hon. Friend the Member for Swansea East (Carolyn Harris) for securing the debate, and for her ongoing commitment to pursuing wider public understanding and support for menopausal and perimenopausal women. The fact that all four nations of the UK are represented here is a real testament to the diligence, determination and doggedness of her campaigning. Having spoken in the debate that she secured last year, I am pleased that this is now a regular feature, and that the needs and experiences of women undergoing this stage of life are now being properly considered.

According to Hansard, the first time that the word “menopause” was used in our Parliament was in 1943, in the Lords, in a debate on “population problems”. It was not mentioned in the Commons until 1964, and the 100th reference was not until 2017. We are in a much healthier position now that we can consider it as one of the areas of life that we should properly appreciate.

I was struck by the comments from my hon. Friend the Member for Swansea about the experiences of women wrongly prescribed antidepressants and anxiety medication when what they needed was HRT. I know at first hand the life-saving potential of medications of that type, but only when they are appropriately prescribed. Side effects can often include excessive sweating, insomnia, agitation, anxiousness and dizziness—all things that can, themselves, be symptoms of menopause. That means that the wrongful prescription of those medications could actually exacerbate the very misery that caused affected women to seek medical support in the first place. At best, it would be treating some of the symptoms but not the underlying causes.

Let us hope that, as a Parliament, we are reflecting a society that increasingly understands and accommodates the symptoms of menopause, which affect so many in our country—around 5.1 million women aged between 45 and 55. As the right hon. Member for Romsey and Southampton North (Caroline Nokes) made clear, many younger women, and people who do not define themselves as women at all, also experience this. They may find it even more difficult to access support as they do not fit the typical profile.

It is essential that every affected person feels confident and able to discuss their symptoms with their employers, and to have requests for workplace adjustments met. We have all now had the chance to see the value of flexible working, and if a woman suffering from hot flushes asks to wear a more forgiving uniform, or to change her work hours so that she is not commuting in crammed transport during rush hour, that should be granted. That is an area that should have been included in the long-promised employment Bill that was so glaringly absent from the Queen’s Speech.

Throughout my career I have often been lucky enough to be one of the youngest, if not the youngest, women within my team, and to have been surrounded by women who were older and more experienced, and who were often going through symptoms of the menopause or the perimenopause. It has meant that I have had the benefit of watching them, listening to them and hearing them. Their generosity, in talking about what they were going through, means that when I get to that stage of life I will know what to look out for, what treatments are available, and what adjustments I should be able to ask for, demand and expect from my employer. We need to foster cultures in every workplace that allow people to have those conversations with each other, with younger colleagues and with their employer, and importantly, to be listened to so that accommodations can be made. That will set a really positive precedent for our society as we move forward.

An important part of that wider societal understanding is the inclusion of menopause in relationship and sex education classes in schools. I am glad that that has been the case since 2019, but I would like to hear from the Minister about how widespread that teaching is. It would be ironic if our children now learn more about menopause than our medical professionals do. Last year I challenged the then Minister, the right hon. Member for Mid Bedfordshire (Ms Dorries), about gaps in training at medical schools, as 41% do not teach about the menopause. She promised improvements by 2024, but I would like to know what the figures are now, because we cannot improve what we are not consistently measuring and tracking.

Many of the physical challenges of the menopause can be addressed through HRT, but access should not be a postcode lottery dependent on GP understanding or sympathy. In Wales and Scotland, women benefit from free prescriptions, including for HRT treatments. Can the Minister tell us what more the Government will do to ensure affordable access, particularly in the context of our current cost of living crisis, and what steps are being taken to address the issues of supply that have been raised by right hon. and hon. Members across the House?

To conclude, I am delighted that this is becoming a regular discussion, not least because we can therefore hold Ministers accountable on progress. I hope our questions are answered today. If not, we will continue to raise them at every opportunity, because suffering is not a necessary or inevitable part of ageing.

We now come to the Front-Bench speeches.

It is a pleasure to serve under your chairmanship, Mr Robertson—also for the first time, I believe. I join other Members in thanking the hon. Member for Swansea East (Carolyn Harris) for securing the debate and informing us all so well on the subject. Her contributions on this matter through the years have clearly made a big impact in this place, and I commend her for that.

Those with an old-fashioned mindset will perhaps look at me standing here and say, “You are a man. What do you know about the menopause? What has it to do with you?” There are many more out there who would agree with that position—that is the current reality—but I say to those people that, as the son of a beloved mother and the father of a daughter first and foremost, conditions that affect women and girls today are just as important to me as any that I might face due to my being a man. That is why I did not hesitate to come along to today’s debate on behalf of the Scottish National party. Hearing the valuable contributions of Members and others from across society can only help my understanding and, hopefully in turn, that of my constituents.

Understanding is the key to this whole debate. It both puzzles and worries me that although women make up half of our population, the menopause remains a taboo subject: one that we will not mention, shrouded in stigma, hidden away, and perhaps even leaving feelings of shame being common. In particular, we as men cannot allow ignorance of conditions affecting the other sex—the women in our lives—to pose a danger to their health and mental wellbeing or their happiness. Also, why should women be made to feel that the men in their life might not want to be bothered talking about the often debilitating effects that the menopause is having on them? That shushing-up mentality must stop, and men can play their part in that.

The veil that too often covers discussions about the menopause is damaging for women who are experiencing it. There are often health and wellbeing implications to the menopause, and if those symptoms are even acknowledged at all, they are often dismissed as “women’s troubles”. Few men probably realise that the menopause can have a serious physical and psychological impact on women. I have heard my own mum refer to “the change of life”. As a man, the term “the change of life” seems to be a pretty dramatic and traumatic thing, so why do we just dismiss it out of hand in the manner that we do?

We have heard today from the hon. Member for Swansea East about the HRT lottery being experienced, particularly in deprived areas. I am so proud of the Scottish Government and their policy of abolishing prescription charges. This is exactly why policies like that matter. The right hon. Member for Romsey and Southampton North (Caroline Nokes) outlined the obstacles to career progression and the financial implications that can be caused by the menopause throughout a lady’s life and, indeed, her career. The hon. Member for Edmonton (Kate Osamor) outlined her experiences and the impact of the matter and the attitudes around the discussions that need to be had within our communities, across all these nations and across ethnic diversities. I thank all hon. Members today for their excellent contributions.

On top of the abolition of prescription charges and the introduction of free sanitary products in schools and community buildings across Scotland, I am proud to say once again that progressive action has been taken by the Scottish Government on the matter of menopause, because shying away from the issues that matter will not help the people to which they matter most of all: the women in our individual lives and the women who power the four nations of the United Kingdom. With a focus on earlier education about the menopause, the Scottish school curriculum includes meaningful learning about this vitally important subject. Our younger generation can now learn and grasp why menopause understanding is vital, seeing it as a relevant health condition. I would like to hear the Minister’s plans in that respect. What action are the UK Government taking now and in future to educate and involve younger persons in the discussion?

Supplementing that educational work, in August 2021 the SNP Scottish Government published a new women’s health plan, which set out 66 individual actions to ensure that all women enjoy the best possible healthcare, suited to their needs throughout their lives. Instead of making decisions behind closed doors, the real-life experiences of women are sought out and considered, recognising the importance of their feedback in effective policy making. From that, the menopause specialists network was established, whereby primary care teams meet on a regular basis to provide specialist, consistent and updated advice and training. This is what effective policy looks like: putting power into the hands of those most affected by the menopause, and enabling them to input and inform the best outcomes for their own lives.

Scotland is providing more than just hope to women that the menopause is to be seen as a normal thing and everyone in the health community is there to support them. I know the Minister here takes note of the outstanding work being done in Scotland on other matters. I hope that she will do the same on menopause matters as well.

We also note that implications of the menopause, unfortunately, display themselves most of all in the workplace. Those experiencing the menopause are the fastest growing demographic in the workplace. Recent data found that 62% of women report being stigmatised by their employers for requesting leave or specialised support to deal with their early menopausal years. Too many employers are choosing to take an ageist and outdated approach to specific healthcare needs and are, frankly, in grave danger of losing out on exceptional talent and experience by taking the decision to treat older women differently from other staff.

Although employment law is a reserved matter, the Scottish Government are working to make our country a fair work nation, where all employers will offer flexible working and support equal working practices by 2025. The hon. Member for Strangford (Jim Shannon) mentioned the pink fan. Those are all matters that need to be taken on board to make the workplace a more practical place for women going through the menopause.

I believe that the UK Government could go further. If they need any inspiration, they can look to our European counterparts. Spain has recently made landmark changes in introducing menstrual leave, whereby employers make workplaces a comfortable place for women to support them from a medical perspective and also take necessary time out for painful periods or menopausal symptoms. I urge the Government to take similar action. If we want to reflect the growing awareness of employee health and wellbeing and to prioritise it, we must integrate such progressive approaches into our entire working culture, rather than depending on individual businesses taking individual actions.

Lastly, as a man, I want to see the Government normalise the menopause discussion and make it a conversation we can all have openly, before finding and offering the solutions we know are required. I want to see more men in this place and across wider society speak up for women and stand in solidarity with them for fair treatment by employers, in particular on matters such as the menopause. We will all experience gender-specific issues in life. The more we learn about and understand those issues, the better we, as a society, can effectively deal with them, for the good of us all.

It is a pleasure to serve under your chairmanship, Mr Robertson. I congratulate the hon. Member for Swansea East (Carolyn Harris) on once again securing a debate on this important issue. It is good to see all four nations represented here this afternoon and both men and women involved in the debate. It is my wedding anniversary today, and it is a pleasure to share it with the hon. Member for Strangford (Jim Shannon) and to show our continuing working relationship—[Laughter.]

To reassure hon. Members, progress has been made since the debate held by the hon. Member for Swansea East last October. It was one of the first debates I took part in as a new Minister, and I can honestly say that virtually every day since then we have worked on many of the issues addressed in that debate to improve outcomes for women going through the menopause. This is an important issue for me not only because it is a key priority area in my portfolio, but because I went through an early menopause over 10 years ago. The hon. Member for Edmonton (Kate Osamor) described her struggle to get her GP to take her seriously, but for someone in their 30s it is even more difficult, and it can be a lonely experience if your peers are not going through the same thing. They are busy getting married and having children; they are certainly not talking about hot flushes and not being able to sleep. It can be a very difficult experience. So, for me, this is a personal mission as well as a ministerial one.

I want to reassure colleagues that I absolutely have a laser focus on delivering many of the pledges made in the previous debate. On the cost of HRT, we announced in that debate that we would accept the move towards reducing the costs. It only affects women in England, but it is an important issue. Around 89% of all prescriptions issued in England are free. People qualify for free prescriptions when they are on income support, universal credit, jobseeker’s allowance and pension credit, so the vast majority of people getting general prescriptions are entitled to free prescriptions.

However, women going through the menopause often do not meet those criteria. I fully recognise that the cost is very high, particularly for women who are on two hormones or who have multiple products that they need dispensing. That is why we are committed to introducing the bespoke prepayment certificate for HRT by April next year. It is very different from the prepayment certificates that exist for general medicine. However, there are steps that we have to take. We are expected to consult the professional bodies involved. There will be changes to both dispensing and prescribing. A statutory instrument needs to be laid to make those changes happen. IT changes are also needed to make these things happen in practical terms, so that when women turn up at the chemist, their prescriptions are actually there for them to collect. We are not making excuses, and this will happen by April next year, not from April next year. If we can do it any quicker, we will. The prescription will be £18.70 for all HRT products, whether that is for two hormones or multiple products, and that will be a considerable cost saving for women.

The supply of HRT has been a challenge. We have seen more than a 30% increase in demand, thanks to all the campaigners raising the profile of the menopause but also highlighting the benefits of HRT and breaking the taboos. GPs and doctors were often worried about the safety of HRT, but campaigners have explained that some of the research that was around 10 or 15 years ago is out of date and that HRT is a safe and effective product for many women. So there has been a huge increase in demand. We have met trade suppliers, manufacturers and pharmacists to discuss the challenges they face and to try to overcome them. Of the more than 70 products that are available, we are now down to pressures on three or four, and even with those we are seeing significant progress.

The hon. Member for Belfast South (Claire Hanna) asked for an update. Maddy McTernan, the head of HRT supply, updated the taskforce this week. We are making good progress. There is commercially sensitive information, which we cannot share, but manufacturers are stepping up to the plate to produce extra supplies. It is not about meeting the demand now. Demand will continue to grow, and we need to future-proof to ensure that we are not in the same situation in six months.

The prepayment certificate will also help. Women will no longer have to try to get a prescription for three or four months in order to keep the cost down. They will be able to get a monthly supply and not have to pay an increased cost for doing so. That will help manage supplies overall. We have also introduced three serious shortage protocols for the three products, so that we can manage the amount that is being dispensed and have better stock control. It will also give powers to pharmacists to give alternative products. That is not always ideal, because I know that some women notice instantly a difference in the effect of a drug, even if it is the same drug but with a change in manufacturer. It is not ideal, but it is helping us get through this acute period, and it will enable us to better control stocks in the longer term. We will be updating colleagues as we go through this, and Maddy and the team from BEIS have been helping us hugely with that.

The UK menopause taskforce that has been set up was one of the asks from the hon. Member for Enfield North (Feryal Clark); it was not a Government suggestion. We agreed to it and have had our second meeting. There are four key areas where we want to make recommendations. Those include education—for women, men, boys and girls, and healthcare professionals too. The taskforce will also look at the workplace, health provision, and research into areas such as testosterone, where we need to be breaking some barriers.

In the short time I have, I would like to touch on the workplace issue, which is crucial. One of the key things about the taskforce is that it is not just about health. We have a BEIS Minister and an employment Minister, and we are going to invite, as was suggested earlier, a Minister from Justice as well so that we reach out to all women affected by the menopause. I am really pleased that the civil service led the way this week when we signed Wellbeing of Women’s menopause workplace pledge. That will not just help women in the civil service who are going through the menopause it is to show other employers the sorts of small changes, such as the pink fan mentioned by the hon. Member for Strangford (Jim Shannon), that can make a big difference. It will also enable women and employers to feel confident to have those discussions at work. As my hon. Friend the Member for Cities of London and Westminster (Nickie Aiken) said, these women are in the prime of life. We have women with extraordinary experience and talent who we should be harnessing, not letting go.

We are really serious about improving GP training. It has been difficult for GPs to get that specialist advice and support, as this is a growing area, but the General Medical Council will be including the menopause as part of its licensing assessment, so it will be a core part of training. The NHS England menopause programme will be producing resources for all types of healthcare professionals so that we can make sure that people are trained.

I know I have to let the hon. Member for Swansea East come back in—

There is plenty of time.

Okay. The NHS itself is setting up a training programme to make sure that at every point that a woman approaches the health service—when meeting GPs or nurses—they get the specialist training they need.

The women’s health strategy is coming forward. I would rather spend time getting it right than rush it through to meet a deadline. We are weeks away from publishing. We have already published our vision and the findings from the consultation, and the strategy will build on that. The menopause will be a priority area within that document. We will also be announcing a women’s health ambassador very shortly, who will be holding my feet to the fire, as will the hon. Member for Swansea East.

I hope I have reassured colleagues that we are doing so much work in this area. Debates such as this are not just about holding me to account. They are about breaking taboos and having lightbulb moments for women across the country, as my right hon. Friend the Member for Romsey and Southampton North (Caroline Nokes) said. I look forward to working with colleagues on both sides of the House and in all four nations to improve the experience for women.

I call Carolyn Harris to wind up.

Thank you, Mr Robertson. I will not take the hour that is left for my summing up, although I could start all over again.

I want to make just a few points. First, I thank everybody for being here and for sharing their personal stories—I am looking in a certain direction. I know it is painful and hard, but when people in this place talk about their personal experiences, it makes us look like what we are—real people with real lives and real feelings—to the outside world. That gives confidence to women out there who are thinking that nobody cares and nobody is listening. Unless we talk to those women, we will not know how they feel. When Nicola Sturgeon appears on “Loose Women” and talks about her menopause, it is inspirational for women right across the UK. When a certain Jim Shannon gets a shout-out as a menopause ambassador on “Loose Women”, it gives confidence to women across the UK that we politicians are listening.

The celebrities who are coming in on Monday are really nervous about coming to Westminster. They think they are coming into a world where they are expected to perform in a particular way, and that we will all be looking at them and thinking, “What do you know about politics?” Through the work they have done, they have proved that they may do politics better than we do, and that they have used their platform to change actually things, without making it party political, which we try not to do on this subject. They are using their platform to share really important messages and really personal stories, in an industry where, traditionally, nobody wants to admit to being a certain age or to potentially being menopausal, because they would be seen as getting on a bit. I really want to thank them.

One thing that it is really important to say is that I would like to see the Davina effect enshrined in legislation—perhaps we can have a show of hands on that—because Davina McCall has played a huge role. I do not think any of us could really have done what we have done without Davina’s documentaries and the work she has done.

On that point, rather than having the Davina McCall effect, perhaps we should all write to whomever we are meant to write to, to ask whether Davina McCall should become a Dame.

That is a perfect suggestion, and it is something that has been playing on my mind lately.

Order. This is a winding-up speech and should last only two minutes.

Yes, two minutes.

The last thing I will say is that everything that everybody has said is wonderful, but as long as women do not have a single prescription charge, do not have a proper diagnosis and proper medication, are giving up work and do not have equal treatment, we are failing. We cannot continue to fail women.

Question put and agreed to.

Resolved,

That this House has considered the menopause.