PARLIAMENTARY DEBATE
Women’s Health Strategy - 8 March 2021 (Commons/Commons Chamber)
Debate Detail
There is already a lot of excellent work under way to achieve that. The Government are working on the next strategy on tackling violence against women and girls, and we have announced plans for a new sexual and reproductive health strategy, led by the Minister responsible for prevention, public health and primary care—my hon. Friend the Member for Bury St Edmunds (Jo Churchill)—which we plan to publish later this year.
Although this focused work is vital, it is also important that we take an end-to-end look at women’s health from adolescence to older age. I am thrilled to inform the House that today we are embarking on the first Government-led national women’s health strategy for England. It will set an ambitious and positive new agenda to improve the health and wellbeing of women across England. As we know, not all women have the same experience, so we want to hear from as many women as possible, from all ages and backgrounds, about what works well and what we need to change as today we launch our call for evidence.
The call for evidence, running until 30 May, seeks to examine women’s experiences of the whole health and care system, including mental health, disabilities and healthy ageing, as well as female-specific issues such as gynaecological conditions, pregnancy and post-natal support, and the menopause. The call for evidence is based around six core themes, which cut across different areas of women’s health, and I would like to set them out briefly in the House.
The first pillar is placing women’s voices at the centre of their health and care. We know that damaging taboos and stigmas remain around many areas of women’s health, which can prevent women from starting conversations about their health or seeking support for healthcare. When women do speak about their health, all too often they are not listened to. As the Minister for patient safety, I regularly hear from and meet people who have been affected by issues of patient safety. As independent reports and inquiries have found, not least the Cumberlege review and the Paterson inquiry, it is often women whom the healthcare system fails to keep safe and fails to listen to, and this has to change.
The second pillar is improving the quality and accessibility of information and education on women’s health. If we are to tackle taboos and ensure that women’s voices are heard, the provision of high-quality information and education is imperative. To give a timely example, March is Endometriosis Awareness Month. Endometriosis is a common condition affecting one in 10 women of reproductive age, yet the average diagnosis time is seven to eight years. It greatly saddens me to hear how so many women think, or worse, are told that the debilitating pain and symptoms that they are experiencing are normal or imagined and that they must live with it. We must ensure that women have access to high-quality information about health concerns. We must also ensure that health and care professionals can access the necessary information to meet the needs of the women they provide care for.
The third pillar is making sure that the health and care system understands and is responsive to women’s health and care needs across their life course. Women have changing health and care needs across their lives, and we know that specific life events, or stages of life, can influence future health. For example, we know that women who have high blood pressure or pre-eclampsia during pregnancy are at greater risk of heart attack and stroke in future. We also know that women can find it difficult to access services that meet their specific needs, or meet their needs in a convenient place or time, and that there are significant inequalities between different groups of women in terms of access to services, experience of services and health outcomes. For example, women of black ethnicity are four times more likely than white women to die in pregnancy and childbirth. That is why I recently established the maternity inequalities oversight forum to bring together experts to consider and address the inequalities of women and babies from different ethnic backgrounds and socioeconomic groups. There is still more to do, so levelling up women’s health must be a priority for us all.
The fourth pillar is maximising women’s health in the workplace. The pandemic has brought home just how important this is. Some 77% of the NHS workforce and 82% of the social care workforce are women, and throughout the pandemic women have been on the frontline, making sure that people receive the health support and care that they need.
There is some evidence that female-specific health conditions—such as heavy menstrual bleeding, endo-metriosis, pregnancy-related issues and the menopause —can affect women’s workforce participation, productivity and outcomes. There is little evidence on other health conditions and disabilities, although we know that common conditions that can lead to sickness absence—for example, mental health conditions and musculoskeletal conditions—are more prevalent in women. Investment in women’s health in the workplace is therefore essential to women’s ability to reach their full potential and contribute to the communities in which they live, so that is a fundamental pillar of our strategy.
The fifth pillar is ensuring that research, evidence and data support improvements in women’s health. We have a world-class research and development system in the UK, but women—particularly women from ethnic minorities, older women, women of childbearing age, those with disabilities, and LGBT women—have been under-represented in research. This has implications for the health support and care that women receive, their options for and awareness of treatments, and the support that they can access afterwards. We must work to ensure that women and women’s health issues are included in research and data collection and so finally end the data gap that sadly exists. The better the evidence, the better we can understand the health and care needs of women and deliver the change that we need to see.
Our sixth and final pillar is understanding and responding to the impacts of covid-19 on women’s health. This pandemic has taught us so much about our society and our health and care system. As we build back better after this pandemic, we must make sure that we fully understand the impact of covid-19 on women’s health issues and what we can do to take that understanding forward.
The call for evidence is about making women’s voices heard. We want to hear from women from all backgrounds and will be inviting all organisations and researchers with expertise in women’s health to provide written evidence, too. We will respond to the call for evidence after the summer and we aim to publish the strategy later this year. I hope that the strategy will be welcomed across the House.
I thank the Members who have been working with us on this vital agenda. I thank my hon. Friend the Member for Thurrock (Jackie Doyle-Price) for breaking down taboos around women’s health through her advocacy in the House, and my hon. Friend the Member for Gosport (Caroline Dinenage) for her initial work on the strategy. I also thank the Members who lead the all-party parliamentary groups on women’s health, on endometriosis, on sexual and reproductive health in the UK and on women and work, and many more. We will keep working with Members in all parties as we take forward this essential work.
This strategy marks a turning point for women in this country. We are making women’s voices heard and putting them at the very centre of their own care, so that we can make sure that our nation’s health system truly works for the whole nation. I commend this statement to the House.
It is welcome that the Government want to understand the plight of women throughout the country, but although the Minister said that this strategy is the first of its kind, in reality it is not. We heard much that was in this announcement when the Government launched the women’s mental health taskforce in 2017. If the Government took this matter seriously, it would be a first. The Minister responsible for mental health at the time, the hon. Member for Thurrock (Jackie Doyle-Price), said:
“This report is a call to action for all providers, commissioners and practitioners across the health care system to drive forward the ethos of trauma- and gender-informed mental health care.”
That echoes what the Minister just said, so why are the Government asking the exact same questions four years later?
A multitude of health concerns are unique to women and are often overlooked. In hospital, I hold the hands of women in their darkest times: young women and girls presenting with eating disorders; trans women admitted after suicide attempts and substance abuse because they had been made to feel as though they do not belong; and women of colour presenting far too late with conditions that could have been easily treatable if they had found healthcare more accessible. I meet many women victims of domestic violence. They use healthcare services more than non-abused women, so I hope to see the Government’s upcoming violence against women and girls strategy address their needs.
The coronavirus crisis has had a disastrous impact on many women, and I have been honoured to listen to colleagues share their heartbreaking experiences of baby loss. My heart breaks for all those women who have had to go through that alone during the pandemic. What support will be offered to women who experience baby loss without their partners by their side? Within maternity services there are huge inequalities. The Minister is right to highlight the fact that black women are four times more likely to die in pregnancy or childbirth, and I welcome the launch of the forum, but the Government have known about these inequalities for years, so why has there not been action sooner? The Government are running a separate sexual and reproductive health strategy; would it not have made more sense to bring it, as part of that working, into this? A part of this which is widely stigmatised is the menopause. How will the Government be seeking to engage women who have to go through difficulties throughout the menopause?
The “Five Year Forward View for Mental Health” recommended that by 2020-21, in England, 30,000 more women each year would be able
“to access evidence-based specialist mental health care during the perinatal period”
and said that that was important. Can the Minister tell us whether that target has been met? Today, it is huge news that a woman of colour has spoken about her mental health struggles during pregnancy. Many women face difficulties but stay silent, afraid to seek help. With stigma attached to mental illness, the Government must ensure that evidence is collected from all of our ethnically diverse communities.
Women are still being misdiagnosed in 2021. With male bodies being seen as the default, there is a huge historical data gap in understanding women’s health needs. It is shocking that women are 50% more likely to be misdiagnosed following a heart attack simply because our symptoms differ from those of men. What research will the Government commission to bridge that divide?
Finally, pay is a gendered issue. Women are 82% of the social care workforce and 90% of the nurses. Can the Minister justify the real-terms pay cut to our frontline NHS staff? Will she end poverty wages in social care? We need healthcare to work for every woman across the UK—young and old, white and women of colour, cisgender and transgender. We cannot wait any longer. Women’s health and wellbeing should not be an annual PR exercise. We need action and we need action now.
The hon. Lady also spoke passionately, as she always does, about the patients she meets as part of her work and the women who are suffering from eating disorders—sadly, that has been a tragic cost of covid. We know that two groups have been affected by the past 12 months in the mental health sphere: people, including women, with pre-existing mental illness; and, in particular, young women aged 15 to 26, in whom we have seen an explosion in the number of referrals—I believe the figure is 22% for young women seeking help with eating disorders. We have committed funding during the spending review, when £500 million was announced, and I announced £79 million on Friday. Part of that is going to deal with the problems that we have as a result of the pandemic, and with young women and girls—and in some cases young men—who are suffering from eating disorders.
The hon. Lady talked about the stillbirth and neonatal target of halving the number of stillbirths by 2025. We are way ahead of our target on that. The Office for National Statistics published new data last week, and I believe we are looking towards a 30% figure already. We are way ahead of target, and that is a result of the measures that have been put in place in the maternity safety arena, including the saving babies’ lives care bundle and the early notification scheme.
I reiterate that what we are announcing today is a call for evidence from women everywhere in the UK: from every organisation and every friend, every partner, every family of every woman.[Official Report, 12 March 2021, Vol. 690, c. 5MC.] The link has been published today. I published it on the Government website and it is on the Department of Health and Social Care website and on my Twitter feed. It is a link that women can easily access using their phones or their laptops, and it takes a few minutes to complete. We want to develop the first ever women’s health strategy within the Department of Health and Social Care that will deal with all the issues—there are too many for me to talk about now—and all the ways in which women have been affected. These will include research funding and cohorts of trials not using women, using all the information that we have from Paterson and Cumberlege and from women stating clearly that women are not listened to in the healthcare sector. To address that, we need to hear not just from the Paterson women and the mesh women who spoke to Cumberlege; we need to hear from all women everywhere, and that is why we have launched this call for evidence today, to develop this strategy before the end of the year.
Within the first minutes of the link going live this morning, we instantly had 300 responses. I have not checked what the figure is now. We need huge numbers of women and yes, absolutely, it is not just about the usual issues that get talked about, although they are an important part of this. Menopause, menstrual health, maternity and neonatal issues are the things we talk about frequently, but this will be about everything. For example, we know that drugs that are used on women are trialled and developed using all-male cohorts, and that doctors are taught in medical school to recognise symptoms that are taken from men and not applied to women. We know about the inequalities, and we need to know about any subject from disability to mental health; anything that a woman experiences in a healthcare setting, we need to know about it.
Abortion is not a part of the women’s health strategy because, as everyone in the House knows, abortion is a free vote issue—it is a conscience issue; it is something that Members decide as individuals, not as parties—and therefore it is more appropriate that that goes into a strategy on sexual and reproductive health and contraception rather than the women’s health strategy. That does not mean that those subjects are off limits when women respond to the call for evidence on the women’s health strategy. Nothing is off limits; women can talk about anything. We have not yet decided what will go into the women’s health strategy, because we want to hear what women have to say and what issues we are contacted about that we can develop in terms of policy. We will be working closely, and officials will be working side by side.
The right hon. Lady also mentioned LARC. Access to SRH services is being maintained during covid-19, with a scaling up of online services. In response to covid, Public Health England launched a national framework for e-sexual and reproductive healthcare, which allows local authorities and service providers to purchase an expanded range of online services, including emergency contraception and the contraceptive pill. Those services have continued during the pandemic.
I congratulate the right hon. Lady on the work that she does in her APPG. I hope that she will inform its members and those she knows who have an interest in women’s health issues to click on the link and provide their evidence to us.
I thank my hon. Friend for her question, which is really important. She is right: many women suffer from a number of complex health issues and have difficult lives. That is why we have made responding so simple, via a link on a phone and taking a few minutes. I really hope that those women hear this call and will respond.
Many women struggle to get anyone to listen or understand that they have an eating disorder. We struggle to identify them early enough or pick up such things. We still need to gather that evidence, because it is at certain points of contact that healthcare professionals do not recognise or realise that they are dealing with an eating disorder. That is the kind of thing that we think we could get fresh evidence about from women by them clicking on the link and letting us know, either via their phone or their laptop. The hon. Lady has a huge number of contacts, so I urge her to inform them and ask them to contribute to the call for evidence.
Our successful vaccine programme has shone a light on concerns based on a lack of trust that make members of some communities more hesitant about coming forward to access services that could save their lives. Will my hon. Friend confirm that she is taking steps to ensure that a range of voices, from different communities, are consulted on this strategy, so that it leads to better outcomes for women and girls from ethnic minority backgrounds?
Contains Parliamentary information licensed under the Open Parliament Licence v3.0.