Menopause (Support and Services) Bill

I beg to move, That the Bill be now read a Second time.

The private Members’ Bills ballot at the start of each Session of Parliament gives each of us the opportunity to put in to champion a cause that we believe will make a real difference. When I was drawn at No. 3, I thought long and hard about what I should focus on. I wanted an issue that meant something to me and that would make a difference in the lives of people who really need it—not just in my constituency, but right across the UK. Being the only female Member drawn in the top seven, I particularly wanted to focus on something that would improve the lives of women up and down the country, and so the Menopause (Support and Services) Bill began to take shape in my head.

I have said all along that this Bill and the menopause more widely is not a political issue, and I maintain that. Women’s health should never be political. So I am not here today to win points; I am here because, right now, menopause support in this country, and indeed around the world, is falling short and failing women. GP training in medical schools, support in workplaces, public health messaging and curriculum content in our schools all need addressing, and I will come to each of those in turn in my speech.

However, I needed more: I needed something that only a change of legislation would put right, and it was a conversation with one of my colleagues in this place that gave me that something. I have always considered myself very fortunate to be a Welshwoman, and why wouldn’t I?—we are taking over the world, guys—but it had not occurred to me until that conversation that there was another reason why being Welsh was an advantage: NHS prescriptions are free in Wales. My colleague, on the other hand, was off to pick up her hormone replacement therapy prescription and was going to pay for it. She could afford to pay for it, but not everyone can. It was one of those eureka moments when I realised that this was the final piece in the jigsaw of my menopause Bill, which was always going to be about raising awareness and bringing focus to the menopause as an issue we all need to consider.

Some 51% of the population are female, which means that 51% of us will personally experience the menopause at some point in our lives. Our experiences will all be unique. Some will sail through and barely notice. Others will suffer the most extreme symptoms: headaches, hot flushes, night sweats, brain fog, brittle nails, weight gain, insomnia, anxiety, low libido, vaginal dryness—and I could go on and on. Many women will present at their GP’s with one or more of those symptoms, and that can be the first hurdle. With 41% of medical schools offering no mandatory menopause training at all, thousands of GPs are qualifying and entering practice with no knowledge of how to diagnose menopause.

I congratulate the hon. Lady on again bringing a taboo subject out of the shadows. I am delighted, as one of the 49%, to be a sponsor of her Bill, not just because she would have beaten me up if I had not been, but because this is a genuinely needed and worthwhile Bill. Does she agree with me that it is not just the 51% or the 13 million who are peri or post-menopausal who are affected, but that it affects many of the 49% and younger women? Many of the conditions that she has described are a huge additional cost to the NHS that, if prescribed for properly—and diagnosed properly—would save a lot of money for the NHS and an awful lot of angst for many women going through that, and the people around them.

I agree with the hon. Gentleman and thank him for sponsoring the Bill. I would say that this is about not just the symptoms women feel, but the consequences in relationships; we have seen far too many marriages and relationships fall by the wayside because of menopause and its symptoms, and now is the time to change all that.

Women presenting to their doctor are often diagnosed with anxiety and depression. That happened to me and I have told my story previously: I presented to my GP believing I was having a nervous breakdown and ended up on antidepressants for 11 years. It was only when I spoke to friends and colleagues in this place and we shared conversations that people do not normally have—or did not have until now—that I realised that many other women were also experiencing what I was experiencing. That means we are seeing women being prescribed antidepressants when hormone replacement therapy may well have been more suitable, or presenting with insomnia and being given sleeping tablets when HRT may well have been more suitable, or being sent to consultants for tests for early onset dementia when visiting their GP about their brain fog and forgetfulness when, again, HRT may well have been more suitable. As hormone levels drop, women are at greater risk of developing a series of other conditions—cardiovascular disease, osteoporosis, type 2 diabetes, obesity, osteoarthritis, depression and dementia—and the cost of investigating and treating these as well as the other additional appointments is putting extra unnecessary pressure on our NHS.

I have heard countless stories of misdiagnosis. As I have said, I went on to suffer for 11 years with what I considered to be depression. Little did I know that over a decade later when I started HRT, I would see my life become transformed and I would have more energy. God, isn’t that scary: more energy? My husband is heading for the backdoor now. But we cannot blame GPs; we must make sure our medical schools reassess their curriculums so in future doctors are educated in the menopause and are able to offer all women the same high-quality care and support. Women are routinely called for cervical smears and breast screening; we need to see them being called for a menopause check-up around the time they turn 40. This would be a quick and an easy solution to helping women become more aware of the symptoms so that they are prepared and, importantly, educated in the available treatments.

I join the warm tributes to the hon. Lady’s genuine cross-party approach to this; it is a testament to her campaigning ability.

I was particularly struck by clause 2 of her Bill which talks about the wider strategy. Does she agree that while HRT is a wonderful prescription for many women there will be some for whom it is not suitable, and therefore wider issues about menopause awareness and training are going to be important if we are to reach as many women and their families as possible?

I do agree and my mantra has become that we can all become menopause warriors because that means we acknowledge the issues and problems and are prepared to work towards ameliorating them.

We can look at the good practice out there to see what can be done. I recently spoke to practice nurse Sharon Hartmann from Tudor Lodge surgery in Weston-super-Mare. The surgery supported Sharon to develop a special interest in menopause care. She is now certified by the British Menopause Society and delivers evidence-based practice to her patients. She is able to monitor progress, control treatment plans and prescribe suitable medication for each individual. I would love to see this kind of service in surgeries or clusters all over the country, with doctors being able to identify the symptoms quickly and ensuring women are then passed down to someone with a wealth of knowledge and experience in menopause care. But it is not just the education of the medical profession that needs attention. We need to address education in our schools, so that the next generation of girls and boys is far more prepared than any of us were. I certainly did not talk about the menopause when I was at school. We did not even talk about periods when I was at school. We want the next generation to talk openly about it, understand what is to come and what they can do to help. We need young men to understand that their mothers, wives, sisters and partners may struggle at some point in their life, and that it is not that they do not love them any more, it is just that the menopause is denying them emotion.

I, too, congratulate the hon. Lady on bringing forward this issue and pursuing it in such a constructive, positive and enthusiastic way not just in the House but outside it too, and on the points she raises about the stigma attached to the menopause and the idea that women of a certain age are maybe past their prime. Absolutely not. People need to know that women’s lives actually might begin at 50. Thank you for what you have done and, I understand, for your constructive work with the Government. What you are doing today is a most important step forward—

Order. I cannot let the right hon. Lady, who is a senior Member of the House, say “you” when she means “her”. Could she just say it again, just to please me?

I was carried away by the excitement of the moment, but you are quite right, Madam Deputy Speaker. The hon. Lady has done so much and will earn the gratitude of the whole country for what she is doing with this positive step forward today.

I agree with everything the right hon. Lady says.

It has been a pleasure to work with some fantastic women in this place who understand how important this issue is and, like me, want to ensure it is at the top of the agenda. The Minister, her predecessor, our shadow Minister, and all my cross-party colleagues and friends have been absolutely fantastic. We are so lucky to have strong male voices, too, who have not only signed the Bill but are here to support it. I want to thank—good grief, the hon. Member for Strangford (Jim Shannon) is not in his place! That is a first. I thank the hon. Members for Strangford and for Hazel Grove (Mr Wragg), my hon. Friends the Members for Bootle (Peter Dowd) and for Blaenau Gwent (Nick Smith), and the hon. Member for East Worthing and Shoreham (Tim Loughton) to name just a few, men who are not afraid to embrace the menopause revolution and have shown themselves to be dedicated menopause warriors.

I am sure we would have heard the voice of our dearly missed colleague, the former Member for Southend West, today if it were not for tragic events. I remember him coming to a menopause event I hosted a couple of years ago. When I asked him if he supported the cause, he told me, “With a wife and four daughters at home, I don’t have any option.” [Laughter.] So today, I would like to add my voice to those who have already spoken in the Chamber and around the country, and send my thoughts and prayers to his wife, his four daughters and his son. David was a very special man and we all miss him greatly. [Hon. Members: “Hear, hear.”]

We need to go further on education. We need to educate ourselves now. A public health campaign would help enormously, as so many women just do not join the dots between their own health issues and the menopause. As I mentioned earlier, 11 years ago I had no idea what was happening to me. If my inbox is anything to go by, I am not alone. I know from conversations I have had with friends and colleagues in this place that they, too, were not sure of the situation they found themselves in because it has been a taboo subject. It has been a dirty little secret that women were ashamed of. My earliest recollection of “the change” was a comedy sketch by Les Dawson dressed as a woman having a conversation over a fake wall with Roy Barraclough, lifting his left breast and referring to his neighbour as “being on the change”. We have to move on from those days. It is not a joke when you live with it and it is not a joke when you experience it. We can do so much more to make sure we do the right thing.

I congratulate my hon. Friend on introducing this Bill, on her passion and on raising it as an issue not just of medical training, but of realisation and understanding for everyone—men and women. Does she agree that one of the challenges in this area is the historical nervousness about taking HRT? The world has moved on since our mothers’ generation, when there were some real problems, and medical knowledge has improved. Does she agree that we need more education on the benefits of HRT, which she has so personally described?

I certainly agree. The information that would explain the situation with HRT is out there, but because we are not looking for it, we do not find it. There is really good information that debunks the myths on HRT, which has moved on a lot. It is a phenomenally different product from what it was in the day when too many people were prepared to criticise the use of it. Unfortunately, if someone does not look for that information, they will not find it and they do not prescribe HRT.

Someone understanding their own menopause is so important. Although we are, I hope, heading towards a time when women will discuss their experiences with family and friends, there is also a lot to be done in workplaces, where talking about symptoms can be a lot harder. Employers have a huge role to play in ensuring that support is available and understanding what their staff are experiencing. I have heard far too many accounts of women being given warnings, being sacked or even being made to feel that they have no choice other than to resign due to menopausal symptoms.

I congratulate my hon. Friend on this most excellent Bill and on the work of the all-party group on menopause. The work of the group also helped to inspire activity with employers across the country. I attended an event on the menopause with Shevaun Haviland, the new head of the British Chambers of Commerce, and the Dorset chamber. There was tremendous engagement from employers, who had never been able to have this kind of conversation. Does my hon. Friend agree that, alongside improving awareness in the medical profession and in society to help to encourage discussion in families, supporting employers to have this conversation is vital for their understanding and for women’s employment?

I certainly do. Very many businesses—really big players in their fields—have contacted me and asked for advice on how they can move forward. What I say to them all is, “Don’t have a policy that is left in a filing cabinet that reflects a tick box. Have a policy that reflects your workforce and what women need and is intended to help them.” I visited several big companies that are really good employers and I have seen the all-singing, all-dancing menopause policy that does all but make a cup of tea, but when I asked the staff, “How is the menopause policy working for you?”, their response was, “I didn’t know we had one.” It cannot be a tick box; it has to be relevant.

Other employers need to take heed of the likes of Timpson—I repeat that James Timpson walks on water, as I said in this Chamber last week—in prioritising the welfare of its staff who are experiencing symptoms of the perimenopause or menopause. There are other big companies, such as PricewaterhouseCoopers, Bristol Myers Squibb and Tesco, that do good work—I could go on, but I know that the right hon. Member for Romsey and Southampton North (Caroline Nokes), who chairs the Women and Equalities Committee, will talk about that.

I pay tribute to my hon. Friend for the amazing campaign she is running. The Bill is making such an important contribution; I think we all sign up to being menopause warriors and menopause revolutionaries. To add to the point about employers, does she see a role for trade unions in promoting the excellent ideas that are in the Bill? Can she give some examples of how we as MPs and menopause warriors could do more in our constituencies to encourage employers and trade unions to take these ideas forward?

I have always thought of my hon. Friend as being Amazonian in his warrior status. I am sure that when he has his photograph taken later today with the lovely Penny Lancaster, he will prove to be Amazonian. In his constituency, the Community union is doing fantastic work with Tata Steel, which has welcomed in the union to hold menopause coffee mornings with the women in its workforce, who, let us not forget, are working in a very male-dominated arena. If they can do it, so many others can. My hon. Friend the Member for Newport East (Jessica Morden) has the Llanwern steelworks in her area, and it, too, is welcoming the Community union’s coffee mornings. I urge both my colleagues to attend one of those to share experience and listen.

Almost 80% of menopausal women are in work, with most planning to work for many more years. However, three quarters report that they are considering reducing their hours and one in four are giving up their jobs because they are finding it too difficult to balance their work life with their symptoms. Our careers should not stop when our periods stop. Whether our jobs are physically or mentally demanding, small adjustments could make all the difference. My hope is that employers listening to this debate will make those adjustments and take pride in the fact that they are menopause-friendly workplaces.

This is a great cause. The hon. Lady and I are working together on various other issues as well, and she is a doughty champion for cross-party working on so many important issues. Will she comment briefly on how small employers can help? As one myself, I have two superb women, Alison and Deborah, who work in my constituency office and they have made me very aware of the issue that is being raised in the House today.

Will the hon. Lady also comment on the “Better for women” report by the Royal College of Obstetricians and Gynaecologists, which has worked with me closely on the hymenoplasty and virginity testing changes that it is bringing forward? Will she say a bit more about those workplace policies, particularly to help small employers understand how they can better support women? The team is so important to small employers, and the individual members all contribute so much at different parts of their lives.

What I would say to the hon. Gentleman is that communication is key here; you cannot provide if you do not know what is needed. Do not be embarrassed and do not shy away from that conversation. If staff members do not feel comfortable talking to one person about it, find someone they will talk to. It is so important that you ask them what they need, not tell them what you are prepared to do. Communication and adaptation to suit the individual is key.