Women’s Health Strategy

With permission, I would like to make a statement about the women’s health strategy. Today is International Women’s Day, and on this important day we must acknowledge that for generations women have lived with a healthcare system that is designed by men, for men. As a result, women have been underrepresented in research. Despite women making up 51% of the population, we still know little about some female-specific issues, and there is less evidence and data on how conditions affect women and men differently. Despite living longer than men, women spend a greater proportion of their lives in ill health and disability, and there are growing geographic inequalities in women’s life expectancy. That makes levelling up women’s health an imperative for us all, so we must meet our goal of extending healthy life expectancy by five years by 2035.

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.

I thank the Minister for the advance copy of the statement. I wish every woman in the House and throughout the country a very happy International Women’s Day.

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?

I join the hon. Lady in wishing every woman across the world a happy International Women’s Day. She opened by talking about the mental health taskforce and saying it is not the first of its kind, but it absolutely is. It was a five-year project that the NHS used to bring together women and organisations from across the healthcare sector to develop a mental health plan—a five-year view—which it did and reported on. As she knows, partly as a result of that, we now have the long-term plan in mental health.

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.

I really welcome this call for evidence and my hon. Friend’s clear commitment to hear from all women everywhere. Can she please reassure me that the consultation will not just be about reproductive health, important though that is, and that it will include all conditions and ensure that women have the ability to express freely what they want to see from their strategy? I welcome the timescale of the strategy coming forward in September.

My right hon. Friend is a huge champion for women’s rights and a Committee Chair. I would ask her, following the work that was undertaken by the all-party parliamentary group on women’s health, to contact anybody she knows who can help to get this dealt with or who she has liaised with throughout her time as Chair of the Women and Equalities Committee, so that they can help to get this message out to the people who they know, to encourage women everywhere—and, as I said, not just women but families and anybody who wants to contribute.

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.

I welcome the Minister’s statement, which is timely on International Women’s Day. I also refer the House to my entry in the Register of Members’ Financial Interests. A gender health gap has arisen during covid-19, and the Scottish Government are also developing a plan to address women’s health inequalities. Research indicates that young women in particular have been found to have increasing anxiety, depression, suicidal ideation and loneliness. With coping strategies and social support diminished, eating disorders are tragically on the rise with high levels of morbidity. Young women disproportionately struggle to be referred for treatment due to an antiquated medical model based on body mass index to identify eating disorders rather than on a psychological model, treating the whole person. Will the Minister work with the all-party parliamentary group on eating disorders and cross-party parliamentarians who want urgently to address this matter via the funding announced, but also to ensure the timely access to treatments for those crying out for help and a diagnosis, saving the lives of young women, and, in many cases, those of young men, too?

I thank the hon. Lady for her question. In fact, we met recently to discuss this very subject, and I have also had meetings with a number of Members from across the House who have an interest in this area. I also thank her for the work that she does in this area. I think that, as a result of our private conversations, she understands both my commitment and that of the Government. I know that she is aware of the funding that we have allocated to assist with this surge of eating disorders that have presented of late and of our commitment in the long-term plan to assist young women with both mental health issues and eating disorders in particular. An eating disorder is the most deadly of all mental health illnesses and also one of the most difficult to treat. I am delighted to hear that this issue is being taken seriously in the devolved nations as well and that Scotland is also embarking on a similar path. I hope that, as we do on all issues related to health, we and the devolved nations will share data and the methods of collecting it, experience and the evidence to develop a women’s health strategy, which will one day be rolled out across the UK.[Official Report, 12 March 2021, Vol. 690, c. 5MC.]

I really congratulate my hon. Friend on her statement today, particularly on International Women’s Day. Does she agree that the women’s health strategy, including the detailed pillars that she has outlined, is the first of its kind and will mark a real step change in approach in the way that it centres women, their voices, their lived experiences, and their evidence in making real change to the future of health policy in England?

I thank my hon. Friend for her encouragement. She is absolutely right. We are very excited about this strategy because it is the first of its kind. That is why we have put quite a tight timeframe on this to keep the momentum going. We will be collating all the information and data before the summer and we will be reporting when we come back after the summer recess. We will then be able to announce our women’s health strategy before the end of this year. I hope that everybody is as excited as I am about women getting involved and giving us their information, telling us what they feel, when we know that their voices are not heard. We have, I believe, provided the platform for women to have their voices heard. I thank my hon. Friend for her remarks and I hope that she will follow this process. I hope that she will download the link, provide evidence herself—I hope that every woman in this House does that—and be there when we announce the women’s health strategy later in the year.

Last year, the all-party parliamentary group on sexual and reproductive health in the UK, which I chair, produced a report called “Women’s Lives, Women’s Rights” on women’s access to contraception. I hope the Minister will shortly meet me to discuss this report, which showed that, over the past 10 years, with cuts to public health budgets and the fragmentation of NHS services, women’s access to contraception has reduced, most strikingly in access to long-acting reversible contraceptives; that black, Asian and minority ethnic women, in particular, lose out; and that abortion rates have increased. What does the Minister say about how we can put this right and how the separate sexual and reproductive health and HIV strategy running alongside a woman’s health strategy will actually work and ensure that women are at the centre of NHS services?

The Government are committed to developing a sexual and reproductive health strategy, which we plan to publish in 2021. Development of the sexual and reproductive health strategy will be separate from the women’s health strategy. However, officials are working closely together to ensure coherence between the sexual and reproductive health strategy and the women’s health strategy. We hope that they will not contradict each other; we want them to work closely together. The sexual and reproductive health strategy is an incredibly important piece of work in its own right.

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.

On International Women’s Day, I would like the House to think about women with complex and multiple needs—addiction, trauma, abuse and eating disorders. Some lives are just too complicated for one service, and some experiences are just too awful for many of us to contemplate. These women can, however, turn their lives around safely with the right support; I think of organisations in my constituency such as the Nelson Trust, which does so much brilliant work. Will my hon. Friend confirm that women with complex and multiple needs will not be forgotten in this strategy?

I would like to reassure my hon. Friend, and I hope that she will do her utmost to make sure that those women she is aware of are aware of the link and will provide us with their evidence. It is the evidence that we need to develop the women’s health strategy, so we need to hear from exactly the women she is talking about. Complex needs are just that: they are very complex. We need to know about these women’s experiences in the healthcare sector—what acts as a barrier to them, where they think they are not heard, where they think their voices are drowned out and where they feel they are not listened to and do not get the services they should get. I will use endometriosis as an example. It can take women seven to eight years to be diagnosed, all the time being told that they may have a mental health condition, that it is something they have to live with and that that level of pain is normal for a woman to experience, when none of those things is true. We want to hear from those women.

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.

I welcome the Minister’s statement on the women’s health strategy. It has already been mentioned this afternoon but, as the chair of the eating disorder all-party parliamentary group, I think it needs emphasising again: eating disorders have the highest mortality rate of all mental health disorders. While eating disorders do not discriminate, they affect women disproportionately. The longer they go untreated, the longer it takes and the more complicated it is to recover. Will the Minister look at the evidence—there is already plenty of it—showing that we urgently need waiting time targets for adult eating disorder services?

I thank the hon. Lady for her question; I was waiting for it as I knew she would be contributing today. We have had private conversations about this issue, and I want to reassure her. I hope she noticed that some of the £79 million I announced last week will be going towards dealing with eating disorders and the recent surge in referrals to mental health services. She is right to say that there is lots of evidence, and we are aware of what happens with eating disorders and how they develop, and we work with charities, as she well knows. We would still like those women to respond to this call to evidence.

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.

Keighley has fantastic women’s mental health charities such as Roshni Gar, which provides culturally appropriate responsive services for south Asian women experiencing mental health issues, and Wellbeing Women Talk & Thrive, which does an excellent job. Will my hon. Friend confirm that the forthcoming women’s health strategy will contain measures to level up access to mental health services for women and girls across England, so that no matter where they come from, they can always access the mental health support that they need?