Menopause (Support and Services) Bill

(Limited Text - Ministerial Extracts only)

2nd reading
Friday 29th October 2021 Commons Chamber

[Liz Kendall]

Absolutely. I must be honest: I was in a quandary about whether I was going to say anything today, but, like the hon. Lady, I thought, “If we in this place, with the power, influence and authority that we have, are too nervous to speak out, what does that say? “ We need to be leaders and champions, and I hope that we are all making a small contribution to that today.

I must say that I have had a very good experience with my GP. Two weeks ago, I did an online survey. A few days later, I had a phone consultation and I got my first HRT prescription last week—ironically, on the same day as the Backbench Business debate on World Menopause Awareness Month—but I know that millions of other women are nowhere near as lucky. Almost one in 10 women have to see their GP more than 10 times before they get proper help and advice. Two thirds of women suffering low mood or anxiety, like my hon. Friend the Member for Swansea East, are wrongly given antidepressants instead of HRT, often for many years. Around one in three women will end up having a hip fracture due to osteoporosis unless they take HRT, as was rightly mentioned by my hon. Friend the Member for Bradford South (Judith Cummins).

The objectives at the heart of this Bill—to raise awareness of the menopause, to make it easier for women to access HRT and to improve the education and training of health professionals—are absolutely essential. I hope when the Minister rises to speak, she will set out the steps her Government will take to make these goals a reality, because frankly, getting women the right diagnosis and the right treatment at the right time is a no-brainer. It is better for women and it is better for the taxpayer, because it will stop women having to have lots of unnecessary doctor’s appointments. It will stop them being put on the wrong medicines for years, leaving the real issue untreated and undiagnosed, and it will reduce the likelihood of women getting conditions such as osteoporosis when they do not need to, which can lead to much more serious and expensive NHS care, such as hip and other operations.

There is lots more I could say on that issue, but I want to use the remaining time I have to talk about the impact of menopause in the workplace, an issue rightly raised and championed by the right hon. Member for Romsey and Southampton North. There are currently more than 4.3 million working women aged 50 to 64. We are the fastest growing group in the UK workforce, often at the peak of our experience, with all the skills and talent that that brings, but 80% of women say that the menopause has affected their working lives.

Around 14 million days are lost at work every year due to menopause, and a quarter of menopausal women at work find the symptoms so debilitating that they are considering reducing their hours, changing their working patterns or leaving the workplace altogether. Women lose their income and careers, businesses lose their talent and the Treasury loses their taxes. Where on earth is the sense in that?

The fundamental problem is that the vast majority of women are too embarrassed, worried or frightened to speak out or discuss the issue with their bosses or line managers. I think the reason for that is the double whammy of sexism and ageism. If a quarter of men in their 50s were considering quitting work or reducing their hours, you can bet your bottom dollar that it would be at the top of the workplace agenda and a solution would pretty quickly be found. Women should not have to suffer in silence. We have to remove the ignorance and stigma about the menopause. It is not a women’s issue or a private matter, let alone a joking matter; it is a mainstream, no excuses, no ifs or buts workplace issue, and it must be addressed. Again, I hope when the Minister rises, she will set out the steps her Government intend to take on this vital issue.

In conclusion, Members will know that I have never been one for revolutions, but on this issue I make an exception.

[The Secretary of State for Health and Social Care (Sajid Javid)]

I think every word that the hon. Lady has said will resonate with millions of people across the country for exactly the reasons she set out. It is powerful to hear from her about her personal experience, and I hope, especially after this day and going forward, that the whole House can co-operate and do much to help with this. I welcome her comments.

[Liz Kendall]

That is very kind of the right hon. Gentleman, and very much appreciated by me, my colleagues and women across the country. I am very proud to join my hon. Friend the Member for Swansea East, all the other women and men in the Chamber today, women outside this place and the organisations who are campaigning on the issue and calling for a menopause revolution. As she said on the radio this morning, let us make women wonderful again. Who on earth could disagree with that? Millions of women across the country deserve nothing less.

--- Later in debate ---

[The Parliamentary Under-Secretary of State for Health and Social Care (Maria Caulfield)]

Once again, I thank the hon. Member for Swansea East (Carolyn Harris) for all her work in raising awareness on the menopause both in the House and publicly. The menopause, for once, has taken centre stage in the press, in Parliament, among the public and, most importantly, among women. The menopause revolution is here.

The menopause is being debated for the second week running, as last week the hon. Lady and my right hon. Friend the Member for Romsey and Southampton North (Caroline Nokes) secured a general debate to mark World Menopause Month. I believe that this is the first time that the menopause has been debated twice in two weeks. I pay tribute to everyone who has spoken in the debate—both this week and last—including the hon. Members for Pontypridd (Alex Davies-Jones), for Luton South (Rachel Hopkins), for Leicester West (Liz Kendall) and for Liverpool, Wavertree (Paula Barker) as well as my hon. Friends the Members for Stourbridge (Suzanne Webb) for Meon Valley (Mrs Drummond), for Thurrock (Jackie Doyle-Price), for Cities of London and Westminster (Nickie Aiken) and for North Devon (Selaine Saxby). I could go on. Every one of them raised experiences from either their own lives or those of their constituents.

We have heard how important this issue is: it directly impacts 51% of the population, and the effects are wide-ranging and often debilitating. Let us be clear, however, that it also indirectly impacts the remaining 49% of the population. The menopause is everyone’s business. Let me therefore update the House on the work that the Government are doing to break down the taboos and improve menopause care for women. It covers three main areas: healthcare; the workplace; and the women’s health strategy.

On healthcare, we know and have heard many times that people often think the menopause is just a woman’s period stopping and hot flushes starting, but it is so much more than that. There are the night sweats, the fatigue, the unexplained anxiety, the brain fog, the headaches and the insomnia. It is important to break down the taboos surrounding menopause so that women can discuss those symptoms with their healthcare professionals and access high-quality healthcare support.

The NICE guidelines are clear that an individualised approach should be adopted at diagnosis and investigation and in managing the menopause. However, the work carried out earlier this year by the menopause improvement programme found that those guidelines are not being consistently followed, and HRT is often not prescribed despite being a safe and appropriate treatment for most menopausal women. We must ensure that those guidelines are followed.

We have recently made a huge amount of improvement in the workplace. With one in four women in the workplace being menopausal or post-menopausal, it is important that employers create a supportive environment. The Chartered Institute of Personnel and Development, the British Menopause Society and the Faculty of Occupational Medicine among others have provided workplace guidelines, which I encourage all employers to explore. As we heard in the House last week, many employers are starting to lead the way, and I pay tribute to all the businesses that have shown such leadership in the area.

The Under-Secretary of State for Work and Pensions, my hon. Friend the Member for Mid Sussex (Mims Davies), is hosting a roundtable with organisations including the British Chambers of Commerce and the Federation of Small Businesses to improve support for and understanding of the menopause, which will make recommendations to Parliament in November. Flexible working options, whether part-time working or job sharing, go a long way to help women in the workplace. The Government’s consultation on making flexible working the default is currently open, and I urge everyone to respond ahead of the 1 December closing date. The Women and Equalities Committee, chaired by my right hon. Friend the Member for Romsey and Southampton North, is about to hold an inquiry on menopause and the workplace. I look forward to its recommendations.

The NHS is leading the way; with a 77% female workforce, it has many measures in place already. I am pleased to say that the civil service will shortly have a menopause policy in work, to follow the guidelines and support the women in our civil service. I wish briefly to touch on the women’s health strategy, because I mentioned it in the debate last week. It will be published towards the end of the year.[Official Report, 15 November 2021, Vol. 703, c. 1MC.] We had more than 110,000 responses to the consultation earlier in the year, and we found that for those between the ages of 40 to 49 and 50 to 59 the menopause was the key issue, and it will be a priority in the health strategy, when it is published.

This Bill is why we are all here today, and I pay tribute to the hon. Member for Swansea East, because there is no doubt that she has made a difference to women’s lives across the country, with the support of other hon. Members, in all parts of this House. Clause 1 seeks to exempt HRT from NHS prescription charges, which are set out in the National Health Service (Charges for Drugs and Appliances) Regulations 2015. Those regulations apply to England only and are amended annually. They set out the prescription charges payable per drug that is dispensed. The charges apply unless someone is exempt because of age, income or other medical exemption, such as epilepsy. It is common for HRT to be prescribed at relatively short intervals, three-monthly or even monthly, in a minority of cases, and a prescription charge applies each time. As we have heard today, a course of HRT treatment often requires more than two medicines, oestrogen and progesterone, or different preparations—patches, tablets, creams and so on. Sometimes that means that women have to pay two charges, even if these products are supplied in a combination pack or included on the same prescription.

I am pleased to announce that although the Government cannot exempt HRT from prescription charges entirely, we have listened carefully to the argument and, as a result, we will amend the regulations to reduce the costs and improve access to HRT. We will do that by reducing the costs of repeatable prescriptions for HRT for women experiencing menopausal symptoms, so that instead of paying for a repeat prescription every month or every three months, the prescriber can issue a batch of prescriptions for up to 12 months with one signature and one prescription charge. The prescriber will set the interval between the issues of the medicine and the number of times the prescription can be repeated, and of course this will be done on clinical grounds. Repeatable prescriptions can be issued either electronically or on paper.

What that will mean in real terms for women is that where it is clinically appropriate, one prescription charge can be paid per year. For example, where a woman currently takes two hormone treatments, oestrogen and progesterone, and receives a repeatable prescription every month, she pays £18.70 each time, which makes a total of £224 every year. Under the changed system, she would pay just £18.70 each year. That is a saving of £205. [Hon. Members: “Hear, hear!”] I feel like the Chancellor, Madam Deputy Speaker. For a woman currently prescribed HRT on a three-monthly interval, moving to a 12-monthly repeatable prescription will make a saving of £66 a year.[Official Report, 15 November 2021, Vol. 703, c. 2MC.] However, we are going further, as we are also committing to reviewing the double hormone issue. The hon. Lady has made a compelling case for our taking this further, to reduce the cost of living, because it is important that we look at this clearly. I am happy to take that away to look at it further, working with her and other colleagues, and NHS colleagues, to see what progress we can make on that specific issue.

As has been described so eloquently today, the cost of HRT is not the only issue, which takes us on to clause 2. A UK-wide menopause strategy is tough, because health is a devolved matter, and we heard last week about the Scottish Government’s plans for a women’s health plan to address many of these issues. In England, we have our own women’s health strategy, in which the menopause will be at the top of the priority list. However, I recognise that there is work to be done on medical school training, workforce support, access to HRT and other therapies—and just recognising that the menopause actually exists. So today I commit to establishing a new menopause taskforce, with the hon. Member for Swansea East as a co-chair. The taskforce will encourage faster action and join up the dots across the system to take a coherent approach to improving support for those experiencing the menopause. The hon. Member set out in her speech, and we have heard today, that menopause should not be a partisan issue. I hope that she will accept my invitation to co-chair the new taskforce.

I hope that I have reassured hon. Members across the House of the Government’s commitment to this issue. It was telling that the Secretary of State was here earlier to hear these very issues. The Government are committed to reducing the cost of prescriptions, to introducing a menopause taskforce and to making the menopause a priority in the women’s health strategy. I heard the hon. Member on Radio 4 this morning, saying that the aim is to keep women wonderful. As a Conservative and as Government Minister, I probably should not say this, but: up the revolution!