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The Minister for Schools (Damian Hinds)
May I say what a pleasure it is to see you in the Chair, Ms Vaz? I think this is the first time I have spoken under your chairship. I join others in congratulating my right hon. Friend the Member for Elmet and Rothwell (Sir Alec Shelbrooke) on securing this important debate. I also thank everybody who has taken part, including the hon. Members for Kingston upon Hull West and Hessle (Emma Hardy) and for Strangford (Jim Shannon), my right hon. Friend the Member for Romsey and Southampton North (Caroline Nokes), and the hon. Member for Newcastle upon Tyne North (Catherine McKinnell), who spoke for the Opposition.
There is clearly strong cross-party support and drive to improve understanding of women’s health issues and ensure that young people are able to both navigate any issues they may face and, crucially, understand and support others. This has been an important follow-up to the debate that my right hon. Friend the Member for Elmet and Rothwell led in this Chamber in 2022 on the importance of raising awareness of endometriosis and the support needed in the workplace, including to tackle the many everyday challenges it can bring for employers and staff, which he outlined so powerfully.
I have seen at first hand the excellent work that my right hon. Friend has been doing to improve information and education on endometriosis more generally. I applaud his dedication to keeping the issue in the spotlight. He made a prominent remark during the previous debate:
“It would take 20 days, at 24 hours a day, to name every woman in this country who suffers from endometriosis.”—[Official Report, 9 February 2022; Vol. 708, c. 394WH.]
That really brings home the scale of what we are talking about, as he said again.
Colleagues in the Department of Health and Social Care are particularly engaged in these issues. The Government have made women’s health a top priority, and we are driving forward a women’s health strategy that is delivering a better standard of care for women and girls. Care for menstrual problems, including endometriosis, is one of the Government’s top delivery priorities for this year. We are investing £25 million to establish women’s health hubs, which will improve access to services for menstrual problems including endometriosis, contraception, menopause and more. Women’s health hubs will also take pressure off secondary care waiting lists.
Ensuring that women and girls have access to high-quality, trusted information is a top priority, too. We have created a women’s health area on the NHS website, which brings together over 100 pages of information, including on periods and endometriosis, and we have launched a video series on endometriosis on the NHS YouTube channel. In April, we ran a campaign in national media titles, supported by the women’s health ambassador for England, encouraging women not to suffer in silence if their periods or menopause symptoms affect their daily lives. That included a specific focus on endometriosis symptoms, and we are planning further campaigns across the year.
Sadly, we are all aware of the taboos and stigma that surround many areas of women’s health, with girls and women not feeling able to talk about issues such as periods. Too many girls and women are made to feel that very painful or heavy periods are normal and something they just have to get used to, rather than told about how they can seek help for those symptoms and understand what is happening to their bodies. Education can and does play an important role in complementing the women’s health strategy, and that of course includes education in schools. Ensuring that there is an early understanding of women’s health issues, including endometriosis, among boys as well as girls—I will come back to that point—can help in removing remaining stigmas and taboos.
My right hon. Friend the Member for Elmet and Rothwell will be aware that last week we published for consultation updated draft statutory guidance for relationships, sex and health education. That is part of the Government’s plan to deliver a brighter future for Britain in which our young people are supported and given the right education at the right time, so they are safe, happy, healthy and equipped with the information they need to succeed.
The revised RSHE curriculum includes strong health education, which focuses on the core knowledge that children and young people need to thrive as they progress into the wider world. To get the RSHE guidance right, we have worked with stakeholders in the sector, faith groups, teachers, academics and young people themselves. We have also worked with colleagues across Government to ensure that the content is accurate and up to date, that the content of lessons is factual and appropriate, and that children have the capacity to fully understand everything they are being taught, including about puberty and menstrual and gynaecological health.
I am pleased to say that that has led us to make significant additions to teaching in this area, including improvements to teaching about health and, in particular, menstrual health. That is in addition to what is already in the national curriculum, in which the menstrual cycle is taught to pupils between 11 and 14 years of age as part of the key stage 3 science curriculum.
The updated draft RSHE guidance states that primary school pupils should be taught the key facts about the menstrual cycle, including physical and emotional changes, from year 4. The secondary curriculum includes more on menstrual and gynaecological health, now specifically including endometriosis, polycystic ovary syndrome, or PCOS, and heavy menstrual bleeding. Those areas are now specifically set out in the “Developing bodies” section of the guidance.
Sir Alec Shelbrooke
I am most grateful to my right hon. Friend the Minister for his response; he is outlining a very clear path to improvement. Will the education about endometriosis, polycystic ovary syndrome and so on in key stage 3 take place at the very start of year 7? I am concerned about taking it out of key stage 2, given that girls will have started their menstrual cycles; in the example I gave, the lady said that she was in pain from her very first period. I accept that he might not be able to respond right now, but can I push him on when the Department thinks it will be appropriate? Does it think it appropriate for girls who are getting ready to start their periods, or for girls who have started their periods?
Damian Hinds
That was a very important and clear question from my right hon. Friend, and I will note two important things in response. First, the guidance is a framework; it is not a week-by-week series of lessons. Earlier, he read out some examples of things that were closer to lesson plans and a sequenced curriculum, which is a further level of detail. The guidance sets out a framework, and then teaching materials are developed. He mentioned a couple of the third parties that are involved in that. We do not specify to schools which third-party material or self-created material they should use. We do not get into such a level of detail that we say, “From the first half-term in year 7, this is what should happen,” but we do not stop it happening either.
The second thing to note is that threaded throughout the RHSE guidance and, indeed, more broadly, is the flexibility for schools to respond to their own circumstances and their children, who they know better than anybody sitting in Whitehall ever could. The general point is that learning about menstruation from year 4 does not mean that teachers are unable to talk about it before year 4 if that is the appropriate thing to do because girls in the class are already at that stage. I hope that that helps to give a little more clarity, but, as ever, I would be happy to follow up with my right hon. Friend the Member for Elmet and Rothwell separately, if he would like. The revised draft guidance sets out that curriculum content on puberty and menstruation should be complemented by sensitive arrangements to help girls prepare for and manage menstruation, including with requests for period products. In response to my right hon. Friend’s earlier point, schools should use appropriate language, such as period pads and menstrual products. The guidance also sets out how and when to seek support, including which adults they can speak to in school if they are worried about their health.
Rightly, the revised guidance supports young people to understand their changing bodies and feelings, how to protect their own health and wellbeing, and when a physical or mental health issue requires attention. We have introduced minimum ages in certain areas to ensure that children are not being taught sensitive or complex subjects before they are fully ready to understand them. But, as I was saying—this comes to the point made by the hon. Member for Kingston upon Hull West and Hessle—when girls start menstruating earlier than year 4, schools have the flexibility to cover that.
The relationships, sex and health education guidance is statutory and part of the basic school curriculum, so schools must have regard to the guidance and can only deviate from it with good reason. I want to take this moment to be totally clear that we do not mean that the subjects should be taught only to girls or should not be taught to boys. It is true that in the previous edition of the guidance, that was there in the rubric. It not being there does not mean that that is no longer the case; it should be taken as read that this is for all pupils.
As the hon. Member for Strangford and others said, it is true that there has sometimes been a tendency—perhaps in generations past, sometimes in generations present—to use phrases such as “women’s problems” and to generalise things as if it is not important that everyone can understand and distinguish between them. That is what we need to move beyond. As I said earlier, relationships, sex and health education is not only about understanding what is happening to our bodies; it is also about understanding the people around us and what we may come into contact with in future.
In an analogous sense, I was pleased that in the 2019 edition of the guidance we included the menopause for the first time, which generations of boys in particular, but also of girls at that age, did not know about. It was not about saying that that was about to happen to them, but of course in our wider lives—remember that this is relationships education as well as sex and health education—it is important that we are all educated on these things.
Sir Alec Shelbrooke
I am grateful for the Minister’s response, but—there is always a but—will he specify whether endometriosis will be taught in schools? I cannot dig out whether he said that it will definitely be taught in schools, so I want clarification on that.
Damian Hinds
I did. Specifically, in key stage 3, in lower secondary school, yes, it should be part of the curriculum at that stage.
Caroline Nokes
Apologies for not having dug around in any great detail in the very recently released guidance, and I absolutely appreciate that this is a debate about endometriosis, but what we might call problem periods can cover a whole range of conditions. We heard evidence on my Committee from Vicky Pattison, who talked about her severe pre-menstrual stress—I cannot remember the precise acronym—and Naga Munchetty spoke of adenomyosis, which I have finally learned how to pronounce. Are both those conditions also included? Teaching young girls to have the language around what is normal and what is not, and giving them the confidence to speak about it, is about more than just saying, “And you might get endometriosis”. There is a whole range of conditions out there.
Damian Hinds
To come back to my earlier point, the secondary curriculum includes more on menstrual and gynaecological health, now specifically including endometriosis, polycystic ovary syndrome and heavy menstrual bleeding. Beyond that, I will have to ask for my right hon. Friend’s forgiveness and ask that I may write to her or that we can follow up separately.
Ofsted will inspect schools on their delivery of the RSHE curriculum. As part of their personal development judgment, inspectors will discuss with schools whether they teach RSHE in line with the RSHE statutory guidance. The guidance is now out for consultation for eight weeks and I have a feeling that colleagues in the Chamber or some of the outside bodies they are in close touch with might take part in that consultation. We will take all responses to the consultation into account in the final version of the guidance.
We are expecting a huge amount of interest in the updated draft guidance and I can confirm from the last time that we had a consultation on draft RSHE guidance that there is, understandably and rightly, a lot of public interest. We hope to analyse that over the summer and publish a final version soon after. Schools will then require time to implement any changes to the curriculum and to consult parents about those changes. It would not be fair to expect them to deliver new content without some time to prepare for it, but where they are ready to deliver new content, they can do so immediately. Indeed, I am sure many schools already cover endometriosis when discussing healthy periods and we have encouraged that.
Following a meeting with the chairs of the all-party parliamentary group on endometriosis in 2021—at the time they were the hon. Member for Kingston upon Hull West and Hessle and our much-loved and much-missed late colleague Sir David Amess—the then Schools Minister agreed to update the Department’s teacher training module on the changing adolescent body so that it too included a direct reference to endometriosis. Once we have finalised the RSHE statutory guidance later this year, we will update the teacher training modules and consider whether any further support is required.
To date, we have invested more than £3 million in a central support package to increase schools’ confidence to teach such subjects, including teacher training modules, non-statutory guidance, a train the trainer programme and teacher webinars on domestic violence, pornography and sexual exploitation. They are all available on a one-stop page for teachers on gov.uk. Of course, there is always more to do to help schools and we will look at that after the publication of the guidance and when we have listened to school leaders, stakeholders and others.
The hon. Member for Newcastle upon Tyne North moved into some parallel important areas of mental health and her party’s concentration on mental health support in secondary school. I remind her that we are already in the process of rolling out mental health support teams across the country. We think that is important for primary as well as secondary schools and it has to be done at a pace at which we can recruit the people required for those teams. As she will know, we have also offered a training grant to all schools—primary as well as secondary—for training for a mental health lead within the existing school staff, with a high level of take-up already.
I am enormously grateful to my right hon. Friend the Member for Elmet and Rothwell for his support in securing the debate. He has raised some very important concerns, as have others. I hope that he is pleased to see the Government’s continued work to improve menstrual and gynaecological health in schools today and for future generations of women. The steps we have taken so far to improve health education are extremely important and we really want to get them right. The Government will continue to make a commitment to support the policy area because it is the right thing to do. I thank my right hon. Friend once more for his continued drive on this important subject and for bringing this crucial debate to Westminster Hall today.