Equality Act 2010 Guidance: Gynaecological Conditions

Tuesday 3rd November 2026 Westminster Hall

16:29

[Tulip Siddiq (Hampstead and Highgate) (Lab)]

I beg to move,

That this House has considered the potential merits of adding gynaecological conditions to Equality Act 2010 guidance.

It is a pleasure to serve under you, Ms Jardine.

Gynaecological health should never cost a woman her livelihood, but almost a third of women with endometriosis are forced to leave work because of their symptoms. Behind the statistics are heartbreaking stories of women who struggle every day to get the support they need in the workplace.

A defining mission of my time in Parliament, which is coming up to 12 years now, has been making the workplace fairer and safer for women up and down the country. One of my proudest achievements in Parliament has been leading the campaign for mandatory flexible working rights, which has enabled parents, particularly women, to thrive at work while balancing their commitments, especially their family commitments.

Some people in the House might remember that in 2019 I delayed the birth of my son to vote against Brexit, because there was no other option. I had to come into Parliament because there was no other way to register the views of my constituents in Hampstead and Highgate. I am very pleased to say that afterwards proxy voting was introduced, which means that MPs can now ask someone to vote for them on the basis of parental absence. However, it should not have taken something like that for proxy voting to be introduced, and my experience showed the world how inaccessible even Parliament is for women.

I am pleased to say that the rules have changed, but we still have a long way to go before we make workplaces fully accessible for women. When one of my very brave constituents told me how they were unfairly dismissed from work after many years of loyal service while they were suffering from crippling endometriosis, and then had to fight for years simply to establish that the law protected them, I was absolutely astounded by her story. That is because not a single gynaecological condition is included in the disability guidance of the Equality Act 2010.

[Helen Maguire (Epsom and Ewell) (LD)]

I also have a constituent who suffers with endometriosis and who has been unable to work as a result; she, too, has not received the support that she requires. Although the Equality Act protects pregnancy, does the hon. Member agree that it should also protect gynaecological conditions such as endometriosis? There are other conditions to consider, too. We know that currently one in six women leave the workplace due to endometriosis, because they just experience apathy, lack of understanding and so on, so it is really important that we empower women with conditions such as endometriosis to be able to remain in work.

[Tulip Siddiq]

I thank the hon. Member for her intervention. She makes a very important point about people not quite understanding what endometriosis is about. I have to say that when my constituent came to me and started talking to me about her situation and her case at work, I had to look up endometriosis; if someone has not personally suffered from it, it can be easy just to dismiss it as something that does not cripple a person’s life. However, it does cripple people’s lives. I will expand on a few of the hon. Member’s points later in my speech.

I am here in Westminster Hall today because of my constituent, who is in the Public Gallery today and who launched a petition, which has received over 110,000 signatures, calling for this situation to be changed. She is a formidable campaigner who I am proud to say lives in our constituency.

The statutory guidance on the definition of disability names Meniere’s disease, epilepsy, schizophrenia, bipolar affective disorder and certain types of depression as examples of conditions whose effects are fluctuating or recurring. However, it is silent on endometriosis, fibroids, polyendocrine metabolic ovarian syndrome and premenstrual dysphoric disorder. These are conditions that affect millions of women, and their effects are, by their very nature, cyclical and recurring.

[Jim Shannon (Strangford) (DUP)]

I commend the hon. Lady for bringing this matter forward. The merits of adding debilitating gynaecological conditions such as endometriosis to the Equality Act list are clear, because doing so would legally guarantee women with those conditions the reasonable workplace adjustments they need to remain in employment. However, does she agree that that will mean very little if the underlying health care system is failing?

I know that it is not the Minister’s direct responsibility, but for us back home we find ourselves in a situation where the care available is severely limited. Women in my constituency of Strangford are trapped on agonising waiting lists and are forced to pay thousands to travel across the water for surgery here simply because the care does not exist at home. Does the hon. Lady agree that protecting women at work is only half the battle? There is still a lot to do in the healthcare system.

[Tulip Siddiq]

I am pleased to see the hon. Member attend every debate in the Chamber; he has not stopped doing that and he is always fighting for the rights of women in any of the debates that we have. He is right to say that we do need to settle what is happening in the workplace, but we also have to look at the healthcare system as well and make sure that it does not become a postcode lottery where women have to travel in order to get treatments that should be available for everyone.

In response to my constituent’s petition, the Government acknowledged that such conditions can affect women’s performance at work, but said they had no plans to amend the guidance. That is why I am standing here today, urging my colleagues in the Government to reconsider that decision. When a woman’s condition is missing from the guidance, she starts every conversation with her employer and the human resources department, as well as every claim, on the back foot. That is because courts and tribunals must take the guidance into account. HR departments and managers will use it as their checklist. It opens the door to legal protection, fairer workplace adjustments and a fairer system for millions of women across the country.

Last month, hon. Members may have seen that the all-party parliamentary group on endometriosis published its “Endometriosis (Not) in the Workplace” report. The results were sobering. Evidence was gathered from more than 6,000 employees with confirmed or suspected endometriosis, and from 250 employers. The inquiry provides one of the most detailed pictures yet of the condition’s impact on working life. These are some of the facts: 97% of employees worked with severe pain; 94% believed employers lacked understanding of the condition; 62% were worried about losing their job; 47% had lost income and 39% were experiencing financial hardship; 49% had difficulties progressing in their career after the condition; 28% had been forced to leave their job altogether; 49% had received no workplace adjustments at all; and 72% of employers said they had no training or guidance on women’s health conditions, such as endometriosis.

It is fair to say that women with endometriosis have been failed by the employment rights system. It is damaging their lives, their families and the economy. With only 11% of employers in the UK having a menstrual health policy, employers are not making the reasonable adjustments to accommodate people with endometriosis, who are forced to suffer in silence. That shocking statistic highlights why there is such widespread discrimination of women with endometriosis. That is why gynaecological conditions must be included as impairments with fluctuating or recurring effects in the Equality Act 2010 guidance on the definition of disability. By doing that, we will strengthen workplace protections for women with disabling gynaecological conditions, including endometriosis, fibroids, PMOS, PMDD, severe menopausal symptoms and other menstrual disorders.

One of the biggest challenges we have—I have learned a lot of this from my constituent who suffers from this issue—is the unpredictable nature of those conditions. Women can experience severe pelvic pain, debilitating fatigue, heavy bleeding that leads to anaemia, bowel and bladder symptoms, bloating, nausea, loss of appetite and other complications that can fluctuate in severity. For example, a woman with endometriosis may be able to function absolutely fine one day, but the next day cannot get up from her bed. Employers should take that into account. It is overwhelmingly evidenced in medical statistics, but my constituent tells me it is being ignored by employers because the conditions are not listed in the guidance, which is what we are fighting for.

I ask the Minister, who I know is passionate about this topic and has been in touch with me about it, to consider four practical steps. First, will she update the Equality Act 2010 guidance? It is issued by a Minister under section 6 of the Act, so no primary legislation is needed. Gynaecological conditions should be named among the examples of conditions that have recurring or fluctuating effects. The guidance should include worked examples of what a flare can look like in a working day, and it should discuss pain that stops a woman travelling, standing up or concentrating, heavy bleeding, fatigue, anaemia and recovery from surgery.

Secondly, will the Minister look at the Equality and Human Rights Commission guidance and set out in the employment code examples of reasonable adjustments for such conditions, such as flexible and hybrid working, adjusted hours on bad days, access to facilities and rest breaks, time off for medical conditions and a phased return from surgery? It is incredible that women have to fight for those things—of course they should have a phased return after surgery, but lots of women do not have that option in the workplace. A lot of those things would cost little or nothing, but they would make the lives of those who are suffering so much easier.

Thirdly, I ask the Minister to give employees something tangible to take back to their managers or to human resources. A simple standard workplace adjustments passport, backed by ACAS guidance, would record what has been agreed so that the woman does not have to explain her condition over and over again every time her manager changes, which is exhausting in itself, and the managers know exactly what is expected of them.

Fourthly, I would build on the Employment Rights Act 2025. Large employers will soon have to publish equality action plans that include support for employees who are going through the menopause. The plans should extend to menstrual and gynaecological health. The Government’s Keep Britain Working agenda and their workplace health system should expressly include women with long-term fluctuating conditions.

Those changes would help not only women with such conditions but everyone living with a non-visible chronic condition whose effects come and go. Those basic changes could save jobs and so much money, and relieve so much anxiety for countless women across the county who are disabled by endometriosis and are not given reasonable adjustments in the workplace. By doing that, we can be a Government who ensure women have workplace protections and the right to reasonable adjustments for their conditions.

As the Minister knows, I was a part of the Treasury, so the economy is always on my mind. This is not just a question of fairness; it is actually about a strong economy and sound business. Endometriosis alone is estimated to cost the UK economy £8.2 billion a year in treatment, lost work and healthcare costs. The Office for National Statistics found that women with endometriosis earned about £4,500 less over the five years after receiving a diagnosis. The Fawcett Society found that one in 10 women who worked during the menopause left their job because of their symptoms, and many others worked on reduced hours.

The PMDD Project found that nine in 10 reported that PMDD significantly or extremely affected their everyday lives—particularly employment. They can be perceived as unreliable, inconsistent or unable to manage their workload, when in reality they are living with a recognised and often severely disabling condition. I am sure the Minister agrees that women are a vital part of our workflows and our economy. It is right that the law and guidance explain that and reflect the reality of their everyday lives.

Employment lawyers acting in such cases describe the same pattern again and again. Very senior women, in whom businesses have invested year after year through training and client development, are managed out after surgery or a period of sickness absence, when a phased return, a flexible pattern of working or a modest change to their duties could have retained them and helped our economy at the same time. The business loses the woman’s skills, client relationships and everything that has been invested in them. It then pays to recruit and train a replacement, and it very often pays again to defend a claim. Claims can take years. At the end of June this year, there were 70,000 claims waiting in employment tribunals—the highest number on record.

The average claim takes well over a year to resolve, with some final hearings being listed for 2028 and 2029. With appeals, a case can run for three years or more. Think about the damage that does to the economy, the business and particularly the morale of all our women who we need back in our economy working for our country. It is three years of legal costs for both the employer and former employee. It is three years of uncertainty and anxiety for all the women, and three years in which neither the business nor the woman can move. That cripples the economy, the business and, often, the woman’s life.

The cases that do reach the courts show what is at stake. In South Gloucestershire council v. Hundal, which was decided by the employment appeal tribunal in 2024, a social worker with endometriosis—who the tribunal found was managing complex cases well despite her disability—had her placement ended because of the absences caused by her medical condition. Her manager had suggested adjustments such as working from home and spreading her four-day week over five days. Neither of those was tried and an occupational health referral was not even considered. The tribunal found that ending her engagement could not be justified and an appeal tribunal agreed.

In another case, a tribunal accepted that a woman with endometriosis could not walk, stand or drive when her systems flared. The condition left her anaemic, exhausted and unable to sleep. It found that she was disabled, observing that nothing in the Equality Act requires a disability to be constant. That is exactly why guidance should be made plain: so that women do not have to waste time, effort and mental energy going to a tribunal to establish it.

Reasonable adjustments are the most effective way to avoid all this. They keep women in work, protect the employer’s investment and stop claims arising in the first place. Prevention is far cheaper than cure. For as long as our employment rights ignore the gynaecological conditions of millions of women in Britain, the injustice will continue. Making reasonable adjustments is simply the fairest thing to do. It is also the most sensible thing to do economically. Naming these conditions in the guidance would give every woman something concrete to point to, and every employer a clear basis on which to act. It would save money and time, and most importantly it would spare women, their families and their employers so much avoidable pain.

The benefits of doing that spread beyond the workplace, to all of us in society. It will improve the mental health and wellbeing of women by enabling them to be seen, heard and protected, and to advocate for themselves. The guidance will also help Department for Work and Pensions assessors, who are rejecting claims from women with endometriosis and other gynaecological conditions. For me, that is a win-win because it will protect women in the economy, education, healthcare, the workplace and beyond. I urge colleagues in Government to recognise what women experience every single day. I believe it is time to end this discrimination once and for all.

[Christine Jardine (in the Chair)]

I remind Members that they should bob if they wish to be called.

16:48

[Sir Alec Shelbrooke (Wetherby and Easingwold) (Con)]

It is a pleasure to serve under your chairmanship, Ms Jardine. I congratulate the hon. Member for Hampstead and Highgate (Tulip Siddiq) on an excellent opening speech, which has covered so many of the aspects that we have spoken about for so many years.

I started to raise the issues of endometriosis about a decade ago in this very room. Again, like the hon. Lady, it came to my attention through someone coming to see me in a constituency surgery. I then realised I had a close friend whose wife had suffered from endometriosis since her teen years. What is striking straightaway is how many people do not know about the condition. Therein lies one of the great problems. I remember when I first started doing this, I got lots of comments about why I was bringing this up as a man. I always found that comment particularly strange—surely we are elected to represent all our constituents, and well over 50% of my constituents are women—but it spoke to a greater problem: people do not understand women’s health needs.

Women’s health needs are exceptionally different from those of men. The reality is that men can sympathise, but cannot empathise, because they are unlikely to suffer from chronic diseases throughout their lives, from teenage years through to old age. Women can have endometriosis long after the menopause—it is not to do with being of a fertile age. Also, the growth of the endometrium is not linked just to having a uterus, as it can spread to other parts of the body.

The hon. Member for Hampstead and Highgate outlined some of the problems, but—I am sorry for this, Ms Jardine—I will get a little more graphic and try to paint a picture of what some gynaecological conditions can mean. If a person who has stage 3 or stage 4 endometriosis, there is a real chance that it has invaded their digestive system—indeed, that can be when problems start to become apparent, but by that time, it can have progressed a long way down the line. I am sure that everybody in this room will have suffered from food poisoning or an upset stomach, when—I do not want to be too graphic—they could not get off the toilet. We all know what is like, and it is horrific, but we stay at home, take our salts and fluids, and work our way through it for 24 hours. What happens is that we feel a bit rotten for a couple of days, but then we go back work.

For people who have reached such a stage of the disease, that happens all the time. They will be sitting at work and will suddenly have to rush to the bathroom. One thing that people recognise is that endometriosis can cause heavy bleeding, and how embarrassing that can be for a teenage girl. The very fact that people may soil themselves without realising is a great problem, which needs sympathetic employers to arrange an office space and position things so that they are able to go to the toilet quickly. There needs to be understanding from fellow employees, and we need to make sure that employers recognise the issues.

I will not dwell on this point, because many other hon. Members want to speak, but education plays an important role. I worked with some girls born in the 21st century who did not know about the condition, which shocked me. If it is taught to all sexes in schools, understanding will come through. If people do not know what a disease is, it is easy to try to dismiss it and say, “This person just takes time off work. Women get heavy periods. They’re just a malingerer—they’re not doing anything.” As I have spoken about for so long, such conditions need to be protected under the Equality Act. I am proud to chair the board of The Endometriosis Foundation, and that our brilliant chief executive officer, Carla Cressy, who has stage 4 endometriosis, has done so much to support people. Research shows that around 90% of affected people experience a mental health impact, and 50% think about taking their lives—unfortunately, about 30 women a year do take their lives. That is how serious the subject is.

If I can leave people with just one message, it is just to think about it. As an employer or a man, think about if you had to go to work every day, not knowing whether you will suddenly soil yourself while sitting at your desk. Think about that, and about how we should be dealing with people who suffer from this terrible disease.

[Christine Jardine (in the Chair)]

I ask Members to stick to an informal time limit of three minutes.

16:53

[Imogen Walker (Hamilton and Clyde Valley) (Lab)]

It is a pleasure to serve under your chairship, Ms Jardine. I am grateful to my hon. Friend the Member for Hampstead and Highgate (Tulip Siddiq) for securing this debate to raise an excellent question. We can clearly see a troubling difference between the care delivered for women’s conditions and that delivered for conditions affecting the general population, which is an issue I have raised with my local NHS board. As hon. Members will know, health is a devolved matter in Scotland, but equality is not. I am open to any solution that would help the women and girls in my constituency to get the healthcare they need, when they need it.

When I met NHS Lanarkshire in November 2025, we discussed waiting lists. I was told that the board aimed to eliminate two-year waits by the spring, which I thought was progress, relatively speaking. However, there was a catch: the exception was gynaecology. I wrote to ask what the plan was for that, but was told that it was difficult and challenging. They were not able to share a plan, nor did they confirm that ensuring that women received the same levels of healthcare as men was a priority. It is true that they are operating in very difficult circumstances, and the SNP-led Scottish Government must take their share of responsibility, but this exception is not the answer. For endometriosis, the average wait in England is nine years and four months, and in Scotland, it is 10 years and two months. That is more than a decade of pain and more, as my hon. Friend described so well. The dreams that young women so rightly have for themselves can be lost in this process, which is devastating.

Many of us have heard somebody say, “Well, if men suffered from this, they would have found a cure,” but there is an even more modest question that we need to ask: what do we need to do to make sure that women get the treatment that already exists? Women are not born to endure. They are not born to accept pain or incapacitation as part of the feminine experience, and when they are ill, they should not be dismissed. They should not be told—it happens at every stage of life, quite frankly—that it is their age or, if it is really bad, that they could take a paracetamol. These examples are, and have been, far too familiar to too many women for far too long. We all know that these problems run deep, and my hon. Friend has cut to the heart of the issue. Much more needs to be done. It should not take a rewriting of the Equality Act to make it happen, but she is right to ask the question, and I thank her for it.

16:54

[Hannah Spencer (Gorton and Denton) (Green)]

A few weeks ago, I posted a video sharing some of what I am learning about endometriosis, and the response was absolutely heartbreaking. My comments were full of people sharing their experiences—years of pain, being dismissed by doctors, struggling to get a diagnosis and then, on top of that, trying to hold down a job and get their employers to understand. I heard about lives turned upside down by a condition that they have no control over and very little support with.

I hear the same stories from people in Gorton. What gets me the most is that it does not have to be this way. All that is needed is for women’s pain and the pain of those who are assigned female at birth to be taken seriously by the doctors who serve them, by the employers they work for and by the Government who represent them, yet instead, as has so often been the case throughout history, it ends up being the people most affected who are left to fight for the change that they deserve. Despite the pain and debilitating symptoms of endometriosis, they are the ones coming up with the ideas, solutions and plans. They are the experts, and we should all be listening.

One in six women with endometriosis leaves the workplace due to their condition. Almost half say that they have struggled to progress in their career because of endometriosis, and almost half had not received workplace adjustments. Almost half had lost income. Despite endometriosis affecting one in 10 women, it is rarely taught effectively at medical schools as part of the curriculum, leaving future healthcare practitioners without the necessary knowledge.

Those with endometriosis in Gorton and Denton and in every constituency across the country are losing money, missing out on opportunities and struggling to stay in employment, not because they do not want to work but because the support simply is not there. We are talking about basic, practical help that could make the difference between someone staying in work and having to give it up completely. Good employers want guidance. They want advice on flexible working, on time off for medical appointments, extra breaks or a phased return after surgery. Good employers want to help their staff so that their businesses can perform to their highest potential.

We need a Government that will finally listen to, and act on, lived experience by adding gynaecological conditions such as endometriosis to the Equality Act 2010 guidance on the definition of disability. These conditions are long term—often lifelong—and by definition, they fluctuate and recur, meeting the criteria for disability. There must be specificity in the guidance to ensure that employees disabled by debilitating chronic conditions such as endometriosis are supported with reasonable adjustments and legally protected against workplace discrimination.

To Sanju Pal, who has campaigned for so long and so hard on this, as well as the tireless work of countless other organisations, and to everyone for sharing their experiences and who are out there fighting for change, I say thank you. This debate is entitled

“the potential merits of adding gynaecological conditions to Equality Act 2010 guidance”,

but I think the people living with these conditions would find it pretty shocking that we even have to debate the merits. The debate should be about how much longer we can afford not to.

16:59

[Gill Furniss (Sheffield Brightside and Hillsborough) (Lab)]

It is a pleasure to serve under your chairpersonship, Ms Jardine. I thank my hon. Friend the Member for Hampstead and Highgate (Tulip Siddiq) for securing this important debate.

Seven years ago, I was sat in this very room for a debate on endometriosis workplace support, in which the much-missed David Amess announced that the all-party parliamentary group on endometriosis would be launching an inquiry into the state of care—at this point I also want to thank the right hon. Member for Wetherby and Easingwold (Sir Alec Shelbrooke) for all his work over the years. I wish I could say that I cannot believe we are having the same debate again, yet I know from the countless emails I have received from women across the country about their experiences that many of the issues identified by the APPG all those years ago still persist.

One constituent recently reached out to me, having been repeatedly bedridden as a result of her pain. She spoke about a fruitless struggle to access healthcare, which had left her untreated and worried about keeping her job. Some changes have been made in the right direction, but we cannot ignore the evidence telling us that support is not reaching far enough. A recent endometriosis APPG call for evidence found that less than half of respondents with the condition had received any workplace adjustments, yet 80% of employers giving evidence supported changes to the guidance to explicitly recognise the condition as meeting the definition of a disability.

Our workplaces are clearly willing to make adjustments, but the guidance is failing them, as well as the people it is supposed to safeguard. The Government and the Equality and Human Rights Commission must review the guidance so that it clearly reflects chronic and fluctuating conditions such as endometriosis. Will the Minister look carefully at the APPG’s findings and consider whether the guidance for employers should now be reviewed?

I have two further questions. First, will the Minister work with the Equality and Human Rights Commission and ACAS on practical guidance that covers support before a diagnosis and the fair handling of short recurring absences? Secondly, as the Government develop the workplace health system, will the Minister ensure that endometriosis and other fluctuating menstrual health conditions are part of that work? Women have waited long enough to be believed by their doctors. They should not have to wait any longer to be supported by their employers.

17:02

[Sureena Brackenridge (Wolverhampton North East) (Lab)]

It is a pleasure to serve under your chairship, Ms Jardine. I am truly grateful to my hon. Friend the Member for Hampstead and Highgate (Tulip Siddiq) for securing this important debate and to everybody else who has championed this issue, including those joining us in the Gallery.

We all know that, for far too long, women’s conditions have often been dismissed. They have not been a priority, and in some cases they have been misunderstood. Some might say that it is down to misogyny that is baked into the system, but these conditions truly impact every stage of women’s lives, from when they are very young girls and through the teenage years, all the way to when we are supposed to be full of wisdom—or not, in some cases. These conditions are fluctuating, which is partly why employers take the opportunity of not having to address reasonable adjustments. In fact, employees requesting reasonable adjustments are often faced by unreasonable expectations.

The scale of the challenge remains significant, so I welcome the fact that waiting lists are coming down in Wolverhampton’s NHS trust. Over 5,800 people in Wolverhampton were waiting for treatment this summer, which is an improvement on the 6,462 the year before, but hon. Members can see the scale that we are still facing. I welcome the Government’s action on the renewed women’s health strategy, but I call for levers across Government Departments to push faster.

Today’s debate is about more than just healthcare; it is also about employment and workplace protections, as we have heard. Too often, the support depends on whether an employer understands and has the resources to support what an individual is going through. That is inconsistent and can lead to further harm for the individual. The Equality Act already provides important protections where a condition meets the legal definition of disability. However, many women find themselves in a grey area where their condition significantly affects everyday life but the support remains inconsistent. That is why I believe there is a strong case for explicitly referencing gynaecological conditions within Equality Act guidance.

Clearer guidance would support employers to be better and to better understand conditions such as endometriosis, fibroids, PMOS and menopause. It would encourage earlier conversations, reduce stigma and support the reasonable adjustments that are needed. In many cases, those adjustments are straightforward, whether it is flexible working, time off for specialist appointments, temporary changes to working patterns or maybe some flexibility with home working. Will the Minister work with the Equality and Human Rights Commission, employers and women’s health organisations to consider how Equality Act guidance can better reflect the realities faced by women living with those conditions?

Women have waited long enough to have these conditions recognised. We are making progress in healthcare and that progress should be welcome, but now we have an opportunity to ensure that the support extends beyond hospitals and GP surgeries and into workplaces.

17:06

[Michelle Welsh (Sherwood Forest) (Lab)]

I congratulate my hon. Friend the Member for Hampstead and Highgate (Tulip Siddiq) on securing this debate. I speak as the chair of the APPG on PMOS and as a woman living with PMOS and endometriosis—I feel like I somehow won the cup when I got both of those. One in eight women in the UK suffer from PMOS, yet despite how common it is, it remains poorly understood, underdiagnosed and too often overlooked. The World Health Organisation estimates that up to 70% of women affected globally remain undiagnosed. Both of those figures are women waiting for answers.

For me, diagnosis took over 18 years. During those years I developed an eating disorder—I became bulimic—experienced depression and lost confidence. I passed out in sixth form on so many occasions. I lost the feeling in my legs and when I went to the GP, he told me over and over again, “It’s all part and parcel of being a woman. Take some paracetamols.” I share that because we must understand what delayed diagnosis costs. It reaches into your relationship with your food, mental health, working life and sense of self. Failure to diagnose does not make the condition disappear; it leaves women managing its consequences without the explanation, treatment or support they deserve.

PMOS affects more than fertility. It can affect metabolism, periods and mental health and it increases the risk of conditions including type 2 diabetes. Earlier diagnosis provides an opportunity to manage those risks and offer support sooner. Instead, women can spend years questioning themselves when the system should be asking the right questions.

Those failures do not fall equally. The condition disproportionately affects women from south Asian and black backgrounds and those on lower incomes, yet access to diagnosis and support remains inconsistent. Without greater awareness, existing inequalities in health can translate into inequalities in employment, career progression and economic opportunity. I cannot tell hon. Members the amount of times I have had a sleepless night before an exam, a driving test or anything important, worried that I would be too ill to stand up and do it.

A woman’s income, ethnicity or postcode should never determine whether she is heard or helped. We must tackle racism, language barriers and unequal access to care. For someone on an insecure contract, attending an appointment can mean losing wages, and asking for flexibility can feel like risking her job. The advice to seek support means little if that support is beyond her reach.

I ask my hon. Friend the Minister to provide for early diagnosis, access to psychological support, targeted action on inequalities and clear workplace guidance. Changing the name of polycystic ovary syndrome to polyendocrine metabolic ovarian syndrome must be matched by changing women’s experience. I cannot get those 18 years back, but we can stop another generation enduring the same wait, the same pain and the same anguish.

Greater awareness of PMOS and endometriosis in the workplace can help to ensure that women are supported, valued and able to thrive at work, rather than being forced to choose between managing their health and progressing in their careers. No woman should have to lose her health, her confidence or her future before the system finally decides to believe her and act.

17:10

[Marie Goldman (Chelmsford) (LD)]

It is a pleasure to serve under your chairship, Ms Jardine. I, too, congratulate the hon. Member for Hampstead and Highgate (Tulip Siddiq) on securing this really important debate. I would also like to join other Members from across the House in congratulating and commending the campaigners, some of whom are in the Gallery, on the incredible work that they do on behalf of not just themselves but all women across the country and, indeed, internationally.

Millions of women face the difficulty and pain of managing gynaecological conditions such as endometriosis, adenomyosis, fibroids, PMDD—the list goes on and on. It is obvious that more must be done to rapidly speed up diagnosis times and provide effective care and accommodations to those with these often incredibly debilitating conditions. Their impacts on women’s everyday lives extend, as we have heard, to education, employment and fertility. Some women leave work altogether because they cannot obtain the support that they need. We cannot—indeed, must not—accept that as normal.

My Liberal Democrat colleagues and I believe that there would be merit in dealing with these conditions in the same way as cancer, HIV and multiple sclerosis, which are deemed to be disabilities, under the Equality Act 2010, from the point of diagnosis and without the need to meet the functional test. I therefore urge the Government to examine that proposal further.

As we have heard, however, even getting a diagnosis is appallingly slow. Women’s symptoms are too often normalised or dismissed across all health conditions. I have heard outrageous stories of women’s persistent health concerns being dismissed with sometimes incredibly sexist comments attached. One young woman described to me fairly recently a particularly awful example. She was explaining to a consultant how she felt physically sick because of her persistent stomach pain, in this case while she was out shopping with friends, only to be dismissed by the doctor, who replied, “I often feel sick when I go shopping with my wife”—[Interruption.] There are groans from the Gallery. That actually happened.

With there being grossly outdated and misplaced attitudes like this, it is hardly surprising that it takes an average of almost 10 years to receive an endometriosis diagnosis in the UK. Recent research by Endometriosis UK has shone a light on the extent of the impact of this condition. In a recent report, the charity found that 97% of those surveyed worked while experiencing severe pain. It is no wonder that almost half of all those with endometriosis said that it had made it difficult to progress in their career, while 28% had had to leave their job altogether because of it. The same survey found that employers overwhelmingly want to help, but with there being little guidance and with employers facing the everyday pressures of running a business, the support for these women often just is not there. That is costing women—in pain, in missed career opportunities and, ultimately, in dignity.

My Liberal Democrat colleagues and I have written to Baroness Merron, the Women’s Health Minister, on several occasions to raise the urgent need to improve care for women with gynaecological conditions. The Government know that health-related economic inactivity costs the UK £212 billion every year. Even if we think about this only in such crude economic terms, the action needed pays for itself. Indeed, one NHS Confederation report found that for every £1 spent on obstetrics and gynaecology, the estimated return on investment was £11. It follows that tackling NHS waiting times for gynaecological services should be a top priority.

That is why it was so disappointing that the women’s health strategy contained no specific, measurable, time-bound target to reduce the backlogs in endometriosis care, while the NHS 10-year health plan did not include endometriosis, adenomyosis, PMOS or fibroids in its prevention agenda. Without there being clear direction from Government, we risk consigning more women to even longer waits and prolonged, unnecessary pain. That is why I was proud that the Liberal Democrats tabled to the Health Bill a new clause that would have ensured that the average wait time for endometriosis and other women-specific conditions was no longer than the average wait time for other elective conditions in the NHS. That would be a meaningful step towards equality in women’s healthcare.

Finally, we know that what gets measured gets done in the NHS. I hope that the Minister takes this away and conducts a serious examination of adding gynaecological conditions to the Equality Act 2010 guidance. We owe it to these women to do all we can to tackle this injustice.

17:15

[Joy Morrissey (Beaconsfield) (Con)]

It is a pleasure to serve under your chairmanship, Ms Jardine. I am grateful to everyone here today and welcome the opportunity to discuss this important issue. I thank all Members for their contributions and the campaigners here today for raising it. I also thank the ladies in the Gallery who are studying public health at University College London; that is wonderful. We need more women bringing these issues to the forefront of our public health agenda.

This subject is close to my heart. I have suffered from a gynaecological condition, and I suffered in silence for a very long time. Oftentimes, we are told that it is just a ladies’ problem and that we can just carry on—“Take a paracetamol and you’ll be fine.” But that is not the case. The condition is debilitating, and one often needs surgery or multiple surgeries. It is a difficult thing to explain to employers or even a spouse, or whoever someone is with. Someone can carry on as a normal human being with the condition, but on some days it completely debilitates their everyday existence. I am very sympathetic to this debate and the need for women’s gynaecological issues to be brought to the forefront of public health.

It is a particularly warm and welcome development that the NHS is recognising biological sex. It is important to acknowledge that biological females with endometriosis and particular ovarian issues—all the things that specifically biological females suffer from—have been neglected over the years.

I do not know whether this is just my experience, but I found things to be very difficult on the NHS. There was a very long waiting list, and I was told that I perhaps did not have endometriosis and needed to go back to just taking some paracetamol to get over what was wrong with me. I did have endometriosis, but that was not found out until I had surgery. So many women suffering from the exact same thing are being told, “Just wait—you’ll be fine”, “It’s just your own personal issue,” or, “Take a paracetamol and you’ll feel better soon.” But it gets worse and worse over time.

I want to make sure that women have access to the same public health resources as everyone else. Those things have fallen through the cracks over the years, which is why I want to raise them in this debate. The reality is that women have to endure debilitating pain, uncertainty or discrimination simply because of a condition that is too often misunderstood or dismissed. It is a reality where overall waiting times for appointments with a gynaecological specialist are higher than they were the month before, the year before and since the last general election.

Women are waiting a very long time just to see a gynaecologist and have basic things checked, and then the referral process takes years and years. It is debilitating, and many women just give up. Many across the House have tried to change the reality of the wait that women face in the NHS. I pay tribute to David Amess for starting the APPG on endometriosis and raising this important issue for the House.

Endometriosis, polycystic ovary syndrome and heavy menstrual bleeding can have a profound impact on women’s lives. They can affect their ability to work, their education, their relationships and their mental wellbeing. Just recently, I heard a powerful story from a brave young woman called Sophia, who shared with me that she is suffering from extreme pain that can affect her ability to attend secondary school. It took a lot of courage for her to talk to me about this. Again and again, she faces the refrain of, “You’ll be fine—it’s just period pain.” Too many young women hear that phrase when it comes to conditions such as endometriosis because our NHS has been too distracted by other realities to put women’s health at the forefront of care and prioritisation.

For women with endometriosis, the average wait for a diagnosis is around nine years—nine years of uncertainty, pain and, in many cases, being told that their symptoms are simply part of being a woman. I hope that we can work together today to bring forward a solution that will help put women’s health at the forefront of care.

17:20

[The Minister for Equalities (Satvir Kaur)]

It is a pleasure to serve under your chairmanship, Ms Jardine. I will endeavour to speak at pace so that I can cover everyone’s points and respond accordingly.

I start by thanking my hon. Friend the Member for Hampstead and Highgate (Tulip Siddiq) for introducing this important debate on a serious issue faced by so many women and girls; I am sure that we can all agree that she spoke extremely passionately. I thank her personally for her ongoing efforts in this campaign. I extend my thanks to the campaigners in the Gallery and acknowledge the challenges that my hon. Friend’s constituent Sanju Pal has faced, which led her to create this petition to add gynaecological conditions to the Equality Act 2010 guidance.

I thank everyone for sharing their stories and for their contributions. I am personally passionate about this issue. The stats speak for themselves; I am not going to repeat them, but we all know that behind every one of them is a woman potentially suffering in silence—a woman getting dismissed and a woman who needs support.

This Government recognise the difficulties and pain that women and girls face in managing symptoms related to gynaecological conditions. As today’s debate has highlighted, menstrual and reproductive health issues can have a significant impact on the physical and mental wellbeing of women and girls, including on their participation in the workplace. The struggle is real and I have felt it myself, so I can relate to the Opposition spokesperson, the hon. Member for Beaconsfield (Joy Morrissey). I personally thank my hon. Friend the Member for Hampstead and Highgate for her efforts inside this House as well: I have definitely reaped the benefits from those internal campaigns. For example, I have been able to vote by proxy when struggling with my health.

As a Government, we do not believe that anyone in this country should have to choose between managing their health and pursuing their career. We are committed to protecting the rights of women against unlawful discrimination in the workplace and ensuring that they have access to redress. As Members will know, depending on the circumstances, the Equality Act already provides protection from discrimination on the grounds of sex, age or disability. The Act’s definition of disability focuses, for the most part, on how a condition affects a person’s day-to-day life, rather than listing specific conditions or impairments. That flexibility is important to allow the law to cover a vast range of conditions, as well as to avoid the risk of excluding changing, fluctuating or progressive conditions that impact on individuals differently.

My hon. Friend and other Members may be aware that the Government intend to produce guidance explaining how the law protects against combined discrimination. We can, of course, consider how gynaecological conditions can form part of that, and I will ensure that that is considered effectively. Alongside that, my hon. Friend and others will agree—I know that she made noises to this effect—that the issue can be addressed more effectively and quickly through ongoing efforts to help employers themselves to take more effective steps to support the health and wellbeing of their female employees: strengthening rights related to sick leave and flexible working, and improving how the health system addresses these conditions.

[Sir Alec Shelbrooke]

I am listening carefully to what the Minister is saying, and I do not doubt for one second her belief in the policy moving forward. However, I am concerned—and it is just a concern—that putting it into the Act will make employers recognise that it is specifically there, whereas saying that the Act can deal with it is still a bit opaque. This is one of the problems we have had; we want specificity, as the hon. Member for Hampstead and Highgate said, to make employers recognise just how serious the situation is.

[Satvir Kaur]

I accept that making it clearer will absolutely help; that should be considered as part of the combined discrimination guidance. I reassure Members that that will be considered. It is also important that we stress what else the Government are doing to address these issues. This debate has been healthy in reflecting that this is a wider issue that cannot only be addressed in legislation, although legislation is, of course, important.

We want to encourage employers to implement workplace adjustments, which have been raised by several Members in the debate, to help women remain in work and thrive in their careers. This Government are committed to that—not just because it is the right thing to do, but because equality is a precondition to our economic success, as many have already pointed out.

By creating more supportive and informed workplaces, we can help ensure that women with endometriosis or other health conditions can remain in work, progress in their careers and reach their full potential. That is why there is a great deal of action being taken by this Government to improve the support and protections available to women experiencing symptoms relating to gynaecological conditions.

In April this year, Mariella Frostrup was appointed as the Government’s women’s employment ambassador. In that role, she will campaign on women’s health throughout their life course, working with employers across the country to strengthen workplace support, raise awareness of key health issues and address wider challenges affecting women in work, highlighting the vital economic contribution that women make.

The ambassador attended the launch of the “Endometriosis (Not) in the Workplace” report. In her remarks, she emphasised that supporting women’s health in the workplace is not only the right thing to do, but vital in retaining talent, reducing inequalities and strengthening the economy. This work will also include engaging with Sir Charlie Mayfield’s independent “Keep Britain Working” review, which highlighted the scale of economic inactivity due to ill health and disability, as well as the important role employers can play in helping people to stay in work.

During the vanguard phase, we have worked with employers, providers, unions and people with health conditions to develop and refine approaches that will help people thrive in work, including promoting early conversations about health needs and supporting reasonable workplace adjustments for women’s health conditions.

As we develop workplace health systems, we are considering how health and work interact across different stages of life, including the impact of endometriosis and other long-term fluctuating menstrual health conditions on people’s ability to remain and thrive in work.

We welcome the involvement of Endometriosis UK in the vanguard phase, which provides valuable insight into the experiences of people living with these conditions and helps inform our approach. As well as taking steps to create more supportive and informed workplaces, the renewed women’s health strategy, published in April, represents a decisive shift towards addressing long-standing failings in women’s health outcomes, experiences, and access to care. Some of the stories shared in this debate are heartbreaking, and all of them have led to this important shift. The women’s health strategy identifies endometriosis as a priority condition and states our commitment to improve the treatment and ongoing care for every woman affected.

Through the plan Make Work Pay, we are strengthening support for people and managing health conditions alongside their work by requiring employers to accept flexible working requests where it is reasonable for them to do so. We want to ensure that all employers are supporting their employees’ health and wellbeing, because that will benefit the employees and their organisation. That is why the Government are getting large employers to publish action plans, which my hon. Friend the Member for Hampstead and Highgate mentioned, setting out how they will make meaningful changes to tackle the barriers women face throughout their working lives, including the steps being taken to improve support for menopause and endometriosis and to address the gender pay gap.

Importantly, the EHRC was mentioned. As Members will know, that is independent of the Government and will make its own operational decisions. I thank all hon. Members for their contributions, and I am sorry if I did not get to everyone’s points.

Question put and agreed to.

Resolved,

That this House has considered the potential merits of adding gynaecological conditions to Equality Act 2010 guidance.

17:30

Sitting adjourned.