Women’s Health Strategy for England
Debate between Baroness Penn and Baroness Barker
Baroness Barker (LD)
My Lords, I agree with much of what the noble Baroness, Lady Thornton, has said. It is always interesting to see what is included and what is excluded in documents such as this. Like the noble Baroness, Lady Thornton, I would like straightaway to query the omission of rights to abortion and sexual healthcare. Is that now the policy of the Government and the Department of Health? If it is, that is a very significant change that will have a huge, detrimental effect on the health of women.
It is notable that this document lists its ambitions at the beginning, talking about the availability of RSHE in schools so that young people know and understand what good health is and what their rights to it are. Unfortunately, there is still a dearth of appropriate material getting to schools and there is equally no commitment to training staff in schools to deliver appropriate training. I therefore ask the Minister when that situation is going to be rectified.
Organisations such as the Faculty of Sexual and Reproductive Healthcare and RCOG have been telling the Government for years that there is an absolute crisis in reproductive health services. We have a completely fragmented system for access to basic contraception, which is having a huge impact. We now know that approximately 50% of pregnancies in this country are unplanned. That statistic in itself tells us how far reproductive health has slid backwards.
I am glad to see the appointment of Professor Dame Lesley Regan. Some of the work that she has done in this report says that investment in contraceptive and fully inclusive reproductive and sexual health services is a public health investment which has a massive return on investment. Every £1 spent on contraception is a saving of £9 in public health services. If you invest that £1 in maternity services, the return on investment increases to £33. It is a no-brainer, yet at the moment we fracture access to services so that women who want access to proper reproductive health services end up going multiple times to multiple places. Why? It is because funding streams are fractured. Can the Minister say when that is going to be rectified? The sooner it is, the swifter we get a proper impact on women’s health.
One of the things that I have noticed, having read the review, is that for the first time it tries to be inclusive in its definitions. I also welcome the statements made about access for lesbians to assisted reproduction. The review includes Roma women. It notes the disparities in the appalling health inequalities for black women and women of colour. It also completely ignores trans people. I have a simple question for the noble Baroness. Is that the policy of the Government and the Department of Health? Are these people going to be excluded from our health policy in future?
The final thing I wish to say is that one of the big things that has been noted all the way through our reviews of continuity of care and the great work by the noble Baroness, Lady Cumberlege, is that continuity of care is key to outcomes, in particular, continuity of care in primary care, which is where most women want to get their health services. Will the Minister say what will be done to do that?
One other thing we certainly know is that we have an impending crisis in the workforce. The skilled women and men—largely women—who have been delivering women’s health services for the past 30 to 40 years are, by and large, about to retire now. Young male and female doctors and nurses, particularly in primary care, have not been given access to training. What will be done to make sure that the looming skills deficit is dealt with? Unless we address that, this is just a load of pipe dreams that will never come to pass.
Baroness Penn (Con)
My Lords, I thank both noble Baronesses for their questions. The noble Baroness, Lady Thornton, said that for too long the voices of women have been ignored in the healthcare system. She is absolutely right, which is why I am proud that this Government have produced the first women’s health strategy in England. It has been widely welcomed, if not overdue. We should recognise that.
The noble Baroness also said that women have not been listened to in the past. That is the feedback across the range of different experiences. That is why I am so pleased that at the heart of the development of this strategy was the call for evidence we held, which saw nearly 100,000 responses. Listening to those responses has really shaped the strategy. We are also cognisant that there may have been people who did not proactively respond to that call for evidence, so we made particular efforts to reach underserved groups who might not otherwise be heard. That is important, and it has been translated into the approach we took in the strategy.
On the question from the noble Baroness, Lady Thornton, we wanted to address a perceived ambiguity in the wording used in the statement on freedom of religion or belief and gender equality at last week’s international interministerial conference and ensure that its scope remains focused on freedom of religion and belief. A revised version of the statement was produced in light of that. I reassure the House that we remain committed to defending and promoting universal and comprehensive sexual and reproductive health and rights, including safe abortion. This is fundamental to unlock the potential agency and freedom of women and girls in this country and across the world.
The noble Baroness, Lady Barker, asked why sexual and reproductive health, and abortion in particular, were not covered in depth in this strategy. The Department of Health and Social Care is developing an action plan to improve sexual and reproductive health, including ensuring that women can continue to access robust and high-quality abortion services. We aim to publish this later this year. I hope that addresses many of the points she raised.
The noble Baroness, Lady Thornton, highlighted the importance of research. She drew my attention to a particular piece of work by the University of Birmingham, which I will happily take back to the department. As someone who was pregnant during the pandemic, I have personal experience of trying to navigate the guidance on whether to get a vaccine combined with the advice that I was at higher risk. That stems from the difficult problem of how to represent women and pregnant women more in medical research. That is not straightforward to solve, but we are making efforts towards it. There will be a new policy research unit in the National Institute for Health and Care Research dedicated to reproductive health. The department’s chief scientific officer, Professor Lucy Chappell, will lead a round table of researchers this autumn to explore the best ways to tackle the underrepresentation of women in research. This will include women from ethnic minority groups, older women, lesbian and bisexual women, pregnant women and disabled women. The NIHR is leading work to improve the diversity of research participants, and we wo;; continue to press ahead with that.
The noble Baroness asked about our action on menopause and our commitment to reducing the cost of accessing HRT treatment. I do not have the latest timelines on that, so I will write to her. We have established the UK Menopause Taskforce to join up and accelerate work across the UK to tackle menopause-related issues. We have also set up work to tackle access to supplies for certain HRT treatments.
On breast cancer screening, the additional money announced in the strategy is aimed at doing exactly what the noble Baroness said about addressing disparities. All the work going into addressing the NHS backlog in elective treatment is looking to close that gap between diagnosis and treatment.
I will address a few other points. On training for teachers, we have invested more than £3 million to date in supporting teachers to teach PSHE in schools. We continue to focus on that.
I will address the question from the noble Baroness, Lady Barker, on trans people and their inclusion or otherwise in this strategy. The strategy’s aim is to improve the health of all women and girls, and we will work with NHS bodies to ensure that women are properly represented in communications and guidance and that there is appropriate use of sex-specific language to communicate matters that relate to women’s and men’s individual health issues and different biological needs. We recognise that some transgender people may experience some of the same issues—for example, transgender men perhaps needing cervical screening or menopause care—and we will ensure that our work acknowledges that. Transgender healthcare is a very important but separate issue. For example, the noble Baroness will know that the NHS is working on guidance to enable GPs to have a better understanding of the health concerns of transgender patients, which will improve their experience of primary and community care.
I will pick up one final point from the noble Baroness, Lady Thornton, about disparities in maternity care for black mothers or mothers from ethnic minorities. I believe a task force has been set up, the Maternity Disparities Taskforce, to look specifically at this. That is an important piece of work that I know is ongoing. I will write to both noble Baronesses in response to the other questions I have not addressed.
Ambulance Services and National Heatwave Emergency
Debate between Baroness Penn and Baroness Barker
Baroness Penn (Con)
My Lords, I know that both the Department for Health and Social Care and NHS England have a strong working relationship with the organisations that the noble Viscount has mentioned. On the detail of that work in terms of the heat health alert, I will have to write to him.
Baroness Barker (LD)
My Lords, handover times at hospitals of nine hours are not uncommon and 26 hours is not unheard of. What are the Government doing to ensure that the other emergency services are working in co-ordination with the ambulance service to make sure that people who need urgent care are getting it?
Baroness Penn (Con)
My Lords, I think there has been some co-ordination with other services looking at this issue. Of course, it varies from area to area and NHS England has focused its support on those areas that are struggling the most and account for the largest delays. We have talked about the taskforce to reduce delays in discharge, but the noble Baroness is also right that there is specific work going on to improve the handover process. We are looking to address the delays in every bit of the system that are causing delays up front to ambulance response times.
Drug-related Mental and Behavioural Disorder Hospital Admissions
Debate between Baroness Penn and Baroness Barker
Baroness Penn (Con)
My Lords, to address this, we have asked Dame Carol Black to complete part 2 of a review of drugs to look at treatment for people with substance misuse problems. As I said earlier, we have increased the funding for drug treatment services in England next year, including for additional in-patient detox beds.
Baroness Barker (LD)
We now have several reports showing that LGBT people have a greater than average incidence of mental health and substance misuse problems. Yet there is no mention of this community in the latest mental health proposals and a complete absence of any mention of this group of people in the NHS plan. What will the Government do to make the leadership of the NHS stop ignoring this particular bunch of taxpayers?
Baroness Penn (Con)
My Lords, in April 2019, we appointed Dr Michael Brady as the first national adviser on LGBT healthcare, and we also had the £1 million LGBT health and social care fund to tackle health inequalities experienced by LGBT people. Projects funded by that initiative included Advonet, which developed a self-advocacy course for LGBT people with mental health issues, and training by the Royal College of General Practitioners for GPs and surgery staff on LGBT health and inequality.
Inheritance Tax: Cohabiting Siblings
Debate between Baroness Penn and Baroness Barker(3 years, 9 months ago)
Lords ChamberRead Full debate Read Hansard Text
Baroness Barker (LD)
Does the Minister agree that there is a considerable risk within the proposal from the noble Lord, Lord Lexden, that family members would find themselves being put under duress not to marry, to preserve family property and so on? It is not the wholly benign measure that he would lead us to believe.
Baroness Penn (Con)
My Lords, I am not entirely sure that that is the Government’s motivation for disagreeing with my noble friend Lord Lexden. The difficulty is around drawing the line between the legal status of marriage and civil partnership and the other status that cohabiting family members may have. It may not necessarily be around the less benign implications of drawing the line in a different place.
Covid-19: Economic Costs
Debate between Baroness Penn and Baroness Barker
Baroness Barker (LD) [V]
What is the estimated cost to the public and private sectors of the decision by Public Health England to release Covid test data to local authorities on a weekly rather than a daily basis and without household identification?
Baroness Penn
My understanding is that local authorities get Covid data on a daily basis and that, since 20 July, individual-level data has been available to the teams that respond to outbreaks in local authorities.