Menopause (Support and Services) Bill

Caroline Nokes Excerpts

2nd reading
Friday 29th October 2021 Commons Chamber

[Caroline Nokes (Romsey and Southampton North) (Con)]

It is always a privilege to be in this Chamber to support the work of the hon. Member for Swansea East (Carolyn Harris). It is just over a week since we last debated the menopause in the Chamber, and I always say that in Parliament we should pick not just our battles but our allies. It is a pleasure to campaign, to hold a revolution and to be a warrior alongside her.

The reality is that all women will go through the menopause, but not all women will suffer symptoms. Only about 80% suffer symptoms and HRT—a brilliant, wonderful solution to some of those symptoms—does not work for everyone, and the same type of HRT does not work for every woman. That is why it is often a case of trial and error, going through many prescriptions to find the form of HRT that works for each woman and resolves their symptoms. We have to address the costs because women will be bearing the burden of prescription after prescription until they find the solution for them.

We have heard a little this morning about education, but no one has yet paid tribute to the brilliant work of my right hon. Friend the Member for East Hampshire (Damian Hinds), who made sure that, as part of personal, social, health and economic education, girls are not just taught about periods, not getting pregnant and contraception but are taught about what might happen when those periods stop. Of course, it is not just a matter for girls. Their male classmates and colleagues, their fathers and brothers, also need to be part of this discussion.

As we have heard repeatedly, there is too little knowledge in schools and in the workplace. I regard this place as a workplace and, until very recently, it was heavily male- dominated, but we are clawing it back, sometimes just one seat at a time. I pay tribute to the work of one of the foremost menopause warriors, Anne Milton, the predecessor of my hon. Friend the Member for Guildford (Angela Richardson). As Deputy Chief Whip, Anne Milton played the crucial pastoral, human resources role of helping many of us with conversations on all sorts of weird and wonderful health issues. It helped that she was previously a nurse, but she was an evangelist for HRT. When I spoke to her about it yesterday, she said, “Just go and get yourself a prescription, because this will solve those hot flushes at night and the fact you wake up in a puddle of sweat.” I still tried to say, “No, I’m sure that’s just my insistence on sleeping under a 13.5 tog duvet.” Apparently not.

I vividly remember being brutally asked by GB News, “What are your menopause symptoms?” I recoiled a little from the question, which I thought was a bit rude. And then I thought, no, I have to talk about it. I regard it as my duty to talk about it so that younger women know, whether it is brain fog, anxiety, hot flushes or night sweats, this is all normal and it can be addressed.

[Angela Richardson (Guildford) (Con)]

I had that conversation with my predecessor, the right hon. Anne Milton, quite a few years ago, and she completely changed my mind about HRT. My mother and aunt had to go through this 30 years before me—I am now 47—and they had difficult reactions to HRT. My aunt died from cancer that, anecdotally, was blamed on HRT.

It was Anne Milton who said to me, in a frank conversation, “This is what women need to live good lives.” I pay tribute to her for having the courage to have that conversation with me, and I pay tribute to my right hon. Friend the Member for Romsey and Southampton North (Caroline Nokes) for the courage she shows in talking about it, too.

[Caroline Nokes]

My hon. Friend has made the point—lead good lives—and that is what we want to do, whether it is at home or at work.

Something in particular has struck me during Menopause Awareness Month. I have spoken to many employers about the menopause workplace pledge, and have talked to members of organisations in the City of London about what they can do to support women. According to a survey carried out by the Fawcett Society, 50% of women working in financial services were not taking on additional responsibilities because they were worried about their menopause symptoms, while 25% were considering leaving work. Women at the height of their careers are potentially losing them, and not providing those brilliant female role models to which we all need to aspire in order to progress in our careers.

I make no criticism of my right hon. Friend the Member for Pudsey (Stuart Andrew), the current Deputy Chief Whip, but I issue a plea to all those in the Whips Office: make sure you have good, strong women in there who can provide advice when it is needed. I pay tribute to Claire Hattrick, who lives in Hampshire and runs the clipboardclaire.com website, providing impartial, informed advice for women when they are going through the menopause. Many of us simply do not know what the symptoms are. We do not understand them, and we do not know where to turn. Claire and many like her across the country provide that advice, free of charge and independently, giving us all hope that the symptoms can be dealt with.

Bills such as this mean that we will debate the issue on the Floor of the House as well as in the wider country. It is about having the conversations, about making sure that we understand, and, most of all, about joining the hon. Member for Swansea East and ensuring that we are all warriors and allies, and that we are going to bring about change.

World Menopause Month

Caroline Nokes Excerpts

Thursday 21st October 2021 Commons Chamber

[Caroline Nokes (Romsey and Southampton North) (Con)]

It is a pleasure to be able to contribute to this debate to mark World Menopause Day earlier this week, and the whole of October being Menopause Awareness Month. The hon. Member for Swansea East (Carolyn Harris) is absolutely bang on: this is not a political issue. I pay tribute to her tireless work, and it is a privilege to follow her excellent contribution. She and I have become something of a tag team on this issue, and it was notable that when we went to request that the Backbench Business Committee give time for the debate, we were quite definitely discussing when, not if.

In July, the Women and Equalities Committee launched our inquiry into menopause in the workplace, and since then we have collected evidence from a wide range of sources about the impact that menopause can have on women and work. However, before I highlight some of the issues that we have so far uncovered, I want to make a quick comment about the menopause and Westminster, or more specifically, the menopause and Whitehall.

Back in 2018, I had the privilege to be a member of the employment taskforce, and I have never forgotten the introduction given by one of the most senior civil servants in Whitehall to one of those meetings, where he spoke of the economy being “menopausal”—like it is some sort of insult, as if it is something to be ashamed of or ridiculed. I challenged him then in the same way that we must all challenge it now, because we have to beat down that stigma, that taboo, and make sure that the menopause is something that we can actually celebrate. I am talking about those brilliant menopausal women who have contributed so much during the course of their careers up to that point; the ones who are approaching the peak of their careers; the ones who have learned the ropes, gained the experience, given confidence to those following behind them and been role models to younger colleagues; the ones who have demonstrated that you can do it. If we allow menopause to be an insult, we are saying that the women who have achieved are suddenly of no use any more, and that is not the case.

But the workplace can be phenomenally difficult when experiencing menopausal symptoms. Goodness, anywhere can be difficult, but a recent survey carried out by the Fawcett Society on behalf of Standard Chartered and the Financial Services Skills Commission, specifically about women in finance who are experiencing the menopause, highlighted some really stark findings. Over 50% of women are worried about taking on additional responsibilities because of the menopause—that is the promotion gone. Twenty-five per cent. of women considered leaving their career altogether because of the menopause—that is the job gone; that is the income gone.

We talk about 1 million women being lost to the workforce. Let that sink in: a million women. Those are experienced, talented, confident, knowledgeable women no longer playing a role in the boardroom and lost to the management tier—decades of experience and advice to younger colleagues simply gone. In stark economic terms, we cannot afford to let that happen. No business, no school, no fire service, no organisation, no Parliament can afford to lose its best and its most experienced.

The really scary thing about the evidence that my Committee has so far received is the number of requests for anonymity from women who want their evidence kept confidential because they are worried about its impact on their careers. That is not acceptable.

Yes, of course the menopause can be difficult. We will all have different symptoms at different times; some will be phenomenally lucky and have no symptoms at all, but some will have symptoms so severe that they cannot carry on at work. We have to break down the stigma and start the conversations so that I never again get an email like the one that I received from a company’s HR director because she did not want her name attached to evidence to the Committee; she wanted it kept private because she was scared about what would happen to her career if anybody in her organisation even thought that she was menopausal.

I cannot predict where the evidence will take the Committee or what recommendations we might make to the Government. We have not even started taking oral evidence, so we are some way off my beating a path to the Minister’s door, or to the door of Ministers in the Department for Business, Energy and Industrial Strategy, to ask for change.

I do not wish to make out that everything is negative. Far from it: the hon. Member for Swansea East gave some fabulous examples of companies that are real trailblazers. In our evidence-taking, I have been completely candid with employers and said, “I want to hear the good as well as the bad—I want to be able to celebrate you and hold you up as a role model to other companies and organisations.”

We have already heard some of the names: Timpson, John Lewis, Tesco, PwC and all the companies that have signed the menopause workplace pledge organised by Wellbeing of Women and supported by Bupa. To all the companies and organisations such as the NAO, which invited me in to talk about the menopause as if I were some sort of expert—it should have had the hon. Lady, who is a far greater expert—I say thank you, because they are starting the conversations. They are just talking about it, and that is the first step.

Nowadays, I am pretty happy to talk to anybody about my menopause or perimenopause symptoms, whatever they are. My induction to that came from GB News, which bluntly came straight out with “What are your symptoms?” I had to give the answer, “I don’t know”—I do not know whether the sweats at night are the start of the menopause or a result of my absolute addiction to a 13.5-tog duvet, which could explain it. Even I baulked at the prospect of using the term “vaginal dryness” in the presence of the Countess of Wessex; others were not quite so reticent.

I am conscious of time, but I want to mention briefly an individual champion. She is not quite my constituent—she is just over the border in North West Hampshire—but Claire Hattrick in Andover runs clipboardclaire.com, a blog dedicated to giving help and advice to other women. In the past week, she has published a whole book on the subject; she is coming to Parliament next week to support the hon. Member for Swansea East, give me a copy of her booklet and make sure that together we champion the brilliant advice out there for menopausal and perimenopausal women and spread the word.

We women born in the late 1960s and early 1970s are the ones most likely to be going through the perimenopause or menopause now. We are determined to speak up, speak out and find paths through the menopause that work for us. We will not be hiding away, because although we might be a pretty unlikely bunch of revolutionaries, it is a revolution that we need.

--- Later in debate ---

[Suzanne Webb (Stourbridge) (Con)]

Periods, labour, childbirth, breast feeding and the menopause—oh, mother nature, please give us a break. Today, we are talking specifically about the menopause. Here we go again: migraines, insomnia, anxiety, aching joints, confidence dips, brain fog, tiredness, flushes, irritation, tears and AC-130—Members may ask what that is. It is fair to say that they will get the picture when I say that my ex-ex-boyfriend described me at one point as being similar to an AC-130, the world’s biggest flying artillery gunship nicknamed “Hell in the Sky”, with three side firing weapons, a 25 mm Gatling gun, a 40mm Bofors cannon, and a 105 mm howitzer firing on all sides. We are talking about the joys of menopausal rage. Members will be pleased to know that the AC-130, so described, was only temporarily in action and was retired some time ago, as was the ex-ex-boyfriend.

Seriously, I do not want to be here talking about this today. I do not like baring my soul about something so deeply personal, let alone here in this great place. This is the only time, Mr Deputy Speaker, that I wish there was a time limit. The taboo around the subject is evident when we consider who is, or who is not, sitting in this Chamber. It is a shame that there are not more people of all ages in here contributing to the debate. Clearly, speaking in this debate is what I needed to do to give women hope that, while this is a club that no one wants to join, ultimately we all do—as a woman. But you know what? Once in, it is a lovely club with some amazing and awesome women.

I thank the hon. Member for Swansea East (Carolyn Harris) and my right hon. Friend the Member for Romsey and Southampton North (Caroline Nokes) for ensuring that we actually had this debate and that I actually came here and spoke out. I came through all of this very early and unscathed. However, I do wish to raise the issue of bone density, which the hon. Member for Bradford South (Judith Cummins) mentioned. Unbelievably, I did not realise what was happening at first—it was some years ago now—but I do now in hindsight. The horror was to do with my bone density. I did not have HRT at the time, so there was a sudden rush to put me on it once we realised that I had practically gone through the menopause. I had a bone density scan and everything was tickety-boo in that area—thank the Lord for that.

Talking about the menopause is a big deal for women. It is for me. I feel that we often have to defend ourselves. We are very much judged on it and women are embarrassed about it, as am I. It is often not talked about, even between women. We just do not want to talk about it. Men are embarrassed about it, too. As I was leaving for this debate, I was speaking to one of the guys in the flat. I told him that I was just about to go and talk in a menopause debate. He said, “Oh, all right. We can’t talk about that, so good luck.” Young women just see something that they think is unique to their mothers and that will not ever happen to them, but, trust me, it actually will and they will certainly know about it when it does happen. Look we must talk about it. We have to educate those who sadly believe that a women’s identity is built only on biological fertility and educate those who think that being menopausal indicates that a woman’s sell-by date has well and truly expired. Well, to whoever said any of the above or thinks it: just look at the amazing number of women sitting on these Benches who entered politics at their supposed sell-by date. We must talk about this so that it is no longer a taboo. And please—so I do not have to stand here talking about it ever again—can we just get it out there? Of course, also for the partners, colleagues and employers of menopausal women, we must share and understand the physical and mental impacts that the menopause can have on women.

The menopause is an entirely natural biological process. I thank the Government for putting it on the agenda. If I remember rightly, it was my hon. Friend the Member for Redditch (Rachel Maclean) who started to do so. The Government are in the process of developing a women’s health strategy, which will look to tackle menopause education. I have long thought that we needed to do more in schools to normalise hormones. From September 2020, relationships and sex education and health education have been compulsory in all state-funded schools. As part of this, pupils are taught about menstrual health and the menopause. A positive attitude to hormones is crucial and much needed, with more education in schools to break the myth that women are only defined by and are relevant through their biological fertility.

Society needs to reframe its attitude. It is okay to be grumpy. Tears are okay. Hot flushes are okay. Hot necks are okay. Layering clothes is the new “en vogue” for any perimenopausal woman, who can go from ambient temperature to extreme heat in the blink of an eye. The coldness in this Chamber is actually so welcome for anyone who is perimenopausal—so I thank the House! Some women fly through the menopause, some deny it and others suffer symptoms that affect their family and professional lives, and they deserve empathy, support and practical solutions.

Let me touch on HRT. As I said, I did end up having some HRT towards the end of that time, but it did not work for me. I think it is important to say that it does not always work for everybody, and it is important for people to have the right conversations with their doctor and to share that experience. If people start to feel other symptoms, as I did, they must go back to their doctor to have that conversation.

[Caroline Nokes]

My hon. Friend makes an important point about HRT not working for everyone. What is also true is that different types of HRT work differently. Of course, the issue of prescription costs comes in for people who have to try several versions.

[Suzanne Webb]

My right hon. Friend makes an important point. That is exactly what happened with me. We went through the process and tried the various options, although I ultimately ended up coming off HRT because it just did not suit me.

Talking about menopause is so important, especially when we often do not realise that we are starting to go through the process. We are not tapped on the shoulder one day and told, “This is it.” It is a slow and confusing process that can create anxiety and depression. Some say that it can be akin to a grieving process. The menopause brings on deep and profound changes, which should not be underestimated, but somewhat embraced, and perimenopausal women should not be confined to the out-of-date shelf. It is for all of us to think about this issue and do something about it; we all need to do something about this.

Black Maternal Health Week

Caroline Nokes Excerpts

Tuesday 14th September 2021 Westminster Hall

[Caroline Nokes (Romsey and Southampton North) (Con)]

I put on record my appreciation to the hon. Member for Streatham (Bell Ribeiro-Addy) for having led the debate today and for her incredible work on this important and sensitive issue.

Alongside me, she is a member of the Women and Equalities Committee. We have been privileged to listen to the evidence of black and mixed-race mothers about the experiences that they have had in giving birth and in supporting their family members in giving birth. We have heard some real horror stories of lost sisters and lost daughters, because their maternal health outcomes have been worse than the outcomes that my hon. Friends the Minister and the Member for Cities of London and Westminster (Nickie Aiken) and I would have had.

It is wrong that in 21st century Britain we can still expect black and mixed-race women and women from ethnic minorities to have such a massive disparity of experience. The Five X More campaign has done some incredible work. In the Select Committee, we have been lucky enough to do roundtables with them, and to listen to their experiences, their recommendations and the changes that they believe would make a real difference.

Those stories have been difficult but important to listen to. The thing I took away was how fed up those women were about having to repeatedly tell the story. They feel that they are not being listened to, that there is no change and that they are not seeing action, when actually, as the hon. Member for Streatham has pointed out, the statistics are so stark that this should be driving immediate and rapid change.

In November last year, the Joint Committee on Human Rights discussed targets. I can sometimes be a bit sceptical about targets and think they do not necessarily always drive the right outcomes and behaviours, but this is a clear case where I think that they would and where I want to see the Government have real ambition to set a target and a timeframe, so that we can see that four times more disparity driven down and ended. It is crucial that we try to do that in a very rapid timescale.

There have also been clear recommendations from the Health and Social Care Committee. Indeed, the Government should be responding to them imminently. Can the Minister update us on that in her response and give us an indication about whether the Government will embrace those recommendations?

I am conscious that my hon. Friend the Minister has done good work on the subject and last year set up a forum designed to bring together experts in the field to meet key stakeholders, to consider and to address the inequalities for women and babies from different ethnic backgrounds and socioeconomic groups. We cannot shy away from that. We also have to look at some of the intersectional challenges, and ensure we are looking not just at race but at the socioeconomic situation.

Can the Minister outline how that forum is assisting policy making? It is crucial and we want to understand what role those experts are playing in feeding into Government to drive policy change. Can she indicate how often the forum has met and what the key recommendations have been? How quickly will those recommendations be acted upon, if indeed they will be acted upon?

One challenge that we heard at the Women and Equalities Committee roundtables was about research. Many experts felt that there was already a great depth of research that had been done, that the knowledge was there and that perhaps further research was not needed. In April this year, we heard that the Government had commissioned the policy research unit in maternal and neonatal health and care at the University of Oxford to develop an English maternal morbidity outcome indicator, which is not easy to say. That is crucially important. We want to see how that indicator is working and when we expect it to be rolled out. I would like to hear the Minister today update us on that work and give us some indication as to whether she is any closer to committing to a target for reducing the deaths of black women in childbirth.

Towards the end of her contribution, the hon. Member for Streatham spoke about continuity of care, which is crucial. We know very well that if there is continuity of care during pregnancy then the birth outcomes would be better for both mother and child. The NHS long-term plan included targeted support around continuity of care, with an aim that by March this year most women would receive the sort of crucial continuity that we are calling for. That was a target that was set, so I would very much welcome the Minister’s updating us on how that is going. We heard from the Health and Social Care Committee that the targets for continuity of care were inadequate and in need of improvement, so perhaps we can have an indication of how the Government will achieve that.

The hon. Member for Streatham finished her speech with a commentary on institutional racism in the national health service. I was really struck—I was going to say this time last year, but perhaps it was a bit earlier—when we took evidence in the Women and Equalities Committee on how much worse the outcomes of covid were for people from black, Asian and minority ethnic communities. One of the messages that we heard from healthcare professionals from black and Asian backgrounds who were working in the NHS was that they were scared to speak up. They were scared to tell their stories to line managers about the pressures that they faced when working in our NHS. In many instances, they felt exposed to racism if they asked for perfectly reasonable adaptations or changes, or for greater levels of personal protective equipment. It is absolutely wrong in the 21st century that we have people working in our health service who are frightened to speak up.

I was struck when we took evidence during the roundtable discussions with black and minority ethnic mothers, and indeed with experts—we heard from Christine Ekechi, who is the most incredible woman, and from the doula Mars Lord, to whom the hon. Member for Streatham referred. They made a really important, shocking and, in many ways, depressing point: too many black women and their partners were not being listened to during childbirth. They were trying to convey how they felt and the worries they had when they felt that things were going wrong. Mothers going through childbirth were scared and instinctively felt that something was going wrong, and they told us repeatedly that they were not listened to. In a 21st-century health service in the sixth largest economy in the world, that is simply not acceptable.

--- Later in debate ---

[Ms Dorries]

Absolutely—across black, Asian and mixed ethnic minority groups as well. The point has been made today that black women do not feel listened to. We hear stories of complaints about pain, prolonged labour and other issues, and black women just do not feel as though they are being listened to in that environment. The core finding of the Cumberlege report, which addressed mesh, sodium valproate and Primodos, was that women are not being listened to, and black women probably even more so in the maternity setting. That issue for women, black women, Asian women and women from mixed ethnic backgrounds needs to be addressed. Women have to be listened to.

Turning to covid-19 and vaccinations, covid-19 has further exposed some of the health and wider inequalities that persist within our society. While considering disparities in the context of the pandemic, initial data suggests that vaccine uptake among ethnic minorities is lower than for other groups. Covid-19 vaccines are recommended in pregnancy. Vaccination is the best way to protect against the known risks of covid-19 for women and babies, including admission of the woman to intensive care and premature birth of the baby.

New findings from a National Perinatal Epidemiology Unit-led study showed that of the 742 women admitted to hospital since vaccination data has been collected, only four had received a single dose of the vaccine and none had received both doses. That means more than 99% of pregnant women admitted to hospital with symptomatic covid-19 are unvaccinated. That is quite stark.

[Caroline Nokes]

On that point, will my hon. Friend reassure me and all Members that the Government will keep pushing the crucial message that the vaccine does not affect fertility or pregnancy, and that it is important for pregnant women and women of childbearing age to get the vaccine?

[Ms Dorries]

Absolutely. My right hon. Friend has done it for me, but I absolutely encourage women to get the vaccine because 99% is a huge figure. There is a basis of mistrust. The reason why many black women do not access some of the health services they should do before pregnancy is because they do not feel listened to and they do not feel they can trust their practitioner. The message of “Take the vaccine” must be pushed.

I will finish by taking the opportunity to urge women to continue to access maternity care and to stress that pregnant women should never hesitate to contact their midwife, maternity team or GP, or to call NHS 111 if they have any concerns. That also applies if parents are worried about their health or the health of their newborn baby. I urge expectant mothers to have their covid-19 vaccination as soon as possible. I do not think we can give out that message often enough.

Covid-19 Update

Caroline Nokes Excerpts

Monday 19th July 2021 Commons Chamber

[Nadhim Zahawi]

The hon. Gentleman attends the Friday briefings that I offer colleagues. He is absolutely right. Last week, Public Health England published some encouraging real-world data that showed that two doses of the vaccines offer around 74% protection for those who are immunosuppressed or immunocompromised. That comes with a caveat that that group of people is not homogenous and we need to unpack some of the data. The JCVI has already recommended in its interim advice on the booster campaign in September that that group goes top of the list for the third dose as a boost. Of course, we have a large clinical trial, which will report imminently on the immunosuppressed and the immunocompromised. We will look at that data with the JCVI. The chief medical officer continues to ask the JCVI to look at what else we can do to protect that group, including through the therapeutics taskforce, which is doing some tremendous work.

[Caroline Nokes (Romsey and Southampton North) (Con) [V]]

There is some real concern among my constituents that they might in some way have the wrong batch of AstraZeneca vaccine. My hon. Friend provided a useful update on Friday, but can he give any further reassurance that no British traveller will be turned away at the border because they have been given the wrong vaccine?

[Nadhim Zahawi]

My right hon. Friend is right that there is no such thing as a wrong batch of Oxford-AstraZeneca vaccine in the United Kingdom. Our independent regulator regulates all manufacturing sites for AstraZeneca, Pfizer and the other vaccines. The AstraZeneca vaccine produced in the Serum Institute is the same vaccine—the Vaxzevria vaccine brand that is approved by the MHRA and the European Medicines Agency. There was some confusion in parts of world such as Malta last week, which the MHRA, the EMA and the Commission helped to clear up. I reassure my right hon. Friend that anyone who has had an Oxford-AstraZeneca vaccine and has the UK app or the letter to demonstrate their vaccination can travel. I think that 33 countries now recognise our vaccine certification.

Covid-19 Update

Caroline Nokes Excerpts

Monday 5th July 2021 Commons Chamber

[Sajid Javid]

I think the hon. Gentleman is suggesting that people should have the freedom to wear a mask if they wish, but it should not be mandatory—it should not be mandated by law. There are countries—I lived in Singapore for three years—where people would wear masks if they were feeling unwell, out of respect for others. If people choose to do that here, that will be a good thing, but it will not be a requirement from the Government. As I said, in certain settings—crowded places such the tube in London—many people would choose to wear masks, despite its not being a legal requirement.

[Caroline Nokes (Romsey and Southampton North) (Con) [V]]

The immunosuppressed want to know what the plan is for them. Will they be allowed tests for spike antibody levels on the NHS? Will they be able to get a booster before September if their antibody tests show that they have no protection, despite being vaccinated?

[Sajid Javid]

My right hon. Friend asks an important question and we are still considering what more we can do to give more confidence to the immunosuppressed, and we will be saying more on this shortly.

Covid-19 Update

Caroline Nokes Excerpts

Monday 14th June 2021 Commons Chamber

[Matt Hancock]

We published the data for the number of imported cases of B1617 and other variants at the time the decision was taken. That data was the data—including up to 7 April—on which we took the decision, which was announced on 19 April, but it does take that time to see the sequencing, because it operationally takes time. Since we have published that data, I have heard endless calls from those on the Opposition Benches, including from the right hon. Lady, that I should have acted on data that we could not see and that had not been gathered, and that is only a way to make a point if you do not care about the truth of what actually happened.

[Caroline Nokes (Romsey and Southampton North) (Con) [V]]

As the evictions ban comes to an end and rate relief ends, what reassurance can my right hon. Friend give businesses such as Fitskool in my constituency, which is still operating under restrictions, that this delay to full step 4 really is the last delay?

[Matt Hancock]

I understand entirely the point that my right hon. Friend is making in terms of these restrictions and the impact on businesses and, in particular, the link to those in rent arrears. That is something I have been discussing with the Communities Secretary, and I am very happy to meet her to discuss how in the short term we can ensure that businesses, such as the one in her constituency that she mentions, get the support they need.

Covid-19 Update

Caroline Nokes Excerpts

Monday 19th April 2021 Commons Chamber

[Matt Hancock]

Of course, the prioritisation for vaccination when it comes to those who are vulnerable is clinically determined. I know that this question has been looked into. We are also looking into work on the links between ME and long covid, which share some similarities but are different conditions. It is an area that needs further work and further research—there is no doubt about that. If there is an update to the clinical advice on prioritisation and whether those with ME need to be in category 6 or category 4, I will update the hon. Lady. Thus far, however, we are following the clinical advice and that is the approach we have taken overall.

[Caroline Nokes (Romsey and Southampton North) (Con) [V]]

I was really pleased to hear my right hon. Friend reference the appointment of Professor Lucy Chappell and the work on vaccines in pregnancy. Will he please update the House on what is being done to reassure young women that there is no plausible way that vaccination can affect fertility? Will he also let us know how quickly he expects pregnant women, who we know might be immunosuppressed, to be called forward for their vaccination, or will they have to wait for the age band that is appropriate?

[Matt Hancock]

I was absolutely delighted that on Friday, following the work of Professor Chappell and others, we were able to make the announcement with respect to the vaccination for those who are pregnant. The prioritisation remains as with people who are not pregnant, so it will essentially be by age unless there is another reason that one might be in a higher group, for instance if you are a social care worker. It does not affect the prioritisation. Hitherto the advice had been understandably cautious, because clinical trials are not done on people who are pregnant. However, there is now very clear advice for those who are pregnant: when it is your turn, come forward and take advice. Have a discussion about your individual circumstances with your clinician. They can then, subject to that individual circumstance, which is of course appropriate in pregnancy, be vaccinated. I am grateful to my right hon. Friend for raising this issue. It was a really important announcement on Friday. Mr Speaker, I probably should have included it in my original statement, but unfortunately it was already rather long. I am absolutely delighted that Professor Chappell and the whole team—it was a big team effort—were able to ensure we made this progress.

Coronavirus

Caroline Nokes Excerpts

Thursday 25th March 2021 Commons Chamber

[Caroline Nokes (Romsey and Southampton North) (Con) [V]]

It is always a pleasure to follow my hon. Friend the Member for Ruislip, Northwood and Pinner (David Simmonds), who talked about the importance of keeping some of the provisions within the Coronavirus Act, very much in a just-in-case manner. I will speak from my perspective as Chair of the Women and Equalities Committee about three components that have caused us concern in the past and one that still does.

We very much welcome the action taken by the Health and Social Care Secretary to remove the Act’s provisions around the Mental Health Act 1983 and sectioning back in December. They had not been used and were therefore not needed. I also very much welcome his actions over the course of the last 24 hours in deciding to retire, as it were, the Care Act 2014 easements, which the Women and Equalities Committee had called for and, indeed, which I would be calling for this afternoon had he not already done it.

However, the same step has not been taken over the education easements in the Act. Too many disabled children have not received the support they need during the pandemic. These easements have not been used since July, yet the justification for keeping them, sent to me by the Under-Secretary of State for Education, my hon. Friend the Member for Chelmsford (Vicky Ford), is that the Secretary of State is keeping them under review in case the evidence changes. The Minister acknowledges in her letter to me, dated today, that the powers are unused and have not been used since last July. Indeed, she goes on to state that, compared with May, June and July last year, these flexibilities are much less needed. If they are unused and the evidence shows that they are less needed, why are they being retained? I am not some great conspiracy theorist; I do not think that this is an attempt by the Secretary of State for Education to keep this power indefinitely, but it is not used and it is not needed, yet it remains on the statute book. Of course, there is no ability to amend just that one section this evening.

Respectfully, I argue that the justification we have been given makes no sense, and I urge the Secretary of State for Education to think again on retaining these powers. Parents are desperately worried that children with special educational needs are not getting access to the assistance they need. They are back in school now, which I absolutely welcome, but I urge the Education Secretary to reconsider and to remove these unneeded easements.

Women’s Health Strategy

Caroline Nokes Excerpts

Monday 8th March 2021 Commons Chamber

[Ms Dorries]

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

The hon. Lady also spoke passionately, as she always does, about the patients she meets as part of her work and the women who are suffering from eating disorders—sadly, that has been a tragic cost of covid. We know that two groups have been affected by the past 12 months in the mental health sphere: people, including women, with pre-existing mental illness; and, in particular, young women aged 15 to 26, in whom we have seen an explosion in the number of referrals—I believe the figure is 22% for young women seeking help with eating disorders. We have committed funding during the spending review, when £500 million was announced, and I announced £79 million on Friday. Part of that is going to deal with the problems that we have as a result of the pandemic, and with young women and girls—and in some cases young men—who are suffering from eating disorders.

The hon. Lady talked about the stillbirth and neonatal target of halving the number of stillbirths by 2025. We are way ahead of our target on that. The Office for National Statistics published new data last week, and I believe we are looking towards a 30% figure already. We are way ahead of target, and that is a result of the measures that have been put in place in the maternity safety arena, including the saving babies’ lives care bundle and the early notification scheme.

I reiterate that what we are announcing today is a call for evidence from women everywhere in the UK: from every organisation and every friend, every partner, every family of every woman.[Official Report, 12 March 2021, Vol. 690, c. 5MC.] The link has been published today. I published it on the Government website and it is on the Department of Health and Social Care website and on my Twitter feed. It is a link that women can easily access using their phones or their laptops, and it takes a few minutes to complete. We want to develop the first ever women’s health strategy within the Department of Health and Social Care that will deal with all the issues—there are too many for me to talk about now—and all the ways in which women have been affected. These will include research funding and cohorts of trials not using women, using all the information that we have from Paterson and Cumberlege and from women stating clearly that women are not listened to in the healthcare sector. To address that, we need to hear not just from the Paterson women and the mesh women who spoke to Cumberlege; we need to hear from all women everywhere, and that is why we have launched this call for evidence today, to develop this strategy before the end of the year.

[Caroline Nokes (Romsey and Southampton North) (Con) [V]]

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

[Ms Dorries]

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

Within the first minutes of the link going live this morning, we instantly had 300 responses. I have not checked what the figure is now. We need huge numbers of women and yes, absolutely, it is not just about the usual issues that get talked about, although they are an important part of this. Menopause, menstrual health, maternity and neonatal issues are the things we talk about frequently, but this will be about everything. For example, we know that drugs that are used on women are trialled and developed using all-male cohorts, and that doctors are taught in medical school to recognise symptoms that are taken from men and not applied to women. We know about the inequalities, and we need to know about any subject from disability to mental health; anything that a woman experiences in a healthcare setting, we need to know about it.

Vaccine Roll-out

Caroline Nokes Excerpts

Thursday 21st January 2021 Commons Chamber

[Matt Hancock]

The armed forces have been incredible in their support for the efforts that we have all had to go to nationally to tackle covid. That is also true with the vaccination programme—especially the logistical expertise that the hon. Gentleman refers to. This UK-wide vaccination effort has been supported enormously by the armed forces. I am very grateful to them for the work that they have done, really going the extra mile to help save lives.

[Caroline Nokes (Romsey and Southampton North) (Con) [V]]

I am very worried about domiciliary carers who might be employed privately or via an agency and how they will access the vaccine. It is very probable that their employment status is not known, yet they could be going into several homes per day, helping vulnerable people. Can my right hon. Friend reassure me that these brilliant carers will not be forgotten?

[Matt Hancock]

Yes, absolutely; that is incredibly important, and we are working to ensure that as many as possible are identified. Category 6 in the Joint Committee on Vaccination and Immunisation categorisation specifically identifies as part of the early vaccination effort those carers who may not be paid carers in a care home but nevertheless care for vulnerable people, because of the incredibly important work that they do.