Leighton Hospital Rebuild

Carolyn Harris Excerpts

Wednesday 28th February 2024 Westminster Hall

[Carolyn Harris (in the Chair)]

I will call Dr Kieran Mullan to move the motion and then the Minister to respond. As is the convention for 30-minute debates, there will not be an opportunity for the Member in charge to wind up.

[Dr Kieran Mullan (Crewe and Nantwich) (Con)]

I beg to move,

That this House has considered the rebuild of Leighton Hospital.

It is a pleasure to serve under your chairmanship, Mrs Harris. My aim today is to take this opportunity to ensure that the rebuild of Leighton Hospital is front and centre of the Minister’s priorities, because a successful rebuild and management of the short-term challenges on the way there are vital to ensuring that my constituents, and residents across the region more broadly, can access excellent healthcare from their local hospital.

All of us involved in the campaign were delighted when we secured Leighton’s place in the £20 billion new hospital programme, which will see 40 hospitals benefit in the largest concerted effort in a generation to modernise our hospital estate. As part of that, Leighton Hospital will receive hundreds of millions of pounds in funding to be rebuilt. The current hospital is a crucial part of our local healthcare services. Built in the early 1970s, Leighton Hospital was opened by the late Queen in 1972. Generations of families have been born there and millions of people have received treatment there, and I know our local community is incredibly proud of its local hospital. Each year, the Mid Cheshire Hospitals NHS Foundation Trust, of which Leighton is the primary site, has more than 100,000 A&E attendances and 290,000 outpatient appointments, and carries out more than 100,000 diagnostic tests. Leighton provides not just healthcare, but over 4,500 job opportunities to members of staff employed at the trust. Those fantastic members of staff cover a whole range of roles, including porters, cooks, receptionists, cleaners, occupational therapists, healthcare assistants, physiotherapists, nurses, doctors and many others.

Having worked in the NHS prior to becoming an MP, I know the difficulties that can arise working in buildings that are in need of refurbishment or, in this case, replacement. The physical infrastructure of the building being worked in is outside the control of the frontline staff, and they often have to do whatever it takes to make it work, but it would be better if they did not have to. Since it was built, Leighton has been expanded with new, modern buildings added on, including a new intensive therapy unit and theatre suite, campaigned for by my hon. and learned Friend the Member for Eddisbury (Edward Timpson) when he represented Crewe and Nantwich.

More recently, I worked with others to secure £15 million for a new A&E department. When it was originally built, much of the building was made with reinforced autoclaved aerated concrete. RAAC is a lightweight, bubbly form of concrete, which was often used in schools, colleges and hospitals from the mid-1960s to the mid-1980s. It is usually found in roofs and occasionally walls and floors, and has since proven to be at risk of structural failure. Since that came to light, it was clear that something needed to be done to ensure that Leighton remains safe for patients.

By the time we started our campaign for a new hospital building, much work had already been done to manage that risk, but it was clear that remedial work would only take us so far and that the best thing to do—not least the better use of taxpayers’ money—was to have a whole new building, so the campaign was launched. Thousands of local residents signed our petition for a rebuild and shared their positive experiences of being treated at Leighton, often having been born there, and they very much wanted to see its future secured. The inclusion of Leighton Hospital in the hospital building programme is a win for its staff and the patients it serves. It has been a privilege to have played a part in securing it, alongside the hard work of so many other key players, including my hon. Friend the Member for Congleton (Fiona Bruce) and my hon. and learned Friend the Member for Eddisbury, and the cross-party support we achieved.

My hon. and learned Friend very much wanted to be here today, but is on an important visit with the Justice Committee. As I know he has done already, I have been glad today to be able to sit down and discuss this important local issue with the excellent Chester South and Eddisbury Conservative candidate for the forthcoming general election, Aphra Brandreth, who is in the Gallery. I know Aphra will continue championing the cause if she is elected as the next MP, which I very much hope she will be.

Having spoken recently with the leadership at Leighton Hospital, I understand that the building programme is coming along well, and I want to thank all those working on the project at Leighton, in NHS England and in the Department of Health and Social Care for their hard work to date. I am delighted that the Leighton site has been selected as the national low-rise hospital 2.0 design template reference site. Procurement of technical advisers is ongoing, and there has been positive engagement with the Cheshire East planning department. The funding allocated for the purchase of the land required to enable a new build has been received, with the purchase expected to be made in the next few weeks. While the trust is waiting for full DHSC and Treasury approval, the current timeline for completion runs through to 2029. That achieves the Government’s goal of ensuring that the proposed projects in the hospital building programme are done before 2030.

However, as with any large infrastructure project, there will always be challenges and room for improvement. Most critically, the RAAC issue has not gone away. The hospital building programme is the long-term solution and we intend to have a whole new hospital to deal with the issue, but in the meantime, remedial works are absolutely necessary to ensure the continued safety of the building.

These challenges can be expected to persist for the next six to seven years. There has been encouraging support to manage them to date, with over £55 million spent in 2022-23 and £28 million in 2023-24, with further spending likely to be needed in the next financial year. A wide range of work has been undertaken, including the construction of a two-storey modular decant ward building. The development provides decant accommodation, which in turn has allowed the trust to undertake essential RAAC refurbishment and stabilisation works to existing wards, ensuring patient safety.

However, the remedial works inevitably create challenges for the dedicated team of staff. Access routes and clinical areas sometimes need to be closed, forcing staff to make large detours and creating a negative impact on the patient and staff experience. It can be difficult to deliver business as usual. Although I appreciate that disruption is at times unavoidable, it would greatly assist the trust if the Minister could talk to colleagues in DHSC and the local NHS to agree a clear, forward-looking timetable for the RAAC work, which will need to carry on and progress as the rebuild does. If there are elements that cannot be agreed in advance, perhaps there could be a smoother mechanism for sign-off to allow more timely decisions to be made.

My second ask is for the Minister to use his considerable skill to work with officials and agree the full cost envelopes and timescales for the whole rebuild as soon as possible, and agree a more streamlined approval process for the elements that are tentatively agreed locally but need sign-off higher up as the work progresses. His attention will benefit the rebuild process not only in Leighton but in other areas if changes can be agreed and implemented across the programme. I am confident that a deep dive by the Minister to understand how it has all been working to date would help identify where improvements in the process could be made.

While I have the Minister’s attention, I want to highlight the potential for Leighton and other NHS hospitals to be heated by deep geothermal resources. A recent study by the British Geological Society identified more than 100 hospitals that sit on deep geothermal resources. As the Minister knows, with a net zero target of 2040, the NHS and hospitals in particular face a considerable challenge to secure net zero heat. I have been working with the Carbon and Energy Fund to develop proposals for identifying the best public sector candidates for deep geothermal, with a focus on NHS sites. I was glad to have the opportunity to meet the Hospitals Minister from the other place, Lord Markham, and his team. We are continuing discussions with them, the Treasury and the Department for Energy Security and Net Zero to see what we might be able to achieve.

I conclude by again paying tribute to all those who were part of the campaign to secure a rebuild of Leighton Hospital, and to all those at the hospital and in the wider NHS who put in an enormous amount of work to secure the progress we have made to date. I know that the Minister will take my questions in the spirit in which they are intended—as positive suggestions as to how we might deliver even more efficient progress—and see what he can do. We remain very happy to have secured the rebuild. We just want to ensure that it is delivered as swiftly as possible, and that Leighton staff and patients are supported to keep on delivering and receiving healthcare within the existing building in the meantime.

Oral Answers to Questions

Carolyn Harris Excerpts

Tuesday 11th July 2023 Commons Chamber

[Maria Caulfield]

I absolutely pay tribute to Tom and to his father. I reassure him that we have many campaigners. Only last week, we received the baton of hope at No. 10 from those campaigning to reduce the number of suicides in this country. We are working on the suicide prevention plan and hope to be able to publish it very soon.

[Carolyn Harris (Swansea East) (Lab)]

14. What steps he is taking to tackle shortages in hormone replacement therapy.

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

We continue to engage regularly with our suppliers to prevent and mitigate supply issues in the short term. We have over 70 HRT products. The vast majority are available. We have two that have serious shortage protocols attached to them, but we are hoping to improve supply on those very soon.

[Carolyn Harris]

Although shortages of Utrogestan are ongoing, there is no alternative progesterone product recommended on the serious shortage protocol. Taking oestrogen without progesterone can be dangerous. Provera is a synthetic progesterone alternative to Utrogestan, but it is not included on the HRT prepayment certificate. Will the Minister commit to placing Provera on the list of products covered by the prepayment certificate as a priority and issue a public health warning highlighting the risks of taking oestrogen without progesterone?

[Maria Caulfield]

We are in the process of issuing another bulletin to both GPs and pharmacists on the serious shortage protocols and to make clear the alternatives available. That is a clinical decision. I will certainly look at the issue of Provera because medicines have to tick off a number of criteria to be eligible for the prepayment certificate. I will certainly look into that particular drug on the hon. Lady’s behalf.

Cancer Medicines: Appraisals

Carolyn Harris Excerpts

Tuesday 13th June 2023 Westminster Hall

[Owen Thompson (Midlothian) (SNP)]

It is a pleasure to see you in the Chair, Mrs Harris. I commend the hon. Member for Strangford (Jim Shannon) on securing this important debate. I will do my best to follow the two previous contributions from the hon. Members for Mitcham and Morden (Siobhain McDonagh) and for Chatham and Aylesford (Tracey Crouch) about their personal experience. I cannot contribute to the debate in that way, but I will do what I can.

All our lives have been touched by cancer in one way or another. We all know someone whose life has been changed in some way by the disease. Therefore the appraisal of cancer medicines is of the utmost importance to us all. These medicines give hope and, indeed, life to so many. Yet even something as vital as the evaluation and distribution of cancer medicines did not escape the upheaval of Brexit. The UK ended its membership of the EU three years ago, and that catastrophe, which Scotland did not want, meant that the Medicines and Healthcare products Regulatory Agency withdrew from the European Medicines Agency. While immediate disruption to patient care was avoided, there have been shortages across the board since Brexit.

In Scotland, the Scottish Medicines Consortium—if I mention it again, it will be easier to say SMC—must review and recommend a new medicine before it can be prescribed on the NHS for routine use. This would take place after a medicine has received a marketing authorisation from the MHRA. The SMC advises and provides recommendations to NHS Scotland. This due diligence must be carried out by medical professionals to ensure everyone’s safety. The Scottish Government remain concerned about the effect of Brexit on the authorisation of medicines, as medicines obviously play a crucial role in the NHS. The authorisation and appraisal of medicines also have a key role in the Scottish Government’s commitment to supporting people to live longer, healthier lives. Diagnosing and treating cancer are a priority for the Scottish Government, which is why they are investing £40 million over five years to support cancer services.

However, the NHS in Scotland has finite resources, and medicines are the second largest item of expenditure for NHS Scotland, so difficult choices have to be made. A number of factors need to be looked at. For example, what benefits does the medicine offer compared with other available treatments? Other factors include the quality of life and amount of extra life that may be gained by patients using the new medicine, how the medicine is administered and whether it will save money later on. Those are all examples of the considerations that have to be included when coming to decisions.

Despite UK Government vows to make the MHRA faster and nimbler, we remain concerned about budget and staff cuts to the organisation. There is also a question about the so-called light-touch approach to authorising generic medicines and relying heavily on approvals from larger regulators in the EU and US. The Financial Times reported that the need for cuts at the MHRA has been driven partly by Brexit and the loss of millions of pounds of annual income from its role in authorising medicines in the EU. There has also been a contraction in UK Government funding after the MHRA was subsumed into the budget of the Department of Health and Social Care, as far as I can see.

The hon. Member for Strangford referred to the payback rate of 26%. That is another thing we must not lose sight of. Two very large pharmaceutical companies have already withdrawn from the voluntary scheme as a result of the increase to the rate, which they claim is now punitive. Any further withdrawals from the scheme will surely only have impacts on patients—the people we all want to be doing everything we can to support.

According to recent research by the Nuffield Trust, although the UK Government and pharmaceutical industry averted immediate disruption to patient care from difficulties in the supply of medicines after leaving the single market, there has been a great level of shortages. A review by Imperial College Business School revealed that fewer novel drugs were authorised by the MHRA in 2021—its first year of independence—than by the European Medicines Agency; the UK saw the approval of 35 drugs, compared with 40 in Europe and 52 in the US. That goes back to the points about the availability of medicines and the options that that then makes available to doctors and their patients. Any reform of the regulatory framework must ensure that patients have a voice; their lived experience must inform regulatory decisions. That is where we can all play our part—by relating the experiences that are brought to us.

A cancer diagnosis can be a heartrending and life-changing event, but it can bring positives, and we can all learn from the experiences of those who have gone through it. We need to do everything we can not to add to that heartache by allowing standards to drop or by creating more red tape that stops people getting the medicines they so urgently need.

Brexit casts a long shadow and it has impacted on this area, so we must ensure that there is no withdrawal from the current EU standards or safety controls on medication. It is in all our interests to ensure that we support the development and appraisal of new medicines. We owe that to all our constituents and none more so than those affected by cancer.

[Carolyn Harris (in the Chair)]

I call the shadow Minister.

Eye Health: National Strategy

Carolyn Harris Excerpts

Wednesday 17th May 2023 Westminster Hall

[Marsha De Cordova]

That is exactly the point. Joining up services, which is what my Bill seeks to do, would essentially save the state money, which is crucial.

I have mentioned devolving services and supporting the pathway. When the Minister responds, will he provide an update on where the Government are up to in creating this referral and joined-up pathway system, or EECR, to be specific?

The third area of the strategy would be workforce expansion. There is a significantly uneven distribution of ophthalmology workforces across England, and a quarter of the profession is nearing retirement age. That is extremely concerning, because nearly 80% of eye care units already do not have enough consultants to meet current demand, with over 50% finding it more difficult to recruit for consultant vacancies. In the last year alone, 65% of units had to use locums to fill those consultant vacancies. What do the Government plan to do to respond to this workforce crisis? They say they are bringing forward their plan, but when will it be published?

At the APPG meeting in April, we addressed the challenges of the eye care workforce. Speakers from the Royal College of Ophthalmologists, the College of Optometrists and the Association of Optometrists all made strong recommendations and put forward credible solutions. Again, I would be happy to facilitate a meeting if the Minister is yet to meet those trade bodies. He would hear first hand their strong and credible recommendations, which seek to address some of the workforce challenges.

The Government must make better use of existing workforces while expanding capacity to meet future needs, including by adopting Labour’s call to double medical school places to 15,000 a year. That needs to be complemented with investment in training for wider eye care and multidisciplinary teams and with an expansion in the number of non-medical roles.

The fourth area would be health intelligence and data.  For too long, population data has not been utilised effectively to pinpoint the location of need and the places where opportunities for change can be found. A strategy would solve that by focusing on robust data collection to inform decisions and improve the delivery of service. The UK has no national data to identify people at risk of sight loss. There is potentially a case for looking at how registration for the certificate of vision impairment system works to see whether it could be used to map out an evidence base to show where people with sight loss are living. The lack of data means there is likely to be unmet need in the system, with some people who experience visual impairment not being treated, and some developing conditions that could be avoided if they were treated earlier—as I said earlier, 50% of all sight loss is avoidable.

Without that data, we do not know whether public expenditure on eye health is meeting people’s needs, because that expenditure is not based on any evidence. Where there are still no treatments for certain conditions, the Government should increase spending on eye research, which gets a fraction of the investment it desperately needs. According to UK Research and Innovation, the Government, charities and other public bodies invested £1.4 billion in medical research in 2018, but only 1.5% of that was invested in eye research. To put that in context, only £9.60 was spent on research for each person affected by sight loss in the UK. That is worrying, given that 250 people begin to lose their vision every day.

The fifth area would be improving public awareness. As I said earlier, 2 million people each year turn up to A&E or try to get a GP appointment for a problem that could be dealt with by a community optometrist. A strategy would involve campaigns on the importance of maintaining good eye health, educating the public on the difference between eye screening and eye tests, and improving signposting to where people need to go for help.

England is the only country in the UK without an eye health strategy. Strategies can deliver positive outcomes, as has been the case in Scotland. In England, there are health strategies for other conditions, so why not for eyes? The benefits would transform lives, alleviate pressure on health services and reduce economic costs. Our goal should be to ensure that no one loses their sight unnecessarily. Most people in the Chamber know that I have a condition called nystagmus. I have been living with my sight loss all my life, but those who come to sight loss later in life face even more barriers and challenges.

I would like the Minister to address the following questions. He will get fed up of me saying this, but why will the Government not commit to an eye health strategy for England? Will they appoint a Minister—it could be this Minister—whose sole responsibility is eye healthcare? What are they doing to ensure that every integrated care board has a MECS and that their commissioning is consistent with that of the 23 that already have such services? Five ICBs have no form of MECS provision at all, so what will the Minister do to ensure there is consistency in our communities? When will the Government publish their overdue long-term workforce plan? Will there be a focus on ophthalmology? As I have highlighted, only 1.5% of the £1.4 billion going into medical research involves eyes, so will the Government increase spending on eye health research?

[Carolyn Harris (in the Chair)]

I remind Members that if they wish to speak in the debate, they should bob. I call Dr Rupa Huq.

Oral Answers to Questions

Carolyn Harris Excerpts

Tuesday 1st November 2022 Commons Chamber

[Helen Whately]

I am sure the hon. Member heard the answer I gave a moment ago to a similar question. I absolutely acknowledge the challenge of discharges. The challenge is nothing new, but it has indeed worsened, in part due to the availability of social care. That is one reason why the Government have announced the £500 million discharge fund. I am just a few days into this job—[Interruption.] I am looking at the proposals on how this will—[Interruption.] If she will listen, I am looking to make sure that we allocate that money effectively, because we know that money is tight and we must absolutely make sure that every penny of the funding is well spent on improving the discharge from hospital to people’s homes.

[Carolyn Harris (Swansea East) (Lab)]

10. When he plans to respond to the all-party parliamentary group on menopause’s report on the impact of menopause.

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

I am very grateful to the hon. Lady for all her work on issues around the menopause and to all those on the all-party group on menopause for their work. I have read her report and the 13 recommendations. The Government are already working on many of those, from the cost of hormone replacement therapy through to supporting women in the workplace.

[Carolyn Harris]

The lack of information about symptoms is a recognised barrier to diagnosis. As a result, only 14% of the 13 million menopausal women in the UK have a diagnosis and are accessing treatment. More resource, training and awareness are urgently needed. Will the Government listen to the APPG’s recommendations and commit to a menopause-specific health check for all women?

[Maria Caulfield]

The hon. Lady is right about the lack of awareness. Awareness is increasing through her campaign and the campaigns of many others. That is why we are seeing a significant rise in the number of women being prescribed HRT, but there is more work to be done. I am looking through the 13 recommendations from her report, and I am very happy, when we meet regularly, to discuss that further.

World Menopause Day

Carolyn Harris Excerpts

Thursday 27th October 2022 Westminster Hall

[Carolyn Harris (Swansea East) (Lab)]

I beg to move,

That this House has considered World Menopause Day.

It is a pleasure to serve under your chairmanship, Mr Hollobone. I thank the Backbench Business Committee for granting time for this important debate. I am delighted to co-sponsor it with the right hon. Member for Romsey and Southampton North (Caroline Nokes), who shares my passion and determination to improve access to support and treatment for those experiencing symptoms of the menopause.

Anyone in or around Parliament last week might have noticed a buzz of activity. The reason, obviously, was that last Tuesday was World Menopause Day. It was an honour to welcome a group of women who have been instrumental in campaigning for change, from grassroots campaigners to clinicians and celebrities who are using their platform to amplify the message. The day ended with a rally in Old Palace Yard, almost 12 months on from our last Westminster menopause rally. Last year, I stood among jubilant women in Parliament Square. We were celebrating the fact that the Government had listened and committed to dramatically reducing the cost of NHS prescriptions for hormone replacement therapy in England, which would bring them somewhere near the free prescriptions in Wales, Scotland and Northern Ireland. They also committed to setting up a taskforce to look at other barriers women face.

This year, many of the same women were back again. They were as determined as they were last year. They were loud—possibly a little louder than last year. But they were a little less jubilant, a little more sceptical and far less confident in the Government’s commitment to the promises that they made in October 2021. However, they have not given up.

At the rally, Menopause Mandate launched a wonderful book, “It’s Beyond a Joke”, a collection of real lived experience stories from women. Some are graphic, some are funny, but some will break your heart. Every one is an honest account of a woman’s personal menopause journey, and every one is different, because no two women experience the same menopause. There are stories of misdiagnosis, insufficient workplace support and HRT shortages. There are stories from women who are struggling to afford the cost of the menopause, and from women who are hitting brick wall after brick wall when they try to access support. Thankfully, there are stories from women who faced some dreadful experiences but came out the other side—stronger, happier and ready to be their wonderful selves all over again.

[Dr Lisa Cameron (East Kilbride, Strathaven and Lesmahagow) (SNP)]

I thank the hon. Lady for bringing this vital debate to Parliament. Her speech is a wonderful contribution on what so many people have gone through. Does she agree that menopause is not just a physical condition or response in the body, but something with a mental health and wellbeing impact? People need access to specialist services and clinicians, so that their psychosocial needs can be met in a holistic way.

--- Later in debate ---

[Carolyn Harris]

I certainly agree with the hon. Lady. I myself spent eight years on antidepressants, believing that I had mental health problems, only to discover that I was actually menopausal. I can assure everyone that that was a relief.

I urge the Minister, his colleagues and any Member who does not have a copy—copies are available in my office—to read the book, and to join the campaign for change and for better access to menopause care. As I said, it has been almost a year since the first Westminster menopause rally, which followed the introduction of my private Member’s Bill, the Menopause (Support and Services) Bill.

Since then, we have seen a Government in chaos. There have been three different Health Secretaries, but now one has returned. An HRT tsar has come and gone within a few short months, leaving merely a list of recommendations. The HRT stock crisis rumbles on, months after the Department of Health and Social Care promised that it would be resolved. We still await the promised annual prepayment certificate for HRT prescriptions in England. As families up and down the country struggle with the costs of fuel, food and energy continuing to rise at an alarming rate, the prepayment certificate is more important than ever. Choices are being made on where to cut back on household expenses and on which luxuries can go. Menopause is not a choice and HRT is not a luxury but, for many women, the monthly cost of their prescriptions will be one of the casualties of family finance cutbacks. It is therefore vital that the promised prepayment certificate is implemented as soon as possible—women have already waited a year. The latest date we were advised for its introduction was April 2023. I would be grateful if we could have a guarantee from the Minister today that this will not slip any further.

Around the same time as my private Member’s Bill on menopause, the all-party parliamentary group on menopause, which I chair, launched its inquiry into the impact of the menopause. Earlier this month we published our latest report, which highlighted a number of areas where urgent change is vitally needed, including a call for better training for medical professionals. Stories from “It’s Beyond a Joke” show just how much that is needed. One woman says:

“The GP doesn’t want to ‘dabble’ in drugs with me”.

Another writes:

“The GP had no idea…Despite me telling him how much better I felt on HRT, it seemed that he was only concerned with getting me to stop taking it as soon as possible”.

A third shares:

“I spoke to my female GP. Her response when I mentioned the menopause was ‘Well you’re about the right age’. She prescribed antidepressants”.

Evidence taken during the APPG inquiry saw the same pattern of misdiagnosis, ongoing symptoms and repeated appointments with GPs. I am not blaming GPs. At most, they will have had only a few hours’ training on the menopause during medical school, and some will have had none at all. I am pleased that the women’s health strategy commits to changing that, but it really does not go far enough. The women who are suffering now cannot wait seven years for current medical students to enter practice. We need a programme in place to upskill those who are practising and prescribing to support women today and ensure that everyone who needs it has access to accurate and comprehensive information and treatment.

We also need the Government to make resources available to the health service to allow it to provide this training and support to help it to improve its menopause service. Adding menopause to the quality and outcomes framework would also help. Incentivising doctors to improve their knowledge of menopausal symptoms and treatment options would undoubtedly increase levels of diagnosis and, ultimately, benefit patients.

The APPG report also recommends that all women be offered a specific menopause check-up with their GP. Identifying and addressing symptoms early is vital. We know that some women will go through perimenopause and reach menopause early on. For some, this is due to medical treatment or surgical procedures, while for others it is due to a natural decline in their hormones. For a high percentage of women, an appointment in their 40s to discuss symptoms and treatment could be life-changing. Early detection saves women not only months and possibly years of unnecessary pain and anguish, but careers, relationships and lives—it is no coincidence that the suicide rate among women increases by 16% between the ages of 45 and 55.

We also need to look at the postcode lottery that women face in accessing HRT. The stark divide between those who can afford to see a private menopause specialist and those who cannot, coupled with the different products offered as primary treatment options in different parts of the country, results in women from lower socioeconomic communities being far less likely to be able to access the best care. Evidence taken during the APPG inquiry made a clear case for the need for a national formulary, which would allow prescribers across the country to offer their patients a choice of all available HRT products.

Another issue that became a key topic of both the report and the book is support in the workplace. A report published earlier this year by the Fawcett Society found that, shockingly, one in 10 women is leaving the workplace due to a lack of support, with thousands of others reducing hours and avoiding promotion. This trend was echoed in the evidence sessions during the APPG’s inquiry and the stories submitted to the Menopause Mandate book. One woman said:

“I have had to recently step down from my role at work as I’m still not able to perform at the level needed…I tried to keep my chin up and work through, but this failed.”

Another wrote:

“I had to retire early, aged 59, as I simply couldn’t cope anymore. So, I lived in poverty for four years. I had so little money I bought no new underwear until I got my pension. I even stole toilet paper from cafes to make ends meet.”

Another woman said:

“I was dismissed from my job because of my debilitating symptoms…I was told by my employer that I was ‘fabricating an illness’. According to them, I had made it into work and looked fine.”

She was told that there was nothing wrong with her.

Such stories are devastating and, sadly, far too common. Thankfully, we are seeing change, and employers are gradually realising that they need to do more. Just two weeks ago, I hosted an event alongside Swansea City football club for businesses in Swansea to learn more about what their staff are experiencing and what employers can do to help. I was delighted by the turnout and was particularly encouraged by the desire among employers in my city to do so much more. I would love nothing more than for Swansea to be a city that really understands and embraces the menopause, and this week I saw signs of that beginning to happen. I went to watch the football on Sunday—the Swansea-Cardiff derby—and I was astounded by the number of men who came up to me, congratulated me on the work I am doing on the menopause, and asked for selfies to show their wives, so that their wives would be proud that they had spoken to the menopause MP. I hope that translates into votes.

By contrast, I heard of a woman who had gone to see her GP for some help for her symptoms. She was told by her GP, “That Carolyn Harris has a lot to answer for.” Well, perhaps I do, but is it really too much to ask that those who are suffering have access to the best possible care and treatment, and that menopausal women across society are given the attention and respect that they deserve in medical settings, in families and in the workplace? Currently, only a quarter of businesses have menopause support policies in place, but by making simple adjustments, employees will feel valued and, ultimately, businesses will retain loyal and experienced members of staff.

We really are just at that start, and I hope that the Government will sit up and listen and prioritise this area of women’s health. Progress is slowly being made, and the conversations taking place in the media and across communities are wonderful to see, because the more we talk, the more we learn. But it is not enough on its own. Support remains woefully inadequate, which, for 51% of the population, is really not good enough.

Twelve months ago, Government Ministers stood at the Dispatch Box and promised that change was coming. Twelve months ago, women celebrated triumphantly in Parliament Square. Twelve months ago, we all felt that our voices were finally being heard. Twelve months on, our economy is very fragile, families are struggling and menopausal women feel that they have been let down. We cannot keep waiting for the Government to fulfil the promises they have made.

Some colleagues in this Chamber will have been lobbied by their constituents to attend today’s debate. Many will have posted menopause-related content, which I know will have been well received by their constituents, because the menopause revolution is marching on. We are not going away. We are not going to stop asking for what is needed, and we will not be silent. We are not asking for special treatment, and we are not asking to be treated differently. We just want the resource, the respect and the support for women to experience the normality that the menopause can all too often rob them of.

[Mr Philip Hollobone (in the Chair)]

The debate can last until 4.30 pm. I am obliged to call the Front Benchers at no later than 3.57 pm, and the guideline limits are 10 minutes for the Scottish National party, 10 minutes for His Majesty’s Opposition, and 10 minutes for the Minister. Then, Carolyn Harris will have three minutes to sum up the debate at the end. It is Back-Bench time until 3.57 pm and eight Members wish to contribute. There is a strict four-minute limit and I strongly discourage speakers from accepting interventions, because if you do, it means that somebody will drop off the list. If you keep it to four minutes, everybody will get in.

--- Later in debate ---

[Carolyn Harris]

I thank the Minister for his kind words. We have worked together previously and I trust his word—I look forward to the certificate happening in April 2023.

I thank all colleagues for everything they have said. Women out there are listening to this debate, and they are grateful that we are talking about the menopause, because it is talking about it that will make a change.

The hon. Member for Strangford (Jim Shannon) did not enlighten the House about the fact that he is now a local hero, after I mentioned him on “Loose Women” as a male menopause warrior. He has now been elevated to sainthood in Strangford.

We are changing the narrative, and we are changing it by talking—in here, to women, to Ministers and to each other. We have taught so many women about the situation they are in. Who would have thought we would be doing that as MPs? The right hon. Member for Romsey and Southampton North (Caroline Nokes) and I sometimes feel like doctors when we are asked for advice on the menopause. So many people have asked to have that conversation.

I am going to contradict the words of a song written by the male menopause warrior-in-chief, Sir Rod Stewart, that says,

“I don’t wanna talk about it”.

Well, that is wrong, because we do need to talk about it. We should talk about it, and we will talk about it until every one of the 13 million women in this country who are not having the appropriate treatment for the menopause have the respect they deserve and their lives are returned to normal.

Question put and agree to.

Resolved,

That this House has considered World Menopause Day.

Women’s Health Strategy for England

Carolyn Harris Excerpts

Wednesday 20th July 2022 Commons Chamber

[Steve Barclay]

The work on this strategy was done before I arrived in the Department, so it was down to my right hon. Friend and to the Minister of State, my hon. Friend the Member for Lewes (Maria Caulfield). It is great to have this opportunity to pay tribute to my predecessor for all that he did to drive this agenda forward. He is absolutely right about the importance of training and early diagnosis. That is why addressing the issue of fragmented services is so important. As a respondent said, where women raise concerns, they often feel like a lone voice in the wind—that was a phrase in the strategy that really resonated with me. Having hubs, centres of excellence and the ability to look at that data and identify it early, alongside the other initiatives in which he played a major role as Secretary of State, such as the diagnostic hubs, are all a key part of the delivery of this strategy.

[Carolyn Harris (Swansea East) (Lab)]

I rise to speak specifically on the menopause services included in the strategy. As co-chair of the Government menopause taskforce, I broadly welcome the strategy but feel that it falls short in some places.

Although better menopause training for doctors of the future is essential, there is not much in the strategy now in terms of upskilling GPs or prescriber medics, such as pharmacists or women’s health nurses. With only 14% of women accessing hormone replacement therapy and menopause care, through medical lack of awareness in diagnosing and prescribing, training medical professionals of the future does nothing for women today.

With 50% of women not even discussing their symptoms, we need a public awareness campaign—outside the one being run by the media and by grassroots and celebrity activists—to ensure that all women get the memo, as it were. We need a commitment to a national formulary for HRT to end postcode lottery in quality, quantity and availability of body identical hormone replacement therapy—I emphasise body identical.

As for HRT costs, I am delighted that my private Member’s Bill that I negotiated with the Government last October now appears as part of the strategy, but I am bitterly disappointed that the timeframe for that once annual charge is delayed until April 2023— 18 months after it was promised—demonstrating to me a lack of urgency in dealing with women’s health issues that affect 51% of the population.

As we are talking about delays and women not being listened to, I am still waiting on responses to six letters to either this Secretary of State or to his predecessor dating back to 5 May asking to discuss all the issues that I have raised today. I would be grateful to have a meeting to discuss them further.

[Steve Barclay]

The hon. Lady says that she is not being listened to, but my understanding is that she is co-chair of the menopause taskforce, which has been set up to look at these issues. Indeed, she has also had meetings with officials on the subject of HRT. It is slightly remiss of her to suggest that she is not being listened to when Health Department officials are meeting with her and when we have a taskforce under way. There is much consensus around the points that she raises. She has highlighted, quite rightly, the importance of HRT, and we have acted on that. Part of the reason for the delay until April is that the IT systems need to be put in place. I well recall, when I was a Treasury Minister, being asked to move at pace in response to covid, because of the cash-flow pressures on businesses, and sometimes having the same colleagues complaining that forward controls and other issues had not been put in place. We need to put the right IT in place. We will do that for April, and the work is under way. The issues that she raises are being addressed, but in an effective way.

As I said to the shadow Secretary of State, we will work with the royal colleges to address the issue of training. It is a perfectly fair point, and I do not think there is disagreement in the House on that. On the wider issue of addressing disparities, that is exactly what the taskforce is about. That is why we have such a relentless focus on data, why we have a women’s health ambassador to give greater voice to these issues, and why we have brought forward specific measures, such as the family hubs and mobile breast screening units, to better address those disparities.

Menopause

Carolyn Harris Excerpts

Thursday 9th June 2022 Westminster Hall

[Carolyn Harris (Swansea East) (Lab)]

I beg to move,

That this House has considered the menopause.

It is a pleasure to serve under your chairmanship, Mr Robertson. It has been four years since I first spoke in a debate in this place on the menopause. Each year that followed, I duly put my name down to speak in the annual debate on or around World Menopause Day, but it was not enough. While it might have gone some way towards breaking down barriers and lifting the taboo on this great unspoken issue, speaking about the menopause was not doing anything for the millions of women across the country who were suffering the symptoms and in desperate need of help. This issue was something I had a burning desire to champion as I learned more and more about how support and services are failing women across the country, and my opportunity came when I was successful in the private Member’s ballot last year.

The twenty-ninth of October 2021 felt like a momentous day. As we gathered in Parliament Square, there were cheers of joy and tears of relief; the Minister herself was there, so she will know what I mean when I say that you could feel the utter delight in the atmosphere as women celebrated what they perceived as a victory. It is no exaggeration to say that, since that day, I have been bombarded with messages asking when the annual prescription charge for hormone replacement therapy in England will be introduced. We now know—I am sure the Minister will explain the technical reasons for this—that the answer is April 2023: 18 months after the commitment was made, 18 months after the cheers and the tears, and 18 months after that delightful taste of victory, which is so rapidly turning sour.

Naturally, I am frustrated. I have been angry, and I have been very vocal. All the explanations for how and why this has happened mean nothing. They do not help the women who are struggling through a cost of living crisis and can barely afford food and heating, let alone “luxuries” like their medication.

[Kim Leadbeater (Batley and Spen) (Lab)]

As a woman of a certain age, I put on record my personal thanks to my hon. Friend for her tireless campaigning on this important issue and thank her on behalf of many of my family and friends who have repeatedly shared with me their praise and admiration for her work. Does she agree that the menopause is not a minor condition, but can severely impact every part of a woman’s life, and that the only way we can properly support menopausal women is by taking a holistic approach, looking at everything from employment to medicines and mental and physical health, and of course—as my hon. Friend is rightly doing—by keeping this important issue firmly on the agenda?

[Carolyn Harris]

I totally agree with my hon. Friend. As she knows, my passion for this subject means that I will champion every one of the issues she has brought to my attention.

Women such as Brioni say:

“We live in deprived communities where HRT is considered a luxury item. The women I support work part time for minimum wage and on temporary contracts. We simply can’t afford the resources, products, private consultations that other women from more privileged backgrounds can.”

I can testify to the truth of that. I discovered quite early on that my own menopause was menopause, not depression, and when I spoke publicly about it, my friends said to me, “You’re posh having a menopause, Carolyn”—posh, because all the symptoms they were experiencing were things they just put up with and shut up with. I put it under the label of menopause, and the fact that I was able to have HRT—because I went private—made me posh. That was the only time in my life I have ever been called posh.

Brioni is from Doncaster, but what she says is relevant in working-class communities right across the country. Women will always put the needs of their families first, and as long as they have to choose between feeding their kids and paying for their prescriptions, we know where they are going to put their money. To all the Brionis out there struggling, I send my personal apologies that their hopes were prematurely raised. It is not what I expected or wanted, and it is certainly not what I am prepared to accept.

Outside this place, the menopause is a priority, and credit for that must go to all those who are campaigning for change at a grassroots level. Thanks to the willingness of so many of them to work together for the greater good, we now have the menopause mandate in place. We are joining women’s voices into a chorus whose mantra is menopause, menopause, menopause, amplifying the individual voices of grassroots campaigners so that all those individuals and their cases, with all their passions, are brought together in one collective.

[Lilian Greenwood (Nottingham South) (Lab)]

My hon. Friend is making an incredibly powerful speech, and we are all very grateful. One of my constituents, who wrote to me recently, wants to be one of the voices joining my hon. Friend in calling for change. She says:

“I’m tired of worrying about my next prescription. Will I be able to talk to the GP? Can I persuade the receptionist to talk to the GP on my behalf and get them to issue a repeat? Will the prescribed HRT be available? Will the pharmacy leave me guessing and calling daily for updates? Will they eventually admit they can’t get hold of it? I don’t want to feel helpless, anxious, potentially suicidal again. Not when this is easily and cheaply treatable.”

She is right, isn’t she? Those are precisely the problems that we need to sort out.

--- Later in debate ---

[Carolyn Harris]

My sympathy goes to my hon. Friend’s constituent, because the story that she tells is a story that I and other colleagues hear day in, day out from women who are troubled, anxious and scared that they are not getting the treatment or that, if they have the treatment, they cannot get their medication.

I am so proud to work with everyone involved in the menopause mandate, and I am heartened by the work that each and every one of them is doing—whether they are on a national television programme addressing millions of people and spreading the message, or helping a handful of women in their local community. Every one of them is making a difference. We have people such as Davina McCall, Lisa Snowdon, Patsy Kensit, Mariella Frostrup and Gabby Logan. These are strong women with loud voices, who are prepared to share their stories to help support women right across this country to get justice. The right hon. Member for Romsey and Southampton North (Caroline Nokes) and I contribute the political platform for the mandate. We have both made it our mission to mention the menopause in every single policy area right across Whitehall, because it deserves a place at every one of those tables.

Obviously, the Department of Health and Social Care has the biggest role to play when it comes to support and treatment for the physical and psychological impact of the symptoms. It is not just about the prescription charges or the availability of products, because I have grave concerns about the suicide rates among women of menopausal age. There is a 16% increase in risk for this cohort, and there have been some devastating stories in the press recently about women who failed to get a diagnosis and treatment, and who consequently ended their lives. Just a fortnight ago, Penny Lancaster sent me a clip from her local paper about a local solicitor who had taken her life after spending 18 months trying to convince her GP to diagnose her and prescribe her HRT.

However, other Departments have a huge role to play in this endeavour, including the Department for Business, Energy and Industrial Strategy. We have seen women in their 40s and 50s leaving the workplace in growing numbers due to the lack of support. The Department for Work and Pensions deals with the fallout from this, with women suddenly claiming benefits—possibly for the first time in their lives. The Home Office needs to consider the impact that the menopause is having on victims of domestic abuse. We know from research by AVA—Against Violence & Abuse—that domestic abuse escalates when a woman is experiencing menopausal symptoms, and that the symptoms are worse for those who are victims of violent relationships. Education is key if we are to ensure not only that medical professionals are sufficiently trained to diagnose and treat the menopause, but that the next generation are more prepared than any of us were.

Something that really concerns me is the disparity in HRT products currently available in the country. We only have to look at the local formularies to realise that levelling up appears to have overlooked menopausal women. Oxfordshire is recommending the use of newer products, while Manchester’s first-line treatment recommendation is cheap oral medication with synthetic progestogens, with patches reserved for more complex cases, such as those with underlying health conditions. That treatment postcode lottery must be taken seriously. I will continue to campaign for a national formulary, so that all women have fair access to all treatment, regardless of where they live.

Something that came to my attention today, which I am now looking into, is the disparity in the advertising of medications on social media. It is my understanding that on Instagram, medication for erectile dysfunction has free rein to be advertised, but lubricants for vaginal dryness and menopause medications are blocked because they relate to the female genitalia and are therefore assumed to be of a sexual nature. I will be writing to Instagram, and indeed other platforms, to clarify the situation. If that is the case, why are male sexual wellness products given the green light, yet medications for women with menopause are categorised as pornographic? If that is the case, the Department for Digital, Culture, Media and Sport can also expect to hear from me.

At Women and Equalities questions on Wednesday, I raised the issue of menopausal support for women on the prison estate. With 39% of women prisoners aged 40 or over, and 38% aged 30 to 39, I would have assumed that it was vital for a menopause strategy to be in place to provide for those women while they serve their sentences. That is primarily because we know that menopause and perimenopause symptoms affect our physical and mental health, as well as our behaviours.

Next Monday is Menopause Monday, and we are bringing Menopause Mandate to Parliament. All Members will have received invites, but will anyone who has not please let my office know? I encourage everyone to come along to the Jubilee Room and meet the fantastic group of women guests and speakers that we have lined up. I am delighted that, in the afternoon, the Fawcett Society will join us to present its recent report on menopause in the workplace. It is a fantastic piece of work, and many of the areas highlighted as concerns are exactly the same as those that colleagues have mentioned today and that are in the menopause mandate. We will also have clinicians, experts and academics explaining why getting the right treatment and support is so important for both physical and mental health. Finally, we will have women telling their own stories about the barriers they have faced in accessing support and treatment for their symptoms.

When Menopause Mandate was first launched, we invited women to not just sign our petition on the implementation of the single prescription charge, but share their own experiences if they felt able to, and it has been humbling to see how many have done that. I urge colleagues, especially those on the Front Benches, to read the submissions on the website, because they really paint a picture of what some women experience every single day.

Take Lucinda from Kent, who told us about her difficulties in being diagnosed and about the impact of her experience:

“My symptoms started at 41. Three and half years and nine GP appointments later, it was the dentist who first said the word perimenopause to me. By this time my confidence was non-existent, I was unemployable, I was being a terrible parent, a vile and unreasonable housemate, and didn’t think anything would ever improve. I thought about removing myself far too often”—

it was that bad. Lauren told us about the impact on her work:

“I was a senior leader in financial services…but in my early forties I left my job, thinking I had early-onset dementia. I went from being an uber-confident competent leader and the only female in a peer group of 18 men to losing all my self-confidence.”

We also heard from Catherine, who told us about the “painful hell” she descended into after being dismissed by her GP and prescribed anti-anxiety medication:

“I was in so much distress, but I was labelled as a ‘challenging patient’. I felt every subsequent doctor was influenced by this label and that prevented them from doing proper investigations.”

Thankfully, all three women eventually got put on to treatment paths that worked for them. In fact, Lauren says that when her doctor finally diagnosed her, she was the happiest menopausal woman in Bristol. Despite the heartbreaking circumstances those women originally faced, it is encouraging to read their stories and to know that they are now content and able to cope, but there are plenty more out there still living the nightmare that Lucinda, Lauren and Catherine previously experienced.

Women have been denied HRT because their doctors are not properly educated in diagnosing the menopause or in the benefits of the treatment. Women have been prescribed HRT, but struggle with the cost of their prescriptions as they wait for the annual prescription charge. Women who have been given a new lease of life since taking HRT, but who have vivid memories of hot flushes, sleepless nights, brain fog and extreme anxiety, are now terrified of the very real prospect of the symptoms returning due to shortages of the product that literally changed their lives. There are women who cannot take HRT, who need more support, and who feel broken, lost and helpless. We want all those women to be like Lucinda, Lauren and Catherine and to find what works for them. We want them to get the support they need and to be the happiest menopausal women in every town and city up and down this country. That is why we will keep fighting.

One good thing that came out of my private Member’s Bill was the establishment of the menopause taskforce, which I co-chair with the Minister. It brings together decision makers, policy advisers and experts in the field from across the four nations. We can share what works, and what does not, and make joint decisions that will help us all to provide the best possible care and resource for women in future.

I am sure the Minister, the civil servants in the Department of Health and Social Care and the Health Secretary himself have had quite enough of me going on and on about the menopause and the Government’s failure to prioritise this area of women’s health. I know I sound like a broken record—I very often get on my own nerves—but I will not stop, because everyone experiencing symptoms of the menopause deserves more. They deserve fair and equal access to affordable treatment and to be listened to, supported and prioritised. They deserve to be able to carry on their lives once menopause hits.

I wish I could put my arms around every one of those broken and desperate women who have reached out on our website, and even more so around the ones who have not had the chance or the courage to do so. I wish I could tell them that everything will be okay, that the prescription charges and the stock crisis will be sorted and that life will get better. I care passionately about this issue, and I know that there are MPs of all parties right across the House who care passionately too, whether or not they are in this room today.

Mr Speaker himself has pledged his support, and I am delighted to say that on Monday evening he will be signing the Wellbeing of Women menopause workplace pledge, which signals the House of Commons position as a progressive and supportive employer. Employers showing that they understand and support their staff is such a positive step, and I am thrilled that Mr Speaker has embraced that and is leading by example.

We are making progress, albeit slowly, and it would appear that globally the UK is seen as a leader in the field. Since last October, I have heard, as has the Chair of the Women and Equalities Committee, the right hon. Member for Romsey and Southampton North, from the press, politicians and experts from across the world. People expressed a desire to learn from what we are doing—from Australia, Canada, Japan, and across mainland Europe. But if we are going to be the world leaders, we need to get it right ourselves. What is so frustrating is that what is needed to completely change women’s lives is so simple. We need to improve support services and access to treatment and give women’s health the priority it deserves. I know the women’s health strategy is on its way, but it is 2022. Why has it taken until now for women’s health to be prioritised? Some 51% of the population are reliant on this, and they have been left out.

No more delays or false hopes. The time for warm words and gestures has well and truly passed. We cannot let menopausal women today suffer any longer, and we must ensure that future generations do not suffer the same experiences as those who came before them. We need a commitment that this will be a priority, and a promise that it will be taken seriously. We need action, and we need it now.

--- Later in debate ---

[Carolyn Harris]

Thank you, Mr Robertson. I will not take the hour that is left for my summing up, although I could start all over again.

I want to make just a few points. First, I thank everybody for being here and for sharing their personal stories—I am looking in a certain direction. I know it is painful and hard, but when people in this place talk about their personal experiences, it makes us look like what we are—real people with real lives and real feelings—to the outside world. That gives confidence to women out there who are thinking that nobody cares and nobody is listening. Unless we talk to those women, we will not know how they feel. When Nicola Sturgeon appears on “Loose Women” and talks about her menopause, it is inspirational for women right across the UK. When a certain Jim Shannon gets a shout-out as a menopause ambassador on “Loose Women”, it gives confidence to women across the UK that we politicians are listening.

The celebrities who are coming in on Monday are really nervous about coming to Westminster. They think they are coming into a world where they are expected to perform in a particular way, and that we will all be looking at them and thinking, “What do you know about politics?” Through the work they have done, they have proved that they may do politics better than we do, and that they have used their platform to change actually things, without making it party political, which we try not to do on this subject. They are using their platform to share really important messages and really personal stories, in an industry where, traditionally, nobody wants to admit to being a certain age or to potentially being menopausal, because they would be seen as getting on a bit. I really want to thank them.

One thing that it is really important to say is that I would like to see the Davina effect enshrined in legislation—perhaps we can have a show of hands on that—because Davina McCall has played a huge role. I do not think any of us could really have done what we have done without Davina’s documentaries and the work she has done.

[Nickie Aiken]

On that point, rather than having the Davina McCall effect, perhaps we should all write to whomever we are meant to write to, to ask whether Davina McCall should become a Dame.

--- Later in debate ---

[Carolyn Harris]

That is a perfect suggestion, and it is something that has been playing on my mind lately.

[Mr Laurence Robertson (in the Chair)]

Order. This is a winding-up speech and should last only two minutes.

[Carolyn Harris]

Yes, two minutes.

The last thing I will say is that everything that everybody has said is wonderful, but as long as women do not have a single prescription charge, do not have a proper diagnosis and proper medication, are giving up work and do not have equal treatment, we are failing. We cannot continue to fail women.

Question put and agreed to.

Resolved,

That this House has considered the menopause.

Skin Conditions and Mental Health

Carolyn Harris Excerpts

Tuesday 25th January 2022 Westminster Hall

[Carolyn Harris (Swansea East) (Lab)]

It is a pleasure to serve under your chairmanship, Mr Gray. I congratulate the right hon. Member for Gainsborough (Sir Edward Leigh) on securing this debate.

As co-chair of the all-party parliamentary group on beauty, aesthetics and wellbeing, I am deeply concerned about the impact on mental health of having a visible difference, particularly for our children and young people growing up in a world where body image seems to become so significant, with the explosion of social media platforms. Living with a skin condition or any form of disfigurement impacts on an individual’s everyday life. At best, they might have to put up with strangers staring or pointing fingers, but for many it is a steady stream of teasing, harassment or bullying, which has a detrimental effect on self-esteem and subsequently on psychological wellbeing.

Almost one in five people across the UK self-identify as having a visible difference—a mark, a scar or a skin condition. We know that at least 1.3 million people are living with a significant disfigurement, which includes 569,000 with facial disfigurements. Although many dermatological clinics can provide support and advice on the physical challenges and treatments, fewer than 5% of them offer any level of specialist mental health support for young people.

I have talked before in this place about the fantastic charity Changing Faces, which provides unique and life-changing counselling and emotional and psychological wellbeing support for those with visible differences and their families. It does an amazing job and relies on voluntary funding and grants that stretch only so far, which means that it can reach only a tiny percentage of the people who need its help. Its mission is to challenge prejudice and discrimination and to change attitudes towards people living with skin conditions and scarring. Its “Pledge to be seen” campaign was launched to ensure that people with a visible difference that affects their appearance are seen and heard across mainstream culture and in workplaces.

I was absolutely delighted last year when the Welsh Government signed the pledge and became the first UK public body to make the commitment to represent and support those with skin conditions or disfigurements. I certainly encourage businesses and brands to do the same and to help to make society more inclusive. Research carried out by Changing Faces showed that people with visible differences are often vulnerable to isolation, loneliness and social anxiety, which is something we would have seen intensify over the last two years of covid.

As we start to emerge from the pandemic, our NHS services across all areas are stretched to full, beyond capacity, and we risk a looming mental health crisis. Something has to be done to tackle the growing gap in specialist mental health support for people with skin conditions. These people are not different; they simply have a visible difference. By seeing them represented in job adverts, brand marketing and campaigns, we will start to reduce the stigma, and I hope, in turn, some of the ridicule and bullying that they currently encounter.

I encourage colleagues from across the House to promote the “Pledge to be seen” campaign, and ask the Government to follow the lead of the Welsh Government by signing the pledge themselves. We all acknowledge the need for better mental health care, but alongside that it is up to us to demonstrate our commitment to reducing intolerance and prejudice, and to promoting opportunity and inclusivity.

Menopause (Support and Services) Bill

Carolyn Harris Excerpts

2nd reading
Friday 29th October 2021 Commons Chamber

[Carolyn Harris (Swansea East) (Lab)]

I beg to move, That the Bill be now read a Second time.

The private Members’ Bills ballot at the start of each Session of Parliament gives each of us the opportunity to put in to champion a cause that we believe will make a real difference. When I was drawn at No. 3, I thought long and hard about what I should focus on. I wanted an issue that meant something to me and that would make a difference in the lives of people who really need it—not just in my constituency, but right across the UK. Being the only female Member drawn in the top seven, I particularly wanted to focus on something that would improve the lives of women up and down the country, and so the Menopause (Support and Services) Bill began to take shape in my head.

I have said all along that this Bill and the menopause more widely is not a political issue, and I maintain that. Women’s health should never be political. So I am not here today to win points; I am here because, right now, menopause support in this country, and indeed around the world, is falling short and failing women. GP training in medical schools, support in workplaces, public health messaging and curriculum content in our schools all need addressing, and I will come to each of those in turn in my speech.

However, I needed more: I needed something that only a change of legislation would put right, and it was a conversation with one of my colleagues in this place that gave me that something. I have always considered myself very fortunate to be a Welshwoman, and why wouldn’t I?—we are taking over the world, guys—but it had not occurred to me until that conversation that there was another reason why being Welsh was an advantage: NHS prescriptions are free in Wales. My colleague, on the other hand, was off to pick up her hormone replacement therapy prescription and was going to pay for it. She could afford to pay for it, but not everyone can. It was one of those eureka moments when I realised that this was the final piece in the jigsaw of my menopause Bill, which was always going to be about raising awareness and bringing a focus to the menopause as an issue we all need to consider.

Some 51% of the population are female, which means that 51% of us will personally experience the menopause at some point in our lives. Our experiences will all be unique. Some will sail through and barely notice. Others will suffer the most extreme symptoms: headaches, hot flushes, night sweats, brain fog, brittle nails, weight gain, insomnia, anxiety, low libido, vaginal dryness—and I could go on and on. Many women will present at their GP’s with one or more of those symptoms, and that can be the first hurdle. With 41% of medical schools offering no mandatory menopause training at all, thousands of GPs are qualifying and entering practice with no knowledge of how to diagnose menopause.

[Tim Loughton (East Worthing and Shoreham) (Con)]

I congratulate the hon. Lady on again bringing a taboo subject out of the shadows. I am delighted, as one of the 49%, to be a sponsor of her Bill, not just because she would have beaten me up if I had not been, but because this is a genuinely needed and worthwhile Bill. Does she agree with me that it is not just the 51% or the 13 million who are peri or post-menopausal who are affected, but that it affects many of the 49% and younger women? Many of the conditions that she has described are a huge additional cost to the NHS that, if prescribed for properly—and diagnosed properly—would save a lot of money for the NHS and an awful lot of angst for many women going through that, and the people around them.

[Carolyn Harris]

I agree with the hon. Gentleman and thank him for sponsoring the Bill. I would say that this is about not just the symptoms women feel, but the consequences in relationships; we have seen far too many marriages and relationships fall by the wayside because of menopause and its symptoms, and now is the time to change all that.

Women presenting to their doctor are often diagnosed with anxiety and depression. That happened to me and I have told my story previously: I presented to my GP believing I was having a nervous breakdown and ended up on antidepressants for 11 years. It was only when I spoke to friends and colleagues in this place and we shared conversations that people do not normally have—or did not have until now—that I realised that many other women were also experiencing what I was experiencing. That means we are seeing women being prescribed antidepressants when hormone replacement therapy may well have been more suitable, or presenting with insomnia and being given sleeping tablets when HRT may well have been more suitable, or being sent to consultants for tests for early onset dementia when visiting their GP about their brain fog and forgetfulness when, again, HRT may well have been more suitable. As hormone levels drop, women are at greater risk of developing a series of other conditions—cardiovascular disease, osteoporosis, type 2 diabetes, obesity, osteoarthritis, depression and dementia—and the cost of investigating and treating these as well as the other additional appointments is putting extra unnecessary pressure on our NHS.

I have heard countless stories of misdiagnosis. As I have said, I went on to suffer for 11 years with what I considered to be depression. Little did I know that over a decade later when I started HRT, I would see my life become transformed and I would have more energy. God, isn’t that scary: more energy? My husband is heading for the backdoor now. But we cannot blame GPs; we must make sure our medical schools reassess their curriculums so in future doctors are educated in the menopause and are able to offer all women the same high-quality care and support. Women are routinely called for cervical smears and breast screening; we need to see them being called for a menopause check-up around the time they turn 40. This would be a quick and an easy solution to helping women become more aware of the symptoms so that they are prepared and, importantly, educated in the available treatments.

[Robert Buckland (South Swindon) (Con)]

I join the warm tributes to the hon. Lady’s genuine cross-party approach to this; it is a testament to her campaigning ability.

I was particularly struck by clause 2 of her Bill which talks about the wider strategy. Does she agree that while HRT is a wonderful prescription for many women there will be some for whom it is not suitable, and therefore wider issues about menopause awareness and training are going to be important if we are to reach as many women and their families as possible?

[Carolyn Harris]

I do agree and my mantra has become that we can all become menopause warriors because that means we acknowledge the issues and problems and are prepared to work towards ameliorating them.

We can look at the good practice out there to see what can be done. I recently spoke to practice nurse Sharon Hartmann from Tudor Lodge surgery in Weston-super-Mare. The surgery supported Sharon to develop a special interest in menopause care. She is now certified by the British Menopause Society and delivers evidence-based practice to her patients. She is able to monitor progress, control treatment plans and prescribe suitable medication for each individual. I would love to see this kind of service in surgeries or clusters all over the country, with doctors being able to identify the symptoms quickly and ensuring women are then passed down to someone with a wealth of knowledge and experience in menopause care. But it is not just the education of the medical profession that needs attention. We need to address education in our schools, so that the next generation of girls and boys is far more prepared than any of us were. I certainly did not talk about the menopause when I was at school. We did not even talk about periods when I was at school. We want the next generation to talk openly about it, understand what is to come and what they can do to help. We need young men to understand that their mothers, wives, sisters and partners may struggle at some point in their life, and that it is not that they do not love them any more, it is just that the menopause is denying them emotion.

[Esther McVey (Tatton) (Con)]

I, too, congratulate the hon. Lady on bringing forward this issue and pursuing it in such a constructive, positive and enthusiastic way not just in the House but outside it too, and on the points she raises about the stigma attached to the menopause and the idea that women of a certain age are maybe past their prime. Absolutely not. People need to know that women’s lives actually might begin at 50. Thank you for what you have done and, I understand, for your constructive work with the Government. What you are doing today is a most important step forward—

[Esther McVey]

I was carried away by the excitement of the moment, but you are quite right, Madam Deputy Speaker. The hon. Lady has done so much and will earn the gratitude of the whole country for what she is doing with this positive step forward today.

[Carolyn Harris]

I agree with everything the right hon. Lady says.

It has been a pleasure to work with some fantastic women in this place who understand how important this issue is and, like me, want to ensure it is at the top of the agenda. The Minister, her predecessor, our shadow Minister, and all my cross-party colleagues and friends have been absolutely fantastic. We are so lucky to have strong male voices, too, who have not only signed the Bill but are here to support it. I want to thank—good grief, the hon. Member for Strangford (Jim Shannon) is not in his place! That is a first. I thank the hon. Members for Strangford and for Hazel Grove (Mr Wragg), my hon. Friends the Members for Bootle (Peter Dowd) and for Blaenau Gwent (Nick Smith), and the hon. Member for East Worthing and Shoreham (Tim Loughton) to name just a few, men who are not afraid to embrace the menopause revolution and have shown themselves to be dedicated menopause warriors.

I am sure we would have heard the voice of our dearly missed colleague, the former Member for Southend West, today if it were not for tragic events. I remember him coming to a menopause event I hosted a couple of years ago. When I asked him if he supported the cause, he told me, “With a wife and four daughters at home, I don’t have any option.” [Laughter.] So today, I would like to add my voice to those who have already spoken in the Chamber and around the country, and send my thoughts and prayers to his wife, his four daughters and his son. David was a very special man and we all miss him greatly. [Hon. Members: “Hear, hear.”]

We need to go further on education. We need to educate ourselves now. A public health campaign would help enormously, as so many women just do not join the dots between their own health issues and the menopause. As I mentioned earlier, 11 years ago I had no idea what was happening to me. If my inbox is anything to go by, I am not alone. I know from conversations I have had with friends and colleagues in this place that they, too, were not sure of the situation they found themselves in because it has been a taboo subject. It has been a dirty little secret that women were ashamed of. My earliest recollection of “the change” was a comedy sketch by Les Dawson dressed as a woman having a conversation over a fake wall with Roy Barraclough, lifting his left breast and referring to his neighbour as “being on the change”. We have to move on from those days. It is not a joke when you live with it and it is not a joke when you experience it. We can do so much more to make sure we do the right thing.

Well, I am not ashamed. That is maybe because I am Welsh and I say what I think. Fortunately, there are a lot of other people out there who are not ashamed. It is fantastic that celebrities such as Davina McCall, Lisa Snowdon, Mariella Frostrup, Penny Lancaster, Nadia Sawalha and Gabby Logan are all sharing their menopause experiences. As the right hon. Member for Tatton (Esther McVey) said, it is sometimes very difficult for someone to talk about their menopause when they are in a profession, because the assumption is made that they are over the hill.

There are some great tools to help us, too, such as the Balance app and the Henpicked website, which provide a wealth of unbiased and factual information about the menopause and aid women in taking control of their health. But it is our responsibility in this place to look at what we can do to ensure that the right message gets to everyone who needs it.

[Ruth Cadbury (Brentford and Isleworth) (Lab)]

I congratulate my hon. Friend on introducing this Bill, on her passion and on raising it as an issue not just of medical training, but of realisation and understanding for everyone—men and women. Does she agree that one of the challenges in this area is the historical nervousness about taking HRT? The world has moved on since our mothers’ generation, when there were some real problems, and medical knowledge has improved. Does she agree that we need more education on the benefits of HRT, which she has so personally described?

[Carolyn Harris]

I certainly agree. The information that would explain the situation with HRT is out there, but because we are not looking for it, we do not find it. There is really good information that debunks the myths on HRT, which has moved on a lot. It is a phenomenally different product from what it was in the day when too many people were prepared to criticise the use of it. Unfortunately, if someone does not look for that information, they will not find it and they do not prescribe HRT.

Someone understanding their own menopause is so important. Although we are, I hope, heading towards a time when women will discuss their experiences with family and friends, there is also a lot to be done in workplaces, where talking about symptoms can be a lot harder. Employers have a huge role to play in ensuring that support is available and understanding what their staff are experiencing. I have heard far too many accounts of women being given warnings, being sacked or even being made to feel that they have no choice other than to resign due to menopausal symptoms.

[Seema Malhotra (Feltham and Heston) (Lab/Co-op)]

I congratulate my hon. Friend on this most excellent Bill and on the work of the all-party group on menopause. The work of the group also helped to inspire activity with employers across the country. I attended an event on the menopause with Shevaun Haviland, the new head of the British Chambers of Commerce, and the Dorset chamber. There was tremendous engagement from employers, who had never been able to have this kind of conversation. Does my hon. Friend agree that, alongside improving awareness in the medical profession and in society to help to encourage discussion in families, supporting employers to have this conversation is vital for their understanding and for women’s employment?

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[Carolyn Harris]

I certainly do. Very many businesses—really big players in their fields—have contacted me and asked for advice on how they can move forward. What I say to them all is, “Don’t have a policy that is left in a filing cabinet that reflects a tick box. Have a policy that reflects your workforce and what women need and is intended to help them.” I visited several big companies that are really good employers and I have seen the all-singing, all-dancing menopause policy that does all but make a cup of tea, but when I asked the staff, “How is the menopause policy working for you?”, their response was, “I didn’t know we had one.” It cannot be a tick box; it has to be relevant.

Other employers need to take heed of the likes of Timpson—I repeat that James Timpson walks on water, as I said in this Chamber last week—in prioritising the welfare of its staff who are experiencing symptoms of the perimenopause or menopause. There are other big companies, such as PricewaterhouseCoopers, Bristol Myers Squibb and Tesco, that do good work—I could go on, but I know that the right hon. Member for Romsey and Southampton North (Caroline Nokes), who chairs the Women and Equalities Committee, will talk about that.

[Stephen Kinnock (Aberavon) (Lab)]

I pay tribute to the amazing campaign that my hon. Friend is running. The Bill is making such an important contribution; I think we all sign up to being menopause warriors and menopause revolutionaries. To add to the point about employers, does she see a role for trade unions in promoting the excellent ideas that are in the Bill? Can she give some examples of how we as MPs and menopause warriors could do more in our constituencies to encourage employers and trade unions to take these ideas forward?

[Carolyn Harris]

I have always thought of my hon. Friend as being Amazonian in his warrior status. I am sure that when he has his photograph taken later today with the lovely Penny Lancaster, he will prove to be Amazonian. In his constituency, the Community union is doing fantastic work with Tata Steel, which has welcomed in the union to hold menopause coffee mornings with the women in its workforce, who, let us not forget, are working in a very male-dominated arena. If they can do it, so many others can. My hon. Friend the Member for Newport East (Jessica Morden) has the Llanwern steelworks in her area, and it, too, is welcoming the Community union’s coffee mornings. I urge both my colleagues to attend one of those to share experience and listen.

Almost 80% of menopausal women are in work, with most planning to work for many more years. However, three quarters report that they are considering reducing their hours and one in four are giving up their jobs because they are finding it too difficult to balance their work life with their symptoms. Our careers should not stop when our periods stop. Whether our jobs are physically or mentally demanding, small adjustments could make all the difference. My hope is that employers listening to this debate will make those adjustments and take pride in the fact that they are menopause-friendly workplaces.

[Mr Richard Holden (North West Durham) (Con)]

This is a great cause. The hon. Lady and I are working together on various other issues as well, and she is a doughty champion for cross-party working on so many important issues. Will she comment briefly on how small employers can help? As one myself, I have two superb women, Alison and Deborah, who work in my constituency office and they have made me very aware of the issue that is being raised in the House today.

Will the hon. Lady also comment on the “Better for women” report by the Royal College of Obstetricians and Gynaecologists, which has worked with me closely on the hymenoplasty and virginity testing changes that it is bringing forward? Will she say a bit more about those workplace policies, particularly to help small employers understand how they can better support women? The team is so important to small employers, and the individual members all contribute so much at different parts of their lives.

[Carolyn Harris]

What I would say to the hon. Gentleman is that communication is key here; you cannot provide if you do not know what is needed. Do not be embarrassed and do not shy away from that conversation. If staff members do not feel comfortable talking to one person about it, find someone they will talk to. It is so important that you ask them what they need, not tell them what you are prepared to do. Communication and adaptation to suit the individual is key.

[Seema Malhotra]

I, too, just want to pick up on the point that my hon. Friend made about women and the workplace. We know that, according to the Centre for Ageing Better, 800,000 people over 50 were wanting to work more and were under-employed—that was the case a year ago, at least. Does she agree—

[Madam Deputy Speaker (Dame Eleanor Laing)]

Order. The hon. Lady has already had one intervention, which was very long. I allowed that, but her second intervention is heading towards being very long and I cannot construct this debate like that. About 30 people wish to speak this morning. I am sure that the promoter of the Bill wants to make sure that as many people as possible get to speak, but that she also will not want to talk out her Bill. I hope that those who support the Bill will not make long interventions and long speeches, because otherwise the Bill will be talked out and we will not achieve the result we are intending to achieve. So I ask for brevity, please, on all sides.

[Carolyn Harris]

Thank you, Madam Deputy Speaker. May I suggest that my hon. Friend and I have a conversation outside the Chamber, where we can expand on what she is seeking to establish?

As women reach this stage in their lives, understanding their own bodies and having support in all areas of their lives is crucial, but it is clear that we have a long way to go. That is why the Bill calls on the Secretary of State to lay before Parliament a United Kingdom, cross-party, cross-Government strategy on menopause support and services that will incorporate all the areas I have spoken about.

[John Lamont (Berwickshire, Roxburgh and Selkirk) (Con)]

I congratulate the hon. Lady on all her work on the Bill. My question is about the UK-wide aspect. Clause 1 applies only to England—prescriptions are free in Scotland—but clause 2 applies across the entirety of the United Kingdom. There is a duty to consult Scottish Ministers. If the policy area is devolved to the Scottish Parliament, how will those discussions work in practice? What would happen if Scottish Ministers did not agree with the strategy agreed by the UK Minister?

[Carolyn Harris]

I am going to leave that to the Minister to worry about. I am sure that the Scottish Government do not want me telling them what to do. I would be happy to have a go. If only I was on the Government Benches, then I would get it sorted.

I am not just asking the Secretary of State to do this. I want to work with him, his Ministers and colleagues from across the House to build a taskforce that will take on these issues and find the solutions, because I truly believe that, working together, we can change this—even in Scotland, if necessary.

We also desperately need to look at prescription charges for HRT in England and at what we can do to ensure that the cost is not a barrier to women accessing it. The menopause does not discriminate, so the cost to treat it should not either. There are women struggling to find almost £20 a month, and that just is not right when it is a time in life that women will reach. There is no avoiding the menopause for half the population. Most women will spend at least a third of their lives perimenopausal, post-menopausal or—the joy—menopausal. We must ensure that those women who need it are not denied HRT because of financial restraints.

[Dehenna Davison (Bishop Auckland) (Con)]

Like everyone else in the House, I thank the hon. Lady for her vociferous campaigning on this really important issue. Assuming that we get there and manage to abolish prescription charges for HRT in England, how does she perceive us running a good communication strategy so that women are still not put off because they do not know that prescription charges have been removed?

[Carolyn Harris]

I am sure that the Minister will enlighten us on that issue. That is the issue: whatever we do today, it has to be communicated to the wider population so that they understand our commitment to their health.

The biggest complaint I have received over the past few months is from women who need both oestrogen and progesterone. Women who have had a hysterectomy can take oestrogen on its own, but everyone else needs both. Despite the two hormones being combined into one product, women are charged individually for the hormones, meaning that each prescription costs them £18.70, and with 86% of women getting only three months’ supply each time, the costs begin to add up.

[Danny Kruger (Devizes) (Con)]

The hon. Lady is being very good about giving way—I am very grateful to her. On the question of cost, I was struck by what she said earlier about her own really difficult experience of being prescribed antidepressants because she was not properly diagnosed with the menopause. I chair the all-party parliamentary group on prescribed drug dependence. She might be aware that last week Dr James Davies of Oxford University published research showing that the NHS currently spends half a billion pounds a year on unnecessary prescriptions of habit-forming drugs. Will she join me in raising serious concerns about that, and does she agree that we must press the Government to review properly the prescriptions of dependence-forming drugs?

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[Carolyn Harris]

I certainly do agree. We have all heard stories about chemists getting back a skip-full of drugs after people have passed away. It is wrong—I totally agree.

That leads me to the next issue: the National Institute for Health and Care Excellence guidelines, which recommend following a three-month trial period. Women are then prescribed HRT on an annual basis. I appreciate that that may not be possible for a small number of women, but from looking into this it is clear to me that that very rarely happens, so women continue to be charged each month, against the advice of the public body. It is clear that that has been overlooked for far too long, leaving far too many women in England either without the vital treatment they need or worrying each month about how they are going to find the money to pay for it. That is why the Bill calls on the Government to do something about it—to find a way to stop women in England being disadvantaged because of the cost of HRT prescriptions. Nothing will have a greater impact on such a huge proportion of society, especially those who are at a socioeconomic disadvantage.

Everyone has a part to play in this revolution—women themselves, educators, medical professionals, families, friends, employers—but it is to start here, in this place, today. For the 13 million women in the UK who are currently either perimenopausal or menopausal, and for all those women who follow, we need a commitment that things are going to change.

It was pointed out to me last week that, according to Hansard, since 1803 “menopause” has only been referenced in Parliament a mere 197 times. I think over the last two weeks I have probably been able to double that single-handedly. Changing the history of Hansard will be some achievement, but making history for menopause will be far more important to the women in this country.

I would like to thank everyone in this place, around the country and indeed across the globe who has been in touch to support this Bill. It has been quite overwhelming, and it is great to see everyone in the Chamber today with their “Menopause Warriors” badges, because this is a revolution for all those whose lives have been or will be impacted by the menopause. The dictionary definition of a revolution is the forcible overthrow of a Government in favour of a new system. Although I do not have time for that today—[Interruption]—not today; it has been a busy two weeks—there are women in Parliament Square today who are expecting us, as those they elected to this place, to do something for them and to do right by them.

Let us join the likes of Tudor Lodge surgery, Timpson and the Balance app as examples of best practice in tackling stigma and the symptoms of the menopause. I urge the Government to work with me to make HRT accessible to everyone, regardless of financial constraints; to ensure that women are diagnosed at their first appointment and get the treatment they need; and to educate everyone, so that those who are experiencing symptoms get the support and understanding they need in every aspect of their lives.

[Robin Millar (Aberconwy) (Con)]

I associate myself with the comments of others and with their praise for the hon. Lady for raising awareness of this issue. Would she be willing to include in the Bill’s provisions those women who will experience a chemically-induced menopause? They will experience the menopause more than once, and sometimes even three times, in their lifetimes.

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[Carolyn Harris]

My revolution intends to help every woman who is experiencing the phenomenon, in whatever capacity, be they 13 years of age—I have heard about some women as young 13—or in their 80s. It does not discriminate, and I want to make sure we do our best for every woman. Our daughters and all those who come after them will have each one of us here today to thank for ensuring that we make progress and that the menopause revolution continues. We cannot let them down. Now is the time to do the right thing and to make sure that women across this country have all the support, guidance and reassurance they need to overcome their menopause.

I believe that the Government are listening. The Minister herself said in this Chamber just last week that the Government are putting the menopause at the top of the women’s health strategy. I believe that today will be the start of putting right the historical injustice that women have experienced, and that 2021 was the year that the menopause revolution was born.

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[Carolyn Harris]

Can I just say, 51% of the population is a huge amount of people who are not getting appropriate care.

[Dr Spencer]

I thank the hon. Member for her intervention and for pointing that out, but I would argue that it is maybe not 51% of the population who are in that situation of needing that care and support. Although 51% will go through the menopause, that is different from saying that 51% of the population will therefore need medical intervention and medical discussions around this.

But like I say, I do not particularly want to get into a deep debate on this; I just wonder whether we could ask the profession what it thinks it can do better, rather than us telling it, top-down. Of course, I would say that, I am a doctor—yadda, yadda, yadda; declarations, etc.—but I just wonder what the profession would say in response to the hon. Member’s campaign about how it can improve things and whether we can hear a bit more about that.

My final point is that, in a sense, I find the fact that we are having to have today’s debate deeply depressing. It is a wider indictment of the problems we have in society with the role and position of women. We have got the Equality Act 2010 and lots of legislation and statute, but as we have heard, when it comes to cultures and attitudes, it is just not there. There really needs to be a step change, given the events of the past year and what we have seen with sexual harassment. I have loads of constituents who come to me and tell me about the disrespect experienced by women. I hear the points made by my hon. Friend the Member for Thurrock (Jackie Doyle-Price). It is frankly appalling that women’s health has been left behind. We need to think carefully about what we can do as leaders of our communities and society to change things and increase respect for girls and women and the position of women in society. On that note, I absolutely pay tribute to the hon. Member for Swansea East for bringing this debate forward and the campaign she is running.

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[Carolyn Harris]

With the leave of the House, I thank the Minister and the Clerks. Wonderful women—thank you! What has happened today is only the beginning, but we can do such great things together. It is all about looking after women. I have just been told that the Welsh Government have also announced that they will be putting mandatory lessons for young people on the national curriculum, and will be delivering a pathway for menopausal women. The revolution has made a big difference. We are keeping women wonderful. Thank you all for your speeches and your time.

I beg to ask leave to withdraw the motion.

[Madam Deputy Speaker (Dame Eleanor Laing)]

The hon. Lady appears to have achieved her objective.

Motion and Bill, by leave, withdrawn.