Oral Answers to Questions

Alec Shelbrooke Excerpts

Tuesday 11th February 2025 Commons Chamber

[Ashley Dalton]

The Government mandate to NHS England was published on 30 January and makes the importance of tackling health inequalities clear. NHS England has an existing programme that targets the most deprived 20% of the population, with the aim of reducing health inequalities. I can reassure my hon. Friend, who has been a determined campaigner on inequalities, that the health inequalities weighting has not been withdrawn. The funding in question, which amounted to £200 million, has been incorporated into the main integrated care board allocation. The weighting of that health inequalities adjustment has been increased from 10% to 10.2%, so that the ICBs still benefit from that extra investment, with funding redistributed to areas with the poorest health outcomes, based on measures of avoidable mortality provided by the Office for National Statistics.

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

I welcome the hon. Lady to her position. She may be unaware of the number of debates that I have led into women’s health and endometriosis and pelvic mesh, and there is an inequality in the health service with how women are treated. Many women are deeply concerned by the announcements and statements about how the concentration on women’s health has been reduced. Will the Minister speak to the president of the Royal College of Obstetricians and Gynaecologists? Following that meeting, will she speak to the Secretary of State, who rightly says that he recognises when mistakes have been made, about reconsidering the approach to women’s health taken in the statement the other week?

[Ashley Dalton]

The Darzi review highlighted that there were too many targets set for the NHS, which made it hard for local systems to prioritise actions. There has been no reduction in women’s health services. The Government are committed to prioritising women’s health as we build an NHS that is fit for the future, and women’s equality will be at the heart of our missions. Women’s health hubs, which provide integrated women’s health services in the community, have a key role in tackling the inequalities faced by women. The Department has invested £25 million over 2023-24 and 2024-25 to support the establishment of at least one pilot women’s health hub in every integrated care system.

Obesity: Food and Diet

Alec Shelbrooke Excerpts

Monday 20th January 2025 Commons Chamber

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

I congratulate the hon. Member for Stroud (Dr Opher) on securing this important debate. There was a lot in his speech with which I agreed, and a lot with which I disagreed. I do not want to explore the subject of childhood obesity, although I think that many of his points about it are quite important; I want to focus on adult obesity.

There are a great many new Members in the Chamber who do not know who I am, so they will not have seen me when I was enormously fat, before I was down to the size I am now. I have struggled with my weight throughout my life, but I have controlled it for several years. Back in 2019 I managed to lose 4 stone through smoking. Cigarettes provided a way for me to diet and keep the weight off. I gave up smoking in May 2022—we do not need to have a debate about smoking and what it does to people—and put on a considerable amount of weight.

There is always a lot of stigma surrounding weight. Everything about weight is stigmatised, whether we are too thin or too fat or dieting—and, by the way, everyone has advice for us when we are dieting. It does not matter what is working; they will say, “What you need to do is this.” I will come on to the weight loss regime that I am on at the moment, but they will say, for instance, “You shouldn’t be giving up drinking, because you will lose your social life.” Well, going to the small Yorkshire village where I live and having several pints over a few hours means having a lot of empty calories—thousands of them—so that is exactly what someone who is trying to lose weight should do; but people always give that advice.

The hon. Member for Strangford (Jim Shannon) mentioned 400 incidences, but what that statistic did not say about the damage that the jabs, as we call them, can do is that half a million people are having them. We are in danger of getting into the same arguments that some of the nutters who talk about the covid jab have got themselves into—that it is deadly and we are poisoning everyone; and this, that and the other. It is administered to millions of people, and drugs will always have side effects. That is something we must remember. The contraceptive pill, used by millions of people, has side effects. Drugs do have side effects, but that is not a reason to rule them out.

I want to expand on this stigma about the jabs. As I said at the outset, I am focusing today on adult obesity, and as I also said, the hon. Member for Stroud made some important points about childhood obesity and the links with food, but much of what he said was based on the idea that people have three meals a day and they are eating too much. That has not been my experience. Many Members, especially new Members, will learn how exhausting this job becomes. At some points in their career, they will ask themselves, “How do I carry on?” and they will turn to sugar to get them through the rest of the day. I see plenty of Members nodding. They will have chocolate bars, because that is the boost we need and that is where we end up. I have done that.

I have what some might describe as an addictive personality: when I cut something out, I replace it with something else. When I cut out cigarettes, I replaced them with food. It has been a difficult journey. I tried to eat healthily and I tried to do things with my weight, but I reached a point at which I could not do it. In the middle of September, I started taking Wegovy, and since then I have lost over 5 stone. I have gone from a body mass index of 42 to one of 30, although there are still a couple of stone that I want to lose. But—and this is the big “but”—people have to work with it. These are not miracle drugs. The biggest mistake that the press made in this regard was referring to “fat-dissolving drugs”. There is no such thing as a fat-dissolving drug; that is blatant nonsense. For me, this drug takes away the cravings. It has enabled me to do the intermittent fasting, having a protein-based meal at 1 pm, a banana at 5 pm and a small meal in the evening with a tiny bit of carbohydrate, and I do not eat after 9 pm. That is how I have dropped the weight.

I cut out drinking for the first eight weeks, although I did drink over Christmas, and I cut out sugar for 12 weeks. I want to build on something that the hon. Member for Stroud said about sugar being a drug. Oh boy, yes, it is a drug. I felt horrific for the first three weeks of cutting out sugar. Having had a little bit of sugar over Christmas, I thought, “It is Christmas; you have to manage the psychology of this.” Well, the first time I had one mince pie, boy, did I know about it! I had to have some grapes later to try to bring about the slow sugar release. There is no doubt that high sugar and salt levels are addictive, but I have a personality that made me do that.

A very interesting point was made on Radio 4 last week. Emma Barnett was interviewing someone about this drug—I missed who it was. She said, “But isn’t there the question of morality when people use drugs to reduce their weight?” This is where I think there is a fundamental misunderstanding of obesity in adults and the issue of weight. What is now emerging is a link, a thread that runs through several aspects of someone’s health, not least related to fatigue, mental health or personality, and what is being discovered is that the drugs have a positive effect in many of those areas.

We need to remove the stigma from talking about being on drugs such as Ozempic, Wegovy and Mounjaro. They are certainly helping me, and I know of many friends and many colleagues in the House who are using them, because they do take away that craving. However, it still comes down to willpower. I stand before Members today, and I feel horrific. I have consumed less than 600 calories so far today and it is now 7.10 pm. I do not feel great, but it is working. I am engaged in a process in which I am trying to lose the weight in the first six months, and in the next six months I will go back to the normal number of calories, do the exercise and build up my fitness. This is a programme and a regime, and it is working for me.

However, I must make the point that if people are not willing to work with these drugs, they will not have the effect. There must be a “brake” in their promotion, because people who think they can just inject themselves at home and lose weight are wrong. It is so easy to cheat. Why do I not feel too great at the moment? There are not enough calories in me. What would give me a boost straight away? Some chocolate, or anything like that. When I cut out sugar, I cut out crisps, cakes, biscuits and various other things, including alcohol for a while. I am not going teetotal for the rest of my life, and I am not cutting out sugar for the rest of my life. People have to find a balance, but it is easy to cheat and they have to want to lose weight.

There is no correlation here, but I think there is an interesting piece of work to be done—I will explain why I am saying this in a moment—on the fact that there has been a huge reduction in smoking in the 21st century and a big rise in obesity. I certainly used cigarettes to help keep my weight down, and I know that many other people do too. If someone feels hungry, they can have a cigarette. I am delighted that I gave up smoking; it took me most of my life to do so. I smoked for most of my adult life, and I have drunk a lot for most of my adult life. I am 49 years old, and I was in my twenties in the 1990s. There was a culture in the ’90s that carried on through.

Why did we push forward with getting people off smoking? We did it because of the absolutely obvious and well-proven health consequences of smoking, such as thrombosis, heart attacks and high blood pressure. Since I have lost 5 stone, my blood pressure has come down by 30 millibars; it is now textbook blood pressure. The hon. Member for Stroud is absolutely right. I had pain in my joints and feet, and I would sweat, but I would not give in to it. When my feet hurt, I would not give in to it, because I thought, “If I give in to it, I’m just going to put on even more weight.” I would not stop, because I have always been fairly active and have kept going.

I make these points because I recently heard a report that if weight-loss jabs were put out on NHS prescription, it would bankrupt the NHS. I think that is absolute nonsense, because we know just how preventive this sort of action is. That is why we got people to give up smoking. We made a lot of tax from the sale of cigarettes, but it cost the NHS billions of pounds. We know that a lot of the conditions that cigarettes cause are equally caused by obesity, along with many other things. Again, the use of weight-loss jabs could prevent the NHS from spending much more money later on diabetes care, orthopaedic care and mental health care. We know that people find being inactive depressing, quite frankly, and that their mental health takes a decline when they become inactive.

We have to separate the issues of childhood obesity and adult obesity, which are two very different things. For those of us who end up starved of sleep, and those who end up never knowing when they will have a proper meal or where they will get it from, it is easy to fall into the traps. I have often found that people who have never had a problem with their weight are full of all the answers for those who do struggle with their weight, who may well tell others what they are doing and then be told, “No, what you want to be doing is this.” It is nonsense.

The use of weight-loss jabs offers the NHS a real advantage, but we have to reduce the stigma and it is right that we ask whether it is moral to use drugs to reduce people’s wight. A lot of people do not have a choice about their weight, and they are now discovering that a small dose of hormonal drugs helps them to control their desire to eat. The long-term effects of obesity on the country’s health, and on the pressure on the NHS, will be reduced. When I become 7 stone lighter than I was back in September, there is no doubt that my health situation will have a far better outlook than it did, and that is the conversation we should be having when it comes to adults.

There has been enough commenting on whether somebody is stick thin or really fat, and enough advice about what people should do to lose weight. We now have some answers that will actually make a difference, and we have to say, “These are the right things to do,” as we do with so many other drugs that help people get through their lives. We do not comment on people using nicotine patches or nicotine gum, yet we do talk about people who are trying to do things to help them lose weight.

[Several hon. Members rose—]

--- Later in debate ---

[Ben Coleman]

The right hon. Member makes an excellent point that I will come to in a moment.

The additives that cause so much harm today have simpler names: sugar, salt and fats. In moderation, all of those are fine, but the problem is that they are being shoved into our food willy-nilly in an effort to preserve it and—on the right hon. Member’s point—to make it cheap, alongside making it more addictive by design. As a result, we have what the House of Lords Food, Diet and Obesity Committee’s report rightly describes as a public health emergency. We now have one of the highest rates of obesity among high-income nations. Only tobacco shortens British lives more than poor diet.

[Sir Alec Shelbrooke]

The hon. Gentleman is making some very important points. I would add that adult obesity is not necessarily down to the kinds of food that he has outlined. When people are tired or feeling depressed, just the satiation of eating—even if it is healthy and they are eating more than they should—has the same effect. I used to have cigarettes, which did that, and sometimes people drink to do it, but it could also be done with healthy food. It is about quantities that cannot always be controlled, and there is a bigger link. I totally agree with what the hon. Gentleman is saying about these addictive substances, but they are not the only part of the puzzle.

--- Later in debate ---

[Jas Athwal (Ilford South) (Lab)]

I thank my hon. Friend the Member for Stroud (Dr Opher) for securing this much-needed debate. I also thank the right hon. Member for Wetherby and Easingwold (Sir Alec Shelbrooke) for sharing his testimony about how he lost 7 stone in such a short time—I tip my turban to him.

I have my own story. I lost 2 stone in two months because of what a doctor told me. Forget the nanny state: he said to me in no uncertain terms, “If you don’t lose weight, you won’t be here in a couple of years’ time.” I went home reeling from that news and did exactly what he told me to do. I lost the weight, had a fantastic body mass index and then I went back for my tests.

However, let me be clear: people cannot undo 20, 30 or 40 years of damage. If we lose somebody, we wish we could have had an extra day to say goodbye, to thank them or just speak to them one more time. Obesity, which leads to so many other diseases, robs people of five, 10 or 15 years of their lives, and means grandchildren are not able to speak to their grandparents. Why? Because those grandparents have passed away. We have to take that on board and counter it.

When I went back for my tests, I asked for an extra test, because I am one of those people who likes to be told—I am quite vain—how fit and healthy I am. I asked for an extra scan, and I got it. To my shock and horror, that extra scan revealed one of my arteries was completely blocked and the other, the left anterior descending artery, affectionately known as the “widow maker”, was 95% blocked, even though I had cycled 85 km the previous day. Very quickly, I went into Barts hospital where I underwent triple heart bypass surgery, and I lived to tell the tale. It was all because of years of decline.

While some conditions cannot be avoided, obesity can. When I say that my BMI was 27, the answer is always that BMI is not something to be relied on, but it is the best scale we have. In Ilford South, where 75% are from the Asian subcontinent, 25 is not the BMI number we should be looking at—it should be 23. I am struggling myself, because my BMI is hovering at 24. Another cultural shift is needed—it Is a cultural problem—because when people look at me, having lost 2 stone, they say, “Are you okay? You look unhealthy.”

[Sir Alec Shelbrooke]

I chuckled to myself when the hon. Gentleman said that, because people ask me if something is seriously wrong. He emphasises the point that weight, whether thin or fat, is a stigmatised subject. Even when people are trying to get themselves healthy, they get criticism. We have to expose that and get on top of it.

[Jas Athwal]

I absolutely agree. People have come round to check on me and ask me whether I really am okay or if I have an underlying problem, because I have lost so much weight. The only downside to losing weight is that it is very expensive—I have needed a new wardrobe.

Obesity is the leading preventable cause of death. Imagine the prize of an extra five, 10 or 15 years with loved ones: tackling obesity can give people more time with those they love. Obesity costs the NHS billions of pounds and impacts many livelihoods. In my constituency of Ilford South, obesity rates are 10% higher than in the rest of London. My neighbours and their loved ones are struggling and suffering unnecessarily.

The obesity crisis is threefold. Access to affordable, healthy food has decreased, while the prevalence of processed food and fast-food outlets has increased. In Ilford, the number of fast-food outlets has grown by a staggering 47.1% in just the last 10 years. Nearly a third of children in my constituency are overweight. They are bombarded with adverts everywhere on their way to school. Even worse, youth clubs have dwindled, leaving many young people with fewer warm places to go after school to enjoy themselves, exercise and socialise.

The affordability of healthy food, the accessibility of unhealthy food and reduced support for young people have fostered an environment in which unhealthy habits are growing. People do not even know how to cook, which causes a crisis of obesity, robs children of the best start in life and sets them up for a lifetime of health problems. We need to be bold enough to confront the growing trend, which is why we are here today. To tackle the accessibility of unhealthy food, Redbridge council set out a local plan to ban fast food outlets 400 metres from school gates, but were they banned? They were not. The Mayor of London’s plan says the same thing. We need to give planning policies the necessary teeth to stop fast food outlets opening right outside schools, and the adverts that bombard our children on the way to and from school.

To increase the affordability of healthy food, we have to work with charities. In Redbridge, we are working with a food bank to create facilities to store fresh fruit and vegetables. Last Friday, I had the privilege of being shown the food bank’s new premises, which we had been working on for the past 18 months. I was shown the cold storage where we will store vegetables. It was mentioned earlier that food banks should be able to store vegetables, because that is the healthy way forward. To give young people a place to go after school, we led investments in local youth centres. We need a holistic approach. We need to look at not just food itself but everything in society.

On a national scale, we have to make changes to protect young people from obesity. The Government must do that by fulfilling our Labour manifesto commitment to ensure that children are no longer exposed to TV adverts for junk food. We have banned paid online junk food adverts, preventing the overexposure of young people to unhealthy, processed and fatty foods, but we can and must do more. As has been mentioned two or three times, we must move away from viewing obesity through the lens of judgment, and confront the ways we have allowed unhealthy choices to be the easiest choices. We must break down the barriers to healthy eating, prevent the manipulation and exploitation of young people, and support everyone to live healthier lives.

Endometriosis: Women in the Workplace

Alec Shelbrooke Excerpts

Wednesday 15th January 2025 Commons Chamber

[Gill Furniss]

I thank the hon. Member for that point.

The issue has been known about for a long time. The women’s health strategy, published in 2022, painted a picture of what workplaces should be like over the next 10 years, arguing that women should

“feel able to speak openly about their health and to be confident that they will be supported by their employer and workplace colleagues, with an end to taboos”

and that

“women experiencing women’s health issues such as period problems, endometriosis, fertility treatment, miscarriage and menopause”

must

“feel well supported in their workplaces.”

This is a far cry from the reality facing women in the workplace today.

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

It is fortuitous that you are in the Chair tonight, Madam Deputy Speaker, given all the work you did on these issues in the last Parliament as Chair of the Women and Equalities Committee.

I think that the hon. Lady attended my Westminster Hall last year, and I am grateful to her for securing this Adjournment debate. As a direct consequence of my Westminster Hall debate, Essex police contacted me, saying, “We are looking into doing this. Can you give us advice on the workplace?” It was a great example of the impact of this place, and employers will be listening to her debate. Des she agree that education and sunlight will help a lot of employers make the right decisions?

[Gill Furniss]

I thank the right hon. Member for that intervention, and I absolutely agree. I pay tribute to you, Madam Deputy Speaker, and to the right hon. Member for the efforts he has put in over many years.

Stigma and a lack of awareness by employers means that reproductive health conditions can have a significant effect on women’s experiences at work. It is almost impossible to remain at work when suffering from chronic pain and the mental toll that these conditions cause.

[Gill Furniss]

I thank my hon. Friend. The average length of time taken is now eight years, which is not good.

Many women feel unable to speak openly about endometriosis as they would other conditions, as if it were something to be ashamed of. Research shows that 23% of women take time off work because of period health issues while 80% lie about reasons for absence if they are related to periods. Having said that, endometriosis is not just about periods; it is a whole-body complaint. I do not think there is an organ in the body up to the chest that has not been found to be affected by what is a crippling disease.

[Sir Alec Shelbrooke]

I want to build on what the hon. Lady said about endometriosis in the workplace. The condition often comes with infection of the digestive system, which can make many women incontinent to the point that they suddenly have to run. That is important to consider, as this is not just about appointments and time off but the conditions in which people work and the understanding they need from their colleagues and bosses.

[Gill Furniss]

I completely agree, and it has serious consequences. Women may need to have a stoma because of the damage done to their bowels. The right hon. Member and I have both met quite young women their 20s who have needed to have hysterectomies and will never be able to bear a child.

Endometriosis should not mean that women have to put their careers on hold and leave the jobs they have worked hard to get. Employers can take simple steps such as offering flexible working, access to period products and time off to attend appointments to build the type of workplace envisioned in the women’s health strategy.

I am pleased that the Government have brought forward the Employment Rights Bill, which will be the biggest boost to workers’ rights in a generation. That offers the perfect opportunity to begin to change the workplace experience of women with endometriosis.

--- Later in debate ---

[The Minister for Secondary Care (Karin Smyth)]

I congratulate my hon. Friend the Member for Sheffield Brightside and Hillsborough (Gill Furniss) on securing this important debate on the impact of endometriosis on women in the workplace. In opposition I supported the work of the APPG. I echo the praise for the campaigning work of Endometriosis UK and the support that you, Madam Deputy Speaker, and others in the Chamber have given to the APPG. I also remember the work of our friend David Amess. I echo the recognition of the recent report by the Women and Equalities Committee on reproductive health conditions. My Department is working across Government on our response, which will be published in due course.

I welcome the progress made on raising awareness—we are moving very fast on this—and on providing better support for women’s health conditions, including endometriosis. Nevertheless, this Government recognise that women with endometriosis have been failed for far too long, and we acknowledge the impact that it has on women’s lives, relationships and participation in education and the workforce. There is still much more work to be done. We are committed to improving support for any women and girls whose periods or women’s conditions disrupt their normal life, work or education.

In addition to receiving support in the workplace, all women should have access to healthcare support to help diagnose and manage this condition. We are making progress to ensure that those with endometriosis receive a timely diagnosis and effective treatment.

[Sir Alec Shelbrooke]

There has been a lot of cross-party work on this issue. I led a debate—the last one before the general election was called, I think—on endometriosis education. It is not prescribed that schools should educate about what a bad period is—I still meet women born in this century who do not know. If someone does not know what a disease is, how do they know that they have it? I urge the Minister to ensure that those messages are pushed in the Department for Education, as we need to ensure that people know what diseases they could have.

[Karin Smyth]

I thank the right hon. Gentleman for that point, which I will talk about later.

On the Employment Rights Bill, our plan to make work pay sets out a significant and ambitious agenda to ensure that workplace rights are fit for a modern economy, empowering working people and contributing to economic growth. On 10 October, the Government fulfilled their manifesto commitment to introduce legislation within 100 days of entering office, by introducing the Employment Rights Bill. As part of the Bill, we are taking the first steps towards requiring employers to publish action plans alongside their gender pay gap figures. The relevant clause sets out that regulations may require employers to develop and publish action plans relating to gender equality, which include measures to address the gender pay gap and support employees going through the menopause. It deliberately does not provide an exhaustive list of matters related to gender equality, giving us the scope to be led by the actions themselves. This reflects the fact that many of the actions employers take will be beneficial for people in a lot of different circumstances; for example, improved provision of flexible working can be valuable for an employee balancing childcare as well as someone managing a health condition such as endometriosis.

In the same way, ensuring that employers support staff going through the menopause will necessitate them taking steps that are positive for supporting women’s health in the workplace more broadly. For example, menopause best practice includes greater discussion around women’s health and awareness of potential workplace adjustments—things that have a much wider potential benefit. As my hon. Friend said, we need to start to reduce the stigma and taboos and remove them from the debate.

Through the Employment Rights Bill, the Government are also making statutory sick pay payable from the first day of sickness absence. This will particularly benefit those who suffer from conditions such as endometriosis, who may need to take time off to manage a flare up. We are also removing the lower earnings limit and extending statutory sick pay to up to 1.3 million additional low-paid employees, particularly benefiting women, young people and those in part-time work.

The Minister for Equalities, my hon. Friend the Member for Llanelli (Dame Nia Griffith), leads for the Government on the Bill from the equalities team, and I can assure my hon. Friend the Member for Sheffield Brightside and Hillsborough that we are working with her and talking about this issue throughout the Government. For example, I regularly join Women and Equalities questions here in the Chamber to make sure we work closely together, and I will continue to work closely with colleagues on these issues.

The new measures we are seeking to introduce build on existing Government support for employers, which recognises their key role in increasing employment opportunities and supporting disabled people and those with health conditions to thrive as part of the workforce. The Government’s current offer to employers includes a digital information service that provides tailored guidance to businesses to support employees to remain in work. That includes guidance on health disclosures and having conversations about health, as well as guidance on legal obligations including statutory sick pay and reasonable adjustments. The service is available across Britain and can currently be accessed from a range of trusted locations, including both the Health and Safety Executive and ACAS websites. We are also taking steps to better understand the challenges faced by women with endometriosis in the workplace and to improve workplace support for those with the condition.

The Government health and wellbeing fund has awarded almost £2 million to 16 voluntary, community and social enterprise organisations leading projects focused on supporting women who experience reproductive health issues to remain in or return to the workplace, including a project on endometriosis delivered by Endometriosis UK.

An Office for National Statistics study is investigating the impact of endometriosis on women’s labour market outcomes. This important study will be a vital step to improving our understanding and will inform future actions policy work. The first publication in this research project, on the characteristics of women diagnosed with endometriosis in England between 2011 and 2021, was published in December.

In addition to providing workplace support for endometriosis, the Government are committed to improving healthcare support and ensuring that women with endometriosis can receive timely diagnosis and treatment. We recognise that patients have been let down for too long while they wait for the care they need. Nearly 600,000 women are on gynaecology waiting lists. It is unacceptable that patients are waiting too long to get the care they need. I thank my hon. Friend the Member for Sheffield Brightside and Hillsborough for her sympathy with the task of reducing those lists, but that is our priority. Cutting waiting lists, including for gynaecology, is a key part of our health mission and a top priority for this Government. We have committed to achieving the NHS constitutional standard that 92% of patients should wait no longer than 18 weeks from referral to treatment by the end of this Parliament, and that absolutely includes those waiting for gynaecology treatment.

My noble Friend Baroness Merron, the Minister responsible for patient safety, women’s health and mental health, and I recently met with the Government’s women’s health ambassador, Professor Dame Lesley Regan, and NHS England to discuss progress on women’s health and current issues including gynaecology waiting lists. Following that meeting I am pleased that our recently published plan for reforming elective care sets out commitments to support the delivery of innovative models in gynaecology offering patients care closer to home and piloting gynaecology pathways in community diagnostic centres for patients with post-menopausal bleeding.

Enabling access to adequate healthcare support begins with providing high-quality education and information on menstrual health, as the right hon. Member for Wetherby and Easingwold (Sir Alec Shelbrooke) highlighted, so that women and girls know when and how to seek help for symptoms such as heavy or painful periods. The compulsory aspects of the curriculum on relationships, sex and health education means all pupils are taught about several areas of women’s health, including menstruation, contraception, fertility, pregnancy and menopause.

My right hon. Friend the Secretary of State for Education has committed to providing teachers with clear guidance that focuses on the wellbeing of children. Her Department will look carefully at all relevant evidence and engage with stakeholders, including young people and parents, ahead of publishing a consultation response and the revised guidance later this year. I am pleased that Dame Lesley Regan, in her role as women’s health ambassador, has been feeding women’s health perspectives into this work.

My Department has worked with NHS England to improve and create new content on endometriosis symptoms, diagnosis and treatment options on the NHS website and YouTube channel. NHS England has also published a decision support tool for managing heavy periods to support women’s understanding of their symptoms and appropriate treatment options to discuss with clinicians. Education and clinical guidelines support healthcare professionals to provide care for women with endometriosis.

The General Medical Council has introduced the medical licensing assessment for most incoming doctors, including all medical students graduating in the academic year 2024-25 and onwards. The content for the assessment includes several topics relating to women’s health, including menstrual problems and endometriosis, and will encourage a better understanding of common women’s health problems in all doctors as they start their careers in the UK, which we all want to see. Endometriosis is also already in the core curriculum for trainee GPs, obstetricians and gynaecologists.

Last year, the National Institute for Health and Care Excellence published updated guidelines on the diagnosis and treatment of endometriosis, and the new and updated recommendations on referral and investigation should help women receive a diagnosis more quickly. Through the National Institute for Health and Care Research, the Department has also commissioned a number of studies focused on endometriosis diagnosis and treatment and patient experience.

In closing, I thank my hon. Friend the Member for Sheffield Brightside and Hillsborough for tabling this debate and for her continued long-standing advocacy for women’s health. Let me affirm the Government’s commitment to supporting the many women who live with endometriosis in the workplace and beyond. This Government are committed to prioritising women’s health as we build an NHS fit for the future. My noble friend Baroness Merron is carefully considering how we take forward the women’s health strategy by aligning it to the Government’s missions and forthcoming 10-year health plan, and women’s equality will be at the heart of our missions. It is vital that we work with women to better understand their experiences and address their concerns, which have been ignored for far too long.

Question put and agreed to.

7.27 pm

House adjourned.

Cumberlege Review: Pelvic Mesh

Alec Shelbrooke Excerpts

Thursday 5th December 2024 Westminster Hall

[Chris Vince (Harlow) (Lab/Co-op)]

I beg to move,

That this House has considered pelvic mesh and the Cumberlege Review.

Thank you, Mr Stringer, for your chairmanship. I sincerely thank all Members who have come to contribute to this debate. I thank the Minister, my hon. Friend the Member for Gorton and Denton (Andrew Gwynne), and the shadow Minister, the hon. Member for Sleaford and North Hykeham (Dr Johnson), for attending. I also particularly thank Baroness Cumberlege for coming along to the debate.

In my first MP constituency surgery I met Debbie— I am delighted that Debbie and her husband Ian are here today. Debbie was active. She was into keeping fit and socialising with friends and family but, following her operation to have pelvic mesh inserted, she was forced to give up work. She now suffers from chronic pain in her hips, pelvis, groin and legs. She often suffers from fatigue. She is unable to exercise. She suffers from incontinence, post-traumatic stress disorder, severe depression and autoimmune disease. She later found out that the operation to have the mesh inserted was not even necessary.

When Debbie had her first operation to have the mesh removed, she was told that it was removed completely, but later found out that was not in fact true. She was forced to have a second operation, where, again, not all the mesh was removed.

Despite winning subsequent court proceedings, she has received no compensation, in part due to the surgeon not being covered by insurance. Debbie’s case shows the barriers for victims of medical negligence. It took seven years for Debbie’s case to get to court. Part of her concern is that the surgeons operating to remove the mesh are the same doctors who did the initial operation to insert it.

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

This is such an important debate, and many of us in this room have been working on this issue for a very long time. I point the hon. Gentleman to the Government’s review of the NHS. We only have nine centres. We have to emphasise how important it is that the review addresses the need for more surgeons in these areas. The issues that he is outlining are so common, yet we only have nine centres.

[Chris Vince]

I thank the right hon. Gentleman for that useful intervention. Following my meeting with Debbie, two further Harlow residents have come forward who have also been part of this scandal. I have spoken to Members across the House who have constituents with the same issue. More than 600 women came forward to be part of the Cumberlege review and the subsequent Hughes review. This is a huge issue that affects many people.

As many Members will be aware, on 21 February 2018, the then Secretary of State, the right hon. Member for Godalming and Ash (Jeremy Hunt), called for an inquiry. The independent medicines and medical devices safety review, chaired by Baroness Julia Cumberlege, who I am delighted to see here today and whose support I am delighted to have, published the “First Do No Harm” report in July 2020. The report considered two medications and one medical device, but I will focus on pelvic mesh implants, which were used in the surgical repair of pelvic organ prolapse and to manage stress urinary incontinence. It was hugely emotional to hear Debbie’s story—to hear at first hand the huge impact that this issue has had on her life.

In her report, Baroness Cumberlege described the accounts of women who had been affected by this issue as “harrowing”. I think we can all agree that that is absolutely the case. I will not go through the whole review, because that would take too long, but I will just highlight a couple of things said by women who came forward and spoke about the impact that the procedure had had on them.

The women said that there was a

“lack of awareness of who to complain to and how to report adverse events”

and reported

“breakdown of family life; loss of jobs, financial support and sometimes housing”.

However, the situation is even worse than that. The women also spoke about a

“loss of identity and self-worth”.

Sometimes, we fail to recognise the massive connection between physical health, including a physical procedure such as this one, and people’s mental health and wellbeing. The women also reported

“a persistent feeling of guilt”.

Nobody who is a victim of medical negligence should feel guilty about that fact.

--- Later in debate ---

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

It is a pleasure to serve under your chairmanship, Mr Stringer. I congratulate the hon. Member for Harlow (Chris Vince); it is encouraging that new-intake MPs are already raising this issue. As he said in his opening remarks, constituents have been to see their Members of Parliament because of the pain, suffering and injustice that they have gone through, and they are still not getting anywhere. I am not sure who the lady is, but it is very nice to see her in the Gallery because it is an exceptionally important issue for women.

Can we get back to one very important fact about this? We are dealing with people who have had their lives destroyed in the prime of life because of something they were recommended by the NHS. In all honesty, if we were at, say, the dentist’s and they said, “We need to do this to your tooth”, we would say, “Okay.” We would not say, “Can I come back tomorrow?” and then google for any issues. We trust the clinicians and listen to what they say.

Let us flip that coin and give the other side: at the time, a lot of those clinicians genuinely thought that vaginal mesh was, for want of a better description, a bit of a miracle cure. As time has gone on, it has become apparent that it was one of the worst procedures that could ever have taken place, and it is the time lag that has created the problem.

I have spoken about this topic many times. I have described some of the things that have happened to some of my constituents, including people who were once extremely active now not being able to stand up. When my constituent came to see me, she had to do the entire surgery stood up and leant over the table because she could not sit. She was younger than I am now. She eventually managed to take out private loans and have the mesh removed. There lies one of the big injustices: this was something done by the NHS, and the NHS has run away from its responsibility to solve the problem.

I accept that it is difficult for someone who has had the procedure to accept that the surgeon who put the mesh in might be the person who will remove it. But we do not have enough experts in this area, which goes back to the intervention I made on the hon. Member for Harlow: as the review of the NHS comes forward, resourcing must be considered. I have said it before and I will say it again: I believe the NHS to be a misogynistic and sexist institution that was too quick to pat women on the head and say, “Oh well, it’s just what women go through,” in so many aspects of gynaecological health, as well as other things.

I have known the Minister for a long time. I consider him to be a friend, and I know that he is in the job because he fundamentally believes in people’s rights. He has a hard task ahead of him. That hard task is not because of what the Minister wants to drive into place; it is because of the pushback that he is going to get from the NHS and the Treasury, which will say that it cannot be done. He is going to have a tough time, but we can already see that this is not a party political issue in the House. Many of us on the Conservative side criticised our own Government in debates on this subject, because they were getting the pushback from the Department of Health and Social Care and the Treasury—and we said that it was not good enough.

Removing mesh is like taking hair out of chewing gum. It is not a simple operation. It is not just that it breaks up and starts to infect other organs in the body, which is what can cause the incontinence, as it makes its way into the gut; it has now been shown that there are low-level infections within the mesh.

My constituent who finally had mesh removed had a period for the first time in 10 years. Think about that for a moment—being told, “Well, we’re not quite sure what is wrong,” and then, when the mesh is removed, suddenly having periods again after a decade. That shows how much the issue has not been taken as seriously as it should have been. The shadow Minister, my hon. Friend the Member for Sleaford and North Hykeham (Dr Johnson), and I were speaking only last week about a constituent who has a similar issue. Where could she find the mesh centres? There are nine mesh centres, but the issue affects the entire country.

The hon. Member for Shipley (Anna Dixon) mentioned the NHS compensation scheme. We moved on from that because it simply was not working. People were not getting the compensation from the scheme because it was not really accessible, and it was confrontational. That comes back to the point of the NHS doing something but not wanting to take responsibility for it. I am afraid that the Minister will be under pressure from people saying, “You must defend the NHS. That is your job. You represent the NHS. When people criticise the NHS, they are criticising you and the Government.” But that is not true: the Minister will have our full support for pushing back in that way.

This is the Thalidomide situation again—it is as controversial and, frankly, as scandalous as Thalidomide. We are talking about the “miracle drug” that women took in pregnancy to stop them from getting morning sickness, and it took years before it was banned; in some countries, it was used for several years after that. We pay compensation to victims of Thalidomide for the rest of their lives. I am proud to have been the Member of Parliament who in 2012 got the health grant extended for another 10 years. It is now a lifetime health grant. I am proud of that; it is something we did in this House. People turn around and say, “Redress is something we have to assess because there are so many people,” but why is that? There are so many people because the procedure was done willy-nilly and now those involved do not want to take responsibility.

Many other Members want to speak, and I will let them have their say. The Minister has my full support and, I am sure, the full support of many Members here—and he is going to need it. I ask him to stay strong, to keep in mind why we are doing this and to remember the victims who have had their lives destroyed in every single aspect. They must have the redress and the ability through the NHS to have the situation rectified so that they are not borrowing £25,000 to go privately to the same surgeon they would see on the NHS.

--- Later in debate ---

[Sir Julian Lewis (New Forest East) (Con)]

Listening to the heartfelt contributions of so many new colleagues, I get the impression that most if not all of them had, like me, never heard of this problem until a constituent walked into their surgery and told them of the terrible experience that they had had.

I have a practical suggestion: at the end of this debate, which will no doubt follow in the footsteps of several previous debates that were equally well informed, passionate and horrifying, we should perhaps put our names to a joint letter to a man called Nick Wallis. He is a freelance journalist who did a wonderful thing: he researched the Post Office Horizon system disaster and wrote a book called “The Great Post Office Scandal”. If I remember correctly, it was serialised for a week on Radio 4, and subsequently he was the consultant to the remarkable production, “Mr Bates vs. The Post Office”. We can have these debates regularly, as we have been doing, and we can upset and horrify each other by recounting our constituents’ pain and the appalling negligence that led to these terrible outcomes, but until the issue grasps the public imagination, I do not think people will get anywhere.

Interestingly, one point that has not been mentioned is the possible responsibility and liability of the large pharmaceutical company that manufactured the mesh in the first place. What research did it undertake? What responsibility does it have? What help can the Government give people who have been irreparably harmed to go after that company for compensation?

There has been one great positive development, which has been referred to several times, and that is the magnificent work of Baroness Cumberlege, who certainly did the whole community of damaged women the best possible service in conducting that excellent review. The question is to what extent will her recommendations be implemented?

I pay tribute in particular to my right hon. Friend the Member for Wetherby and Easingwold (Sir Alec Shelbrooke), who spoke earlier, and the hon. Member for Washington and Gateshead South (Mrs Hodgson), from whom we are about to hear, for their exemplary leadership of the all-party parliamentary group on this terrible disaster and for keeping the flame burning all these years. I say “all these years” because it has been a long time. Looking back on my own website to check my contributions, I see that this is now the fourth full- scale debate in which my colleagues and I have gone over the same ground. If anybody is interested, the dates of the previous three debates, which were packed with testimony and interesting information, were 19 April 2018 —slightly longer ago from now than the entire duration of the second world war—8 July 2021 and 3 February 2022. It would not be appropriate for me to go over in detail what has been said previously, as it is all there on the record, but it is important to recognise that we are talking about thousands and thousands of damaged women—10,000 at the very least, and as we have heard, some estimates put the number as high as 40,000.

Treatment centres have been mentioned, but there is a particular question about who has the skill to practise in the treatment centres. Who will put themselves forward as being appropriately skilled? It will be the very people who inserted the mesh in the first place.

In one of the earlier debates, I cited a constituent who was 35 when she was given what was described to her as “routine surgery”, 16 years before the debate in question took place. I said then:

“She was initially told that it was her fault that her body was rejecting the two mesh implants. She then went through a cycle of implants, the removal of protrusions and eroded segments and seven bouts of surgery. Three TVTs—trans-vaginal tapes—are still inside her, she suffers chronic pain from orbital nerve damage, constantly needs painkillers and has had constant side effects, indifferent treatment and a refusal to admit fault or to refer her to an out-of-area specialist in mesh removal.”—[Official Report, 19 April 2018; Vol. 639, c. 508.]

[Sir Alec Shelbrooke]

My right hon. Friend has just made an important point. He spoke about the removal of protrusions and seven surgeries. That almost puts a gloss on what has happened. We have all heard from women who have had the surgery and the experience of many of them is that they have been butchered. It is important to make that clear in this debate, especially for new Members, because we have discussed this in Parliament before: when we think of surgery, we think of any other normal surgery, but this surgery leaves huge amounts of scar tissue and has butchered women in ways that I will not go into now. That must be recognised when we describe some of the remedials that have happened, mainly because those carrying them out do not really know what they are doing at this stage.

[Sir Julian Lewis]

Exactly right. That is why my constituent said at the time, “I do not want anyone from the hospital coming near me ever again. I have lost complete faith in them. I have been lied to and told repeatedly that it was my body rejecting the mesh. But unbelievably they kept putting more in.”

Over this period of six or more years I have probably tabled about 12 or 15 questions for written answer, obviously to a previous Government. I will quote three, which were all in the aftermath of the Cumberlege report. In June 2021—for the benefit of Hansard it was question 16777—I asked the Secretary of State for Health and Social Care

“what checks his Department carried out to ensure that surgeons awarded NHS contracts for the removal of failed vaginal mesh implants had not previously been responsible for (a) originally implanting them, and subsequently (b) denying that anything had gone wrong with them; and whether any personnel awarded NHS contracts to work at mesh remediation specialist centres are known by his Department to be currently facing legal proceedings for implanting mesh which injured women who are now seeking its removal at such centres.”

The answer, which came from the then Minister of State, read:

“It is the responsibility of the employing organisations”—

presumably the NHS—

“to ensure that the staff undertaking mesh implantation and/or dealing with mesh complications are qualified and competent to do so. NHS England’s procurement process to identify the specialist centres to deal with the complications of mesh considered a range of clinical and service quality issues. No assessment was undertaken regarding National Health Service contracts or staff facing legal proceedings.”

Somebody in the process of suing a surgeon but still needing ongoing care may have no other option but to go to a mesh centre headed up by—guess who?—the surgeon who she is suing because he damaged her in the first place.

The second written question I will refer to was in July 2021—question No. 31274—which read:

“To ask the Secretary of State for Health and Social Care, with reference to the debate on the Independent Medicines and Medical Devices Safety Review on 8 July 2021…what steps he plans to take to research new and improved techniques for removal of eroded surgical mesh implants.”

As we have heard, it is intolerably difficult to remove this stuff. One would think that the very least the NHS could do would be to make a dedicated effort to develop new techniques for doing it. The description of it being like removing hair from chewing gum is vivid. I have sometimes speculated—I am not in any way qualified to do so—that maybe the answer to this might be to develop some sort of technique that could harmlessly dissolve the material and let it be gradually flushed away, rather than physically trying to disentangle it with the risk of doing more damage. That may be completely and utterly impracticable, but my point is that we do not know because no proper national effort is being made to find a way in which this disaster can be, to some extent, effectively rectified without harming the victims further.