Women’s Health

Alice Macdonald Excerpts

Thursday 27th February 2025 Westminster Hall

[Alice Macdonald (Norwich North) (Lab/Co-op)]

It is a pleasure to serve under your leadership, Dr Huq. I thank my hon. Friend the Member for Hastings and Rye (Helena Dollimore) for securing this important debate. As we have heard for far too long, women have been paying the price of an NHS that simply is not working. Women know that; in a survey that I saw, half of women said that they believed that their health was treated as second class.

Our economy is also paying the price. There are many areas that we could mention, but I want to focus on one in particular: the often very challenging journey that people experience when trying to have a baby. More than 3.5 million people in the UK go through some kind of fertility challenge, and that obviously has a huge impact on women. It can happen for a variety of reasons and is often heartbreaking. There is no one-size-fits-all approach to addressing fertility, but the National Institute for Health and Care Excellence guidelines are clear that, for women under 40 with a clinical diagnosis requiring in vitro fertilisation, or with unexplained infertility for two years, three NHS-funded cycles of IVF should be offered. The guidelines also recommend that women aged between 40 and 42 should be offered one cycle of IVF on the NHS, subject to some conditions.

Yet the reality is a postcode lottery. It is down to local integrated care boards to decide their approach, and only around a quarter of ICBs in England offer a full three cycles. The east of England, where my constituency is, has the lowest proportion of NHS-funded cycles, and my own ICB of Norfolk and Waveney offers two cycles. In other areas—north-east London, for example—the full three cycles are funded, whereas in areas such as Hampshire only one is.

Recent data tells us that fewer than 27% of IVF patients receive NHS funding nationally. When we think about our NHS, that is a huge anomaly. It means that most patients are paying for their treatment. Other factors also come into play: inequalities are stark when it comes to access and outcomes for black and ethnic minority patients, as well as for those in female same-sex relationships.

The postcode lottery needs to end. We must address those inequalities in access to NHS funding. There also needs to be greater education for healthcare professionals around fertility, regarding diagnosis and treatment, and for people themselves, so that patients have the choice and know what to do when it comes to their own fertility.

Beyond medical treatment, there is also not enough support in the workplace. We really need a whole-of-Government approach to this issue. It is not just about the Department of Health and Social Care; there are so many other areas, including, importantly, the Department for Work and Pensions. There is no legal right to time off for fertility treatment and currently, under the Equality and Human Rights Commission’s code of practice, fertility treatment is compared with cosmetic dental surgery. That means that many employers regard fertility treatment as a “nice to have”—an elective choice. Instead, it should be treated as a medical procedure that is needed.

I have heard stories of women losing their jobs simply because they have attended an IVF appointment. That needs to change. That is why I am campaigning, with Fertility Matters at Work and others, for a change in the law, so that people—women, in particular—have a right to paid time off for fertility treatment. I have met the Minister for Employment, my hon. Friend the Member for Birkenhead (Alison McGovern), to discuss the issue, and I welcome the continued engagement with the Government. I hope the Minister will meet us to discuss those demands. Many companies, including Centrica, E.ON and Cadent, already give women time off because they know it makes sense for productivity and happiness at work. Almost one in five people undergoing fertility treatment end up leaving their jobs because of the impact.

I also want to touch on miscarriage, another aspect of the journey; I know that my hon. Friend the Member for Walthamstow (Ms Creasy) will mention it as well. We need a right to time off for miscarriage before 24 weeks. It causes huge trauma, and women do not recover from it straight away. They need to be given time.

In the 30 seconds that I have left, I want to touch on gynaecology in my area of Norfolk. The situation is dire: we have the worst wait for gynaecology treatment in England. We are nowhere near the 92% target of 18 weeks: the figure is 44% in Norfolk and Waveney. Research from the House of Commons Library shows that more than 1,000 patients have been waiting for more than a year in Norfolk and Waveney, and that has a massive impact on women’s health.

I have to stop there. I wanted to talk about women’s health hubs, but I am sure that others will. There are so many issues to discuss, but when it comes to fertility and gynaecology, we simply cannot wait. Our manifesto promised that we will not neglect women’s health again, and I am sure that we will live up to that promise.

[Dr Rupa Huq (in the Chair)]

With a time limit of four minutes—the clock is counting backwards—I call Jim Shannon.

--- Later in debate ---

[Alice Macdonald]

In Norfolk we had a virtual health hub. When we look at whether the health hubs are working and share best practice, can we talk about whether that is the best format for a health hub or whether a physical one would be better?

[Ashley Dalton]

That is something that we will take on board and consider as we move forward.

We have heard a lot about menopause and peri- menopause from many Members, including my hon. Friend the Member for Broxtowe (Juliet Campbell). We are supporting women through the whole menopause process. Menopause and perimenopause symptoms can be wide-ranging and debilitating. NHS England is developing a range of tools and interventions to help upskill more GPs in menopause care, including awareness of mental health symptoms during menopause, and developing a menopause workforce support package for employees. I can also confirm that we are using community diagnostic centres to pilot pathways for women who suffer from post-menopausal bleeding.