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.

Endometriosis: Women in the Workplace

Alice Macdonald Excerpts

Wednesday 15th January 2025 Commons Chamber

[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.

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

I thank my hon. Friend for securing this important debate. As she mentioned, endometriosis can have a knock-on effect on many areas of a woman’s life. It can affect mental health, and it can also have an impact on fertility, yet there is no statutory right to time off work for fertility treatment, or indeed in many other scenarios. Does she agree that we should welcome the support that employers provide in this area and encourage others to do much more to support women going through endometriosis and so many other difficult conditions?

[Gill Furniss]

I thank my hon. Friend for that point, and I completely agree.

Although the Employment Rights Bill does require large employers to publish equality action plans, there is no specific mention of reproductive conditions. What discussions is the Minister having with her colleagues in the Department for Business and Trade to ensure that those issues are not forgotten?

What hope can we have that employers will understand the condition if even some medical professionals do not? All too often, we have heard stories from women who have been told, “It’s just a heavy period” and, “Suck it up—every woman goes through this.”

Winter Preparedness

Alice Macdonald Excerpts

Wednesday 18th December 2024 Commons Chamber

[Karin Smyth]

I think the hon. Gentleman knows that I cannot do that from the Dispatch Box, but my officials will have heard his request and what he has said about that specific case, and I will ensure that he receives an answer.

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

I pay tribute to the hard-working NHS staff in Norwich and in Norfolk as a whole. Norfolk County Council has used artificial intelligence to identify more than 1,000 people who are risk of being admitted to hospital because of falls this Christmas. Does the Minister welcome that use of AI, and will she expand on how we are using technology, now and in the future, to help alleviate winter pressures?

[Karin Smyth]

I do not wish to test your patience, Madam Deputy Speaker, but good falls practice has not been prioritised over the past decade, and the failure to prioritise it and continue the work that I know was being done many years ago is yet another testament to the failure of the Conservative party. My hon. Friend is right to refer to the way we can use AI to help the system to improve, so that this hugely preventable problem, which is so damaging to the elderly in particular, no longer occurs.

Dental Healthcare: East Anglia

Alice Macdonald Excerpts

Wednesday 11th December 2024 Westminster Hall

[Jerome Mayhew]

I will take an intervention from my other constituency neighbour, the hon. Member for Norwich North (Alice Macdonald).

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

Does the hon. Member recognise the support from all parties for a new dental school in Norwich? Does he welcome the £1.5 million that was announced last week by the Greater Norwich Growth Board in support of the bid for a new dental school?

[Jerome Mayhew]

That is the kind of intervention that I find constructive and helpful, and I am very grateful to the hon. Member for making it. She is, of course, quite right. We disagree on many things, as I do with the hon. Member for North Norfolk (Steff Aquarone), but there are some things that bring us together, and the need for a dental training school at the University of East Anglia is one of them.

Oral Answers to Questions

Alice Macdonald Excerpts

Tuesday 19th November 2024 Commons Chamber

[Wes Streeting]

I am in no doubt about the state that general practice was left in by our Conservative predecessors. That is why, in making decisions about funding allocations for the year ahead, we are taking into account all the pressures that general practice is under, as we clean up the mess left by the Conservatives.

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

In summer 2023, I spoke to Rachel, who suffers from endometriosis. She was told that she might have to wait 18 months for urgent surgery. She is still waiting. In fact, she has had the menopause induced to help tackle her symptoms. Can the Minister tell me what the Government are doing to improve the diagnosis and treatment of women, including Rachel, who have had to wait far too long?

Access to Primary Healthcare

Alice Macdonald Excerpts

Wednesday 16th October 2024 Commons Chamber

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

I congratulate the hon. Member for Harrogate and Knaresborough (Tom Gordon) on his cultured and moving speech—and on delivering it without notes, which is always very impressive.

I am pleased to have the opportunity to speak in today’s debate. I come from a family that is rich with GPs—primary caregivers who are the bedrock of our NHS. My grandad, aunt and uncle were all GPs, and my cousin is a qualified GP too. Over the generations they have served, times have got harder and pressures have grown. Under successive Conservative Governments, we saw decades of under-investment and mismanagement, and a lack of long-term planning, which has left primary care on its knees. Indeed, during the election campaign we had to fight to save our NHS walk-in centre, which has become important for so many people in my constituency —I am glad to say that we succeeded. However, as the Health Secretary said when he visited Lionwood medical practice in Norwich North, “The cavalry is coming”; in fact, it has arrived. We know that the task is monumental, but as the party that created the NHS, Labour knows how to fix it.

I welcome our 10-year plan, which has primary care at its heart. It will make sure that we shift from hospital to community, and from sickness to prevention. Because of the black hole in funding that we have been left by the Conservatives, we know that money is tight, but we have already taken action by investing £82 million to recruit 1,000 newly qualified GPs.

Of course, primary care refers to dentistry too. My county of Norfolk has been allowed to become a dental desert—or, as the Secretary of State has said,

“the Sahara of dental deserts”.—[Official Report, 23 July 2024; Vol. 752, c. 506.]

A recent ONS dentistry report states that 99.7% of new patients in East Anglia cannot access NHS dental care, which is shocking and totally unacceptable.

I note that many pregnant women are unable to access the free NHS dentistry care to which they are entitled. In fact, brand-new data from the British Dental Association and the Women’s Institute shows that nearly 1.5 million NHS dental appointments for pregnant women and new mums have been lost since the start of the covid pandemic. I ask the Minister to focus on what we can do to improve women’s access to dental care, because dentistry is a feminist issue too. I welcome our plans to rescue NHS dentistry, and I will continue pushing with colleagues across Norfolk—I can see the hon. Member for North Norfolk (Steff Aquarone) in the Chamber—for the dental school that we so desperately need.

Let me finish with the Health Secretary’s own words: “The cavalry is coming.” We will fix the NHS and make sure it is fit for purpose.

Oral Answers to Questions

Alice Macdonald Excerpts

Tuesday 23rd July 2024 Commons Chamber

The Secretary of State was asked—

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

1. What assessment his Department has made of the effectiveness of the NHS dental contracting framework.

[Lewis Atkinson (Sunderland Central) (Lab)]

17. What assessment his Department has made of the effectiveness of the NHS dental contracting framework.

--- Later in debate ---

[Alice Macdonald]

I welcome my right hon. Friend to his place. Norfolk is a dental desert and my constituents are suffering. As well as reforming the contract, we need to train more dentists. In the east of England we do not have a dental school, but the University of East Anglia has put forward proposals for one. Will he meet me, other hon. Members from Norfolk and representatives from the University of East Anglia to discuss this important proposal?

[Wes Streeting]

It is appalling that Norfolk and Waveney are so poorly served in terms of dentistry. There are only 36 dentists per 100,000 people, compared with the national average of 53, so when my hon. Friend says that her community is a dental desert, Members should know that it is the Sahara of dental deserts. We will work with partners to ensure that patients across the country can access a dentist when they need one. I am aware, not least thanks to her advocacy and the advocacy of other Labour MPs across Norfolk, of the University of East Anglia’s proposal, and I would be delighted to meet her and my colleagues.