Women’s Health Strategy

Debate between Baroness Walmsley and Lord Kamall

Thursday 23rd April 2026 Lords Chamber

[Lord Kamall (Con)]

My Lords, I thank the Minister for tabling the Statement. I am sure that the ambitions for the renewed women’s health strategy will be supported by noble Lords from all Benches. I know that the Minister recognises that women have too often felt unheard, as conditions such as endometriosis and chronic pelvic pain go underdiagnosed.

There was emphasis in the Statement on listening to women and tackling entrenched inequalities. This is, of course, welcome. We support the focus on a shift from treatment to prevention and from hospital to community, as well as the ambition to unlock the potential of digital innovation through NHS Online. I also thank the Minister for acknowledging that these initiatives build on work undertaken by previous Governments.

However, many women will judge this strategy not by its intentions and words but by whether it leads to tangible improvements in their day-to-day experience of care. All Governments announce grand strategies, but sometimes fail to deliver. While many of these individual announcements are welcome, I hope the Minister will allow me to ask for further clarity on a few points.

First, on waiting times and access to care, it is encouraging that waiting times for overall gynaecology have begun to move in the right direction, but many women are still waiting too long for diagnosis and treatment. We know what that leads to—a range of conditions, often worsening outcomes and poor quality of life. Can the Minister tell us what the department is doing to speed up the whole pathway from when the patient first presents through to treatment? How will it ensure that there is greater transparency for patients, so that they know where they are in the queue and how long they really have to wait, rather than estimates?

Secondly, the strategy rightly places an emphasis on listening to women and acting on their experiences. I am sure that noble Lords across the House share that objective. However, experience suggests that, unless you have clear structures for accountability, good intentions do not always translate into change. How will the department ensure that any feedback gathered in a patient consultation is not just perfunctory but consistently acted upon, and that it reflects a diversity of women’s experiences? There will be a range of experiences; it will not be the same for all women, especially for those who face additional barriers to being heard.

I will give your Lordships a couple of examples from my time in the department. I wonder what progress has been made. I remember when a young official came up to me and told me about her friend, a young Black lady, who had lost her baby. When they asked for the investigation and the paperwork, it had magically disappeared. How do we make sure that that sort of incident does not happen again, that there is real accountability and that there is no gaslighting, particularly for women from ethnic minority communities?

Another example comes from when I spoke to the baby loss charity Sands. Of course, we value the work that the noble Baroness, Lady Amos, is doing on maternity care. I recently received an email from a lady whom I met at Sands, which said: “For almost three years, my case was handled by the same caseworker. Of course, sometimes I questioned their competence, but at least the caseworker knew my case and they knew about things. And, despite being advised that my complaint was at its final stages, I’ve just been told that it’s been reallocated to a new case handler. Someone has to relearn the case, but has not yet been given a date for when that case will be heard”. I wonder what the Minister’s department can do to ensure that people who have suffered terribly, and are still suffering physically and emotionally from what has happened, really get the justice that they deserve.

Let us move on to patient safety and redress. The Statement refers to unacceptable experiences of women harmed in the past. As the House will be aware, the recommendations of the Hughes report were intended to provide redress for medical interventions such as the pelvic mesh, sodium valproate and hormone pregnancy tests, but many women are still waiting for some form of redress or help. Often, they are racking up bills, such as taxi bills to go to appointments, and many of them are still in pain.

When I was in the department and I was being asked the question, in the Minister’s place, I would go back to the department and ask what we are doing about this. The first answer I would be given was that I should leave it to the responsible Minister as I was the Minister responsible for technology, innovation and life sciences. When I probed again over time, I was told by one official that the Treasury does not like to write blank cheques. That is understandable—the Treasury is the guardian of the national finances. I used to ask whether anyone was doing any work on how much this would cost so that we could then present to the Treasury the cost of providing some form of redress.

The Hughes report suggested £20,000 each for mesh victims and £100,000 for sodium valproate victims. We welcome the fact that 100 of the 10,000 women who suffered from the pelvic mesh issue have received some payout from manufacturers. What about the others? I am told that many women missed out due to limitations for civil claims. What can the Minister’s department do to help those poor women who are still suffering and make sure that more women receive redress as quickly as possible? As a result of the Hughes report, we now know that it is not a blank cheque. We know that there will be negotiations between the Department of Health and the Treasury. Can the Minister update us on those discussions so we can better understand whether these women are finally going to achieve some form of justice?

Going forward, we need not only to make up for the mistakes of the past that have occurred under all Governments but to address the outstanding issues, making sure that those women who suffered are receiving long-term support and learning the lessons so that if, sadly, this ever happens again, we know how to address those issues and give the appropriate care, compassion and redress to those who suffer.

Overall, there are a number of different issues covered by the women’s health strategy. I know some noble Lords will be concerned that, although it is wonderful to have a grand, overall strategy, what about the individual interventions that we need from the departments, clinicians and others? How do we deliver on all those various issues that women suffer from to make sure that patients across the country—whatever party they support or however they feel—particularly female patients, believe that the renewed women’s health strategy will finally deliver a safe system of health for all of them and justice for those who have suffered in the past?

[Baroness Walmsley (LD)]

My Lords, I thank the Minister and I, too, welcome the women’s health strategy, as it includes many important objectives. In communities up and down the country, we have seen the devastating toll of sustained failures to invest in and deliver better women’s health. Women’s lives, families and economic productivity are damaged when they do not receive treatment in a timely way. Indeed, this also happens when menopause difficulties are ignored. This is because vital services remain understaffed and underfunded, while women and girls go without the care they need.

In 2022, we had the previous women’s health strategy, which had similar important goals to this one with similar delivery mechanisms and the same reliance on local systems to make it happen. Yet four years on, the problems remain stubbornly in place, with half a million women suffering long waits for gynaecology, patchy access to services, women reporting that they are not listened to, women not being given pain relief when they need it and serious conditions diagnosed too late. These facts must give the Government pause for thought that perhaps things need to be done differently this time.

Medical misogyny is still a perverse and unacceptable norm in the health service and that requires a culture change, which is notoriously difficult to achieve. How does the Minister’s department plan to go about it?

This strategy is being implemented when the NHS is already stretched and ICBs are facing cuts while, at the same time, taking on some of the responsibilities of the disappearing NHS England. Now we also have soaring inflation, due to Trump’s war in Iran. In this climate, can we reasonably expect the strategy to deliver meaningful change? I really hope so.

Although the issues affecting women’s health generally are numerous, the NHS failures in maternity services are the most widely reported and deeply shocking. Review after review has uncovered the same failures across the country: a failure to listen to women, a lack of time for training, inadequate staffing levels leading to staff burnout, a lack of proper assessment, poor management of risk and a failure to learn lessons when things go wrong. All this is leading to a rise in perinatal mortality, with the figures showing inequality between different groups, such as those on lower incomes and some ethnic minority groups. How will that be tackled by the strategy?

That is why the Liberal Democrats recently launched our maternity secure package to make Britain the safest place in the world to give birth. We want every maternity unit in the country brought up to a good or outstanding level of safety. That could be done by guaranteeing one-to-one midwifery and specialist doctors on every unit. Will the Minister consider incorporating these proposals into the new strategy?

On medical misinformation, many people now get their health advice online, particularly via social media. Long waits for NHS services and GP appointments are pushing people into getting their so-called information this way, but advice on those platforms does not adhere to clinical standards or guidelines, which is leading to rampant medical disinformation, with sometimes disastrous results. There is some evidence that this is a particular issue in women’s health, where gaps in scientific knowledge and public awareness are being exploited. Does the Minister have any plans to tackle that?

It is possible to fight back. In order to be helpful, we are calling for the following for the Minister’s consideration. The first is a new kitemark for health apps and digital tools that are clinically proven to help people to lead healthier lives, regulated by the GMC. The second is a big effort by the NHS, with a ring-fenced budget, to dominate the health advice social media ecosystem and algorithms, with clinically approved information in plain English. That could improve patient care and save staff time and costs. The third is a new verification requirement for any social media account claiming to be written by a medical professional.

I have a few more questions before I finish. In line with the 10-year health plan’s objective to make care more local, is the Minister confident that women in every area will benefit from a family health hub, as promised, without the threat of closure or cuts, especially in this time of reduced resources for ICBs?

How will the new system linking feedback from patients to provider funding work? Will the results for each unit be made public? Will improved staffing be funded to achieve the promise that women no longer face long waits for diagnosis for conditions such as endometriosis? Will we be able to hear from the Minister in the education department about the promised menstrual education programme to ensure that girls are better equipped to recognise the difference between healthy and unhealthy periods, and will the programme be evaluated by the girls receiving it? Finally and most importantly, will women themselves be involved in developing the implementation plans for the new measures in the strategy and coproduction of their communication with other women?

Tobacco and Vapes Bill

Debate between Baroness Walmsley and Lord Kamall

Committee stage
Monday 3rd November 2025 Grand Committee

[Baroness Walmsley (LD)]

My Lords, I have added my name to Amendment 34 in the name of my noble friend Lord Russell and Amendments 141 and 143 in the name of my noble friend Lord Rennard. I will also rehearse arguments in favour of Amendment 33 in the name of the noble Baroness, Lady Bennett of Manor Castle, for the consideration of the Committee. The noble Baroness, Lady Fox, suggested there is some confusion about why people might want to ban filters. I agree with the noble Lord, Lord Crisp, that a ban is about both public health and environmental considerations.

It has been clearly shown that filters of all kinds have no health benefits whatever. Indeed, I maintain that they are actively harmful to health, but I will come to that later. They are also very costly to public authorities and bad for wildlife and the environment. Filters have been called, by a Back-Bench Member of the government party,

“the deadliest fraud in the history of human civilisation”.—[Official Report, Commons, 26/3/25; col. 1043.]

because they were formerly advertised—when cigarette advertising was still allowed—as being safer and less harmful to health than cigarettes without filters. This lie has had a long tail because even now only 25% of people understand that they have no health benefits.

As a result of the false perception that the filter—because of its very name as pointed out by the noble Lords, Lord Young and Lord Bourne—removes some of the tar and other harmful tobacco chemicals, evidence shows that smokers of filtered cigarettes inhale deeper and more frequently. Proof that filters were invented to deceive is the fact that they were deliberately made from a white substance which turns brown when heated, adding to the illusion that they were removing some of the harmful elements from the tobacco smoke. This was deliberately to mislead the smoker.

Filters of all kinds are bad for the environment. The plastic ones in particular contain thousands of toxic substances, including microplastics and nanoplastics. They take up to 10 years to break down in the environment, releasing all these microplastics as well as the 7,000 toxic chemicals from the on average five millimetres of tobacco that remains attached to each butt. These are washed into our soils and water systems and damage marine life, other wildlife and our drinking water.

Microplastics are ubiquitous. They have been found from the top of Mount Everest to the deepest oceans. They cause cancer, including colorectal, liver, pancreatic, breast and lung cancers, and the levels of them found in human brains—causing who knows what effects—have increased by 50% since 2016, according to pathologists. Even the so-called biodegradable ones contain microplastics in the glue and in any case take a very long time to break down. I deliberately put one in my compost heap, and it was still there a year later. In any case, they, too, always have some tobacco attached. They have zero health benefit and lead to a false sense of security.

The environmental damage is also very costly. We all pay to clean them up when they are discarded through littering; as has been said, local authorities spend £40 million every year, money paid by taxpayers—you and I—which could be better spent on public health and other services. Some 86% of the public and even most smokers believe that manufacturers should switch to fully biodegradable filters rather than plastic ones, but, frankly, I think that is not enough to fix the problem, for the reasons I have outlined.

The killer fact, to coin a phrase, is that there is a strong epidemiological link between the rise in the prevalence of cigarettes containing filters and the proportionate rise of a kind of cancer called adenocarcinoma, while other lung cancers have fallen along with the reduced prevalence of smoking overall. A paper by Min-Ae Song et al published in the Journal of the National Cancer Institute in America in 2017 analysed 3,284 citations in scientific literature and internal tobacco company documents and concluded thus:

“The analysis strongly suggests that filter ventilation has contributed to the rise in lung adenocarcinomas among smokers. Thus, the FDA should consider regulating its use, up to and including a ban”.


Indeed, such a link had originally been suggested by the surgeon-general as far back as 2014. Therefore, I am inclined to support Amendment 33 in the name of the noble Baroness, Lady Bennett, but at the very least I hope the Government will accept Amendment 34 in my name and that of my noble friend Lord Russell.

On Amendments 141 and 143 in the name of my noble friend Lord Rennard, I hope the Minister will see the sense of consulting on this. Not every cigarette smoked by a child or a young person or an adult smoker comes immediately out of a packet bearing health warnings. Many children, when they start illicit smoking, share a packet among themselves and many never get to see the packet at all. That is why the principle, already accepted by successive Governments, that a health warning on the packet should accompany tobacco-containing products should apply to individual products and not just the packaging. I am aware that the Government plan to make sure that there is an insert in each packet signposting smokers to cessation services and products. This is a welcome positive measure to accompany the deterrent measures of health warnings, but it is not enough. I am sure the first thing many will do is throw away the insert and never read it, as people sometimes do with pills. They cannot throw away the paper that wraps the cigarette. That is why it would be the most effective place to put the warnings.

If you believe that the health warnings on packages work and deter, how much more effective would it be to reinforce that message every time a cigarette is removed from them? A consultation and a review of the evidence of the ban in other countries would be a good idea, and I recommend it to the Minister.

[Lord Kamall (Con)]

My Lords, I thank the noble Baronesses, Lady Bennett of Manor Castle, Lady Grey-Thompson and Lady Walmsley, and the noble Earl, Lord Russell, for introducing the amendments in their names.

Puberty-suppressing Hormones

Debate between Baroness Walmsley and Lord Kamall

Monday 16th December 2024 Lords Chamber

[Lord Kamall (Con)]

My Lords, I thank the Minister for the Statement and the right honourable Secretary of State for the careful and sensitive way in which he delivered the Statement in the other place. In line with my right honourable friend the shadow Secretary of State in the other place, from these Benches we welcome the Government’s announcement. Whatever your politics, most people believe that one of the first duties of any Government is to protect their citizens, especially our children.

As the Secretary of State said, there has been too much heat, and perhaps toxicity, around the issue of services for children experiencing gender dysphoria, so I welcome the tone with which His Majesty’s Government have approached this issue—less heat, more light—and that they continue to take an evidence-based but compassionate approach. I also take this opportunity to thank the noble Baroness, Lady Cass, for leading the review on gender services for children. The Cass review highlighted the importance of putting scientific evidence above ideology and laid out the fact that we simply do not know enough about the long-term impacts of puberty blockers on children. That is why my right honourable friend in the other place, the Member for Louth and Horncastle, when Secretary of State, banned the routine prescription of puberty blockers for gender dysphoria, and later extended that ban to private clinics.

We welcome the decision of the Government to follow the recommendations of the independent Commission on Human Medicines to extend the banning order until a safe prescribing environment can be established for these medicines. This is a common-sense approach, and allows time for more evidence to be examined to consider the holistic and long-term impacts of puberty blockers on children. The Secretary of State announced the clinical trials to gather evidence but, given understandable concerns about the risks of any clinical trial, can the Minister reassure your Lordships that these trials will have robust safeguards to ensure the well-being and safety of any children taking part, while recognising the importance of having these trials in the first place?

The Secretary of State in the other place also spoke about alternatives to puberty blockers for children suffering from gender dysphoria. As someone who takes an interest in social prescribing, I welcome the Government’s recognition that medication is not always the best solution, so will the Minister share details of some of the alternatives to puberty blockers that will be offered to children?

Finally, noble Lords will be concerned that, despite the lack of evidence, puberty blockers were prescribed to children with gender dysphoria when their safety could not be guaranteed. What steps are the Government and the NHS taking to ensure that a similar situation does not occur again and that future decisions are led by evidence? I look forward to the Minister’s responses.

[Baroness Walmsley (LD)]

My Lords, on these Benches we welcome the tone of the Secretary of State’s Statement. I have often said that there are many ways of being human. Growing up can often be a very trying time for teenagers. How much more difficult, then, for those young people with gender distress who are struggling with finding out who they are while being different from their peers, and all without adequate support? It is high time that proper services were put in place for young people struggling alone with these issues. Their families too need help to support them at this difficult time. For too long, children and young people who are struggling with their gender identity have been badly let down by a low standard of care, exceptionally long waiting lists, even by the standard of mental health waiting lists, and an increasingly toxic debate.

We always want to see policy based on the evidence. With any medical treatment, especially for children and young people, the most important thing is to follow the evidence on safety and effectiveness. It is crucial that these sorts of decisions are made by expert clinicians, based on the best possible evidence. It is also important that the results of the consultation and the advice of the Commission on Human Medicines are made public.

Some might wonder why the treatment is deemed not safe for gender dysphoria patients but safe enough for children with early-onset puberty. More transparency might clear up the confusion and give more confidence to patients and their families. However, the Secretary of State himself admits that he does not know what effect the sudden withdrawal of this treatment for young people already embarked on a course of puberty blockers will have. These are the young people with the most urgent need for other types of care in the current situation, so what clinical advice have the Government taken about the effect of withdrawing these drugs on the physical and mental state of young sufferers of gender incongruence already on the drugs, and what physical and psychological support will be offered to them?

In the current circumstances, plans for a clinical trial are welcome, but we would like to know the criteria for those eligible to participate. What assessment have the Government made of the recent Council of Europe report, which raises the ethical and rights implications of offering participation in the trial to only a small group of patients? If the only way to continue access to these drugs is through participation in the clinical trial, whose scope, length and start date have yet to be announced, this lays the Government open to accusations of coercion and breaches of human rights.

We welcome the plans for additional treatment centres in Manchester and Bristol as well as London, but can the Minister say why they will not be up and running for two years? Is it lack of funding, lack of premises or lack of sufficient therapists with the appropriate specialist training? This is a very sensitive area, so the wrong people could do more harm than good. If that is the reason, is there a plan for training up more qualified therapists in time for the opening of the regional treatment centres? I very much look forward to the Minister’s replies to these questions.