World Menopause Day

Caroline Nokes Excerpts

Thursday 27th October 2022 Westminster Hall

[Caroline Nokes (Romsey and Southampton North) (Con)]

It is a pleasure to serve under your chairmanship, Mr Hollobone. I pay tribute to the hon. Member for Swansea East (Carolyn Harris), and to my hon. Friend the Member for Lewes (Maria Caulfield), who did so much to ensure that people can get prescriptions for HRT over the counter. I also pay tribute to my hon. Friend the Member for Mid Sussex (Mims Davies), who is here but cannot speak in the debate. In her role as employment Minister, she recognises that the menopause is not simply a health issue; it also affects the economy, employment and women’s wellbeing in later life. I hesitate to use that phrase; I must declare my interest.

I will give the Minister a hard time. Back in July, the Women and Equalities Committee published our “Menopause and the workplace” report. I recognise that he is a Health Minister, but I hope he understands my disappointment that we are still waiting for a Health response to our report. This afternoon, I was sent an email apologising again for the fact that tomorrow the response to that report will be one month late, and telling me to expect the full response in the coming months. It is a very bad plan to tell a menopausal woman to wait for anything. They should not be waiting for their single prescription over 12 months, and we should not be waiting for months for the Government to come up with a response to a very sensible—I would say that—report.

What do I actually want from that response? I want to see flexible working, so I want an employment Bill. That is not the Minister’s responsibility. I want to see a consultation on whether the menopause should be a protected characteristic. That is not the Minister’s responsibility either. I am disappointed, because we should have a cross-Government response to the report.

We should see mandatory workplace policies, with the Department for Business, Energy and Industrial Strategy leading the way to provide that resource to employers, free of charge on its website, as easy as anything. Great organisations such as Henpicked already do that. I was at the Menopause Friendly employers awards last month, and it was absolutely brilliant. Lots of employers have signed up, but why is BEIS not leading the way on that? We want to see the enactment of section 14 of the Equality Act 2010. That will be lost on the Minister; he will not know what I am talking about. I urge him to talk to the Government Equalities Office and at least consider that.

I want to see menopause ambassadors Government. It was great that Maddy McTernan was appointed HRT tsar, but she has returned to vaccines now. I want confidence from the Health Minister, as I have him here today, that Dame Lesley Regan will stay in place as the women’s health ambassador and that there will be a real commitment to the women’s health strategy. I shuddered when we had an “ABCD” of priorities, because I thought, “How long does it take to get to W for women’s health?” That was from the former Health Secretary; I hope the new Health Secretary will reinvigorate the women’s health agenda, and I urge the Minister to encourage him to do so.

I would like to see the Government working with a large-scale public sector employer to trial menopause workplace leave. I hesitate to point this out to the Minister, but it seems to me that the NHS is a large-scale public sector employer with lots of women working in it, so it might be ideal. I also want to see better training for GPs, and I want to know who is supporting our GPs. It is great that the workforce in general practice have been hugely feminised over the last few decades, but those women working in the health service also need support.

I want to champion the local women doing such fantastic work, whether that is Claire Hattrick and Jo Ibbott in Hampshire, or the brilliant GP I met at the Sutton Women’s Centre, where I went to do a menopause event, who was absolutely taking the message out there: “Your menopause can be celebrated and enjoyed, but it also needs to be managed.” For my final shot to the Minister, let us have a national formulary, let us deal with HRT shortages once and for all, and let us ensure that the info is out there for women.

--- Later in debate ---

[Will Quince]

I certainly agree with that. I also want to say thank you in passing to PHS Group; it is important that employers play their part, and it is good to hear about what that organisation is doing. I did some work with it on the period product scheme in a previous role as Minister for Children and Families. We should celebrate companies that are doing the right thing by their employees.

Somebody said that the hon. Member for Swansea East—I will call her my hon. Friend—has a lot to answer for. There is no more effective campaigner in the House of Commons. I recognise the incredible work that she has done in raising awareness of the menopause, which affects millions of women across our United Kingdom. I also thank her for chairing the all-party parliamentary group, which recently published its first report, on menopause support.

It will not have escaped your notice, Mr Hollobone, that I am not my hon. Friend the Member for Sleaford and North Hykeham (Dr Johnson). I have stepped in at the last minute, and I wish her well.

The hon. Member for Swansea East said that women are more sceptical and less jubilant. Although I am not the Minister responsible for this policy area or brief, the hon. Lady knows me and knows the issues on which we have campaigned together. She knows that, in me, she has an ally at the Department of Health and Social Care. She referred to men at the football coming to get a selfie with her. I think I speak for all men in the Chamber when I say that I would be honoured to have a selfie with her. In seriousness, I was moved by the stories that she and others told of the impact of the menopause on women in the workplace. In bringing about the change that we all want to see, she has an ally in me. That change is an issue not just for the Department of Health and Social Care but for BEIS. I have heard that loud and clear.

I thank my right hon. Friend the Member for Romsey and Southampton North (Caroline Nokes) for all her work as Chair of the Women and Equalities Committee. Its recent report, “Menopause and the workplace”, to which she referred, demonstrates the significance of the topic to the House. I know that my hon. Friend the Member for Sleaford and North Hykeham has written, albeit today, to my right hon. Friend to explain that we are carefully considering the Committee’s recommendations. We will respond in due course, and I will ensure that that happens—I will chase it up today. I will also speak with BEIS and the Government Equalities Office about the issues my right hon. Friend raised.

I thank all Members who have spoken, whether on behalf of themselves or their constituents, to mark World Menopause Day. It is important to say that 51% of our population will experience the menopause. There is no question but that the stigmatisation of this important part of life must end. That begins with us talking more openly about the symptoms and the treatment and support available. Vitally, when women talk, we have to listen.

I would like to update the House on the Government’s important work in this area and to reflect on how far we have come and the distance we still have to go, and I will respond to as many of the points raised by hon. Members as I can. For too long, women’s experiences of menopause support have not been good enough. That was the clear message from our call for evidence on the women’s health strategy last year. The menopause was the third most selected topic for inclusion in the strategy. It was chosen by 48% of nearly 100,000 individual respondents.

During last year’s debate on World Menopause Day, the Government committed to listening and to making menopause a priority for our women’s health strategy. I am delighted that the first ever women’s health strategy for England has been published. It contains our 10-year ambitions and the immediate actions we are taking to improve the health and wellbeing of women and girls across our country, from adolescents through to older age. It details an ambitious programme of work to improve menopause care.

It is important to stress that we are not implementing the strategy alone. As I think was said already, we appointed Professor Dame Lesley Regan as the first women’s health ambassador. The hon. Member for Swansea East and I have worked with her on both baby loss and maternal health. She is an expert, and she will do an amazing job as the first women’s health ambassador for England. She will help us to raise the profile of women’s health and break down harmful taboos. I have no doubt that she will bring a range of voices to help us implement the strategy and deliver on our commitments.

Numerous Members raised healthcare support. I bring to the House’s attention the NHS England national menopause care improvement programme, which is improving clinical menopause care in England and reducing disparities in access to treatment. That important work sits alongside a menopause education and training package that the NHS is developing for healthcare professionals.

I turn to the important point of raising awareness. My right hon. Friend the Member for South Northamptonshire (Dame Andrea Leadsom) said that we know more about Viagra than about the menopause, and she may well be right. Awareness is vital to tackling the stigma around the menopause. We want everyone in this country to be educated about the menopause from an early age. All women going through the menopause and perimenopause should be able to recognise the symptoms and know their options. We are transforming the NHS website into a world-class first port of call for women’s health and have recently updated the menopause page.

As my hon. Friend the Member for North Devon (Selaine Saxby) rightly pointed out, we should educate the next generation of boys and girls to help break taboos and ensure that children growing up today can speak about the menopause openly. Menopause is included—I know this as a former schools Minister—in the statutory relationships, sex and health education curriculum, and we are working across Government to understand women’s health topics that teachers feel less confident about to provide further support.

The hon. Member for Enfield North (Feryal Clark) raised the issue of HRT supply. Although most HRT products remain in good supply, various factors, including increased demand, have led to supply issues with a limited number of products. That has improved significantly recently, and we have been working hard to ensure that women can access the treatment they need. We are implementing the recommendations of the HRT supply taskforce and continuing to use serious shortage protocols where appropriate. We keep that under close review.

The hon. Members for Swansea East and for Enfield North and my right hon. Friend the Member for South Northamptonshire mentioned the cost of HRT—an incredibly important issue. We are committed to reducing the cost of HRT prescriptions through a bespoke prepayment certificate for HRT, which we will introduce from April 2023, subject—here is the caveat—to the necessary consultation with professional bodies. The hon. Member for Swansea East asked me for a cast-iron guarantee, but she knows that I do not make promises that I cannot keep. I am not the Minister responsible, but I do know and firmly believe that politics is the art of the possible, and as long as I am a Minister of State at the Department of Health and Social Care I will ensure that the Department’s feet are held to the fire to deliver on that April 2023 ambition. It is taking longer than any of us would like because we have developed an entirely new system, and we have to create an implementation programme as well.

[Caroline Nokes]

I am not sure that what we have heard is entirely consistent. The Minister, who I know will work hard on this, indicated that there still needed to be a consultation with professional bodies, but he then indicated that the delay was in bringing forward a whole new technical system. Can he clarify that point?

[Will Quince]

My right hon. Friend is right to push me on that point. The reason for any potential delay would only be around the consultation that we would need to have. The delay—as in why we could not have done it before April 2023—is because we needed to design a whole new system. We are confident that that will be okay for April 2023. I am caveating it only because I am not the Minister responsible, and I try wherever possible not to make promises that I definitely cannot deliver on. I will not be the Minister delivering on this, but I have no doubt that the Minister who will be responsible will be able to update my right hon. Friend in due course.

Importantly, numerous Members mentioned menopause in the workplace, and, as I mentioned earlier, there were some very difficult stories. As a former Department for Work and Pensions Minister, I know the impact that that has on individuals who want to go to work and on employers, so we have to tackle that. This summer the Government responded to the independent, Government-commissioned report into menopause in the workplace, and we committed to working with a range of stakeholders to consider what more we can do. That will include an employer-led, Government-backed communications campaign on menopause in the workplace.

My right hon. Friend the Member for Romsey and Southampton North mentioned the civil service and the NHS. They are two of the biggest employers and they have signed Wellbeing of Women’s menopause workplace pledge, which is a public commitment to making our organisations a supportive and understanding place for employees going through the menopause. I encourage all other employers to do the same.

Hon. Members also referenced an employment Bill. Again, that is a promise that I cannot make because it does not fall under the remit of the Department of Health and Social Care. Nevertheless, I will have that conversation with my counterpart at BEIS.

I want to ensure that the hon. Member for Swansea East has plenty of time to sum up, so I will conclude by thanking all right hon. and hon. Members for their contributions to this important debate and for their dedicated work across Parliament to improve the experiences of women in this country going through the menopause. As I said, they have an ally in me at the Department of Health and Social Care. I am glad that we have had the opportunity to discuss this hugely important topic and that I have had the opportunity to update the House on the work under way. It is vital that this conversation continues.