Skin Conditions and Mental Health

Carolyn Harris Excerpts

Tuesday 25th January 2022 Westminster Hall

[Carolyn Harris (Swansea East) (Lab)]

It is a pleasure to serve under your chairmanship, Mr Gray. I congratulate the right hon. Member for Gainsborough (Sir Edward Leigh) on securing this debate.

As co-chair of the all-party parliamentary group on beauty, aesthetics and wellbeing, I am deeply concerned about the impact on mental health of having a visible difference, particularly for our children and young people growing up in a world where body image seems to become so significant, with the explosion of social media platforms. Living with a skin condition or any form of disfigurement impacts on an individual’s everyday life. At best, they might have to put up with strangers staring or pointing fingers, but for many it is a steady stream of teasing, harassment or bullying, which has a detrimental effect on self-esteem and subsequently on psychological wellbeing.

Almost one in five people across the UK self-identify as having a visible difference—a mark, a scar or a skin condition. We know that at least 1.3 million people are living with a significant disfigurement, which includes 569,000 with facial disfigurements. Although many dermatological clinics can provide support and advice on the physical challenges and treatments, fewer than 5% of them offer any level of specialist mental health support for young people.

I have talked before in this place about the fantastic charity Changing Faces, which provides unique and life-changing counselling and emotional and psychological wellbeing support for those with visible differences and their families. It does an amazing job and relies on voluntary funding and grants that stretch only so far, which means that it can reach only a tiny percentage of the people who need its help. Its mission is to challenge prejudice and discrimination and to change attitudes towards people living with skin conditions and scarring. Its “Pledge to be seen” campaign was launched to ensure that people with a visible difference that affects their appearance are seen and heard across mainstream culture and in workplaces.

I was absolutely delighted last year when the Welsh Government signed the pledge and became the first UK public body to make the commitment to represent and support those with skin conditions or disfigurements. I certainly encourage businesses and brands to do the same and to help to make society more inclusive. Research carried out by Changing Faces showed that people with visible differences are often vulnerable to isolation, loneliness and social anxiety, which is something we would have seen intensify over the last two years of covid.

As we start to emerge from the pandemic, our NHS services across all areas are stretched to full, beyond capacity, and we risk a looming mental health crisis. Something has to be done to tackle the growing gap in specialist mental health support for people with skin conditions. These people are not different; they simply have a visible difference. By seeing them represented in job adverts, brand marketing and campaigns, we will start to reduce the stigma, and I hope, in turn, some of the ridicule and bullying that they currently encounter.

I encourage colleagues from across the House to promote the “Pledge to be seen” campaign, and ask the Government to follow the lead of the Welsh Government by signing the pledge themselves. We all acknowledge the need for better mental health care, but alongside that it is up to us to demonstrate our commitment to reducing intolerance and prejudice, and to promoting opportunity and inclusivity.

Menopause (Support and Services) Bill

Carolyn Harris Excerpts

2nd reading
Friday 29th October 2021 Commons Chamber

[Carolyn Harris (Swansea East) (Lab)]

I beg to move, That the Bill be now read a Second time.

The private Members’ Bills ballot at the start of each Session of Parliament gives each of us the opportunity to put in to champion a cause that we believe will make a real difference. When I was drawn at No. 3, I thought long and hard about what I should focus on. I wanted an issue that meant something to me and that would make a difference in the lives of people who really need it—not just in my constituency, but right across the UK. Being the only female Member drawn in the top seven, I particularly wanted to focus on something that would improve the lives of women up and down the country, and so the Menopause (Support and Services) Bill began to take shape in my head.

I have said all along that this Bill and the menopause more widely is not a political issue, and I maintain that. Women’s health should never be political. So I am not here today to win points; I am here because, right now, menopause support in this country, and indeed around the world, is falling short and failing women. GP training in medical schools, support in workplaces, public health messaging and curriculum content in our schools all need addressing, and I will come to each of those in turn in my speech.

However, I needed more: I needed something that only a change of legislation would put right, and it was a conversation with one of my colleagues in this place that gave me that something. I have always considered myself very fortunate to be a Welshwoman, and why wouldn’t I?—we are taking over the world, guys—but it had not occurred to me until that conversation that there was another reason why being Welsh was an advantage: NHS prescriptions are free in Wales. My colleague, on the other hand, was off to pick up her hormone replacement therapy prescription and was going to pay for it. She could afford to pay for it, but not everyone can. It was one of those eureka moments when I realised that this was the final piece in the jigsaw of my menopause Bill, which was always going to be about raising awareness and bringing a focus to the menopause as an issue we all need to consider.

Some 51% of the population are female, which means that 51% of us will personally experience the menopause at some point in our lives. Our experiences will all be unique. Some will sail through and barely notice. Others will suffer the most extreme symptoms: headaches, hot flushes, night sweats, brain fog, brittle nails, weight gain, insomnia, anxiety, low libido, vaginal dryness—and I could go on and on. Many women will present at their GP’s with one or more of those symptoms, and that can be the first hurdle. With 41% of medical schools offering no mandatory menopause training at all, thousands of GPs are qualifying and entering practice with no knowledge of how to diagnose menopause.

[Tim Loughton (East Worthing and Shoreham) (Con)]

I congratulate the hon. Lady on again bringing a taboo subject out of the shadows. I am delighted, as one of the 49%, to be a sponsor of her Bill, not just because she would have beaten me up if I had not been, but because this is a genuinely needed and worthwhile Bill. Does she agree with me that it is not just the 51% or the 13 million who are peri or post-menopausal who are affected, but that it affects many of the 49% and younger women? Many of the conditions that she has described are a huge additional cost to the NHS that, if prescribed for properly—and diagnosed properly—would save a lot of money for the NHS and an awful lot of angst for many women going through that, and the people around them.

[Carolyn Harris]

I agree with the hon. Gentleman and thank him for sponsoring the Bill. I would say that this is about not just the symptoms women feel, but the consequences in relationships; we have seen far too many marriages and relationships fall by the wayside because of menopause and its symptoms, and now is the time to change all that.

Women presenting to their doctor are often diagnosed with anxiety and depression. That happened to me and I have told my story previously: I presented to my GP believing I was having a nervous breakdown and ended up on antidepressants for 11 years. It was only when I spoke to friends and colleagues in this place and we shared conversations that people do not normally have—or did not have until now—that I realised that many other women were also experiencing what I was experiencing. That means we are seeing women being prescribed antidepressants when hormone replacement therapy may well have been more suitable, or presenting with insomnia and being given sleeping tablets when HRT may well have been more suitable, or being sent to consultants for tests for early onset dementia when visiting their GP about their brain fog and forgetfulness when, again, HRT may well have been more suitable. As hormone levels drop, women are at greater risk of developing a series of other conditions—cardiovascular disease, osteoporosis, type 2 diabetes, obesity, osteoarthritis, depression and dementia—and the cost of investigating and treating these as well as the other additional appointments is putting extra unnecessary pressure on our NHS.

I have heard countless stories of misdiagnosis. As I have said, I went on to suffer for 11 years with what I considered to be depression. Little did I know that over a decade later when I started HRT, I would see my life become transformed and I would have more energy. God, isn’t that scary: more energy? My husband is heading for the backdoor now. But we cannot blame GPs; we must make sure our medical schools reassess their curriculums so in future doctors are educated in the menopause and are able to offer all women the same high-quality care and support. Women are routinely called for cervical smears and breast screening; we need to see them being called for a menopause check-up around the time they turn 40. This would be a quick and an easy solution to helping women become more aware of the symptoms so that they are prepared and, importantly, educated in the available treatments.

[Robert Buckland (South Swindon) (Con)]

I join the warm tributes to the hon. Lady’s genuine cross-party approach to this; it is a testament to her campaigning ability.

I was particularly struck by clause 2 of her Bill which talks about the wider strategy. Does she agree that while HRT is a wonderful prescription for many women there will be some for whom it is not suitable, and therefore wider issues about menopause awareness and training are going to be important if we are to reach as many women and their families as possible?

[Carolyn Harris]

I do agree and my mantra has become that we can all become menopause warriors because that means we acknowledge the issues and problems and are prepared to work towards ameliorating them.

We can look at the good practice out there to see what can be done. I recently spoke to practice nurse Sharon Hartmann from Tudor Lodge surgery in Weston-super-Mare. The surgery supported Sharon to develop a special interest in menopause care. She is now certified by the British Menopause Society and delivers evidence-based practice to her patients. She is able to monitor progress, control treatment plans and prescribe suitable medication for each individual. I would love to see this kind of service in surgeries or clusters all over the country, with doctors being able to identify the symptoms quickly and ensuring women are then passed down to someone with a wealth of knowledge and experience in menopause care. But it is not just the education of the medical profession that needs attention. We need to address education in our schools, so that the next generation of girls and boys is far more prepared than any of us were. I certainly did not talk about the menopause when I was at school. We did not even talk about periods when I was at school. We want the next generation to talk openly about it, understand what is to come and what they can do to help. We need young men to understand that their mothers, wives, sisters and partners may struggle at some point in their life, and that it is not that they do not love them any more, it is just that the menopause is denying them emotion.

[Esther McVey (Tatton) (Con)]

I, too, congratulate the hon. Lady on bringing forward this issue and pursuing it in such a constructive, positive and enthusiastic way not just in the House but outside it too, and on the points she raises about the stigma attached to the menopause and the idea that women of a certain age are maybe past their prime. Absolutely not. People need to know that women’s lives actually might begin at 50. Thank you for what you have done and, I understand, for your constructive work with the Government. What you are doing today is a most important step forward—

[Esther McVey]

I was carried away by the excitement of the moment, but you are quite right, Madam Deputy Speaker. The hon. Lady has done so much and will earn the gratitude of the whole country for what she is doing with this positive step forward today.

[Carolyn Harris]

I agree with everything the right hon. Lady says.

It has been a pleasure to work with some fantastic women in this place who understand how important this issue is and, like me, want to ensure it is at the top of the agenda. The Minister, her predecessor, our shadow Minister, and all my cross-party colleagues and friends have been absolutely fantastic. We are so lucky to have strong male voices, too, who have not only signed the Bill but are here to support it. I want to thank—good grief, the hon. Member for Strangford (Jim Shannon) is not in his place! That is a first. I thank the hon. Members for Strangford and for Hazel Grove (Mr Wragg), my hon. Friends the Members for Bootle (Peter Dowd) and for Blaenau Gwent (Nick Smith), and the hon. Member for East Worthing and Shoreham (Tim Loughton) to name just a few, men who are not afraid to embrace the menopause revolution and have shown themselves to be dedicated menopause warriors.

I am sure we would have heard the voice of our dearly missed colleague, the former Member for Southend West, today if it were not for tragic events. I remember him coming to a menopause event I hosted a couple of years ago. When I asked him if he supported the cause, he told me, “With a wife and four daughters at home, I don’t have any option.” [Laughter.] So today, I would like to add my voice to those who have already spoken in the Chamber and around the country, and send my thoughts and prayers to his wife, his four daughters and his son. David was a very special man and we all miss him greatly. [Hon. Members: “Hear, hear.”]

We need to go further on education. We need to educate ourselves now. A public health campaign would help enormously, as so many women just do not join the dots between their own health issues and the menopause. As I mentioned earlier, 11 years ago I had no idea what was happening to me. If my inbox is anything to go by, I am not alone. I know from conversations I have had with friends and colleagues in this place that they, too, were not sure of the situation they found themselves in because it has been a taboo subject. It has been a dirty little secret that women were ashamed of. My earliest recollection of “the change” was a comedy sketch by Les Dawson dressed as a woman having a conversation over a fake wall with Roy Barraclough, lifting his left breast and referring to his neighbour as “being on the change”. We have to move on from those days. It is not a joke when you live with it and it is not a joke when you experience it. We can do so much more to make sure we do the right thing.

Well, I am not ashamed. That is maybe because I am Welsh and I say what I think. Fortunately, there are a lot of other people out there who are not ashamed. It is fantastic that celebrities such as Davina McCall, Lisa Snowdon, Mariella Frostrup, Penny Lancaster, Nadia Sawalha and Gabby Logan are all sharing their menopause experiences. As the right hon. Member for Tatton (Esther McVey) said, it is sometimes very difficult for someone to talk about their menopause when they are in a profession, because the assumption is made that they are over the hill.

There are some great tools to help us, too, such as the Balance app and the Henpicked website, which provide a wealth of unbiased and factual information about the menopause and aid women in taking control of their health. But it is our responsibility in this place to look at what we can do to ensure that the right message gets to everyone who needs it.

[Ruth Cadbury (Brentford and Isleworth) (Lab)]

I congratulate my hon. Friend on introducing this Bill, on her passion and on raising it as an issue not just of medical training, but of realisation and understanding for everyone—men and women. Does she agree that one of the challenges in this area is the historical nervousness about taking HRT? The world has moved on since our mothers’ generation, when there were some real problems, and medical knowledge has improved. Does she agree that we need more education on the benefits of HRT, which she has so personally described?

[Carolyn Harris]

I certainly agree. The information that would explain the situation with HRT is out there, but because we are not looking for it, we do not find it. There is really good information that debunks the myths on HRT, which has moved on a lot. It is a phenomenally different product from what it was in the day when too many people were prepared to criticise the use of it. Unfortunately, if someone does not look for that information, they will not find it and they do not prescribe HRT.

Someone understanding their own menopause is so important. Although we are, I hope, heading towards a time when women will discuss their experiences with family and friends, there is also a lot to be done in workplaces, where talking about symptoms can be a lot harder. Employers have a huge role to play in ensuring that support is available and understanding what their staff are experiencing. I have heard far too many accounts of women being given warnings, being sacked or even being made to feel that they have no choice other than to resign due to menopausal symptoms.

[Seema Malhotra (Feltham and Heston) (Lab/Co-op)]

I congratulate my hon. Friend on this most excellent Bill and on the work of the all-party group on menopause. The work of the group also helped to inspire activity with employers across the country. I attended an event on the menopause with Shevaun Haviland, the new head of the British Chambers of Commerce, and the Dorset chamber. There was tremendous engagement from employers, who had never been able to have this kind of conversation. Does my hon. Friend agree that, alongside improving awareness in the medical profession and in society to help to encourage discussion in families, supporting employers to have this conversation is vital for their understanding and for women’s employment?

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[Carolyn Harris]

I certainly do. Very many businesses—really big players in their fields—have contacted me and asked for advice on how they can move forward. What I say to them all is, “Don’t have a policy that is left in a filing cabinet that reflects a tick box. Have a policy that reflects your workforce and what women need and is intended to help them.” I visited several big companies that are really good employers and I have seen the all-singing, all-dancing menopause policy that does all but make a cup of tea, but when I asked the staff, “How is the menopause policy working for you?”, their response was, “I didn’t know we had one.” It cannot be a tick box; it has to be relevant.

Other employers need to take heed of the likes of Timpson—I repeat that James Timpson walks on water, as I said in this Chamber last week—in prioritising the welfare of its staff who are experiencing symptoms of the perimenopause or menopause. There are other big companies, such as PricewaterhouseCoopers, Bristol Myers Squibb and Tesco, that do good work—I could go on, but I know that the right hon. Member for Romsey and Southampton North (Caroline Nokes), who chairs the Women and Equalities Committee, will talk about that.

[Stephen Kinnock (Aberavon) (Lab)]

I pay tribute to the amazing campaign that my hon. Friend is running. The Bill is making such an important contribution; I think we all sign up to being menopause warriors and menopause revolutionaries. To add to the point about employers, does she see a role for trade unions in promoting the excellent ideas that are in the Bill? Can she give some examples of how we as MPs and menopause warriors could do more in our constituencies to encourage employers and trade unions to take these ideas forward?

[Carolyn Harris]

I have always thought of my hon. Friend as being Amazonian in his warrior status. I am sure that when he has his photograph taken later today with the lovely Penny Lancaster, he will prove to be Amazonian. In his constituency, the Community union is doing fantastic work with Tata Steel, which has welcomed in the union to hold menopause coffee mornings with the women in its workforce, who, let us not forget, are working in a very male-dominated arena. If they can do it, so many others can. My hon. Friend the Member for Newport East (Jessica Morden) has the Llanwern steelworks in her area, and it, too, is welcoming the Community union’s coffee mornings. I urge both my colleagues to attend one of those to share experience and listen.

Almost 80% of menopausal women are in work, with most planning to work for many more years. However, three quarters report that they are considering reducing their hours and one in four are giving up their jobs because they are finding it too difficult to balance their work life with their symptoms. Our careers should not stop when our periods stop. Whether our jobs are physically or mentally demanding, small adjustments could make all the difference. My hope is that employers listening to this debate will make those adjustments and take pride in the fact that they are menopause-friendly workplaces.

[Mr Richard Holden (North West Durham) (Con)]

This is a great cause. The hon. Lady and I are working together on various other issues as well, and she is a doughty champion for cross-party working on so many important issues. Will she comment briefly on how small employers can help? As one myself, I have two superb women, Alison and Deborah, who work in my constituency office and they have made me very aware of the issue that is being raised in the House today.

Will the hon. Lady also comment on the “Better for women” report by the Royal College of Obstetricians and Gynaecologists, which has worked with me closely on the hymenoplasty and virginity testing changes that it is bringing forward? Will she say a bit more about those workplace policies, particularly to help small employers understand how they can better support women? The team is so important to small employers, and the individual members all contribute so much at different parts of their lives.

[Carolyn Harris]

What I would say to the hon. Gentleman is that communication is key here; you cannot provide if you do not know what is needed. Do not be embarrassed and do not shy away from that conversation. If staff members do not feel comfortable talking to one person about it, find someone they will talk to. It is so important that you ask them what they need, not tell them what you are prepared to do. Communication and adaptation to suit the individual is key.

[Seema Malhotra]

I, too, just want to pick up on the point that my hon. Friend made about women and the workplace. We know that, according to the Centre for Ageing Better, 800,000 people over 50 were wanting to work more and were under-employed—that was the case a year ago, at least. Does she agree—

[Madam Deputy Speaker (Dame Eleanor Laing)]

Order. The hon. Lady has already had one intervention, which was very long. I allowed that, but her second intervention is heading towards being very long and I cannot construct this debate like that. About 30 people wish to speak this morning. I am sure that the promoter of the Bill wants to make sure that as many people as possible get to speak, but that she also will not want to talk out her Bill. I hope that those who support the Bill will not make long interventions and long speeches, because otherwise the Bill will be talked out and we will not achieve the result we are intending to achieve. So I ask for brevity, please, on all sides.

[Carolyn Harris]

Thank you, Madam Deputy Speaker. May I suggest that my hon. Friend and I have a conversation outside the Chamber, where we can expand on what she is seeking to establish?

As women reach this stage in their lives, understanding their own bodies and having support in all areas of their lives is crucial, but it is clear that we have a long way to go. That is why the Bill calls on the Secretary of State to lay before Parliament a United Kingdom, cross-party, cross-Government strategy on menopause support and services that will incorporate all the areas I have spoken about.

[John Lamont (Berwickshire, Roxburgh and Selkirk) (Con)]

I congratulate the hon. Lady on all her work on the Bill. My question is about the UK-wide aspect. Clause 1 applies only to England—prescriptions are free in Scotland—but clause 2 applies across the entirety of the United Kingdom. There is a duty to consult Scottish Ministers. If the policy area is devolved to the Scottish Parliament, how will those discussions work in practice? What would happen if Scottish Ministers did not agree with the strategy agreed by the UK Minister?

[Carolyn Harris]

I am going to leave that to the Minister to worry about. I am sure that the Scottish Government do not want me telling them what to do. I would be happy to have a go. If only I was on the Government Benches, then I would get it sorted.

I am not just asking the Secretary of State to do this. I want to work with him, his Ministers and colleagues from across the House to build a taskforce that will take on these issues and find the solutions, because I truly believe that, working together, we can change this—even in Scotland, if necessary.

We also desperately need to look at prescription charges for HRT in England and at what we can do to ensure that the cost is not a barrier to women accessing it. The menopause does not discriminate, so the cost to treat it should not either. There are women struggling to find almost £20 a month, and that just is not right when it is a time in life that women will reach. There is no avoiding the menopause for half the population. Most women will spend at least a third of their lives perimenopausal, post-menopausal or—the joy—menopausal. We must ensure that those women who need it are not denied HRT because of financial restraints.

[Dehenna Davison (Bishop Auckland) (Con)]

Like everyone else in the House, I thank the hon. Lady for her vociferous campaigning on this really important issue. Assuming that we get there and manage to abolish prescription charges for HRT in England, how does she perceive us running a good communication strategy so that women are still not put off because they do not know that prescription charges have been removed?

[Carolyn Harris]

I am sure that the Minister will enlighten us on that issue. That is the issue: whatever we do today, it has to be communicated to the wider population so that they understand our commitment to their health.

The biggest complaint I have received over the past few months is from women who need both oestrogen and progesterone. Women who have had a hysterectomy can take oestrogen on its own, but everyone else needs both. Despite the two hormones being combined into one product, women are charged individually for the hormones, meaning that each prescription costs them £18.70, and with 86% of women getting only three months’ supply each time, the costs begin to add up.

[Danny Kruger (Devizes) (Con)]

The hon. Lady is being very good about giving way—I am very grateful to her. On the question of cost, I was struck by what she said earlier about her own really difficult experience of being prescribed antidepressants because she was not properly diagnosed with the menopause. I chair the all-party parliamentary group on prescribed drug dependence. She might be aware that last week Dr James Davies of Oxford University published research showing that the NHS currently spends half a billion pounds a year on unnecessary prescriptions of habit-forming drugs. Will she join me in raising serious concerns about that, and does she agree that we must press the Government to review properly the prescriptions of dependence-forming drugs?

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[Carolyn Harris]

I certainly do agree. We have all heard stories about chemists getting back a skip-full of drugs after people have passed away. It is wrong—I totally agree.

That leads me to the next issue: the National Institute for Health and Care Excellence guidelines, which recommend following a three-month trial period. Women are then prescribed HRT on an annual basis. I appreciate that that may not be possible for a small number of women, but from looking into this it is clear to me that that very rarely happens, so women continue to be charged each month, against the advice of the public body. It is clear that that has been overlooked for far too long, leaving far too many women in England either without the vital treatment they need or worrying each month about how they are going to find the money to pay for it. That is why the Bill calls on the Government to do something about it—to find a way to stop women in England being disadvantaged because of the cost of HRT prescriptions. Nothing will have a greater impact on such a huge proportion of society, especially those who are at a socioeconomic disadvantage.

Everyone has a part to play in this revolution—women themselves, educators, medical professionals, families, friends, employers—but it is to start here, in this place, today. For the 13 million women in the UK who are currently either perimenopausal or menopausal, and for all those women who follow, we need a commitment that things are going to change.

It was pointed out to me last week that, according to Hansard, since 1803 “menopause” has only been referenced in Parliament a mere 197 times. I think over the last two weeks I have probably been able to double that single-handedly. Changing the history of Hansard will be some achievement, but making history for menopause will be far more important to the women in this country.

I would like to thank everyone in this place, around the country and indeed across the globe who has been in touch to support this Bill. It has been quite overwhelming, and it is great to see everyone in the Chamber today with their “Menopause Warriors” badges, because this is a revolution for all those whose lives have been or will be impacted by the menopause. The dictionary definition of a revolution is the forcible overthrow of a Government in favour of a new system. Although I do not have time for that today—[Interruption]—not today; it has been a busy two weeks—there are women in Parliament Square today who are expecting us, as those they elected to this place, to do something for them and to do right by them.

Let us join the likes of Tudor Lodge surgery, Timpson and the Balance app as examples of best practice in tackling stigma and the symptoms of the menopause. I urge the Government to work with me to make HRT accessible to everyone, regardless of financial constraints; to ensure that women are diagnosed at their first appointment and get the treatment they need; and to educate everyone, so that those who are experiencing symptoms get the support and understanding they need in every aspect of their lives.

[Robin Millar (Aberconwy) (Con)]

I associate myself with the comments of others and with their praise for the hon. Lady for raising awareness of this issue. Would she be willing to include in the Bill’s provisions those women who will experience a chemically-induced menopause? They will experience the menopause more than once, and sometimes even three times, in their lifetimes.

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[Carolyn Harris]

My revolution intends to help every woman who is experiencing the phenomenon, in whatever capacity, be they 13 years of age—I have heard about some women as young 13—or in their 80s. It does not discriminate, and I want to make sure we do our best for every woman. Our daughters and all those who come after them will have each one of us here today to thank for ensuring that we make progress and that the menopause revolution continues. We cannot let them down. Now is the time to do the right thing and to make sure that women across this country have all the support, guidance and reassurance they need to overcome their menopause.

I believe that the Government are listening. The Minister herself said in this Chamber just last week that the Government are putting the menopause at the top of the women’s health strategy. I believe that today will be the start of putting right the historical injustice that women have experienced, and that 2021 was the year that the menopause revolution was born.

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[Carolyn Harris]

Can I just say, 51% of the population is a huge amount of people who are not getting appropriate care.

[Dr Spencer]

I thank the hon. Member for her intervention and for pointing that out, but I would argue that it is maybe not 51% of the population who are in that situation of needing that care and support. Although 51% will go through the menopause, that is different from saying that 51% of the population will therefore need medical intervention and medical discussions around this.

But like I say, I do not particularly want to get into a deep debate on this; I just wonder whether we could ask the profession what it thinks it can do better, rather than us telling it, top-down. Of course, I would say that, I am a doctor—yadda, yadda, yadda; declarations, etc.—but I just wonder what the profession would say in response to the hon. Member’s campaign about how it can improve things and whether we can hear a bit more about that.

My final point is that, in a sense, I find the fact that we are having to have today’s debate deeply depressing. It is a wider indictment of the problems we have in society with the role and position of women. We have got the Equality Act 2010 and lots of legislation and statute, but as we have heard, when it comes to cultures and attitudes, it is just not there. There really needs to be a step change, given the events of the past year and what we have seen with sexual harassment. I have loads of constituents who come to me and tell me about the disrespect experienced by women. I hear the points made by my hon. Friend the Member for Thurrock (Jackie Doyle-Price). It is frankly appalling that women’s health has been left behind. We need to think carefully about what we can do as leaders of our communities and society to change things and increase respect for girls and women and the position of women in society. On that note, I absolutely pay tribute to the hon. Member for Swansea East for bringing this debate forward and the campaign she is running.

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[Carolyn Harris]

With the leave of the House, I thank the Minister and the Clerks. Wonderful women—thank you! What has happened today is only the beginning, but we can do such great things together. It is all about looking after women. I have just been told that the Welsh Government have also announced that they will be putting mandatory lessons for young people on the national curriculum, and will be delivering a pathway for menopausal women. The revolution has made a big difference. We are keeping women wonderful. Thank you all for your speeches and your time.

I beg to ask leave to withdraw the motion.

[Madam Deputy Speaker (Dame Eleanor Laing)]

The hon. Lady appears to have achieved her objective.

Motion and Bill, by leave, withdrawn.

World Menopause Month

Carolyn Harris Excerpts

Thursday 21st October 2021 Commons Chamber

[Carolyn Harris (Swansea East) (Lab)]

I beg to move,

That this House has considered World Menopause Month.

It is rare to stand up in this place and open with the words, “This is not a political issue”, but that is what I am doing today. Women’s health is too important to be used to gain political advantage or score points against each other. Women’s health is so important, and women have suffered for far too long. To stop that we must work together across the House to bring about change. Today is just the start. Today we can talk about the perimenopause and menopause, and we can share our experiences and discuss all the areas that desperately need change. In doing so, we will break the taboo. Breaking the taboo is a huge step forward, but it does not stop there. Talking is great, but action is better.

The menopause is something that every woman will experience at some point in her lifetime. When and how we experience it is unique to each of us. For some, it will be a simple transition with relatively few side-effects. For others, the side-effects will be extreme—physically painful, mentally challenging and, at their peak, completely debilitating.

It is estimated that 13 million women in the UK are either perimenopausal or menopausal. That is almost a fifth of the population. Can we imagine any other condition that affects that many people being so woefully overlooked and misunderstood? This issue is not just about the women experiencing the symptoms; its impact directly affects husbands, partners, children, friends and colleagues. It really is an issue that we need to take seriously.

Next Friday, my private Member’s Bill, the Menopause (Support and Services) Bill, comes to this place for its Second Reading. I have been blown away by the support I have received from Members right across this House and the other place, and from outside—the press, celebrities, the general public and businesses. It seems that finally, after years of whispered comments and clandestine conversations, everyone is ready to talk about the menopause. Women are ready to stand up and share their experiences.

Hot flushes, night sweats, brain fog, weight gain, insomnia, anxiety, vaginal dryness, poor concentration—I could go on; the list is endless. Hormone imbalance does all those things to our bodies. For many, help is available in the form of hormone replacement therapy. It is not for everyone, but for those of us it does suit, including me, it is honestly life changing. After 11 years on antidepressants, I am now on HRT and weaning myself off antidepressants, having realised that I was not having a nervous breakdown but actually going through the menopause. I have been on HRT for only a relatively short time, but I did not realise how much of me I had lost to the menopause until I started taking it.

Despite the fact that HRT makes such a difference to so many of us—it is no exaggeration to say that it can quite literally save women’s lives—it remains the only hormone medication that is not exempt from prescription charges in England. For many, because they need both progesterone and oestrogen, the cost is double. I can guarantee that mums on a tight budget will make sure that their kids have everything they need before finding the £20 to pay for the prescription, which means that that cost is a real barrier for many women up and down the country. But we can change that—and I hope that we will with my Bill. Every MP in England will have constituents who would benefit from that change in legislation. We cannot let them down.

Let us look at what else we can do, once we have broken down the financial barrier, to reduce the impact on women’s lives during the perimenopause and menopause. Let us look at where else women are being failed. Menopause training in medical schools is unacceptably poor, with 41% offering no mandatory menopause training at all. Curriculum content in schools needs to be reviewed so that the next generation of girls and boys are educated and prepared for this stage of their lives.

Support in the workplace is still a lottery, with some employers excelling but others letting their employees down at a really difficult time. The right hon. Member for Romsey and Southampton North (Caroline Nokes), with whom I work closely on this issue, will speak later about workplace support and the excellent work being done by the Women and Equalities Committee, but I want briefly to mention a few companies that are really taking the issue seriously. Yesterday, the all-party parliamentary group on menopause held a session focused on workplace support, and we heard some really good examples of best practice from PricewaterhouseCoopers, Network Rail, Bristol Myers Squibb, Tesco and John Lewis. We also heard from Timpson. James Timpson—the man walks on water! He announced on Monday that Timpson will be allowing staff to claim back their HRT prescription charges on expenses. I cannot praise the man enough. This is a true example of a company that cares about the welfare of its employees and understands that in offering this benefit it will retain its experienced workforce who are invaluable.

The fact that so many organisations are starting to wake up to this is such a positive step forward. It is a joy to be able to stand here today and celebrate that, but we need it to be the norm, not the exception. The UK’s workforce is changing. More than three-quarters of menopausal women are now in employment. We need employers to change, too, so that women feel comfortable speaking to their managers about their symptoms and what adjustments they need. In fact, we need to educate everyone, so that talking about the menopause with medical professionals, among friends and within families, as well as in the workplace, becomes a natural thing for women to do.

Earlier this year, ahead of a Westminster Hall debate that had the topic of menopause support, the Chamber engagement team helped me hugely by creating a survey for anyone impacted by the menopause to share their experiences. I was taken aback by the number of responses we received in just a couple of days, and by how honest and insightful they were. Looking again at those responses and at the hundreds of emails coming into my inbox makes me realise just how many women out there are now ready to reach out and share their experiences. I am honoured that they are choosing to do that, but it saddens me that many of them have never spoken about their symptoms with anyone else.

[Mr William Wragg (Hazel Grove) (Con)]

It is impossible to resist any campaign spearheaded by the hon. Lady and this is one I am very proud indeed to be able to support. I look forward to the Second Reading of her private Member’s Bill next week, which I will be here to support. What would she say to the men out there as to how they can be supportive and better understand the menopause, rather than treat it as a taboo subject?

[Carolyn Harris]

I would say, “Take the example of the hon. Gentleman, who has become a menopause warrior: be there for the women in your lives and make sure you provide listening ears and thoughtful words on how you can support your loved ones and the women in your workplaces.”

I understand that women have found it difficult to talk, because across society we have been encouraged not to. A funny story, but a very true story, is that I remember my mum ushering me out of a room when her and my aunts were discussing a “rather difficult sensitive issue”. One of my aunts will probably be absolutely horrified that I am talking about this now. They were discussing her menopause. I hasten to add that I was 36 years of age at the time—[Laughter.]—but that just goes to show the taboo around talking about this subject. There will be some people out there who will be absolutely astounded that I used the expression “vaginal dryness” in the Chamber of the House of Commons, but it is a fact of life.

The stories that women are sharing with me are often really distressing: from women who have struggled for years with no support and feel it has ruined their lives, to women who have experienced early menopause due to medication or surgery and feel that they are literally on their own; and from women who have experienced some of the most extreme physical symptoms and those whose mental health has really suffered, struggling in silence because that is what they thought they had to do and did not know what was happening to them.

In the public engagement survey earlier this year, Helen shared her story. She told us:

“My perimenopause symptoms started at 41....by the time I was 42, I had developed palpitations and anxiety attacks. I suddenly couldn’t leave the house or meet people and was scared all the time that something was seriously wrong with my heart. I was a shell of the woman I used to be.”

Then there are those who have taken the next step and visited their GP to ask for help, only to be turned away or sent packing with a prescription for antidepressants. I am not pointing the finger at GPs because I know how hard they work, but there is a woeful lack in their training and understanding of the menopause. Many are not able to join up the dots and women go undiagnosed.

In our survey, Catherine explained how she had experienced that exact problem. She said:

“With my own research I’ve had to work hard to convince my GP that constant increases and changes in antidepressants weren’t working and my difficulties were hormonal. I nearly lost my job and my husband...it’s taken 6 months to finally receive the HRT I need. Within 2 months of taking HRT I have successfully weaned off antidepressants, been able to start exercising and my home, work and personal life is”

completely “transformed”.

It does feel like we are starting to turn a corner. If we can just bring all the pieces of the jigsaw together, we can change the future for ourselves, our daughters, for our daughters’ daughters and for women who follow on behind us forever more. We can stop menopause being something people are afraid to talk about. We can help to ensure that everyone understands the symptoms so that women know what is happening to them and family and friends are able to support them. We can make sure that women get the right diagnosis and the right treatment plan for them to help to alleviate their symptoms, and we can ensure that every workplace is a menopause-friendly workplace so that women can continue to succeed in their careers. It is time for change. It is time for the menopause revolution. Women want it, women need it, and women deserve it.

[Mr Deputy Speaker (Mr Nigel Evans)]

I am going to try to have this debate without putting a clock on. If people can show discipline and keep their speeches to about six minutes, we will get everybody in with an equal time.

--- Later in debate ---

[Carolyn Harris]

I hope that colleagues truly appreciate the impact that us in this place talking about this subject has on those watching and listening. I have lost count of the people who have contacted me and thanked me for raising the issue. The emotion and gratitude from those women, who finally feel that they have a voice, is truly overwhelming. But Parliament is not just being watched today by the women out there; we are being watched on the global stage. Me on the global stage—terrifying, isn’t it? But I am absolutely loving the fact that I have legislators, press, medical professionals and academics from right across the world saying, “You were talking about something in the UK Parliament; we want to learn from you.” We will be world leaders on this.

We have warriors such as Davina McCall, Louise Newson, Penny Lancaster, Louise Minchin, Lisa Snowdon, Gabby Logan, Nadia Sawalha, Mariella Frostrup and Kate Muir—prominent women in the media who are telling their story—as well as the Countess of Wessex and so many more voices. Everyone in this place brave enough to embrace talking about the menopause is a menopause warrior and is playing a huge role in allowing women to be fabulous all their lives. So, words I never thought we would say in the House of Commons Chamber—long live the revolution!

[Mr Deputy Speaker (Mr Nigel Evans)]

They don’t come more fabulous than you, Carolyn.

Congratulations to everyone on taking part in the debate. I am really pleased that Sir David Amess was mentioned today. I am absolutely certain that, had the tragedy not happened, he would have been here today cheering you all on.

Question put and agreed to.

Resolved,

That this House has considered World Menopause Month.

Menopausal Symptoms: Support

Carolyn Harris Excerpts

Wednesday 9th June 2021 Westminster Hall

[Ms Nusrat Ghani (in the Chair)]

I remind hon. Members that there have been some changes to normal practice in order to support the new hybrid arrangements. I remind Members participating physically and virtually that they must arrive for the start of the debates in Westminster Hall and that they are expected to remain for the entire debate. I remind Members participating virtually that they are visible at all times to us in the Boothroyd Room. If they have any technical problems, they must email [e-mail]. Those Members attending physically must clean their spaces before they use them and as they leave the room. Mr Speaker has stated that masks should be worn in Westminster Hall, unless you are speaking.

[Carolyn Harris (Swansea East) (Lab)]

I beg to move,

That this House has considered support for people experiencing menopausal symptoms.

It is a pleasure to be opening this important debate in person, Ms Ghani, and to serve under your chairmanship. I thank the Chamber engagement team for their support in creating a dedicated webpage for anyone impacted by the menopause to share their experiences with me ahead of the debate—this is a fantastic service available to us all in the House—and the responses that I have received have been honest, insightful and true examples of why we need to open up the discussion and remove the stigma that still surrounds the menopause. In total, 728 people responded to the public survey and I will share some of their experiences with Members later.

On World Menopause Day in 2018, I made a speech in the main House of Commons Chamber calling on the Government to commit to make a difference to the lives of all women experiencing symptoms of the menopause. At present, approximately 13 million of us in the UK are either perimenopausal or post-menopausal. That is almost a fifth of the entire population. In that debate back in 2018, I spoke of the need for changes in the curriculum to better educate our young people; improved public education to help women who are suffering and those closest to them; better training for GPs to ensure that women are correctly diagnosed and given the right treatments; and mandatory workplace menopause policies, so that women may continue to work through what can be the most difficult time of their lives.

With many pressure groups and the media now shining a light on issues to do with menopause, we are starting to talk about it more, but now we also need to start taking action. Education is key here, both public education—so that women understand what is happening to their bodies and feel confident in making informed decisions about the path they choose—and professional education, which is severely lacking.

A recent survey on menopause support revealed the shocking truth about training in medical schools. An astounding 41% of UK universities do not have mandatory menopause education on the curriculum. Menopause will, at some point, directly affect half of the population, and yet it is completed overlooked when training the people that we will all turn to for help.

Women are suffering unnecessarily, and while some barely notice any changes, for others the suffering is unbearable—stressful, debilitating and completely life-changing. Despite that, many doctors complete their training and leave university with absolutely no education about menopause at all. I am fairly confident that no other medical condition set to impact the lives of more than 50% of the population would be left out in that way.

The Royal College of General Practitioners states that menopause is included in the curriculum, although not mandatory or standardised. Bearing in mind that we know more than 40% are not providing mandatory training, however, women who are suffering and turn to their GP for help cannot be assured that the doctor they visit will be competent in recognising their symptoms, let alone to provide them with the treatment plan and medication they need. In our public engagement survey, Gillian shared her experience, saying that her GP told her to ask her mother as her experience would be the same:

“I walked out with a leaflet…no support, no advice, no understanding”.

Far too many women are still being misdiagnosed and prescribed anti-depressants, and they suffer extreme symptoms without the correct treatment and support. This needs to change. GPs should follow up-to-date guidance from the National Institute for Health and Care Excellence on the menopause and hormone replacement therapy, and they should recommend such treatment if it is appropriate. Sadly, far too many women are denied this path, because many doctors are unaware or ill informed. Even those who are lucky enough to visit a GP who recognises their symptoms and understands the benefits of HRT treatment still face barriers.

In Scotland and Wales, prescriptions are free to everyone, but unfortunately women in England are forced to pay £9.35 per item. For some, their treatment may include multiple items every time. Lisa responded to our survey by saying:

“Free HRT prescriptions are needed. I’m currently charged two prescription charges for one box of medication.”

Lesley said:

“It’s a process of elimination getting the correct medication. It’s so expensive and I have found it very difficult to pay for the prescriptions.”

That is not something to be taken lightly. It is not just the odd hot flush or moment of forgetfulness. Menopausal symptoms can ruin women’s lives, and until something is done to improve the standard of diagnosis and treatment, they will continue to ruin even more.

Women deserve so much better. They are giving up their careers and ending relationships because of the severity of their symptoms and the impact on their physical and mental wellbeing. It is no coincidence that suicide rates for women peak between the ages of 45 and 54, which is the average age that most women reach the menopause or experience perimenopausal symptoms. This cannot carry on. I do not want to be standing here in another two and a half years talking about the same things.

Education on the menopause, which is slowly being incorporated into the curriculum in secondary schools, is a positive step forward, but it is just one part of a much bigger picture. Public health guidance, standardised compulsory training for those in the medical professions, and fully funded HRT treatments and workplace policies need to follow. Women should not feel inferior or incapable of doing their job because of the effects of the menopause on their health and wellbeing, but, sadly, too many do.

The situation could be so easily rectified. Simple changes in the workplace, such as flexible working hours, relaxed uniform policies and adaptations to the working environment, could all make such a difference. Dinah talked about this in her survey response. She explained that in her workplace, she was

“surprised to find no menopause policy whereas we have policies for most conceivable events.”

She added that she told her manager about her menopausal symptoms and how she felt that they were interfering with her capacity to do her job. She said:

“I was offered no support, we just talked about how I could stop making mistakes.”

The Government have alluded to that in their call for evidence for the women’s health strategy. One of the areas being considered is maximising women’s health in the workplace, with menopause being one of the female-specific conditions mentioned that impacts on women’s participation in work. I urge anyone affected to complete the public survey before the deadline of 13 June, and details can be found on the Government website.

None of the things I have mentioned are big on their own. They are all easy to rectify, but the lack of them all is having a devastating impact on so many lives. We have the power to change that, and we must seize the opportunity. I plan to set up an all-party parliamentary group on menopause support over the coming months. I have already had colleagues from across the House express an interest in joining, and I would be delighted to hear from more MPs and peers—both male and female—who I know share my passion to make a difference.

Women should not be left to suffer through a lack of awareness, inadequate support or financial restraints. Every woman experiencing menopausal or perimenopausal symptoms should be confident that they will be able to access the right treatment and support in every aspect of their lives. Women deserve to see medical schools providing appropriate training so doctors can diagnose and prescribe appropriately. Women deserve to have mandatory menopause policies in their place of work. They deserve to be given the reassurance that they can access treatment without worrying about how to pay for it and they deserve to be assured of all the support and care that they need. Women have been suffering in silence for far too long. This debate has given them a voice. Now it is up to us to listen and act.

--- Later in debate ---

[Carolyn Harris]

Thanks from me and from every woman out there who is suffering. I totally agree with the Minister that there is no room for politics in women’s health. Together, those of us in this room and in Parliament can make a change. We can, and we will, create a menopause mandate, and we will transform menopause support and services going forward. Of that, I am confident.

Question put and agreed to.

Resolved,

That this House has considered support for people experiencing menopausal symptoms.

Botulinum Toxin and Cosmetic Fillers (Children) Bill

Carolyn Harris Excerpts

Committee stage & Committee Debate: House of Commons
Wednesday 25th November 2020 Public Bill Committees

[The Chair]

Welcome to this Public Bill Committee. Before we begin, I have a few preliminary announcements. Members will all understand the need to respect social distancing guidance; if necessary, I will intervene to remind you. Note passing should be electronic only. The Hansard reporters would be grateful if Members emailed their speaking notes to hansardnotes @parliament.uk.

The selection list for today’s sitting is available in the room and online. It shows how the selected amendments and clauses have been grouped together for debate. Formal decisions on amendments and clauses will be taken in the order they appear in the Bill.

Clause 1

Offence of administering certain substances to a child

[Carolyn Harris (Swansea East) (Lab)]

I beg to move amendment 1, in clause 1, page 1, line 17, after “practitioner” insert “and deemed the procedure to be medically necessary”.

[The Chair]

With this it will be convenient to discuss amendment 2, in clause 1, page 1, line 21, after “practitioner” insert “who deemed the procedure to be medically necessary”.

--- Later in debate ---

[Carolyn Harris]

Thank you, Ms Rees. I am not being presumptuous by sitting in the shadow Minister’s seat; I am merely observing social distancing. I would not presume to elevate myself to such great heights.

I would first like to congratulate the hon. Member for Sevenoaks on having secured parliamentary time to debate this important issue, and I welcome the Bill’s principle of protecting vulnerable young people. The amendments I have tabled are simply intended to improve the Bill. They aim to ensure that no person under 18 years of age receives a non-surgical cosmetic procedure unless it is deemed medically necessary, and medical advice has previously been sought.

As the co-chair of the all-party parliamentary group on beauty, aesthetics and wellbeing, alongside my hon. and dear Friend the Member for Bradford South, I recognise the importance of this Bill and its aim of protecting our young people. The APPG is currently conducting an important inquiry into non-surgical cosmetic procedures, and we have found that all representatives from the beauty industry and beyond are united in supporting a restriction on all persons under 18 years of age.

I am concerned that the Bill, as it is currently worded, would allow registered medical practitioners, as well as regulated health professionals under the direction of a registered medical practitioner, to carry out procedures on any person under the age of 18 without needing to provide medical evidence. I want to be absolutely clear: no practitioner should be exempted from this measure simply because of their qualification level.

It is important to make the case for rare exceptions, as non-surgical cosmetic procedures have uses outside aesthetics: for example, when treating certain muscle conditions such as dystonia, which is a type of uncontrollable muscle spasm. At the beauty, aesthetics and wellbeing APPG session yesterday, on ethics and mental health, it was emphasised by our expert witnesses that medical exemptions must be at the discretion of medical professionals such as psychologists, not left to the devices of the practitioner. One thing I found very disturbing is that we were given evidence by eminent experts in this field who told a story of some medical practitioners seeking excuses to carry out procedures during lockdown that would have justified them being able to practise. I felt that the Minister should know that.

I know that the hon. Member for Sevenoaks accepts the principle of these amendments, and I urge the Minister to consider how to protect vulnerable groups in our society, especially young people who are influenced by social media, peers, and in some cases the industry itself. I know that the hon. Lady will keep us informed about progress, and I urge the Government to make sure that we find a way to protect these young people going forward.

[The Minister for Patient Safety, Mental Health and Suicide Prevention (Ms Nadine Dorries)]

It is a delight to serve under your chairmanship, Ms Rees. I pay tribute to my hon. Friend the Member for Sevenoaks for all the hard work and commitment she has put into bringing the Bill forward. She had the delight of being drawn first in the ballot, but the passion and commitment she has shown to this issue, which is close to all our hearts, is second to none.

I thank the right hon. Member for North Durham and the hon. Member for Swansea East. Since I took up this post, the right hon. Gentleman has contacted me, written to me, spoken to me personally, and cornered me in the Tea Room and the corridors to talk to me about this subject many times. I know that he is passionately committed to the subject and the amendments that we are here to talk about. He has been relentless in his pursuit, letter writing and lobbying on the issue.

The hon. Member for Swansea East never rises to speak unless she firmly believes in what she is saying. She is an MP of principle and belief. It is a delight to have her in the House and we are the better for her presence here.

Can I clarify something, Ms Rees? Do you want me to make my comments now or are we going to the hon. Member for Swansea East first?

--- Later in debate ---

[Laura Trott (Sevenoaks) (Con)]

It is honour to serve under your chairmanship, Ms Rees. Before I start, I thank everyone in the room today. This has long been an overlooked area of policy, but with the work of everyone here, perhaps that will not be the case for much longer. As the right hon. Member for North Durham has said, it is a welcome first step.

I pay particular tribute to the work of the hon. Members for Swansea East and for Bradford South, and the all-party parliamentary group on beauty, aesthetics and wellbeing that they lead. The group’s findings have underpinned the substance of the Bill and I thank them for sponsoring it.

I completely agree with the sentiments behind the amendments. It is right that we should restrict these treatments for under-18s to only where it is absolutely medically necessary. The advice I have received is that that is covered in the Bill, inasmuch as UK doctors must be registered and hold a licence to practise with the GMC. The GMC publishes specific ethical guidance that says that doctors performing cosmetic interventions can provide treatment to children only when it is deemed to be medically in the best interests of the patient.

I accept that, as the right hon. Member for North Durham said, in some cases at the moment this is not happening correctly when it comes to botox, but to create a new legal precedent around the wording “deemed medically necessary” would add a layer of complexity, given that it is generally for the GMC to decide what is in the best interests of the patient. As he also mentioned, it would also produce two different authorities—the GMC and the court—which would then opine on the same issue. That could cause confusion.

I understand the thrust of the amendments, but if the hon. Member for Swansea East is content to withdraw them, I will work with hon. Members on some form of strengthened wording, which we can bring forward on Report.

[Carolyn Harris]

I welcome the comments from both the Minister and the hon. Member for Sevenoaks. We would welcome the opportunity to work with the hon. Lady to ensure that we strengthen the Bill. I beg to ask leave to withdraw the amendment.

Amendment, by leave, withdrawn.

[Judith Cummins (Bradford South) (Lab)]

I beg to move amendment 3, in clause 1, page 1, line 23, after “age,” insert “including by requiring and recording proof of this information,”.

It is a pleasure to serve under your chairmanship, Ms Rees. First, I thank the hon. Member for Sevenoaks for introducing this Bill and successfully bringing it to Committee. It is long overdue. I thank her from the bottom of my heart.

I stand in support of the Bill’s principles and I want to reiterate a point made by my hon. Friend the Member for Swansea East. My amendments seek to enhance the Bill and close the gaps in the wording. This amendment is a probing amendment and it deals with ensuring that a framework for age identification is present when practitioners are assessing a client for a non-surgical cosmetic procedure.

I am concerned that, as currently worded, the Bill leaves open to interpretation what reasonable steps a practitioner must make to establish the age of the person receiving the procedure. I want the Bill to make it clear that practitioners must request proof of age before any procedure is undertaken, verify the authenticity of that document and ensure that it is recorded, to ensure that there is no doubt about a client’s age. We need clear and explicit guidelines to ensure that vulnerable young people do not fall through the net.

My hon. Friend the Member for Swansea East and I established and became the co-chairs of the all-party parliamentary group on beauty, aesthetics and wellbeing. I am worried about how few protections there are for children under 18 years of age when it comes to non-surgical cosmetic procedures.

I was also in attendance at our inquiry into ethics and mental health. It will be no surprise that all our expert witnesses agreed that young people are at their most vulnerable in their teenage years. They are faced with many pressures, including societal pressures, which make ideal beauty standards the norm, especially in this age of social media. We must ensure we put safeguards in place to protect our young people.

I ask the hon. Member for Sevenoaks and the Government to consider this amendment to ensure that proper mechanisms are in place to strengthen the process of age verification for non-surgical cosmetic procedures and to improve the accountability of all practitioners. The amendment requires the practitioner to formally log and prove a client’s age.

Like my hon. Friend the Member for Swansea East, I welcome the opportunity to adapt the wording of the amendment should the hon. Member for Sevenoaks be unable to accept it. I ask that this amendment be considered.

--- Later in debate ---

[Mr Kevan Jones]

I welcome the Bill, but there are issues with it and those need to be improved.

Clause 1 goes to the heart of trying to stop the wild west that we have in this sector, but my concern is with the get-out-of-jail card for medical practitioners. Again, while most will follow the rules, there is clear evidence that we have medical practitioners signing prescriptions for botox and then selling them on. If we had a robust GMC or regulator that was clamping down on this, that would solve some of these problems, but I have seen no evidence of that at all.

The Bill will make a start on improving this situation, as the hon. Member for Sevenoaks said. There are existing regulations, but they are toothless. Do they provide the powers to intervene? Yes, I think so, but that is not happening. Certainly, the situation with prescription botox needs to be tightened up.

The problem I have, as I said in my earlier contribution, is the allowing of medical practitioners to administer these products to under-18s. I understand that there are perfectly good medical reasons that they are needed, and it would be wrong for the Bill to block those altogether, but I believe that regulation on this could be strengthened, and I know the hon. Lady and the Minister said that they will look at that.

I do not know whether this is something that the Minister could talk to the GMC about or whether we could get it into the Bill, or indeed if it is in the regulations that go alongside the Bill, but before an under-18 is prescribed these treatments, there should be a written prognosis giving the reason that they are needed. There should also be a clinical treatment plan outlining how and why those will be administered over a certain period, as well as a written statement relating to the supporting evidence, the consent of the patient and their guardians, and an agreement with the patient in advance on the expected outcomes. That would strengthen the rules.

Most practitioners will abide by the rules, but I have been looking at the sector for five or six years, and frankly, my experience is that there are medical professionals out there who are just out to make money.

[Carolyn Harris]

Does my right hon. Friend agree that the practice of remote prescription serves only to further damage the reputation of the industry? During a recent evidence session, a GP stated that they were offering a lifetime botox prescription for £50. That is a dangerous practice and it needs to be considered very deeply before we move forward on the issue.

[Mr Jones]

I agree. There are adverts on Amazon in this sector, and treatments offered include fillers, although certain other terms are used. People are not allowed to advertise botox, but they get around that by advertising consultations. In response to the question, many practitioners are not qualified at all and hold no medical qualifications, so how do they get access to botox? They do so because people are signing prescriptions. I fear that a situation may arise in which that practice continues, although it needs to stop.

Another issue is that under the definition the botox can be bought because this is basically a free market, as I see it. A practitioner could then administer the botox to a young person with no regard to that individual’s medical history. A medical practitioner, under the definition, could even be defined as a dentist. That needs tightening up. I do not think that would be onerous for doctors, who are quite rightly prescribing botox injections and other things for perfectly legitimate medical use. Doctors and patients are protected when those uses are laid out.

If I had more faith in the GMC to clamp down, I would be content to leave the situation as it is. I am sorry, but having seen the way the GMC operates, I see that the organisation is not friendly to the complainant or to the patient organisation. It protects the doctor. We took self-regulation away from solicitors, and I have concluded that self-regulation should be taken away from doctors. I did not start with that position, but have come to it.

The Minister promised a Bill on GMC reform in the last Parliament, and one is certainly needed, because frankly, the patient is at a disadvantage in a host of areas, not just this one. It cannot be right that it took my constituent’s case five years to reach the GMC, with huge hurdles to overcome to get there. I hear what the hon. Member for Sevenoaks says, but we should try to tighten things up a bit. The Bill will certainly be improved if we can.

Historical Stillbirth Burials and Cremations

Carolyn Harris Excerpts

Thursday 6th February 2020 Commons Chamber

[Carolyn Harris (Swansea East) (Lab)]

I would like to take the opportunity to thank the Leader of the House for allocating time for this debate and to warmly thank everyone for their kind words about the work that I have done. This place is at its best when we show compassion and work together to resolve the issues that matter to people. The work that we have done on children’s funerals—on what I like to call Martin’s fund—is typical of the kind of things that we can achieve when we work together.

Decades ago, when a woman had a miscarriage or gave birth to a stillborn baby, she was usually urged to forget about what had happened and often to try just to move on and have another baby as soon as possible. Families were not given time to grieve or offered any form of counselling. There were no special rooms with cold “cuddle cots”. Rarely were there opportunities for parents to even hold their babies for just a few minutes, for the first and last time, let alone take any photographs or gather mementoes for a treasured memory box. Babies were simply taken away quickly and quietly by hospital staff, to be buried or cremated in an undisclosed place. Fathers were usually advised to hide baby products at home, to help with the healing process and avoid traumatising the mother further. They were sometimes asked to pay for the burial. I found it really painful to hear the story of a man who had kept the receipt of his child’s funeral as the only memento of that child. These little ones’ innocent bodies were either cremated, buried in a communal plot sometimes, or placed in a coffin with a woman who had recently passed away. In some military cemeteries, babies were given their own plot, but marked simply with a number, never with a name.

On 19 January 1958, my mother delivered a full-term baby girl. She was 8 lbs in weight, but she never took her breath. In those days, there were not endless antenatal appointments or scans, or reminders to pregnant women to count the kicks, so my sister’s death was totally unexpected for my mum. Until her dying day, my mother believed that my sister had been buried with an elderly woman, but I honestly do not know if that was a fact or if it was a story that she had invented to comfort herself and over the years had come to believe as the truth My mother never grieved for my sister properly. She put up a wall. She was always afraid to show emotion. She was the most wonderful, loving mother in the world, but she was pretty rubbish on hugs, because she was terrified that if she showed love, something bad would happen.

When I had a scan when I was having Martin, the date of birth they gave for him was 18 January 1981. It traumatised my mother that I was going to be having a baby on the day that she lost hers. Thankfully, Martin was born on 24 January, but my mother always believed that 19 January, the date on which Martin was due, was a bad omen and that we were to lose him in the way that we were. She carried her child for nine months. She prepared to be a mammy and then she left hospital without her baby, with no support and no idea of where her little girl’s final resting place would be. My mother never really grieved for my sister until the day I lost Martin, and then she grieved as a mother and as a grandmother. My mother’s life was destroyed on the day that we lost Martin, because she remembered Martin and she remembered the baby she had lost 30 years before.

The practice of taking stillborn babies’ bodies and burying them without disclosing the location to the parents continued right up until the late 1980s. In the years since, families have started to search for their little ones’ graves. One lady, Paula Jackson, dedicates her spare time, for free, to helping people to find their babies, and in the last 15 years has found 800 babies. Thanks to Paula and her group, Brief Lives Remembered, parents have been able to find peace after years of grief and uncertainty. They now have a place to visit and the opportunity to place a headstone or a flower, or something to commemorate the memory of their loved baby. But some women do not feel comfortable asking for help. They feel ashamed or at fault. They feel as if they deserted their children, even though they were never given a choice.

We should not be expecting these women to be asking; it should not be up to Paula. I commend her for the fantastic work that she has done, but she is spending her own time and her own money to help these families. Surely there must be a way of sharing information about where these babies are buried, whether from council records or hospital maternity units, undertakers, crematoriums or cemeteries. That has to be an easy way of finding out what happened to each of these babies. I am hoping that the words from the Chamber today will resonate more than any policy, and that those who have the information will allow us to see it and share it so that those families who want to know where their babies are buried or cremated will easily be able to find out.

[Dame Diana Johnson]

My hon. Friend is making an incredible speech, and my heart goes out to the family circumstances that she has described. I want to ask her about institutions taking a proactive role by looking at the records they have and the information they can provide. It seems to me that lots of institutions—I am thinking of councils, in particular—do not do anything until someone asks a question, at which point it becomes a battle and is not the easiest thing to do. Does she agree?

[Carolyn Harris]

I certainly agree. I think the consensus in this Chamber—and some news channels, no doubt—will prompt local authorities, hospitals and other people to come forward and offer us the information we need.

Like my own mother, many have gone to their graves without knowing the locations of their babies. Many more are alive and still suffering from the grief and guilt, and very often from post-traumatic stress disorder. These mothers and fathers should be offered counselling and emotional support if they need it. They should be helped to manage their grief, to locate their baby and to live the rest of their lives with a sense of peace that they have not known for a long time.

This matter was raised this week by BBC journalist Frankie McCamley. Since the story was run on BBC News, I have been overwhelmed by communications from parents and other family members about their babies. Indeed, today the Doorkeeper sought me out because one lady has travelled here from the south coast just to hear us discussing the issue today, and she wants to tell me her mother’s story. People generations below the mums and dads who lost their babies are suffering, and are asking me to help them to find their babies; a lot of people out there need us to help them to get closure. I have received so many heart-breaking messages that I have suggested to some members of my staff that they do not read them, because I know they will be traumatised.

With everything that goes on in today’s world, this issue may seem relatively unimportant to some, but to anyone who has lost a child, memories and a grave visit are the things that bring an element of comfort. It took me a long time to stop visiting Martin’s grave. I would spend hours and hours and hours there. I would go to the grave, sit there and talk to Martin about everything I was feeling psychologically—all the questions I had, all the anger, all the guilt, and everything I wanted to communicate to him. I now know that Martin is in my heart, on my shoulder and in my head; he is everywhere. But until people get to the point in their grief where they understand that the person they have lost may not be here physically, but will always be with them, they need something to focus on.

I am asking that we find a way of helping the parents who want and need this closure to find their baby’s resting place, giving them the opportunity to have the peace so many of them seek, and—most importantly—a chance to say their final goodbye.

Baby Loss Awareness Week

Carolyn Harris Excerpts

Tuesday 8th October 2019 Commons Chamber

[Patricia Gibson]

I thank my hon. Friend, and I think she has made an excellent point. The shadow of a stillbirth will hang over any subsequent pregnancy, should it take place, and we need to be mindful of that.

[Carolyn Harris (Swansea East) (Lab)]

Will the hon. Lady join me in this poignant debate in saying how dreadfully sorry we all are that, on 27 September in Bronzefield women’s prison, a baby was born and died? We know no more than that at the moment, but it seems appropriate in this debate that we pay our respects to that baby and their mam.

[Patricia Gibson]

Absolutely. I absolutely share the hon. Lady’s sentiments. I think the important thing for all the people affected by that terrible loss is that they get the answers they need. We cannot turn back time, but what parents want are answers and explanations. To know that their baby mattered and that their loss is not going to be swept under the carpet is extremely important at those times.

I know there might be awareness day fatigue, but this particular awareness day does matter to those affected by baby loss. It is a week of remembrance, culminating in International Baby Loss Remembrance Day on 15 October. It is a space—a day—where we can collectively remember our babies, comforted by the knowledge that others have also experienced this indescribable loss and can understand the pain we feel. When you have experienced this, it really is easy to feel that no one could ever comprehend the scale of such a loss, but of course others who have gone through it do.

This day is not just about remembrance of our lost babies, although that is extremely important; it is a reminder that those who live with this are not on their own. Sadly, thousands of people in the UK and millions worldwide have suffered this loss. There are many who do understand, and more and more of us are willing to speak out. If we can take some of the isolation out of the grief for our lost babies and if we can give better aftercare to the parents who have suffered this loss, perhaps we could all have better mental health, despite suffering a loss of such huge magnitude in our lives.

Medical Aesthetics Industry: Regulation

Carolyn Harris Excerpts

Tuesday 14th May 2019 Westminster Hall

[Jackie Doyle-Price]

Thanks very much—my hon. Friend the Member for South Leicestershire (Alberto Costa). I am pleased that the all-party parliamentary group has been established since we last debated the issue in this place, and I thank the hon. Member for Swansea West—

[Carolyn Harris (Swansea East) (Lab)]

East.

[Jackie Doyle-Price]

I thank the hon. Members for Swansea East (Carolyn Harris)—I never know my east from my west—and for Bradford South (Judith Cummins) for joining that group. It is great to have the hon. Member for Falkirk (John Mc Nally) here, who obviously takes a keen interest in these matters.

[Carolyn Harris]

I apologise, Mr Owen; I tried to get here earlier. May I first congratulate the Department on today’s announcement? Our all-party parliamentary group’s inquiry is the first to assess the current regulation of non-surgical cosmetic procedures and its adequacy in ensuring customer safety. I offer the Minister the opportunity to come and to talk to us and hear the inquiry’s findings.

[Jackie Doyle-Price]

I accept that invitation most gratefully, and I look forward to hearing the conclusions. The time is right for us to take action on this, and I am grateful for the support of Members from across the House in wanting to do that and to do the right thing, with the intention of protecting consumers, which is obviously central to us, but also ensuring a system of regulation that is proportionate for the industry. We need to make sure that we balance both of those.

We have not really given the industry enough attention, given the speed with which it has grown. We increasingly see examples of consumers receiving poor treatment; my hon. Friend the Member for South Leicestershire referred to his constituent, to whom I am grateful for sharing her story. We need to make everyone much more aware of the risk because, as he says, people think it is just like having a haircut; it is becoming extremely normal to have what are poisons injected into the face. We need to make sure that everyone is aware of the risk before they undertake such a procedure, so that they can make an informed judgment.

Acquired Brain Injury

Carolyn Harris Excerpts

Thursday 9th May 2019 Commons Chamber

[Carolyn Harris (Swansea East) (Lab)]

First, I congratulate my dear friend the hon. Member for Rhondda (Chris Bryant) on securing today’s debate.

Every year, an estimated 350,000 people are admitted to hospital in the UK as a direct result of an acquired brain injury; to put that figure into perspective, that is one person every 90 seconds. Whether that is due to illness, accident or some other form of trauma, the severity of that injury and consequently the rehabilitation they require varies considerably. For those with severe brain injuries, the long-term issues can be vast, affecting their personality, relationships and behaviour. It is quite obvious that early diagnosis and better access to timely and effective rehabilitation will greatly improve a patient’s chance of eventually regaining their independence, but it is essential that we also look at the wider long-term complications of acquired brain injury and particularly at the associated problems that patients face.

At a recent session of the all-party parliamentary group for gambling-related harm, I met George. Back in 2009, George was a typical 23-year-old young man with a bright future. He had a decent job, a supportive family and a strong network of friends. It was on a night out with those friends that his life changed forever. In an unprovoked attack outside the nightclub where he had been spending the evening, George was punched with such force that he suffered lasting trauma to the left side of his brain. After spending several weeks in a coma and months in hospital, George was left with significant psychological, emotional, cognitive, behavioural and physical impairments.

As a result of the severity of his injuries and the complexity of his ongoing disabilities, George was eventually awarded significant compensation, but this only led him to further problems. A friend introduced George to online gambling, something he had no previous interest in, but he now had the time and the money. George very quickly became addicted, making frequent and significant deposits with a wide variety of online gambling platforms. The result is that George has lost all his compensation, as well as money obtained by taking out additional loans and credit cards. At one point, he gambled and lost—this is breathtaking—£67,000 in just 40 minutes. He is now at least £15,000 in debt and, with no income, has no hope of meeting these liabilities.

George is not alone. Research has identified that brain injury survivors are 27% more likely to develop problem gambling or addiction than the general population, and that risk is found particularly among people with frontal lobe damage. Headway, the brain injury association, which celebrates its 40th anniversary this year, is doing a fantastic job supporting people like George, but it has highlighted that much more needs to be done within the gambling industry to protect these vulnerable individuals.

Survivors of a brain injury are prone to impulsive behaviour, lacking in reasoning skills and often socially isolated. Add to this in some cases the fact that they are suddenly in possession of a large sum of money that they are not necessarily capable of controlling independently, and it is not difficult to see how quickly and easily addiction can develop. The gambling industry needs to offer more and to work alongside brain injury specialists to provide support for individuals. The Gambling Commission has said it will be strengthening the requirements of licences to better identify customers and make self-exclusion schemes more effective, but this is not enough on its own.

Brain injury survivors such as George have already suffered so much, with their bright futures indefinitely stolen from them because of the trauma or illness they have experienced. They continue to suffer daily from the lasting effects of their injury as well as the associated anxiety and emotional difficulties. From an early stage in George’s addiction, the gambling platforms were made aware of his vulnerability, but despite this knowledge they continued to allow him to gamble on their sites, robbing him of his much needed compensation, which was intended to give him a stress-free existence after his injury. Brain injury survivors are vulnerable, and at the moment the gambling industry appears to be exploiting that vulnerability.

It is not just about gambling. The consequences of brain injury affect so many people in so many ways, and we have to start looking more closely at this issue. We need better diagnosis, better care, and rehabilitation support, and I am very pleased to be a vice-chair of the APPG on acquired brain injury that my hon. Friend the Member for Rhondda has established and chairs with such great passion, and I congratulate him.

Children with Life-limiting Conditions

Carolyn Harris Excerpts

Tuesday 29th January 2019 Westminster Hall

[Carolyn Harris (Swansea East) (Lab)]

It is a pleasure to serve under your chairmanship, Ms Dorries. I congratulate the hon. Member for Strangford (Jim Shannon) on securing this important debate and on his speech. We have campaigned together on many issues and I am happy to participate in his debate today.

Many hon. Members will be aware of my campaigning work to support families who have lost a child. I am very proud to have brought about the introduction of the children’s funeral fund to support grieving parents with the costs of their child’s funeral. My campaign came after my own experience of losing my son Martin and having to take out a loan to cover his funeral.

I lost Martin very suddenly in a car accident. From the perspective of a parent, I have no idea whether it is worse to lose your child suddenly, like blowing out a candle, or to watch them pass away slowly from a life-threatening or life-limiting condition; all I know is that, whatever happens, it is the end of the world. It feels as if it is a bank holiday and the world is still going on around you—you cannot comprehend why people are still putting the kettle on, taking the milk in and having the post delivered. It is such a painful experience: nothing can prepare you for it, and realistically it is not something that you will ever recover from. Nothing will ever be the same again. You think that you will never worry again about anything like how much the telephone or electricity bill is, because nothing will ever matter again, but in reality it is more painful: you worry more and you keep waiting for that moment when something really bad will happen again. I think that stays with you for the rest of your life.

Tragically, the parents of 5,000 babies, children and young people have to face that dreadful pain every year. It is a pain that nobody can help them with, but one thing that we can do for those families at such a difficult time is try to lessen or ease their financial worries. There are very many additional costs when you lose a child, apart from the funeral. At the time, it seems as if all the other things do not really matter, but they do. Someone whose child has a life-threatening illness has to think about parking at the hospital, childcare for their other children, making sure they have clean pyjamas, pants and vests, and maybe having to give up work to look after them.

When a child passes away as a result of a long-term disability, the family may well have been receiving a benefit because of the child’s health, such as carer’s allowance, disability living allowance or child benefit. As well as the personal loss, they will face a huge and immediate financial loss. I will never, ever forget losing Martin on a Monday—I had cashed his family allowance that morning—and getting a letter the following week asking me to repay it because I had sent in the death certificate to say that Martin was not with me anymore. As a parent, you cannot imagine how painful it is even to get that letter, let alone to try to find the money to pay back. It may be small, but for a parent it is the end of the world.

That is not the only financial hardship that parents face when they lose a child; as I said, there is also the cost of the funeral. Royal London has found that the average cost of a funeral in 2018 was £3,757. For someone who is not anticipating losing a child, or who is on a low income, that is an insurmountable amount. Some people have actually asked me why I did not have insurance. Why would you insure a child? Why would you consider insuring against a child’s passing?

As hon. Members may be aware, health in Wales is a devolved matter. I am very proud that the Welsh Government led by example and introduced a children’s funeral fund in 2017. I will say only that I had a letter from the Prime Minister on Easter Sunday last year, yet we still do not have a children’s fund throughout the United Kingdom. Scotland has introduced it and, in the absence of Stormont, Northern Ireland has done it on a local level, so it is only parents in England who are not getting support with their child’s funeral. The Welsh Government, who were the first to introduce such a fund, have announced an additional £1 million investment to support the work of the end-of-life care implementation board. That funding will go towards a variety of areas, including training for staff on having difficult end-of-life care conversations with parents.

I give personal thanks for the work of the wonderful charities Tŷ Hafan, Hope House and Tŷ Gobaith, which provide care to children and families in my constituency and across Wales. After I lost Martin, I spent a lot of time trying to do what I could to help other families. I provided pastoral care for mentally and physically handicapped children, and I went to work for a children’s cancer charity. I felt like my personal experience would help those parents. Today I still talk to parents who have lost a child and try to reason with them by saying, “The thoughts that you are thinking, the worries that you are having, the fears and the fright that you will experience day in, day out for the rest of your life—they’re real but they’re not abnormal, and you need to share.” As a country, we should support these people financially and give them that little bit of comfort, so that it is only the emotion—something nobody can ever help you with. I urge the Minister to do whatever she can to ensure that families in such a position never have to worry about the incidentals of life and can grieve with dignity and peace of mind.