Access to Migraine Treatment

David Mundell Excerpts

Wednesday 20th March 2024 Westminster Hall

[Dehenna Davison]

I agree with the hon. Member. In severe cases, migraine is absolutely a disability. It ruins lives. There is a separate discussion to have with the Department for Work and Pensions—I do not want to put all the pressure on the Department of Health and Social Care—about how it addresses chronic migraine and intractable migraine when making its assessments. I thank the hon. Member for raising that really important point, which came through from a number of our survey respondents as well.

Some workplaces make adjustments, such as allowing flexible working, but there are also reports of workplaces not making suitable adjustments. One respondent said:

“There is a complete lack of understanding that chronic migraine is a disability and employers are not willing to make allowances for this condition in the way they do with other disabilities.”

Shockingly, the Migraine Trust found that 56% of migraine patients said that their workplace had not made reasonable adjustments. That is why the organisation has launched its workplace pledge this week to encourage employers to make small, often low-cost adjustments that can make a huge difference for staff with migraine. We must remember that with one in seven people living with migraine, there is a good chance that even if someone does not, at least one of their colleagues probably does.

The impact of migraine on the workplace is not just confined to individuals dealing with the stress of potentially losing a job and income; there is a wider impact on the economy too. The Work Foundation has found that migraine causes between 28 million and 43 million lost work days per year in the UK, at a cost of around £4.4 billion. When we add the cost of that absenteeism to the cost of presenteeism—showing up and putting on a brave face but not being able to function normally —the Migraine Trust estimates that the total cost is closer to £9 billion.

We often talk about the need to improve productivity here in the UK, so surely helping those living with migraine access quicker and better treatment so they are able to work and fire on all cylinders would be a great step forward. That is especially so when coupled with the fact that, according to the Journal of Health Economics and Outcomes Research, the excess fiscal costs to the Government of one person living with migraine come to £19,823. That is the cost for one person, when there are 10 million in the UK battling the illness.

Giving up work for health reasons is not a choice that anyone makes lightly. For many, as well as the financial cost, there can be a significant cost to people’s mental health. Research by the Migraine Trust found that 78% of those living with migraine said it had a negative impact on their mental health and 65% reported experiencing anxiety as a result. People are missing work, cancelling arrangements with friends, missing out on social experiences that they have been looking forward to—and paid for—and feeling like they are a burden on their family. Others may not believe them, and they may wait months if not years to see a specialist; or they have the hope of trying another preventive that might work, only to have that shatter when it is another one that does not do so, and all the while they are living with excruciating pain. They are losing friends, losing relationships and feeling like they are losing their mind.

For some people such as Mollie, the darkness takes over entirely. She said that

“deep inside, I still had that same passion for life that all people in their twenties do. I want nothing more than to go outside and live my life, but this condition has me trapped in my own living room. My pain is now so severe, it has impacted on my mental health so intensely I contemplate suicide every single day of my life and have almost succeeded at times simply because I want the physical pain to end”.

We are here today to help people such as Mollie. We have a responsibility to help them and the millions of others suffering through migraine who need a lifeline. By improving access to treatments we can give them that lifeline. I hope the Minister will agree to meet me and the two brilliant charities represented here today to discuss further how we can do just that together.

[David Mundell (in the Chair)]

I ask hon. Members who wish to be called to bob.

Sexual Harassment of Surgeons and Other Medical Professionals

David Mundell Excerpts

Wednesday 13th December 2023 Westminster Hall

[David Mundell (in the Chair)]

I will call Rosie Duffield to move the motion. I will then call the Minister to respond. There will be no opportunity for the Member in charge to wind up, as is the convention for 30-minute debates.

[Rosie Duffield (Canterbury) (Lab)]

I beg to move,

That this House has considered the matter of sexual harassment of surgeons and other medical professionals.

It is a pleasure to serve under your chairship, Mr Mundell. I am grateful for the opportunity to raise the issue of sexual assault against surgeons, nurses, doctors and other healthcare professionals and patients in clinical settings. In April, I used my Prime Minister’s question to mention the report commissioned by the Women’s Rights Network and written by my friend, the sociologist and criminologist Professor Jo Phoenix, entitled “When we are at our most vulnerable”. The report revealed some truly shocking statistics about violent sexual assault, and everyday inappropriate and unwanted acts intruding into the work lives of professionals and disrupting the recovery of the most vulnerable and ill. How dare we call ourselves a civilised society if we turn a blind eye to this and do not do everything possible to support those women, and some men, who are brave enough to come forward, as well as those who do not feel that they can and suffer in silence?

Professor Phoenix found that more than 6,500 rapes and sexual assaults had been committed in hospitals in England and Wales over a period of nearly four years. Some were against children under 13, yet in a mere 265 cases—a minute 4.1%—was anyone known to have been charged. In total, 2,088 rapes and 4,451 sexual assaults—6,539 cases—were recorded by police forces from January 2019, and one in seven of those, or 266 a year, took place on hospital wards. As the researchers at the Women’s Rights Network sent freedom of information requests to 43 police forces across the UK and 35 responded, the figures are, in truth, even higher and even more shocking.

HIV Action Plan Annual Update 2022-23

David Mundell Excerpts

Tuesday 18th July 2023 Westminster Hall

[David Mundell (Dumfriesshire, Clydesdale and Tweeddale) (Con)]

It really is a great pleasure to serve under your chairmanship, Dame Caroline. I am grateful to my hon. Friend the Member for West Bromwich East (Nicola Richards) for securing this timely debate and for her thoughtful contribution, which laid out the principal issues. I am also grateful to my right hon. Friend the Member for Romsey and Southampton North (Caroline Nokes) for making sure that the full gamut of issues was covered, because sometimes it is possible for the perception to be that this is just an issue about gay men, and it is not. The hon. Member for Vauxhall (Florence Eshalomi), who, along with me and others, is a co-chair of the all-party parliamentary group on HIV and AIDS, made it absolutely clear that this is a wider issue than for just that one group.

As the HIV action plan has put in print, we have already reached the UN’s 95-95-95 target and are hopefully within touching distance of ending new transmissions by 2030. If that can be achieved, we should be clear that it is a milestone, equivalent to the eradication of polio in past years. I believe it is also a tangible example of British leadership in health and a testament to consistent and concerted efforts, which have produced incremental gains, giant leaps and, ultimately, a pathway that others have followed. As we have heard, however, we are not there yet.

The HIV action plan makes it clear that the goal will not be reached without PrEP. We know that PrEP works, with new transmissions of HIV dropping by over a third from 2019, but a recent survey by Prepster, the National AIDS Trust, the Terrence Higgins Trust, Sophia Forum and One Voice Network found that many people end up being diagnosed with HIV while waiting for PrEP. We need to close the gap between awareness of risk, accessing services and receiving PrEP, and I absolutely agree with the hon. Member for Brighton, Kemptown (Lloyd Russell-Moyle) about the availability of PrEP. I could sit down after this speech, go on my phone and order PrEP to be delivered to me from India in the next few days, but I could not go to a pharmacy in the centre of London or, indeed, in my own constituency to receive that. Not only is that discriminatory, in the sense that people who can afford to buy it or access online services have an advantage; as the hon. Member suggested, it is putting the risk ahead of the reality that people are already accessing it. It is far better to get it from a pharmacy than from an Indian or other overseas supplier.

Our targets on new transmissions will not be reached if we have not identified those who are living with HIV, and we have heard Members speak about that. Many of these issues are devolved in relation to Scotland, but one thing that I would like to see there is a properly funded national testing week. To maximise its impact, it should work in tandem with that which already takes place in England, because having a UK-wide event—with a focus on national television, in the national media and on social media—is a much better way to draw attention to the issue. We have heard from my right hon. Friend the Member for Romsey and Southampton North; like her, I can confirm that even someone like me can use a test kit. I am grateful—this will interest the hon. Member for Vauxhall—that the funding is at least better now in Vauxhall, because people used to have to phone up at 3 am to get the kit. If someone tried to phone at about 9 am, all the kits for that day had been distributed, but now people seem to be able to get them 24 hours a day. Virtually anyone can use such a kit effectively.

As the action plan identifies, reaching those who do not know that they are living with HIV will mean targeting hard-to-reach parts of our society, and those who either do not see themselves at risk or ignore the risk because of stigma. Opt-out testing has proven to be a success in that regard, and it is also cost-effective. When I was in South Africa, I had the opportunity to hear directly from medical professionals that opt-out testing, where it applies, has had a remarkable effect on the identification of cases in women. There are issues with support and treatment, but in terms of identification of cases, South Africa demonstrates that opt-out testing has a proven record. We should not prevaricate before rolling out opt-out testing beyond the areas already identified. Agencies and charities are champing at the bit to partner the Government to do just that.

The position of no new transmissions is almost tangible, but, as with the progress we have already made, it will not come without consistent and concerted action. Like the hon. Member for Vauxhall, I commend the all-party parliamentary group on HIV and AIDS, and the Members across both Houses who are part of it, for the continued commitment to action. As the hon. Lady did, I vouch that the group will continue to work with any charity, trust, health board or Government to get our country to the position of no new transitions and to highlight the issue globally.

Medicinal Cannabis: Economic Contribution

David Mundell Excerpts

Thursday 20th April 2023 Westminster Hall

[David Mundell (Dumfriesshire, Clydesdale and Tweeddale) (Con)]

I beg to move,

That this House has considered the economic contribution of medicinal cannabis.

It is a pleasure to serve under your chairmanship, Mr Stringer. I thank the Backbench Business Committee for allocating this debate. This slot on a Thursday afternoon is a challenge for many Members to attend because they have constituency commitments on a Thursday afternoon, but I am confident that we will have a good-quality debate and, importantly, that the issues I want to raise will be put on the record.

I am conscious that a number of these issues relate to the Department for Business and Trade and that my hon. Friend the Minister will obviously respond in his capacity as a Minister in the Department of Health and Social Care. I hope that if any issues are not within my hon. Friend’s remit and he does not feel able to respond, he will undertake to take them forward with ministerial colleagues.

Many Members will have been introduced to the issue of medical cannabis by constituents getting in contact to tell them, as their MP, about the real difference that this form of cannabis has made or could make to their own or their families’ lives. Such testimonies, along with scientific study after scientific study, led to my right hon. Friend the Member for Bromsgrove (Sajid Javid), when he was Home Secretary, legalising medical cannabis in 2018, and thereby ending the potential criminalisation of those living with or just trying to manage multiple sclerosis, cancer or epilepsy. That was a significant step forward for patients.

Some 17,000 UK patients are estimated to have been prescribed Sativex, nabilone and Epidyolex in the UK last year. I am sure that many Members of Parliament could tell a story from their constituents about what a difference such prescriptions have made to the quality of users’ lives by easing agonising muscle stiffness, by reducing chemotherapy-induced sickness, or as a therapy for seizures, especially for children.

The 2018 legal changes were also a significant step for the medical cannabis industry in the UK. We should be clear that medical cannabis is just that. This is a legitimate industry, and an industry of the future. Its products do not come from humid, tinfoil-draped sheds or sunlamp-lit lofts; they come from laboratories and facilities that are as controlled an environment as those that synthesise a vaccine, for example. I know that to be the case, having seen at first hand such facilities being developed in my own constituency. The medical cannabis industry is one of legal and professional standards, rigorous regulators, approvals, licensing, inspections and almost endless specialist equipment—be it quantum sensors, microscopes or leaf barometers—not to mention stringent safety and security protocols.

Of note is not just the standards to which the cannabis is produced but the volumes produced. In the UK in 2021, some 59 hectares were harvested, producing 329 tonnes of cannabis for medical and scientific purposes. Of that, 213 tonnes were exported—more than half the reported world total. Beneath those impressive headline figures, though, is the impact that the industry can have on local economies and local communities. That is why I have been and remain very supportive of the development of a facility in my constituency by Hilltop Leaf.

Too often, investment in new industries is funnelled into enormous singular developments captured by large corporate interests, or it goes straight into cities. Rural and agricultural communities such as those I represent often get overlooked, with seemingly only wind farms and tourism receiving investment. The medical cannabis industry is an antidote to that.

In many ways, I feel the growing of medical herbs is a form of farm diversification—an evolution of horticulture that builds on local strengths and skills. I hope that the investment by Hilltop Leaf, with one of the largest greenhouses in the UK, will demonstrate that medical cannabis can have a transformational impact on local communities. It will bring a variety of good horticultural, administrative, managerial and logistical jobs that I hope will anchor young people, who often feel the gravitational pull of large cities for the want of opportunities in a rural area such as the one I represent, which has seen the demise of traditional industries such as textiles. It could also meet nearly 10% of the UK’s 2019 domestic need.

For all the successes of the UK cannabis sector to date, it could be so much more. Bureaucratic, legal, administrative, regulatory, medical, licensing and planning issues all inhibit the industry’s potential and hinder vital investment in rural Britain. Indeed, the over-onerous process for being licensed in the first instance has given me cause to worry about the development in my constituency stalling. I am afraid the UK’s approach to the industry is incoherent and insufficiently consistent.

Yes, medical cannabis can be prescribed, but only by specialists, and that is predominantly being done outside the NHS, particularly in Scotland. Although I said earlier that in 2021 some 17,000 people received legal prescriptions for medical cannabis, it is conservatively estimated that next year there will be approximately 337,000 potential patients. That could be many times larger should new conditions be covered. This state of legality but inaccessibility is grossly unfair, and is contrary to the principles of our health service that those who can pay can get private prescriptions—or source their requirements from drug dealers—while those who cannot pay go without. All the while, there are almost 24 million prescriptions for opioids in the UK. Those figures, in differential terms, are staggering.

The potential savings for the NHS in the prescribing of medical cannabis have been detailed, with one US study showing a potential provider saving of 29% because of reductions in opioid dosage. As I said, by confirming the efficiency of medical cannabis in helping with certain conditions while stopping it being readily available, we are pointing those who are desperate to illegal markets. Do we really think that patient safety is best served by criminal suppliers, who provide a product of poor quality that is likely to contain contaminants because of the fashion in which it was grown? I certainly do not. Do we need to see the benefits for British growers, supply chains, jobs and tax revenues bypassed and go instead to criminals and smugglers, both here and overseas? Clearly not, especially when the medical cannabis sector has a potential value to the UK economy of more than £1 billion.

Our incoherence also extends to cannabidiol, or CBD. We allow its purchase—indeed, the UK’s CBD market is the second largest globally and was worth £300 million in 2019—but our hemp licensing measures mean that the flowers and leaves, where CBD is found, must be destroyed. As such, the CBD market fulfils its needs through overseas imports, and British supply chains do not benefit. Growers are necessarily forsaking the opportunity to yield a crop of £10,000 per acre, compared with £400 for wheat, because of this approach. Such yields would be a real boon for rural Britain.

If the UK’s regulatory, legal and medical frameworks were in line with those elsewhere, it is estimated that up to 100,000 jobs of the future could be created, and they would be good-quality jobs, as I have already set out. It is an opportunity that should be within our grasp, but unfortunately we currently do not seem able to take it forward. On 14 November last year, I was disappointed when a fellow Member asked the Business Department about its willingness to take forward the approach to the medical cannabis industry as part of its medical sciences strategy and commitment for the UK to be a world leader in such fields; unfortunately, the then Minister gave what I regarded as a lukewarm and non-committal answer.

As I am sure the Minister and all present will agree, nascent industries need nurturing, and the medical cannabis sector is no different. Much like the plants that the sector grows, the industry is seeking the conditions to grow. I hope the Government will be minded to support the sector and the economic benefits it could bring, particularly to rural Britain. This should not be considered an ask for wholesale legalisation, which is a completely different debate; it is an ask for consistency and coherence for the industry, and for access to medical cannabis for NHS patients.

We need the various strands in Government to be stitched together to provide support, rather than maintaining a strange patchwork of overlapping and clashing components. The UK Government and, where appropriate, the devolved Administrations should therefore accept the need to review the prescribing process, medical guidelines, acceptable tetrahydrocannabinol levels, and the overlapping legal and regulatory components. My specific ask of the UK Government is that they appoint a senior official to do so holistically, and that individual should be mandated to engage directly with the industry.

With coherent and consistent oversight, and by bringing the UK into line internationally, the medical cannabis sector could help to get rural Britain, and particularly constituencies such as mine, growing economically. In doing so, we could supply our domestic market with homegrown supplies and, even more importantly, relieve the pain and suffering of hundreds of thousands of our constituents, if they could access the prescriptions they need.

--- Later in debate ---

[David Mundell]

I feel that we have had a very useful debate. Like you, Mr Stringer, I chair these sittings and it is extremely good to get half an hour from a Minister rather than five minutes. Although it was not necessarily comfortable for him, we were able to cover a lot of ground. Whether deliberately or otherwise, he came back to one of the issues that I raised, which was the need for co-ordination in Government on this issue. The hon. Member for Inverclyde (Ronnie Cowan) read out the list of Government Departments with an interest in this matter, and I am sure there are others that were missed, such as the Cabinet Office and the former bailiwick of my right hon. and learned Friend the Member for Kenilworth and Southam (Sir Jeremy Wright), the Law Officers. There is a need for co-ordination. I do not think the Minister was saying this, but we cannot push back to the industry and say, “Well, actually, it’s your job to co-ordinate all these different bits in Government.” The industry needs to have a clear “in” or conduit to Government to discuss and engage on these issues.

I fully understand, having been a Minister myself, that it is not possible to commit the Home Office—of all Departments, it is certainly not possible to commit the Home Office. We know how government operates, but we need to have a co-ordinated approach with which the industry can engage. Of course the Minister is right that this should not be economically driven in terms of the clinical decisions, but we have already made the decision, as my right hon. and learned Friend said. We are not debating whether this should be done; that decision has been made, and now we want to do it on a basis that benefits not only the patients, but the economy of the United Kingdom.

It is always poignant to hear individual examples. In any debate in which he participates, the hon. Member for Strangford (Jim Shannon) is particularly good at bringing the discussion down to the personal level of individual examples, and I thank him for doing that today, as I do my right hon. and learned Friend the Member for Kenilworth and Southam. I have had the pleasure of meeting Alfie’s mother in my constituency. She is a very powerful advocate, but I do not believe, or think that anybody who has taken part in this debate believes, that the pain and suffering of anybody should be the requirement for us to do the right thing.

I was remiss in my opening remarks in not referencing the APPG, because I have engaged with it and particularly the hon. Members for Gower (Tonia Antoniazzi) and for Edinburgh West (Christine Jardine), who are also strong advocates on these matters.

Although I did not agree with everything that the hon. Member for Inverclyde said, which is often the case, what I did admire particularly was his passion for this subject, which came across clearly. It is shared by many hon. Members across the House.

I welcome the opportunity that we have had to air the issues, and the Minister’s full and well intentioned response, but we need to see action. I reiterate that the principal ask is for co-ordination within Government to take this forward. We are not requiring those in the industry and those lobbying for patient interests to manage the process across a wide range of Departments. That is one doable ask that could flow from today’s debate, and I hope that it will.

Question put and agreed to.

Resolved,

That this House has considered the economic contribution of medicinal cannabis.

Performance-enhancing Drugs and Body Image

David Mundell Excerpts

Tuesday 21st February 2023 Westminster Hall

[Dr Luke Evans (Bosworth) (Con)]

I beg to move,

That this House has considered the matter of steroid and image and performance enhancing drug use.

It is a pleasure to serve under your chairmanship, Ms Fovargue.

We need to talk about steroids in the UK. I am talking about not just any steroids but anabolic steroids and image and performance-enhancing drugs—or IPEDs. There are an estimated 500,000 to 1 million users in the UK, but no one is talking about it. The closest we get is the “natty or not?” discussions on social media about naturally built men and women versus people who are enhanced. There is particular discussion about Hollywood actors.

[David Mundell in the Chair]

I will not cast any aspersions about who does or does not use steroids and performance-enhancing drugs, but it is fair to say that the debate is becoming bigger and louder, not only in this country but in America and throughout the western world. The Priory Group did some research about 10 years ago and estimated that around 50,000 people were using steroids; its estimate now is that 500,000 people are using them. It says that

“we are sleepwalking into a health crisis”.

I know from my time as a GP that when it comes to—[Interruption.]

[David Mundell (in the Chair)]

Order.

--- Later in debate ---

On resuming—

[David Mundell (in the Chair)]

The debate can continue to 5.38 pm.

[Dr Evans]

It is a pleasure to serve under your chairmanship, Mr Mundell.

Until we were rudely interrupted by that vote, I was saying that we need to talk about steroids in the UK because, as the Priory Group has said:

“we are sleepwalking into a…crisis.”

As a GP, I know that the obesity epidemic has been a real problem, but part of the nation is actually getting fitter while part of it is getting fatter. I will concentrate on the part that is getting fitter, because of those who go the gym—mainly men—we know that one in 10 suffer from bigorexia. What am I talking about? Bigorexia is body dysmorphia—the idea that someone’s muscles are not big enough, no matter how much they eat or train. It is important to understand that this is a growing epidemic in our country; even more importantly, it is quite prolific in the gay community. I will break the issue down into three sections. I will talk a little bit about how I came to this topic, the drivers behind it, and, most importantly, what needs to be done.

Growing up, I was a fairly normal kid. At the age of 14 or 15, I was playing sport and was reasonably academic, but I was an outlier, because for my 15th birthday I had saved up £500 to buy a multigym. In my head, I wanted to improve my rugby, get girls, fight off bullies and improve my body image. Surprisingly, I was the under-16s first-team captain, but the other three aims fell to one side. Looking back, I think, “How many other young men feel like this?” That was 25 years ago. I think the points I mentioned are the driving forces behind why men want to go to the gym and improve their body image. Society says to them, “We need to be perfect”, but what is that perfect image?

--- Later in debate ---

[Sarah Jones (Croydon Central) (Lab)]

It is a pleasure to serve under your chairmanship, Mr Mundell. I congratulate the hon. Member for Bosworth (Dr Evans) on securing this debate. It is an important topic and he is doing some excellent campaigning. His description of bigorexia, the impact of social media and all the pressures on young men to get the perfect body image was powerful. It is true that we have been talking about these issues when it comes to women for a long time, but we have not been talking about men. I have twin boys who are 12 years old, and they tell me repeatedly that they want a six pack. They do not have one and they will not have one any time soon, but they are already thinking in that way.

The hon. Member for Bosworth mentioned Andrew Tate as a particularly powerful online influencer; they are putting great pressure on our young boys. I took a group of scouts around Parliament last week, and they were all telling me how poor Andrew Tate had been badly done by and locked up in prison for no reason. The hon. Member made the point that sometimes some of these men talk sense and sound like they are all about empowering men, but on the other hand they are being incredibly misogynistic and spreading awful mistruths. That is very true; I see it time and again.

This is an important conversation to have, and there is a wider conversation about the role that we can all play in developing what it means to be a man. I have done lots of debates about knife crime, and we talk endlessly about boys who feel they have to carry knives and be macho in order to be a man. There are boys now who go to the gym and are tempted to take steroids because they feel that is what it is to be a man. There is the growth of the horrific incel movement, with men who define themselves as not being attractive and not able to attract women. The Government need to think about all those important things in the round. It is a wider issue than this debate today.

We have covered a lot of the issues that the Government need to think about. The first thing is the law. As has been said, steroids are a class C drug, so they are illegal to own and sell. Possession is punishable by up to two years in prison or a fine, and people can get 14 years in prison for supply. Other drugs are illegal to ship or sell, but not to buy or possess. An example is the tanning drug melanotan, which I had not heard of until this debate, but it sounds like a strange thing to want to do. As with all classified substances, the Government are responsible for clamping down on the sale and use of those drugs. Although the Opposition said that the 10-year drugs plan did not go far enough, it did contain a lot of good policies. However, the fact that it did not include any of those steroids is amiss, and perhaps the Government should look at that again.

We have already talked about the physical side effects, which go way beyond what people read about when they decide that they want to get steroids. There are the potentially lethal impacts of strokes or heart attacks, as well as erectile dysfunction, sterility and loss of hair. We clearly need more information on all those things to tell people what they are likely to face if they take steroids. The other aspect is mental health. We know that use of these drugs is very high. It seems there is a debate online about the number being between 500,000 and 1 million. Perhaps 1 million is not quite right, but a large number of people in the UK use steroids; the hon. Member for Bosworth referred to the figures from UK Anti-Doping.

In a 2016 survey, 56% of steroid users said they were motivated by improving their body image, so getting stronger and fitter is not the driver here—it is body image. We all know the pressures to look good and conform to shockingly rigid beauty standards that are presented by the media. “Love Island” is back on television, as the hon. Member for Bosworth said, and there is really powerful pressure that very few of us are able to ignore. I certainly worry about my weight all the time, and why would men not do the same? We do not talk about that as much as we should.

Fads come and go, and new things will come on the market as soon as we tackle some of the older things. Recently I saw reports of a new procedure called buccal fat removal, which takes the fat out of one’s cheek. It is quite extraordinary, but apparently suddenly very popular. Surgeries and techniques and fitness tips change almost daily, but their impact on our mental health, especially that of young people, is relenting.

A study in 2021 found that 54% of men displayed signs of body dysmorphia and said that low body confidence had negative effects on aspects of their lives, while 49% of women admitted to often thinking about being lean and maintaining an extreme exercise programme and feeling anxiety at missing a workout. Over 80% of those aged 18 to 24 showed at least one sign of body dysmorphia. We have heard many more stats. The hon. Member for Cumbernauld, Kilsyth and Kirkintilloch East (Stuart C. McDonald) talked about lots of the recommendations. The Women and Equalities Committee has heard that over 60% of women feel negatively about their bodies, but the equivalent figure for men does not come to the fore in the way that it should.

It is important to say that there is help out there for people who need it. The eating disorder charity Beat and the Campaign Against Living Miserably offer support to those affected by eating disorders, body dysmorphia and drugs. Help is out there for everyone, including men. Whatever toxic male influencers may say, there is no shame in seeking help for performance-enhancing drug use and body image issues. It is a sign of bravery and strength, not weakness. We should be clear that alongside proper enforcement of the law to tackle the crime, we should also tackle the causes of the crime. The next Labour Government will guarantee mental health treatment within a month for all who need it. That is a wider issue that the Government need to address.

The hon. Member for Bosworth very eloquently asked questions to the Minister. I know he is a Health Minister, so it is hard for him to talk about Home Office issues, but hopefully he can pass on the comments from this debate to his Home Office colleagues. There is a question about what is being done to stop the sale of these steroids. I was able to find a vast number of websites just by looking on Google. The websites ukroids247.com and hench-club.com will sell someone steroids. There is also onlinesteroidsuk.org. There were absolutely loads of them.

Although selling steroids is illegal and the Government say they are acting to stop such websites, there is little evidence that anything much is being done, so I ask the Minister: what will the Home Office do to tackle the sale of controlled IPEDs online? Will he look again at the 10-year drug strategy and perhaps expand it into this space? Will the Government commission a national review on steroid use, as has been mentioned, which the Health and Social Care Committee recommended?

The reasons that people use steroids and other image and performance-enhancing drugs are complex, but the drugs are illegal and cause serious harm to physical and mental health. This is an issue of public health as much as one of crime. It is clear from today that the Government must go further. We all need to catch up on the changing nature of the drugs that are available for people to buy. We need to move at the same speed as social media and do what we can to ease the pressure on young men in particular to build their body image by using these kinds of drugs. I am looking forward to hearing what the Minister has to say.

[David Mundell (in the Chair)]

I remind the Minister that he can go to 5.38 pm, while obviously leaving some time for Dr Evans to wind up.

Motor Neurone Disease Research: Government Funding

David Mundell Excerpts

Tuesday 13th December 2022 Westminster Hall

[David Mundell (in the Chair)]

I will call Karl Turner to move the motion, and then call the Minister to respond to what is a timely debate following the sad death of Doddie Weir, who through his My Name’5 Doddie foundation was such a great campaigner on the issue. There will be no opportunity for the Member in charge to make a winding-up speech, as is the convention for 30-minute debates.

[Karl Turner (Kingston upon Hull East) (Lab)]

I beg to move,

That this House has considered Government funding for research into motor neurone disease.

It is an absolute pleasure to serve under your chairship, Mr Mundell. MND is a devastating, debilitating and untimely life-limiting disease. We saw that just two weeks ago with the tragic loss of Doddie Weir, to which you have referred. Doddie was a giant of a man, both on and off the field, but the MND Association estimates that in the UK six people a day die of MND. A third of them die within 12 months of diagnosis, but it is now more than a year since the Government pledged—in response to the tireless efforts of campaigners and following meetings between me and the then Business Secretary, the right hon. Member for Spelthorne (Kwasi Kwarteng)—to invest £50 million. We met the Secretary of State that day with campaigners, and he gave an assurance to us all that immediate action, meaning immediate money, would be forthcoming. It was not.

Motor Neurone Disease

David Mundell Excerpts

Thursday 20th October 2022 Commons Chamber

[David Mundell (Dumfriesshire, Clydesdale and Tweeddale) (Con)]

The issues and concerns about MND were brought back to me in the past few weeks when Jim Hughes, a very prominent local businessman in the community where I live, in Moffat, in my constituency, was taken by the disease. Jim was a larger-than-life character and this just reaffirms that the disease can take anyone.

The disease first came to my attention during the referendum campaign. In the “Better Together” campaign, there was a young man called Gordon Aikman who had worked in the Scottish Parliament for the Labour party and was an important support to Alistair Darling during those activities. Gordon was just in his late 20s and his initial symptoms were very minor—he had a numbness in his fingers, for example. When he went to have some medical examination, he received this dreadful diagnosis. The hon. Member for Coatbridge, Chryston and Bellshill (Steven Bonnar) mentioned Doddie Weir, as I will, because the disease has often been dwarfed by the courage of those who, like Jimmy, Doddie and Gordon, have been driven to raise awareness of it. Gordon, before he died at only 31, raised half a million pounds, some of it through a dreadful thing—I think my hon. Friend the Member for Berwickshire, Roxburgh and Selkirk (John Lamont) will remember—called the ice bucket challenge. People had to appear, often on video, and have a bucket of ice poured over their head. Lord Darling having that done to him was a moment of amusement I will retain.

As well as campaigning, Gordon summoned the strength to give a stark message that, a number of years on, is worth repeating. He said:

“MND is a progressive, neurodegenerative condition that eats away at your body until you can no longer walk, talk, eat or breathe for yourself. There is no cure. Soon it will kill me…It’ll be too late for me, but we can and we must find a cure for the next generation. With your help I can turn a negative into a positive.”

From the experiences that Members have relayed in today’s debate, that is what we want to see the Government do, Minister. We want them to take the negative, and the experiences, passion and fervour of these individuals, and turn that into action.

It has been a huge pleasure for me on a number of occasions to meet Doddie Weir, a giant of a man both on and off the pitch. He has the courage and the ability—I am sure Jimmy Johnstone was the same—to reach out to people who do not necessarily take health seriously and connect. We have heard many discussions in the Chamber about how men, particularly middle-aged and older men, do not take their health seriously, but by working with rugby interests and in communities across the Borders and across Scotland, his My Name’5 Doddie Foundation has been a hugely positive force. For anyone who has not visited its website, let me say that it really is very worthwhile and demonstrates a host of ways in which people can help and become involved. Constituents of mine, such as Hilary Carmichael in Boreland, in Dumfriesshire, who had no personal connection to Doddie have been inspired to campaign locally—to run small events to raise funds. We see that happening across the piece, including to larger organisations such as Peebles rugby football club, which took part in August in the MND big pull weekend. Given all the money that has been raised by Gordon, Doddie and those people who have come to understand and be concerned about the disease, we want to see the Government matching that level of support.

Some of these issues are devolved in Scotland, and the Scottish Government have played a positive part. Indeed, the Euan MacDonald Centre for MND research in Edinburgh is making great strides. There is also research into terazosin, which may be able to slow the progression of MND, and, again, that is to be welcomed, along with the £50 million the Government have already committed and the £375 million for research into neuro- degenerative diseases in general.

However, as Members have indicated, they want to see a vigour and a focus in that research and they want to see the Government playing their part to ensure that we can move, hopefully, towards a cure and a fitting real legacy for people such as Doddie, Gordon, Jimmy Johnstone, and Jim Hughes who have effectively given their life for this disease.

Endometriosis and Polycystic Ovary Syndrome

David Mundell Excerpts

Monday 1st November 2021 Westminster Hall

[David Mundell (in the Chair)]

Before we begin, I encourage Members to wear masks when they are not speaking. This is in line with the current Government guidance and that of the House of Commons Commission. I remind Members that they are asked by the House to have a covid lateral flow test twice a week if coming on to the parliamentary estate. This can be done either at the testing centre in the House or at home. Please also give each other and members of staff space when seated and when entering and leaving the room.

I am sure that most Members will be aware that this debate was originally scheduled to take place on 18 October. It was delayed so that Members could pay tribute to our colleague and friend, Sir David Amess. His loss was felt acutely across the House, but it is a testament to him that his loss will have touched many well beyond these walls. I know it will have been particularly felt by many of those watching or with an interest in today’s debate, as Sir David was a champion of those living with endometriosis, having chaired the all-party parliamentary group on endometriosis since its inception in 2018. He was a crusader for the cause long before that, after a constituent contacted him about their struggles with the condition. His signature passion, charm and humour will be sorely missed from today’s debate, but I am confident that Members here will make contributions that do justice to a cause he cared so much about and, in so doing, pay tribute to him.

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[Taiwo Owatemi]

I thank the hon. Member for raising that important point, which absolutely highlights that need.

The Government urgently need to invest in research projects and create more streamlined diagnostic practice. That must start with better GP training, as hon. Members have highlighted, so that GPs no longer inadvertently gaslight or misdiagnose anyone with endometriosis or PCOS. It must extend to more accurate and less invasive screening technology to confirm the diagnosis. Once women are finally diagnosed, there is currently no targeted treatment for endometriosis—none at all. Similarly, there is no drug or treatment on the UK market that has evidence-based approval to treat PCOS. We need funding for this research, as well as facilities to carry it out.

There is only one dedicated PCOS clinic in the whole of the UK, and I am proud to say that the clinic is in my own city of Coventry. I visited the clinic recently and spoke with the head researcher, Professor Harpal Randeva, and their specialist nurse, Danielle Bate. They stressed the importance of treating PCOS as a disease in need of its own funding body. Currently, the limited funding for PCOS and endometriosis alike is attached to funding bundles for several other diseases, as is clear from the Government’s response to the petition. We should not be attaching research funding for these conditions as addendums to general funds for fertility diseases or other endocrine diseases. Endometriosis and PCOS impact millions of women in the UK. They are not afterthoughts, and we cannot continue to treat them as such in funding discourse. We should encourage funding charities to set up independent boards for PCOS and endometriosis.

Earlier this year, a Department of Health and Social Care consultation acknowledged the importance of improving research into women’s health. The strategy for that improvement is, according to the Government, now in development, and it would be great to hear from the Minister what progress is being made. I also ask the Minister whether the strategy will commit to establishing independent well-supported funding bodies for research into both endometriosis and PCOS, which are so desperately and deservingly needed.

I will end my remarks by thanking all the brave women suffering from endometriosis or PCOS who continue to fight for increased resources. Without their remarkable self-advocacy and will to advocate for each other, I am certain that we would not be here today. I hope the debate will provide an opportunity for the Government to listen and act.

[David Mundell (in the Chair)]

As a lot of Members want to speak, I ask Members to stick to about three and a half minutes so that everybody who wants to speak gets the opportunity to do so. I call Emma Hardy, and then Jackie Doyle-Price.

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[Jackie Doyle-Price (Thurrock) (Con)]

May I associate myself with your words, Mr Mundell, and with the words of the two previous speakers in regard to Sir David Amess, who was a great personal friend of mine? I was so happy to be able to work with him on this cause. He brought to it his characteristic passion and commitment, and frankly, he was good at keeping us all on the ball. We will miss his leadership, but we will endeavour to make sure that the points he campaigned for are delivered. As has been mentioned, he took up this issue when he was visited by his constituent, Carla Cressy. The cause is one of the main beneficiaries from the sales of his book, “Ayes & Ears”, which is available in all good bookshops; I encourage everyone to make their donation there.

As the hon. Member for Kingston upon Hull West and Hessle (Emma Hardy) has outlined, Sir David led an inquiry for the all-party group on endometriosis. As many as 11,000 members of the public got involved in it, and that is quite an achievement for an all-party group. It is a testament to the fact that he always used good publicity to draw attention to the issues that he really cared about.

For a condition that affects 10% of women, there has been staggeringly little focus on endometriosis. If something affected 10% of men, would we be having this kind of debate? I think not. We really owe it to all the women who suffer for years with the most debilitating and chronic pain and disability because of this condition. I am grateful to the hon. Member for Coventry North West (Taiwo Owatemi) for mentioning the obsessive focus on fertility, because the truth of the matter is that women who suffer from endometriosis start to suffer from it the moment they start their periods.

We could do so much if we had a greater understanding of what a healthy period is. We are all brought up to think, “This is your lot in life; it’s all quite normal.” We might be struggling with the most debilitating pain and thinking that everybody else is going through the same thing, when in fact they are not and we are suffering from very unhealthy periods. We need much more understanding not just in the medical profession, but among girls, so they can be more alive to problems and not wait eight years for a diagnosis. As the hon. Lady said, endometriosis is often diagnosed only when women are trying to get pregnant, by which time so much damage might have been done. If the condition had been diagnosed earlier, treatment could have been given to alleviate it.

We often talk about funding, and one of the biggest challenges in the NHS is not so much the quantum of funding but whether we spend it wisely. If we gave people tools to look after their conditions and enable them to know when they are suffering from ill health, we would reduce the amount that the NHS has to spend on the condition. It is a no-brainer. I am pleased to see the Minister in her place. She has had to listen to me bang on about these issues many times—I never miss an opportunity to beat Ministers over the head when it comes to women’s health—but I know she gets it.

We need to think properly about the wellbeing of women, and the impact that their biology and gynaecology have on wellbeing, and we must think beyond childbirth and pregnancy. Only last year Baroness Cumberlege produced her report “First Do No Harm”, one of the headline conclusions of which was that women are not heard. When women seek medical advice, they are belittled, diminished, shunted along and told, “This is all very normal.” That must stop, because women are important. Women will have healthy pregnancies if they get support earlier. We will all be better off, because we will have less work absence, a more productive economy and less demand on the NHS. It is a no-brainer. I ask the Minister for more research into endometriosis and more awareness so that people can be diagnosed earlier.

[David Mundell (in the Chair)]

I will now impose a formal time limit of three and a half minutes on speeches.

[Hannah Bardell (Livingston) (SNP)]

It is a pleasure and an honour to speak in this debate. As Members before me have done, I pay huge tribute to and give thanks for the work of Sir David Amess. He worked tirelessly to raise awareness and improve services for those affected by endometriosis. His loss is felt keenly across the House and among those involved in the causes that he fought so hard for, such as endometriosis. It will be a true honour and a privilege to follow in his footsteps with the hon. Member for Kingston upon Hull West and Hessle (Emma Hardy). We decided that it was important to make a cross-party effort to take on Sir David’s role, because that was the spirit in which he approached the issue. In fact, the last conversation I ever had with him was about how we could ensure that the report did not sit and gather dust, and how we could include and encourage local groups in our constituencies. I know we all have many of them in our constituencies.

I want to take a moment to mention and pay tribute to Endo Warriors in West Lothian, where Candice and Claire are tireless campaigners—that is why the fourth largest number of signatures to this petition came from my constituency. I also pay tribute to Endo Bonds, which works tirelessly across Scotland, and to Andrew Horne and Emma Cox at Endometriosis UK. There are many people in this space and a lot of sufferers, many of whom I have met. When we did that report, I took evidence from sufferers in Scotland. The stories were truly heartbreaking. That was in the middle of the pandemic, when those who suffer from endometriosis were having to wait longer than ever to get treatment and diagnosis. The number of Members who have taken an interest and want to speak in this debate shows that so much more time, effort, money and research must be dedicated to both endometriosis and PCOS, which devastates and blights the lives of women and sufferers across the UK.

As we know, endometriosis is a gynaecological condition, but many do not know that it is as common as diabetes. It affects one in 10 women and those assigned female at birth, thus affecting millions across the UK. It is a condition with a wide spectrum of symptoms. I have friends who suffer from it, and it has such a profound impact on their lives. As other hon. Members have said, the response of some medical professionals simply needs to change. We need ongoing medical intervention and research to improve sufferers’ lives.

From an economic perspective, endometriosis costs the UK £8.2 billion per year through treatment, healthcare costs and the impact on work and employment. This is not necessarily about the financial impact, however; it is about the impact on the lives of those who suffer. Despite the prevalence and impact of endometriosis, there is very little research funding for it or widespread awareness about it, unlike with cancer or diabetes. Yet it is ranked by the NHS as one of the top 20 conditions involving pain so disabling that it can prevent sufferers from doing daily tasks. That list includes well-researched and well-funded conditions such as heart attacks, kidney stones, appendicitis and arthritis, to name a few.

Men have held positions of power for centuries and, as the hon. Member for Thurrock (Jackie Doyle-Price) said, if the sufferers were men, we would probably have a solution and a cure by now. The fact that Sir David was so determined to fight, in such an inclusive way, for the women who suffer from the condition is a reminder to us all of the need to take that work forward.

In 2018, only 2.1% of publicly funded research in the UK went on reproductive and menstrual health, down from 4.5% in 2014. In Scotland, we have committed to reducing the time taken to obtain a diagnosis from eight and a half years to 12 months during the life of the next Parliament—that is an ambitious target. So often, the nations of the UK are played off against each other. Of course, this is an area where we should compete, but we also need to work together so that we can share ideas, fresh thinking and opportunities. That is what the hon. Member for Kingston upon Hull West and Hessle and I will do in the all-party parliamentary group. We look forward to working with Members and having many more debates on endometriosis and PCOS so that sufferers do not continue to suffer, as they have done for so long.

[David Mundell (in the Chair)]

We really need to stick to the time if everyone is to have an opportunity to speak. I call Robert Largan.

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[Bell Ribeiro-Addy (Streatham) (Lab)]

It is a pleasure to serve under your chairmanship, Mr Mundell. I also want to pay tribute to Sir David Amess because, on coming into Parliament, I found it very impressive that for once a man was taking up an issue that affected so many women. I know it is usually the women in the House who put these issues forward, so we definitely have to pay tribute to Sir David Amess for the feminist that he was in that respect.

Even though the condition is so common and the impacts are so devastating, we have heard time and again that research is woefully lacking. PCOS is definitely one of the leading causes of fertility problems in women, and endometriosis can be as well. It can also have a devastating impact on someone’s self-esteem, and if not properly managed, it can lead to additional health problems later on.

I know this because I have endometriosis. My own experience began when I was young, and I did not think it was a particular issue. I always had extremely painful periods, and that was just life. With all these things that have to do with women, we are told, “Once you have a baby, you’ll be fine,” and on being diagnosed with endometriosis or potentially having it, I was told, “Once you have a baby, you’ll be fine.”

I remember that when things began to get bad one night in 2017, I was sitting up in the office of my right hon. Friend the Member for Hackney North and Stoke Newington (Ms Abbott), for whom I worked. I began to feel twinges while I was working late, and things got so bad—the piercing pain got so bad in my side—that I had hobble over the river to St Thomas’s Hospital. I was in so much pain that I was kept in for the next couple of days.

I then began waiting for an appointment from my GP. I had to wait so long for it that I called up and asked, and they were confused about what they were meant to do next. It was only after many months that I was able to get that appointment, and I then had to wait for the next appointment time, as we often do. That was a longer process, which went on for another two years.

Throughout that time, I would have pain every day, as I do now, and I would have to wake up quite late, because I would have pain mostly in the night-time. For the majority of women, their bosses are not so understanding. However, thanks to my right hon. Friend, I was able to make it work with my times by coming into work slightly later and working slightly later to work around my pain. How many employers would be that understanding?

Eventually, I was given a date for a laparoscopy in May 2019—I will not mention the hospital, because it will be hearing from me—and it went so badly it was unbelievable. I was in and out of there so quickly: I had the procedure, those involved woke me up and told me they had not found anything, and they said I would come to soon and would go home. I was in so much pain that I could not walk, and instead of treating me any further, they said there was nothing they could do for me, put me in a wheelchair—still in the gown I had had on for the operation, with blood on—and wheeled me round to A&E.

Obviously, those in A&E were absolutely fuming, because the staff are not meant to do that, and they sent me back up to the gynaecological ward. Again, I was gaslighted there, as somebody told me that I would have to think about what I was doing because I clearly just had some sort of muscle pain. I tell this story today, with not much time, because I cannot tell you how many women have experienced that.

My diagnosis took five years. Thankfully, I went to King’s College Hospital, where I was born. I probably should have gone there first; I turned out okay, which shows that it is a good hospital. It was able to treat my condition, and I instantaneously felt the relief of having the endometriosis removed, as much as that is possible. But it grows back, so I am now on the list, with other women, waiting for further treatment. We cannot keep women waiting this long.

I can say from experience that the amount of pain you go through really does affect you every day, so I say to Members right across the House that if they ever see me looking at them slightly strangely, unless they have said anything particularly obnoxious, it may just be because I am in a lot of pain. Thank you very much, Mr Mundell, for allowing me—oh no, I still have some more time.

[David Mundell (in the Chair)]

No, the clock is going the other way.

[Bell Ribeiro-Addy]

In that case, thank you.

[David Mundell (in the Chair)]

I thank the hon. Member for her contribution.

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

It is a pleasure to serve with you in the Chair this afternoon, Mr Mundell. I associate myself with your remarks and those of others during this debate about our colleague Sir David Amess, and my thoughts and prayers are with his wife and kids at this very difficult time.

I am pleased to participate in this debate today in order to recognise publicly the great work that Endo Borders, set up by Tao McCready—who lives in my constituency—is doing on behalf of women who suffer from this terrible condition. Mr Mundell, as the other Member of Parliament for the Scottish borders, I know that you are familiar with that group and the important work it is doing in our area. Tao was diagnosed with endometriosis in 2017, following multiple misdiagnoses, and went on to set up Endo Borders in 2019, giving up a career to focus on supporting the local community and raising awareness of the condition. Not only is it a fantastic group for women in the Scottish borders; it also reaches out to women across the country who are suffering from endometriosis. I had the privilege of attending a recent meeting of Endo Borders, and was really impressed by the courage of the women who were sharing their stories.

Endo affects one in 10 women in the United Kingdom, but despite its prevalence not much is known about it and relatively few people have heard of it—I certainly had not until I met that group. There is currently no cure for endo, and its exact cause is unknown. In Scotland, the average diagnosis time is eight years. The difficulty is that there is not a specific list of symptoms for endo, as the condition presents differently in different women. Research by Endometriosis UK found that 54% of the UK population were unaware of the condition, and 45% of women were unaware of its symptoms. To put that in perspective, a far greater proportion of the population has heard of diabetes, and endometriosis affects a similar number of people.

What can be done to help women suffering from this condition, particularly those who live in my constituency in Scotland? First, clearly awareness about endometriosis needs to be raised, and it is crucial to ensure that Scotland comes into line with England by providing menstrual health education at school. Without learning about the menstrual cycle at a young age, conditions such as endo will continue to go unrecognised, marginalised and misunderstood.

Secondly, although there are three specialist centres for endo in Scotland, the all-party parliamentary group on endometriosis found that because those services have been commissioned at a local level, it can sometimes be difficult to get referrals to the different health board areas in which those services are based. It cannot just be a postcode lottery. My colleague Rachael Hamilton MSP recently called on the Scottish Government to present a credible plan for how to reduce their own waiting time target for diagnosing endometriosis from eight years to less than one year, and I eagerly await the publication of that plan.

Finally, I am absolutely clear that more can and should be done to improve research into this condition that affects so many women and the way they live their daily lives. I therefore support calls to ensure that funding is directed towards new research into the diagnosis and treatment of this terrible illness, ultimately focusing on a cure.

To conclude, I thank the petitioners for securing this important debate, and the team at Endo Borders for the invaluable work they do to support women suffering from this terrible condition.

[David Mundell (in the Chair)]

I share your praise for Tao McCready and the work of Endo Borders.

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[Christian Wakeford (Bury South) (Con)]

It is a pleasure to serve under your chairmanship, Mr Mundell. I thank the hon. Member for Coventry North West (Taiwo Owatemi) for securing and leading this important debate. More importantly, I also thank the hon. Member for Streatham (Bell Ribeiro-Addy) for her own personal story, which I found very moving. In common with everyone else in the Chamber, it would be remiss of me not to mention Sir David Amess and the very important work that he did as chair of the all-party parliamentary group.

As we have heard, endo affects one in 10 women in the UK. It is a common, chronic, complex and fluctuating condition that brings about unimaginable pain. Like many Members here, I first found out about endo shortly after I was elected; I had never heard of it before. It was in a constituency surgery, where Katie came to meet me. She talked about her debilitating pain, the impact on her mental health and her endo sisters who were taking their own lives because of the pain while awaiting treatment. She described the gaslighting she had to go through—“It’s just a bad period.” That is just the norm for anyone suffering from endo, and we should all be ashamed of that.

It is clear from today’s debate, from previous debates and from constituents across the UK that, despite the severity of the condition, it is still taboo to talk about women’s health and gynaecological conditions. I remember speaking in last year’s debate on the Cumberlege report. It is a damning and concerning fact that we talk about and listen to women’s health issues only when men talk about them. Many in this Chamber have been giving their own personal stories, and I fear that we are at risk of still not truly understanding the issue because men are not talking about it. We spend so much more money on erectile dysfunction than on endometriosis—that shows where our priorities are.

Workplace attitudes often do not help. We have heard the stories over and over again in the House when it comes to endo: women are often not believed or supported by doctors, employers or even loved ones. It is shocking that in 21st-century Britain women are still being dismissed as lazy, unreliable, dishonest and a nuisance in the workplace. In the 2020 BBC survey on endo, almost all the women responded by saying that they felt that their careers had been hampered by having the disease.

If appropriate workplace support for employees suffering from endo and polycystic ovary syndrome is to be obtained, we need business leaders and managers to be equipped with the necessary information and knowledge to be compassionate when dealing with these cases. We should begin by encouraging employers to become endo-friendly, making sure that there is access to support for all those who suffer from it.

The current definition has been highlighted by the hon. Member for Kingston upon Hull West and Hessle (Emma Hardy). Unfortunately, endo sisters do not qualify for statutory sick pay because the condition is long-lasting and chronic. That is something we can quite easily and quickly fix. We have already heard that before covid it took, on average, eight years to be diagnosed with endometriosis. That backlog will only have become worse. We need to factor in GPs’ ability to understand the condition better. We can do so much more, and we have a duty to do so.

In conclusion, endometriosis costs the UK £8.2 billion per year through treatment, healthcare costs and the impact on work and employment. We need to deal with this, and not just from a financial perspective but from a moral one.

[David Mundell (in the Chair)]

I am going to call Barbara Keeley and then I will ask Alex Davies-Jones to make the final Back-Bench contribution.

[Barbara Keeley (Worsley and Eccles South) (Lab)]

It is a pleasure to speak in the debate with you in the Chair, Mr Mundell. I thank my hon. Friend the Member for Coventry North West (Taiwo Owatemi) for the way she opened this important debate.

Endometriosis and polycystic ovary syndrome affect one in 10 women and those assigned female at birth in the UK. As we have discussed, that means that over 1.5 million individuals are enduring a painful condition that can affect every aspect of their life. It is staggering that these conditions are so under-recognised. Common symptoms for a diagnosis include severe pain and heavy bleeding, but for those who have these conditions, that description barely scratches the surface of the reality of living with such a severe gynaecological disease.

One constituent wrote to me with a powerful testimony about her experience of living with polycystic ovary syndrome. She told me of the wide range of debilitating symptoms of her condition. She felt lacking in confidence and scared for her health and future. She felt that no one understood her, and she felt alone and overwhelmed by the condition. Constituents who have contacted me about endometriosis or PCOS report significant diagnosis times of between four and 14 years. This is an unacceptable amount of time for patients to wait while not getting the right care or even having a name for the condition that is causing their symptoms.

I had endometriosis and it had a big impact on my life. I was not diagnosed until the age of 32. I had multiple surgical interventions over more than 10 years. Surgery, as we have heard from my hon. Friend the Member for Streatham (Bell Ribeiro-Addy), does not cure endometriosis; it just comes back and back. Delays in diagnosing and managing endometriosis and PCOS can affect quality of life. Worse than the impact on quality of life, they result in a dangerous progression of the disease.

We have all touched on the work of the all-party parliamentary group on endometriosis, and I join Members in paying tribute to the work of Sir David Amess as its chair. There was an excellent report produced following an inquiry. I recommend that report and its 34 recommendations to the Minister, particularly those on investment in further research into gynaecological diseases, so that the waiting time for diagnosis can be reduced.

To these recommendations, we must now add the need to address the gynaecology backlog made worse by the pandemic. NHS England data indicate that the waiting list for gynaecology services has seen the largest increase of all the specialties since the pandemic began. Endometriosis UK’s recent survey showed that four fifths of patients with confirmed or suspected endometriosis had had NHS appointments for their condition postponed or cancelled due to the pandemic, and a third had not been given a new appointment date.

Sarah Lambrechts told the Health and Social Care Committee about her experience of having surgery for endometriosis delayed due to the backlog caused by the pandemic. The delay is, in her case, going to be for 18 months to two years. She said:

“I am 25 years old. For the next 18 months or two years—however long—I cannot plan my life. I cannot plan my career progression. I cannot plan to have a family. I cannot take care of myself some days.”

It is very sad that Sarah and thousands of others have experienced such an impact from the disease. We need urgent action so that those who have lived with the debilitating symptoms of endometriosis and PCOS for so long are not suffering because of a long wait for treatment caused by the backlog in NHS care. We owe it to those who have lived with these symptoms, often for many years, as I did, to reduce diagnosis time, improve treatments and, eventually, find a cure.

[David Mundell (in the Chair)]

I now call Alex Davies-Jones, who will not be our last Back-Bench contributor. I did not realise that Gavin Robinson wanted to speak. We will be able to squeeze him in, I think.

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[Kirsten Oswald]

My hon. Friend is right: we have to listen to women’s experiences, and I think the hon. Member for Bury South (Christian Wakeford) referenced that too. That really matters here. I never imagined talking about my experience of menstrual irregularity, ranging from nothing at all to a full, continuous six months of periods, which was both debilitating and, frankly, somewhat concerning.

It is fair to say that these are the kind of challenges that women would really rather do without. We heard about the irregular nature of fertility, including irregular ovulation, or no ovulation, which is an issue for women with PCOS, who of course probably do not know that until they find out that they are not pregnant when they are trying to be; reduced fertility—difficulty becoming pregnant—can be the reason why many women become aware that they have PCOS. That was certainly my experience, and it explained many other things. I may have a wee glimmer of light in what is possibly a quite depressing contribution: I have two amazing sons thanks to just a wee bit of PCOS-related medical assistance.

I can tell hon. Members, as we heard so eloquently from others, that women with PCOS can have a difficult time in many ways, particularly with issues such as hirsutism—unwanted facial or bodily hair. I cannot emphasise strongly enough how women are influenced by this. Again, there is no solution. Imagine the impact on the self-esteem of young women in particular. However, PCOS does not only affect young women, and young women are not alone in facing a severe impact on their life from these kinds of issues. None of us wants to sprout a beard, feel unable to go swimming or have to cover up from head to toe. Noting symptoms as oily skin and acne do not really cover the magnitude of those either.

PCOS is often assumed to related only to fertility, and that is a big issue, but all these other issues affect how the world sees us and how we present ourselves to the world. Thinning hair—male pattern baldness, basically —2014 is crushing to have to deal with. Being overweight is so common among PCOS-affected women because our bodies metabolise differently. For some women, that has a significant impact on both their health and on how they interact with the world. There are also depressions and mood changes. If I went through everything, we would be here all day. So many things have a connection to PCOS but, again, we cannot say exactly what or why because the research is not there.

As a younger woman with no idea of where to go for support, it was heartening to hear of women, such as the hon. Member for Streatham, speak about communities supporting one another. That is really helpful when diagnosis is not straightforward or where the issues are not resolvable, but we need to do better than that DIY approach. For young women and teenagers, it is rubbish in the age of Instagram to have to deal with unexplained weight gain or hair growing where it should not, and worries about the future. As for menopause, I have no idea what it will mean, but I would certainly like to know. When I looked into aging women, the best I could establish is that it is thought to be a medical black hole. That is simply not good enough, and that is why research is needed.

To conclude, I thank all the women who have been in touch with me about this matter—so many of them. I thank Verity PCOS and my constituent Anji Sandhu, who is in the process of setting up a group to raise awareness of PCOS and its challenges so that we can talk about it more. That will help because so many women are affected and rely on us here to take it seriously. At the moment it feels to them like a big, dirty secret, and that is what needs to stop. That is why we need research, and I hope that the Minister has something positive to say on that.

[David Mundell (in the Chair)]

Before I call the shadow Minister, Alex Norris, I will say that I am sure he and the Minister will want to help me allow the hon. Member for Coventry North West a couple of minutes to wind up at the end of the debate.

--- Later in debate ---

[Taiwo Owatemi]

I thank all hon. Members who have spoken so passionately in this important debate. I look forward to hearing from the Government about their strategy to make funding for endometriosis and PCOS more readily available, and about how their strategy to improve research on women’s health will establish well-supported and dedicated funding bodies for both endometriosis and PCOS research.

I will highlight some of the many important remarks made during the debate. My hon. Friend the Member for Kingston upon Hull West and Hessle (Emma Hardy) underlined the fact that we do not know what causes endometriosis and that we need dedicated funding to determine the cause of the condition. I completely agree with the hon. Member for Thurrock (Jackie Doyle-Price) on the crucial point about the need to destigmatise and demystify many of the symptoms associated with endometriosis and PCOS.

Finally, I thank my hon. Friends the Members for Streatham (Bell Ribeiro-Addy) and for Worsley and Eccles South (Barbara Keeley), as well as the hon. Member for East Renfrewshire (Kirsten Oswald), for their powerful stories, which illustrated better than statistics or figures ever could the need to support women who suffer from these conditions. Simply put, we need more funding for research into endometriosis and PCOS so that we can combat both. I thank every Member who participated in the debate.

[David Mundell (in the Chair)]

Although I am sure that Mr Norris was correct in saying that Sir David would have been pleased with the terms of the debate, as the Minister said, I am sure that Sir David would also have been holding her feet to the fire afterwards.

Question put and agreed to.

Resolved,

That this House has considered e-petition 328570, relating to research into endometriosis and polycystic ovary syndrome.

Covid-19 Update

David Mundell Excerpts

Monday 6th September 2021 Commons Chamber

[Nadhim Zahawi]

The hon. Gentleman is absolutely right: 11 November is the date by which care homes and care home providers will have to comply with the legislation on the vaccination programme. I would be happy to share with him the guidance and the communication that we have sent out to the sector, and I will write to him after this statement.

[David Mundell (Dumfriesshire, Clydesdale and Tweeddale) (Con)]

I particularly welcome what the Minister had to say about pregnant women. My own daughter is expecting a baby in January, and she found it very difficult to get such definitive advice earlier in the summer, although she has now had her jab. I want to ask the Minister specifically about another issue. How can UK citizens who have had their vaccinations abroad ensure that those vaccinations are held up as valid here in the United Kingdom? For example, I have a constituent who had his AstraZeneca vaccinations in Saudi Arabia and is struggling to have them recognised here.

[Nadhim Zahawi]

My right hon. Friend is absolutely right; we are working flat out. We have the pilot scheme in which we recognise vaccinations from America and Europe, and we are looking to expand that to other countries so that people who have had a vaccines from a list of approved vaccines in those countries can benefit from the same freedoms that people who have been double-vaccinated in the UK have.

Patients with Heart Failure

David Mundell Excerpts

Thursday 11th March 2021 Westminster Hall

[David Mundell (in the Chair)]

I remind hon. Members that there have been changes to normal practice in order to support the new hybrid arrangements. Timings of debates have been amended to allow technical arrangements to be made for the next debate. There will also be suspensions between each debate.

I remind Members participating physically and virtually that they must arrive for the start of debates in Westminster Hall. Members are expected to remain for the entire debate. If Members attending virtually have any technical problems, they should email the Westminster Hall Clerks’ email address. Members attending physically should clean their spaces before they use them and as they leave the room.