Gynaecological Services: Waiting Lists

Feryal Clark Excerpts

Wednesday 6th July 2022 Westminster Hall

[Feryal Clark (Enfield North) (Lab)]

It is a pleasure to serve under your chairmanship, Mr Robertson. I thank my hon. Friend the Member for Kingston upon Hull West and Hessle (Emma Hardy) for securing this important debate and for her continued advocacy of this issue and many issues affecting health inequality, which predominantly affects women. I praise the contribution of my hon. Friend the Member for West Ham (Ms Brown), who set out some harrowing stories of women undergoing hysteroscopy, such as Emily and Francesca, who are ignored and brushed aside. We know that there are thousands more Emilys and Francescas.

That is why the debate is so vital—not just because of the need for meaningful progress on the long-promised women’s health strategy, but because fundamentally we are discussing issues that affect more than 50% of the population. Too often women’s health is pigeon-holed as niche and as a subsection of healthcare. The idea that gynaecological conditions are manageable for long periods of time, and can be deprioritised as a result, is just not acceptable.

Let me set out what that deprioritisation means. It means endometriosis surgery being delayed five times, resulting in irreversible fertility loss, and severe chronic pain. That perception must change, and women must be given the access to healthcare that they desperately need. Any other area of public policy that affected more than half of the population would not be treated in that way, and quite frankly, women have had enough.

We know that timely access to healthcare matters to women, and to young women in particular—the Government’s consultation on women’s health strategy tells us so. Gynaecological conditions were the No.1 topic chosen by women under 30, yet they are being consistently let down and made to wait day after day, year after year. Waiting lists are spiralling in all parts of the NHS, with records being broken consistently, but in gynaecology those spiralling lists are having a disproportionate impact. As we have heard, the Royal College of Obstetricians and Gynaecologists has found that gynaecological waiting lists across the UK have now reached 610,000—an increase of more than 106% since 2008. That backlog is made worse by significant geographic disparities in care.

Waiting lists are growing across the country: there has been an 89% rise in the north-west; a 97% increase in the midlands; and a 144% increase in the east of England. That means that the chance of getting what little care is available is down to a complete postcode lottery. That is disgraceful.

In my own clinical commissioning group area, north central London, the situation is absolutely dire. There are more than 10,000 women on the gynaecological waiting list, and 311 of them have been waiting for over a year. That not only puts pressure on gynaecological services, but has a knock-on effect on the rest of the NHS. Since 2010, emergency admissions for endometriosis have increased by 87%. Women are in A&E for ruptured cysts after their appointments and surgery are cancelled.

If women were listened to, and the services that they rely on were properly resourced, we would not be where we are. For women, the waiting times are having an impact that is far wider than just on their physical health, as we heard from my hon. Friends. The RCOG survey also showed that 80% of women surveyed felt that their mental health had been negatively impacted while waiting for care. If the problem is not tackled as a matter of urgency, the figures will only get worse and the impact will be more devastating.

Tinkering around the edges simply will not cut it. We need a fundamental rethink of how women’s healthcare is treated. We are in a situation in which, in some cases, we do not even have basic frameworks and clinical guidance in place. For example, there is no National Institute for Health and Care Excellence guidelines on how polycystic ovary syndrome should be treated. Just 8% of women feel that they have sufficient information when it comes to gynaecological conditions. What practical steps will the Minister take to ensure that women have the information that they need to make informed decisions?

I am sure that the Minister will tell us that the Government have listened and that the women’s health strategy will make a real change, but let us just look at how they have been listening. In the women’s health strategy consultation only 0.5% of respondents were from the north or the midlands, and only 7% were from non-white backgrounds. A women’s healthcare strategy that considers the experiences of only a small group of women will not be worth the paper it is written on. When it comes to gynaecology, the Government’s own vision for the women’s health strategy recognises that there is a problem. The unconscious bias that sees women’s health less well served than those in other parts of the system, and consistently losing out and being deprioritised compared with other surgical specialties, must be challenged.

Can the Minister confirm today whether the strategy will be published before recess and will follow through on the issues identified in the vision document? Furthermore, will he include an action plan to ensure that the strategy does not just remain a plan but makes practical changes to the way healthcare is delivered for women? Women who are suffering day after day, as they are being made to wait, deserve action. I hope the Minister has heard the asks from my hon. Friends the Members for Kingston upon Hull West and Hessle and for West Ham. I look forward to the Minister’s response.