Incontinence

Irene Campbell Excerpts

Thursday 19th June 2025 Commons Chamber

[Sonia Kumar (Dudley) (Lab)]

I beg to move,

That this House has considered the matter of incontinence.

I thank the Backbench Business Committee and its Chair, the hon. Member for Harrow East (Bob Blackman), who helped secure this debate. I am delighted that we are debating this vital but often ignored issue during World Continence Week.

The definition of a taboo is a subject so difficult, repulsive or offensive that it cannot be mentioned in polite conversation and can be articulated only in hushed, embarrassed tones. Once, menstruation was a taboo and we were not supposed to talk about it. Once, cancer was a taboo, and in some communities it still is. Once, mental health was a taboo and people covered it up. We can now discuss those things more openly without embarrassment, we can seek the right medical advice and treatment, and we can offer support to one another and fight for decent healthcare for every aspect of the human body.

How did I get here, in this Chamber, talking about human bodily functions? This has been a journey for me. I spoke in the Westminster Hall debate on women’s health in February. As a physiotherapist, I talked about pelvic health and the importance of rehabilitation and pelvic floor exercises. My words seemed to have struck a chord. Colleagues, residents and professionals all emailed me to thank me for speaking out and to share their experiences. It started to snowball, and I asked myself, “Why aren’t we talking about this more?” I am advised that this is the first ever general debate on this topic in the Chamber, so I congratulate the House.

What are we actually talking about? We are talking about the involuntary loss of faeces and urine, which can be caused by pregnancy, neurological conditions, multiple sclerosis, spinal cord surgery, musculoskeletal conditions, disabilities, menopause, prostrate-related conditions and many more reasons. The crippling fear for patients is that it might happen at work, in public or in social settings. Patients have told me that they feel like a prisoner in their own homes, caught by a condition that means people avoid others, do not go out, cannot go to work, do not have relationships and feel a crushing sense of shame. People’s mental health suffers to the point of serious illness.

Our language reflects society’s attitudes: “wetting your knickers”, “peeing your pants”, or ruder variants that I will not say. Yet we are talking about a range of conditions that affect millions of our residents. Did you know, Madam Deputy Speaker, that bladder and bowel incontinence is more common than hay fever? The NHS estimates that 14 million people live with bladder problems—one in five of the population—and it is men as well as women. The NHS says that 2 million men experience involuntary loss of urine. A third of women live with these conditions right now—that’s right: a third. Yet this is another aspect of health that is woefully unsupported and pushed off the agenda. It affects 1.5 million children and young people. One in 12 children across the UK battle these debilitating symptoms, including bed wetting, chronic constipation and soiling. Half a million adults have bowel conditions that lead to the involuntary loss of faeces.

We have a population that is getting older and surviving complex conditions, such as cancer, and that will increase the prevalence of bladder and bowel dysfunction. When it comes to bowel conditions, we are talking about the involuntary loss of faecal matter, which can be because of irritable bowel syndrome, Crohn’s disease or other conditions, such as bowel cancer. I have not even touched on what people suffer when they are doubly incontinent. Our NHS collects data on anything and everything. The number of patients with continence care needs to be routinely published, and it is not. My first ask of the Minister —and I have several—is, why not?

The House will note—notwithstanding the title of the debate—that I avoid the terms “incontinence” and “continence”. I have spoken to so many people with bladder and bowel conditions, and my feeling is they are the wrong words to use and they carry too much stigma.

To give justice to the debate, I have conducted roundtables with experts and patients and have shared anonymous surveys. Dawn shared her story with me. She noticed some urinary leakage 10 years ago, when she was 50. Now, at the age of 60, she spoke to me about her journey. She did not go to the GP because she felt ashamed. It got worse and she began to see the gynaecologist. She got the strength to speak to the GP, who gave her tablets. Three rounds of tablets did not work. Her symptoms got worse, and she was unable to leave the House. The gynaecologist referred her to a physiotherapist and specialist nurses. I asked what went wrong here: it was the lack of prevention.

Prevention, prevention, prevention is key. Physiotherapy is recommended as an integral part of women’s health, especially with pelvic floor dysfunction. According to the 2019 NHS long-term plan,

“Physiotherapy is by far the most cost-effective intervention for preventing and treating mild to moderate incontinence and prolapse”.

Insufficient physiotherapist numbers mean that women who experience pelvic floor dysfunction or prolapse wait months or years, or miss out on treatment entirely. Women often end up needing surgery that could have been avoided with earlier intervention. Dawn eventually received specialist care, and her symptoms have vastly improved. She only gets the odd leakage here and there. Her advice to others is

“see your GP… don’t leave it and ask for a referral to see a specialist”.

I had the privilege of seeing one such specialist service in my constituency—Dudley adult bladder and bowel service, known as DABBS—where I met patients and practitioners like Ola Rawlins, team lead and clinical pelvic health physiotherapist, who shared her story, which was eye-opening. Patients told me how GPs ask about bowels but seldom bladders. A patient—Leanne—said she felt ignored, fobbed of and misdirected. One felt like a “prisoner”. Ola’s patients felt like a ball bouncing around different parts of the system. Men, especially those with prostate cancer, were reluctant to take part in self-help groups, and many men did not even know they had a pelvic floor and thought only women did.

Yet symptoms can be easily treated with the right interventions, treatments and course of rehabilitation. Research shows that for every £1 spent on women’s health services, there is a return of £13, thanks to a reduction in emergency admissions, fewer missed days at work and better long-term health outcomes. I know the Department of Health and Social Care is consulting on the men’s health strategy, and I trust that the Minister will ensure that this aspect of men’s health is front and centre.

The DABB service calls itself a “Cinderella service”. The testimonies of patients and professionals is humbling to hear, but it makes me so angry. We are letting too many people down. So what must change? We need to talk about the taboo, and we need action. We need a renaissance of public toilets: to maintain the ones we have, open the ones that are closed and build new ones. I want to see bins in both men’s and women’s toilets, so people can throw these products in the bin. I support the Boys Need Bins campaign by Prostate Cancer UK, and I congratulate the all-party parliamentary group for bladder and bowel continence care for its work. I ask that this place be a pioneer in this space by placing bins in all men’s toilets.

We also need better food labelling, so that fibre is listed on products and people can understand how they can get better bowel health. We need to ensure that the AI and robotics revolution in healthcare does not miss bladder and bowel care. We need a joined-up service between GPs, hospitals, clinics and patient groups. Perhaps we could have more sympathetic and subtle signage in healthcare settings. Products provided outside healthcare settings could have simple labels on shelves, such as “body care” instead of “incontinence products”. That tackles the embarrassment of being seen by a friend or neighbour buying them in the shops.

I urge the Minister, as the 10-year plan nears publication, to ensure that bladder and bowel care is included. Much needs to change, but today I have five concrete asks for the Minister. First, we need a public information campaign to raise awareness and smash the stigma, as recommended by Dr Sara Webb of the Royal College of Midwives. The NHS rightly spends millions on campaigns, such as cancer screenings, the use of 111 and sepsis awareness. Will the Minister commit to a campaign on bladder and bowel care?

[Irene Campbell (North Ayrshire and Arran) (Lab)]

Many years ago, when I worked in the NHS, the board tried to save money by changing the incontinence products that people used. The products were not quite the same, which caused a lot of distress for the people who used them, as well as a lot of inconvenience for the health professionals working with patients, particularly the district nurse team. In the end, it did not really save any money. Does my hon. Friend agree that it is important that people get access to the products that work for them?

[Sonia Kumar]

I agree that products need to be readily available, and that is one of my recommendations.

Secondly, beyond awareness is prevention. We need real understanding, and I want bladder and bowel health to form part of the school syllabus, enmeshed into the curriculum. That is a recommendation from surgeon Dr Robinson from the Royal College of Obstetricians and Gynaecologists. Let us give teachers the tools to teach it. I want this to form part of the training of all healthcare professionals, so that medical professions understand bladder and bowel care from their earliest time in the job. We need a specialist workforce that includes physiotherapists, nurses, surgeons and many others. Can the Minister commit to placing this issue high on the agenda for schools, and to building a specialist multidisciplinary workforce who have the relevant skills and knowledge?

Thirdly, we need enhanced research and development on bladder and bowel conditions and their treatment. That does not necessarily mean vastly increasing spending; it could mean looking at how resources could be better prioritised. We cannot diagnose, treat and rehabilitate, or look into future medical interventions, if there is limited research.

Fourthly—this recommendation is from Dr Ashish Pradhan, chair of the British Society of Urogynaecology —can the Minister commit to banning misleading advertisements that send the wrong message? Products subject to no regulation are advertised, and patients are told to live with their symptoms.

Fifthly, I have a recommendation from a patient I met, Leanne. Could we have a one-stop shop in which all services are under one roof, care that is closer to home, and cheaper incontinence products? They are exempt from VAT if they are purchased for personal use, or use by a registered charity, but what if they are purchased by care homes?

Those are my five demands, backed by experts—five things that will ensure real progress. I look forward to the Minister’s response. Lastly, let me say this to men, women, young people and children listening to this debate: you are not alone, and there is no shame. This subject is often surrounded by silence. It is a subject that people do not want to talk about, or do not know about, and that the NHS does not do enough about. That ends now, and it ends here.

Access to NHS Dentistry

Irene Campbell Excerpts

Thursday 22nd May 2025 Commons Chamber

[Irene Campbell (North Ayrshire and Arran) (Lab)]

When the NHS was introduced, it made the biggest positive changes ever to the health of the general population. The original “How to use your NHS” booklet from 1948 stated:

“It will provide you with all medical, dental and nursing care. Everyone—rich or poor, man, woman or child—can use it or any part of it.”

On the topic of dentistry, it said:

“After 5th July you can go to any dentist taking part in the new arrangements (there will be a list at your Post Office).”

At that time, 83% of registered dentists signed up to work in the NHS. Currently, in England, approximately 66% are signed up to work in the NHS, a significant reduction since the early days that demonstrates a clear barrier to access.

As a former NHS manager in Scotland, I have seen the importance of early intervention when it comes to health inequalities, particularly in dentistry. Scotland too has an access crisis, with decreasing numbers of NHS participating dentists. Naturally, those lower levels of participation affect patient access to NHS dental services, and dentists lose the chance to pick up early signs of decay, cancers and other serious issues, which results in higher costs for the NHS and worse outcomes for patients.

Additionally, children and adults from the most deprived areas were less likely than their wealthier counterparts to have seen their dentist within the last two years. Recent statistics from Public Health Scotland showed that 55.9% of children from the most deprived areas have seen their dentist in the last two years, compared with 75.8% for children in the least deprived areas. Those figures drop to 42.7% and 53.5% for adults.

In September 2008, the gap in child participation between the most and least deprived areas was three percentage points. That increased to seven percentage points by 2010, 18 percentage points in 2021, and then 20 percentage points in 2023. We cannot let that continue. As oral health inequalities continue to grow, it is important that our NHS strategy involves a focus on increasing participation and access in more deprived areas. Otherwise, we will continue to see further such worrying trends, which cause more serious problems further down the line.

[Several hon. Members rose—]

Parkinson’s Disease

Irene Campbell Excerpts

Wednesday 21st May 2025 Westminster Hall

[Paul Davies]

We have to keep an open mind, look at what is being done in other places, countries and regions, and learn from that. We should take that on board and relate any changes in the future to good practice elsewhere. I thank the hon. Gentleman for the intervention.

A diagnosis of Parkinson’s is life-changing, and patients deserve immediate, comprehensive support. That is why Parkinson’s UK launched Parkinson’s Connect, which is a pioneering programme that enables healthcare professionals to refer newly diagnosed patients directly to a network of support. This includes access to specialist nurses, care advisers, local support groups and educational resources.

[Irene Campbell (North Ayrshire and Arran) (Lab)]

I want to look at things in a positive way for a moment. In my constituency, the local newspaper, the Ardrossan and Saltcoats Herald, highlights that the North Ayrshire table tennis club holds classes for people with Parkinson’s, and that the activity has been very well received. In 2024, a constituent of mine, Steve Morley from Stevenston, who took up table tennis to help with his symptoms after his Parkinson’s diagnosis, played at the World Masters in Rome. That is excellent. Does my hon. Friend agree that it is important to provide support for those with Parkinson’s who are keen to keep active?

[Paul Davies]

I absolutely agree. This is not a case of placing people with Parkinson’s in the corner and providing them with medication; this is about helping them to lead full lives, improving their quality of life and aiding them to do what they want to do. I know from people I have met in the Parkinson’s community that that is exactly what they want to do, so I absolutely agree with my hon. Friend.

Early intervention can make a profound difference in how patients manage their condition and maintain their independence. For people with Parkinson’s, receiving medication on time—within 30 minutes of the prescribed schedule—is not a convenience; it is a necessity. Delays can lead to severe symptoms, including immobility, pain and, in extreme cases, life-threatening complications. However, more than half of hospitalised patients report problems receiving their medication on time.

Maternal Mental Health

Irene Campbell Excerpts

Wednesday 5th February 2025 Westminster Hall

[Laura Kyrke-Smith]

Absolutely—that is one way in which people can experience severe mental health challenges and consequences, and it needs to be considered. I also want to acknowledge that new dads and partners experience mental health challenges too, but given our limited time, I am focusing today on maternal mental health.

[Irene Campbell (North Ayrshire and Arran) (Lab)]

Does my hon. Friend agree that stigma around mental health, particularly maternal mental health, can be used by abusers as a barrier to women getting help? Domestic violence during the perinatal period and the effects on mental health require widespread attention, so that survivors can feel comfortable and safe when asking for support.

[Laura Kyrke-Smith]

I agree; we need to shed more light on this, precisely for that and other reasons.

I will touch briefly on my first recommendation, which is to ensure that specialist perinatal mental health services are protected. In the last 10 years, there have been significant steps forward. Mother and baby units in particular can be an important part of someone’s treatment and recovery, as well as having significant benefits for the parent-infant relationship.

Tragically, there are still too many stories of women not being able to access those units. They are perhaps too far away from where a woman lives, or there is not a bed available, or the need for a mother to get that care has not been identified properly. We are still seeing mothers with newborns being put into adult psychiatric units and separated from their babies, despite the national guidance saying that mother and baby units are best practice. Continued support for these services is crucial, both in mother and baby units and in the community, and that must include research to develop the best interventions and robust evaluations of the care provided.

The Mental Health Bill is a sorely needed piece of legislation, and I really welcome it, but I wonder whether it might include a provision to ensure that all women who have given birth within the 12 months prior to admission to a psychiatric unit are given the option of being admitted to a ward where they can remain with their baby. That could help to prevent women from falling through the cracks in the system, as they do currently.

Secondly, I turn to routine maternity care, which is where the mental health support for the vast majority of women can and should sit. Again, we have seen progress, with some vital new services in place, including care for women experiencing baby loss, severe fear of childbirth, birth trauma and loss of custody at birth.