Women’s Health

Juliet Campbell Excerpts

Thursday 27th February 2025 Westminster Hall

[Juliet Campbell (Broxtowe) (Lab)]

It is a pleasure to serve under your chairmanship, Dr Huq. I congratulate my hon. Friend the Member for Hastings and Rye (Helena Dollimore) on securing this debate.

Menopause is a biological process that marks the end of a woman’s menstrual cycle and fertility, and it typically occurs between the ages of 45 and 55. It is a universal experience for women around the world. The journey to that point is known as perimenopause, which can last for several years, and that is what I will focus on today. The perimenopausal stage in a woman’s health remains in the shadows, under-prioritised and under-resourced by policymakers, employers and healthcare providers alike. Perimenopause is overlooked despite its relevance to health, education, employment and demography.

During the transition into the menopause, a woman’s body undergoes various changes as it prepares to end its reproductive years. Typically, the transition begins in the mid-40s, but it can start as early as the mid-30s and last as long as into the mid-50s. It usually lasts for about four years, but it can extend to up to eight years. During the perimenopausal stage, oestrogen levels fluctuate, leading to irregular menstrual cycles, and as the ovaries gradually produce less oestrogen, it can cause various other symptoms.

Perimenopause is diagnosed based on symptoms and menstrual history, and the treatment focuses on managing the symptoms, including through lifestyle changes, hormone therapy—although less so—and other medications. The symptoms of perimenopause can affect daily activities. They affect work and relationships. Women in my Broxtowe constituency have told me that they have needed to take time off work due to the symptoms, which they did not understand and neither did their healthcare professionals.

We know that absences from work have a significant impact on our economy. As has been said, it can cost billions of pounds per year. Some women need to reduce their working hours, to take extended leave, or to leave the workforce entirely. This can affect their career progression, depending on how young they are. At a time when the Government are focusing on growing our economy, we cannot ignore the economic costs of not helping and supporting women in their perimenopause.

Few women seek help or attention, and due to a lack of understanding they receive very little support if they do. Their symptoms might be subtle and they will come on gradually. They might not even know that they are connected to the hormone fluctuations of the menopause transition. Many women do not even understand the signs and symptoms of the perimenopausal stage, as the menstrual cycle continues. This lack of awareness and education about the perimenopause, among both women and healthcare providers, leads to underdiagnosis and undertreatment.

I raise this issue because I would like to go back to my constituency and assure people that perimenopause will be included in any future Government policy.

Terminally Ill Adults (End of Life) Bill (Thirteenth sitting)

Juliet Campbell Excerpts

Committee stage
Tuesday 25th February 2025 Public Bill Committees

[Danny Kruger]

I am grateful, Mr Dowd. I recognise the force of what the hon. Member for Penistone and Stocksbridge is saying. To be clear, the amendments that I am supporting would not deny disabled people any of the other rights that are being awarded in the Bill. She is absolutely right that a disabled person with a terminal illness would qualify just as much as someone who was not disabled. That is absolutely right.

The purpose of the amendment is to ensure that people whose illness is a direct consequence of a mental disorder in particular would not be eligible. The reference to disability is because of the confusion, which I expect the hon. Member for Spen Valley recognises in current law and guidance, about where the distinction between disability and terminal illness lies. That is our concern. The purpose of the amendment is to ensure that people would not be deemed as eligible for an assisted death in consequence of disability or mental illness. I know that is what the hon. Lady is trying to do with the amendment, and with the clause that it amends, so we are on the same page. Our concern is that, by including the words “For the avoidance of doubt” and the word “only”, we will be leaving quite a large loophole, through which, I am afraid to say, some vulnerable people might fall.

I look forward to the Division on the amendments. We have not been able to discuss them all in close detail, but I am grateful to Members for the debate that we have had.

Amendment 399 agreed to.

[Juliet Campbell (Broxtowe) (Lab)]

I beg to move amendment 123, in clause 2, page 1, line 23, leave out “an inevitably” and insert “a typically”.

This amendment changes the definition of what it is to be terminally ill from having an “inevitably” to a “typically” progressive illness, disease or medical condition that cannot be reversed by treatment.

[The Chair]

With this it will be convenient to discuss the following:

Amendment 9, in clause 2, page 1, line 24, after “reversed” insert

“or the progress controlled or substantially slowed”.

This amendment would mean that illness, disease or medical condition etc, the progress of which can be managed or controlled by treatment are not characterised as terminal illness.

Amendment 48, in clause 2, page 2, line 2, leave out

“can reasonably be expected within 6 months”

and insert

“is expected with reasonable certainty within 6 months, even if the person were to undergo all recommended treatment”.

Amendment 282, in clause 2, page 2, line 2, leave out

“reasonably be expected within 6 months”

and insert

“be expected with reasonable certainty within one month, even if the person were to undergo all recommended treatment.”

This amendment would restrict the scope of assisted dying to people who, with reasonable certainty, would die within one month, even if they were to undergo all recommended treatment.

Amendment 51, in clause 2, page 2, line 2, leave out from “expected” to end.

This amendment would remove the six-month time requirement for a person to be eligible to request assistance under the Act.

Amendment 234, in clause 2, page 2, line 2, leave out “within 6 months” and insert—

“(i) in the case of a neurodegenerative illness, disease, or medical condition, within 12 months; or

(ii) in the case of any other illness, disease, or medical condition, within 6 months.”

This amendment changes the definition of a terminal illness for the purposes of the Act to include neurodegenerative illnesses, diseases or medical conditions where a person’s death in consequence of such an illness can reasonably be expected within 12 months.

Amendment 10, in clause 2, page 2, line 6, at end insert

“, providing the treatment does not alter the overall prognosis of the condition.”

This amendment, which is linked to Amendment 9, would mean that illness, disease or medical condition etc, the progress of which can be managed or controlled by treatment are not characterised as terminal illness.

Amendment 402, in clause 2, page 2, line 6, at end insert—

“(2) A person who would not otherwise meet the requirements of subsection (1), shall not be considered to meet those requirements as a result of stopping eating or drinking.”

This amendment means that someone who is not terminally ill within the meaning of subsection (1) cannot bring themselves within that definition by stopping eating or drinking or both.

[Juliet Campbell]

The amendment would change the definition of what it is to be terminally ill, from having an “inevitably” to a “typically” progressive illness, disease or medical condition that cannot be reversed by treatment.

The limits of medicine, and where they manifest in our healthcare system, have been repeatedly discussed and have come up in oral and written evidence. The Bill’s supporters have frequently used the argument that our current medical care is limited to highlight the benefits of assisted dying, by stating that even with the best care available, not everyone can be prevented from experiencing significant suffering as their life comes to an end. However, such an understanding of the limits of medicine is not consistently applied in the Bill. The truth, as is repeatedly corroborated in the written evidence, is that in many cases we simply cannot reasonably know how long a person could survive.

Witnesses have explained that predicting whether someone is inevitably terminal is often not a certainty. Even when a disease is considered advanced or at the end stage, there are variables—such as an individual’s response to a treatment, access to care, new clinical trials, medical intervention, or a person’s overall resistance —that can influence the outcome. When practising medicine, doctors often use terms like prognosis, life expectancy, or expectation, rather than definitive statements on the degree of someone’s terminal prognosis. The variables in prognosis make the amendment necessary.

The term “typically” better acknowledges the limitations of the knowledge of medical practitioners. In written evidence, Dr Chris Paxton, a retired GP of 38 years, says:

“No doctor can accurately predict if a terminally ill patient has six months or more to live. I have seen many patients being told they have only months to live, continuing living many years after their ‘terminal’ diagnosis.”

The concept of a condition being “typically” terminal acknowledges that although a disease usually leads to death, there may be exceptions where individuals survive longer than expected, or even achieve remission.

The process of assisted dying must maintain honesty and transparency with patients who are seeking assisted death. A declaration of certainty is implied by using the word “inevitably”. In her written evidence, Dr Ariel Dempsey, who is currently studying end of life care, says:

“Physician prognostic estimates are variable, optimistic/pessimistic, uncertain, and more often than not, inaccurate. For example, a prognosis of 6 months is required for hospice eligibility in the U.S., yet it is not uncommon for hospice patients to live beyond six months, even without life-prolonging treatment.”

For individuals seeking assisted death, the use of the word “inevitably” can lead to an over-reliance and overconfidence in the judgment of their doctors. If someone believes without question that they will inevitably die within six months, an assisted death may seem like an obvious and minimally life-limiting choice. The problem is that a claim that someone’s death is imminent and inevitable within six months simply may not be true.

Not only does the use of the word “inevitable” risk embedding dishonesty in our law, but it risks doctors who agree to engage in assisted dying and end of life care becoming overburdened with the responsibility of proclaiming an individual’s prognosis. Having considered the circumstances that surround a person’s illness, a doctor can only give a prognosis that is typical and give a typical indication of their life expectancy.

--- Later in debate ---

[Dr Neil Shastri-Hurst (Solihull West and Shirley) (Con)]

Will the hon. Lady give way?

[Juliet Campbell]

I have almost finished, so I will carry on.

If we give doctors the essentially impossible task of proving that death will inevitability occur in six months, there is a risk of an individual being advised to stop treatment, to accelerate them artificially into a serious or terminal state or speed it up to ensure their eligibility. As medical intervention is so key in the prognosis of a seriously ill patient, it makes no sense to me to use language that is not consistent with real-life medical experiences or reasonably within the scope of medical diagnosis.

[Tom Gordon (Harrogate and Knaresborough) (LD)]

It is an honour to serve under your chairmanship, Mr Dowd. I speak in support of amendment 234, which is tabled in my name and seeks to ensure that people suffering from neurodegenerative conditions are not excluded from the dignity and autonomy that the Bill seeks to provide. The amendment would extend the eligibility period for those with neurodegenerative conditions from six months to 12 months—a simple yet crucial change that could alleviate needless suffering and ensure fairness in our approach to end of life care.

The intention of the amendment is to change the law to match that in five of the six Australian states. The wording mirrors that found in those jurisdictions. Conditions that would be affected by the change include motor neurone disease, Huntington’s disease, multiple system atrophy, progressive supranuclear palsy, Parkinson’s and many others. Although Alzheimer’s is a neuro-degenerative condition, those with Alzheimer’s would not be eligible for an assisted death should the amendment pass because they would not have the mental capacity.

--- Later in debate ---

[Kim Leadbeater]

Colleagues will be pleased to know that, despite my copious notes, I do not intend to speak for very long, because I believe we have had a very thorough and robust debate on these issues. The Minister makes a valuable point on amendment 402, which I do not think anyone else raised. Coincidentally, it relates to the person in the Public Gallery this morning, whose mum had a horrible form of cancer and had to have her tongue removed. She would have stopped eating or drinking, but it was not a choice; it was an inevitable result of her condition. She would have been excluded from having an assisted death, which I am sure is not the intention of my hon. Friend the Member for Bradford West.

We have had an excellent debate and covered a lot of ground. I do not intend to add anything more on this group of amendments. I will only say that if we get a move on, we might be able to get through clause 2 before we close at 5 o’clock.

[Juliet Campbell]

I beg to ask leave to withdraw the amendment.

Amendment, by leave, withdrawn.

Amendment proposed: 9, in clause 2, page 1, line 24, after “reversed” insert

“or the progress controlled or substantially slowed”.—(Rebecca Paul.)

This amendment would mean that illness, disease or medical condition etc, the progress of which can be managed or controlled by treatment are not characterised as terminal illness.

Question put, That the amendment be made.

Terminally Ill Adults (End of Life) Bill (Fourth sitting)

Juliet Campbell Excerpts

Committee stage
Wednesday 29th January 2025 Public Bill Committees

[Rachel Hopkins]

You have given clarity. Thank you.

[Juliet Campbell (Broxtowe) (Lab)]

Q My question is for Professor Shakespeare and Dr Griffiths. Clause 4 of the Bill offers the opportunity for clinicians to instigate the discussion on assisted dying. Could you both tell me your view on that, please?

Professor Shakespeare: It is natural and right that somebody should discuss their wishes with a doctor who supports and treats them. I do not think there is a problem there. Marie’s suggestion that there should be a wider body to look at this is very relevant. At the moment, doctors refer women for abortions, and that does not stop them also supporting pregnant women. I do not think that women would distrust their doctor because they are sometimes involved, at some point, with an abortion decision. That is quite obvious. As my colleague Yogi Amin said, the Bill covers what the terminal illness is, and why we should support people to voluntarily exercise their choices. Lots of doctors will not be in favour of this, but they will be clinically professional and they will discuss with the person. I do not have a concern about that. You are more likely to be kept alive against your will than you are to end your life under this Act.

Dr Griffiths: My first point is that, for me, the Bill raises concerns because it relies on doctors’ interpretations of prognosis. If a doctor assumes that you have six months left to live, and is therefore going to start having a conversation with you about the possibility of assisted suicide, that draws into question how we allow assumptions to be made about whether an individual has six months left to live. That is particularly the case given that we have evidence that shows that, with certain interventions or mishaps surrounding prognosis, individuals can live for months, years and decades longer. The idea of bringing in the conversation from the point of view of the medical practitioner could, arguably, accelerate one’s death—if you take into account that their idea of prognosis might be flawed.

It also, I think, raises problems, because we know that many individuals with health conditions and impairments—irrespective of whether we want to create this false line between disabled people and people with terminal illness—do not have access to advocacy or representation in these kinds of processes. Having a conversation where there is extreme credibility and validity that rests on the medical practitioner could exacerbate issues around coercion.

We could take a moment of reflection. When we were going through the pandemic, the Parliamentary and Health Service Ombudsman highlighted how medical practitioners could think about “do not attempt resuscitation” orders and how they were utilised in the disabled people’s community. That has parallels with the issue we have here, where medical practitioners will be making assumptions about whether conversations or applications should be made.

Yogi Amin: Can I just raise one point on representation? I point Members to paragraph 10 in my written submission, which tries to make the important point that if we are involving courts, individuals need access to justice. They need access to advice, and that means legal aid. I point in that paragraph to the provision of non-means-tested legal aid, just like in the case of parents of children and the withdrawal of life-sustaining treatment. Those current rules are in place for parents, and a similar arrangement could be put in place for individuals who are brought before the court in this matter.

[Liz Saville Roberts (Dwyfor Meirionnydd) (PC)]

Q I have a question for Mr Amin. England and Wales is a single jurisdiction, but health is devolved and we have been discussing an amendment to clause 12 in relation to the court of a multidisciplinary arrangement, as opposed to the High Court. What are the implications for the Committee to understand in how this plays out, with health being devolved but the jurisdiction being single?

Yogi Amin: If the legal panel is not a High Court judge, but it is a multidisciplinary panel, then it just draws upon the people in the local areas. The Court of Protection operates in England and Wales and the judges apply the law the same way. That is what the panel would do in this case. Are you more concerned about the make-up of the panel or how they apply it?

Income Tax (Charge)

Juliet Campbell Excerpts

Tuesday 5th November 2024 Commons Chamber

[Juliet Campbell (Broxtowe) (Lab)]

It is an honour and a privilege to be making my maiden speech in this Budget debate. Our plans for the NHS and public services give me hope, and a sense of pride that they will once again be here, ready for all of us. I make my maiden speech today with a sense of gratitude and humility, and I thank my Broxtowe constituents for putting their trust in me to represent them here in this esteemed place. I pay tribute to my predecessor, Darren Henry, for all he has done for the residents in Broxtowe. Darren worked hard to establish banking hubs and continued the efforts of Anna Soubry in working with local groups to fight for our railway services. Their work in securing step-free access to Beeston station will give everyone the opportunity to visit our brilliant constituency.

I look forward to expanding upon Labour’s legacy in Broxtowe, where Labour last made its mark under the tireless efforts of Nick Palmer. Nick represented Broxtowe from 1997 to 2010, bringing about reform through many successful Bills. I would like to thank my family for their support and encouragement, particularly my son, my daughter-in-law and my brothers. I would also like to thank all the members in Broxtowe who have been a tremendous help to me. To those who have gone above and beyond: you know who you are, and I will never forget your kindness and generosity.

I began my career as a civil servant before moving into the NHS, where I worked my way up to become a senior manager, but it was education that brought me into politics. In 2011, I set up a not-for-profit organisation that focused on dyslexia, and I sincerely hope that what I advocated for—reform of the teacher training curriculum with regard to SEND provision for dyslexic students—can make it into the education reforms soon. I was elected as a councillor in 2018 and my cabinet brief was quite varied. It included public health and wellbeing, equalities, refugees, violence against women and girls, and community safety. I wanted to be part of the change that this country so desperately needed after almost a decade of austerity and decline that hit every single community in this country.

Broxtowe is a wonderful, thriving constituency of two halves. In the north, I have a particular soft spot for Eastwood, as it borders Bilborough, where I was raised. Eastwood, of course, is the birthplace of one of the most popular English novelists of the 20th century, D. H. Lawrence, who showed a much more clandestine side of British society. As well as risqué classic novels, Broxtowe has a beautiful and diverse landscape that hosts the brilliant Attenborough nature reserve. Located in the southernmost part of the constituency, it spans 540 acres of conserved land, wetland, woodland and lakes. Visitors may spot 250 species of bird, including several nationally rare species of heron and rail that have been spotted there over the years.

Broxtowe is also home to businesses, from the small and independently run to the headquarters of large international companies such as Boots, Worldline and the UK arm of Raleigh. I have had the pleasure of visiting Caunton Engineering, a steelwork company with an excellent apprenticeship scheme that offers brilliant opportunities to young professionals.

Broxtowe also hosts Forever Stars, a baby loss charity that supports families who lose their children during pregnancy or shortly after birth. Its sensitive and innovative work with hospitals is truly inspiring.

At the heart of my constituency is Chilwell, home to the impressive Chetwynd barracks, which has resisted closure three times in the past 10 years. Chetwynd is home to a reserves training and mobilisation centre that specialises in engineering. My dad is an engineer who received his training in Nottingham through the Territorial Army, and I am committed to ensuring that the voice of our armed forces is heard here in Parliament.

I stand here today as the youngest of five children, born to parents who migrated to the UK from Jamaica in the 1960s. My parents brought me up to believe that I could do anything I wanted, and that the only barriers in front of me were those that I chose to notice. I took notice of none of them. Too often, factors such as class, race, gender and disability can be perceived as hurdles in the pursuit of ambition. They should not be, and I have dedicated much of my career to challenging and advocating for the removal of barriers, so that all have the opportunity to reach their potential.

Reflecting on my journey, I must say that I have thoroughly enjoyed my varied career, but today, as I give my maiden speech in this great House as the Member of Parliament for Broxtowe, I think this is my best role yet.