Menopause

Laurence Robertson Excerpts

Thursday 9th June 2022 Westminster Hall

[Charlotte Nichols (Warrington North) (Lab)]

It is a pleasure to see you serve in the Chair, Mr Robertson. I commend my hon. Friend the Member for Swansea East (Carolyn Harris) for securing the debate, and for her ongoing commitment to pursuing wider public understanding and support for menopausal and perimenopausal women. The fact that all four nations of the UK are represented here is a real testament to the diligence, determination and doggedness of her campaigning. Having spoken in the debate that she secured last year, I am pleased that this is now a regular feature, and that the needs and experiences of women undergoing this stage of life are now being properly considered.

According to Hansard, the first time that the word “menopause” was used in our Parliament was in 1943, in the Lords, in a debate on “population problems”. It was not mentioned in the Commons until 1964, and the 100th reference was not until 2017. We are in a much healthier position now that we can consider it as one of the areas of life that we should properly appreciate.

I was struck by the comments from my hon. Friend the Member for Swansea about the experiences of women wrongly prescribed antidepressants and anxiety medication when what they needed was HRT. I know at first hand the life-saving potential of medications of that type, but only when they are appropriately prescribed. Side effects can often include excessive sweating, insomnia, agitation, anxiousness and dizziness—all things that can, themselves, be symptoms of menopause. That means that the wrongful prescription of those medications could actually exacerbate the very misery that caused affected women to seek medical support in the first place. At best, it would be treating some of the symptoms but not the underlying causes.

Let us hope that, as a Parliament, we are reflecting a society that increasingly understands and accommodates the symptoms of menopause, which affect so many in our country—around 5.1 million women aged between 45 and 55. As the right hon. Member for Romsey and Southampton North (Caroline Nokes) made clear, many younger women, and people who do not define themselves as women at all, also experience this. They may find it even more difficult to access support as they do not fit the typical profile.

It is essential that every affected person feels confident and able to discuss their symptoms with their employers, and to have requests for workplace adjustments met. We have all now had the chance to see the value of flexible working, and if a woman suffering from hot flushes asks to wear a more forgiving uniform, or to change her work hours so that she is not commuting in crammed transport during rush hour, that should be granted. That is an area that should have been included in the long-promised employment Bill that was so glaringly absent from the Queen’s Speech.

Throughout my career I have often been lucky enough to be one of the youngest, if not the youngest, women within my team, and to have been surrounded by women who were older and more experienced, and who were often going through symptoms of the menopause or the perimenopause. It has meant that I have had the benefit of watching them, listening to them and hearing them. Their generosity, in talking about what they were going through, means that when I get to that stage of life I will know what to look out for, what treatments are available, and what adjustments I should be able to ask for, demand and expect from my employer. We need to foster cultures in every workplace that allow people to have those conversations with each other, with younger colleagues and with their employer, and importantly, to be listened to so that accommodations can be made. That will set a really positive precedent for our society as we move forward.

An important part of that wider societal understanding is the inclusion of menopause in relationship and sex education classes in schools. I am glad that that has been the case since 2019, but I would like to hear from the Minister about how widespread that teaching is. It would be ironic if our children now learn more about menopause than our medical professionals do. Last year I challenged the then Minister, the right hon. Member for Mid Bedfordshire (Ms Dorries), about gaps in training at medical schools, as 41% do not teach about the menopause. She promised improvements by 2024, but I would like to know what the figures are now, because we cannot improve what we are not consistently measuring and tracking.

Many of the physical challenges of the menopause can be addressed through HRT, but access should not be a postcode lottery dependent on GP understanding or sympathy. In Wales and Scotland, women benefit from free prescriptions, including for HRT treatments. Can the Minister tell us what more the Government will do to ensure affordable access, particularly in the context of our current cost of living crisis, and what steps are being taken to address the issues of supply that have been raised by right hon. and hon. Members across the House?

To conclude, I am delighted that this is becoming a regular discussion, not least because we can therefore hold Ministers accountable on progress. I hope our questions are answered today. If not, we will continue to raise them at every opportunity, because suffering is not a necessary or inevitable part of ageing.

[Mr Laurence Robertson (in the Chair)]

We now come to the Front-Bench speeches.

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[The Parliamentary Under-Secretary of State for Health and Social Care (Maria Caulfield)]

It is a pleasure to serve under your chairmanship, Mr Robertson. I congratulate the hon. Member for Swansea East (Carolyn Harris) on once again securing a debate on this important issue. It is good to see all four nations represented here this afternoon and both men and women involved in the debate. It is my wedding anniversary today, and it is a pleasure to share it with the hon. Member for Strangford (Jim Shannon) and to show our continuing working relationship—[Laughter.]

To reassure hon. Members, progress has been made since the debate held by the hon. Member for Swansea East last October. It was one of the first debates I took part in as a new Minister, and I can honestly say that virtually every day since then we have worked on many of the issues addressed in that debate to improve outcomes for women going through the menopause. This is an important issue for me not only because it is a key priority area in my portfolio, but because I went through an early menopause over 10 years ago. The hon. Member for Edmonton (Kate Osamor) described her struggle to get her GP to take her seriously, but for someone in their 30s it is even more difficult, and it can be a lonely experience if your peers are not going through the same thing. They are busy getting married and having children; they are certainly not talking about hot flushes and not being able to sleep. It can be a very difficult experience. So, for me, this is a personal mission as well as a ministerial one.

I want to reassure colleagues that I absolutely have a laser focus on delivering many of the pledges made in the previous debate. On the cost of HRT, we announced in that debate that we would accept the move towards reducing the costs. It only affects women in England, but it is an important issue. Around 89% of all prescriptions issued in England are free. People qualify for free prescriptions when they are on income support, universal credit, jobseeker’s allowance and pension credit, so the vast majority of people getting general prescriptions are entitled to free prescriptions.

However, women going through the menopause often do not meet those criteria. I fully recognise that the cost is very high, particularly for women who are on two hormones or who have multiple products that they need dispensing. That is why we are committed to introducing the bespoke prepayment certificate for HRT by April next year. It is very different from the prepayment certificates that exist for general medicine. However, there are steps that we have to take. We are expected to consult the professional bodies involved. There will be changes to both dispensing and prescribing. A statutory instrument needs to be laid to make those changes happen. IT changes are also needed to make these things happen in practical terms, so that when women turn up at the chemist, their prescriptions are actually there for them to collect. We are not making excuses, and this will happen by April next year, not from April next year. If we can do it any quicker, we will. The prescription will be £18.70 for all HRT products, whether that is for two hormones or multiple products, and that will be a considerable cost saving for women.

The supply of HRT has been a challenge. We have seen more than a 30% increase in demand, thanks to all the campaigners raising the profile of the menopause but also highlighting the benefits of HRT and breaking the taboos. GPs and doctors were often worried about the safety of HRT, but campaigners have explained that some of the research that was around 10 or 15 years ago is out of date and that HRT is a safe and effective product for many women. So there has been a huge increase in demand. We have met trade suppliers, manufacturers and pharmacists to discuss the challenges they face and to try to overcome them. Of the more than 70 products that are available, we are now down to pressures on three or four, and even with those we are seeing significant progress.

The hon. Member for Belfast South (Claire Hanna) asked for an update. Maddy McTernan, the head of HRT supply, updated the taskforce this week. We are making good progress. There is commercially sensitive information, which we cannot share, but manufacturers are stepping up to the plate to produce extra supplies. It is not about meeting the demand now. Demand will continue to grow, and we need to future-proof to ensure that we are not in the same situation in six months.

The prepayment certificate will also help. Women will no longer have to try to get a prescription for three or four months in order to keep the cost down. They will be able to get a monthly supply and not have to pay an increased cost for doing so. That will help manage supplies overall. We have also introduced three serious shortage protocols for the three products, so that we can manage the amount that is being dispensed and have better stock control. It will also give powers to pharmacists to give alternative products. That is not always ideal, because I know that some women notice instantly a difference in the effect of a drug, even if it is the same drug but with a change in manufacturer. It is not ideal, but it is helping us get through this acute period, and it will enable us to better control stocks in the longer term. We will be updating colleagues as we go through this, and Maddy and the team from BEIS have been helping us hugely with that.

The UK menopause taskforce that has been set up was one of the asks from the hon. Member for Enfield North (Feryal Clark); it was not a Government suggestion. We agreed to it and have had our second meeting. There are four key areas where we want to make recommendations. Those include education—for women, men, boys and girls, and healthcare professionals too. The taskforce will also look at the workplace, health provision, and research into areas such as testosterone, where we need to be breaking some barriers.

In the short time I have, I would like to touch on the workplace issue, which is crucial. One of the key things about the taskforce is that it is not just about health. We have a BEIS Minister and an employment Minister, and we are going to invite, as was suggested earlier, a Minister from Justice as well so that we reach out to all women affected by the menopause. I am really pleased that the civil service led the way this week when we signed Wellbeing of Women’s menopause workplace pledge. That will not just help women in the civil service who are going through the menopause it is to show other employers the sorts of small changes, such as the pink fan mentioned by the hon. Member for Strangford (Jim Shannon), that can make a big difference. It will also enable women and employers to feel confident to have those discussions at work. As my hon. Friend the Member for Cities of London and Westminster (Nickie Aiken) said, these women are in the prime of life. We have women with extraordinary experience and talent who we should be harnessing, not letting go.

We are really serious about improving GP training. It has been difficult for GPs to get that specialist advice and support, as this is a growing area, but the General Medical Council will be including the menopause as part of its licensing assessment, so it will be a core part of training. The NHS England menopause programme will be producing resources for all types of healthcare professionals so that we can make sure that people are trained.

I know I have to let the hon. Member for Swansea East come back in—

[Mr Laurence Robertson (in the Chair)]

There is plenty of time.

[Maria Caulfield]

Okay. The NHS itself is setting up a training programme to make sure that at every point that a woman approaches the health service—when meeting GPs or nurses—they get the specialist training they need.

The women’s health strategy is coming forward. I would rather spend time getting it right than rush it through to meet a deadline. We are weeks away from publishing. We have already published our vision and the findings from the consultation, and the strategy will build on that. The menopause will be a priority area within that document. We will also be announcing a women’s health ambassador very shortly, who will be holding my feet to the fire, as will the hon. Member for Swansea East.

I hope I have reassured colleagues that we are doing so much work in this area. Debates such as this are not just about holding me to account. They are about breaking taboos and having lightbulb moments for women across the country, as my right hon. Friend the Member for Romsey and Southampton North (Caroline Nokes) said. I look forward to working with colleagues on both sides of the House and in all four nations to improve the experience for women.

[Mr Laurence Robertson (in the Chair)]

I call Carolyn Harris to wind up.

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[Carolyn Harris]

That is a perfect suggestion, and it is something that has been playing on my mind lately.

[Mr Laurence Robertson (in the Chair)]

Order. This is a winding-up speech and should last only two minutes.

[Carolyn Harris]

Yes, two minutes.

The last thing I will say is that everything that everybody has said is wonderful, but as long as women do not have a single prescription charge, do not have a proper diagnosis and proper medication, are giving up work and do not have equal treatment, we are failing. We cannot continue to fail women.

Question put and agreed to.

Resolved,

That this House has considered the menopause.