Menopause (Support and Services) Bill

Debate between Liz Kendall and Jackie Doyle-Price

2nd reading
Friday 29th October 2021 Commons Chamber

[Liz Kendall (Leicester West) (Lab)]

It is a privilege to speak in the debate, and to follow the right hon. Member for Romsey and Southampton North (Caroline Nokes) and the other Members who have spoken so far. I think that by speaking out about the menopause, Members on both sides of the House, women and men, will be giving a voice to 13 million menopausal and perimenopausal women in the country whose needs have been downplayed or ignored for too long.

I must begin by paying tribute to my hon. Friend the Member for Swansea East (Carolyn Harris), a phenomenal campaigner who is working across party lines, and with organisations up and down the country, to push this agenda, make a practical difference to women’s lives, and get the job done. I am very proud to stand alongside her today.

I feel that at this point I should make a personal declaration of interest in this topic, as many of my colleagues have already done today. To be honest, I am not really sure when the symptoms first started, but they have been building steadily over the last year—the truly terrifying sense of anxiety and panic that I had never experienced before; feeling completely exhausted, sore and aching all over, wondering in the evenings if I could make it up the stairs to go to bed, let alone do the exercise that has always been such an important part of my life; the itching, the hair loss, and just feeling downright low; and above all, what I can only describe as the catastrophically bad sleep, night after night. I would finally emerge in the morning drenched with sweat, thinking, “How on earth am I going to make it through the day?”

Like so many other women, I had absolutely no idea what was going on. I thought that there could be reasons for each of those symptoms individually, but together they felt overwhelming. 1t was only when a friend of mine recommended that I check out the MegsMenopause website that the penny finally dropped. This was something real, something really was happening, it had a name, and there was something that I could do about it that might start gradually getting the old me back.

[Jackie Doyle-Price]

I thank the hon. Lady for being so honest and open about this. She has just said that she did not know what was happening to her. Given that she is an intelligent, well-informed woman, does that not illustrate the importance of better education about this condition?

[Liz Kendall]

Absolutely. I must be honest: I was in a quandary about whether I was going to say anything today, but, like the hon. Lady, I thought, “If we in this place, with the power, influence and authority that we have, are too nervous to speak out, what does that say? “ We need to be leaders and champions, and I hope that we are all making a small contribution to that today.

I must say that I have had a very good experience with my GP. Two weeks ago, I did an online survey. A few days later, I had a phone consultation and I got my first HRT prescription last week—ironically, on the same day as the Backbench Business debate on World Menopause Awareness Month—but I know that millions of other women are nowhere near as lucky. Almost one in 10 women have to see their GP more than 10 times before they get proper help and advice. Two thirds of women suffering low mood or anxiety, like my hon. Friend the Member for Swansea East, are wrongly given antidepressants instead of HRT, often for many years. Around one in three women will end up having a hip fracture due to osteoporosis unless they take HRT, as was rightly mentioned by my hon. Friend the Member for Bradford South (Judith Cummins).

The objectives at the heart of this Bill—to raise awareness of the menopause, to make it easier for women to access HRT and to improve the education and training of health professionals—are absolutely essential. I hope when the Minister rises to speak, she will set out the steps her Government will take to make these goals a reality, because frankly, getting women the right diagnosis and the right treatment at the right time is a no-brainer. It is better for women and it is better for the taxpayer, because it will stop women having to have lots of unnecessary doctor’s appointments. It will stop them being put on the wrong medicines for years, leaving the real issue untreated and undiagnosed, and it will reduce the likelihood of women getting conditions such as osteoporosis when they do not need to, which can lead to much more serious and expensive NHS care, such as hip and other operations.

There is lots more I could say on that issue, but I want to use the remaining time I have to talk about the impact of menopause in the workplace, an issue rightly raised and championed by the right hon. Member for Romsey and Southampton North. There are currently more than 4.3 million working women aged 50 to 64. We are the fastest growing group in the UK workforce, often at the peak of our experience, with all the skills and talent that that brings, but 80% of women say that the menopause has affected their working lives.

Around 14 million days are lost at work every year due to menopause, and a quarter of menopausal women at work find the symptoms so debilitating that they are considering reducing their hours, changing their working patterns or leaving the workplace altogether. Women lose their income and careers, businesses lose their talent and the Treasury loses their taxes. Where on earth is the sense in that?

The fundamental problem is that the vast majority of women are too embarrassed, worried or frightened to speak out or discuss the issue with their bosses or line managers. I think the reason for that is the double whammy of sexism and ageism. If a quarter of men in their 50s were considering quitting work or reducing their hours, you can bet your bottom dollar that it would be at the top of the workplace agenda and a solution would pretty quickly be found. Women should not have to suffer in silence. We have to remove the ignorance and stigma about the menopause. It is not a women’s issue or a private matter, let alone a joking matter; it is a mainstream, no excuses, no ifs or buts workplace issue, and it must be addressed. Again, I hope when the Minister rises, she will set out the steps her Government intend to take on this vital issue.

In conclusion, Members will know that I have never been one for revolutions, but on this issue I make an exception.

Social Care

Debate between Liz Kendall and Jackie Doyle-Price

Wednesday 25th October 2017 Commons Chamber

[Jackie Doyle-Price]

I need to make progress. I apologise to my right hon. Friend.

On delayed transfers of care, the Government are clear that no one should stay in a hospital bed for longer than is necessary. Doing so removes people’s dignity and reduces their quality of life. It leads to poorer health and care outcomes, and it is more expensive for the taxpayer. I will set out in more detail the work we are doing to reduce delayed transfers of care. That is critical, because a well-functioning social care system enables the NHS to provide the best possible service.

We are clear that we must make much faster and more significant progress well in advance of winter to help to free up hospital beds for the sickest patients and reduce pressures on overcrowded A&E departments. Last year, there were 2.25 million delayed discharges, up 24.5% from the 1.81 million in the previous year. Just over a third of those delays were attributable to social care. The proportion of delays attributable to social care increased over the last year by four percentage points to 37% in August 2017.

We have put in place an agile and supportive improvement infrastructure, and I have been very clear about priorities. First, in this year’s mandate to NHS England we set out a clear expectation that delayed transfers of care should equate to no more than 3.5% of all hospital beds by September. Those in the system have worked extremely hard to agree spending plans and put in place actions to make use of the additional funding, and they deserve real congratulation for their efforts. Since February, there have been significant improvements in the health and care system where local government and the NHS have worked together to tackle the challenge of delayed transfers of care, with a record decrease in month-on-month delayed discharges in April 2017.

[Liz Kendall (Leicester West) (Lab)]

Will the Minister give way?

[Jackie Doyle-Price]

I must make progress. Secondly, we put in place a comprehensive sector-led support offer. In early July, NHS England, NHS Improvement, the Local Government Association and the Association of Directors of Adult Social Services published a definitive national offer to support the NHS and local government to reduce delays. This package supports all organisations to make improvements and includes the integration of better care fund planning requirements to clarify how this and other aspects of the better care fund planning process will operate.

[Liz Kendall]

Will the Minister give way?

[Jackie Doyle-Price]

I have limited time, and I really must get this improvement on the record.

The package also includes joint NHS England, NHS Improvement, LGA and ADASS guidance on implementing trusted assessors; the introduction of greater transparency through the publication of a dashboard showing how local areas in England are performing against metrics; and plans for local government to deliver an equal share to the NHS of the expectation to free up 2,500 hospital beds. The package sets out clear expectations for each local area, reflecting the fact that reducing such delays in transfers of care must be a shared endeavour across the NHS and social care. Those expectations are stretching, but they are vital for people’s welfare, particularly over the winter period.

Thirdly, we have asked the chief executive of the Care Quality Commission to undertake 20 reviews of the most challenged areas to consider how well they are working at the health and social care boundary. Twelve of the reviews are under way and a further eight will be announced in November, based on the performance dashboard and informed by returns from July. Those reviews commenced in the summer, and the majority of them are due to be completed by the end of November. They are identifying issues and driving rapid improvement.

Fourthly, we have provided guidance on best practice, including how to put in place “trusted assessor” arrangements, which can allow more efficient discharge from hospital by avoiding duplicative patient assessments by different organisations. All areas have now submitted their better care fund plans, which include their trajectories for reducing delays.

Finally, in October we asked NHS England to extend the GP and pharmacy influenza vaccination service to include all paid careworkers in the nursing and residential care sector. They will be able to access the service via local GPs and pharmacies free of charge.

I know that the hon. Member for Worsley and Eccles South is concerned about the provisions for those that fail to improve, and I want to tackle head-on the suggestion that there will be fines. We are not talking about fines at all. The money that has been earmarked will continue to be retained by local authorities.

[Liz Kendall]

Leicestershire County Council fears that it could have £22 million removed from its budget because of fines for delayed discharges, when the Government have cut its funds. The Conservative deputy leader, Byron Rhodes, says:

“I can’t think of anything more stupid.”

The Conservative leader, Nick Rushton, says:

“How long can we put up with the Secretary of State?”

That is the reality of the policy. What is the Minister going to do about it?

[Jackie Doyle-Price]

I reject the suggestion that there will be any kind of fine. The £22 million that the hon. Lady talks about will be retained for spending within Leicestershire. That funding has been allocated for a specific purpose, and where local authorities are not showing the improvement that we expect, we will work collaboratively with them and advise them how best to use that money.

Let me put on record exactly what we are going to do. There is significant variation in performance across local areas. We know that 41 health and wellbeing boards are collectively responsible for 56.4% of adult social care delayed transfers of care. That cannot be right, when other local authority areas have none. In particular, Newcastle has no adult social care delayed transfers of care, and if it can do that, other areas can as well, provided we have good partnerships and good leadership. I trust that I have demonstrated the extent to which the Government are supportive of the best performing systems where local government and the NHS are working together to tackle this challenge. However, we are clear that we must make much faster and more significant progress in advance of winter to help to free up hospital beds for the sickest patients and to reduce pressures on our A&E departments.

It is right that there should be consequences for those who fail to improve. Earlier this month, we wrote to all local authority areas informing them that if their performance did not improve, the Government may direct the spending of the poorest performers—it is not a fine—and we reserve the right to review allocations. It is important to note that the allocations will remain with local government to be spent on adult social care. It is not a fine; this is about making sure that public money delivers the intended outcomes.