Health: Lesbian, Bisexual and Trans Women

Lord Bethell Excerpts

Thursday 5th March 2020 Lords Chamber

[Baroness Barker]

To ask Her Majesty’s Government what steps they are taking to improve health outcomes for lesbian, bisexual and trans women.

[Lord Bethell (Con)]

My Lords, I welcome this timely Question ahead of the national LBT Women’s Health Week. The Government remain committed to providing comprehensive healthcare for all, irrespective of gender or sexual orientation. Throughout the LGBT action plan, we are taking steps to ensure that the needs of LGBT people are placed at the heart of our services. While we have made significant progress, we are not complacent. We recognise that more must be done to continue improving access to and the provision of health services.

[Baroness Barker (LD)]

I thank the Minister for that Answer. Despite a legal duty to be inclusive, there is growing evidence that LGBT women’s health is neglected. Across all cancers, we have a higher incidence than our heterosexual counterparts. Will the Department of Health and Social Care work with NHS England to change commissioning standards and to monitor services and outputs for LGBT women?

[Lord Bethell]

The noble Baroness is absolutely right. The national LBGT survey and the recent GP patient survey indicate that health outcomes for LBT women are lower than average, and this causes concern. We are interested in finding ways of commissioning services so that that can be rectified. It is not just in cancer services but in smear tests and other areas of clinical provision.

[Baroness Thornton (Lab)]

My Lords, the Minister’s Answer gives me great optimism because it seems from the report by the Women and Equalities Select Committee in the Commons that there is an LGBT action plan on which the Government Equalities Office has the lead and which covers LGBT-inclusive healthcare, but it is separate from and not included in the NHS long-term plan. I think the Minister would agree with me that this is unhelpful. It seems to imply that the responsibility for LGBT-inclusive healthcare lies with the Government Equalities Office rather than with health and social care institutions. Will the Minister look into this and perhaps write to me about whether it is a good idea that this is the case, and perhaps suggest a solution to it?

[Lord Bethell]

I assure the noble Baroness that the LGBT action plan, which is, as she described, a detailed programme to address these issues, is delivered by Dr Michael Brady, the national LGBT health adviser, who works very closely with the NHS. LGBT issues are at the centre of the long-term health plan and will remain so.

[Lord Lucas (Con)]

My Lords, will my noble friend please give particular emphasis to the needs of young people with gender dysphoria, to improving the services available for them and, in particular, to funding research into what courses of treatment lead to the best outcomes?

[Lord Bethell]

My noble friend is entirely right to raise the issue of adult gender dysphoria. Delays in finding the right consultations are of concern to the Government. Those delays have an impact on the mental health of those concerned. It is a focus of the LGBT action plan, and I would be glad to update my noble friend as progress is made.

[Baroness Brinton (LD)]

My Lords, last year’s Women and Equalities Committee report, Health and Social Care and LGBT Communities, recommended:

“Training can be the first exposure that students have to LGBT health needs. All registration bodies should ensure that case studies … does not play into stereotypes. Registration bodies should develop these case studies in cooperation with local LGBT organisations.”


Can the Minister tell the House whether organisations are now following this advice?

[Lord Bethell]

The noble Baroness is entirely right to ask about training, which is at the heart of our LGBT action plan. NHS England has funded the Royal College of Physicians to develop the UK’s first accredited training course on gender medicine and has developed online and video content to help to create the type of training we believe will have an impact. The training of the workforce and its awareness of LBGT needs will be at the heart of improvement in this area. That is why we are focusing our efforts on training.

[Baroness Barker]

My Lords, the Government funded Dr Michael Brady’s post but he does not actually have any authority to bring about change in the NHS. Does the noble Lord agree that such change will come about only when its leadership and the various medical professional bodies admit the present failings towards women? Women are dying as a result. There needs to be change and that change needs to be urgent.

[Lord Bethell]

I assure the noble Baroness that there is full recognition and awareness of and concern about this issue. The impact of Dr Michael Brady, whom I spoke to yesterday, is profound. He has a very high profile within the department, and the work he has done is valued and will make an impact.

[Lord Hunt of Kings Heath (Lab)]

My Lords, is this not an illustration of the problems with the NHS’s current structure? Ministers can proclaim anything they like from the Dispatch Box, but at the moment, they do not control what is happening in the NHS. It is time for Ministers to restore their power of direction over the NHS.

[Lord Bethell]

The noble Lord makes an interesting point, but it is simply not true that Ministers do not drive change or have an impact on reforms in the NHS. We have a profound and energetic reform agenda, and it is being driven through with energy and determination.