Menopause

Lord Markham Excerpts

Tuesday 18th October 2022 Lords Chamber

[Baroness Thornton]

To ask His Majesty’s Government what steps they are taking (1) to support women going through menopause, and (2) to increase general awareness about the challenges it poses.

[The Parliamentary Under-Secretary of State, Department of Health and Social Care (Lord Markham) (Con)]

My Lords, the menopause is a priority area in the women’s health strategy. The NHS has a programme to improve clinical menopause care in England and reduce disparities in access to treatment. It is also developing an education and training package on menopause for healthcare professionals. We have appointed Professor Dame Lesley Regan as the women’s health ambassador for England. Her role includes raising awareness of women’s health issues, including menopause.

[Baroness Thornton (Lab)]

I thank the Minister for that Answer. Today is World Menopause Day. My Question is broader than those which concern only the medical response, so I would regard the Minister’s response as inadequate. Given the doubling of menopause-related discrimination claims in a year, showing that we are losing working women from the economy who are otherwise at the peak of their skills and experience, should the Minister not counter employer mismanagement of a transition that all women go through by requiring the HSE and the EHRC to publish advice on this urgently, as neither of them do so?

[Lord Markham (Con)]

I thank the noble Baroness. I agree that it is fitting that we should be having this debate today, World Menopause Day. I completely agree with the importance of this subject for employers, productivity and the economy as a whole, as well as for women’s health.

As I am sure the noble Baroness is aware, 10% of people end up leaving their job during menopause. That is a real loss to business and those individuals. That is why, through our strategy, we are appointing an employee champion in this area. Their job will be to reach out to employers and work with them to make sure that this subject is very high up on their agenda. As an employer myself, in my personal entrepreneurial life, I agree that it is an area of utmost importance.

[Lord Patel (CB)]

My Lords, women with post-menopausal symptoms are disadvantaged by not getting the treatment they need due to restrictions put on the treatments by local formularies. Does the Minister agree that we need a national formulary where all hormone replacement therapy treatments are available to women who need them, and that that national formulary should be made mandatory? If he does not agree, why not?

[Lord Markham (Con)]

I agree that we want to make sure that there is national access. I understand that, whereas we had 30% take-up as long ago as the 1990s, with the incorrect scare around some of the causes since then, that rate is only about 15% today. There is clearly a need to increase awareness and the ability for people to receive treatment.

I am aware of the issue around formularies; I have heard that they believe that it can be resolved. I will take it away and write to the noble Lord to make sure that it is properly dealt with.

[Baroness Brinton (LD)]

My Lords, in the initial Answer that he gave to the noble Baroness, Lady Thornton, the Minister said that access to support during the menopause is vital. Does he therefore agree that, for health and economic reasons, the menopause should be added to the quality and outcomes framework to encourage doctors to investigate and treat patients who present with symptoms associated with the menopause?

[Lord Markham (Con)]

Yes. The noble Baroness will be aware that only 55% of women showing symptoms felt able to talk to GPs about it and another 30% felt that there were delays in diagnosis. Clearly, more work needs to be done. I know that it is part of the core curriculum—that is not the proper phrasing; please excuse me. The whole point of appointing a women’s health ambassador is to make sure that every avenue and channel is used to maximise access, whether at the level of GPs or as part of the education or formularies.

[Baroness Gale (Lab)]

My Lords, what consideration has been given to allow women who need treatment for the menopause to have free prescriptions, as they do in Wales, for example, where no one has to pay for any prescriptions, and in Scotland and Northern Ireland? Only in England are there prescription fees. Free prescriptions would be a great help to women and would remove a financial barrier to accessing treatment.

--- Later in debate ---

[Lord Markham (Con)]

With constraints on the public purse, I like many others believe that targeted support is probably the best form of support, and 60% of women receive it free. At the same time, as I am sure the noble Baroness is aware, to prevent it being a barrier to the others, next year we are introducing a fixed cap so that the costs should be a maximum of only £19 per year, which I believe will not act as a disincentive to the 40% who can afford to pay.

[Lord Kakkar (CB)]

My Lords, I draw attention to my registered interests. The menopause is associated with an increased risk of heart attacks and strokes as a result of falling oestrogen levels. Despite this, women are consistently less well represented in cardiovascular clinical research than men. Is the Minister content that the ongoing publicly funded research effort in cardiovascular disease will be able adequately to address the challenge of postmenopausal heart disease?

[Lord Markham (Con)]

I will not pretend to be able to give a detailed answer at this point. I am aware that part of the funding through the health and wellbeing fund is to make sure that women’s reproductive health is included in some of those research programmes, but I will look specifically at the cardiovascular point and respond in writing.

[Baroness Hussein-Ece (LD)]

My Lords, is the Minister aware of the report from the Fawcett Society which estimated that 900,000 women have left the workforce and countless others are reducing their hours and avoiding promotion because of their menopause symptoms? The Minister partially addressed this in response to the noble Baroness earlier, but what plans do the Government have, if any, to stem the flow of those experienced women leaving the workforce, which has an ongoing impact on equalities and the ability of women to pursue their careers in the way that men do?

[Lord Markham (Con)]

I again agree with the point. Helpfully, the noble Baroness, Lady Thornton, pointed me towards the excellent Fawcett Society report this morning, for which I am grateful. It makes for a very interesting read. As I mentioned earlier, the statistic that 10% of women during the menopause end up leaving employment is a telling one. That is what the appointment of health ambassador for the employers is all about. I hope that noble Lords will see the seriousness with which I take this subject, because it is vital not only to women but to the economy and business as a whole. This time next year—if I am still here—I commit to doing a stocktake report on the progress that we have made on this over the year, because I think it is vital.

[Baroness Chakrabarti (Lab)]

My Lords, I am grateful to the Minister for the very serious tone of his response to this Question. I declare an interest which is not in the register but is self-evident from my date of birth, which is public information. Will he readdress that part of my noble friend’s question that was about the EHRC and whether that public body has a role in setting out guidance for employers? Will he, in the light of his commitment on this subject, suggest that the Equality Act needs to be at the very least enforced and possibly beefed up in this regard?

[Lord Markham (Con)]

I apologise if I have not answered the point on the EHRC satisfactorily and it is best that I follow it up in writing to make sure that I do so.

On the Equality Act, as I am sure everyone is aware, menopause should be covered as a protected characteristic within the terms of discrimination, be it on grounds of sex or age, and I believe there are cases where it has been shown to be used correctly in that regard, so the capability is there. However, if there is not adequate reason for redress under the Equality Act, that would obviously need to be looked at in the future.